1
|
Chen WT, Wang XX, Zheng WL, Zhang WQ, Mao LJ, Zhuo JN, Zhou ST, Yang RH. [Exploring the causality between intestinal flora and hyperplastic scars of human based on two-sample Mendelian randomization analysis]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:333-341. [PMID: 38664027 DOI: 10.3760/cma.j.cn501225-20231129-00215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Objective: To investigate the causality between intestinal flora and hypertrophic scars (HS) of human. Methods: This study was a study based on two-sample Mendelian randomization (TSMR) analysis. The data on intestinal flora (n=18 473) and HS (n=208 248) of human were obtained from the genome-wide association study database. Genetically variable genes at five levels (phylum, class, order, family, and genus) of known intestinal flora, i.e., single nucleotide polymorphisms (SNPs), were extracted as instrumental variables for linkage disequilibrium (LD) analysis. Human genotype-phenotype association analysis was performed using PhenoScanner V2 database to exclude SNPs unrelated to HS in intestinal flora and analyze whether the selected SNPs were weak instrumental variables. The causal relationship between intestinal flora SNPs and HS was analyzed through four methods of TSMR analysis, namely inverse variance weighted (IVW), MR-Egger regression, weighted median, and weighted mode. Scatter plots of significant results from the four aforementioned analysis methods were plotted to analyze the correlation between intestinal flora SNPs and HS. Both IVW test and MR-Egger regression test were used to assess the heterogeneity of intestinal flora SNPs, MR-Egger regression test and MR-PRESSO outlier test were used to assess the horizontal multiplicity of intestinal flora SNPs, and leave-one-out sensitivity analysis was used to determine whether HS was caused by a single SNP in the intestinal flora. Reverse TSMR analyses were performed for HS SNPs and genus Intestinimonas or genus Ruminococcus2, respectively, to detect whether there was reverse causality between them. Results: A total of 196 known intestinal flora, belonging to 9 phyla, 16 classes, 20 orders, 32 families, and 119 genera, were obtained, and multiple SNPs were obtained from each flora as instrumental variables. LD analysis showed that the SNPs of the intestinal flora were consistent with the hypothesis that genetic variation was strongly associated with exposure factors, except for rs1000888, rs12566247, and rs994794. Human genotype-phenotype association analysis showed that none of the selected SNPs after LD analysis was excluded and there were no weak instrumental variables. IVW, MR-Egger regression, weighted median, and weighted mode of TSMR analysis showed that both genus Intestinimonas and genus Ruminococcus2 were causally associated with HS. Among them, forest plots of IVW and MR-Egger regression analyses also showed that 16 SNPs (the same SNPs number of this genus below) of genus Intestinimonas and 15 SNPs (the same SNPs number of this genus below) of genus Ruminococcus2 were protective factors for HS. Further, IVW analysis showed that genus Intestinimonas SNPs (with odds ratio of 0.62, 95% confidence interval of 0.41-0.93, P<0.05) and genus Ruminococcus2 SNPs (with odds ratio of 0.62, 95% confidence interval of 0.40-0.97, P<0.05) were negatively correlated with the risk of HS. Scatter plots showed that SNPs of genus Intestinimonas and genus Ruminococcus2 were protective factors of HS. Both IVW test and MR-Egger regression test showed that SNPs of genus Intestinimonas (with Q values of 5.73 and 5.76, respectively, P>0.05) and genus Ruminococcus2 (with Q values of 13.67 and 15.61, respectively, P>0.05) were not heterogeneous. MR-Egger regression test showed that the SNPs of genus Intestinimonas and genus Ruminococcus2 had no horizontal multiplicity (with intercepts of 0.01 and 0.06, respectively, P>0.05); MR-PRESSO outlier test showed that the SNPs of genus Intestinimonas and genus Ruminococcus2 had no horizontal multiplicity (P>0.05). Leave-one-out sensitivity analysis showed that no single intestinal flora SNP drove the occurrence of HS. Reverse TSMR analysis showed no reverse causality between HS SNPs and genus Intestinimonas or genus Ruminococcus2 (with odds ratios of 1.01 and 0.99, respectively, 95% confidence intervals of 0.97-1.06 and 0.96-1.04, respectively, P>0.05). Conclusions: There is a causal relationship between intestinal flora and HS of human, in which genus Intestinimonas and genus Ruminococcus2 have a certain effect on inhibiting HS.
Collapse
Affiliation(s)
- W T Chen
- The First Clinical College of Medicine, Guangdong Medical University, Zhanjiang 524023, China
| | - X X Wang
- Department of Burn Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510030, China
| | - W L Zheng
- Department of Burn and Plastic Surgery, the First People's Hospital of Shaoguan, Shaoguan 512000, China
| | - W Q Zhang
- The First Clinical College of Medicine, Guangdong Medical University, Zhanjiang 524023, China
| | - L J Mao
- Department of Burn Plastic Surgery and Wound Repair, Guangzhou First People's Hospital, Guangzhou 510180, China
| | - J N Zhuo
- The First Clinical College of Medicine, Guangdong Medical University, Zhanjiang 524023, China
| | - S T Zhou
- Dermatology Department, Foshan First People's Hospital, Foshan 528000, China
| | - R H Yang
- The First Clinical College of Medicine, Guangdong Medical University, Zhanjiang 524023, China Department of Burn Plastic Surgery and Wound Repair, Guangzhou First People's Hospital, Guangzhou 510180, China
| |
Collapse
|
2
|
Chen WT, Hsieh CY, Liu YH, Cheong PL, Wang YM, Sun CW. Author Correction: Migraine classification by machine learning with functional near-infrared spectroscopy during the mental arithmetic task. Sci Rep 2024; 14:6065. [PMID: 38480737 PMCID: PMC10937707 DOI: 10.1038/s41598-024-56279-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Wei-Ta Chen
- Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, No. 268, Xin 2nd Rd., Xinyi Dist, Keelung, 20148, Taiwan, ROC
- Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec.2, Shipai Rd., Beitou Dist, Taipei, 112201, Taiwan, ROC
| | - Cing-Yan Hsieh
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
| | - Yao-Hong Liu
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
| | - Pou-Leng Cheong
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
- Department of Pediatrics, National Taiwan University Hospital, Hisnchu Branch, No. 25, Ln. 442, Sec.1, Jingguo Rd., North Dist, Hsinchu, 30059, Taiwan, ROC
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Min Wang
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
| | - Chia-Wei Sun
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC.
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC.
- Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112304, Taiwan, ROC.
| |
Collapse
|
3
|
Chen WT, Hsiao FJ, Coppola G, Wang SJ. Decoding pain through facial expressions: a study of patients with migraine. J Headache Pain 2024; 25:33. [PMID: 38462615 PMCID: PMC10926654 DOI: 10.1186/s10194-024-01742-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The present study used the Facial Action Coding System (FACS) to analyse changes in facial activities in individuals with migraine during resting conditions to determine the potential of facial expressions to convey information about pain during headache episodes. METHODS Facial activity was recorded in calm and resting conditions by using a camera for both healthy controls (HC) and patients with episodic migraine (EM) and chronic migraine (CM). The FACS was employed to analyse the collected facial images, and intensity scores for each of the 20 action units (AUs) representing expressions were generated. The groups and headache pain conditions were then examined for each AU. RESULTS The study involved 304 participants, that is, 46 HCs, 174 patients with EM, and 84 patients with CM. Elevated headache pain levels were associated with increased lid tightener activity and reduced mouth stretch. In the CM group, moderate to severe headache attacks exhibited decreased activation in the mouth stretch, alongside increased activation in the lid tightener, nose wrinkle, and cheek raiser, compared to mild headache attacks (all corrected p < 0.05). Notably, lid tightener activation was positively correlated with the Numeric Rating Scale (NRS) level of headache (p = 0.012). Moreover, the lip corner depressor was identified to be indicative of emotional depression severity (p < 0.001). CONCLUSION Facial expressions, particularly lid tightener actions, served as inherent indicators of headache intensity in individuals with migraine, even during resting conditions. This indicates that the proposed approach holds promise for providing a subjective evaluation of headaches, offering the benefits of real-time assessment and convenience for patients with migraine.
Collapse
Affiliation(s)
- Wei-Ta Chen
- Brain Research Center, National Yang Ming Chiao Tung University, 155, Linong Street Sec 2, Taipei, 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, 155, Linong Street Sec 2, Taipei, 112, Taiwan.
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, 155, Linong Street Sec 2, Taipei, 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
4
|
Wang YF, Tzeng YS, Yu CC, Ling YH, Chen SP, Lai KL, Chen WT, Wang SJ. Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache. J Headache Pain 2023; 24:145. [PMID: 37907887 PMCID: PMC10619252 DOI: 10.1186/s10194-023-01685-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE The present study aimed to compare sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache (MOH). METHODS Consecutive patients with newly diagnosed chronic migraine (CM) with and without MOH based on the Third Edition of International Classification of Headache Disorders (ICHD-3) were enrolled prospectively from the headache clinic of a tertiary medical center. Demographics and clinical profiles were collected by using a questionnaire, which included current use of tobacco, alcohol, and caffeinated beverages, the Leeds Dependence Questionnaire (LDQ), the Severity of Dependence Scale (SDS), the Headache Impact Test-6 (HIT-6), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS In total, 1419 CM patients (1135F/284 M, mean age 41.7 ± 13.9 years) were recruited, including 799 with MOH (640F/159 M, mean age 42.5 ± 13.2 years) (56.3%). Smoking was associated with an increased risk for MOH in men (odds ratio [OR] = 3.60 [95% confidence interval = 1.73-7.50], p = 0.001), but not in women (OR = 1.34 [0.88-2.04], p = 0.171) (p = 0.021 for interaction). Hypnotic use ≥ 3 days/week was a risk factor for MOH (OR = 2.55 [95% confidence interval = 2.00-3.24], p < 0.001), regardless of sex. By using receiver operating characteristics (ROC) curves, the cutoff scores of the LDQ for MOH were determined at 7 for women and 6 for men, and those for the SDS were 5 and 4, respectively (area under curve all ≥ 0.83). Among patients with MOH, the male sex was associated with a shorter latency between migraine onset and CM onset (12.9 ± 11.1 vs. 15.4 ± 11.5 years, p = 0.008), despite less average headache intensity (6.7 ± 1.9 vs. 7.2 ± 1.9, p = 0.005), functional impacts (HIT-6: 63.4 ± 8.3 vs. 65.1 ± 8.0, p = 0.009), and sleep disturbances (PSQI: 10.9 ± 4.4 vs. 12.2 ± 4.3, p = 0.001). CONCLUSIONS The current study identified an association between smoking and MOH in men, as well as sex-specific cutoffs of the LDQ and the SDS, for MOH. MOH was characterized by a shorter latency between migraine onset and CM onset in men and a more severe phenotype in women. Sex should be considered as an important factor in the evaluation of MOH.
Collapse
Grants
- 109-2314-B-075 -054 and 110-2314-B-075 -041 -MY3 Taiwan National Science and Technology Council
- 104-2314-B-010-015-MY2, 106-2321-B-010-009, 107-2321-B-010-001, 108-2321-B-010-014 -MY2, 108-2321-B-010 001, 108-2314-B-010-023-MY3, and 110-2321-B-010-005 Taiwan National Science and Technology Council
- V108C-092, V109C-096, V110C-111, V111C-161, V112C-078, and V112D67-003-MY3-1 Taipei Veterans General Hospital
Collapse
Affiliation(s)
- Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan.
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yi-Shiang Tzeng
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
| | - Chia-Chun Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
| | - Yu-Hsiang Ling
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Ministry of Health and Welfare Keelung Hospital, Keelung, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan.
