1
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Xu J, Yuki N, Kokubun N, Gao F, Shan F, Shi Q, Wang Y. Macrophages are scavengers for injured myelin in a rabbit model of acute inflammatory demyelinating polyneuropathy. Neuroreport 2023; 34:860-867. [PMID: 37942737 PMCID: PMC10635405 DOI: 10.1097/wnr.0000000000001964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023]
Abstract
In acute inflammatory demyelinating polyneuropathy (AIDP), myelin vesiculation mediated by complement activation contributes to nerve injury. Macrophage infiltration of the spinal roots has been demonstrated in AIDP, but its pathological significance remains uncertain. The present study aimed to investigate the role of macrophages in the pathogenic sequence of AIDP. A rabbit model of AIDP was induced by immunization with galactocerebroside. Immunostaining was performed to localize the macrophages and myelin injury. The rabbit developed tetraparesis with electrophysiological and pathological features of peripheral nerve demyelination. Immunostaining demonstrated colocalization of IgG antibodies, complement deposition and myelin injury apart from macrophages. Immunostaining and electron microscopy showed myelin injury preceded macrophage infiltration. There was significant disruption of voltage-gated sodium channel clusters at the nodes of Ranvier in the spinal roots. Macrophages acted may as scavengers to remove myelin debris following complement activation-mediated demyelination in the AIDP rabbit. Lesions at the node of Ranvier contribute to conduction failure and muscle weakness.
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Affiliation(s)
- Jie Xu
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
| | | | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Feng Gao
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
| | - Fangzhen Shan
- Medical Research Center, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
| | - Qiguang Shi
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
| | - Yuzhong Wang
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
- Medical Research Center, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
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2
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Shibano M, Kubota T, Kokubun N, Miyaji Y, Kuriki H, Ito Y, Hamanoue H, Takahashi MP. Periodic paralysis due to cumulative effects of rare variants in SCN4A with small functional alterations. Muscle Nerve 2022; 66:757-761. [PMID: 36116128 DOI: 10.1002/mus.27725] [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: 01/23/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION/AIMS Mutations in the SCN4A gene encoding a voltage-gated sodium channel (Nav1.4) cause hyperkalemic periodic paralysis (HyperPP) and hypokalemic periodic paralysis (HypoPP). Typically, both HyperPP and HypoPP are considered as monogenic disorders caused by a missense mutation with a large functional effect. However, a few cases with atypical periodic paralysis phenotype have been caused by multiple mutations in ion-channel genes expressed in skeletal muscles. In this study we investigated the underlying pathogenic mechanisms in such cases. METHODS We clinically assessed two families: proband 1 with HyperPP and proband 2 with atypical periodic paralysis with hypokalemia. Genetic analyses were performed by next-generation sequencing and conventional Sanger sequencing, followed by electrophysiological analyses of the mutant Nav1.4 channels expressed in human embryonic kidney 293T (HEK293T) cells using the whole-cell patch-clamp technique. RESULTS In proband 1, K880del was identified in the SCN4A gene. In proband 2, K880del and a novel mutation, R1639H, were identified in the same allele of the SCN4A gene. Functional analyses revealed that the K880del in SCN4A has a weak functional effect on hNav1.4, increasing the excitability of the sarcolemma, which could represent a potential pathogenic factor. Although R1639H alone did not reveal functional changes strong enough to be pathogenic, Nav1.4 with both K880del and R1639H showed enhanced activation compared with K880del alone, indicating that R1639H may modify the hNav1.4 channel function. DISCUSSION A cumulative effect of variants with small functional alterations may be considered as the underpinning oligogenic pathogenic mechanisms for the unusual phenotype of periodic paralysis.
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Affiliation(s)
- Maki Shibano
- Clinical Neurophysiology, Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoya Kubota
- Clinical Neurophysiology, Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Shimotsuga, Japan
| | - Yosuke Miyaji
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroko Kuriki
- Department of Clinical Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuzuru Ito
- Department of Endocrinology and Metabolism, Yokohama City University Medical Center, Yokohama, Japan
| | - Haruka Hamanoue
- Department of Clinical Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masanori P Takahashi
- Clinical Neurophysiology, Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan
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3
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Komagamine T, Suzuki K, Kokubun N, Komagamine J, Kawasaki A, Funakoshi K, Hirata K. Sleep-related hallucinations in patients with Parkinson's disease. PLoS One 2022; 17:e0276736. [PMID: 36282859 PMCID: PMC9595548 DOI: 10.1371/journal.pone.0276736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/12/2022] [Indexed: 01/24/2023] Open
Abstract
Given that sleep-wake cycle dysfunction can cause hallucinations in Parkinson's disease patients, sleep-related hallucinations may be a different subtype from hallucinations that occur only during full wakefulness. However, few studies that distinguish the onset situations of hallucinations related to sleep from those that occur in full wakefulness have been conducted to investigate hallucinations in Parkinson's disease patients. Therefore, we conducted a multicenter observational study to investigate the prevalence of and factors associated with sleep-related hallucinations in patients with Parkinson's disease. Information on hallucinations was collected by using a questionnaire and face-to-face interviews. Of 100 consecutive patients with Parkinson's disease, 29 (29%) reported sleep-related hallucinations, and 16 (16%) reported hallucinations only in the full wakefulness. A longer duration of Parkinson's disease treatment (OR 1.35, 95% CI 1.07 to 1.72), higher Beck Depression Inventory-II scores (OR 1.07; 95% CI 1.01 to 1.14), and higher rapid eye movement sleep behavior disorder scores (OR 5.60; 95% CI 1.54 to 20.38) were independent factors associated with the presence of sleep-related hallucinations in a multivariable analysis. Sleep-related hallucinations, but not daytime hallucinations, were associated with probable rapid eye movement sleep behavior disorder. Phenomenological discrimination between sleep-related hallucinations and daytime hallucinations is important for elucidating the full pathology in Parkinson's disease and the mechanisms underlying hallucinations.
