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Background The femoral anterior tangent (FAT) line refers to a line parallel to the anterior surface of the distal femur in the axial plane. This study aimed to evaluate the effectiveness of a new operation support system which uses the FAT line to set the femoral component rotational alignment in total knee arthroplasty (TKA). Methods A total of 170 consecutive knees in 139 patients undergoing primary TKA with the JIGEN (Jig Engaged Three-dimensional (3D) Pre-Operative Planning Software for TKA) operation support system was examined. The JIGEN system creates 3D models of bones using computed tomography data, allowing for surgical simulations such as positioning of implants while calculating positions of the intramedullary alignment rod (IM rod) and surgical jig. We retrospectively analyzed the FAT line angle relative to the surgical epicondylar axis (SEA) on the axis plane perpendicular to the IM rod and evaluated the accuracy of the femoral component alignment after TKA with the 3D measurement system. Results The FAT line was 9.6° ± 3.7° (range, 1.4°–20.4°) internally rotated relative to the SEA. The average absolute error was 1.4° ± 1.1° in the coronal plane, 2.0° ± 1.5° in the sagittal plane, and 1.6° ± 1.3° in the axial plane. The femoral component outliers (i.e., >3° away from the goal alignment) were 7.7% in the coronal plane, 20.6% in the sagittal plane, and 10.3% in the axial plane. Conclusions Our findings suggest that the FAT line is a reliable and reproducibly identifiable axis for the accurate determination of proper rotational alignment in TKA. An operation support system which uses the FAT line for determining intraoperative femoral component rotation can effectively achieve highly accurate positioning of the femoral component in TKA.

Background: This study aimed to assess the reliability of the posterior condylar axis (PCA), the most widely used alternative reference for the surgical transepicondylar axis (sTEA), as a reference for appropriate femoral rotational alignment in total knee arthroplasty (TKA) by comparing variances with other alternative reference axes. Methods: A total of 305 knees in 233 Japanese patients who underwent TKA due to varus knee osteoarthritis were assessed in this study. Variances and relationships between alternative references were determined. Angles of alternative reference axes relative to the sTEA in the axial plane were measured using computer software based on computed tomography. Results: The PCA line was 3.0°±1.8° (range, -2.1° to 8.8°) internally rotated relative to the sTEA. No significant differences were observed in the PCA angle relative to the sTEA angle between males and females. The variance with respect to the sTEA was significantly smaller in the order of anatomical transepicondylar axis (aTEA), PCA, and antero-posterior axis (APA). The variance of the APA and that of the femoral anterior tangent line (FAT) did not significantly differ, while the variance of the FAT was significantly smaller than that of the trochlear anterior line (TAL). The proportion of outliers for PCA (>3° away from the average value) was 9.8%. The PCA was weakly correlated with the aTEA, APA, FAT, and TAL. Conclusions: In terms of variance with respect to the sTEA, the PCA was second to aTEA in reliability as an alternative reference axis, and was on average 3.0°±1.8° internally rotated relative to the sTEA. Our findings suggest that the PCA is a reliable and reproducibly identifiable alternative axis for accurately determining femoral rotational alignment in TKA.

