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Nakamori M, Toko M, Yamada H, Hayashi Y, Ushio K, Yoshikawa K, Haruta A, Hiraoka A, Yoshikawa M, Nagasaki T, Mikami Y, Maruyama H. Association between motor symptoms of Parkinson's disease and swallowing disorders. Neurol Sci 2024; 45:2021-2026. [PMID: 38055077 PMCID: PMC11021328 DOI: 10.1007/s10072-023-07238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Parkinson's disease (PD) presents with motor symptoms that hinder physical activity. This study aimed to thoroughly investigate swallowing dysfunction in patients with PD using videofluoroscopy (VF) and the Movement Disorder Society (MDS)-Unified PD Rating Scale (UPDRS) sub-scores. METHODS This study was part of an intervention project to evaluate the effectiveness of cervical percutaneous interferential current stimulation in patients with Hoehn and Yahr stages 2-4 PD. Baseline data, including swallowing-related indicators such as VF, were obtained and compared to the MDS-UPDRS sub-scores including rigidity, tremor, postural instability/gait difficulty, and limb scores. RESULTS Twenty-seven patients were included in this study. In the VF analysis, laryngeal penetration/aspiration, oral cavity residue, epiglottic vallecular residue, and pharyngeal residue were observed with remarkable frequency. The multivariate analysis revealed that the mean rigidity score of UPDRS was an independent and significantly correlated factor with laryngeal penetration/aspiration during the ingestion of 10 mL of water (odds ratio 1.294, 95% confidence interval 1.035-1.617; p = 0.024). CONCLUSION This study revealed a correlation between muscle rigidity and laryngeal penetration or aspiration risk. The detailed comparative analysis of various individual PD symptoms and swallowing disorders was substantial, which enabled early detection of the risk of swallowing disorder and the implementation of appropriate measures. TRIAL REGISTRATION NUMBER jRCTs062220013.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Yamada H, Toko M, Nakamori M, Ueno H, Aoki S, Sugimoto T, Yasutomi H, Nakamichi K, Maruyama H. Progressive multifocal leukoencephalopathy associated with systemic lupus erythematosus: longitudinal observation of lymphocytes, JC virus in cerebrospinal fluid, and brain magnetic resonance imaging. J Neurovirol 2024:10.1007/s13365-024-01203-0. [PMID: 38502271 DOI: 10.1007/s13365-024-01203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/29/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Abstract
Progressive multifocal leukoencephalopathy (PML) rarely occurs in patients with systemic lupus erythematosus (SLE). This report presents the case of a patient who developed PML due to SLE-associated multiple factors. A 60-year-old woman diagnosed with SLE undergoing multiple immunosuppressive therapies, including azathioprine, presented with cerebral cortical symptoms, lymphocytopenia, and vitamin B12 deficiency and was subsequently diagnosed with SLE-associated PML. We evaluated the cause and disease activity of PML, focusing on the longitudinal assessment of lymphocytopenia, JC virus (JCV) DNA copy number in the cerebrospinal fluid, and magnetic resonance imaging (MRI) findings. Discontinuing azathioprine and initiating alternative immunosuppressive treatments with intramuscular vitamin B12 injections affected lymphocytopenia and disease management. However, despite recovery from lymphopenia and JCV DNA copy number being low, the large hyperintense and punctate lesions observed on the fluid-attenuated inversion recovery (FLAIR) images exhibited varying behaviors, indicating that the balance between contributing factors for PML may have fluctuated after the initial treatment. Clinicians should be meticulous when assessing the underlying pathology of the multifactorial causes of PML due to SLE. The difference in the transition pattern of these lesions on FLAIR images may be one of the characteristics of MRI findings in PML associated with SLE, reflecting fluctuations in disease activity and the progression stage of PML.