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Affiliation(s)
- Tomoko Komagamine
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
- Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, Tochigi, Japan
- * E-mail:
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Junpei Komagamine
- Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, Tochigi, Japan
| | - Akiko Kawasaki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Kei Funakoshi
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
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Warwick‐Evans V, Kelly N, Dalla Rosa L, Friedlaender A, Hinke JT, Kim JH, Kokubun N, Santora JA, Secchi ER, Seyboth E, Trathan PN. Using seabird and whale distribution models to estimate spatial consumption of krill to inform fishery management. Ecosphere 2022. [DOI: 10.1002/ecs2.4083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - N. Kelly
- Department of Agriculture, Water and the Environment Australian Antarctic Division Kingston Tasmania Australia
| | - L. Dalla Rosa
- Laboratório de Ecologia e Conservação da Megafauna Marinha Instituto de Oceanografia, Universidade Federal de Rio Grande—FURG Rio Grande Brazil
| | - A. Friedlaender
- Institute for Marine Sciences University of California Santa Cruz Santa Cruz California USA
| | - J. T. Hinke
- Antarctic Ecosystem Research Division, Southwest Fisheries Science Center, National Marine Fisheries Service National Oceanic and Atmospheric Administration La Jolla California USA
| | - J. H. Kim
- Korea Polar Research Institute Incheon South Korea
| | - N. Kokubun
- National Institute of Polar Research Tokyo Japan
| | - J. A. Santora
- Fisheries Ecology Division, Southwest Fisheries Science Center, National Marine Fisheries Service National Oceanic and Atmospheric Administration Santa Cruz California USA
- Department of Applied Mathematics University of California Santa Cruz Santa Cruz California USA
| | - E. R. Secchi
- Laboratório de Ecologia e Conservação da Megafauna Marinha Instituto de Oceanografia, Universidade Federal de Rio Grande—FURG Rio Grande Brazil
| | - E. Seyboth
- Laboratório de Ecologia e Conservação da Megafauna Marinha Instituto de Oceanografia, Universidade Federal de Rio Grande—FURG Rio Grande Brazil
- Centre for Sustainable Oceans, Faculty of Applied Sciences Cape Peninsula University of Cape Town Cape Town South Africa
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5
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Kobayashi S, Kokubun N, Aoki R, Hamaguchi M, Matsuda H, Suzuki K. Possible role of neutrophils in astrocyte injury in neuromyelitis optica spectrum disorder. J Neurol Sci 2022; 438:120293. [PMID: 35623232 DOI: 10.1016/j.jns.2022.120293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/14/2022] [Accepted: 05/18/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Saro Kobayashi
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Reika Aoki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Mai Hamaguchi
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Hadzki Matsuda
- Department of Neurosurgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
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6
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Ogaki K, Fujita H, Kokubun N, Hamaguchi M, Nishino I, Suzuki K. [Anti-mitochondrial M2 antibody-positive myositis preceded by heart failure and cardiac conduction disturbance. A case report]. Rinsho Shinkeigaku 2022; 62:135-139. [PMID: 35095048 DOI: 10.5692/clinicalneurol.cn-001644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 69-year-old man visited our hospital complaining of fatigue in the lower extremities while walking. The patient had a two-year history of congestive heart failure and received a permanent artificial pacemaker implantation for sick sinus syndrome. Physical examination revealed proximal muscle weakness and exaggerated lumbar lordosis. Serum creatine kinase level was 1,455 U/l. The atrophies of the paraspinal muscles at thoracic to lumbar spine levels, rectus abdominis and soleus muscles were detected on computed tomography. Muscle biopsy showed mild to moderate variability in muscle fiber size with regenerating and necrotic muscle fibers. Mononuclear cell infiltration was not found. HLA-ABC expression was minimum. After anti-mitochondrial M2 antibody was detected, administration of oral prednisolone resulted in improvements in muscle strength and serum creatine kinase level. Based on the clinical course, examination and clinical findings, the patient was diagnosed as anti-mitochondrial M2 antibody positive myositis. Anti-mitochondrial M2 positive myositis is not only difficult to diagnose by muscle biopsy, but can also be preceded or complicated by fatal cardiac complications.