Resume Objectif Etudier les facteurs predictifs de poussee de polyarthrite rhumatoide (PR) apres arret du methotrexate chez des patients japonais presentant une faible activite stable de la maladie sous traitement combine de tocilizumab (TCZ) et methotrexate (MTX). Methodes Cette etude prospective multicentrique en ouvert non controlee porte sur des patients japonais atteints de PR presentant une faible activite de la maladie (indice CDAI [Clinical Disease Activity Index] ≤ 10) depuis ≥ 12 semaines sous traitement combine de TCZ et MTX. Le MTX a ete arrete apres 12 semaines d’administration toutes les deux semaines tandis que le TCZ etait maintenu. Une poussee de la maladie a ete definie comme soit un score CDAI > 10, soit l’administration d’un traitement de secours pour quelque cause que ce soit, meme avec un CDAI ≤ 10. L’influence des caracteristiques a l’inclusion sur les poussees de la maladie a la semaine 64 (52 semaines apres l’arret du MTX) a ete evaluee par des modeles de regression logistique. Resultats Des analyses d’efficacite ont ete effectuees chez 49 patients, dont 15 avaient presente une poussee de la maladie a la semaine 64. La proportion (intervalle de confiance [IC] a 95 %) de patients ayant une faible activite de la maladie sans poussee a la semaine 64 etait de 69,4 % (54,6–81,8 %). L’intervalle d’administration du TCZ etait plus long que celui indique sur l’etiquette au Japon (c.-a-d. administration par intraveineuse toutes les quatre semaines ou sous-cutanee toutes les deux semaines) chez 27 % des patients presentant une poussee et 6 % des patients sans poussee. Selon l’analyse multivariee, le sexe masculin (odds ratio [OR] 18,00, IC 95 % 2,80–115,56) et l’intervalle d’administration etendu du TCZ (OR 12,00, IC 95 % 1,72–83,80) etaient des facteurs predictifs independants de poussee de la maladie. Conclusion Les patients de sexe masculin et ceux recevant du TCZ selon un intervalle etendu presentent un risque eleve de poussee de la maladie apres l’arret du MTX concomitant. Numero d’enregistrement de l’essai jRCTs041180071, UMIN000021247.

Objectives Patients with rheumatoid arthritis (RA) usually switch to a second biological disease-modifying antirheumatic drugs (bDMARDs) when the first has proven to be ineffective, although some may discontinue bDMARDs treatment altogether. We investigated the total rate of bDMARDs retention and the risk of bDMARDs discontinuation in patients with RA. Methods The study included 564 patients with RA who started bDMARDs treatment before 2008 ( Results Among 564 patients, 74 had discontinued bDMARDs treatment due to AEs. Male sex and Steinbrocker class 3–4 were more frequent, while rheumatoid factor and concomitant methotrexate treatment were less frequent, in those aged ≥65 years than in those aged Conclusions Older patients are at higher risk of discontinuing bDMARDs treatment due to AEs than younger patients.

This study aimed to evaluate the efficacy of add-on iguratimod (IGU) in patients with rheumatoid arthritis (RA patients) who inadequately respond to either tocilizumab (TCZ) or tumor necrosis factor alpha inhibitors (TNFi).Twenty-three RA patients treated with TCZ (the TCZ group) and 23 RA patients treated with TNFi (the TNFi group) were enrolled in this 24-week retrospective study from our multicenter registry. All inadequate responders to either TCZ or TNFi received add-on IGU. Baseline demographics and disease activity at 24 weeks after initiating add-on IGU were compared between the two groups.Baseline clinical disease activity index (CDAI) values in the TCZ group and TNFi group were 14.1 and 11.8 (Add-on IGU was more effective in inadequate responders to TCZ than in inadequate responders to TNFi.

To improve component-placement accuracy in total knee arthroplasty, we developed two devices: an original extramedullary patient-specific guide for the femur and an original extramedullary universal guide for the tibia (EM-TIBIA). We also developed a new function in ZedView, a three-dimensional surgical assistive software, that provides the parameters necessary to install the EM-TIBIA. Compared with conventional manual methods based on X-ray two-dimensional images or ZedView, these newly developed devices function as an extramedullary intraoperative support guide in conjunction with ZedView, simplifying surgical procedures. We conducted a study to evaluate the efficacy and safety of the surgery using the new guides and software function. Nineteen patients underwent surgery. On the femoral side, the mean absolute difference of the installation alignment was within 3° for all parameters. On the other hand, on the tibial side, the mean absolute difference from the preoperative plan for the rotation was 5.26±5.30°. The proportion of patients whose difference fell within ±3° was 52.6% (95% confi dence interval: 28.9 to 75.6%), and did not meet the pre-specified criteria for efficacy (P=0.261). No serious adverse events were reported, and no excessive bleeding, thrombosis, infections, or intraoperative or postoperative fractures were noted. The two new guides can easily reproduce the preoperative plan as 3D intraoperative support jigs, but errors can occur on the tibia side due to soft tissue that is not recognized by CT, creating problems in installation accuracy.