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Affiliation(s)
- Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Department of Neurology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomohiro Sugimoto
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroko Yasutomi
- Department of Diagnostic Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuo Nakamichi
- Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Eto F, Toko M, Takahashi S, Maruyama H. Cortical Reflex Myoclonus in a Patient with Hyperammonemic Encephalopathy. Balkan Med J 2024; 41:145-146. [PMID: 38008922 PMCID: PMC10913111 DOI: 10.4274/balkanmedj.galenos.2023.2023-9-96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/30/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- Futoshi Eto
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Neurology, Koyo Newtown Hospital, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shoichi Takahashi
- Department of Gastroenterology, Koyo Newtown Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Neshige S, Toko M, Aoki S, Maruyama H. Density spectrum array and difficult to diagnose seizure activity. QJM 2023; 116:947-948. [PMID: 37338538 DOI: 10.1093/qjmed/hcad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/12/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- Shuichiro Neshige
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
- Epilepsy Center, Hiroshima University Hospital, 1-2-3 Minami-ku Kasumi, Hiroshima 734-8551, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
- Epilepsy Center, Hiroshima University Hospital, 1-2-3 Minami-ku Kasumi, Hiroshima 734-8551, Japan
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Nakamori M, Shimizu Y, Takahashi T, Toko M, Yamada H, Hayashi Y, Ushio K, Yoshikawa K, Hiraoka A, Yoshikawa M, Nagasaki T, Mikami Y, Maruyama H. Swallowing sound index analysis using electronic stethoscope and artificial intelligence for patients with Parkinson's disease. J Neurol Sci 2023; 454:120831. [PMID: 37837871 DOI: 10.1016/j.jns.2023.120831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/20/2023] [Accepted: 10/08/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND AND PURPOSE Several noninvasive tools assess swallowing disorders, including electronic stethoscope artificial intelligence (AI) analysis for remote diagnosis, with the potential for telemedicine. This study investigated the swallowing sound index in patients with Parkinson's disease (PD). METHODS This single-arm, open-label trial assessed the impact of cervical percutaneous interferential current stimulation on swallowing in patients with PD classified as Hoehn-Yahr stages 2-4. Stimulation was conducted for 8 weeks. Baseline data were used to examine the link between the swallowing sound index and indicators such as videofluoroscopy (VF). Furthermore, we examined changes in the swallowing sound index after the intervention. RESULTS Twenty-five patients were included. The swallowing sound index in patients with PD was higher than that in those with amyotrophic lateral sclerosis but considerably lower than that in healthy controls. The number of patients with normal EAT-10 scores positively correlated with the swallowing sound index, whereas elevated C-reactive protein levels were negatively correlated with the swallowing sound index. However, the index displayed no correlation with other indicators, including the VF results. Despite the intervention, the index remained unchanged throughout the study. CONCLUSION In patients with PD, a decrease in the swallowing sound index suggests a potential association between swallowing disorders and the risk of aspiration pneumonia. TRIAL REGISTRATION NUMBER jRCTs062220013.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tamayo Takahashi
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Nakamori M, Toko M, Yamada H, Hayashi Y, Haruta A, Hiraoka A, Yoshikawa M, Nagasaki T, Ushio K, Yoshikawa K, Shimizu Y, Mikami Y, Maruyama H. Detailed findings of videofluoroscopic examination among patients with Parkinson's disease on the effect of cervical percutaneous interferential current stimulation. Front Neurol 2023; 14:1279161. [PMID: 38020611 PMCID: PMC10664245 DOI: 10.3389/fneur.2023.1279161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Parkinson's disease (PD) leads to various types of swallowing disorders. We investigated the effect of cervical percutaneous interferential current stimulation on dysphagia. By conducting detailed qualitative and quantitative analysis of videofluoroscopic examination, we aimed to understand dysphagia in patients with PD and investigate its effects on swallowing function. Methods Patients received cervical percutaneous interferential current stimulation for 20 min twice a week for 8 weeks. In this exploratory study, we evaluated aspiration/laryngeal penetration, oral cavity residue, vallecular residue, and pharyngeal residue. In addition, we performed temporal analysis. Results Twenty-five patients were completely evaluated. At baseline, the proportions of laryngeal penetration/aspiration, oral cavity residue, epiglottic vallecula residue, and pharyngeal residue were 40.0, 88.0, 72.0, 60.0, and 16.0%, respectively. Conversely, pharyngeal transit time, laryngeal elevation delay time, pharyngeal delay time, and swallowing reflex delay were nearly within the normal ranges. Cervical percutaneous interferential current sensory stimulation improved only oral cavity residue at the end of the intervention, from 88.0 to 56.0%. Discussion Patients with PD demonstrated remarkably high frequencies of residues in the oral and pharyngeal regions. The usefulness of cervical interferential current stimulation was partially demonstrated for oral cavity residue. Considering that PD exhibits diverse symptoms, further accumulation of cases and knowledge is warranted. Trial registration jRCTs062220013.