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Affiliation(s)
- Keitaro Ogaki
- Department of Neurology, Dokkyo Medical University, Tochigi
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Tochigi
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi
| | - Mai Hamaguchi
- Department of Neurology, Dokkyo Medical University, Tochigi
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neurology, National Center of Neurology and Psychiatry, Tokyo.,Department of Clinical Genome Analysis, Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi
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7
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Hamaguchi M, Kokubun N, Matsuda H, Onuma H, Aoki R, Takahashi W, Mitani K, Suzuki K. A case report of secondary neurolymphomatosis showing selective nerve infiltration and massive lumbar plexus enlargement. BMC Neurol 2021; 21:296. [PMID: 34311723 PMCID: PMC8314556 DOI: 10.1186/s12883-021-02330-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background Neurolymphomatosis (NL) is a rare manifestation of malignant lymphoma that shows selective infiltration to the peripheral nervous system primarily or secondarily. We report a patient with secondary NL caused by germinal center B-cell (GCB)-type diffuse large B-cell lymphoma (DLBCL) who showed selective infiltration of the lumbar plexus to the spinal cord and massive nerve enlargement resulting in severe pain. Case presentation A 72-year-old female exhibited asymmetric motor and sensory impairments and pain in the lower limbs that progressed for five months. Magnetic resonance imaging (MRI) showed an enlarged lumbar plexus, which continued to the cauda equina via the L3 and L4 spinal nerves. Her symptoms gradually worsened. Ten months after the onset of symptoms, the enlarged cauda equina filled the spinal canal space, and the spinal cord was swollen. A cauda equina biopsy was performed, and she was diagnosed with GCB-type DLBCL with CD10 positivity. The primary tumor was found in a mammary cyst. The autopsy study did not show apparent infiltration, except in the nervous system. Conclusions Although there are many neurologic phenotypes of malignant lymphoma, the association between the cytological characteristics of lymphoma and the neurological phenotypes is still unclear. Several reports of CD10-positive secondary NL are available, whereas peripheral or central nervous tissue origin lymphoma cases are mostly negative for CD10. CD10 staining may be useful for distinguishing primary NL from secondary NL. NL often has a strong organotropism for peripheral nervous tissue, which makes early diagnosis challenging. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02330-5.
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Affiliation(s)
- Mai Hamaguchi
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan.
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Hadzki Matsuda
- Department of Neurosurgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Hiroki Onuma
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Reika Aoki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
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8
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Komagamine T, Kokubun N, Hirata K. Hystero-epilepsy in the Tuesday Lessons and NMDA receptor function: A hypothesis for dissociative disorder. Med Hypotheses 2021; 150:110567. [PMID: 33799161 DOI: 10.1016/j.mehy.2021.110567] [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: 12/01/2020] [Revised: 02/16/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Abstract
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients demonstrate characteristic multistage progression and movement disorders, which are analogous to hystero-epilepsy in Jean-Martin Charcot's Tuesday Lessons. First, based on a review of the Tuesday Lessons recorded by Charcot's pupils, we hypothesized that there were patients with anti-NMDAR encephalitis among those diagnosed with hystero-epilepsy in the nineteenth century. We found acute-onset multiple neuropsychiatric manifestations resembling anti-NMDAR encephalitis among patients with hystero-epilepsy. Patients with drug withdrawal syndrome, dissociative and conversion disorders and patients under hypnosis from the modern point of view were also identified. These results suggested that hystero-epilepsy in the Tuesday Lessons could encompass dissociative and conversion disorders, hypnosis, drug withdrawal syndrome, and anti-NMDAR encephalitis-like manifestations. Based on Charcot's observations and current progress in molecular biology, such as the identification of glutamate/NMDAR system dysfunction in drug withdrawal syndrome, we then hypothesized that patients with dissociative and conversion disorders and those under hypnosis could also have hypofunction of the glutamatergic system. The NMDAR hypofunction hypothesis is emerging as a pathogenesis of schizophrenia. NMDAR antagonists are known to evoke symptoms similar to schizophrenia, anti-NMDAR encephalitis and near-death experiences. In current clinical reports, spectrum disorders such as dissociative disorder and conversion disorder have been observed in patients with anti-NMDAR encephalitis. Our hypothesis will offer an expansion of the NMDAR hypofunction hypothesis from psychosis to functional neurological disorders and normal specific situations, such as hypnosis, thanatosis, and near-death experiences.
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Affiliation(s)
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Japan.
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Japan.
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9
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Tsukui D, Ishihara Y, Kokubun N, Hirata K, Suzuki K. Postcentral gyrus infarction with spared proprioceptive sensation. eNeurologicalSci 2020; 21:100267. [PMID: 32939401 PMCID: PMC7479268 DOI: 10.1016/j.ensci.2020.100267] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 11/28/2022] Open
Abstract
We here report a patient with postcentral gyrus infarction whose touch and pain sensations in the right forearm and hand were impaired but proprioceptive sensation was spared. We observed the clinicoradiological correlation between sensory impairment of tactile and pain sensation with spared proprioceptive sensation and the posterior postcentral gyrus lesion, which may be important in understanding the function of human primary sensory cortex. The characteristic sensory impairment was shown in postcentral gyrus infarcts. The patient had impaired tactile sensation with spared proprioceptive sensation. We discuss the primary sensory cortex lesion and dissociated sensory impairment.