Objectives The study aimed to investigate the effectiveness and tolerance of biological disease-modifying antirheumatic drugs (bDMARDs) therapy administered concomitantly with tacrolimus (TAC) treatment in patients with rheumatoid arthritis. Methods 2792 patients who underwent therapy with five bDMARDs (etanercept: ETN, adalimumab, golimumab, tocilizumab, and abatacept: ABT) were enrolled. Among the study subjects, 1582 were concomitant methotrexate (MTX group), 147 were concomitant TAC (TAC group), and 1063 were non-concomitant MTX and TAC (non-MTX/TAC group). The primary outcome was the incident rate of discontinuation of bDMARDs by adverse events (AEs) or loss of efficacy. Results Concerning the analysis for each reasons of discontinuation, including AEs and loss of efficacy, the hazards ratio (HR) was significantly lower in the TAC group than in non-MTX/TAC groups (AEs: HR = 0.39, 95% confidence interval, 0.23–0.68, loss of efficacy: HR = 0.49, 95% confidence interval, 0.30–0.78). The loss of efficacy with the use of ETN and ABT was lower in the TAC group than in non-MTX/TAC groups. Concomitant TAC did not induce elevated risk for discontinuation of AEs in all bDMARD analyses. Conclusions Concomitant TAC with ABT or ETN showed higher retention rates than bDMARDs therapy without TAC or MTX. AEs did not increase over long-term observation.

Previous research on the relationship between rumination and behavioral impulsivity has been limited because impulsivity was assessed by using individual tasks. This study examined the concurrent associations of a latent variable named impulsive action with rumination and depression to alleviate the task-impurity problem and the low reliability of laboratory tasks assessing impulsivity. This study also examined whether stressors mediated the association between impulsive action and rumination. University students in Japan (

Objective To investigate predictors of disease flare after methotrexate discontinuation in Japanese rheumatoid arthritis (RA) patients with sustained low disease activity undergoing tocilizumab plus methotrexate combination therapy. Methods Participants of this multicenter, open-label, uncontrolled, prospective study were RA patients maintaining low disease activity (Clinical Disease Activity Index [CDAI] ≤ 10) for ≥ 12 weeks with tocilizumab plus methotrexate. Methotrexate was discontinued after 12 weeks of biweekly administration while continuing tocilizumab therapy. Disease flare was defined as either a CDAI score > 10 or intervention with rescue treatments for any reason even if the CDAI score was ≤ 10. The impact of baseline characteristics on disease flare at week 64 (52 weeks after methotrexate discontinuation) was assessed with logistic regression models. Results Efficacy analyses were performed in 49 patients, of whom 15 had a disease flare by week 64. The proportion (95% confidence interval [CI]) of patients who maintained low disease activity without a flare at week 64 was 69.4% (54.6–81.8%). The dosing interval of tocilizumab was longer than that described on the drug label in Japan (i.e., intravenously every 4 weeks, or subcutaneously every 2 weeks) in 27% and 6% of patients with and without a flare, respectively. Multivariate analysis revealed that male sex (odds ratio [OR]: 18.00, 95% CI: 2.80–115.56) and extended dosing interval of tocilizumab (OR: 12.00, 95% CI: 1.72–83.80) were independent predictors of disease flare. Conclusion Male patients and those receiving tocilizumab at an extended dosing interval are at high risk of disease flare after discontinuation of concomitant methotrexate. Trial registration number jRCTs041180071, UMIN000021247.

