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Sasaki R, Kojima S, Otsuru N, Yokota H, Saito K, Shirozu H, Onishi H. Beta resting-state functional connectivity predicts tactile spatial acuity. Cereb Cortex 2023; 33:9514-9523. [PMID: 37344255 PMCID: PMC10431746 DOI: 10.1093/cercor/bhad221] [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: 04/04/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/23/2023] Open
Abstract
Tactile perception is a complex phenomenon that is processed by multiple cortical regions via the primary somatosensory cortex (S1). Although somatosensory gating in the S1 using paired-pulse stimulation can predict tactile performance, the functional relevance of cortico-cortical connections to tactile perception remains unclear. We investigated the mechanisms by which corticocortical and local networks predict tactile spatial acuity in 42 adults using magnetoencephalography (MEG). Resting-state MEG was recorded with the eyes open, whereas evoked responses were assessed using single- and paired-pulse electrical stimulation. Source data were used to estimate the S1-seed resting-state functional connectivity (rs-FC) in the whole brain and the evoked response in the S1. Two-point discrimination threshold was assessed using a custom-made device. The beta rs-FC revealed a negative correlation between the discrimination threshold and S1-superior parietal lobule, S1-inferior parietal lobule, and S1-superior temporal gyrus connection (all P < 0.049); strong connectivity was associated with better performance. Somatosensory gating of N20m was also negatively correlated with the discrimination threshold (P = 0.015), with weak gating associated with better performance. This is the first study to demonstrate that specific beta corticocortical networks functionally support tactile spatial acuity as well as the local inhibitory network.
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Affiliation(s)
- Ryoki Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Hiroshi Shirozu
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, 1-14-1 Masago, Nishi-Ku, Niigata City, Niigata 950-2085, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
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Higashijima T, Shirozu H, Saitsu H, Sonoda M, Fujita A, Masuda H, Yamamoto T, Matsumoto N, Kameyama S. Incomplete hippocampal inversion in patients with mutations in genes involved in sonic hedgehog signaling. Heliyon 2023; 9:e14712. [PMID: 37012904 PMCID: PMC10066535 DOI: 10.1016/j.heliyon.2023.e14712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/01/2023] [Accepted: 03/15/2023] [Indexed: 03/28/2023] Open
Abstract
Sonic hedgehog (Shh) signaling pathways are known to play an important role in the morphological development of the hippocampus in vivo, but their actual roles in humans have not been clarified. Hypothalamic hamartoma (HH) is known to be associated with germline or somatic gene mutations of Shh signaling. We hypothesized that patients with HH and mutations of Shh-related genes also show hippocampal maldevelopment and an abnormal hippocampal infolding angle (HIA). We analyzed 45 patients (age: 1-37 years) with HH who underwent stereotactic radiofrequency thermocoagulation and found Shh-related gene mutations in 20 patients. In addition, 44 pediatric patients without HH (age: 2-25 years) who underwent magnetic resonance imaging (MRI) examinations under the same conditions during the same period were included in this study as a control group. HIA evaluated on MRI was compared between patients with gene mutations and the control group. The median HIA at the cerebral peduncle slice in patients with the gene mutation was 74.36° on the left and 76.11° on the right, and these values were significantly smaller than the corresponding values in the control group (80.46° and 80.56°, respectively, p < 0.01). Thus, mutations of Shh-related genes were correlated to incomplete hippocampal inversion. The HIA, particularly at the cerebral peduncle slice, is a potential indicator of abnormalities of the Shh-signaling pathway.
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Shirozu H. [Neuroimaging in the Diagnosis of Epilepsy]. No Shinkei Geka 2023; 51:43-57. [PMID: 36682748 DOI: 10.11477/mf.1436204714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Neuroimaging is commonly used for presurgical evaluation in epilepsy surgery. Neuroimaging for epilepsy includes structural and functional neuroimaging. Lesions detected by structural neuroimaging are crucial to determine the indication of epilepsy surgery, as well as to predict seizure outcomes, as patients with MRI-visible lesions are likely to have better seizure outcomes. However, MRI lesions sometimes show very faint findings; therefore, the diagnosis of structural neuroimaging requires sophisticated skills. Moreover, the epilepsy focus should not only involve the MRI-visible lesion, but also the surrounding tissue with abnormal neuronal function. The MRI-lesion, which is almost the same as that epileptogenic lesion, is a part of the epileptogenic zone. Surgical strategy should be conducted by comprehensive evaluation including neuroimaging in addition to other modalities.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery, National Hospital Organization, Nishiniigata Chuo Hospital
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Nakatani M, Inouchi M, Daifu-Kobayashi M, Murai T, Togawa J, Kajikawa S, Kobayashi K, Hitomi T, Kunieda T, Hashimoto S, Inaji M, Shirozu H, Kanazawa K, Iwasaki M, Usui N, Inoue Y, Maehara T, Ikeda A. Ictal direct current shifts contribute to defining the core ictal focus in epilepsy surgery. Brain Commun 2022; 4:fcac222. [PMID: 36381989 PMCID: PMC9639799 DOI: 10.1093/braincomms/fcac222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/01/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Abstract
Identifying the minimal and optimal epileptogenic area to resect and cure is the goal of epilepsy surgery. To achieve this, EEG analysis is recognized as the most direct way to detect epileptogenic lesions from spatiotemporal perspectives. Although ictal direct-current shifts (below 1 Hz) and ictal high-frequency oscillations (above 80 Hz) have received increasing attention as good indicators that can add more specific information to the conventionally defined seizure-onset zone, large cohort studies on postoperative outcomes are still lacking. This work aimed to clarify whether this additional information, particularly ictal direct-current shifts which is assumed to reflect extracellular potassium concentration, really improve postoperative outcomes. To assess the usefulness in epilepsy surgery, we collected unique EEG data sets recorded with a longer time constant of 10 s using an alternate current amplifier. Sixty-one patients (15 with mesial temporal lobe epilepsy and 46 with neocortical epilepsy) who had undergone invasive presurgical evaluation for medically refractory seizures at five institutes in Japan were retrospectively enrolled in this study. Among intracranially implanted electrodes, the two core electrodes of both ictal direct-current shifts and ictal high-frequency oscillations were independently identified by board-certified clinicians based on unified methods. The occurrence patterns, such as their onset time, duration, and amplitude (power) were evaluated to extract the features of both ictal direct-current shifts and ictal high-frequency oscillations. Additionally, we examined whether the resection ratio of the core electrodes of ictal direct-current shifts and ictal high-frequency oscillations independently correlated with favourable outcomes. A total of 53 patients with 327 seizures were analyzed for wide-band EEG analysis, and 49 patients were analyzed for outcome analysis. Ictal direct-current shifts were detected in the seizure-onset zone more frequently than ictal high-frequency oscillations among both patients (92% versus 71%) and seizures (86% versus 62%). Additionally, ictal direct-current shifts significantly preceded ictal high-frequency oscillations in patients exhibiting both biomarkers, and ictal direct-current shifts occurred more frequently in neocortical epilepsy patients than in mesial temporal lobe epilepsy patients. Finally, although a low corresponding rate was observed for ictal direct-current shifts and ictal high-frequency oscillations (39%) at the electrode level, complete resection of the core area of ictal direct-current shifts significantly correlated with favourable outcomes, similar to ictal high-frequency oscillation outcomes. Our results provide a proof of concept that the independent significance of ictal direct-current shifts from ictal high-frequency oscillations should be considered as reliable biomarkers to achieve favourable outcomes in epilepsy surgery. Moreover, the different distribution of the core areas of ictal direct-current shifts and ictal high-frequency oscillations may provide new insights into the underlying mechanisms of epilepsy, in which not only neurons but also glial cells may be actively involved via extracellular potassium levels.