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Nakamori M, Ishikawa R, Watanabe T, Toko M, Naito H, Takahashi T, Simizu Y, Yamazaki Y, Maruyama H. Swallowing sound evaluation using an electronic stethoscope and artificial intelligence analysis for patients with amyotrophic lateral sclerosis. Front Neurol 2023; 14:1212024. [PMID: 37602264 PMCID: PMC10435850 DOI: 10.3389/fneur.2023.1212024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023] Open
Abstract
Background and purpose Non-invasive, simple, and repetitive swallowing evaluation is required to prevent aspiration pneumonia in neurological care. We investigated the usefulness of swallowing sound evaluation in patients with amyotrophic lateral sclerosis (ALS) using our new electronic stethoscope artificial intelligence (AI) analysis tool. Methods We studied patients with ALS who provided written informed consent. We used an electronic stethoscope, placed a Bluetooth-enabled electronic stethoscope on the upper end of the sternum, performed a 3-mL water swallow three times, and remotely identified the intermittent sound components of the water flow caused at that time by AI, with the maximum value as the swallowing sound index. We examined the correlation between the swallowing sound index and patient background, including swallowing-related parameters. Results We evaluated 24 patients with ALS (age 64.0 ± 11.8 years, 13 women, median duration of illness 17.5 months). The median ALS Functional Rating Scale-Revised (ALSFRS-R) score was 41 (minimum 18, maximum 47). In all cases, the mean swallowing sound index was 0.209 ± 0.088. A multivariate analysis showed that a decrease in the swallowing sound index was significantly associated with a low ALSFRS-R score, an ALSFRS-R bulbar symptom score, % vital capacity, tongue pressure, a Mann Assessment of Swallowing Ability (MASA) score, and a MASA pharyngeal phase-related score. Conclusion Swallowing sound evaluation using an electronic stethoscope AI analysis showed a correlation with existing indicators in swallowing evaluation in ALS and suggested its usefulness as a new method. This is expected to be a useful examination method in home and remote medical care.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ruoyi Ishikawa
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tomoaki Watanabe
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroyuki Naito
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Tamayo Takahashi
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshitaka Simizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yu Yamazaki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Nakamori M, Toko M, Yamada H, Hayashi Y, Yoshikawa K, Yoshikawa M, Nagasaki T, Hiraoka A, Shimizu Y, Mikami Y, Maruyama H. Impact of neck percutaneous interferential current sensory stimulation on swallowing function in patients with Parkinson's disease: A single-arm, open-label study protocol. Contemp Clin Trials Commun 2023; 33:101158. [PMID: 37342176 PMCID: PMC10277457 DOI: 10.1016/j.conctc.2023.101158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/26/2023] [Accepted: 06/02/2023] [Indexed: 06/22/2023] Open
Abstract
Background Parkinson's disease (PD) can lead to swallowing dysfunction, resulting in aspiration pneumonia. Among the types of swallowing disorders, a characteristic and serious problem associated with PD is silent aspiration due to pharyngeal and laryngeal hypoesthesia. Methods This single-arm, open-label study aims to evaluate the effectiveness of percutaneous neck interferential current sensory stimulation in enhancing swallowing function in patients with PD. The efficacy and safety of percutaneous neck interferential current sensory stimulation will be investigated for patients diagnosed with PD, based on the Movement Disorder Society criteria, of Hoehn-Yahr stages 2-4. The patients will receive neck percutaneous interferential current sensory stimulation for 20 min twice a week for 8 weeks using a Gentle Stim® (FoodCare Co., Ltd., Kanagawa, Japan) device. Once the intervention is initiated, evaluations will be performed every 4 weeks for a 16-week period. The primary endpoint to be assessed is the proportion of patients with normal cough with 1% citric acid at the end of the intervention (8 weeks after intervention initiation) compared with that at the beginning. This clinical trial will examine the usefulness of percutaneous neck interferential current sensory stimulation in patients with PD. In addition, this study will use novel instruments, such as multichannel surface electromyography and electronic stethoscope, to evaluate swallowing function. Discussion This novel evaluation can provide insights into dysphagia in patients with PD and the usefulness of percutaneous neck interferential current stimulation. This exploratory study is limited by its single-arm, open-label design and small size. Trial registration number jRCTs062220013; pre-results.