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
5
|
Hsiao FJ, Chen WT, Wu YT, Pan LLH, Wang YF, Chen SP, Lai KL, Coppola G, Wang SJ. Characteristic oscillatory brain networks for predicting patients with chronic migraine. J Headache Pain 2023; 24:139. [PMID: 37848845 PMCID: PMC10583316 DOI: 10.1186/s10194-023-01677-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
To determine specific resting-state network patterns underlying alterations in chronic migraine, we employed oscillatory connectivity and machine learning techniques to distinguish patients with chronic migraine from healthy controls and patients with other pain disorders. This cross-sectional study included 350 participants (70 healthy controls, 100 patients with chronic migraine, 40 patients with chronic migraine with comorbid fibromyalgia, 35 patients with fibromyalgia, 30 patients with chronic tension-type headache, and 75 patients with episodic migraine). We collected resting-state magnetoencephalographic data for analysis. Source-based oscillatory connectivity within each network, including the pain-related network, default mode network, sensorimotor network, visual network, and insula to default mode network, was examined to determine intrinsic connectivity across a frequency range of 1-40 Hz. Features were extracted to establish and validate classification models constructed using machine learning algorithms. The findings indicated that oscillatory connectivity revealed brain network abnormalities in patients with chronic migraine compared with healthy controls, and that oscillatory connectivity exhibited distinct patterns between various pain disorders. After the incorporation of network features, the best classification model demonstrated excellent performance in distinguishing patients with chronic migraine from healthy controls, achieving high accuracy on both training and testing datasets (accuracy > 92.6% and area under the curve > 0.93). Moreover, in validation tests, classification models exhibited high accuracy in discriminating patients with chronic migraine from all other groups of patients (accuracy > 75.7% and area under the curve > 0.8). In conclusion, oscillatory synchrony within the pain-related network and default mode network corresponded to altered neurophysiological processes in patients with chronic migraine. Thus, these networks can serve as pivotal signatures in the model for identifying patients with chronic migraine, providing reliable and generalisable results. This approach may facilitate the objective and individualised diagnosis of migraine.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wei-Ta Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, 11217, Taiwan
- Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Yu-Te Wu
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, 11217, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, 11217, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, 11217, Taiwan
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, 11217, Taiwan.
| |
Collapse
|
6
|
Chuang CH, Li JY, King JT, Chen WT, Chen SP, Wang YF, Liu HY, Hsiao FJ, Pan LLH, Wang SJ, Lai KL. Abnormal heart rate variability and its application in predicting treatment efficacy in patients with chronic migraine: An exploratory study. Cephalalgia 2023; 43:3331024231206781. [PMID: 37851663 DOI: 10.1177/03331024231206781] [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] [Indexed: 10/20/2023]
Abstract
AIM This study aimed to investigate the extent of autonomic nervous system dysfunction in patients with chronic migraine using heart rate variability analysis. In addition, we explored the potential association between heart rate variability and treatment outcomes in patients receiving preventive treatment. METHODS In this cross-sectional and prospective study, we compared heart rate variability profiles in 81 preventive-naïve chronic migraine patients and 58 healthy controls. In addition, treatment responses of patients, who received a 12-week treatment with flunarizine, were assessed in relation to baseline heart rate variability. RESULTS We observed that chronic migraine patients had a reduced heart rate variability, signifying autonomic dysfunction in comparison to healthy controls. Furthermore, patients presenting normal heart rate variability, characterized by a standard deviation exceeding 30 milliseconds in normal-to-normal RR intervals, experienced a superior response to flunarizine treatment. This improvement was exemplified by a significantly larger reduction in monthly headache days for patients with higher heart rate variability compared to those with lower heart rate variability: -9.7 (5.9) vs. -6.2 (6.0) days (p = .026). CONCLUSIONS Autonomic dysfunction occurs in chronic migraine as evaluated by heart rate variability. A preserved function is associated with a better treatment outcome to flunarizine.Trial registration: Neurologic Signatures of Chronic Pain Disorders, NCT02747940. Registered 22 April 2016, https://clinicaltrials.gov/ct2/show/NCT02747940.
Collapse
Affiliation(s)
- Chun-Hsiang Chuang
- Research Center for Education and Mind Sciences, College of Education, National Tsing Hua University, Hsinchu, Taiwan
- Institute of Information Systems and Applications, College of Electrical Engineering and Computer Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Jhe-Yu Li
- Research Center for Education and Mind Sciences, College of Education, National Tsing Hua University, Hsinchu, Taiwan
- Department of Computer Science and Engineering, National Taiwan Ocean University, Keelung, Taiwan
| | - Jung-Tai King
- College of Hua-Shih College of Education, National Dong Hwa University, Hualien, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Yu Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
7
|
Puledda F, Viganò A, Sebastianelli G, Parisi V, Hsiao FJ, Wang SJ, Chen WT, Massimini M, Coppola G. Electrophysiological findings in migraine may reflect abnormal synaptic plasticity mechanisms: A narrative review. Cephalalgia 2023; 43:3331024231195780. [PMID: 37622421 DOI: 10.1177/03331024231195780] [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] [Indexed: 08/26/2023]
Abstract
BACKGROUND The cyclical brain disorder of sensory processing accompanying migraine phases lacks an explanatory unified theory. METHODS We searched Pubmed for non-invasive neurophysiological studies on migraine and related conditions using transcranial magnetic stimulation, electroencephalography, visual and somatosensory evoked potentials. We summarized the literature, reviewed methods, and proposed a unified theory for the pathophysiology of electrophysiological abnormalities underlying migraine recurrence. RESULTS All electrophysiological modalities have determined specific changes in brain dynamics across the different phases of the migraine cycle. Transcranial magnetic stimulation studies show unbalanced recruitment of inhibitory and excitatory circuits, more consistently in aura, which ultimately results in a substantially distorted response to neuromodulation protocols. Electroencephalography investigations highlight a steady pattern of reduced alpha and increased slow rhythms, largely located in posterior brain regions, which tends to normalize closer to the attacks. Finally, non-painful evoked potentials suggest dysfunctions in habituation mechanisms of sensory cortices that revert during ictal phases. CONCLUSION Electrophysiology shows dynamic and recurrent functional alterations within the brainstem-thalamus-cortex loop varies continuously and recurrently in migraineurs. Given the central role of these structures in the selection, elaboration, and learning of sensory information, these functional alterations suggest chronic, probably genetically determined dysfunctions of the synaptic short- and long-term learning mechanisms.
Collapse
Affiliation(s)
- Francesca Puledda
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Gabriele Sebastianelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
| | | | - Fu-Jung Hsiao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy
| |
Collapse
|
8
|
Liu HY, Lee PL, Chou KH, Wang YF, Chen SP, Lai KL, Pan LL, Lin CP, Wang SJ, Chen WT. Brain morphometry changes with fatigue severity in fibromyalgia. Clin Exp Rheumatol 2023; 41:1230-1237. [PMID: 36067237 DOI: 10.55563/clinexprheumatol/zviutu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES This study investigated brain morphometry changes associated with fatigue severity in fibromyalgia (FM). METHODS Clinical profiles and brain-MRI data were collected in patients with FM. Patients were divided into three groups based on their fatigue severity. Using voxel-based morphometry analysis and trend analysis, neural substrates showing volumetric changes associated with fatigue severity across the three groups were identified. Their seed-to-voxel structural covariance (SC) networks with the whole brain were studied in distribution and strength. RESULTS Among the 138 enrolled patients with FM, 23, 57, and 58 were categorised into the mild, moderate, and severe fatigue groups, respectively. The number of musculoskeletal pain regions and intensity of pain were not associated with fatigue severity, but somatic symptoms and psychiatric distress, including waking unrefreshed, depression, and anxiety, were associated with fatigue severity. After adjusting for anxiety and depression, decreased bilateral thalamic volumes were associated with higher fatigue severity. The SC distributions of the thalamic seed were more widespread to the frontal, parietal, subcortical, and limbic regions in patients with higher fatigue severity. In addition, increased right inferior temporal cortex volumes were associated with higher fatigue severity. The SC distributions of the right inferior temporal seed were more over the temporal cortex and the SC strengths of the seed were higher with the bilateral occipital cortex in patients with higher fatigue severity. CONCLUSIONS The thalamus and the right inferior temporal cortex are implicated in the manifestation of fatigue severity in FM. Future therapeutic strategies targeting these regions are worthy of investigation.
Collapse
Affiliation(s)
- Hung-Yu Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, and School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Lin Lee
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, and Brain Research Centre, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, and School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital; School of Medicine, National Yang Ming Chiao Tung University, Taipei; Brain Research Centre, National Yang Ming Chiao Tung University, Taipei, and Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, and School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Ling Pan
- Brain Research Centre, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital; School of Medicine, National Yang Ming Chiao Tung University, Taipei, and Brain Research Centre, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital; School of Medicine, National Yang Ming Chiao Tung University, Taipei; Brain Research Centre, National Yang Ming Chiao Tung University, Taipei, and Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Taiwan.
| |
Collapse
|
9
|
Hsiao FJ, Chen WT, Wang YF, Chen SP, Lai KL, Coppola G, Wang SJ. Identification of patients with chronic migraine by using sensory-evoked oscillations from the electroencephalogram classifier. Cephalalgia 2023; 43:3331024231176074. [PMID: 37194198 DOI: 10.1177/03331024231176074] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND To examine whether the modulating evoked cortical oscillations could be brain signatures among patients with chronic migraine, we investigated cortical modulation using an electroencephalogram with machine learning techniques. METHODS We directly record evoked electroencephalogram activity during nonpainful, painful, and repetitive painful electrical stimulation tasks. Cortical modulation for experimental pain and habituation processing was analyzed and used to differentiate patients with chronic migraine from healthy controls using a validated machine-learning model. RESULTS This study included 80 participants: 40 healthy controls and 40 patients with chronic migraine. Evoked somatosensory oscillations were dominant in the alpha band. Longer latency (nonpainful and repetitive painful) and augmented power (nonpainful and repetitive painful) were present among patients with chronic migraine. However, for painful tasks, alpha increases were observed among healthy controls. The oscillatory activity ratios between repetitive painful and painful tasks represented the frequency modulation and power habituation among healthy controls, respectively, but not among patients with chronic migraine. The classification models with oscillatory features exhibited high performance in differentiating patients with chronic migraine from healthy controls. CONCLUSION Altered oscillatory characteristics of sensory processing and cortical modulation reflected the neuropathology of patients with chronic migraine. These characteristics can be reliably used to identify patients with chronic migraine using a machine-learning approach.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
10
|
Tsao YC, Wang YF, Fuh JL, Chen WT, Lai KL, Liu HY, Wang SJ, Chen SP. Transient visual disturbances are associated with disability and suicide risk in patients with migraine without aura. J Chin Med Assoc 2023:02118582-990000000-00190. [PMID: 36907842 DOI: 10.1097/jcma.0000000000000912] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND To investigate the characteristics and clinical correlates of transient visual disturbances (TVDs) in patients with migraine without aura (MO). Patients with MO frequently report TVDs, which differ from typical visual aura, but the clinical significance of these TVDs has not been determined. METHODS Patients with MO who attended our headache clinics were enrolled. Structured questionnaires were used to acquire data on participants' headache profiles, disability, comorbidities, and lifetime suicidal ideation and suicide attempts. A semi-structured visual phenomenon questionnaire was used to characterize TVDs. Headache specialists interviewed the participants for diagnosis and the verification of questionnaire responses. RESULTS Patients with MO (n = 7,200; female/male ratio = 3.56, mean age 40.1 ± 13.4 years) were divided into two groups based on the presence (n = 2,488) or absence (n = 4,712) of TVDs. Patients with TVDs had more headache-related disability, psychiatric comorbidities, and photophobia than did those without TVDs. Suicidal ideation and suicide attempts were more common among patients with than among those without TVDs [ideation: odds ratio (OR) = 1.92, 95% confidence interval (CI) 1.71-2.15, p < 0.001; suicide attempt: OR = 2.23, 95% CI 1.80-2.75, p < 0.001]. CONCLUSION The presence of TVDs may imply greater migraine-related disability, photophobia, and suicidal ideation/suicide attempt risk in patients with MO.