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Affiliation(s)
- Mitsuyoshi Nakatani
- Department of Neurology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Morito Inouchi
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
- Department of Neurology, Kyoto City Hospital, 1-2 Mibuhigashitakadacho , Nakagyo-ku, Kyoto 604-8845 , Japan
| | - Masako Daifu-Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Tomohiko Murai
- Department of Neurology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Jumpei Togawa
- Department of Neurology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Shunsuke Kajikawa
- Department of Neurology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Katsuya Kobayashi
- Department of Neurology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Takefumi Hitomi
- Department of Laboratory Medicine, Kyoto University, 54 Shogoin-Kawaharacho , Sakyo-ku, Kyoto 606-8507 , Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine , Shitsukawa, Toon City, Ehime, 791-0295 , Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
| | - Satoka Hashimoto
- Department of Functional Neurosurgery, Tokyo Medical and Dental University , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 , JAPAN
| | - Motoki Inaji
- Department of Functional Neurosurgery, Tokyo Medical and Dental University , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 , JAPAN
| | - Hiroshi Shirozu
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital , 1-14-1 Masago, Nishi-ku, Niigata 950-2085 , Japan
| | - Kyoko Kanazawa
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry , 4-1-1 Ogawa-higashi-cho, Kodaira-shi, Tokyo 187-8551 , Japan
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry , 4-1-1 Ogawa-higashi-cho, Kodaira-shi, Tokyo 187-8551 , Japan
| | - Naotaka Usui
- Department of Neurosurgery, Shizuoka Institute of Epilepsy and Neurological Disorders , Urushiyama 886, Aoi-ku, Shizuoka 420-8688 , Japan
| | - Yushi Inoue
- Department of Psychiatry, Shizuoka Institute of Epilepsy and Neurological Disorders , Urushiyama 886, Aoi-ku, Shizuoka 420-8688 , Japan
| | - Taketoshi Maehara
- Department of Functional Neurosurgery, Tokyo Medical and Dental University , 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510 , JAPAN
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine , 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507 , Japan
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Shirozu H, Masuda H, Kameyama S. A Special Approach for Stereotactic Radiofrequency Thermocoagulation of Hypothalamic Hamartomas With Bilateral Attachments to the Hypothalamus: The Transthird Ventricular Approach to the Contralateral Attachment. Neurosurgery 2022; 91:295-303. [PMID: 35394461 DOI: 10.1227/neu.0000000000001996] [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: 07/31/2021] [Accepted: 02/12/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Disconnection surgery for the treatment of epileptic hypothalamic hamartomas (HHs) is strategically difficult in cases with complex-shaped HHs, especially with bilateral hypothalamic attachments, despite its effectiveness. OBJECTIVE To evaluate the feasibility of a new approach for stereotactic radiofrequency thermocoagulation (SRT) using penetration of the third ventricle (SRT-TT) aiming to disconnect bilateral hypothalamic attachments in a single-staged, unilateral procedure. METHODS Ninety patients (median age at surgery, 5.0 years) who had HHs with bilateral hypothalamic attachments and were followed for at least 1 year after their last SRT were retrospectively reviewed. RESULTS Thirty-three patients underwent SRT-TT as initial surgery. Of the 58 patients after mid-2013 when SRT-TT was introduced, 33 underwent SRT-TT and 12 (20.7%) required reoperation (ReSRT), whereas 20 of 57 patients (35.1%) without SRT-TT underwent reoperation. Reoperation was required in significantly fewer patients after mid-2013 (n = 12 of 58, 20.7%) than before mid-2013 (n = 15 of 32, 46.9%) (P = .01). Final seizure freedoms were not different between before and after mid-2013 (gelastic seizure freedom, n = 30 [93.8%] vs n = 49 [84.5%] and other types of seizure freedom, n = 21 of 31 [67.7%] vs n = 32 of 38 [84.2%]). Persistent complications were less in SRT-TT than in ReSRT using the bilateral approach, but not significantly. However, hormonal replacement was required significantly more often in ReSRT using the bilateral approach (4 of 9, 44.4%) than in SRT-TT (3 of 32, 9.4%) (P = .01). CONCLUSION SRT-TT enabled disconnection of bilateral attachments of HHs in a single-staged procedure, which reduced the additional invasiveness of reoperation. Moreover, SRT-TT reduced damage to the contralateral hypothalamus, with fewer endocrinological complications than the bilateral approach.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan.,Hypothalamic Hamartoma Center, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan.,Hypothalamic Hamartoma Center, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Niigata Seiro Hospital, Seiro, Niigata, Japan
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Abstract
Deep brain stimulation (DBS) is a well-established treatment for drug-resistant involuntary movements. However, the conventional quadripole cylindrical lead creates electrical fields in all directions, and the resulting spread to adjacent eloquent structures may induce unintended effects. Novel directional leads have therefore been designed to allow directional stimulation (DS). Directional leads have the advantage of widening the therapeutic window (TW), compensating for slight misplacement of the lead and requiring less electrical power to provide the same effect as a cylindrical lead. Conversely, the increase in the number of contacts from four to eight and the addition of directional elements has made stimulation programming more complex. For these reasons, new treatment strategies are required to allow effective directional DBS. During lead implantation, the directional segment should be placed in a "sweet spot," and the orientation of the directional segment is important for programming. Trial-and-error testing of a large number of contacts is unnecessary, and efficient and systematic execution of the programmed procedure is desirable. Recent improvements in imaging technologies have enabled image-guided programming. In the future, optimal stimulations are expected to be programmed by directional recording of local field potentials.
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Affiliation(s)
- Hiroshi Masuda
- Division of Functional Neurosurgery, Nishiniigata National Hospital
| | - Hiroshi Shirozu
- Division of Functional Neurosurgery, Nishiniigata National Hospital
| | - Yosuke Ito
- Division of Functional Neurosurgery, Nishiniigata National Hospital
| | - Masafumi Fukuda
- Division of Functional Neurosurgery, Nishiniigata National Hospital
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University
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Shirozu H, Masuda H, Kameyama S. Long-term seizure outcomes in patients with hypothalamic hamartoma treated by stereotactic radiofrequency thermocoagulation. Epilepsia 2021; 62:2697-2706. [PMID: 34541660 DOI: 10.1111/epi.17071] [Citation(s) in RCA: 1] [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: 07/13/2021] [Revised: 08/25/2021] [Accepted: 09/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate long-term seizure outcomes in patients with hypothalamic hamartoma (HH) following stereotactic radiofrequency thermocoagulation (SRT). METHODS A total of 131 patients with HH who underwent SRT and were followed for at least three years after the last SRT were enrolled. Seizure outcomes were evaluated for gelastic seizures (GS) and other types of seizures (nGS) separately using the International League Against Epilepsy classification. Classes 1 and 2 were considered seizure-free. Kaplan-Meier survival analyses were used to estimate the proportion remaining seizure-free after the first and last SRTs. Risk factors relating to outcomes were analyzed by log-rank tests and a multivariate Cox proportional hazards model. RESULTS Reoperation was performed in 34 patients (26.2%). Median total follow-up was 61 (range, 36-202) months. Seizure freedom was obtained in 116 patients (88.6%) for GS and 85 of 108 patients (78.7%) for nGS at the last follow-up. Mean GS-free survival times improved from after the first (64.1 [95%CI 57.3-70.9] months) to after the last SRT (80.2 [95%CI 75.7-84.8] months). About 90% of GS recurrences after the first SRT were found within 6 months, though a few patients recurred more than 2 years after the first SRT. On the other hand, mean nGS-free survival times after the first and last SRTs were not different between after the first SRT (84.4 [95%CI 73.0-90.7] months) and after the last SRT (83.1 [95%CI 74.1-92.0] months). There was no factor related to GS outcomes, but the significant factor for nGS-free survival after the last SRT was multiple previous treatments (p=0.01, hazard ratio=15.65, 95%CI 1.79-137.16). SIGNIFICANCE The last SRT was almost equivalent to achieving complete disconnection of HHs from the hypothalamus according to our strategy. Considering the epileptogenic network, GS outcomes depend on complete disconnection, whereas nGS outcomes are not affected by surgical factors but independency of secondary epileptogenesis.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan.,Hypothalamic Hamartoma Center, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan.,Hypothalamic Hamartoma Center, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Niigata Seiro Hospital, Niigata, Japan
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Kojima S, Otsuru N, Miyaguchi S, Yokota H, Nagasaka K, Saito K, Inukai Y, Shirozu H, Onishi H. The intervention of mechanical tactile stimulation modulates somatosensory evoked magnetic fields and cortical oscillations. Eur J Neurosci 2021; 53:3433-3446. [PMID: 33772899 DOI: 10.1111/ejn.15209] [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: 07/22/2020] [Revised: 02/28/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
The different cortical activity evoked by a mechanical tactile stimulus depends on tactile stimulus patterns, which demonstrates that simple stimuli (i.e., global synchronous stimulation the stimulus area) activate the primary somatosensory cortex alone, whereas complex stimuli (i.e., stimulation while moving in the stimulus area) activate not only the primary somatosensory cortex but also the primary motor area. Here, we investigated whether the effects of a repetitive mechanical tactile stimulation (MS) on somatosensory evoked magnetic fields (SEFs) and cortical oscillations depend on MS patterns. This single-blinded study included 15 healthy participants. Two types interventions of MS lasting 20 min were used: a repetitive global tactile stimulation (RGS) was used to stimulate the finger by using 24 pins installed on a finger pad, whereas a sequential stepwise displacement tactile stimulation (SSDS) was used to stimulate the finger by moving a row of six pins between the left and right sides on the finger pad. Each parameter was measured pre- and post-intervention. The P50m amplitude of the SEF was increased by RGS and decreased by SSDS. The modulation of P50m was correlated with its amplitude before RGS and with the modulation of beta band oscillation at the resting state after SSDS. This study showed that the effects of a 20-min MS on SEFs and cortical oscillations depend on mechanical tactile stimulus patterns. Moreover, our results offer potential for the modulation of tactile functions and selection of stimulation patterns according to cortical states.