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Affiliation(s)
- Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuki Hayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshikazu Nagasaki
- Department of Oral and Maxillofacial Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Aya Hiraoka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Ishiguro T, Konno T, Hara N, Zhu B, Okada S, Shibata M, Saika R, Kitano T, Toko M, Nezu T, Hama Y, Kawazoe T, Takahashi-Iwata I, Yabe I, Sato K, Takeda H, Toda S, Nishimiya J, Teduka T, Nozaki H, Kasuga K, Miyashita A, Onodera O, Ikeuchi T. Novel Partial Deletions, Frameshift and Missense Mutations of CSF1R in Patents with CSF1R-Related Leukoencephalopathy. Eur J Neurol 2023. [PMID: 36943150 DOI: 10.1111/ene.15796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND CSF1R-related leukoencephalopathy is an adult-onset leukoencephalopathy caused by mutations in CSF1R. The present study aimed to explore the broader genetic spectrum of CSF1R-related leukoencephalopathy in association with clinical and imaging features. METHODS Mutational analysis of CSF1R was performed for 100 consecutive patients with adult-onset leukoencephalopathy. Sequence and copy number variation (CNV) analyses of CSF1R were performed. The genomic ranges of the deletions were determined by long-read sequencing. Ligand-dependent autophosphorylation of CSF1R was examined in cells expressing the CSF1R mutants identified in this study. RESULTS We identified CSF1R mutations in 15 patients, accounting for 15% of the adult-onset leukoencephalopathy cases. Seven novel and five previously reported CSF1R mutations were identified. The novel mutations, including three missense and one in-frame 3-bp deletion, were located in the tyrosine kinase domain (TKD) of CSF1R. Functional assays revealed that none of the novel mutations in the TKD showed autophosphorylation of CSF1R. We identified two partial deletions of CSF1R that resulted in the lack of the C-terminal region, including the distal TKD, in two patients. Variable clinical features including cognitive impairment, psychiatric symptoms, and gait disturbance were observed. Various degrees of the white matter lesions and corpus callosum abnormalities on MRI and characteristic calcifications on CT were observed as imaging features. CONCLUSIONS Our results highlighted the importance of examining the CNV of CSF1R even when Sanger or exome sequencing reveal no CSF1R mutations. Genetic examination of sequences and CNV analyses of CSF1R are recommended for an accurate diagnosis of CSF1R-related leukoencephalopathy.