Collapse
Affiliation(s)
- Yu-Chien Tsao
- Keelung Hospital of the Ministry of Health and Welfare, Keelung, Taiwan, ROC
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yen-Feng Wang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jong-Ling Fuh
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wei-Ta Chen
- Keelung Hospital of the Ministry of Health and Welfare, Keelung, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kuan-Lin Lai
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hung-Yu Liu
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shuu-Jiun Wang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shih-Pin Chen
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| |
Collapse
|
11
|
Lin PT, Wang YF, Hseu SS, Fuh JL, Lirng JF, Wu JW, Chen ST, Chen SP, Chen WT, Wang SJ. The SIH-EBP Score: A grading scale to predict the response to the first epidural blood patch in spontaneous intracranial hypotension. Cephalalgia 2023; 43:3331024221147488. [PMID: 36786320 DOI: 10.1177/03331024221147488] [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] [Indexed: 02/15/2023]
Abstract
BACKGROUND To develop and validate an easy-to-use scoring system to predict the response to the first epidural blood patching in patients with spontaneous intracranial hypotension. METHODS This study recruited consecutive patients with spontaneous intracranial hypotension receiving epidural blood patching in a tertiary medical center, which were chronologically divided into a derivation cohort and a validation cohort. In the derivation cohort, factors associated with the first epidural blood patching response were identified by using multivariable logistic regression modeling. A scoring system was developed, and the cutoff score was determined by using the receiver operating characteristic curve. The findings were verified in an independent validation cohort. RESULTS The study involved 280 patients in the derivation cohort and 78 patients in the validation cohort. The spontaneous intracranial hypotension-epidural blood patching score (range 0-5) included two clinical variables (sex and age) and two radiological variables (midbrain-pons angle and anterior epidural cerebrospinal fluid collections). A score of ≥3 was predictive of the first epidural blood patching response, which was consistent in the validation cohort. Overall, patients who scored ≥3 were more likely to respond to the first epidural blood patching (odds ratio = 10.3). CONCLUSION For patients with spontaneous intracranial hypotension-epidural blood patching score ≥3, it is prudent to attempt at least one targeted epidural blood patching before considering more invasive interventions.
Collapse
Affiliation(s)
- Po-Tso Lin
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Shya Hseu
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Anaesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jiing-Feng Lirng
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jr-Wei Wu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Ting Chen
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Ministry of Health and Welfare Keelung Hospital, Keelung, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
12
|
Wu JW, Chen ST, Wang YF, Lai KL, Chen TY, Chen SP, Chen WT, Wang SJ. Sphenopalatine ganglion volumetry in episodic cluster headache: from symptom laterality to cranial autonomic symptoms. J Headache Pain 2023; 24:2. [PMID: 36597044 PMCID: PMC9809027 DOI: 10.1186/s10194-022-01534-5] [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: 10/31/2022] [Accepted: 12/09/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Sphenopalatine ganglion (SPG) is a peripheral structure that plays an important role in cluster headache (CH). Hence, a reliable method to measure the volume of SPG is crucial for studying the peripheral mechanism of CH. Additionally, the association between the clinical profiles and the morphology of the SPG in CH remains undetermined. This study aims to use the manual measurement of SPG volume to investigate its associations with CH, including headache laterality, cranial autonomic symptoms (CASs), presence of restlessness or agitation, and other clinical profiles. METHODS We prospectively recruited consecutive CH patients at a tertiary medical center between April 2020 and April 2022. A total of eighty side-locked, in-bout, episodic CH patients and 40 non-headache healthy controls received 1.5 T brain MRI focusing on structural neuroimaging of the SPG. The manual measurement process for SPG was under axial and sagittal FIESTA imaging, with reference T2 weight images (sagittal and axial) for localization. The inter-observer agreement of the SPG volume (both sides of the SPG from CH patients and controls) between the two observers was calculated. In CH patients, clinical profiles and the number of CASs (range 0-5) were recorded to analyze their association with SPG volume. RESULTS The inter-observer agreement between the two raters was excellent for the new SPG volumetry method at 0.88 (95% CI: 0.84-0.90, p < 0.001). The mean [SD] SPG volume was larger in CH patients than in non-headache controls (35.89 [12.94] vs. 26.13 [8.62] μL, p < 0.001). In CH patients, the SPG volume was larger on the pain side than on the non-pain side (38.87 [14.71] vs. 32.91 [12.70] μL, p < 0.001). The number of CASs was positively moderately correlated with the pain-side SPG volume (Pearson r = 0.320, p = 0.004) but not the non-pain side SPG volume (Pearson r = 0.207, p = 0.066). CONCLUSIONS This proof-of-concept study successfully measured the SPG volume and demonstrated its associations with symptomatology in patients with episodic CH. The direct measurement of SPG provide insights into studies on peripheral mechanism of CH.
Collapse
Affiliation(s)
- Jr-Wei Wu
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, 11217 Taiwan ,grid.278247.c0000 0004 0604 5314Center for Quality Management, Taipei Veterans General Hospital, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Ting Chen
- grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, 11217 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Lin Lai
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, 11217 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ting-Yi Chen
- grid.278247.c0000 0004 0604 5314Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, 11217 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ta Chen
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, 11217 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.454740.6Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Shuu-Jiun Wang
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Rd, Taipei, 11217 Taiwan ,grid.260539.b0000 0001 2059 7017College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
13
|
Hsiao FJ, Chen WT, Pan LLH, Liu HY, Wang YF, Chen SP, Lai KL, Coppola G, Wang SJ. Resting-state magnetoencephalographic oscillatory connectivity to identify patients with chronic migraine using machine learning. J Headache Pain 2022; 23:130. [PMID: 36192689 PMCID: PMC9531441 DOI: 10.1186/s10194-022-01500-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 07/26/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
To identify and validate the neural signatures of resting-state oscillatory connectivity for chronic migraine (CM), we used machine learning techniques to classify patients with CM from healthy controls (HC) and patients with other pain disorders. The cross-sectional study obtained resting-state magnetoencephalographic data from 240 participants (70 HC, 100 CM, 35 episodic migraine [EM], and 35 fibromyalgia [FM]). Source-based oscillatory connectivity of relevant cortical regions was calculated to determine intrinsic connectivity at 1–40 Hz. A classification model that employed a support vector machine was developed using the magnetoencephalographic data to assess the reliability and generalizability of CM identification. In the findings, the discriminative features that differentiate CM from HC were principally observed from the functional interactions between salience, sensorimotor, and part of the default mode networks. The classification model with these features exhibited excellent performance in distinguishing patients with CM from HC (accuracy ≥ 86.8%, area under the curve (AUC) ≥ 0.9) and from those with EM (accuracy: 94.5%, AUC: 0.96). The model also achieved high performance (accuracy: 89.1%, AUC: 0.91) in classifying CM from other pain disorders (FM in this study). These resting-state magnetoencephalographic electrophysiological features yield oscillatory connectivity to identify patients with CM from those with a different type of migraine and pain disorder, with adequate reliability and generalizability.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wei-Ta Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, Taiwan, 11217. .,Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, Taiwan, 11217
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, Taiwan, 11217
| | - Shih-Pin Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, Taiwan, 11217
| | - Kuan-Lin Lai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, Taiwan, 11217
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shih Pai Rd Sec 2, Taipei, Taiwan, 11217
| |
Collapse
|
14
|
Tsao YC, Wang YF, Fuh JL, Chen WT, Lai KL, Liu HY, Wang SJ, Chen SP. Non-aura visual disturbance with high visual aura rating scale scores has stronger association with migraine chronification than typical aura. Cephalalgia 2022; 42:1487-1497. [PMID: 36068697 DOI: 10.1177/03331024221123074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate the clinical correlates of visual symptoms in patients with migraine. METHOD Patients with migraine that attended our headache clinics were enrolled. Headache profiles, disability, and comorbidities were acquired with structured questionnaires. A semi-structured visual phenomenon questionnaire was also used to assess the characteristics of visual symptoms, including visual aura in patients with migraine with aura and transient visual disturbance in patients with migraine without aura. Headache specialists interviewed with the participants for the ascertainment of diagnosis and verification of the questionnaires. RESULT Migraine with aura patients with visual aura (n = 743, female/male = 2.3, mean age: 34.7 ± 12.2 years) and migraine without aura patients with non-aura transient visual disturbance (n = 1,808, female/male = 4.4, mean age: 39.4 ± 12.6 years) were enrolled. Patients with transient visual disturbance had higher headache-related disability and more psychiatric comorbidities. Chronic migraine was more common in migraine without aura than migraine with aura patients (41.9% vs. 11.8%, OR = 5.48 [95% CI: 4.33-7.02], p < 0.001). The associations remained after adjusting confounding factors. CONCLUSION Presence of non-aura transient visual disturbance may suggest a higher migraine-related disability and is linked to higher risk of chronic migraine than typical migraine aura in migraine patients. Further studies are needed to elucidate the potential mechanism.
Collapse
Affiliation(s)
- Yu-Chien Tsao
- Keelung Hospital of the Ministry of Health and Welfare, Keelung, Taiwan.,Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Ling Fuh
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Keelung Hospital of the Ministry of Health and Welfare, Keelung, Taiwan.,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Pin Chen
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
15
|
Chen WT, Hsieh CY, Liu YH, Cheong PL, Wang YM, Sun CW. Migraine classification by machine learning with functional near-infrared spectroscopy during the mental arithmetic task. Sci Rep 2022; 12:14590. [PMID: 36028633 PMCID: PMC9418153 DOI: 10.1038/s41598-022-17619-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
Migraine is a common and complex neurovascular disorder. Clinically, the diagnosis of migraine mainly relies on scales, but the degree of pain is too subjective to be a reliable indicator. It is even more difficult to diagnose the medication-overuse headache, which can only be evaluated by whether the symptom is improved after the medication adjustment. Therefore, an objective migraine classification system to assist doctors in making a more accurate diagnosis is needed. In this research, 13 healthy subjects (HC), 9 chronic migraine subjects (CM), and 12 medication-overuse headache subjects (MOH) were measured by functional near-infrared spectroscopy (fNIRS) to observe the change of the hemoglobin in the prefrontal cortex (PFC) during the mental arithmetic task (MAT). Our model shows the sensitivity and specificity of CM are 100% and 75%, and that of MOH is 75% and 100%.The results of the classification of the three groups prove that fNIRS combines with machine learning is feasible for the migraine classification.
Collapse
Affiliation(s)
- Wei-Ta Chen
- Department of Neurology, Keelung Hospital,Ministry of Health and Welfare, No. 268, Xin 2nd Rd., Xinyi Dist, Keelung, 20148, Taiwan, ROC
- Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec.2, Shipai Rd., Beitou Dist, Taipei, 112201, Taiwan, ROC
| | - Cing-Yan Hsieh
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
| | - Yao-Hong Liu
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
| | - Pou-Leng Cheong
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
- Department of Pediatrics, National Taiwan University Hospital, Hisnchu Branch, No. 25, Ln. 442, Sec.1, Jingguo Rd., North Dist, Hsinchu, 30059, Taiwan, ROC
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Min Wang
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC
| | - Chia-Wei Sun
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC.
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, No. 1001, University Road, East District, Hsinchu, 300093, Taiwan, ROC.
- Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 112304, Taiwan, ROC.
| |
Collapse
|
16
|
Liaw YC, Wang YF, Chen WT, Chen SP, Wu JW, Chen ST, Lai KL, Fuh JL, Wang SJ. Sex-related differences in cluster headache: A hospital-based study in Taiwan. Cephalalgia 2022; 42:1532-1542. [PMID: 36003003 DOI: 10.1177/03331024221120054] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To compare the clinical profiles between male and female cluster headache patients from a large cohort. METHODS This hospital-based study enrolled patients diagnosed with cluster headache between 1997 to 2021. Participants completed structured questionnaires collecting information on demographics, clinical profiles, and quality of life. Treatment regimens and effectiveness were determined through medical chart review. All variables were compared between the sexes. RESULTS In total, 798 patients (M/F:659/139) were enrolled. The male-to-female ratio was 4.7:1 for the full study period, but it declined from 5.2:1 to 4.3:1 for patients enrolled before and after 2010, respectively. The frequencies of chronic cluster headache (M:1.2%, F:1.4%) and aura (M:0.3%, F:0.7%) were low but similar between the sexes. Most headache features showed no difference between men and women. Female patients had significantly longer attack duration, shorter inter-bout duration, higher frequencies for eyelid edema, nausea and vomiting and lower frequencies for conjunctival injection and pacing. Sex difference did not influence headache-associated disability, anxiety, or depression, but poor sleep quality was significantly more common in women. Among menstruating women, 22/122 (18.0%) reported worsening headaches during menses. The effectiveness of treatment was similar between the sexes. CONCLUSIONS Despite a decline of male-to-female ratio in the past two decades, most clinical profiles were similar between the sexes.