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Affiliation(s)
- Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Yasuto Inukai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Hiroshi Shirozu
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
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Kameyama S, Masuda H, Shirozu H. Location of emotional corticobulbar tract in the internal capsule. J Neurol Sci 2020; 420:117228. [PMID: 33248382 DOI: 10.1016/j.jns.2020.117228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 10/26/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
Emotional facial paresis (EFP) is a rare neurological symptom with intact volitional facial movement. The exact location of emotional corticobulbar tract remains unclear. EFP was frequently recognized following the surgery of stereotactic radiofrequency thermocoagulation for hypothalamic hamartoma in 84.5% of 58 patients. To examine our hypothesis that EFP might be caused by stereotactic trajectories passing through an area including the internal capsule (IC), topographical locations of trajectories were analyzed and compared between the EFP-positive group (n = 41) and the EFP-negative group (n = 8). In the EFP-positive group, multiple (2 to 5) trajectories focused within the genu of the IC in 31 (75.6%) cases, whereas a single trajectory passed through the genu in 8 (19.5%) cases. In the EFP-negative group, 6 (75.0%) of 8 patients had a single trajectory and only one patient had two trajectories passing through the genu of the IC. The ratio between multiple trajectories and a single trajectory relevant to the genu differed significantly between two groups (p < 0.01). The multiple trajectories focusing in the genu have high risks of EFP, whereas a single trajectory seemed to incidentally cause EFP. The results proved our hypothesis and provided a high probability that the emotional corticobulbar tract passes through the genu rather than anterior or posterior limbs of the IC. The location of the emotional corticobulbar tract is in the genu of the IC.
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Affiliation(s)
- Shigeki Kameyama
- Department of Neurosurgery, Hypothalamic Hamartoma Center, National Hospital Organization, Nishiniigata Chuo Hospital, Niigata, Japan; Department of Neurosurgery, Niigata Seiro Hospital, Seiro, Niigata, Japan.
| | - Hiroshi Masuda
- Department of Neurosurgery, Hypothalamic Hamartoma Center, National Hospital Organization, Nishiniigata Chuo Hospital, Niigata, Japan.
| | - Hiroshi Shirozu
- Department of Neurosurgery, Hypothalamic Hamartoma Center, National Hospital Organization, Nishiniigata Chuo Hospital, Niigata, Japan.
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Shirozu H, Masuda H, Kameyama S. Significance of the electrophysiological border between hypothalamic hamartomas and the hypothalamus for the target of ablation surgery identified by intraoperative semimicrorecording. Epilepsia 2020; 61:2739-2747. [PMID: 33084060 DOI: 10.1111/epi.16730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/13/2020] [Revised: 09/25/2020] [Accepted: 09/26/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Ablation surgery has become the first line of treatment for hypothalamic hamartomas (HHs). For effective treatment, optimum targeting of ablation is mandatory. The present study aimed to evaluate the correspondence between the electrophysiological features of HHs and morphological targeting by semimicrorecording during stereotactic radiofrequency thermocoagulation (SRT). METHODS Eighty HH patients who underwent SRT were involved. Semimicrorecording was performed on the first trajectory. The distance from the center of the target at the morphological border (TMB) determined by magnetic resonance imaging, differences in discharge patterns, and area potentials (APs) were measured. RESULTS The electrophysiological border (EB) between the HH and hypothalamus was detected by semimicrorecording in 73 (91.3%), AP increase (API) in the HH was detected in 31 (38.8%), and spike discharges (SDs) of the HH were detected in 56 patients (70.0%). Semimicrorecording showed significantly different APs among structures passing through the trajectory, except between API and SDs. The median distances from the center of the TMB to the EB, API, SDs, and AP decline were -3.50, -2.49, -1.38, and +2.00 mm, respectively. SIGNIFICANCE The electrophysiological features of HHs were shown by semimicrorecording during SRT. The EB corresponded to the morphological border. The electrophysiologically active area of HHs was located near the border. Ablation surgery should focus on disconnection at the border between the HH and the hypothalamus to maximize its effectiveness, as well as to reduce complications.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan.,Hypothalamic Hamartoma Center, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan.,Hypothalamic Hamartoma Center, National Hospital Organization Nishiniigata Chuo Hospital, Niigata, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Niigata Seiro Hospital, Niigata, Japan
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Shirozu H, Masuda H, Fukuda M, Kameyama S. O1-045 MEG analysis of spike onset zone in various epileptogenic lesions. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2020.04.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shirozu H, Masuda H, Kameyama S. Repeat stereotactic radiofrequency thermocoagulation in patients with hypothalamic hamartoma and seizure recurrence. Epilepsia Open 2020; 5:107-120. [PMID: 32140649 PMCID: PMC7049799 DOI: 10.1002/epi4.12378] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/04/2019] [Revised: 01/02/2020] [Accepted: 01/04/2020] [Indexed: 11/09/2022] Open
Abstract
Objective To evaluate the feasibility of repeat stereotactic radiofrequency thermocoagulation (re‐SRT) for patients with hypothalamic hamartoma (HH) and to clarify clinical and surgical factors for seizure outcomes. Methods Hypothalamic hamartoma patients with gelastic seizures (GSs) who underwent SRT were retrospectively reviewed. Seizure outcomes were evaluated separately for GS and other types of seizures (non‐GS). Surgical complications were compared between re‐SRT and first SRT. Clinical and surgical factors related to both seizure recurrences after first SRT and final seizure outcomes were analyzed. Results Participants comprised 150 patients (92 males; median age at surgery, 8 years; range, 1.7‐50 years). Of those, 122 (81.3%) had non‐GS. Forty‐three patients (28.7%) underwent re‐SRT. Freedom from GS was achieved by first SRT in 103 patients (68.7%), second SRT in 30/40 (67.5%), third SRT in 3/10 (30.0%), and fourth SRT in 2/3 (66.7%). Finally, 135 patients (90.0%) became GS‐free. Ninety patients (73.8%) achieved non‐GS freedom, with first SRT in all except one case. Transient complications were more frequent with first SRT (118/150, 78.7%) than re‐SRT (35/56, 62.5%), whereas persistent complications were more frequent with re‐SRT (7/56, 12.5%) than with first SRT (3/150, 2.0%). Multivariate analyses revealed only younger age at surgery (≤1 year) as related to GS recurrence after first SRT, with no variables affecting final GS outcomes. Meanwhile, seizure type (tonic seizure), intellectual disability, and genetic syndromes were significant factors for both non‐GS recurrence and final outcomes. Multiple previous treatments were significantly related to final non‐GS outcomes as well. Size and subtype of HH and surgical factors were unrelated to seizure outcomes. Significance Repeat stereotactic radiofrequency thermocoagulation provides potential opportunities to achieve freedom from recurrent GS, albeit with increased risks of persistent complications. Non‐GS and intellectual disability could offer early surgical indications, and repeated ineffective treatments should be avoided.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery National Hospital Organization Nishiniigata Chuo Hospital Niigata Japan.,Hypothalamic Hamartoma Center National Hospital Organization Nishiniigata Chuo Hospital Niigata Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery National Hospital Organization Nishiniigata Chuo Hospital Niigata Japan.,Hypothalamic Hamartoma Center National Hospital Organization Nishiniigata Chuo Hospital Niigata Japan
| | - Shigeki Kameyama
- Department of Functional Neurosurgery National Hospital Organization Nishiniigata Chuo Hospital Niigata Japan.,Hypothalamic Hamartoma Center National Hospital Organization Nishiniigata Chuo Hospital Niigata Japan.,Department of Neurosurgery Saiseikai Niigata Hospital Niigata Japan
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Shirozu H, Hashizume A, Masuda H, Kakita A, Otsubo H, Kameyama S. Surgical strategy for focal cortical dysplasia based on the analysis of the spike onset and peak zones on magnetoencephalography. J Neurosurg 2019; 133:1850-1862. [PMID: 31585422 DOI: 10.3171/2019.6.jns191058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/15/2019] [Accepted: 06/24/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to elucidate the surgical strategy for focal cortical dysplasia (FCD) based on the interictal analysis on magnetoencephalography (MEG). For this purpose, the correlation between the spike onset zone (Sp-OZ) and the spike peak zone (Sp-PZ) on MEG was evaluated to clarify the differences in the Sp-OZ and its correlation with Sp-PZ in FCD subtypes to develop an appropriate surgical strategy. METHODS Forty-one FCD patients (n = 17 type I, n = 13 type IIa, and n = 11 type IIb) were included. The Sp-OZ was identified by the summation of gradient magnetic-field topography (GMFT) magnitudes at interictal MEG spike onset, and Sp-PZ was defined as the distribution of the equivalent current dipole (ECD) at spike peak. Correlations between Sp-OZ and Sp-PZ distributions were evaluated and compared with clinical factors and seizure outcomes retrospectively. RESULTS Good seizure outcomes (Engel class I) were obtained significantly more often in patients with FCD type IIb (10/11, 90.9%) than those with type IIa (4/13, 30.8%; p = 0.003) and type I (6/17, 35.3%; p = 0.004). The Sp-OZ was significantly smaller (1 or 2 gyri) in type IIb (10, 90.9%) than in type IIa (4, 30.8%; p = 0.003) or type I (9, 53.0%; p = 0.036). Concordant correlations between the Sp-OZ and Sp-PZ were significantly more frequent in type IIb (7, 63.6%) than in type IIa (1, 7.7%; p = 0.015) or type I (1, 5.8%; p = 0.004). Complete resection of the Sp-OZ achieved significantly better seizure outcomes (Engel class I: 9/10, 90%) than incomplete resection (11/31, 35.5%) (p = 0.003). In contrast, complete resection of the Sp-PZ showed no significant difference in good seizure outcomes (9/13, 69.2%) compared with incomplete resection (11/28, 39.3%). CONCLUSIONS The Sp-OZ detected by MEG using GMFT and its correlation with Sp-PZ were related to FCD subtypes. A discordant distribution between Sp-OZ and Sp-PZ in type I and IIa FCD indicated an extensive epileptogenic zone and a complex epileptic network. Type IIb showed a restricted epileptogenic zone with the smaller Sp-OZ and concordance between Sp-OZ and Sp-PZ. Complete resection of the Sp-OZ provided significantly better seizure outcomes than incomplete resection. Complete resection of the Sp-PZ was not related to seizure outcomes. There was a definite difference in the epileptogenic zone among FCD subtypes; hence, an individual surgical strategy taking into account the correlation between the Sp-OZ and Sp-PZ should be considered.
