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Katsuki M, Matsumori Y, Kashiwagi K, Kawamura S, Koh A. Efficacy of Kampo medicine Kakkonto as acute medication to treat tension-type headache among musculoskeletal pain patients using regular analgesics. Rinsho Shinkeigaku 2023; 63:73-77. [PMID: 36725011 DOI: 10.5692/clinicalneurol.cn-001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Tension-type headache (TTH) is the most prevalent type of primary headache disorder. Its acute pharmacotherapy is acetaminophen or non-steroidal anti-inflammatory drugs based on the Japanese Clinical Practice Guideline for Headache Disorders 2021. With Japan's aging population, however, the number of TTH patients with comorbidities that have been treated by analgesics is increasing. Under this context, it is sometimes difficult to select an acute pharmacotherapy for TTH. Kakkonto, Japanese traditional herbal kampo medicine, is empirically used for TTH. We hypothesized that kakkonto has efficacy for TTH with painful comorbidities. MATERIALS AND METHODS We prospectively collected 10 consecutive TTH patients who had already taken analgesics for comorbidities. We prescribed 2.5 g of kakkonto (TJ-1), and patients took it. A numerical rating scale for pain before and 2 hours after kakkonto intake was evaluated. RESULTS Eight women and 2 men were included. The mean age was 71.0 ± 13.4 years old. Four patients had lower back pain, 2 had lumbar spinal stenosis, 2 had knee pain, 1 had neck pain, and 1 had shoulder myofasciitis. Celecoxib was used for 4 patients, acetaminophen for 3, loxoprofen for 2, and a combination of tramadol and acetaminophen for 1, as routinely used analgesics. The median numerical rating scale statistically improved from the median of 4 to that of 0. There were no side effects of kakkonto. CONCLUSION Kakkonto showed efficacy as an acute medication for TTH with comorbidities that have been treated by analgesic.
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Affiliation(s)
| | | | | | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital
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Katsuki M, Kashiwagi K, Kawamura S, Tachikawa S, Koh A. Fremanezumab for Migraine Prevention in Japanese Elderly Aged Over 70 Years Old. Cureus 2023; 15:e34052. [PMID: 36824556 PMCID: PMC9942430 DOI: 10.7759/cureus.34052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 01/23/2023] Open
Abstract
Background Elderly migraine is a public health problem with prolonged life expectancy, and effective prophylactic treatment is needed. There were no reports on fremanezumab for the elderly. We described the real-world data of fremanezumab, calcitonin gene-related peptide-related monoclonal antibody (CGRP-mAB), for migraine in elderly over 70 years old. Methods We retrospectively investigated six elderly migraine patients over 70 years old treated with fremanezumab. Headache impact test-6 (HIT-6), monthly headache days (MHD), and monthly acute medication intake days (AMD) before one and three months after starting fremanezumab treatment were evaluated. Results Three women and three men (median age 78; range: 71-99) were included. One was chronic migraine (CM), three were CM and medication-overuse headache, and two were episodic migraine and tension-type headache. All six patients received monthly fremanezumab. The median MHD before, during one, and three months after treatment were 30 (4-30), 30 (4-30), and 29 (15-30, n=4). Those of AMD were 17 (0-30), 9.5 (0-30), and 1 (0-28). Those about HIT-6 were 64 (56-72), 59.5 (52-70), and 55.5 (48-64). Two (33.3%) of the six patients experienced therapeutic effectiveness. There were no side effects. Conclusion We described the six elderly migraine patients aged over 70 years old treated with fremanezumab. Two (33.3%) of the six patients experienced therapeutic effectiveness. This is the first report of fremanezumab for elderly migraine patients aged over 70 years old. Further evidence accumulation is needed about CGRP-mABs for the elderly.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Kenta Kashiwagi
- Department of Neurology, Itoigawa General Hospital, Itoigawa, JPN
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Senju Tachikawa
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
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Muacevic A, Adler JR, Kawamura S, Tachikawa S, Koh A. One-Time Use of Galcanezumab or Fremanezumab for Migraine Prevention. Cureus 2023; 15:e34180. [PMID: 36843788 PMCID: PMC9951121 DOI: 10.7759/cureus.34180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 01/27/2023] Open
Abstract
