Shoko Saito’s research while affiliated with Chuo University and other places

Objectives Hyper- and hyposensitivity in multiple modalities have been well-documented in subjects with autistic spectrum disorder (ASD) but not in subjects with acquired brain injury (ABI). The purpose of this study was to determine whether subjects with ABI experience altered sensory processing in multiple sensory modalities, and to examine the relationships between impaired sensory processing and the emotional state. Methods and procedures Sixty-eight patients with brain or spinal cord tumors participated in the study. Cognitive ability and emotional function were tested, and subjective changes were evaluated in two directions (hyper- and hyposensitivity) and five modalities (visual, auditory, tactile, olfactory, and gustatory) at two time points (after disease onset and after surgery). Results One-fifth of the participants complained of hypersensitivity in the visual domain, and a similar proportion complained of hyposensitivity in the auditory and tactile domains. Additionally, one-third of participants complained of two or more sensory abnormalities after disease onset. A hierarchical regression analysis indicated that auditory and tactile sensory changes predicted a depressive state. Conclusion In conclusion, multimodal sensory changes occurred in patients with brain tumors, manifesting as hyper- or hyposensitivity. Sensory changes might be related to depressive state, but the results were inconclusive.

Background Tumors trigger both depression and anxiety about death because they can be terminal. However, the relationship between depression and time perspective in patients with life-threatening diseases remains unclear. In this study, we examined the effects of depression on time perspective in patients with brain tumors using a projective method, i.e., the Circle Test. Methods Participants (40 depressed patients, Dp; 35 non-depressed patients, NDp; and 40 healthy non-depressed controls, NDc) were administered the Circle Test of time perspectives and self-rating depression scales before and after surgery. The Circle Test data were analyzed using traditional indices, i.e., time dominance and relatedness, and novel measurements, i.e., time area and proportion. Results Although the traditional indices showed no differences, the results for the novel measurements differed among the Dp, NDp, and NDc groups. The overall time perspective was smaller in the Dp group than in the NDc group; furthermore, the proportions of the future and past perspectives were higher and lower, respectively, in the Dp group compared to the NDp group. Limitations Patients with brain tumors and depressed controls could not be compared, because no healthy control was depressed. Differences in depression-related changes in time perspective between patients with brain tumors and healthy controls should be examined in future studies. Conclusions Depressed patients with brain tumors may experience changes in time perspectives according to the results for our novel measurements, and this might play an important role in treatment adherence.

Lesion studies have shown that the right temporal lobe is crucial for recognition of facial expressions, particularly fear expressions. However, in previous studies, premorbid abilities of the patients were unknown and the effects of epileptic discharge could not be excluded. Herein, we report a case of a patient who underwent assessments of facial recognition before and after brain surgery and exhibited biased recognition of facial expressions. The patient was a 29-year-old right-handed male who underwent an awake craniotomy. Compared with the preoperative assessment, after the surgery, he showed biased recognition of surprised facial expressions, and his ability to recognize other facial expressions either improved or remained unchanged. These findings support the idea that the right temporal lobe is crucial for the recognition of facial expressions of surprise and that functional connectivity between various brain regions plays an important role in the ability to recognize facial expressions.

Recently, researchers have focused on the embodied sense of self (ESS), which consists of the minimal and narrative selves. Although a study demonstrated that the ESS is related to brain dysfunction empirically, the subjective aspects of the ESS, and a systematic approach to it, have not yet been examined in brain-damaged patients. To examine this, we measured the ESS of patients with brain tumors before and after awake craniotomy. A self-reported questionnaire called the Embodied Sense of Self Scale (ESSS) was used to measure the ESS in patients with brain tumors before and after surgery. For comparison, age-matched controls also completed the ESSS. The ESSS scores of the patients with brain tumors before surgery were higher than those of the controls and improved after surgery. Before surgery, patients with left hemispheric lesions had a poorer ESSS than those with right hemispheric lesions. Episodic memory disturbance was highly correlated with malfunction of narrative self and ownership. Brain lesions were associated with anomalous ESSS, associated with hemispheric laterality and cognitive dysfunction.

Background: Hearing preservation in patients with vestibular schwannomas remains difficult by microsurgery or radiosurgery. Method: In this study, awake surgery via the retrosigmoid approach was performed for vestibular schwannomas (volume, 11.6 ± 11.2 ml; range, 1.3-26.4 ml) in eight consecutive patients with preoperative quartering of pure tone audiometry (PTA) of 53 ± 27 dB. Results: After surgery, hearing was preserved in seven patients and improved in one patient. The postoperative quartering PTA was 51 ± 21 dB. Serviceable hearing (class A + B + C) using the American Association of Otolaryngology-Head and Neck Surgery (AAO-HNS) classification was preserved in all patients. Preoperative useful hearing (AAO-HNS class A + B) was observed in three patients, and useful hearing was preserved in all three of these patients after surgery. In addition, useful facial nerve function (House-Blackmann Grade 1) was preserved in all patients. Conclusions: These results suggest that awake surgery for vestibular schwannomas is associated with low patient morbidity, including with respect to hearing and facial nerve function.

Introduction We analyzed factors associated with worsened paresis at 1-month follow-up in patients with brain tumors located in the primary motor area (M1) to establish protocols for safe awake craniotomy for M1 lesions. Methods Patients with M1 brain tumors who underwent awake surgery in our hospital (n = 61) were evaluated before, during, and immediately and 1 month after surgery for severity of paresis, tumor location, extent of resection, complications, preoperative motor strength, histology, and operative strategies (surgery stopped or continued after deterioration of motor function). Results Worsened paresis at 1-month follow-up was significantly associated with worsened paresis immediately after surgery and also with operative strategy. Specifically, when motor function deteriorated during awake surgery and did not recover within 5 to 10 minutes, no deterioration was observed at 1-month follow-up in cases where we stopped surgery, whereas 6 of 13 cases showed deteriorated motor function at 1-month follow-up in cases where we continued surgery. Conclusion Stopping tumor resection on deterioration of motor function during awake surgery may help prevent worsened paresis at 1-month follow-up.

Previous research has explored whether the Japanese concept of Indecisiveness is different from western cultures. The aim of the study was to develop a questionnaire scale to measure the concept of Japanese Indecisiveness (Yujufudan). In the first study, a factor analysis was carried out using data from 255 college students. Four different factors, “reflection” “procrastination” “referring to others” and “anxiety” were obtained. In the second study, a decision-making task was administered to 55 college students. The scores obtained from the factor analysis in the first study predicted performance on the decision-making task. These results demonstrated the validity and reliability for the Japanese Indecisiveness Scale to measure Japanese Indecisiveness (Yujufudan).

Objective: An awake craniotomy is a safe neurological surgical technique that minimizes the risk of brain damage. During the course of this surgery, the patient is asked to perform motor or cognitive tasks, but some patients exhibit severe sleepiness. Thus, the present study investigated the predictive value of a patient's preoperative neuropsychological background in terms of sleepiness during an awake craniotomy. Methods: Thirty-seven patients with brain tumor who underwent awake craniotomy were included in this study. Prior to craniotomy, the patient evaluated cognitive status, and during the surgery, each patient's performance and attitude toward cognitive tasks were recorded by neuropsychologists. Results: The present findings showed that the construction and calculation abilities of the patients were moderately correlated with their sleepiness. Conclusion: These results indicate that the preoperative cognitive functioning of patients was related to their sleepiness during the awake craniotomy procedure and that the patients who exhibited sleepiness during an awake craniotomy had previously experienced reduced functioning in the parietal lobe.