Collapse
Affiliation(s)
- Yi-Chia Liaw
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jr-Wei Wu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Ting Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
17
|
Chin CG, Chen WT, Lin YK, Chung CC, Hsieh MH. Electrocardiographic abnormalities in a patient with pre-excitation and acute myocardial infarction undergoing percutaneous coronary intervention and ablation. J Chin Med Assoc 2022; 85:804-807. [PMID: 35648143 DOI: 10.1097/jcma.0000000000000750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Pre-excitation syndrome can either mimic or mask myocardial infarction, making the diagnosis of acute myocardial infarction difficult. Herein, we report the case of a male patient with Wolf-Parkinson-White (WPW) syndrome who presented to our emergency department with severe chest pain. Non-ST-elevation myocardial infarction was suspected because of cardiac enzyme elevation and abnormal ST-T changes identified through electrocardiography. The patient underwent percutaneous coronary intervention; a left anterior descending artery stenotic lesion was dilated, and drug-eluting stents were implanted. One month later, he underwent successful radiofrequency catheter ablation for his accessory pathway and tachycardia. We present the series of electrocardiographic ST-T abnormalities to raise awareness of the value of diagnosing myocardial injury early in patients with WPW syndrome.
Collapse
Affiliation(s)
- Chye-Gen Chin
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC
| | - Wei-Ta Chen
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC
| | - Yung-Kuo Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC
| | - Cheng-Chih Chung
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ming-Hsiung Hsieh
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan, ROC
| |
Collapse
|
18
|
Pan LLH, Wang YF, Ling YH, Lai KL, Chen SP, Chen WT, Treede RD, Wang SJ. Pain sensitivities predict prophylactic treatment outcomes of flunarizine in chronic migraine patients: A prospective study. Cephalalgia 2022; 42:899-909. [PMID: 35400174 DOI: 10.1177/03331024221080572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND We aimed to assess the differences in quantitative sensory testing between chronic migraine and healthy controls and to explore the association between pain sensitivities and outcomes in chronic migraine following preventive treatment. METHODS In this prospective open-label study, preventive-naïve chronic migraine and healthy controls were recruited, and cold, heat, mechanical punctate, and pressure pain thresholds over the dermatomes of first branch of trigeminal nerve and first thoracic nerve were measured by quantitative sensory testing at baseline. Chronic migraines were treated with flunarizine and treatment response was defined as ≥50% reduction in the number of monthly headache days over the 12-week treatment period. RESULTS Eighty-four chronic migraines and fifty age-and-sex-matched healthy controls were included in the analysis. The chronic migraine had higher cold pain thresholds over the dermatomes of the first branch of trigeminal nerve and the first thoracic nerve (p < 0.001 and < 0.001), lower pressure pain thresholds over the dermatomes of the first thoracic nerve (p = 0.003), heat pain thresholds over the dermatomes of the first branch of the trigeminal nerve and the first thoracic nerve (p < 0.001 and p = 0.015) than healthy controls. After treatment, 24/84 chronic migraine had treatment response. The responders with relatively normal pain sensitivity had higher heat pain thresholds over the dermatome of the first branch of the trigeminal nerve (p = 0.002), mechanical punctate pain thresholds over the dermatomes of the first branch of the trigeminal nerve (p = 0.023), and pressure pain thresholds over the dermatomes of the first branch of the trigeminal nerve (p = 0.026) than the hypersensitive non-responders. Decision tree analysis showed that patients with mechanical punctate pain threshold over the dermatomes of the first branch of the trigeminal nerve > 158 g (p = 0.020) or heat pain threshold over the dermatome of the first branch of the trigeminal nerve > 44.9°C (p = 0.002) were more likely to be responders. CONCLUSIONS Chronic migraine were generally more sensitive compared to healthy controls. Preventive treatment with flunarizine should be recommended particularly for chronic migraine who have relatively normal sensitivity to mechanical punctate or heat pain.Trial registration: This study was registered on ClinicalTrials.gov (Identifier: NCT02747940).
Collapse
Affiliation(s)
- Li-Ling Hope Pan
- Brain Research Center, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- College of Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hsiang Ling
- College of Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- College of Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,College of Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,College of Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, 38004Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Rolf-Detlef Treede
- Chair of Neurophysiology, Mannheim Center for Translational Neurosciences, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Shuu-Jiun Wang
- Brain Research Center, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,College of Medicine, 34914National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
19
|
Wang YF, Liao YC, Tzeng YS, Chen SP, Lirng JF, Fuh JL, Chen WT, Lai KL, Lee YC, Wang SJ. Mutation screening and association analysis of NOTCH3 p.R544C in patients with migraine with or without aura. Cephalalgia 2022; 42:888-898. [PMID: 35302383 DOI: 10.1177/03331024221080891] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The role of the NOTCH3 p.R544C variant, the predominant variant of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in multiple East Asian regions, in migraine is unknown. METHODS Migraine patients (n = 2,884) (2,279F/605M, mean age 38.8 ± 11.7 years), including 324 (11.2%) with migraine with aura, were prospectively enrolled by headache specialists according to the International Classification of Headache Disorders criteria. These patients and 3,502 population controls free of stroke, dementia, and headache were genotyped for NOTCH3 p.R544C by TaqMan genotyping assay or Axiom Genome-Wide TWB 2.0 Array. Clinical manifestations and brain magnetic resonance images were examined and compared between migraine patients with and without NOTCH3 p.R544C. RESULTS Thirty-two migraine patients (1.1%) and 36 controls (1.0%) harbored the p.R544C variant, and the percentages were comparable among migraine patients without and with aura, and controls (1.2%, vs. 0.6% vs. 1.0%, p = 0.625). Overall, migraine patients with and without the p.R544C variant had similar percentages of migraine with aura, headache characteristics, frequencies and disabilities. However, those with p.R544C were less likely to have pulsatile headaches (50.0% vs. 68.2%, p = 0.028), and more likely to have moderate to severe white matter hyperintensities in the external capsule (18.8% vs. 1.2%, p = 0.006) and anterior temporal lobe (12.5% vs. 0%, p = 0.008). CONCLUSIONS Our findings suggest that NOTCH3 p.R544C does not increase the risk of migraine with aura, or migraine as a whole, and generally does not alter clinical manifestations of migraine. The role of NOTCH3 variants, as well as potential influences from ethnicity or modifier genes, in migraine needs to be further clarified.
Collapse
Affiliation(s)
- Yen-Feng Wang
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chu Liao
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Shiang Tzeng
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jiing-Feng Lirng
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chung Lee
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, 46615Taipei Veterans General Hospital, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
20
|
Chen WT, Chien CC, Ho WS, Ou JH, Chen SC, Kao CM. Effects of treatment processes on AOC removal and changes of bacterial diversity in a water treatment plant. J Environ Manage 2022; 311:114853. [PMID: 35276566 DOI: 10.1016/j.jenvman.2022.114853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/27/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
The effectiveness of different treatment processes on assimilable organic carbon (AOC) removal and bacterial diversity variations was evaluated in a water treatment plant. The van der Kooij technique was applied for AOC analysis and responses of bacterial communities were characterized by the metagenomics assay. Results show that the AOC concentrations were about 93, 148, 43, 51, 37, and 38 μg acetate-C/L in effluents of raw water basin, preozonation, rapid sand filtration (RSF), ozonation, biofiltration [biological activated carbon (BAC) filtration], and chlorination (clear water), respectively. Increased AOC concentrations were observed after preozonation, ozonation, and chlorination units due to the production of biodegradable organic matters after the oxidation processes. Results indicate that the oxidation processes were the main causes of AOC formation, which resulted in significant increases in AOC concentrations (18-59% increment). The AOC removal efficiencies were 47, 28, and 60% in the RSF, biofiltration, and the whole system, respectively. RSF and biofiltration were responsible for the AOC treatment and both processes played key roles in AOC removal. Thus, both RSF and biofiltration processes would contribute to AOC treatment after oxidation. Sediments from the raw water basin and filter samples from RSF and BAC units were collected and analyzed for bacterial communities. Results from scanning electron microscope analysis indicate that bacterial colonization was observed in filter materials. This indicates that the surfaces of the filter materials were beneficial to bacterial growth and AOC removal via the adsorption and biodegradation mechanisms. Next generation sequencing analyses demonstrate that water treatment processes resulted in the changes of bacterial diversity and community profiles in filters of RSF and BAC. According to the findings of bacterial composition and interactions, the dominant bacterial phyla were Proteobacteria (41% in RSF and 56% in BAC) followed by Planctomycetes and Acidobacteria in RSF and BAC systems, which might affect the AOC biodegradation efficiency. Results would be useful in developing AOC treatment and management processes in water treatment plants.
Collapse
Affiliation(s)
- W T Chen
- Institute of Environmental Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - C C Chien
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Chung-Li City, Taoyuan, Taiwan
| | - W S Ho
- Institute of Environmental Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - J H Ou
- Institute of Environmental Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - S C Chen
- Department of Life Sciences, National Central University, Taoyuan, Taiwan.
| | - C M Kao
- Institute of Environmental Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan.
| |
Collapse
|
21
|
Hsiao FJ, Chen WT, Pan LLH, Liu HY, Wang YF, Chen SP, Lai KL, Coppola G, Wang SJ. Dynamic brainstem and somatosensory cortical excitability during migraine cycles. J Headache Pain 2022; 23:21. [PMID: 35123411 PMCID: PMC8903675 DOI: 10.1186/s10194-022-01392-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/12/2021] [Accepted: 01/20/2022] [Indexed: 11/22/2022] Open
Abstract
Abstract Background Migraine has complex pathophysiological characteristics and episodic attacks. To decipher the cyclic neurophysiological features of migraine attacks, in this study, we compared neuronal excitability in the brainstem and primary somatosensory (S1) region between migraine phases for 30 consecutive days in two patients with episodic migraine. Methods Both patients underwent EEG recording of event-related potentials with the somatosensory and paired-pulse paradigms for 30 consecutive days. The migraine cycle was divided into the following phases: 24–48 h before headache onset (Pre2), within 24 h before headache onset (Pre1), during the migraine attack (Ictal), within 24 h after headache offset (Post1), and the interval of ˃48 h between the last and next headache phase (Interictal). The normalised current intensity in the brainstem and S1 and gating ratio in the S1 were recorded and examined. Results Six migraine cycles (three for each patient) were analysed. In both patients, the somatosensory excitability in the brainstem (peaking at 12–14 ms after stimulation) and S1 (peaking at 18–19 ms after stimulation) peaked in the Pre1 phase. The S1 inhibitory capability was higher in the Ictal phase than in the Pre1 phase. Conclusion This study demonstrates that migraine is a cyclic excitatory disorder and that the neural substrates involved include the somatosensory system, starting in the brainstem and spanning subsequently to the S1 before the migraine occurs. Further investigations with larger sample sizes are warranted.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan. .,Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 201, Shihpai Rd Sec 2, Taipei, 112, Taiwan.
| |
Collapse
|
22
|
Wu JW, Lai PY, Chen YL, Wang YF, Lirng JF, Chen ST, Lai KL, Chen WT, Wu YT, Wang SJ. The Use of Neuroimaging for Predicting Sumatriptan Treatment Response in Patients With Migraine. Front Neurol 2022; 13:798695. [PMID: 35173673 PMCID: PMC8841861 DOI: 10.3389/fneur.2022.798695] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/07/2022] [Indexed: 01/14/2023] Open
Abstract
Objectives To identify the neuroimaging predictors for the responsiveness of patients to sumatriptan and use an independent cohort for external validation. Methods Structuralized headache questionnaire and 3-Tesla brain magnetic resonance imaging were performed in migraine patients. Regional brain volumes were automatically calculated using FreeSurfer version 6.0, including bilateral amygdala, anterior cingulated cortex, caudate, putamen, precuneus, orbitofrontal cortex, superior frontal gyri, middle frontal gyri, hippocampus, and parahippocampus. A sumatriptan-responder was defined as headache relief within 2 h after the intake of sumatriptan in at least two out of three treated attacks. We constructed a prediction model for sumatriptan response using the regional brain volume and validated it with an independent cohort of migraine patients. Results A total of 105 migraine patients were recruited, including 73 sumatriptan responders (69.5%) and 32 (30.5%) non-responders. We divided the migraine patients into derivation (n = 73) and validation cohorts (n = 32). In the derivation cohort, left hippocampal volume was larger in sumatriptan responders (responders vs. non-responders: 3,929.5 ± 403.1 vs. 3,611.0 ± 389.9 mm3, p = 0.002), and patients with a larger left hippocampal volume had a higher response rate to sumatriptan (>4,036.2 vs. ≤4,036.2 mm3: 92.0 vs. 56.3%, p = 0.001). Based on the findings, we constructed a prediction model using the cutoff value of 4,036.2 mm3, and we found that patients with a left hippocampal volume >4,032.6 mm3 had a higher response rate to sumatriptan than those with a left hippocampal volume ≤4,032.6 mm3 (84.6 vs. 42.1%, odds ratio [OR] = 7.6 [95% confidence interval = 1.3–44.0], p = 0.013) in the validation cohort. Conclusion Our study showed that left hippocampal volume is helpful to identify sumatriptan non-responders. This proof-of-concept study shows that left hippocampal volume could be used to predict the treatment response to sumatriptan in migraine patients.