Background There are no reports on the effectiveness of one-time use of the calcitonin gene-related peptide-related monoclonal antibodies (CGRP-mABs) evaluated at one and three months for migraine prevention. Here, we present the real-world data of one-time administration of CGRP-mABs, galcanezumab and fremanezumab, for migraine prevention. Methodology We retrospectively investigated eight migraine patients treated with one-time administration of galcanezumab 240 mg or fremanezumab 225 mg. Monthly headache days (MHD), monthly acute medication intake days (AMD), and Headache Impact Test-6 (HIT-6) scores before, one, and three months after one-time CGRP-mABs administration were evaluated. Results A total of five women and three men were included (median age = 46.5 years, range = 19-63 years). Overall, six were episodic migraine, and two were chronic migraine. Five patients received one-time administration of fremanezumab and three received galcanezumab. In total, six (75.0%) patients experienced therapeutic effectiveness one month after the one-time administration. Five of the six maintained the therapeutic effect until three months, but one had aggravation. As a result, six (75.0%) patients reached or maintained therapeutic conditions three months after the one-time administration of CGRP-mABs without side effects. All patients continued previously used oral prophylaxis during the observational period. Significant reductions in MHD, AMD, and HIT-6 scores were observed three months after the initial administration (p = 0.008, p = 0.005, and p < 0.001, respectively). Conclusions Six of the eight patients experienced or maintained therapeutic effectiveness at three months despite the one-time administration of CGRP-mABs. Our results suggest that one-time use of CGRP-mABs may be a new treatment option in combination with oral prophylaxis.
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Shen W, Jiang N, Zhou W. What can traditional Chinese medicine do for adult neurogenesis? Front Neurosci 2023; 17:1158228. [PMID: 37123359 PMCID: PMC10130459 DOI: 10.3389/fnins.2023.1158228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
Adult neurogenesis plays a crucial role in cognitive function and mood regulation, while aberrant adult neurogenesis contributes to various neurological and psychiatric diseases. With a better understanding of the significance of adult neurogenesis, the demand for improving adult neurogenesis is increasing. More and more research has shown that traditional Chinese medicine (TCM), including TCM prescriptions (TCMPs), Chinese herbal medicine, and bioactive components, has unique advantages in treating neurological and psychiatric diseases by regulating adult neurogenesis at various stages, including proliferation, differentiation, and maturation. In this review, we summarize the progress of TCM in improving adult neurogenesis and the key possible mechanisms by which TCM may benefit it. Finally, we suggest the possible strategies of TCM to improve adult neurogenesis in the treatment of neuropsychiatric disorders.
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Affiliation(s)
- Wei Shen
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Ning Jiang
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
- *Correspondence: Ning Jiang, ; Wenxia Zhou,
| | - Wenxia Zhou
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
- *Correspondence: Ning Jiang, ; Wenxia Zhou,
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Katsuki M, Kawahara J, Matsumori Y, Yamagishi C, Koh A, Kawamura S, Kashiwagi K, Kito T, Entani A, Yamamoto T, Otake M, Ikeda T, Yamagishi F. Questionnaire-Based Survey during COVID-19 Vaccination on the Prevalence of Elderly's Migraine, Chronic Daily Headache, and Medication-Overuse Headache in One Japanese City-Itoigawa Hisui Study. J Clin Med 2022; 11:4707. [PMID: 36012946 PMCID: PMC9409693 DOI: 10.3390/jcm11164707] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The prevalence of headache disorders, migraine, chronic daily headache (CDH), and medication-overuse headache (MOH) among the elderly in Japan has not been sufficiently investigated. We performed a questionnaire-based survey and revealed 3-month headache prevalence and headaches' characteristics. METHODS The population aged over 64 was investigated in Itoigawa during their third coronavirus disease 2019 vaccination. Migraine, MOH was defined as The International Classification of Headache Disorders Third edition. CDH was defined as a headache occurring at least 15 days per month. K-means++ were used to perform clustering. RESULTS Among 2858 valid responses, headache disorders, migraine, CDH, and MOH prevalence was 11.97%, 0.91%, 1.57%, and 0.70%, respectively. Combined-analgesic and non-opioid analgesic were widely used. Only one migraineur used prophylactic medication. We performed k-means++ to group the 332 MOH patients into four clusters. Cluster 1 seemed to have tension-type headache-like headache characteristics, cluster 2 seemed to have MOH-like headache characteristics, cluster 3 seemed to have severe headaches with comorbidities such as dyslipidemia, stroke, and depression, and cluster 4 seemed to have migraine-like headache characteristics with photophobia and phonophobia. CONCLUSIONS This is the largest prevalence survey in the Japanese elderly. Headache disorders are still the elderly's burden. Clustering suggested that severe headaches associated with some comorbidities may be unique to the elderly.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Junko Kawahara