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Affiliation(s)
- Daisuke Tsukui
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yugo Ishihara
- Clinical Training Center, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
- Corresponding author at: Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
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10
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Iwasaki A, Kokubun N, Funakoshi K, Hirata K, Suzuki K. Hydrocephalus due to marked enlargement of spinal roots in a patient with chronic inflammatory demyelinating polyradiculoneuropathy. Eur J Neurol 2020; 27:2385-2388. [DOI: 10.1111/ene.14492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- A. Iwasaki
- Department of Neurology Dokkyo Medical University Tochigi Japan
| | - N. Kokubun
- Department of Neurology Dokkyo Medical University Tochigi Japan
| | - K. Funakoshi
- Department of Neurology Dokkyo Medical University Tochigi Japan
| | - K. Hirata
- Department of Neurology Dokkyo Medical University Tochigi Japan
| | - K. Suzuki
- Department of Neurology Dokkyo Medical University Tochigi Japan
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11
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Kokubun N. S11-1 Congenital myasthenic syndrome. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2020.04.082] [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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12
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Kubota T, Wu F, Vicart S, Nakaza M, Sternberg D, Watanabe D, Furuta M, Kokunai Y, Abe T, Kokubun N, Fontaine B, Cannon SC, Takahashi MP. Hypokalaemic periodic paralysis with a charge-retaining substitution in the voltage sensor. Brain Commun 2020; 2:fcaa103. [PMID: 33005891 PMCID: PMC7519726 DOI: 10.1093/braincomms/fcaa103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 05/26/2020] [Accepted: 06/02/2020] [Indexed: 01/06/2023] Open
Abstract
Familial hypokalaemic periodic paralysis is a rare skeletal muscle disease caused by the dysregulation of sarcolemmal excitability. Hypokalaemic periodic paralysis is characterized by repeated episodes of paralytic attacks with hypokalaemia, and several variants in CACNA1S coding for CaV1.1 and SCN4A coding for NaV1.4 have been established as causative mutations. Most of the mutations are substitutions to a non-charged residue, from the positively charged arginine (R) in transmembrane segment 4 (S4) of a voltage sensor in either CaV1.1 or NaV1.4. Mutant channels have aberrant leak currents called 'gating pore currents', and the widely accepted consensus is that this current is the essential pathological mechanism that produces susceptibility to anomalous depolarization and failure of muscle excitability during a paralytic attack. Here, we have identified five hypokalaemic periodic paralysis cases from two different ethnic backgrounds, Japanese and French, with charge-preserving substitutions in S4 from arginine, R, to lysine, K. An R to K substitution has not previously been reported for any other hypokalaemic periodic paralysis families. One case is R219K in NaV1.4, which is located at the first charge in S4 of Domain I. The other four cases all have R897K in CaV1.1, which is located at the first charge in S4 of Domain III. Gating pore currents were not detected in expression studies of CaV1.1-R897K. NaV1.4-R219K mutant channels revealed a distinct, but small, gating pore current. Simulation studies indicated that the small-amplitude gating pore current conducted by NaV1.4-R219K is not likely to be sufficient to be a risk factor for depolarization-induced paralytic attacks. Our rare cases with typical hypokalaemic periodic paralysis phenotypes do not fit the canonical view that the essential defect in hypokalaemic periodic paralysis mutant channels is the gating pore current and raise the possibility that hypokalaemic periodic paralysis pathogenesis might be heterogeneous and diverse.
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Affiliation(s)
- Tomoya Kubota
- Division of Health Sciences, Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, 1-7, Yamadaoka, Suita, Osaka, 5650871, Japan.,Department of Neurology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Department of Biochemistry and Molecular Biology, The University of Chicago, Chicago, IL 60637, USA
| | - Fenfen Wu
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Savine Vicart
- Sorbonne Université, INSERM, Assistance Publique -Hôpitaux de Paris, Center of Research in Myology-UMR 974, Service of Neuro-Myology (CMR Muscle Channelopathies), Institute of Myology, University Hospital Pitié-Salpêtrière, Paris, France
| | - Maki Nakaza
- Division of Health Sciences, Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, 1-7, Yamadaoka, Suita, Osaka, 5650871, Japan
| | - Damien Sternberg
- Sorbonne Université, INSERM, Assistance Publique -Hôpitaux de Paris, Center of Research in Myology-UMR 974, Service of Neuro-Myology (CMR Muscle Channelopathies), Institute of Myology, University Hospital Pitié-Salpêtrière, Paris, France
| | - Daisuke Watanabe
- Department of Neurology, National Hospital Organization Hakone Hospital, Odawara, Japan
| | - Mitsuru Furuta
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Department of Neurology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
| | - Yosuke Kokunai
- Department of Neurology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Sorbonne Université, INSERM, Assistance Publique -Hôpitaux de Paris, Center of Research in Myology-UMR 974, Service of Neuro-Myology (CMR Muscle Channelopathies), Institute of Myology, University Hospital Pitié-Salpêtrière, Paris, France
| | - Tatsuya Abe
- Department of Neurology, National Hospital Organization Hakone Hospital, Odawara, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Bertrand Fontaine
- Sorbonne Université, INSERM, Assistance Publique -Hôpitaux de Paris, Center of Research in Myology-UMR 974, Service of Neuro-Myology (CMR Muscle Channelopathies), Institute of Myology, University Hospital Pitié-Salpêtrière, Paris, France
| | - Stephen C Cannon
- Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Masanori P Takahashi
- Division of Health Sciences, Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, 1-7, Yamadaoka, Suita, Osaka, 5650871, Japan.,Department of Neurology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Aoki R, Kokubun N, Komagamine T, Ishii Y, Nishino I, Hirata K. [Selective muscular atrophy in a family with hereditary myopathy with early respiratory failure]. Rinsho Shinkeigaku 2020; 60:334-339. [PMID: 32307395 DOI: 10.5692/clinicalneurol.cn-001380] [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] [Indexed: 11/05/2022]
Abstract
Hereditary myopathy with early respiratory failure (HMERF) with heterozygous mutations in the titin gene (TTN) is characterized by respiratory failure developing from the early phase of limb weakness or gait disturbance. Here, we describe a characteristic distribution of muscle involvement in three members of a HMERF family with a TTN mutation. Despite the differences in severity exhibited among the father, daughter and son, the systemic imaging studies showed a similar pattern among these individuals. The semitendinosus and fibularis longus muscles were selectively affected, as described previously. In addition, we found marked atrophy in the sternocleidomastoid and psoas major muscles, regardless of the disease severity. The atrophy in selective trunk muscles observed in routine CT scans can be useful for the differential diagnosis of hereditary myopathies with heart and respiratory failure.