Objective This study aimed to examine anxiety and depression experienced by patients with rheumatoid arthritis (RA) using EuroQoL 5-Dimensional Descriptive System (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) scores. Methods We analyzed 1005 Japanese patients with RA. Stepwise multiple linear regression analysis was performed to evaluate the independent influence of variables on EQ-5D and HADS scores. Pearson correlation coefficients were also calculated to explore relationships between variables. Results The mean EQ-5D score was 0.74 for all patients (mean age, 63.2 years; mean disease duration, 13.6 years; mean Health Assessment Questionnaire Disability Index [HAQ-DI], 0.78; mean HADS total [HADS-T] score, 10.3; mean disease activity score assessed by 28 joints based on CRP [DAS28-CRP], 2.8). The EQ-5D score was strongly correlated with HAQ-DI and was moderately correlated with age, Steinbrocker functional class, HADS-T score, tender joint count assessed by 28 joints, pain on a visual analog scale (pain-VAS), patient's global assessment of disease activity (general-VAS), and DAS28-CRP. The HADS-T score was moderately correlated with HAQ-DI, pain-VAS, general-VAS, and DAS28-CRP. Factors that influenced the EQ-5D score included HAQ-DI (β = -0.533), pain-VAS (β = -0.128), HADS-T score (β = -0.142), DAS28-CRP (β = -0.187), and prednisolone use (β = -0.056). Factors that influenced the HADS score included HAQ-DI (β = 0.348), general-VAS (β = 0.145), disease duration (β = 0.094), and worklessness (β = 0.083). Conclusions The HADS score is an independent factor associated with EQ-5D in patients with RA. Our findings suggest that the assessment of anxiety and depression is essential in achieving better quality of life for patients with RA.

This study aimed to evaluate whether the level of serum matrix metalloproteinase-3 (MMP-3), a marker of synovium inflammation, is affected by clinical characteristics of patients in rheumatoid arthritis (RA) patients.We analyzed data from 1087 female patients with RA. Pearson's correlation coefficients were calculated to explore associations between variables. Stepwise multiple linear regression analysis was performed to evaluate patient background variables that could potentially affect serum MMP-3 levels.Serum MMP-3 was moderately correlated with C-reactive protein (CRP) (r: 0.478). Factors that independently influenced serum MMP-3 levels were CRP (β: 0.450), prednisolone (PSL) use (β: 0.100), estimated glomerular filtration rate (eGFR) (β: -0.085), swollen joint count assessed on 28 joints (β: 0.072), and body mass index (β: -0.061) in female patients with RA. In RA patients with PSL use, factors that independently influenced serum MMP-3 levels were CRP (β: 0.480), eGFR (β: -0.175), and PSL dose (β: 0.171).Our findings suggest that steroid therapy and renal dysfunction affect serum MMP-3 levels in patients with RA.

This study aimed to determine whether serum matrix metalloproteinase-3 (MMP-3) levels can predict remission in rheumatoid arthritis (RA) patients treated with adalimumab (ADA).Subjects were 114 RA patients continuously treated with ADA for 52 weeks. Predictive factors at baseline and 4 weeks after initiation of ADA therapy for the achievement of remission (28-point count Disease Activity Score-CRP (DAS28-CRP) 2.3) at 52 weeks were evaluated by multivariate logistic regression analysis.DAS28-CRP at 4 weeks (odds ratio (OR) 0.614, 95% confidence interval (CI) 0.382-0.988) and improvement in serum MMP-3 levels at 4 weeks (OR 1.057, 95% CI 1.002-1.032) were independent predictors of remission at 52 weeks. The best cut-off level of DAS28-CRP and improvement in serum MMP-3 levels at 4 weeks for predicting remission at 52 weeks was 3.73 (sensitivity: 90%, specificity: 50%, area under the receiver operating characteristic curve (AUC): 62%) and 39.93% (sensitivity: 47%, specificity: 83%, AUC: 64%), respectively.Our findings suggest that a high rate of improvement in serum MMP-3 levels at 4 weeks after initiation of ADA therapy can predict remission at 52 weeks in RA patients.

Objectives: To evaluate the efficacy and safety of methotrexate (MTX) discontinuation in Japanese rheumatoid arthritis (RA) patients with sustained low disease activity undergoing combinati...