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Affiliation(s)
- Takanobu Ishiguro
- Department of Neurology, Brain Research Institute, Niigata University, Niigata
| | - Takuya Konno
- Department of Neurology, Brain Research Institute, Niigata University, Niigata
| | - Norikazu Hara
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata
| | - Bin Zhu
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata
| | - Satoshi Okada
- Department of Neurology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa
| | - Mamoru Shibata
- Department of Neurology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa
| | - Reiko Saika
- Department of Neurology, Osaka, Red Cross Hospital, Osaka
| | - Takaya Kitano
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima
| | - Yuka Hama
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira
| | - Tomoya Kawazoe
- Department of Neurology, Tokyo, Metropolitan Neurological Hospital, Fuchu
| | | | - Ichiro Yabe
- Department of Neurology, Hokkaido University School of Medicine, Sapporo
| | - Kota Sato
- Department of Neurology, Brain Attack Center Ota Memorial Hospital, Fukuyama
| | - Hayato Takeda
- Department of Neurology, University of Tsukuba, Tsukuba
| | - Shintaro Toda
- Kyoto Katsura Hospital, Katsura, Department of Neurology
| | - Jin Nishimiya
- Department of Neurology, Gyotoku General Hospital, Ichikawa
| | - Toshiyuki Teduka
- Department of Neurology, Brain Research Institute, Niigata University, Niigata
| | - Hiroaki Nozaki
- Department of Neurology, Brain Research Institute, Niigata University, Niigata
| | - Kensaku Kasuga
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata
| | - Akinori Miyashita
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata
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Toko M, Ohshita T, Kurashige T, Morino H, Kume K, Yamashita H, Sobue G, Iwasaki Y, Sone J, Kawakami H, Maruyama H. Correction to: FXTAS is difficult to differentiate from neuronal intranuclear inclusion disease through skin biopsy: a case report. BMC Neurol 2021; 21:413. [PMID: 34706668 PMCID: PMC8554977 DOI: 10.1186/s12883-021-02452-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Megumi Toko
- Department of Neurology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan.,Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Tomohiko Ohshita
- Department of Neurology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan. .,Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Takashi Kurashige
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Caner Center, 3-1 Aoyama-cho, Kure, Hiroshima, 737-0023, Japan
| | - Hiroyuki Morino
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Kodai Kume
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.,Department of Supportive and Promotive Medicine of the Municipal Hospital, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe Kagawa, Miki-cho, Kita-gun, 761-0793, Japan
| | - Hiroshi Yamashita
- Department of Neurology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Gen Sobue
- Aichi Medical University, Nagakute, Aichi, Japan
| | - Yasushi Iwasaki
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan
| | - Jun Sone
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.,Department of Neurology, National Hospital Organization Suzuka National Hospital, 3-2-1, Kasado, Suzuka, Mie, 513-8501, Japan
| | - Hideshi Kawakami
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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Toko M, Ohshita T, Kurashige T, Morino H, Kume K, Yamashita H, Sobue G, Iwasaki Y, Sone J, Kawakami H, Maruyama H. FXTAS is difficult to differentiate from neuronal intranuclear inclusion disease through skin biopsy: a case report. BMC Neurol 2021; 21:396. [PMID: 34641814 PMCID: PMC8513318 DOI: 10.1186/s12883-021-02425-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022] Open
Abstract
Background Both fragile X-associated tremor/ataxia syndrome (FXTAS) and late-onset neuronal intranuclear inclusion disease (NIID) show CGG/GGC trinucleotide repeat expansions. Differentiating these diseases are difficult because of the similarity in their clinical and radiological features. It is unclear that skin biopsy can distinguish NIID from FXTAS. We performed a skin biopsy in an FXTAS case with cognitive dysfunction and peripheral neuropathy without tremor, which was initially suspected to be NIID. Case presentation The patient underwent neurological assessment and examinations, including laboratory tests, electrophysiologic test, imaging, skin biopsy, and genetic test. A brain MRI showed hyperintensity lesions along the corticomedullary junction on diffusion-weighted imaging (DWI) in addition to middle cerebellar peduncle sign (MCP sign). We suspected NIID from the clinical picture and the radiological findings, and performed a skin biopsy. The skin biopsy specimen showed ubiquitin- and p62-positive intranuclear inclusions, suggesting NIID. However, a genetic analysis for NIID using repeat-primed polymerase chain reaction (RP-PCR) revealed no expansion detected in the Notch 2 N-terminal like C (NOTCH2NLC) gene. We then performed genetic analysis for FXTAS using RP-PCR, which revealed a repeat CGG/GGC expansion in the FMRP translational regulator 1 (FMR1) gene. The number of repeats was 83. We finally diagnosed the patient with FXTAS rather than NIID. Conclusions For the differential diagnosis of FXTAS and NIID, a skin biopsy alone is insufficient; instead, genetic analysis, is essential. Further investigations in additional cases based on genetic analysis are needed to elucidate the clinical and pathological differences between FXTAS and NIID.