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Affiliation(s)
- Reika Aoki
- Department of Neurology, Dokkyo Medical University
| | | | | | - Yuko Ishii
- Department of Neurology, Dokkyo Medical University
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP)
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14
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Komagamine T, Kokubun N, Hirata K. Battey's operation as a treatment for hysteria: a review of a series of cases in the nineteenth century. Hist Psychiatry 2020; 31:55-66. [PMID: 31538814 DOI: 10.1177/0957154x19877145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Ovarian resection as a treatment for hysteria, called 'Battey's operation' or 'normal ovariotomy', was performed in the nineteenth century. Battey later reported that the resected ovaries appeared to have 'cystic degeneration'. Currently, patients with acute neuropsychiatric symptoms are screened for teratomas for the differential diagnosis of anti-NMDA receptor encephalitis. There is now a hypothesis that ovarian lesions resulting in paraneoplastic encephalitis were among the patients who underwent Battey's operation. We identified 94 published cases of Battey's operation for neuropsychiatric symptoms in the late nineteenth century. Among 36 cases with detailed descriptions, we found 3 patients who showed acute onset neuropsychiatric symptoms with macropathological ovarian findings that were compatible with teratoma. They showed favourable prognoses after surgery and might have motivated the surgeons to perform the operation.
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Miyamoto M, Imataka G, Ichikawa G, Saito Y, Kashiwagi T, Kaji Y, Wake K, Funakoshi K, Nagashima T, Kokubun N, Yoshihara S. Successful treatment of a 12-year-old boy with Guillain-Barré syndrome requiring tracheostomy due to respiratory muscle paralysis: A case report. Exp Ther Med 2019; 19:1091-1094. [PMID: 32010274 DOI: 10.3892/etm.2019.8311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/08/2019] [Accepted: 10/16/2019] [Indexed: 01/10/2023] Open
Abstract
Childhood Guillain-Barré syndrome (GBS) occasionally leads to respiratory failure early after onset, requiring long-term ventilation management after tracheal intubation. However, patients requiring tracheostomy management are rare. In the present study, a case of a 12-year-old boy with GBS who required artificial respiration management due to rapid progression of respiratory muscle paralysis is reported. Intravenous immunoglobulin (IVIg) and pulse steroid therapy were provided; however, both were ineffective and tracheostomy was necessary 26 days after onset. A second course of IVIg and pulse steroid therapy was administered on day 34. With continued rehabilitation, the patient was able to walk long distances on day 74 and was subsequently discharged on day 89. In cases of severe GBS, when IVIg and pulse steroid therapy do not improve the respiratory muscle strength of the patient, early tracheostomy may improve the patient's quality of life during artificial respiration management.
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Affiliation(s)
- Manabu Miyamoto
- Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - George Imataka
- Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Go Ichikawa
- Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Yutaka Saito
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Takashi Kashiwagi
- Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Yoshiyuki Kaji
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Koji Wake
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Kei Funakoshi
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Takahide Nagashima
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
| | - Shigemi Yoshihara
- Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan
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16
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Horigome H, Ishikawa Y, Kokubun N, Yoshinaga M, Sumitomo N, Lin L, Kato Y, Tanabe-Kameda Y, Ohno S, Nagashima M, Horie M. Multivariate analysis of TU wave complex on electrocardiogram in Andersen-Tawil syndrome with KCNJ2 mutations. Ann Noninvasive Electrocardiol 2019; 25:e12721. [PMID: 31724784 PMCID: PMC7358888 DOI: 10.1111/anec.12721] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 09/26/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The exact differences between the TU wave complex of ATS1 and that of healthy individuals remain to be investigated. We sought to characterize the TU wave complex of Andersen-Tawil syndrome type 1 (ATS1) using high frequency electrocardiogram (ECG) data. METHODS Electrocardiograms were recorded as time series data with a 2 kHz frequency ECG amplifier in 13 patients with ATS1 (positive for KCNJ2 mutation, ATS1 group) and age-matched healthy individuals (control group). Conventional ECG parameters were measured, and principal component analysis (PCA) and independent component analysis (ICA) were applied to the TU wave complex. RESULTS Time from T peak (Tp) to U peak (Up), time from bottom (B) to Up, and time from B to U end (BUe, U duration) (0.232 ± 0.018 vs. 0.165 ± 0.017, p < .0001), where B is the lowest point between T and U waves, were all longer in the ATS1 group than the control group. Multivariate logistic regression analysis revealed that BUe could completely differentiate the two groups. PCA ratios in the ATS1 group were significantly larger than the control group (26.5 ± 12.3 vs. 10.4 ± 6.2, p = .0005). ICA revealed 1 or 2 U-wave-specific independent components (ICs) that exclusively comprise the U wave in ATS1, whereas U waves in the control group were composed of some ICs that also comprised T waves. CONCLUSIONS U-wave-related temporal parameters, particularly BUe, and the existence of U-wave-specific ICs, extracted in the ICA, are useful for differentiation of U waves in ATS1 from those in healthy individuals.