Collapse
Affiliation(s)
- Jr-Wei Wu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pi-Yi Lai
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Lin Chen
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jiing-Feng Lirng
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-Ting Chen
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Te Wu
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- *Correspondence: Shuu-Jiun Wang ;
| |
Collapse
|
23
|
Hsiao FJ, Chen WT, Pan LLH, Liu HY, Wang YF, Chen SP, Lai KL, Wang SJ. Machine learning-based prediction of heat pain sensitivity by using resting-state EEG. FRONT BIOSCI-LANDMRK 2021; 26:1537-1547. [PMID: 34994168 DOI: 10.52586/5047] [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: 09/09/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The development of quantitative, objective signatures or predictors to evaluate pain sensitivity is crucial in the clinical management of pain and in precision medicine. This study combined multimodal (neurophysiology and psychometrics) signatures to classify the training dataset and predict the testing dataset on individual heat pain sensitivity. METHODS Healthy individuals were recruited in this study. Individual heat pain sensitivity and psychometric scores, as well as the resting-state electroencephalography (EEG) data, were obtained from each participant. Participants were divided into low-sensitivity and high-sensitivity subgroups according to their heat pain sensitivity. Psychometric data obtained from psychometric measurements and power spectral density (PSD) and functional connectivity (FC) derived from resting-state EEG analysis were subjected to feature selection with an independent t test and were then trained and predicted using machine learning models, including support vector machine (SVM) and k-nearest neighbor. RESULTS In total, 85 participants were recruited in this study, and their data were divided into training (n = 65) and testing (n = 20) datasets. We identified the resting-state PSD and FC, which can serve as brain signatures to classify heat pain as high-sensitive or low-sensitive. Using machine learning algorithms of SVM with different kernels, we obtained an accuracy of 86.2%-93.8% in classifying the participants into thermal pain high-sensitivity and low-sensitivity groups; moreover, using the trained model of cubic SVM, an accuracy of 80% was achieved in predicting the pain sensitivity of an independent dataset of combined PSD and FC features of resting-state EEG data. CONCLUSION Acceptable accuracy in classification and prediction by using the SVM model indicated that pain sensitivity could be achieved, leading to considerable possibilities of the use of objective evaluation of pain perception in clinical practice. However, the predictive model presented in this study requires further validation by studies with a larger dataset.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 11217 Taipei, Taiwan.,Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, 20147 Keelung, Taiwan
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 11217 Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 11217 Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 11217 Taipei, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 11217 Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,School of Medicine, National Yang-Ming Chiao-Tung University, 11221 Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 11217 Taipei, Taiwan
| |
Collapse
|
24
|
Ossiander M, Huang YW, Chen WT, Wang Z, Yin X, Ibrahim YA, Schultze M, Capasso F. Author Correction: Slow light nanocoatings for ultrashort pulse compression. Nat Commun 2021; 12:7076. [PMID: 34848746 PMCID: PMC8632878 DOI: 10.1038/s41467-021-27446-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- M Ossiander
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA.
| | - Y-W Huang
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA.,Department of Photonics, National Yang Ming Chiao Tung University, Hsinchu, 30010, Taiwan
| | - W T Chen
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA
| | - Z Wang
- Institute of Experimental Physics, Graz University of Technology, Petersgasse 16, 8010, Graz, Austria
| | - X Yin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA
| | - Y A Ibrahim
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA.,University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - M Schultze
- Institute of Experimental Physics, Graz University of Technology, Petersgasse 16, 8010, Graz, Austria
| | - F Capasso
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA.
| |
Collapse
|
25
|
Ossiander M, Huang YW, Chen WT, Wang Z, Yin X, Ibrahim YA, Schultze M, Capasso F. Slow light nanocoatings for ultrashort pulse compression. Nat Commun 2021; 12:6518. [PMID: 34764297 PMCID: PMC8586156 DOI: 10.1038/s41467-021-26920-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/22/2021] [Indexed: 11/09/2022] Open
Abstract
Transparent materials do not absorb light but have profound influence on the phase evolution of transmitted radiation. One consequence is chromatic dispersion, i.e., light of different frequencies travels at different velocities, causing ultrashort laser pulses to elongate in time while propagating. Here we experimentally demonstrate ultrathin nanostructured coatings that resolve this challenge: we tailor the dispersion of silicon nanopillar arrays such that they temporally reshape pulses upon transmission using slow light effects and act as ultrashort laser pulse compressors. The coatings induce anomalous group delay dispersion in the visible to near-infrared spectral region around 800 nm wavelength over an 80 nm bandwidth. We characterize the arrays' performance in the spectral domain via white light interferometry and directly demonstrate the temporal compression of femtosecond laser pulses. Applying these coatings to conventional optics renders them ultrashort pulse compatible and suitable for a wide range of applications.
Collapse
Affiliation(s)
- M Ossiander
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA.
| | - Y-W Huang
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA
- Department of Photonics, National Yang Ming Chiao Tung University, Hsinchu, 30010, Taiwan
| | - W T Chen
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA
| | - Z Wang
- Institute of Experimental Physics, Graz University of Technology, Petersgasse 16, 8010, Graz, Austria
| | - X Yin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA
| | - Y A Ibrahim
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA
- University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - M Schultze
- Institute of Experimental Physics, Graz University of Technology, Petersgasse 16, 8010, Graz, Austria
| | - F Capasso
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Cambridge, MA, 02138, USA.
| |
Collapse
|
26
|
Wang YH, Chen WT. Foreign body cystic granuloma and abscess after acupoint catgut embedding. Br J Dermatol 2021; 185:e1. [PMID: 33822365 DOI: 10.1111/bjd.20056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Y H Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - W T Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Department of Aesthetic Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Immunology, College of Medicine, National Taiwan University, Taiwan
| |
Collapse
|
27
|
Lin YJ, Ko YC, Chow LH, Hsiao FJ, Liu HY, Wang PN, Chen WT. Salivary cortisol is associated with cognitive changes in patients with fibromyalgia. Sci Rep 2021; 11:1311. [PMID: 33446677 PMCID: PMC7809444 DOI: 10.1038/s41598-020-79349-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 12/04/2020] [Indexed: 12/18/2022] Open
Abstract
Fibromyalgia (FM) is a stress-related chronic pain disorder with common cognitive complaints. This study characterized cognitive dysfunction in patients with FM and explored whether these changes are linked to altered cortisol levels. Consecutive 44 patients with FM and 48 healthy controls were enrolled for the assessments of subjective and objective cognitive functions and diurnal levels of salivary cortisol (sampled at awakening, 30 min after awakening, 3 pm, and bedtime). All measurements were compared between the groups and evaluated for clinical correlation. The FM group had more subjective cognitive complaints and performed poorer in objective cognitive testing in memory (delayed recall in Chinese Version Verbal Learning Test and Taylor Complex Figure Test), language (Boston Naming Test), and executive domains (Wisconsin Card Sorting Test) after adjustments for education. The diurnal cortisol levels of patients with FM tended to be lower, especially at 30 min after awakening and bedtime. Moreover, moderate positive correlations existed between the Chinese Version Verbal Learning Test, Boston Naming Test and the morning cortisol levels within the FM group. We suggested the altered cognitive function in FM may be linked to stress maladaptation. Future studies are warranted to elucidate whether stress management improves cognitive performance in patients with FM.
Collapse
Affiliation(s)
- Yi-Ju Lin
- Division of General Neurology, Department of Neurology, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, 112, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chieh Ko
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Lok-Hi Chow
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hung-Yu Liu
- Division of General Neurology, Department of Neurology, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, 112, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Ning Wang
- Division of General Neurology, Department of Neurology, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, 112, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Ta Chen
- Division of General Neurology, Department of Neurology, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, 112, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
28
|
Abstract
PURPOSE OF REVIEW Tension-type headache is often regarded as the "normal" headache due to its high prevalence and mild disability in contrast with migraine. Clinically, both headaches are common comorbidities to each other. To date there has been many studies linked migraine to a brain excitability disorder. This review summarized earlier studies on brain excitability of TTH and discuss if TTH is a separate clinical entity from migraine as suggested by the diagnostic criteria. RECENT FINDINGS A recent magnetoencephalographic study from our group enrolled patients with "strict-criteria" TTH (i.e., absence of any migraine characteristics and associated symptoms) to compare the somatosensory excitability with patients with migraine and controls. This study provided evidence that TTH and migraine differ in excitability profiles and the measurement of preactivation excitability was able to discriminate TTH from migraine. Earlier studies on brain excitability of TTH yielded negative findings or a common change shared with migraine. Future studies using strict diagnostic criteria to avoid the unwanted interference from migraine comorbidity may help decipher the "true" pathophysiology of TTH, which may pave the way to a TTH-specific brain signature and treatment.
Collapse
Affiliation(s)
- Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan.
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan
| |
Collapse
|
29
|
Hsiao FJ, Chen WT, Liu HY, Wang YF, Chen SP, Lai KL, Pan LLH, Wang SJ. Individual pain sensitivity is associated with resting-state cortical activities in healthy individuals but not in patients with migraine: a magnetoencephalography study. J Headache Pain 2020; 21:133. [PMID: 33198621 PMCID: PMC7670775 DOI: 10.1186/s10194-020-01200-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/27/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022] Open
Abstract
Background Pain sensitivity may determine the risk, severity, prognosis, and efficacy of treatment of clinical pain. Magnetic resonance imaging studies have linked thermal pain sensitivity to changes in brain structure. However, the neural correlates of mechanical pain sensitivity remain to be clarified through investigation of direct neural activities on the resting-state cortical oscillation and synchrony. Methods We recorded the resting-state magnetoencephalographic (MEG) activities of 27 healthy individuals and 30 patients with episodic migraine (EM) and analyzed the source-based oscillatory powers and functional connectivity at 2 to 59 Hz in pain-related cortical regions, which are the bilateral anterior cingulate cortex (ACC), medial orbitofrontal (MOF) cortex, lateral orbitofrontal (LOF) cortex, insula cortex, primary somatosensory cortex (SI), primary motor cortex (MI), and posterior cingulate cortex (PCC). The mechanical punctate pain threshold (MPPT) was obtained at the supraorbital area (the first branch of the trigeminal nerve dermatome, V1) and the forearm (the first thoracic nerve dermatome, T1) and further correlated with MEG measures. Results The MPPT is inversely correlated with the resting-state relative powers of gamma oscillation in healthy individuals (all corrected P < 0.05). Specifically, inverse correlation was noted between the MPPT at V1 and gamma powers in the bilateral insula (r = − 0.592 [left] and − 0.529 [right]), PCC (r = − 0.619 and − 0.541) and MI (r = − 0.497 and − 0.549) and between the MPPT at T1 and powers in the left PCC (r = − 0.561) and bilateral MI (r = − 0.509 and − 0.520). Furthermore, resting-state functional connectivity at the delta to beta bands, especially between frontal (MOF, ACC, LOF, and MI), parietal (PCC), and sensorimotor (bilateral SI and MI) regions, showed a positive correlation with the MPPT at V1 and T1 (all corrected P < 0.05). By contrast, in patients with EM, the MPPT was not associated with resting-state cortical activities. Conclusions Pain sensitivity in healthy individuals is associated with the resting-state gamma oscillation and functional connectivity in pain-related cortical regions. Further studies must be conducted in a large population to confirm whether resting-state cortical activities can be an objective measurement of pain sensitivity in individuals without clinical pain. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-020-01200-8.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Ling Hope Pan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| |
Collapse
|
30
|
Hsiao FJ, Chen WT, Ko YC, Liu HY, Wang YF, Chen SP, Lai KL, Lin HY, Coppola G, Wang SJ. Neuromagnetic Amygdala Response to Pain-Related Fear as a Brain Signature of Fibromyalgia. Pain Ther 2020; 9:765-781. [PMID: 33090368 PMCID: PMC7648811 DOI: 10.1007/s40122-020-00206-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/22/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction Fibromyalgia (FM) is a chronic pain condition characterized by impaired emotional regulation. This study explored the brain response to pain-related fear as a potential brain signature of FM. Methods We used a conditioned fear task and magnetoencephalography to record pain-related fear responses in patients with FM. Two blocks of 30 fear responses were collected to compute the response strength in the first block and the strength difference between the first and second blocks (fear habituation). These measurements were investigated for their clinical relevance and compared with measurements obtained from healthy controls and patients with chronic migraine (CM), a different chronic pain condition often comorbid with FM. Results Pain-related fear clearly activated the bilateral amygdala and anterior insula in patients with FM (n = 52), patients with CM (n = 50), and the controls (n = 30); the response strength in the first block was consistent across groups. However, fear habituation in the right amygdala decreased in the FM group (vs. CM and control groups, both p ≤ 0.001, no difference between CM and control groups). At the 3-month follow-up, the patients with FM reporting < 30% improvement in pain severity (n = 15) after pregabalin treatment exhibited lower fear habituation in the left amygdala at baseline (vs. ≥ 30% improvement, n = 22, p = 0.019). Receiver operating characteristic analysis confirmed that amygdala fear habituation is a suitable predictor of diagnosis and treatment outcomes of FM (area under the curve > 0.7). Conclusions Amygdala activation to pain-related fear is maladaptive and linked to treatment outcomes in patients with FM. Because the aberrant amygdala response was not observed in the CM group, this response is a potential brain signature of FM. Trial Registration ClinicalTrials.gov Identifier, NCT02747940.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Yu-Chieh Ko
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung-Yu Liu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiao-Yi Lin
- Department of Allergy, Immunology and Rheumatology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| |
Collapse
|
31
|
Li ST, Chin CG, Chen WT. Fixed preexcitation during decremental atrioventricular conduction. What is the mechanism? J Electrocardiol 2020; 62:129-131. [PMID: 32866911 DOI: 10.1016/j.jelectrocard.2020.08.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/30/2022]
Abstract
Fasciculoventricular pathway (FVP) is a rare form of preexcitation syndrome. A FVP connects the fascicle and the ventricle. It is indistinguishable to the common preexcitation pathways on the 12‑lead electrocardiography. We herein present a case of FVP, who was with the same His-ventricular interval and QRS morphology during sinus rhythm, junctional beats and rapid atrial pacing rhythm. Using a mapping catheter at the right ventricular anterior (RV) wall, we can clearly demonstrate the activation of RV with and without FVP conduction. With FVP conduction, the RV was activated from basal wall to apex. Without FVP conduction, the activation direction was reversed.
