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Objects: Recently, a non-neuronal cardiac cholinergic system, in which cardiomyocytes are equipped with components to synthesize acetylcholine, is considered to be important for maintaining physiological homeostasis in the heart, according to its anti-ischemia and hypoxia effects and angiogenesis-enhancing effects to salvage myocardium. Furthermore, it influences sustaining blood brain barrier functions. However, it remains to be fully elucidated whether any substance plays a role in activating the system.Methods: Using Katsuo extract derived from dried bonito, called Katsuobushi in Japanese, we performed in vitro and in vivo studies whether Katsuo extract activates the non-neuronal cardiac cholinergic system and influences the associated physiological responses, specifically focusing on anti-inflammatory property and potentiation of blood brain barrier functions.Results: Katsuo extract potently activates the non-neuronal cardiac cholinergic system and the parasympathetic nervous system. In vitro and in vivo murine models clearly showed that Katsuo extract also exerted anti-inflammatory action by suppressing cytokine production and microglial activation against pathogenic and non-pathogenic factors. Furthermore, it upregulated blood brain barrier components, such as claudin-5 and occludin, strengthened the function and prevented disruption in a brain injury model, and finally influenced murine higher brain functions by activating resiliency against depressive or anxiety-like behaviors.Conclusion: Therefore, the novel findings of this study indicate that Katsuo extract possesses characteristic anti-inflammatory and blood brain barrier consolidation effects, and the non-neuronal cardiac cholinergic system activation. The intake might be effective in influencing pathophysiology of neuroinflammation-related diseases.

Background: Examining the relationship between the behavioural and psychological symptoms of dementia (BPSD) and residence status is crucial to improving BPSD and reducing the burden on caregivers. However, studies on how BPSD differ between individuals living at home and those in institutional settings are lacking. We conducted a questionnaire survey among healthcare providers (HCPs) involved in dementia care and nursing to clarify the characteristics of BPSD by residence status in patients with Alzheimer's disease (AD) living at home or in facilities. Methods: We sent questionnaires to HCPs and asked them to answer questions on up to five cases that needed treatment for BPSD and who received long-term care insurance services from 1 April 2016 to 31 March 2017. Responses were received for 371 cases, of which 130 diagnosed with AD were analyzed. The patients were divided into two groups: patients with AD living at home (home care group) and patients with AD living in facilities (facility care group). A Chi-square test was used to identify differences between the two groups. A binomial logistic regression analysis was also conducted to clarify the association between residence status and BPSD. Results: Of the 130 patients, 72 lived at home (home care group) and 58 resided in facilities (facility care group). None of the background factors was significantly different between the two groups. The Chi-square test indicated that sleep disturbance was significantly more common in the facility care group (60.3% in the facility care group vs. 33.3% in the home care group, P = 0.003), while the logistic regression analysis indicated that sleep disturbance was significantly associated with residence status (odds ratio: 2.529, P = 0.038). Conclusions: Sleep disturbances were more frequently observed among patients with AD living in institutions than among those living in their homes.

Demented people frequently show behavioural and psychiatric symptoms, including agitation, aggression, depression, anxiety, irritability, disinhibition, hallucination and delusion, which are collectively referred to as behavioural and psychological symptoms of dementia (BPSD). In some cases, these individuals be admitted to a psychiatric hospital because of the appearance or exacerbation of BPSD. However, even after admission, BPSD affect their quality of life. It is therefore important to clarify the pathophysiology of BPSD and to develop an effective treatment for them. Although the causes of BPSD are considered to be multiple, including biological, psychological, and environmental variables, the involvement of pathological changes in diseased brains is still not clear. Here, we report a case of concomitant argyrophilic grain disease (AGD) and dementia with Lewy bodies (DLB) who required admission to a psychiatric hospital because of severe anxiety, agitation, and depression. We then discuss the association between the distribution of pathological changes and the appearance of such psychiatric symptoms. An 81-year-old woman complained of chest discomfort, a pounding heart, the feeling of being smothered, and anxiety without any physical findings. She was referred to a psychiatrist at the age of 83 and diagnosed with having panic disorder. Paroxetine was prescribed, but her symptoms remained. She often got agitated and complained of suicidal thoughts. Because the cognitive decline progressed gradually, she was referred to another psychiatrist the same year. At the first visit, she complained of agitation, palpitation, and dyspnoea but denied