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Affiliation(s)
- Hiroshi Shirozu
- 1Department of Functional Neurosurgery, National Hospital Organization, Nishiniigata Chuo Hospital, Niigata
| | - Akira Hashizume
- 2Department of Neurosurgery, Takanobashi Central Hospital, Hiroshima
| | - Hiroshi Masuda
- 1Department of Functional Neurosurgery, National Hospital Organization, Nishiniigata Chuo Hospital, Niigata
| | - Akiyoshi Kakita
- 3Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan; and
| | - Hiroshi Otsubo
- 4Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shigeki Kameyama
- 1Department of Functional Neurosurgery, National Hospital Organization, Nishiniigata Chuo Hospital, Niigata
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Fukuda M, Masuda H, Shirozu H, Ito Y, Higashijima T, Hiraishi T, Oishi M, Fujii Y. S15-4. Intraoperative monitoring during neurosurgery for posterior fossa lesions. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.06.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shirozu H, Masuda H, Ito Y, Higashijima T, Fukuda M, Kameyama S. P2-04-05. Characteristics of EEG in patients with epilepsy due to hypothalamic hamartoma. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.06.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fujita A, Higashijima T, Shirozu H, Masuda H, Sonoda M, Tohyama J, Kato M, Nakashima M, Tsurusaki Y, Mitsuhashi S, Mizuguchi T, Takata A, Miyatake S, Miyake N, Fukuda M, Kameyama S, Saitsu H, Matsumoto N. Pathogenic variants of DYNC2H1, KIAA0556, and PTPN11 associated with hypothalamic hamartoma. Neurology 2019; 93:e237-e251. [PMID: 31197031 DOI: 10.1212/wnl.0000000000007774] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/04/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Intensive genetic analysis was performed to reveal comprehensive molecular insights into hypothalamic hamartoma (HH). METHODS Thirty-eight individuals with HH were investigated by whole exome sequencing, target capture-based deep sequencing, or single nucleotide polymorphism (SNP) array using DNA extracted from blood leukocytes or HH samples. RESULTS We identified a germline variant of KIAA0556, which encodes a ciliary protein, and 2 somatic variants of PTPN11, which forms part of the RAS/mitogen-activated protein kinase (MAPK) pathway, as well as variants in known genes associated with HH. An SNP array identified (among 3 patients) one germline copy-neutral loss of heterozygosity (cnLOH) at 6p22.3-p21.31 and 2 somatic cnLOH; one at 11q12.2-q25 that included DYNC2H1, which encodes a ciliary motor protein, and the other at 17p13.3-p11.2. A germline heterozygous variant and an identical somatic variant of DYNC2H1 arising from cnLOH at 11q12.2-q25 were confirmed in one patient (whose HH tissue, therefore, contains biallelic variants of DYNC2H1). Furthermore, a combination of a germline and a somatic DYNC2H1 variant was detected in another patient. CONCLUSIONS Overall, our cohort identified germline/somatic alterations in 34% (13/38) of patients with HH. Disruption of the Shh signaling pathway associated with cilia or the RAS/MAPK pathway may lead to the development of HH.
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Affiliation(s)
- Atsushi Fujita
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Takefumi Higashijima
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiroshi Shirozu
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiroshi Masuda
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masaki Sonoda
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Jun Tohyama
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Mitsuhiro Kato
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Mitsuko Nakashima
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yoshinori Tsurusaki
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Satomi Mitsuhashi
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Takeshi Mizuguchi
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Atsushi Takata
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Satoko Miyatake
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Noriko Miyake
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masafumi Fukuda
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Shigeki Kameyama
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hirotomo Saitsu
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan
| | - Naomichi Matsumoto
- From the Departments of Human Genetics (A.F., S. Mitsuhashi, T.M., A.T., S. Miyatake, N. Miyake, N. Matsumoto) and Neurosurgery (M.S.), Yokohama City University Graduate School of Medicine; Departments of Functional Neurosurgery (T.H., H. Shirozu, H.M., M.F., S.K.) and Child Neurology (J.T.), Epilepsy Center, National Hospital Organization Nishiniigata Chuo Hospital Niigata, Japan; Department of Pediatrics and Neurology (M.S.), Wayne State University, Children's Hospital of Michigan, Detroit Medical Center; Department of Pediatrics (M.K.), Showa University School of Medicine, Tokyo; Department of Biochemistry (M.N., H. Saitsu), Hamamatsu University School of Medicine; and Clinical Research Institute (Y.T.), Kanagawa Children's Medical Center, Yokohama, Japan.
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Kitaura H, Shirozu H, Masuda H, Fukuda M, Fujii Y, Kakita A. Pathophysiological Characteristics Associated With Epileptogenesis in Human Hippocampal Sclerosis. EBioMedicine 2018; 29:38-46. [PMID: 29478873 PMCID: PMC5925580 DOI: 10.1016/j.ebiom.2018.02.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 12/11/2017] [Revised: 02/07/2018] [Accepted: 02/15/2018] [Indexed: 12/29/2022] Open
Abstract
Mesial temporal lobe epilepsy (MTLE) is the most frequent focal epileptic syndrome in adults, and the majority of seizures originate primarily from the hippocampus. The resected hippocampal tissue often shows severe neuronal loss, a condition referred to as hippocampal sclerosis (HS). In order to understand hippocampal epileptogenesis in MTLE, it seems important to clarify any discrepancies between the clinical and pathological features of affected patients. Here we investigated epileptiform activities ex vivo using living hippocampal tissue taken from patients with MTLE. Flavoprotein fluorescence imaging and local field potential recordings revealed that epileptiform activities developed from the subiculum. Moreover, physiological and morphological experiments revealed possible impairment of K+ clearance in the subiculum affected by HS. Stimulation of mossy fibers induced recurrent trans-synaptic activity in the granule cell layer of the dentate gyrus, suggesting that mossy fiber sprouting in HS also contributes to the epileptogenic mechanism. These results indicate that pathophysiological alterations involving the subiculum and dentate gyrus could be responsible for epileptogenesis in patients with MTLE.
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Affiliation(s)
- Hiroki Kitaura
- Department of Pathology, Brain Research Institute, Niigata University, 1 Asahimachi, Chuo-ku, Niigata 951-8585, Japan.
| | - Hiroshi Shirozu
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, 1 Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Hiroshi Masuda
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, 1 Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Masafumi Fukuda
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, 1 Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1 Asahimachi, Chuo-ku, Niigata 951-8585, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, 1 Asahimachi, Chuo-ku, Niigata 951-8585, Japan
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Fukuda M, Masuda H, Shirozu H, Ito Y, Nakayama Y, Higashijima T, Fujii Y. Additional resective surgery after the failure of initial surgery in patients with intractable epilepsy. Neurol Res 2017; 39:1049-1055. [PMID: 28889791 DOI: 10.1080/01616412.2017.1376471] [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: 10/18/2022]
Abstract
Objectives There are three conceivable reasons for the failure of resective surgery for intractable epilepsy: incomplete resection of the epileptogenic zone including or overlapping with eloquent area (group A); incorrect determination of the epileptogenic zone prior to the first surgery (group B); and the development of a new epileptic focus after the first surgery (group C). We examined the relationship between the reason for failure of initial surgery and patient outcomes after repeated surgical resection. Methods The study included 18 patients (5.1%) underwent additional surgery after failure of the initial operation. Post-operative outcomes, complications and other clinical data were collected by retrospective chart review. Results Four patients (22.2%) were assigned to group A, 13 (72.2%) were assigned to group B, and 1 patient was assigned to group C (5.6%). Six patients (40.0%) were seizure-free for 2 or more years after additional surgery. In group B, 11 patients underwent additional resection of the cortex adjacent to the previously resected area and 2 underwent re-operation involving a site distant from the previously resected area; notably, the latter 2 patients did not achieve seizure-free status post-surgery. After the first operation, only one patient (group A) experienced transient paresis; after additional surgery, 10 of 18 patients (56%; 3 group A, 6 group B, and 1 group C) experienced various complications. Discussion Although additional resective surgery provided freedom from seizures in about 40% of the patients, it is important to weigh a high risk of complications against possible benefits when considering additional surgery.