Collapse
Affiliation(s)
- Shyuan-Tzer Li
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chye-Gen Chin
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ta Chen
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| |
Collapse
|
32
|
Lai KL, Niddam DM, Fuh JL, Chen WT, Wu JC, Wang SJ. Reply to letter to the editor: Insights into chronic migraine pathophysiology - what measures of gray matter reveal. Cephalalgia 2020; 40:1138-1139. [PMID: 32536269 DOI: 10.1177/0333102420933262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
33
|
Pan LLH, Wang YF, Lai KL, Chen WT, Chen SP, Ling YH, Chou LW, Treede RD, Wang SJ. Mechanical punctate pain threshold is associated with headache frequency and phase in patients with migraine. Cephalalgia 2020; 40:990-997. [DOI: 10.1177/0333102420925540] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective Previous studies regarding the quantitative sensory testing are inconsistent in migraine. We hypothesized that the quantitative sensory testing results were influenced by headache frequency or migraine phase. Methods This study recruited chronic and episodic migraine patients as well as healthy controls. Participants underwent quantitative sensory testing, including heat, cold, and mechanical punctate pain thresholds at the supraorbital area (V1 dermatome) and the forearm (T1 dermatome). Prospective headache diaries were used for headache frequency and migraine phase when quantitative sensory testing was performed. Results Twenty-eight chronic migraine, 64 episodic migraine and 32 healthy controls completed the study. Significant higher mechanical punctate pain thresholds were found in episodic migraine but not chronic migraine when compared with healthy controls. The mechanical punctate pain thresholds decreased as headache frequency increased then nadired. In episodic migraine, mechanical punctate pain thresholds were highest ( p < 0.05) in those in the interictal phase and declined when approaching the ictal phase in both V1 and T1 dermatomes. Linear regression analyses showed that in those with episodic migraine, headache frequency and phase were independently associated with mechanical punctate pain thresholds and accounted for 29.7% and 38.9% of the variance in V1 ( p = 0.003) and T1 ( p < 0.001) respectively. Of note, unlike mechanical punctate pain thresholds, our study did not demonstrate similar findings for heat pain thresholds and cold pain thresholds in migraine. Conclusion Our study provides new insights into the dynamic changes of quantitative sensory testing, especially mechanical punctate pain thresholds in patients with migraine. Mechanical punctate pain thresholds vary depending on headache frequency and migraine phase, providing an explanation for the inconsistency across studies.
Collapse
Affiliation(s)
- Li-Ling Hope Pan
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Feng Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Pin Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hsiang Ling
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Wei Chou
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan
| | - Rolf-Detlef Treede
- Chair of Neurophysiology, Mannheim Center for Translational Neurosciences, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
34
|
Tang CW, Hsiao FJ, Lee PL, Tsai YA, Hsu YF, Chen WT, Lin YY, Stagg CJ, Lee IH. β-Oscillations Reflect Recovery of the Paretic Upper Limb in Subacute Stroke. Neurorehabil Neural Repair 2020; 34:450-462. [PMID: 32321366 PMCID: PMC7250642 DOI: 10.1177/1545968320913502] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background. Recovery of upper limb function post-stroke can be partly predicted by initial motor function, but the mechanisms underpinning these improvements have yet to be determined. Here, we sought to identify neural correlates of post-stroke recovery using longitudinal magnetoencephalography (MEG) assessments in subacute stroke survivors. Methods. First-ever, subcortical ischemic stroke survivors with unilateral mild to moderate hand paresis were evaluated at 3, 5, and 12 weeks after stroke using a finger-lifting task in the MEG. Cortical activity patterns in the β-band (16-30 Hz) were compared with matched healthy controls. Results. All stroke survivors (n=22; 17 males) had improvements in action research arm test (ARAT) and Fugl-Meyer upper extremity (FM-UE) scores between 3 and 12 weeks. At 3 weeks post-stroke the peak amplitudes of the movement-related ipsilesional β-band event-related desynchronization (β-ERD) and synchronization (β-ERS) in primary motor cortex (M1) were significantly lower than the healthy controls (p<0.001) and were correlated with both the FM-UE and ARAT scores (r=0.51-0.69, p<0.017). The decreased β-ERS peak amplitudes were observed both in paretic and non-paretic hand movement particularly at 3 weeks post-stroke, suggesting a generalized disinhibition status. The peak amplitudes of ipsilesional β-ERS at week 3 post-stroke correlated with the FM-UE score at 12 weeks (r=0.54, p=0.03) but no longer significant when controlling for the FM-UE score at 3 weeks post-stroke.Conclusions. Although early β-band activity does not independently predict outcome at 3 months after stroke, it mirrors functional changes, giving a potential insight into the mechanisms underpinning recovery of motor function in subacute stroke.
Collapse
Affiliation(s)
- Chih-Wei Tang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Fu-Jung Hsiao
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Po-Lei Lee
- National Central University, Taoyuan County, Taiwan
| | - Yun-An Tsai
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Wei-Ta Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Yung-Yang Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - I-Hui Lee
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
35
|
Lai KL, Niddam DM, Fuh JL, Chen WT, Wu JC, Wang SJ. Cortical morphological changes in chronic migraine in a Taiwanese cohort: Surface- and voxel-based analyses. Cephalalgia 2020; 40:575-585. [PMID: 32299230 DOI: 10.1177/0333102420920005] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous voxel- or surface-based morphometric analysis studies have revealed alterations in cortical structure in patients with chronic migraine, yet with inconsistent results. The discrepancies may be derived partly from the sample heterogeneity. Employing both methods in a clinically homogenous group may provide a clearer view. METHODS Structural MRI data from 30 prevention-naïve patients with chronic migraine without medication overuse headache or a history of major depression and 30 healthy controls were analyzed. Vertex-wise (surface-based) or voxel-wise (voxel-based) linear models were applied, after controlling for age and gender, to investigate between-group differences. Averaged cortical thicknesses and volumes from regions showing group differences were correlated with parameters related to clinical profiles. RESULTS Surface-based morphometry showed significantly thinner cortices in the bilateral insular cortex, caudal middle frontal gyrus, precentral gyrus, and parietal lobes in patients with chronic migraine relative to healthy controls. Additionally, the number of migraine days in the month preceding MRI examination was correlated negatively with right insular cortical thickness. Voxel-based morphometry (VBM) did not show any group differences or clinical correlations. CONCLUSION Patients with chronic migraine without medication overuse headache, major depression, or prior preventive treatment had reduced cortical thickness in regions within the pain-processing network. Compared to voxel-based morphometry, surface-based morphometry analysis may be more sensitive to subtle structural differences between healthy controls and patients with chronic migraine.
Collapse
Affiliation(s)
- Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
36
|
Liu HY, Lee PL, Chou KH, Lai KL, Wang YF, Chen SP, Chen WT, Wang SJ. The cerebellum is associated with 2-year prognosis in patients with high-frequency migraine. J Headache Pain 2020; 21:29. [PMID: 32188423 PMCID: PMC7081533 DOI: 10.1186/s10194-020-01096-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 01/25/2020] [Accepted: 03/09/2020] [Indexed: 11/15/2022] Open
Abstract
Background The increase of headache frequency is associated with higher headache related disability and lower quality of life in patients with migraine. However, the pathophysiology of migraine progression, persistence, or remission is elusive. The purpose of this study is to identify the brain signatures that are predictive of the long-term outcomes among patients with high-frequency migraine (HFM: 10–30 headache days/month). Methods We prospectively enrolled patients with HFM and healthy controls and collected their baseline clinical profiles and brain-MRI data at first visit. We longitudinally followed the patients and determined their outcomes at 2-year follow-up. Good outcome was defined as ≥50% reduction of baseline headache days and poor outcome was defined as reduction < 50% or frequency increase. Voxel-based morphometry was used to study gray matter volume (GMV), and structural covariance was used to investigate structural connectivity. Results Among 56 patients with HFM, 37 had good outcome and 19 poor outcome. Compared to the healthy controls (n = 37), patients with poor outcome had decreased GMV over the left posterior cingulate gyrus, and increased GMV over the bilateral cerebellum and the right precentral gyrus. Further, patients with poor outcome had greater GMV over the right and the left cerebella compared to patients with good outcome, and the GMVs of the cerebella were correlated to 2-year headache frequencies (right: r = 0.38, P = 0.005; left: r = 0.35, P = 0.009). Structural connectivity were increased between the cerebellum and the cuneus, the calcarine cortex, and the temporal lobe, respectively, in patients with poor outcome, and was decreased between the cerebellum and the prefrontal cortex in patients with poor outcome. The structural covariance integrities between the right cerebellum and the right cuneus were correlated to 2-year headache frequencies (r = 0.36, P = 0.008). Conclusions Structural volume and connectivity changes of the cerebellum may underlie headache persistence in patients with HFM.
Collapse
Affiliation(s)
- Hung-Yu Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Lin Lee
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
37
|
Abstract
BACKGROUND Medication overuse headache may be associated with widespread alterations along the thalamocortical pathway, a pathway involved in pain perception and disease progression. This study addressed whether brain metabolites in key regions of the thalamocortical pathway differed between chronic migraine patients with medication overuse headache and without medication overuse headache. METHODS Magnetic resonance spectroscopic imaging was used to map metabolites in the bilateral anterior cingulate cortices, mid cingulate cortices, posterior cingulate cortices, and the thalami. Sixteen patients with medication overuse headache were compared with 16 matched patients without medication overuse headache and 16 matched healthy controls. RESULTS Glutamate and glutamine in the right mid cingulate cortex and myo-inositol in the left anterior cingulate cortex were significantly higher in patients with medication overuse headache than patients without medication overuse headache, but similar to healthy controls. Both patient groups exhibited reduced N-acetyl-aspartate and creatine in the thalamus, reduced myo-inositol in the right anterior cingulate cortex, and elevated choline in the right mid cingulate cortex. Finally, a negative association between myo-inositol laterality index in the anterior cingulate cortices and number of days per month with acute medication use was found across all patients. CONCLUSIONS Patients with medication overuse headache were characterized by a distinct concentration profile of myo-inositol, a glial marker, in the anterior cingulate cortices that may have arisen from medication overuse and could contribute to the development of medication overuse headache.
