中高年発症の幻覚・妄想に認知症の原因タンパク質の関与を実証 ~独自のPET技術でタウ病変を可視化、精神症の早期診断、治療薬開発への応用に期待~

ad

2026-08-03 量子科学技術研究開発機構,京都大学,慶応義塾大学,東京科学大学

量子科学技術研究開発機構(QST)、京都大学、慶應義塾大学、東京科学大学などの共同研究グループは、40歳以降に初めて幻覚や妄想を呈する「中高年発症の精神症」の患者において、認知症の原因タンパク質であるタウタンパク質の異常蓄積を世界で初めて生体脳で実証した。QSTが開発した高感度PET薬剤 florzolotau(¹⁸F)を用いて37名を解析した結果、患者の約65%でタウ病変が認められ、健常者(約15%)を大きく上回った。また、患者にはアルツハイマー病型(アミロイドβ陽性)と非アルツハイマー病型の双方が存在し、多様な神経変性疾患が背景にある可能性が示された。さらに、アミロイドβ陽性例では、タウ蓄積量が多いほど遂行機能が低下することも確認された。本成果は、中高年発症の精神症が認知症の前駆症状である可能性を支持するとともに、PETによる客観的な病態評価を通じた早期診断・早期介入や、患者ごとの病態に応じた根本的治療薬の開発につながる重要な知見である。

中高年発症の幻覚・妄想に認知症の原因タンパク質の関与を実証 ~独自のPET技術でタウ病変を可視化、精神症の早期診断、治療薬開発への応用に期待~
​図1.タウPETとアミロイドPETそれぞれの陽性の割合​

<関連情報>

晩発性精神病におけるタウ病理の高頻度発現:PET研究 High prevalence of tau pathologies in late-onset psychosis: A PET study

Manabu Kubota,Shin Kurose,Kenji Tagai,Yuki Momota,Masanori Ichihashi,Hironobu Endo,Chie Seki,Sho Moriguchi,Yasuharu Yamamoto,Yuko Kataoka,Ryoji Goto,Takehiro Tamura,Hiroki Shiwaku,Kiwamu Matsuoka,Hisaomi Suzuki,Mitsumoto Onaya,Takahiko Tokuda,Hiroyuki Uchida,Hidehiko Takahashi,Kazunori Kawamura,Ming-Rong Zhang,Makoto Higuchi & Keisuke Takahata
Molecular Psychiatry  Published:03 August 2026
DOI:https://doi.org/10.1038/s41380-026-03749-3

Abstract

Late-onset psychosis (LOP) exhibits distinct clinical features compared with younger-onset psychosis. Although postmortem and epidemiological studies have suggested an association between LOP and neurodegenerative processes, particularly tauopathies, in vivo evidence remains limited. This study aimed to investigate the involvement of Alzheimer’s disease (AD) and non-AD tauopathies in LOP using amyloid PET and tau PET with florzolotau (18F) (18F-florzolotau; also known as 18F-APN-1607 or 18F-PM-PBB3), a tracer capable of detecting a broad range of tau pathologies. Thirty-seven patients with LOP and 47 age-matched controls underwent PET scans with 11C-PiB and 18F-florzolotau to assess group differences in amyloid beta (Aβ) and tau accumulation. Diagnostic effects on regional 18F-florzolotau standardized uptake value ratios (SUVRs) were assessed. Associations between regional SUVRs and cognitive and clinical features were examined separately in Aβ-positive and Aβ-negative subgroups. Patients exhibited significantly higher positivity rates for both Aβ (13 of 37 patients, 35.1%) and tau (24 patients, 64.9%) than controls (one of 47 controls, 2.1% for Aβ and seven controls, 14.9% for tau). A significant diagnostic effect was observed on regional 18F-florzolotau SUVRs (P = 0.004), with post-hoc analyses revealing increased tracer retention in the parietal cortex. This diagnostic effect remained robust when the analysis was restricted to Aβ-negative participants (P = 0.002). Among Aβ-positive patients, greater parietal tau burden was associated with lower Frontal Assessment Battery scores. In conclusion, this in vivo PET study demonstrated a high prevalence of AD-like and non-AD-like tau accumulation patterns in LOP, suggesting that LOP may be associated with heterogeneous tau-related neurodegenerative processes.

医療・健康
ad
ad
Follow
ad
タイトルとURLをコピーしました