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Affiliation(s)
- Masafumi Fukuda
- a Department of Neurosurgery , Nishi-Niigata National Chuo Hospital , Niigata-City , Japan
| | - Hiroshi Masuda
- a Department of Neurosurgery , Nishi-Niigata National Chuo Hospital , Niigata-City , Japan
| | - Hiroshi Shirozu
- a Department of Neurosurgery , Nishi-Niigata National Chuo Hospital , Niigata-City , Japan
| | - Yosuke Ito
- a Department of Neurosurgery , Nishi-Niigata National Chuo Hospital , Niigata-City , Japan
| | - Yoko Nakayama
- a Department of Neurosurgery , Nishi-Niigata National Chuo Hospital , Niigata-City , Japan
| | - Takefumi Higashijima
- a Department of Neurosurgery , Nishi-Niigata National Chuo Hospital , Niigata-City , Japan
| | - Yukihiko Fujii
- b Department of Neurosurgery , Brain Research Institute, University of Niigata , Niigata-City , Japan
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Sonoda M, Masuda H, Shirozu H, Ito Y, Akazawa K, Asano E, Kameyama S. Predictors of cognitive function in patients with hypothalamic hamartoma following stereotactic radiofrequency thermocoagulation surgery. Epilepsia 2017; 58:1556-1565. [DOI: 10.1111/epi.13838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Masaki Sonoda
- Hypothalamic Hamartoma Center; Department of Functional Neurosurgery; Nishi-Niigata Chuo National Hospital; Niigata Japan
- Department of Neurosurgery; Graduate School of Medicine; Yokohama City University; Yokohama Kanagawa Japan
| | - Hiroshi Masuda
- Hypothalamic Hamartoma Center; Department of Functional Neurosurgery; Nishi-Niigata Chuo National Hospital; Niigata Japan
| | - Hiroshi Shirozu
- Hypothalamic Hamartoma Center; Department of Functional Neurosurgery; Nishi-Niigata Chuo National Hospital; Niigata Japan
| | - Yosuke Ito
- Hypothalamic Hamartoma Center; Department of Functional Neurosurgery; Nishi-Niigata Chuo National Hospital; Niigata Japan
| | - Kohei Akazawa
- Department of Medical Informatics; Niigata University Medical and Dental Hospital; Niigata Japan
| | - Eishi Asano
- Department of Pediatrics; Children's Hospital of Michigan; Detroit Medical Center; Wayne State University; Detroit Michigan U.S.A
- Department of Neurology; Children's Hospital of Michigan; Detroit Medical Center; Wayne State University; Detroit Michigan U.S.A
| | - Shigeki Kameyama
- Hypothalamic Hamartoma Center; Department of Functional Neurosurgery; Nishi-Niigata Chuo National Hospital; Niigata Japan
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Shirozu H, Hashizume A, Masuda H, Ito Y, Nakayama Y, Higashijima T, Fukuda M, Kameyama S. Analysis of ictal magnetoencephalography using gradient magnetic-field topography (GMFT) in patients with neocortical epilepsy. Clin Neurophysiol 2017. [PMID: 28646743 DOI: 10.1016/j.clinph.2017.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 02/01/2023]
Abstract
OBJECTIVE We aimed to validate the usefulness of gradient magnetic-field topography (GMFT) for analysis of ictal magnetoencephalography (MEG) in patients with neocortical epilepsy. METHODS We identified 13 patients presenting with an ictal event during preoperative MEG. We applied equivalent current dipole (ECD) estimation and GMFT to detect and localize the ictal MEG onset, and compared these methods with the ictal onset zone (IOZ) derived from chronic intracranial electroencephalography. The surgical resection areas and outcomes were also evaluated. RESULTS GMFT detected and localized the ictal MEG onset in all patients, whereas ECD estimation showed localized ECDs in only 2. The delineation of GMFT was concordant with the IOZ at the gyral-unit level in 10 of 12 patients (83.3%). The detectability and precision of delineation of ictal MEG activity by GMFT were significantly superior to those of ECD (p<0.05 and p<0.01, respectively). Complete resection of the IOZ in the concordant group provided seizure freedom in 3 patients, whereas seizures remained in 9 patients who had incomplete resections. CONCLUSIONS Because of its higher spatial resolution, GMFT of ictal MEG is superior to conventional ECD estimation in patients with neocortical epilepsy. SIGNIFICANCE Ictal MEG study is a useful tool to estimate the seizure onset in patients with neocortical epilepsy.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan.
| | - Akira Hashizume
- Department of Neurosurgery, Takanobashi Central Hospital, 2-4-16, Kokutaiji-chou, Naka-ku, Hiroshima 730-0042, Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Yosuke Ito
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Yoko Nakayama
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Takefumi Higashijima
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Masafumi Fukuda
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan
| | - Shigeki Kameyama
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, 1-14-1, Masago, Nishi-ku, Niigata 950-2085, Japan
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Nakayama Y, Masuda H, Shirozu H, Ito Y, Higashijima T, Kitaura H, Fujii Y, Kakita A, Fukuda M. Features of amygdala in patients with mesial temporal lobe epilepsy and hippocampal sclerosis: An MRI volumetric and histopathological study. Epilepsy Res 2017. [PMID: 28622539 DOI: 10.1016/j.eplepsyres.2017.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/25/2022]
Abstract
OBJECTIVE It is well-known that there is a correlation between the neuropathological grade of hippocampal sclerosis (HS) and neuroradiological atrophy of the hippocampus in mesial temporal lobe epilepsy (mTLE) patients. However, there is no strict definition or criterion regarding neuron loss and atrophy of the amygdala neighboring the hippocampus. We examined the relationship between HS and neuronal loss in the amygdala. MATERIALS AND METHODS Nineteen mTLE patients with neuropathological proof of HS were assigned to Group A, while seven mTLE patients without HS were assigned to Group B. We used FreeSurfer software to measure amygdala volume automatically based on pre-operation magnetic resonance images. Neurons observed using Klüver-Barrera (KB) staining in resected amygdala tissue were counted. and the extent of immunostaining with stress marker antibodies was semiquantitatively evaluated. RESULTS There was no significant difference in amygdala volume between the two groups (Group A: 1.41±0.24; Group B: 1.41±0.29cm3; p=0.98), nor in the neuron cellularity of resected amygdala specimens (Group A: 3.98±0.97; Group B: 3.67±0.67 10×-4 number of neurons/μm2; p=0.40). However, the HSP70 level, representing acute stress against epilepsy, in Group A patients was significantly larger than that in Group B. There was no significant difference in the level of Bcl-2, which is known as a protein that inhibits cell death, between the two groups. CONCLUSIONS Neuronal loss and volume loss in the amygdala may not necessarily follow hippocampal sclerosis. From the analysis of stress proteins, epileptic attacks are as likely to damage the amygdala as the hippocampus but do not lead to neuronal death in the amygdala.
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Affiliation(s)
- Yoko Nakayama
- Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, 950-2085, Japan; Department of Pathology, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8585, Japan; Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8585, Japan
| | - Hiroshi Masuda
- Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, 950-2085, Japan
| | - Hiroshi Shirozu
- Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, 950-2085, Japan
| | - Yosuke Ito
- Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, 950-2085, Japan
| | - Takefumi Higashijima
- Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, 950-2085, Japan
| | - Hiroki Kitaura
- Department of Pathology, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8585, Japan
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8585, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, University of Niigata, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8585, Japan
| | - Masafumi Fukuda
- Department of Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Nishi-ku, Niigata, 950-2085, Japan.
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Kitaura H, Sonoda M, Teramoto S, Shirozu H, Shimizu H, Kimura T, Masuda H, Ito Y, Takahashi H, Kwak S, Kameyama S, Kakita A. Ca 2+ -permeable AMPA receptors associated with epileptogenesis of hypothalamic hamartoma. Epilepsia 2017; 58:e59-e63. [PMID: 28195308 DOI: 10.1111/epi.13700] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 11/28/2022]
Abstract
Hypothalamic hamartoma (HH), composed of neurons and glia without apparent cytologic abnormalities, is a rare developmental malformation in humans. Patients with HH often have characteristic medically refractory gelastic seizures, and intrinsic epileptogenesis within the lesions has been speculated. Herein we provide evidence to suggest that in HH neurons, Ca2+ permeability through α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors is aberrantly elevated. In needle biopsy specimens of HH tissue, field potential recordings demonstrated spontaneous epileptiform activities similar to those observed in other etiologically distinct epileptogenic tissues. In HH, however, these activities were clearly abolished by application of Joro Spider Toxin (JSTX), a specific inhibitor of the Ca2+ -permeable AMPA receptor. Consistent with these physiologic findings, the neuronal nuclei showed disappearance of adenosine deaminase acting on RNA 2 (ADAR2) immunoreactivity. Furthermore, examination of glutamate receptor 2 (GluA2) messenger RNA (mRNA) revealed that editing efficiency at the glutamine/arginine site was significantly low. These results suggest that neurons in HH may bear Ca2+ -permeable AMPA receptors due to dislocation of ADAR2.
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Affiliation(s)
- Hiroki Kitaura
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Masaki Sonoda
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Sayaka Teramoto
- Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Shirozu
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hiroshi Shimizu
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Tadashi Kimura
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Hiroshi Masuda
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Yosuke Ito
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hitoshi Takahashi
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Shin Kwak
- Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
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Abstract
OBJECTIVE
The authors undertook this study to validate the feasibility and safety of stereotactic radiofrequency thermocoagulation (SRT) for the surgical treatment of giant hypothalamic hamartoma (HH).