Collapse
Affiliation(s)
- David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics, National Chengchi University, Taipei, Taiwan.,Research Center for Mind, Brain and Learning, National Chengchi University, Taipei, Taiwan
| | - Yi-Ru Lin
- Department of Electronic and Computer Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| |
Collapse
|
38
|
Chen WT, Yu CH, Sun CW. Altered near-infrared spectroscopy response to breath-holding in patients with fibromyalgia. J Biophotonics 2019; 12:e201800142. [PMID: 29952139 DOI: 10.1002/jbio.201800142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/23/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
Fibromyalgia (FM) is a complex syndrome characterized by chronic widespread pain and a heightened response to pressure. Most medical researches pointed out that FM patients with endothelial dysfunction and arterial stiffness. A continuous-wave near-infrared spectroscopy (NIRS) system is used in present study to measure the hemodynamic changes elicited by breath-holding task in patients with FM. Each patient completed a questionnaire survey including demographics, characteristics of body pain, associated symptoms, headache profiles and Hospital Anxiety and Depression Scale. A total of 27 FM patients and 26 health controls were enrolled. In comparison with healthy controls, patients with FM showed lower maximal and averaged change of oxyhemoglobin concentration in both the left (1.634 ±0.890 and 0.810 ±0.525 μM) and the right (1.576 ±0.897 and 0.811 ±0.601 μM) prefrontal cortex than healthy controls (P < .05 for both sides) during the breath-holding task. In conclusion, FM is associated with altered cerebrovascular reactivity measured by NIRS and breath-holding task, which may reflect endothelial dysfunction or arterial stiffness. Oxygenated hemoglobin concentration changes of healthy controls and FM patients.
Collapse
Affiliation(s)
- Wei-Ta Chen
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chuan-Hsiang Yu
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu City, Taiwan
| | - Chia-Wei Sun
- Biomedical Optical Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu City, Taiwan
| |
Collapse
|
39
|
Liu YT, Chen YC, Kwan SY, Chou CC, Yu HY, Yen DJ, Liao KK, Chen WT, Lin YY, Chen RS, Jih KY, Lu SF, Wu YT, Wang PS, Hsiao FJ. Aberrant Sensory Gating of the Primary Somatosensory Cortex Contributes to the Motor Circuit Dysfunction in Paroxysmal Kinesigenic Dyskinesia. Front Neurol 2018; 9:831. [PMID: 30386286 PMCID: PMC6198142 DOI: 10.3389/fneur.2018.00831] [Citation(s) in RCA: 10] [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: 07/25/2018] [Accepted: 09/18/2018] [Indexed: 12/19/2022] Open
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is conventionally regarded as a movement disorder (MD) and characterized by episodic hyperkinesia by sudden movements. However, patients of PKD often have sensory aura and respond excellently to antiepileptic agents. PRRT2 mutations, the most common genetic etiology of PKD, could cause epilepsy syndromes as well. Standing in the twilight zone between MDs and epilepsy, the pathogenesis of PKD is unclear. Gamma oscillations arise from the inhibitory interneurons which are crucial in the thalamocortical circuits. The role of synchronized gamma oscillations in sensory gating is an important mechanism of automatic cortical inhibition. The patterns of gamma oscillations have been used to characterize neurophysiological features of many neurological diseases, including epilepsy and MDs. This study was aimed to investigate the features of gamma synchronizations in PKD. In the paired-pulse electrical-stimulation task, we recorded the magnetoencephalographic data with distributed source modeling and time-frequency analysis in 19 patients of newly-diagnosed PKD without receiving pharmacotherapy and 18 healthy controls. In combination with the magnetic resonance imaging, the source of gamma oscillations was localized in the primary somatosensory cortex. Somatosensory evoked fields of PKD patients had a reduced peak frequency (p < 0.001 for the first and the second response) and a prolonged peak latency (the first response p = 0.02, the second response p = 0.002), indicating the synchronization of gamma oscillation is significantly attenuated. The power ratio between two responses was much higher in the PKD group (p = 0.013), indicating the incompetence of activity suppression. Aberrant gamma synchronizations revealed the defective sensory gating of the somatosensory area contributes the pathogenesis of PKD. Our findings documented disinhibited cortical function is a pathomechanism common to PKD and epilepsy, thus rationalized the clinical overlaps of these two diseases and the therapeutic effect of antiepileptic agents for PKD. There is a greater reduction of the peak gamma frequency in PRRT2-related PKD than the non-PRRT PKD group (p = 0.028 for the first response, p = 0.004 for the second response). Loss-of-function PRRT2 mutations could lead to synaptic dysfunction. The disinhibiton change on neurophysiology reflected the impacts of PRRT2 mutations on human neurophysiology.
Collapse
Affiliation(s)
- Yo-Tsen Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Chieh Chen
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shang-Yeong Kwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Der-Jen Yen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kwong-Kum Liao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Yang Lin
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Rou-Shayn Chen
- Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kang-Yang Jih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Fen Lu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Te Wu
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Po-Shan Wang
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.,Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
40
|
Zou ZT, Hu WT, Cao W, Chen WT. [Relationship between expression level of sex-determining region Y box 9 and metastasis of oral squamous cell carcinoma]. Zhonghua Kou Qiang Yi Xue Za Zhi 2018; 53:688-693. [PMID: 30392226 DOI: 10.3760/cma.j.issn.1002-0098.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects of sex-detemining region Y box9 (SOX9) expression levels on the proliferation, migration and metastasis in oral squamous cell carcinoma (OSCC). Methods: A total of 74 OSCC pathological specimens were collected from Shanghai OSCC Tissue and Biological Informations Bank, and clinicopathological information of these specimens were collected. Immunohistochemistry assay was used to examine the expression levels of SOX9 in OSCC and to analyze their relationship with clinicopathological features. Cell counting kit-8 assay and cloning formation was used to observe the relationship between the expression levels of SOX9 and the proliferation of OSCC. Transwell experiment and scratch test were used to detect the difference of the ability of OSCC in cell lines with different expression levels of SOX9. Results: The risk of lymph node metastasis in patients with high expression of SOX9 was significantly increased (P=0.010). In the Transwell experiment, the number of HN6 cells (671.0±57.4, P=0.000) migrated to the lower chamber more than that of CAL27 cells (172.0±13.9). In the scratch experiment, HN6 cells [0 h: (93.7±2.1) μm; 6 h: (56.7±2.5) μm; 12 h: (29.7±3.1) μm] migrated faster than CAL27 [0 h: (93.7±1.5) μm; 6 h: (78.0±2.0) μm; 12 h: (42.0±3.0) μm](P<0.05). The migration ability of the cell line (HN6) with high-expression of SOX9 was significantly higher than that in cell line (CAL27) with low-expression SOX9 (P<0.05). The expression levels of SOX9 in OSCC were no significant on cell proliferation (P>0.05). Conclusions: High expression of SOX9 can promote the migration and lymph node metastasis of OSCC. SOX9 is a candidate gene target for the diagnosis and intervention of lymph node metastasis in OSCC.
Collapse
Affiliation(s)
- Z T Zou
- School of Stomatology, Weifang Medical University Weifang Shandong 261000, China (Present address: Department of Oral Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology & National Clinical Research Center of Stomatology, Shanghai 200011, China)
| | - W T Hu
- Depertment of Stomatology, Affiliated Hospital of Weifang Medical University
| | - W Cao
- Department of Oral Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology & National Clinical Research Center of Stomatology, Shanghai 200010, China
| | - W T Chen
- Department of Oral Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology & National Clinical Research Center of Stomatology, Shanghai 200010, China
| |
Collapse
|
41
|
Kang JW, Yang WH, Chi JE, Chen WT. Higher Ventricular Premature Complex Burden is Associated with Lower Systolic Blood Pressure Response. Acta Cardiol Sin 2018; 34:152-158. [PMID: 29643701 DOI: 10.6515/acs.201803_34(2).20171117a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Ventricular premature complexes (VPCs) with a burden higher than 10% to 20% of total daily heart beats can cause VPC-induced cardiomyopathy. The systolic blood pressure response (SBPR) is the difference between the SBP during maximal exercise and rest. A low SBPR was recently identified to be a marker of cardiomyopathy. The aim of this manuscript was to clarify the association between VPC burden and SBPR. Methods From January to December 2015, all patients with a VPC burden larger than 240 beats/day on Holter recordings and treadmill exercise tests were enrolled. The patients with a heart rhythm other than sinus rhythm, coronary artery disease, and severe cardiomyopathy were excluded. The SBPR was measured during a treadmill test. The basic characteristics and echocardiographic findings were collected. Results All patients were classified into three groups: Group 1; 240-1,000 VPCs/day (n = 78), Group 2; 1,000-10,000 VPCs/day (n = 54), and Group 3; > 10,000 VPCs/day (n = 21). Group 1 had a higher SBPR than the other groups. Multivariate analysis revealed that only VPC burden was associated with SBPR. Receiver operating characteristic curve analysis showed that a VPC burden > 1,055 beats/day predicted a SBPR < 40 mmHg. The results were consistent in all subgroups. There were no significant differences in echocardiographic findings among the groups. Conclusions AVPC burden higher than 1,055 beats/day was associated with a reduced SBPR.
Collapse
Affiliation(s)
- Jing-Wei Kang
- School of Medicine, College of Medicine, Taipei Medical University
| | - Wei-Hsiang Yang
- School of Medicine, College of Medicine, Taipei Medical University
| | - Jia-En Chi
- School of Medicine, College of Medicine, Taipei Medical University
| | - Wei-Ta Chen
- School of Medicine, College of Medicine, Taipei Medical University.,Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
42
|
Chen WT, Chou KH, Lee PL, Hsiao FJ, Niddam DM, Lai KL, Fuh JL, Lin CP, Wang SJ. Comparison of gray matter volume between migraine and "strict-criteria" tension-type headache. J Headache Pain 2018; 19:4. [PMID: 29335889 PMCID: PMC5768588 DOI: 10.1186/s10194-018-0834-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 12/04/2017] [Accepted: 01/02/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Despite evidently distinct symptoms, tension-type headache (TTH) and migraine are highly comorbid and exhibit many similarities in clinical practice. The purpose of this study was to investigate whether both types of headaches are similar in brain morphology. METHODS Consecutive patients with TTH and age- and sex-matched patients with migraine and healthy controls were enrolled for brain magnetic resonance imaging examination. Patients with TTH were excluded if they reported any headache features or associated symptoms of migraine. Changes in gray matter (GM) volume associated with headache diagnosis (TTH vs. migraine) and frequency (episodic vs. chronic) were examined using voxel-based morphometry. The correlation with headache profile and the discriminative ability between TTH and migraine were also investigated for these GM changes. RESULTS In comparison with controls (n = 43), the patients with TTH (25 episodic and 24 chronic) exhibited a GM volume increase in the anterior cingulate cortex, supramarginal gyrus, temporal pole, lateral occipital cortex, and caudate. The patients with migraine (31 episodic and 25 chronic) conversely exhibited a GM volume decrease in the orbitofrontal cortex. These GM changes did not correlate with any headache profile. A voxel-wise 2 × 2 factorial analysis further revealed the substantial effects of headache types and frequency in the comparison of GM volume between TTH and migraine. Specifically, the migraine group (vs. TTH) had a GM decrease in the superior and middle frontal gyri, cerebellum, dorsal striatum, and precuneus. The chronic group (vs. episodic group) otherwise demonstrated a GM decrease in the bilateral insula and anterior cingulate cortex. In receiver operating characteristic analysis, the GM volumes of the left superior frontal gyrus and right cerebellum V combined had good discriminative ability for distinguishing TTH and migraine (area under the curve = 0.806). CONCLUSIONS TTH and migraine are separate headache disorders with different characteristics in relation to GM changes. The major morphological difference between the two types of headaches is the relative GM decrease of the prefrontal and cerebellar regions in migraine, which may reflect a higher allostatic load associated with this disabling headache.