- Department of Health Promotion, Itoigawa City, Itoigawa 941-8501, Niigata, Japan
| | | | - Chinami Yamagishi
- Department of Health Promotion, Itoigawa City, Itoigawa 941-8501, Niigata, Japan
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Kenta Kashiwagi
- Department of Neurology, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Tomohiro Kito
- Department of Neurosurgery, Nou National Health Insurance Clinic, Itoigawa 949-1331, Niigata, Japan
| | - Akio Entani
- Department of Internal Medicine, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Toshiko Yamamoto
- Department of Nursing, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Miyako Otake
- Department of Nursing, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
| | - Takashi Ikeda
- Department of Health Promotion, Itoigawa City, Itoigawa 941-8501, Niigata, Japan
| | - Fuminori Yamagishi
- Department of Surgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan
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Katsuki M, Yamagishi C, Matsumori Y, Koh A, Kawamura S, Kashiwagi K, Kito T, Entani A, Yamamoto T, Ikeda T, Yamagishi F. Questionnaire-based survey on the prevalence of medication-overuse headache in Japanese one city-Itoigawa study. Neurol Sci 2022; 43:3811-3822. [PMID: 35043356 PMCID: PMC8765819 DOI: 10.1007/s10072-021-05831-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The medication-overuse headache (MOH) prevalence has not been investigated in a general Japanese population. We performed questionnaire-based survey and revealed MOH prevalence and its characteristics. We also performed clustering to obtain insight for MOH subgrouping. METHODS In this cross-sectional study, the 15-64-year-old population was investigated in Itoigawa during their COVID-19 vaccination under the national policy. MOH was defined as ≥ 15 days/month plus self-report of use of pain medications ≥ 10 or 15 days/month in the last 3 months. Ward method and k-means + + were used to perform clustering MOH patients. RESULTS Among 5865 valid responses, MOH prevalence was 2.32%. MOH was common among females and the middle-aged. Combination-analgesic is the most overused as 50%. MOH had aggravation by routine physical activity, moderate or severe pain, and migraine-like, compared to non-MOH. The 136 MOH patients could be grouped into 3 clusters. Age and frequency of acute medication use were essential factors for clustering. CONCLUSIONS This is the first study of MOH prevalence in Japan. Most MOH characteristics were similar to previous reports worldwide. Public awareness of proper headache treatment knowledge is still needed. Clustering results may be important for subtype grouping from a social perspective apart from existing clinical subtypes.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan.
| | - Chinami Yamagishi
- Department of Health Promotion, Itoigawa City, Itoigawa, Niigata, 941-8501, Japan
| | | | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan
| | - Kenta Kashiwagi
- Department of Neurology, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan
| | - Tomohiro Kito
- Department of Neurosurgery, Nou National Health Insurance Clinic, Itoigawa, Niigata, 949-1331, Japan
| | - Akio Entani
- Department of Internal Medicine, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan
| | - Toshiko Yamamoto
- Department of Nursing, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan
| | - Takashi Ikeda
- Department of Health Promotion, Itoigawa City, Itoigawa, Niigata, 941-8501, Japan
| | - Fuminori Yamagishi
- Department of Surgery, Itoigawa General Hospital, Itoigawa, Niigata, 941-0006, Japan
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Katsuki M, Kashiwagi K, Kawamura S, Koh A. The Efficacy of Japanese Herbal Kampo Medicine as an Acute and Prophylactic Medication to Treat Chronic Daily Headache and Medication Overuse Headache:-Single Arm Retrospective Study. Cureus 2022; 14:e25419. [PMID: 35769688 PMCID: PMC9233981 DOI: 10.7759/cureus.25419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/05/2022] Open
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