Previous research on relationships between self-reported impulsivity and behavioral impulsivity has been limited because behavioral impulsivity was assessed using individual tasks. To alleviate the task-impurity problem and the low reliability of laboratory tasks assessing impulsivity, the present study examined the correlations between a latent variable constructed from the performances of three laboratory tasks assessing impulsive action and each dimension of self-reported impulsivity. University students in Japan ( N = 176) responded to the UPPS-P Impulsive Behavior Scale assessing five dimensions of self-reported impulsivity that included the following: negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency. They also conducted laboratory tasks for assessing impulsive action: the go/no-go task, stop signal task, and Conners continuous performance test 3rd edition (CCPT). Results indicated weak correlations between each dimension of self-reported impulsivity and the latent variable named impulsive action constructed from the performances of three laboratory tasks (mean r = .10) and with the performances of individual laboratory tasks (mean r = .03). The latent variable of impulsive action and the commission error rate in the CCPT were significantly correlated with sensation seeking. However, this association disappeared after controlling for the influence of gender. These findings suggested that measures of self-reported and behavioral impulsivity might assess different constructs.

Previous research has suggested that individuals with dysphoria have more intrusive thoughts than do individuals without dysphoria when engaging in thought suppression by using distraction. We hypothesized that meta-awareness of suppression mediates the relationship between severity of depressive symptoms and the frequency of intrusive thoughts during distraction. In Experiment 1, participants were instructed to suppress thoughts about a distressing story by focusing on a memory task (focused-distraction condition), or to simply suppress their thoughts (suppression condition). Results indicated the severity of depressive symptoms predicted increased meta-awareness of suppression and a higher frequency of intrusive thoughts in the focused-distraction condition. Moreover, meta-awareness of suppression mediated the relationship between the severity of depressive symptoms and the frequency of intrusive thoughts. This relationship was not found in the suppression condition. In Experiment 2, we replicated the f...

Objective.To evaluate the rates of retention and discontinuation of adalimumab (ADA) due to efficacy and safety in Japanese patients with rheumatoid arthritis (RA).Methods.All patients with RA (n = 476) who were treated with ADA in the Tsurumai Biologics Communication Registry were enrolled.Results.The retention rate of ADA was 46% at 5 years. When focusing on insufficient efficacy, previous biologics use and high baseline disease activity were significant risk factors for up to 1 year. Methotrexate (MTX) use was a significantly low risk factor after 1 year of treatment.Conclusion.Concomitant MTX contributes to the longterm efficacy of ADA therapy.

The present study examined how levels of construal affect retrieval-induced forgetting. Higher-level construal is associated with the focus on the similarities among stimuli, suggesting that high-level construal promotes relational processing. Based on this fact, retrieval-induced forgetting may be reduced or eliminated under high-level construal condition because of the effect of relational processing. Two experiments were conducted using a retrieval-practice paradigm with different stimuli while priming the level of construal. A meta-analysis synthesizing the results showed that retrieval-induced forgetting occurred under the low-level construal condition, whereas forgetting did not occur under the high-level construal condition. These results suggest that abstract thinking can eliminate retrieval-induced forgetting because of relational processing, demonstrating the role of the levels of construal on memory inhibition.

We conducted two experiments to investigate the effects of word list consistency and group collaboration on false memory. Using the DRM (Deese-Roediger-McDermott) paradigm, the first experiment (n = 121) examined false memory in a group; participants collaborated to select keywords using a between-subject condition of a consistent or randomized word list. The proportion of false responses was larger than that of error responses, especially for the consistent word list condition (p

Intrusive thoughts and difficulty in controlling thoughts are common, not only for people with psychological disorders, but also for healthy people. Individual differences in thought control ability may underlie such problems. The Thought Control Ability Questionnaire (TCAQ), which consists of 25 items, was developed by Luciano et al. (2005) in order to measure individual differences in the perceived ability to control unwanted intrusive thoughts. The purpose of the present study was to develop the Japanese version of the TCAQ and evaluate its reliability and validity. We translated the English version of the TCAQ into Japanese. We also conducted confirmatory factor analysis with a one factor solution, similar to the previous study. Based on the analysis, we excluded items whose factor loadings were lower than .30, resulting in 22 items for the Japanese version of the TCAQ. The model exhibited acceptable goodness-of-fit. The Japanese version of the TCAQ also demonstrated good reliability as well as evidence of construct validity. Thus, the development of the Japanese version of the TCAQ was successful.