Collapse
Affiliation(s)
- Wei-Ta Chen
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. .,Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Kun-Hsien Chou
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Lin Lee
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Po Lin
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
43
|
Niddam DM, Lai KL, Tsai SY, Lin YR, Chen WT, Fuh JL, Wang SJ. Neurochemical changes in the medial wall of the brain in chronic migraine. Brain 2017; 141:377-390. [DOI: 10.1093/brain/awx331] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/18/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- David M Niddam
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, Taipei Municipal Gandau Hospital. Taipei, Taiwan
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics, National Chengchi University, Taipei, Taiwan
- Research Center for Mind, Brain and Learning, National Chengchi University, Taipei, Taiwan
| | - Yi-Ru Lin
- Department of Electronic and Computer Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| |
Collapse
|
44
|
Hsiao FJ, Chen WT, Lin YY. Association between stimulus-evoked somatosensory inhibition and movement-related sensorimotor oscillation: A magnetoencephalographic study. Neurosci Lett 2017; 664:74-78. [PMID: 29128631 DOI: 10.1016/j.neulet.2017.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 09/14/2017] [Revised: 10/30/2017] [Accepted: 11/07/2017] [Indexed: 12/14/2022]
Abstract
The interaction between the somatosensory and motor cortices is understood; however, their functional relationship remains elusive. To elucidate the association between somatosensory and sensorimotor functions, this study investigated the correlation between somatosensory activities in response to paired-pulse stimulation and sensorimotor oscillations during self-paced finger movement in 18 healthy male subjects by using a magnetoencephalographic recording. The main finding was that stimulus-evoked somatosensory gating activities were significantly correlated with movement-related sensorimotor oscillatory responses. Specifically, the gating ratios of somatosensory N20m were related to the power changes of sensorimotor beta event-related desynchronization (ERD) (p=0.003) and event-related synchronization (ERS) (p=0.05). In conclusion, we confirmed that the inhibition of stimulus-evoked somatosensory responses is associated with the oscillatory characteristics of movement-related sensorimotor activities.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Department of Neurology, National Yang-Ming University, Taipei, Taiwan; Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yung-Yang Lin
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Department of Neurology, National Yang-Ming University, Taipei, Taiwan; Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
45
|
Hsiao FJ, Wang SJ, Lin YY, Fuh JL, Ko YC, Wang PN, Chen WT. Altered insula-default mode network connectivity in fibromyalgia: a resting-state magnetoencephalographic study. J Headache Pain 2017; 18:89. [PMID: 28831711 PMCID: PMC5567574 DOI: 10.1186/s10194-017-0799-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/15/2017] [Indexed: 11/11/2022] Open
Abstract
Background Fibromyalgia (FM) is a disabling chronic pain syndrome with unknown pathophysiology. Functional magnetic resonance imaging studies on FM have suggested altered brain connectivity between the insula and the default mode network (DMN). However, this connectivity change has not been characterized through direct neural signals for exploring the embedded spectrotemporal features and the pertinent clinical relevance. Methods We recorded the resting-state magnetoencephalographic activities of 28 patients with FM and 28 age- and sex-matched controls, and analyzed the source-based functional connectivity between the insula and the DMN at 1–40 Hz by using the minimum norm estimates and imaginary coherence methods. We also measured the connectivity between the DMN and the primary visual (V1) and somatosensory (S1) cortices as intrapatient negative controls. Connectivity measurement was further correlated with the clinical parameters of FM. Results Compared with the controls, patients with FM reported more tender points (15.2±2.0 vs. 5.9±3.7) and higher total tenderness score (TTS; 29.1±7.0 vs. 7.7±5.5; both p < 0.001); they also had decreased insula–DMN connectivity at the theta band (4–8 Hz; left, p = 0.007; right, p = 0.035), but displayed unchanged V1–DMN and S1–DMN connectivity (p > 0.05). When patients with FM and the controls were combined together, the insula-DMN theta connectivity was negatively correlated with the number of tender points (left insula, r = −0.428, p = 0.001; right insula, r = −0.4, p = 0.002) and TTS score (left insula, r = −0.429, p = 0.001; right insula, r = −0.389, p = 0.003). Furthermore, in patients with FM, the right insula–DMN connectivity at the beta band (13–25 Hz) was negatively correlated with the number of tender points (r = −0.532, p = 0.004) and TTS (r = −0.428, p = 0.023), and the bilateral insula–DMN connectivity at the delta band (1–4 Hz) was negatively correlated with FM Symptom Severity (left: r = −0.423, p = 0.025; right: r = −0.437, p = 0.020) and functional disability (Fibromyalgia Impact Questionnaire; left: r = −0.415, p = 0.028; right: r = −0.374, p = 0.050). Conclusions We confirmed the frequency-specific reorganization of the insula–DMN connectivity in FM. The clinical relevance of this connectivity change may warrant future studies to elucidate its causal relationship and potential as a neurological signature for FM. Electronic supplementary material The online version of this article (doi:10.1186/s10194-017-0799-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan
| | - Yung-Yang Lin
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan
| | - Jong-Ling Fuh
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan
| | - Yu-Chieh Ko
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Ning Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan. .,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2 Shih-Pai Rd, Taipei, Taiwan.
| |
Collapse
|
46
|
Hsiao FJ, Hsu WY, Chen WT, Chen RS, Lin YY. Abnormal Somatosensory Synchronization in Patients With Paroxysmal Kinesigenic Dyskinesia: A Magnetoencephalographic Study. Clin EEG Neurosci 2017; 48:288-294. [PMID: 27515699 DOI: 10.1177/1550059416662575] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Paroxysmal kinesigenic dyskinesia (PKD) is a rare group of hyperkinetic movement disorders characterized by brief attacks of choreoathetosis or dystonia. To clarify the alterations of the functional connectivity within the somatosensory network in PKD patients, magnetoencephalographic (MEG) responses to paired median-nerve electrical stimulation were recorded in 10 PKD patients treated by carbamazepine or oxcarbamazepine and 22 age-matched controls. In patients, MEG recordings were obtained during drug-on and -off periods. Source-based functional connectivity analysis was performed between contralateral primary (cSI) and secondary (cSII), and ipsilateral secondary (iSII) somatosensory areas. During drug-off periods, patients with PKD demonstrated decreased cSI-iSII and increased cSII-iSII somatosensory connectivity at theta band. Drug-on periods lowered the functional connectivity in cSI-cSII at alpha and beta bands and in cSII-iSII at theta band compared with the drug-off periods. We suggest that altered theta functional connectivity in cSI-iSII and cSII-iSII could be the neurophysiological signatures in PKD.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- 1 Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,3 Laboratory of Neurophysiology at Medical Research Division, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wan-Yu Hsu
- 2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,3 Laboratory of Neurophysiology at Medical Research Division, Taipei Veterans General Hospital, Taipei, Taiwan.,4 Department of Neurology, University of California, San Francisco, CA, USA
| | - Wei-Ta Chen
- 1 Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,5 Department of Neurology, National Yang-Ming University, Taipei, Taiwan.,6 Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Rou-Shayn Chen
- 7 Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.,8 College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yung-Yang Lin
- 1 Brain Research Center, National Yang-Ming University, Taipei, Taiwan.,2 Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,3 Laboratory of Neurophysiology at Medical Research Division, Taipei Veterans General Hospital, Taipei, Taiwan.,5 Department of Neurology, National Yang-Ming University, Taipei, Taiwan.,6 Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan.,9 Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,10 Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
47
|
Hsiao FJ, Wang SJ, Lin YY, Fuh JL, Ko YC, Wang PN, Chen WT. Somatosensory gating is altered and associated with migraine chronification: A magnetoencephalographic study. Cephalalgia 2017; 38:744-753. [DOI: 10.1177/0333102417712718] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Brain excitability is changed in migraine but not fully characterized yet. This study explored if somatosensory gating is altered in migraine and linked to migraine chronification. Methods Paired electrical stimuli were delivered to the left index fingers of 21 patients with migraine without aura (MO), 22 patients with chronic migraine (CM), and 36 controls. The first and second responses to the paired stimuli were obtained from the contralateral primary (cSI), contralateral secondary (cSII) and ipsilateral secondary (iSII) somatosensory cortices to compute the gating ratios (second vs. first response strengths). Results The first and second cSI responses and gating ratios differed in all groups ( p < 0.05); the responses were typically smaller in the MO and CM groups. The cSI gating ratio increased as a continuum across controls (0.73 ± 0.04, p < 0.001), MO (0.83 ± 0.04) to CM (0.97 ± 0.06) and was higher in CM vs. controls ( p < 0.001). When MO and CM were combined, cSI gating ratio was associated with headache frequency (r = 0.418, p = 0.005). Paired responses and gating ratios of cSII and iSII did not differ among the groups. Conclusions Somatosensory gating is altered in migraine and associated with headache chronification. Further studies must clarify if this abnormal sensory modulation is a true gating deficit independent of low preexcitation level.
Collapse
Affiliation(s)
- Fu-Jung Hsiao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yung-Yang Lin
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jong-Ling Fuh
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Chieh Ko
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Ning Wang
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ta Chen
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
48
|
Khorasaninejad M, Shi Z, Zhu AY, Chen WT, Sanjeev V, Zaidi A, Capasso F. Achromatic Metalens over 60 nm Bandwidth in the Visible and Metalens with Reverse Chromatic Dispersion. Nano Lett 2017; 17:1819-1824. [PMID: 28125234 DOI: 10.1021/acs.nanolett.6b05137] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
In this Letter, we experimentally report an achromatic metalens (AML) operating over a continuous bandwidth in the visible. This is accomplished via dispersion engineering of dielectric phase shifters: titanium dioxide nanopillars tiled on a dielectric spacer layer above a metallic mirror. The AML works in reflection mode with a focal length independent of wavelength from λ = 490 to 550 nm. We also design a metalens with reverse chromatic dispersion, where the focal length increases as the wavelength increases, contrary to conventional diffractive lenses. The ability to engineer the chromatic dispersion of metalenses at will enables a wide variety of applications that were not previously possible. In particular, for the AML design, we envision applications such as imaging under LED illumination, fluorescence, and photoluminescence spectroscopy.
Collapse
Affiliation(s)
| | | | | | | | - V Sanjeev
- University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | | | | |
Collapse
|
49
|
Zhang SS, Tan JJ, Li L, Chen WT, Han NJ, Guo SP, Zheng S, Liu Y, Gao YN. [Up-regulation of DLK1 in non-small cell lung cancer and the relevant molecular mechanism]. Zhonghua Zhong Liu Za Zhi 2017; 38:510-4. [PMID: 27531264 DOI: 10.3760/cma.j.issn.0253-3766.2016.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the expression of delta-like 1 homolog (DLK1) gene in non-small cell lung cancer (NSCLC) and its regulatory mechanism. METHODS The expression levels of DLK1 protein in 204 NSCLC tissues were examined by immunohistochemical (IHC) staining, and the correlation between DLK1expression and clinicopathological features was analyzed. Bisulfate sequencing PCR (BSP) of DNA samples from the tumor tissues of 18 NSCLC patients was performed to evaluate the DNA methylation status of CpG island in the DLK1 promoter region, and also compared with the corresponding IHC staining of DLK1 protein in the same samples. RESULTS Among the 102 squamous cell carcinoma (SCC) tissue specimens and their adjacent normal bronchial epithelia, DLK1 was up-regulated in 72 and 37 samples, respectively (P=0.001), and among 102 adenocarcinomas (ADC) tissues and their adjacent alveolar tissues, DLK1 was up-regulated in 77 and 7 samples, respectively (P<0.001). In addition, overexpression of DLK1 was significantly associated with histological type, clinical stage and tumor size of NSCLC (P<0.05 for all). The expression of DLK1protein was inversely correlated with its promoter methylation (P<0.05). CONCLUSION DLK1 expression is up-regulated in NSCLCs, which may be due, at least in part, to the DNA hypomethylation in the promoter region of theDLK1 gene.
Collapse
Affiliation(s)
- S S Zhang
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - J J Tan
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - L Li
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - W T Chen
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - N J Han
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - S P Guo
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - S Zheng
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - Y Liu
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| | - Y N Gao
- Department of Etiology and Carcinogenesis, Beijing Key Laboratory of Carcinogenesis and Cancer Prevention, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China
| |
Collapse
|
50
|
Wu JW, Hseu SS, Fuh JL, Lirng JF, Wang YF, Chen WT, Chen SP, Wang SJ. Factors predicting response to the first epidural blood patch in spontaneous intracranial hypotension. Brain 2017; 140:344-352. [DOI: 10.1093/brain/aww328] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/08/2016] [Accepted: 10/31/2016] [Indexed: 01/03/2023] Open
|