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Affiliation(s)
- Hitoshi Horigome
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Masao Yoshinaga
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Lisheng Lin
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshiaki Kato
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuri Tanabe-Kameda
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
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17
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Kokubun N. S6-2. Guillain-Barré syndrome. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.06.093] [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: 10/26/2022]
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18
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Kokubun N, Aoki R, Nagashima T, Komagamine T, Kuroda Y, Horie M, Hirata K. Clinical and neurophysiological variability in Andersen-Tawil syndrome. Muscle Nerve 2019; 60:752-757. [PMID: 31509255 DOI: 10.1002/mus.26705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Andersen-Tawil syndrome (ATS) is characterized by a triad of periodic paralysis, ventricular arrhythmias, and dysmorphism. However, patients often lack one or more of these features. METHODS Clinical and neurophysiological features were reviewed of five members in two families with heterozygous mutations in KCNJ2 (R218Q and R67W). RESULTS Only one patient had all features of the triad of ATS. One patient had low-set ears, and the others had minor anomalies. Bidirectional ventricular tachycardias were seen in two patients. Two patients (R67W) never had episodes of paralysis. The long exercise test was abnormal in three patients with episodes of paralysis, but normal in two without paralytic episodes. DISCUSSION ATS patients without skeletal muscle symptoms can have normal neurophysiological examinations. They can show variability in phenotype or the severity of arrhythmias. Such variability among patients who share the same gene mutations may result in underdiagnosis of ATS.
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Affiliation(s)
- Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Reika Aoki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | | | | | - Yusuke Kuroda
- Department of Cardiology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
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19
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Sone J, Mitsuhashi S, Fujita A, Mizuguchi T, Hamanaka K, Mori K, Koike H, Hashiguchi A, Takashima H, Sugiyama H, Kohno Y, Takiyama Y, Maeda K, Doi H, Koyano S, Takeuchi H, Kawamoto M, Kohara N, Ando T, Ieda T, Kita Y, Kokubun N, Tsuboi Y, Katoh K, Kino Y, Katsuno M, Iwasaki Y, Yoshida M, Tanaka F, Suzuki IK, Frith MC, Matsumoto N, Sobue G. Long-read sequencing identifies GGC repeat expansions in NOTCH2NLC associated with neuronal intranuclear inclusion disease. Nat Genet 2019; 51:1215-1221. [PMID: 31332381 DOI: 10.1038/s41588-019-0459-y] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022]
Abstract
. The average onset age is 59.7 years among approximately 140 NIID cases consisting of mostly sporadic and several familial cases. By linkage mapping of a large NIID family with several affected members (Family 1), we identified a 58.1 Mb linked region at 1p22.1-q21.3 with a maximum logarithm of the odds score of 4.21. By long-read sequencing, we identified a GGC repeat expansion in the 5' region of NOTCH2NLC (Notch 2 N-terminal like C) in all affected family members. Furthermore, we found similar expansions in 8 unrelated families with NIID and 40 sporadic NIID cases. We observed abnormal anti-sense transcripts in fibroblasts specifically from patients but not unaffected individuals. This work shows that repeat expansion in human-specific NOTCH2NLC, a gene that evolved by segmental duplication, causes a human disease.
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Affiliation(s)
- Jun Sone
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Neurology, National hospital organization Suzuka National Hospital, Suzuka, Japan
| | - Satomi Mitsuhashi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Atsushi Fujita
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kohei Hamanaka
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Keiko Mori
- Department of Neurology, Oyamada Memorial Spa Hospital, Yokkaichi, Japan
| | - Haruki Koike
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihiro Hashiguchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroshi Sugiyama
- Department of Neurology, National Hospital Organization Utano National Hospital, Kyoto, Japan
| | - Yutaka Kohno
- Department of Neurology, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Yoshihisa Takiyama
- Department of Neurology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Kengo Maeda
- Department of Neurology, National hospital organization Higashi-Ohmi General Medical Center, Higashi-Ohmi, Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shigeru Koyano
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Michi Kawamoto
- Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuo Kohara
- Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuo Ando
- Department of Neurology, Anjo Kosei Hospital, Anjo, Japan
| | - Toshiaki Ieda
- Department of Neurology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Yasushi Kita
- Department of Neurology, Hyogo Brain and Heart Center, Himeji, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Kazutaka Katoh
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Yoshihiro Kino
- Department of Bioinformatics and Molecular Neuropathology, Meiji Pharmaceutical University, Tokyo, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasushi Iwasaki
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan
| | - Mari Yoshida
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ikuo K Suzuki
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Martin C Frith
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan.,Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan.,Computational Bio Big-Data Open Innovation Laboratory, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Gen Sobue
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan. .,Department of Neurology, and Brain and Mind Research Center, Nagoya University Graduate School of Medicine, Nagoya, Japan. .,Aichi Medical University, Nagakute, Aichi, Japan.