The cognitive function to project oneself into the specific past or future is labeled mental time travel (MTT). MTT to the past is considered "episodic memory" and the future is termed "episodic future thinking". Remembering the past and imaging the future during MTT both draw on information stored in episodic memory: a process that enables integration of episodic information into a coherent event representation. Recent studies suggested that episodic information in past/future event representations varies with temporal distance from the present to the event. However, it is unclear whether the influence on temporal distance is actually caused by the function of episodic memory retrieval. The present study investigated the relationship between episodic memory and temporal concepts with a lexical decision task. The results indicate that remembering the past activated temporal concepts of the near future more than that of the far future. This finding suggests that the rich information derived from episodic memory modulates the subjective sense of time in episodic future thinking.

The relationship between depressive rumination and dimensions of social problem solving were investigated in a Japanese, nonclinical population. University students (N = 227) completed the Beck Depression Inventory—Second Edition, Ruminative Responses Scale, Means-Ends Problem-Solving (MEPS) test, and Social Problem-Solving Inventory—Revised Short Version (SPSI-R:S). Results indicated that after controlling for depression, trait rumination, especially its brooding subcomponent, was positively correlated with negative problem orientation and avoidance style. Unexpectedly, trait rumination was weakly but positively associated with an effective problem-solving style, as assessed by the SPSI-R:S and MEPS. These findings suggest that one pathway through which rumination leads to depression in nonclinical populations could be through increasing negative problem orientation and avoidance problem-solving style. Results also suggested that reflection, compared to brooding, was positively associated with positive problem orientation and more strongly associated with rationale problem-solving style. These findings suggest that reflection leads to active problem solving.

This study aimed to evaluate whether normal serum matrix metalloproteinase-3 (MMP-3) levels can be used to predict clinical remission and normal physical function at a single time point when treating patients with rheumatoid arthritis (RA) in daily practice settings. Subjects were all 1321 RA patients who were treated at our hospital. The accuracy of serum MMP-3 levels was larger than those of C-reactive protein (CRP) levels for predicting clinical remission [Simplified Disease Activity Index (SDAI) ≤ 3.3], normal function [Disability Index of the Health Assessment Questionnaire (HAQ-DI) ≤ 0.5], and both in clinical remission and with normal function (clinical remission + normal function) using receiver operating characteristic curve analysis. Serum MMP-3 levels were significantly correlated with CRP levels [r 0.229 (men), r 0.476 (women)] using Pearson’s correlation coefficients. Among patients with normal CRP levels (n = 807), the percentage of patients in clinical remission, with normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. In addition, among patients with the 28-point count Disease Activity Score-CRP (DAS28-CRP) remission (DAS28-CRP