METHODS
Of the 109 patients who underwent SRT for hypothalamic hamartoma (HH) at the authors' institution between 1997 and 2013, 16 patients (9 female, 7 male) had giant HHs (maximum diameter ≥ 30 mm). The clinical records of these 16 patients were retrospectively reviewed.
RESULTS
The patients' age at first SRT ranged from 1 to 22 years (median 5 years). The maximum diameter of their HHs was 30–80 mm (mean 38.5 mm). Eleven HHs had bilateral attachments to the hypothalamus. All patients had gelastic seizures (GS), and 12 had types of seizures other than GS. Some of these patients also had mental retardation (n = 10, 62.5%), behavioral disorders (n = 8, 50.0%), and precocious puberty (n = 11, 68.8%). A total of 22 SRT procedures were performed; 5 patients underwent repeat SRT procedures. There was no mortality or permanent morbidity. After 17 of the 22 procedures, the patients experienced transient complications, including high fever (n = 7), hyperphagia (n = 3), hyponatremia (n = 6), disturbance of consciousness (n = 1), cyst enlargement (n = 1), and epidural hematoma (n = 1). Thirteen patients (81.3%) achieved freedom from GS after the final SRT procedure during a follow-up period ranging from 6 to 60 months (mean 23 months). Twelve patients had nongelastic seizures in addition to GS, and 7 (58.3%) of these 12 patients experienced freedom from their nongelastic seizures.
CONCLUSIONS
SRT provided minimal invasiveness and excellent seizure outcomes even in patients with giant HHs. Repeat SRT is safe for residual GS. SRT is a feasible single surgical strategy for HH regardless of the tumor's size or shape.
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Affiliation(s)
- Hiroshi Shirozu
- 1Department of Functional Neurosurgery and
- 2Hypothalamic Hamartoma Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hiroshi Masuda
- 1Department of Functional Neurosurgery and
- 2Hypothalamic Hamartoma Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Yosuke Ito
- 1Department of Functional Neurosurgery and
- 2Hypothalamic Hamartoma Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Masaki Sonoda
- 1Department of Functional Neurosurgery and
- 2Hypothalamic Hamartoma Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Shigeki Kameyama
- 1Department of Functional Neurosurgery and
- 2Hypothalamic Hamartoma Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
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Shirozu H, Hashizume A, Masuda H, Fukuda M, Ito Y, Nakayama Y, Higashijima T, Kameyama S. Spatiotemporal Accuracy of Gradient Magnetic-Field Topography (GMFT) Confirmed by Simultaneous Magnetoencephalography and Intracranial Electroencephalography Recordings in Patients with Intractable Epilepsy. Front Neural Circuits 2016; 10:65. [PMID: 27594827 PMCID: PMC4990550 DOI: 10.3389/fncir.2016.00065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/27/2016] [Accepted: 08/03/2016] [Indexed: 11/13/2022] Open
Abstract
Gradient magnetic-field topography (GMFT) is one method for analyzing magnetoencephalography (MEG) and representing the spatiotemporal dynamics of activity on the brain surface. In contrast to spatial filters, GMFT does not include a process reconstructing sources by mixing sensor signals with adequate weighting. Consequently, noisy sensors have localized and limited effects on the results, and GMFT can handle MEG recordings with low signal-to-noise ratio. This property is derived from the principle of the planar-type gradiometer, which obtains maximum gradient magnetic-field signals just above the electrical current source. We assumed that this characteristic allows GMFT to represent even faint changes in brain activities that cannot be achieved with conventional equivalent current dipole analysis or spatial filters. GMFT is thus hypothesized to represent brain surface activities from onset to propagation of epileptic discharges. This study aimed to validate the spatiotemporal accuracy of GMFT by analyzing epileptic activities using simultaneous MEG and intracranial electroencephalography (iEEG) recordings. Participants in this study comprised 12 patients with intractable epilepsy. Epileptic spikes simultaneously detected on both MEG and iEEG were analyzed by GMFT and voltage topography (VT), respectively. Discrepancies in spatial distribution between GMFT and VT were evaluated for each epileptic spike. On the lateral cortices, areas of GMFT activity onset were almost concordant with VT activities arising at the gyral unit level (concordance rate, 66.7-100%). Median time lag between GMFT and VT at onset in each patient was 11.0-42.0 ms. On the temporal base, VT represented basal activities, whereas GMFT failed but instead represented propagated activities of the lateral temporal cortices. Activities limited to within the basal temporal or deep brain region were not reflected on GMFT. In conclusion, GMFT appears to accurately represent brain activities of the lateral cortices at the gyral unit level. The slight time lag between GMFT and VT is likely attributable to differences in the detection principles underlying MEG and iEEG. GMFT has great potential for investigating the spatiotemporal dynamics of lateral brain surface activities.
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Affiliation(s)
- Hiroshi Shirozu
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
| | - Akira Hashizume
- Department of Neurosurgery, Takanobashi Central Hospital Hiroshima, Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
| | - Masafumi Fukuda
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
| | - Yosuke Ito
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
| | - Yoko Nakayama
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
| | - Takefumi Higashijima
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
| | - Shigeki Kameyama
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata, Japan
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Onishi H, Sugawara K, Yamashiro K, Sato D, Kirimoto H, Tamaki H, Shirozu H, Kameyama S. Inhibitory effect of intensity and interstimulus interval of conditioning stimuli on somatosensory evoked magnetic fields. Eur J Neurosci 2016; 44:2104-13. [PMID: 27319980 DOI: 10.1111/ejn.13317] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 06/14/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Abstract
Magnetoencephalography (MEG) recordings were performed to investigate the inhibitory effects of conditioning stimuli with various types of interstimulus intervals (ISIs) or intensities on somatosensory evoked magnetic fields (SEFs) using a 306-ch whole-head MEG system. Twenty-three healthy volunteers participated in this study. Electrical stimuli were applied to the right median nerve at the wrist. Six pulse trains with ISIs of 500 ms were presented in Experiment 1. A paired-pulse paradigm with three kinds of conditioning stimulus (CON) intensities, 500 ms before the test stimulus (TS), was applied in Experiment 2. Finally, three CONs 500 or 1000 ms before TS were presented in Experiment 3. Three main SEF deflections (N20m, P35m, and P60m) were observed, and the source activities of P35m and P60m significantly decreased after the 2nd pulse of a six pulse trains. These source activities also significantly decreased with increasing intensity of CON. In addition, these attenuations of source activities were affected by CON-CON or CON-TS intervals. These results indicated that the source activities were modulated by the intensity and ISIs of CONs. Furthermore, P35m after the stimulation were very sensitive to CONs; however, the attenuation of P60m after the stimulation lasted for a longer period than that of P35m. Our findings suggest that the conditioning stimulation had inhibitory effects on subsequent evoked cortical responses for more than 500 ms. Our results also provide important clues about the nature of short-latency somatosensory responses in human studies.
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Affiliation(s)
- Hideaki Onishi
- Institute for human movement and medical sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
| | - Kazuhiro Sugawara
- Institute for human movement and medical sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
| | - Koya Yamashiro
- Institute for human movement and medical sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
| | - Daisuke Sato
- Institute for human movement and medical sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
| | - Hikari Kirimoto
- Institute for human movement and medical sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
| | - Hiroyuki Tamaki
- Institute for human movement and medical sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Japan
| | - Hiroshi Shirozu
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
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Usami K, Matsumoto R, Sawamoto N, Murakami H, Inouchi M, Fumuro T, Shimotake A, Kato T, Mima T, Shirozu H, Masuda H, Fukuyama H, Takahashi R, Kameyama S, Ikeda A. Epileptic network of hypothalamic hamartoma: An EEG-fMRI study. Epilepsy Res 2016; 125:1-9. [PMID: 27295078 DOI: 10.1016/j.eplepsyres.2016.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/20/2016] [Accepted: 05/27/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the brain networks involved in epileptogenesis/encephalopathy associated with hypothalamic hamartoma (HH) by EEG with functional MRI (EEG-fMRI), and evaluate its efficacy in locating the HH interface in comparison with subtraction ictal SPECT coregistered to MRI (SISCOM). METHODS Eight HH patients underwent EEG-fMRI. All had gelastic seizures (GS) and 7 developed other seizure types. Using a general linear model, spike-related activation/deactivation was analyzed individually by applying a hemodynamic response function before, at, and after spike onset (time-shift model=-8-+4s). Group analysis was also performed. The sensitivity of EEG-fMRI in identifying the HH interface was compared with SISCOM in HH patients having unilateral hypothalamic attachment. RESULTS EEG-fMRI revealed activation and/or deactivation in subcortical structures and neocortices in all patients. 6/8 patients showed activation in or around the hypothalamus with the HH interface with time-shift model before spike onset. Group analysis showed common activation in the ipsilateral hypothalamus, brainstem tegmentum, and contralateral cerebellum. Deactivation occurred in the default mode network (DMN) and bilateral hippocampi. Among 5 patients with unilateral hypothalamic attachment, activation in or around the ipsilateral hypothalamus was seen in 3 using EEG-fMRI, whereas hyperperfusion was seen in 1 by SISCOM. SIGNIFICANCE Group analysis of this preliminary study may suggest that the commonly activated subcortical network is related to generation of GS and that frequent spikes lead to deactivation of the DMN and hippocampi, and eventually to a form of epileptic encephalopathy. Inter-individual variance in neocortex activation explains various seizure types among patients. EEG-fMRI enhances sensitivity in detecting the HH interface compared with SISCOM.