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20
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Igarashi H, Kokubun N, Funakoshi K, Sakurai S, Hirata K. [Oculomotor nerve compression on MRI in a 56-year-old man with pituitary apoplexy due to panhypophisitis]. Rinsho Shinkeigaku 2018; 58:668-672. [PMID: 30369523 DOI: 10.5692/clinicalneurol.cn-001192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 56-year-old man noted sudden onset of headache, fever, right pupil-spared oculomotor nerve palsy and consciousness disturbance. Swelling of pituitary with T1 high intensity on brain MRI suggested the diagnosis of pituitary apoplexy. Considering significant decrease of pituitary anterior lobe hormone and central diabetes insipidus, high dose of hydrocortisone was administered. Eight days after onset, consciousness level and headache improved. On day 30, brain MRI revealed the reduction of mass size, and on day 46, photophobia and double vision disappeared. Following the rapid response to steroid and disappearance of pituitary lesion, pituitary apoplexy was probably caused by panhypophisitis. Thin-slice brain MRI confirmed the compression of oculomotor nerve at inlet zone of cavernous sinus, suggesting the mechanism of oculomotor palsy was perfusion impairment of feeding artery.
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Affiliation(s)
| | | | | | - Shintaro Sakurai
- Department of Endocrinology and Metabolism, Dokkyo Medical University
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21
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Kokubun N. S6-4. CIDP syndrome with anti-NF155 and -CNTN1 IgG4 antibodies. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.02.041] [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: 10/17/2022]
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22
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Tanabe H, Higuchi Y, Yuan JH, Hashiguchi A, Yoshimura A, Ishihara S, Nozuma S, Okamoto Y, Matsuura E, Ishiura H, Mitsui J, Takashima R, Kokubun N, Maeda K, Asano Y, Sunami Y, Kono Y, Ishigaki Y, Yanamoto S, Fukae J, Kida H, Morita M, Tsuji S, Takashima H. Clinical and genetic features of Charcot-Marie-Tooth disease 2F and hereditary motor neuropathy 2B in Japan. J Peripher Nerv Syst 2018; 23:40-48. [PMID: 29381233 PMCID: PMC5873406 DOI: 10.1111/jns.12252] [Citation(s) in RCA: 11] [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: 12/06/2017] [Revised: 01/23/2018] [Accepted: 01/23/2018] [Indexed: 12/12/2022]
Abstract
Mutations in small heat shock protein beta‐1 (HspB1) have been linked to Charcot‐Marie‐Tooth (CMT) disease type 2F and distal hereditary motor neuropathy type 2B. Only four cases with HSPB1 mutations have been reported to date in Japan. In this study between April 2007 and October 2014, we conducted gene panel sequencing in a case series of 1,030 patients with inherited peripheral neuropathies (IPNs) using DNA microarray, targeted resequencing, and whole‐exome sequencing. We identified HSPB1 variants in 1.3% (13 of 1,030) of the patients with IPNs, who exhibited a male predominance. Based on neurological and electrophysiological findings, seven patients were diagnosed with CMT disease type 2F, whereas the remaining six patients were diagnosed with distal hereditary motor neuropathy type 2B. P39L, R127W, S135C, R140G, K141Q, T151I, and P182A mutations identified in 12 patients were described previously, whereas a novel K123* variant with unknown significance was found in 1 patient. Diabetes and impaired glucose tolerance were detected in 6 of the 13 patients. Our findings suggest that HSPB1 mutations result in two phenotypes of inherited neuropathies and extend the phenotypic spectrum of HSPB1‐related disorders.