Background Certolizumab pegol (CZP) is a polyethylene glycol (PEG)ylated Fc-free new anti-TNF α agent. However few data still reported clinical efficacy of CZP treatment in the routine practice. Objectives This study aimed to provide clinical evidence of an adequate observational period for predicting remission and low disease activity (LDA) achievement at 52 weeks in RA patients treated with Certolizumab pegol (CZP). Methods Patients with a diagnosis of RA according to the 2010 ACR/EULAR criteria who had been prescribed CZP from Tsurumai Biologics Communication Registry (TBCR) between May 2013 and October 2015 were enrolled.The final study cohort of 98 Japanese RA patients. We reviewed the methods about the improvement of DAS28-ESR and SDAI which was an index of disease activity of RA using Wilcoxon signed-rank test and the rate of remission and LDA patients at Week4, 8, 12, 24 and 52 by LOCF method. Also we used ROC analysis in order to determine the optimal period to achieve remission for the DAS-ESR and SDAI at Week52. Results The group of patients included 16 males and 82 females. The mean age was 59.5±14.7 years old; the disease duration was 9.4±8.8 years; the patients of receiving methotrexate (MTX) was 73 cases (74%); the MTX dose was 11.2±3.6 mg/week and b-DMARD naive patients was 57 cases (61%). Clinical findings related to RA were as follows: mean tender joint count, 5.2±4.7; swollen joint count, 5.0±4.0; patient9s and physician9s global assessment of disease activity, 48.9±27.4 and 42.3±23.2mm; CRP, 1.9±2.2 mg/dL; ESR, 47.4±34.0 mm/h; MMP3, 233±186 ng/ml; the rate of rheumatoid factor positive patients was 78%; DAS28 (ESR), 4.84±1.36; and SDAI, 21.2±11.3. The mean DAS-ESR improved to 3.54±1.35, 3.31±1.46, 3.37±1.47 and 3.31±1.43 at Week 4, 12, 24 and 52 (p Conclusions The new TNF-antagonist therapy of CZP was effective early and rapidly in patients with active Japanese RA. This study suggested that eight weeks is an adequate optimal period to judge whether the achieved remission or not at Week 52. Disclosure of Interest Y. Kanayama: None declared, A. Kaneko Speakers bureau: Mitsubishi Tanabe Pharma, Takeda Pharma, Eisai Pharma, Chugai Pharma, Abbott, Bristol-Myers Squibb, UCB, Janssen, and Pfizer, N. Takahashi Speakers bureau: Abbvie Japan Co. Ltd, Eisai Co. Ltd, UCB Japan Co. Ltd, MitsubishiTanabe Pharma Corporation, Takeda Pharmaceutical Company Ltd, Pfizer Co. Ltd, Chugai Pharmaceutical Co. Ltd, Janssen Pharmaceutical K.K., and, T. Kato: None declared, M. Hayashi: None declared, Y. Hattori: None declared, N. Asai: None declared, N. Ishiguro Grant/research support from: Daiichi Sankyo, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Taisho Toyama Pharmaceutical, Kaken Pharmaceutical, Eisai, Janssen Pharmaceutical, Bristol- Myers Squibb, AbbVie, Chugai Pharmaceutical, Mitsubishi Tanabe Pharmaceutical, Astellas Pharma, and Pfizer Japan, Speakers bureau: Daiichi Sankyo, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Taisho Toyama Pharmaceutical, Kaken Pharmaceutical, Eisai, Janssen Pharmaceutical, Bristol-Myers Squibb, AbbVie, Chugai, T. Kojima Speakers bureau: Mitsubishi Tanabe Pharma, Takeda Pharma, Eisai Pharma, AbbVie, Bristol-Myers Squibb, and Pfizer, Janssenn Pharmaceutical Companies, Astellas Pharma and Chugai Pharma

In the present study, we investigated how brain images affect metacomprehension judgments of neuroscience research. Participants made a prereading judgment of comprehension of the text topic and then read a text about neuroimaging findings. In Experiment 1, participants read text only or text accompanying brain images. In Experiment 2, participants read text accompanying bar graphs or text accompanying brain images. Then participants were asked to rate their comprehension of the text. Finally, they completed comprehension tests. The results of Experiment 1 showed that the text accompanying brain images was associated with higher metacomprehension judgments than was the text only, whereas the performance of the comprehension test did not differ between each condition. The results of Experiment 2 showed that the text accompanying brain images was associated not only with credibility of the text, but also with higher metacomprehension judgments than was the text accompanying the bar graphs, whereas the performance of the comprehension test did not differ between each condition. The findings suggest that the readers' subjective judgments differ from actual comprehension.