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Affiliation(s)
- Kiyohide Usami
- Department of Neurology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Riki Matsumoto
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
| | - Nobukatsu Sawamoto
- Department of Neurology, Kyoto University, Graduate School of Medicine, Kyoto, Japan; Human Brain Research Center, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Hiroatsu Murakami
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Morito Inouchi
- Department of Neurology, Kyoto University, Graduate School of Medicine, Kyoto, Japan; Department of Respiratory Medicine, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Tomoyuki Fumuro
- Research and Educational Unit of Leaders for Integrated Medical System, Kyoto University, Kyoto, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Takeo Kato
- Department of Pediatrics, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Tatsuya Mima
- Human Brain Research Center, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Shirozu
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hiroshi Masuda
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University, Graduate School of Medicine, Kyoto, Japan.
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Kameyama S, Shirozu H, Masuda H, Ito Y, Sonoda M, Akazawa K. MRI-guided stereotactic radiofrequency thermocoagulation for 100 hypothalamic hamartomas. J Neurosurg 2016; 124:1503-12. [DOI: 10.3171/2015.4.jns1582] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECT
The aim of this study was to elucidate the invasiveness, effectiveness, and feasibility of MRI-guided stereotactic radiofrequency thermocoagulation (SRT) for hypothalamic hamartoma (HH).
METHODS
The authors examined the clinical records of 100 consecutive patients (66 male and 34 female) with intractable gelastic seizures (GS) caused by HH, who underwent SRT as a sole surgical treatment between 1997 and 2013.
The median duration of follow-up was 3 years (range 1–17 years). Seventy cases involved pediatric patients. Ninety percent of patients also had other types of seizures (non-GS). The maximum diameter of the HHs ranged from 5 to 80 mm (median 15 mm), and 15 of the tumors were giant HHs with a diameter of 30 mm or more. Comorbidities included precocious puberty (33.0%), behavioral disorder (49.0%), and mental retardation (50.0%).
RESULTS
A total of 140 SRT procedures were performed. There was no adaptive restriction for the giant or the subtype of HH, regardless of any prior history of surgical treatment or comorbidities. Patients in this case series exhibited delayed precocious puberty (9.0%), pituitary dysfunction (2.0%), and weight gain (7.0%), besides the transient hypothalamic symptoms after SRT. Freedom from GS was achieved in 86.0% of patients, freedom from other types of seizures in 78.9%, and freedom from all seizures in 71.0%. Repeat surgeries were not effective for non-GS. Seizure freedom led to disappearance of behavioral disorders and to intellectual improvement.
CONCLUSIONS
The present SRT procedure is a minimally invasive and highly effective surgical procedure without adaptive limitations. SRT involves only a single surgical procedure appropriate for all forms of epileptogenic HH and should be considered in patients with an early history of GS.
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Affiliation(s)
- Shigeki Kameyama
- 1Hypothalamic Hamartoma Center, Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital; and
| | - Hiroshi Shirozu
- 1Hypothalamic Hamartoma Center, Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital; and
| | - Hiroshi Masuda
- 1Hypothalamic Hamartoma Center, Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital; and
| | - Yosuke Ito
- 1Hypothalamic Hamartoma Center, Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital; and
| | - Masaki Sonoda
- 1Hypothalamic Hamartoma Center, Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital; and
| | - Kohei Akazawa
- 2Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
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Kameyama S, Masuda H, Shirozu H, Ito Y, Sonoda M, Kimura J. Ephaptic transmission is the origin of the abnormal muscle response seen in hemifacial spasm. Clin Neurophysiol 2016; 127:2240-5. [DOI: 10.1016/j.clinph.2016.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 01/29/2016] [Accepted: 02/07/2016] [Indexed: 10/22/2022]
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Saitsu H, Sonoda M, Higashijima T, Shirozu H, Masuda H, Tohyama J, Kato M, Nakashima M, Tsurusaki Y, Mizuguchi T, Miyatake S, Miyake N, Kameyama S, Matsumoto N. Somatic mutations in GLI3 and OFD1 involved in sonic hedgehog signaling cause hypothalamic hamartoma. Ann Clin Transl Neurol 2016; 3:356-65. [PMID: 27231705 PMCID: PMC4863748 DOI: 10.1002/acn3.300] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 02/27/2016] [Accepted: 02/29/2016] [Indexed: 01/14/2023] Open
Abstract
Objective Hypothalamic hamartoma (HH) is a congenital anomalous brain tumor. Although most HHs are found without any other systemic features, HH is observed in syndromic disorders such as Pallister–Hall syndrome (PHS) and oral‐facial‐digital syndrome (OFD). Here, we explore the possible involvement of somatic mutations in HH. Methods We analyzed paired blood and hamartoma samples from 18 individuals, including three with digital anomalies, by whole‐exome sequencing. Detected somatic mutations were validated by Sanger sequencing and deep sequencing of target amplicons. The effect of GLI3 mutations on its transcriptional properties was evaluated by luciferase assays using reporters containing eight copies of the GLI‐binding site and a mutated control sequence disrupting GLI binding. Results We found hamartoma‐specific somatic truncation mutations in GLI3 and OFD1, known regulators of sonic hedgehog (Shh) signaling, in two and three individuals, respectively. Deep sequencing of amplicons covering the mutations showed mutant allele rates of 7–54%. Somatic mutations in OFD1 at Xp22 were found only in male individuals. Potential pathogenic somatic mutations in UBR5 and ZNF263 were also identified in each individual. Germline nonsense mutations in GLI3 and OFD1 were identified in each individual with PHS and OFD type I in our series, respectively. The truncated GLI3 showed stronger repressor activity than the wild‐type protein. We did not detect somatic mutations in the remaining 9 individuals. Interpretation Our data indicate that a spectrum of human disorders can be caused by lesion‐specific somatic mutations, and suggest that impaired Shh signaling is one of the pathomechanisms of HH.
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Affiliation(s)
- Hirotomo Saitsu
- Department of Human Genetics Yokohama City University Graduate School of Medicine Yokohama 236-0004 Japan; Department of Biochemistry Hamamatsu University School of Medicine Hamamatsu 431-3192 Japan
| | - Masaki Sonoda
- Department of Functional Neurosurgery Epilepsy Center Nishi-Niigata Chuo National Hospital Niigata 950-2085 Japan
| | - Takefumi Higashijima
- Department of Functional Neurosurgery Epilepsy Center Nishi-Niigata Chuo National Hospital Niigata 950-2085 Japan
| | - Hiroshi Shirozu
- Department of Functional Neurosurgery Epilepsy Center Nishi-Niigata Chuo National Hospital Niigata 950-2085 Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery Epilepsy Center Nishi-Niigata Chuo National Hospital Niigata 950-2085 Japan
| | - Jun Tohyama
- Department of Child Neurology Nishi-Niigata Chuo National Hospital Niigata 950-2085 Japan
| | - Mitsuhiro Kato
- Department of Pediatrics Showa University School of Medicine Tokyo 142-8666 Japan
| | - Mitsuko Nakashima
- Department of Human Genetics Yokohama City University Graduate School of Medicine Yokohama 236-0004 Japan
| | - Yoshinori Tsurusaki
- Clinical Research Institute Kanagawa Children's Medical Center Yokohama 232-8555 Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics Yokohama City University Graduate School of Medicine Yokohama 236-0004 Japan
| | - Satoko Miyatake
- Department of Human Genetics Yokohama City University Graduate School of Medicine Yokohama 236-0004 Japan
| | - Noriko Miyake
- Department of Human Genetics Yokohama City University Graduate School of Medicine Yokohama 236-0004 Japan
| | - Shigeki Kameyama
- Department of Functional Neurosurgery Epilepsy Center Nishi-Niigata Chuo National Hospital Niigata 950-2085 Japan
| | - Naomichi Matsumoto
- Department of Human Genetics Yokohama City University Graduate School of Medicine Yokohama 236-0004 Japan
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Nakashima M, Saitsu H, Takei N, Tohyama J, Kato M, Kitaura H, Shiina M, Shirozu H, Masuda H, Watanabe K, Ohba C, Tsurusaki Y, Miyake N, Zheng Y, Sato T, Takebayashi H, Ogata K, Kameyama S, Kakita A, Matsumoto N. Somatic Mutations in the MTOR gene cause focal cortical dysplasia type IIb. Ann Neurol 2015; 78:375-86. [PMID: 26018084 DOI: 10.1002/ana.24444] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 05/26/2015] [Accepted: 05/26/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Focal cortical dysplasia (FCD) type IIb is a cortical malformation characterized by cortical architectural abnormalities, dysmorphic neurons, and balloon cells. It has been suggested that FCDs are caused by somatic mutations in cells in the developing brain. Here, we explore the possible involvement of somatic mutations in FCD type IIb. METHODS We collected a total of 24 blood-brain paired samples with FCD, including 13 individuals with FCD type IIb, 5 with type IIa, and 6 with type I. We performed whole-exome sequencing using paired samples from 9 of the FCD type IIb subjects. Somatic MTOR mutations were identified and further investigated using all 24 paired samples by deep sequencing of the entire gene's coding region. Somatic MTOR mutations were confirmed by droplet digital polymerase chain reaction. The effect of MTOR mutations on mammalian target of rapamycin (mTOR) kinase signaling was evaluated by immunohistochemistry and Western blotting analyses of brain samples and by in vitro transfection experiments. RESULTS We identified four lesion-specific somatic MTOR mutations in 6 of 13 (46%) individuals with FCD type IIb showing mutant allele rates of 1.11% to 9.31%. Functional analyses showed that phosphorylation of ribosomal protein S6 in FCD type IIb brain tissues with MTOR mutations was clearly elevated, compared to control samples. Transfection of any of the four MTOR mutants into HEK293T cells led to elevated phosphorylation of 4EBP, the direct target of mTOR kinase. INTERPRETATION We found low-prevalence somatic mutations in MTOR in FCD type IIb, indicating that activating somatic mutations in MTOR cause FCD type IIb.