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Affiliation(s)
- Megumi Toko
- Department of Neurology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan.,Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Tomohiko Ohshita
- Department of Neurology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan. .,Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Takashi Kurashige
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Caner Center, 3-1 Aoyama-cho, Kure, Hiroshima, 737-0023, Japan
| | - Hiroyuki Morino
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Kodai Kume
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.,Department of Supportive and Promotive Medicine of the Municipal Hospital, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Hiroshi Yamashita
- Department of Neurology, Hiroshima City Asa Citizens Hospital, 2-1-1, Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Gen Sobue
- Aichi Medical University, Nagakute, Aichi, Japan
| | - Yasushi Iwasaki
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan
| | - Jun Sone
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.,Department of Neurology, National Hospital Organization Suzuka National Hospital, 3-2-1, Kasado, Suzuka, Mie, 513-8501, Japan
| | - Hideshi Kawakami
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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12
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Neshige S, Ono N, Iryo T, Watanabe T, Yamada H, Mine N, Takebayashi Y, Kikumoto M, Toko M, Maruyama H. Nationwide online EEG education during coronavirus disease 2019 pandemic. Clin Neurophysiol 2021; 132:2763-2765. [PMID: 34583118 PMCID: PMC8416360 DOI: 10.1016/j.clinph.2021.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Shuichiro Neshige
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan; Epilepsy Center, Hiroshima University Hospital, Japan.
| | - Narumi Ono
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Takafumi Iryo
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Tomoaki Watanabe
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Naoko Mine
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Yoshiko Takebayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Mai Kikumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan; Epilepsy Center, Hiroshima University Hospital, Japan
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13
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Kikumoto M, Nezu T, Shiga Y, Motoda A, Toko M, Kurashige T, Ueno H, Takahashi T, Morino H, Sone J, Iwasaki Y, Sobue G, Maruyama H. Case of Neuronal Intranuclear Inclusion Disease With Dynamic Perfusion Changes Lacking Typical Signs on Diffusion-Weighted Imaging. Neurol Genet 2021; 7:e601. [PMID: 34131587 PMCID: PMC8195458 DOI: 10.1212/nxg.0000000000000601] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/13/2021] [Indexed: 11/21/2022]
Affiliation(s)
- Mai Kikumoto
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Yuji Shiga
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Atsuko Motoda
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Takashi Kurashige
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Hiroyuki Morino
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Jun Sone
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Yasushi Iwasaki
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Gen Sobue
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics (M.K., T.N., Y. Shiga, A.M., M.T., T.K., H.U., T.T., H. Morino, H. Maruyama), Hiroshima University Graduate School of Biomedical and Health Sciences; Department of Neurology (T.K.), National Hospital Organization Kure Medical Center and Chugoku Cancer Center; Division of Rehabilitation (T.T.), Hiroshima International University; Department of Neurology (J.S.), National Hospital Organization Suzuka National Hospital; Institute for Medical Science of Aging (J.S., Y.I.), Aichi Medical University, Nagakute; and Department of Neurology (G.S.), Nagoya University Graduate School of Medicine, Japan
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Toko M, Kitamura J, Ueno H, Ohshita T, Nemoto K, Ochi K, Higaki T, Akiyama Y, Awai K, Maruyama H. Prospective Memory Deficits in Multiple Sclerosis: Voxel-based Morphometry and Double Inversion Recovery Analysis. Intern Med 2021; 60:39-46. [PMID: 33390470 PMCID: PMC7835463 DOI: 10.2169/internalmedicine.5058-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective Prospective memory (PM) is an important social cognitive function in everyday life. PM is one of the most affected cognitive domains in multiple sclerosis (MS) patients. Gray matter (GM) atrophy and plaques have been attracting attention for various cognitive impairments in MS patients. This study aimed to clarify the atrophic GM regions associated with PM deficits and investigate the relationship between the atrophic GM regions and GM plaques. Methods Twenty-one MS patients and 10 healthy controls (HCs) underwent neuropsychological tests and MRI. PM was assessed using subtests of the Rivermead Behavioural Memory Test. A lesion symptom analysis was performed using voxel-based morphometry (VBM). We then evaluated GM plaques in the corresponding areas using double inversion recovery (DIR). Results MS patients showed lower PM scores than HCs (p=0.0064). The GM volume of MS patients tended to be lower than those of HCs. VBM analyses revealed correlations of the PM score with the orbital part of the left inferior frontal gyrus, the left hippocampus, and the right parahippocampus. There was no GM plaque in the orbital part of the left inferior frontal gyrus and the right parahippocampus. Only one patient (4.8%) had GM plaque in the left hippocampus. Conclusion The left inferior frontal gyrus, the left hippocampus, and the right parahippocampus were associated with PM in MS, whereas these atrophic GM regions were not associated with GM plaque. Regardless of the location of plaques on DIR, both PM deficit and GM atrophy should be detected using neuropsychological tests and VBM in MS patients.
