The prevalence of ASD has changed dramatically recently. Centers for Disease Control and Prevention (CDC) reported that the ASD prevalence among 8 - year- old children was 1.47% (one in 68) in the Autism and Developmental Disabilities Monitoring (ADDM) Network surveillance conducted by CDC within 2010, and the prevalence increased by 120% in a decade. Moreover, the ASD prevalence among children aged 3 - 17 years was 2.24% (one in 45) in the 2014 National Health Interview Survey (NHIS) , which showed significant increase (1.25%) compared to the survey from 2011 to 2013. The methods of epidemiological survey of developmental disorders varies, which can be seen in the ADDM and NHIS, where different sampling strategies are used, including different age groups and using different diagnostic criteria. Therefore, the ASD prevalence reported in those surveys are not directly comparable. In addition, previous biological researches suggested the existent of endophenotype. New research methods combining behavioral assessments in community placements with biological assessments using biomarkers has been established overseas for early detection of ASD. Check- up systems for early detection of ASD, which is based on scientific methodology, is needed in Japan as well. The evaluation of the biological characteristics of ASD accurately and non- invasively is required in the future.

View full abstract

Environment in early life is one of the psychological, emotional and social factors relating to the development of chronic pain in the period of maturity. Here, we review the exploration of mechanisms associated with the effect of early life stress on the neuropathic pain in maturation period and of the functional alteration of nervous system in the brain. Maternal separation and social isolation (MSSI) induces the emotional dysfunction in the maturation period of mice. MSSI mice showed the enhancement of mechanical and thermal hyperalgesia induced by partial sciatic nerve ligation which is model of neuropathic pain. Alteration of BDNF levels in the brain is involved in the development of neuropathic pain - induced emotional dysfunction in MSSI mice. Furthermore, MSSI increased the p- ERK, a neuronal activation maker, positive cells in multi brain regions, suggesting that increased brain activity induced by MSSI contributes to the enhancement of neuropathic pain. Thus, our findings demonstrate that early life stress may produce the exacerbation and chronification of pain.

View full abstract

Sarin gas was dispersed in Matsumoto city in 1994 and in the Tokyo subway in 1995. The victims of these attacks, conducted by a cult group, not only had acute sarin poisoning but also experienced severe trauma due to seeing other people being injured or killed. This study reviews mental and somatic symptoms in victims of the sarin gas attacks. In our clinical study after 5 years from the Tokyo subway attack, structured clinical inter views (CAPS) and self - rating questionnaires were used to assess the symptoms of the victims. Not only PTSD symptoms but also non- specific mental or somatic symptoms persisted in the victims at a high rate. This fact that non - specific mental or somatic symptoms were frequently found suggests similarities to the patients with Gulf War syndrome. Concerning somatic symptoms, complains about eyes were most prominent. In our study, a total of 11 victims were diagnosed with current or lifetime PTSD according to CAPS. Victims with PTSD showed higher anxiety levels and more visual memory impairment. These results indicated that longitudinal follow- up for mental and somatic symptoms are necessary in victims of sarin gas attack.

View full abstract

On March 20, 1995, about 5500 people were affected by the sarin released from the plastic bag placed in the subway car in Tokyo, 12 of whom have died (Tokyo subway sarin gas attack) . Sarin is a kind of organic phosphoric acid compounds, which are potent acetylcholine (Ach) esterase inhibitors. Through the effect on the cholinergic receptors it inhibits the neurotransmission in the autonomic nervous system. The chronic brain disorder and its related sustained changes of the brain function were suggested in victims of sarin gas attack. In this paper, I overviewed the previous reports of the long- term impact of the sarin on the nervous systems in victims of this gas attack. The review of the previous works suggested the possibility that the sudden and excessive load of the sarin on the Ach-nervous system contribute the chronic damage of the neuronal, mental and behavioral damages even years after the accident. Further, in addition to the overview of the functional and anatomical investigation by neuropsychological tests and MRI, I discussed the usefulness of the long- term investigation of the in- vivo cerebral molecular changes by PET/SPECT imaging.

View full abstract

Sarin is a toxic substance which inhibits acetylcholinesterase. Although cholinesterase activity recovers about three months after exposure to sarin, some symptoms and signs have been reported to last for a long time and even develop after a certain period of time. The long - term effect of sarin has been investigated through follow - up of victims of Matsumoto sarin attack in 1994 and Tokyo subway attack in 1995. Eye symptoms such as asthenopia as well as general fatigue and vertigo/dizziness were frequently experienced by the victims. Abnormal findings in posturography and ophthalmologic examinations were also reported. Pathophysiology of long - term complication of sarin should be further investigated. In addition, given that the effects of psychological factors related to trauma and biological factors are not mutually exclusive, long- term physical symptoms of the victims should be taken care of from a psychosomatic viewpoint.

View full abstract

Approximately 30% of the veterans serving in the first Persian Gulf War (1990 - 1991) are estimated to have complaints about their health such as joint pain, fatigue, myalgia, headache, memory or concentration difficulties, depression, sleep disturbances, and rash. This constellation of subjective and nonspecific symptoms has come to be described as Gulf War illness or Gulf War syndrome, while its diagnostic entity has not yet been established. In the present manuscript, the possible implications of the exposure to toxins including nerve and mustard chemical weapons, or pyridostigmine bromide, and psychological stress were reviewed especially from the viewpoint of the comparison with the symptoms observed in victims of the Tokyo subway sarin poisoning (1995) . The victims could provide precious data concerning the long term consequences of exposure to sarin, one of the chemical weapons actually exposed to Gulf War veterans. By comparing the symptoms and other neuropsychological data of Tokyo sarin victims with those of Gulf War veterans, we may be able to clarify the long term effect of sarin exposure and its relation to the development of Gulf War illness.

View full abstract

After the Tokyo subway sarin attack in 1995, the support activities for the victims were started by volunteers. One of the activities was annual follow - up investigation of the healthy condition of the victims. In 2001, the Recvery Support Center (R.S.C.) was established as a non profit organization (NPO) to perform support and care of the victims and their family. The R. S. C. has continued to do annual follow - up investigation until now. We also performed the healthy survey for the victims in response to a request of the R. S. C. in 2004. The results from the follow- up investigations demonstrated that the victims have been suffered from various physical, mental and ocular symptoms for 20 years. Although the acute lethal toxicity of sarin is well known, the chronic effects or disturbances on health condition have not been well understood. A further follow- up investigation is necessary to clarify the chronic disturbances due to sarin gas poisoning.

View full abstract