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Affiliation(s)
- Mitsuko Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuyuki Takei
- Department of Molecular Neurobiology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Jun Tohyama
- Department of Child Neurology, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Hiroki Kitaura
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Masaaki Shiina
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroshi Shirozu
- Department of Functional Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hiroshi Masuda
- Department of Functional Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Keisuke Watanabe
- Division of Neurobiology and Anatomy, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Chihiro Ohba
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshinori Tsurusaki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yingjun Zheng
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Tatsuhiro Sato
- Division of Biochemistry, School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Hirohide Takebayashi
- Division of Neurobiology and Anatomy, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuhiro Ogata
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shigeki Kameyama
- Department of Functional Neurosurgery, Epilepsy Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Shirozu H, Masuda H, Ito Y, Sonoda M, Kameyama S. 1-P-F-7. Analysis of ictal high-frequency oscillation patterns of intracranial EEGs in surgical epilepsy cases due to various etiologies. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kameyama S, Masuda H, Shirozu H, Ito Y, Sonoda M, Onda K, Kimura J. 2-P-E-8. Ephaptic transmission as the origin of abnormal muscle response seen in hemifacial spasm. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kojima S, Onishi H, Sugawara K, Miyaguchi S, Kirimoto H, Tamaki H, Shirozu H, Kameyama S. No relation between afferent facilitation induced by digital nerve stimulation and the latency of cutaneomuscular reflexes and somatosensory evoked magnetic fields. Front Hum Neurosci 2014; 8:1023. [PMID: 25566038 PMCID: PMC4274984 DOI: 10.3389/fnhum.2014.01023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 07/15/2014] [Accepted: 12/04/2014] [Indexed: 11/13/2022] Open
Abstract
Primary motor cortex (M1) excitability can be assessed using transcranial magnetic stimulation (TMS) and can be modulated by a conditioning electrical stimulus delivered to a peripheral nerve prior to TMS. This is known as afferent facilitation (AF). The aim of this study was to determine whether AF can be induced by digital nerve stimulation and to evaluate the relation between the interstimulus interval (ISI) required for AF and the latency of the E2 component of the cutaneomuscular reflex (CMR) and the prominent somatosensory evoked field (SEF) deflection that occurs approximately 70 ms after digital nerve stimulation (P60m). Stimulation of the digital nerve of the right index finger was followed, at various time intervals, by single-pulse TMS applied to the contralateral hemisphere. The ISI between digital nerve stimulation and TMS was 20, 30, 40, 50, 60, 70, 80, 100, 140, 180, 200, or 220 ms. Single-pulse TMS was performed alone as a control. SEFs were recorded following digital nerve stimulation of the index finger, and the equivalent current dipole of prominent deflections that occurred around 70 ms after the stimulation was calculated. CMRs were recorded following digital nerve stimulation during muscle contraction. Motor evoked potentials (MEPs) were facilitated at an ISI between 50 and 100 ms in 11 of 13 subjects, and the facilitated MEP amplitude was larger than the unconditioned MEP amplitude (p < 0.01). There was no significant correlation between the ISI at which AF was maximal and the latency of the P60m component of the SEF (r = −0.50, p = 0.12) or the E2 component of the CMR (r = −0.54, p = 0.88). These results indicate that the precise ISI required for AF cannot be predicted using SEF or CMR.
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Affiliation(s)
- Sho Kojima
- Graduate School of Health and Welfare, Niigata University of Health and Welfare Niigata City, Niigata, Japan ; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata City, Niigata, Japan ; Tokyo Bay Rehabilitation Hospital Narashino City, Chiba, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata City, Niigata, Japan
| | - Kazuhiro Sugawara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata City, Niigata, Japan
| | - Shota Miyaguchi
- Graduate School of Health and Welfare, Niigata University of Health and Welfare Niigata City, Niigata, Japan ; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata City, Niigata, Japan
| | - Hikari Kirimoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata City, Niigata, Japan
| | - Hiroyuki Tamaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata City, Niigata, Japan
| | - Hiroshi Shirozu
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata City, Niigata, Japan
| | - Shigeki Kameyama
- Department of Neurosurgery, Nishi-Niigata Chuo National Hospital Niigata City, Niigata, Japan
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Shirozu H, Iida K, Hashizume A, Hanaya R, Kiura Y, Kurisu K, Arita K, Otsubo H. Gradient magnetic-field topography reflecting cortical activities of neocortical epilepsy spikes. Epilepsy Res 2010; 90:121-31. [DOI: 10.1016/j.eplepsyres.2010.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 04/01/2010] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
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Hashizume A, Iida K, Shirozu H, Hanaya R, Kiura Y, Kurisu K, Otsubo H. Gradient magnetic-field topography for dynamic changes of epileptic discharges. Brain Res 2007; 1144:175-9. [PMID: 17331481 DOI: 10.1016/j.brainres.2007.01.129] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 11/14/2006] [Revised: 01/22/2007] [Accepted: 01/23/2007] [Indexed: 11/15/2022]
Abstract
We developed gradient magnetic-field topography (GMFT) for magnetoencephalography (MEG). We plotted the Euclidean norms of gradient magnetic fields occurring at the centers of 102 sensors onto 49-point grids and projected these norms onto the MRI brain surface of a 12-year-old boy who presented with neocortical epilepsy secondary to a left temporal tumor. The peak gradient magnetic field located posterior to the tumor and correlated to MEG dipoles. The gradient magnetic field propagated to the temporo-parietal region and corresponded with spike locations on electrocorticography. GMFT revealed the location and distribution of spikes while avoiding the inverse problem.
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Affiliation(s)
- Akira Hashizume
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Hiroshima, 734-8551, Japan
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Kinoshita Y, Kiya K, Satoh H, Sadatomo T, Mizoue T, Tsumura R, Shirozu H, Sugiyama K, Kurisu K. [Cerebellar ganglioglioma associated with a huge cyst: case report]. No Shinkei Geka 2002; 30:503-7. [PMID: 11993173] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Gangliogliomas represent approximately 0.2% of all the intracranial tumors. Ganglioglioma arising from the cerebellum is rare, with a rate of 1.5-9% of CNS gangliogliomas. The authors report a case of cerebellar ganglioglioma with a huge cyst. A 28-year-old man presented headache and ataxia. Computerized tomography (CT) demonstrated a huge cyst at the vermian region with calcification located at the peripheral side of the cyst. Magnetic resonance imaging (MRI) with administration of Gd-DTPA showed a slightly enhanced small mass at the left side of the cyst. Preoperative diagnosis of the lesion seemed to be a cystic astrocytoma. The tumor was removed subtotally through the midline suboccipital approach. Pathological examination of the tumor specimen revealed a ganglioglioma. The postoperative course was uneventful with no sign of tumor regrowth on repeated MRI. According to the previous 17 reports of cerebellar ganglioglioma including our case, the shorter interval from onset to the diagnosis and clinical symptoms such as increased intracranial pressure were conspicuous as compared with supratentorial ganglioglioma because of the anatomically narrow space of the posterior fossa. Neuroradiological findings showed tumor enhancement in 86% of the cases, calcification in 67%, and cyst formation in 53%.
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Affiliation(s)
- Yasuyuki Kinoshita
- Department of Neurosurgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-Kanda, Minami-ku, Hiroshima 734-8530, Japan
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Abstract
The aim of this study is to reveal whether the penis per se actually becomes tumescent and flaccid, in time sequence, in the human fetus at term. We observed the fetal penis with real-time ultrasonography in 50 male human fetuses at 36-39 weeks' gestation and measured the penile length once at a given time per 1-min epoch for each case during the 60-min window of examination. Thirty-eight were excluded due to a lack of continuous ultrasound visualization of the penis. Penile length changes were statistically analyzed for the remaining 12 fetuses using the 'least median of squares regression'. Penile length was seen to be significantly stratified into two groups: 22.5% at tumescence (group median = 20.8 mm) and 77.5% at flaccidity (group median = 16.0 mm). Penile tumescence was found to occur at the following frequency during the given observation period: once in 41.7%, twice in 50.0% and three times in 8.3% with durations ranging from 5 to 17 min. These findings indicate penile tumescence exists in the term fetus. The frequency and duration of penile tumescence are in good correlation with neonates.
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Affiliation(s)
- H Shirozu
- Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University 60, Fukuoka, Japan
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