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Affiliation(s)
- Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Juri Kitamura
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
- Department of Neurology, National Hospital Organization Higashihiroshima Medical Center, Japan
| | - Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Tomohiko Ohshita
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Kazuhide Ochi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
- Department of Neurology, Hiroshima City Asa Citizens Hospital, Japan
| | - Toru Higaki
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Yuji Akiyama
- Department of Clinical Radiology, Hiroshima University Hospital, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
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15
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Kurashige T, Morino H, Matsuda Y, Mukai T, Murao T, Toko M, Kume K, Ohsawa R, Torii T, Tokinobu H, Maruyama H, Kawakami H. Retinitis pigmentosa prior to familial ALS caused by a homozygous cilia and flagella-associated protein 410 mutation. J Neurol Neurosurg Psychiatry 2020; 91:220-222. [PMID: 31431468 DOI: 10.1136/jnnp-2019-321279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/25/2019] [Accepted: 08/11/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Takashi Kurashige
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan .,Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroyuki Morino
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yukiko Matsuda
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Tomoya Mukai
- Department of Neurology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Tomomi Murao
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kodai Kume
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Ohsawa
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Torii
- Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Hiroshi Tokinobu
- Department of Neurology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hideshi Kawakami
- Department of Epidemiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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16
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Toko M, Oiwa H, Mihara S, Sugiyama E. Biopsy of the temporal artery in a patient with giant cell arteritis. Intern Med 2013; 52:2165. [PMID: 24042537 DOI: 10.2169/internalmedicine.52.0884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Megumi Toko
- Department of Rheumatology, Hiroshima City Hospital, Japan
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Abstract
In the ets gene family of transcription factors, ELK1 belongs to the subfamily of Ternary Complex Factors (TCFs) which bind to the Serum Response Element (SRE) in conjunction with a dimer of Serum Response Factors (SRFs). The primary structure of the human Elk1 gene was determined by genomic cloning. The gene structure of Elk1 spans 15.2 kb and consists of seven exons and six introns. The coding sequence resides on exons 3, 4, 5, 6 and 7. Sequencing of cDNA clones isolated from human hippocampus library revealed that the second exon was often skipped by an alternative splicing event. All introns commenced with nucleotides GT at the 5' boundary and ended with nucleotides AG at the 3' boundary, in agreement with the proposed consensus sequence for intron spliced donor and acceptance sites. Sequence inspection of the 5'-flanking region revealed the absence of a 'TATA' box and the presence of putative cis-acting regulatory elements such as Sp1, GATA-1, CCAAT, and c-Myb. Moreover, the sequence analysis of Elk2 locus on 14q32.3 confirmed that Elk2 gene corresponds to a processed pseudogene of Elk1 which has been reported between alpha 1 gene (IGHA1) and pseudo gamma gene (IGHGP) of immunoglobulin heavy chain. Furthermore, the results of Southern analysis using DNAs from human-mouse hybrid cell lines carrying a part of 14q32 region revealed that there is another locus hybridizing to Elk1 cDNA on 14q32.2 --> qter region in addition to Elk2 locus between IGHA1 and IGHGP loci.
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Affiliation(s)
- T Yamauchi
- Department of Materials and Biosystem Engineering, Faculty of Engineering, Toyama University, Toyama-city, Japan
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