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Affiliation(s)
- Hajime Tanabe
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yujiro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Jun-Hui Yuan
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihiro Hashiguchi
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akiko Yoshimura
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Satoshi Ishihara
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Satoshi Nozuma
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuji Okamoto
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Eiji Matsuura
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroyuki Ishiura
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jun Mitsui
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Kengo Maeda
- Department of Neurology, National Hospital Organization Higashi-ohmi General Medical Center, Shiga, Japan
| | - Yuri Asano
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Yoko Sunami
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Yu Kono
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Shosaburo Yanamoto
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Jiro Fukae
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hiroshi Kida
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Mitsuya Morita
- Division of Neurology, Jichi Medical University, Tochigi, Japan
| | - Shoji Tsuji
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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23
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Komagamine T, Kokubun N, Suzuki K, Hirata K. Tactile hallucination as hypnagogic hallucination in Parkinson disease patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1042] [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: 11/30/2022]
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24
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Kuwabara S, Mori M, Misawa S, Suzuki M, Nishiyama K, Mutoh T, Doi S, Kokubun N, Kamijo M, Yoshikawa H, Abe K, Nishida Y, Okada K, Sekiguchi K, Sakamoto K, Kusunoki S, Sobue G, Kaji R. Intravenous immunoglobulin for maintenance treatment of chronic inflammatory demyelinating polyneuropathy: a multicentre, open-label, 52-week phase III trial. J Neurol Neurosurg Psychiatry 2017; 88:832-838. [PMID: 28768822 PMCID: PMC5629934 DOI: 10.1136/jnnp-2017-316427] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/14/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Short-term efficacy of induction therapy with intravenous immunoglobulin (Ig) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) is well established. However, data of previous studies on maintenance therapy were limited up to 24-week treatment period. We aimed to investigate the efficacy and safety of longer-term intravenous Ig therapy for 52 weeks. METHODS This study was an open-label phase 3 clinical trial conducted in 49 Japanese tertiary centres. 49 patients with CIDP who fulfilled diagnostic criteria were included. After an induction intravenous Ig therapy (0.4 g/kg/day for five consecutive days), maintenance dose intravenous Ig (1.0 g/kg) was given every 3 weeks for up to 52 weeks. The primary outcome measures were the responder rate at week 28 and relapse rate at week 52. The response and relapse were defined with the adjusted Inflammatory Neuropathy Cause and Treatment scale. RESULTS At week 28, the responder rate was 77.6% (38/49 patients; 95% CI 63% to 88%), and the 38 responders continued the maintenance therapy. At week 52, 4 of the 38 (10.5%) had a relapse (95% CI 3% to 25%). During 52 weeks, 34 (69.4%) of the 49 enrolled patients had a maintained improvement. Adverse events were reported in 94% of the patients; two patients (66-year-old and 76-year-old men with hypertension or diabetes) developed cerebral infarction (lacunar infarct with good recovery), and the other adverse effects were mild and resolved by the end of the study period. CONCLUSIONS Maintenance treatment with 1.0 g/kg intravenous Ig every 3 weeks is an efficacious therapy for patients with CIDP, and approximately 70% of them had a sustained remission for 52 weeks. Thrombotic complications should be carefully monitored, particularly in elderly patients with vascular risk factors. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT01824251).
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Affiliation(s)
- Satoshi Kuwabara
- Department of Neurology, Chiba University Hospital, Chiba, Japan
| | - Masahiro Mori
- Department of Neurology, Chiba University Hospital, Chiba, Japan
| | - Sonoko Misawa
- Department of Neurology, Chiba University Hospital, Chiba, Japan
| | - Miki Suzuki
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazutoshi Nishiyama
- Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Tatsuro Mutoh
- Department of Neurology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shizuki Doi
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Mikiko Kamijo
- Department of Neurology, Chubu Rosai Hospital, Nagoya, Japan
| | - Hiroo Yoshikawa
- Division of Neurology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Koji Abe
- Department of Neurology, Okayama University School of Medicine, Okayama, Japan
| | | | - Kazumasa Okada
- Department of Neurology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Kenji Sekiguchi
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Susumu Kusunoki
- Department of Neurology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Gen Sobue
- Department of Neurology, Nagoya University School of Medicine, Nagoya, Japan
| | - Ryuji Kaji
- Department of Neurology, Tokushima University School of Medicine, Tokushima, Japan
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Kokubun N, Nagashima T, Aoki R, Komagamine T, Hirata K. Phenotypic discordance in a family with Andersen-Tawil syndrome with a heterozygous missense mutation (R67W) in KCNJ2. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1855] [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: 11/29/2022]
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26
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Funakoshi K, Nagashima T, Kokubun N, Hirtata K, Yuki N. Anti-ganglioside complex antibodies in chronic immune-mediated neuropathies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3717] [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: 10/18/2022]
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27
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Kubota T, Watanabe D, Kokubun N, Furuta M, Kokunai Y, Abe T, Takahashi M. Arginine-to-lysine mutations in the voltage sensor are associated with hypokalemic periodic paralysis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1857] [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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28
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Suzuki K, Kokubun N, Okamura M, Hirata K. Hyperostosis Frontalis Interna in Myotonic Dystrophy. Intern Med 2017; 56:2539-2540. [PMID: 28824073 PMCID: PMC5643191 DOI: 10.2169/internalmedicine.8664-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Japan
| | - Madoka Okamura
- Department of Neurology, Dokkyo Medical University, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Japan
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29
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Kokubun N, Nagashima T, Funakoshi K, Komagamine T, Hirata K, Yuki N. P1-06. Two CIDP patients with anti-CNTN1 IgG4 antibodies and nephrotic syndrome. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.06.014] [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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30
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Vallat JM, Yuki N, Sekiguchi K, Kokubun N, Oka N, Mathis S, Magy L, Sherman DL, Brophy PJ, Devaux JJ. Paranodal lesions in chronic inflammatory demyelinating polyneuropathy associated with anti-Neurofascin 155 antibodies. Neuromuscul Disord 2017; 27:290-293. [DOI: 10.1016/j.nmd.2016.10.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/04/2016] [Accepted: 10/18/2016] [Indexed: 11/29/2022]
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31
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Kuroda Y, Yuasa S, Watanabe Y, Ito S, Egashira T, Seki T, Hattori T, Ohno S, Kodaira M, Suzuki T, Hashimoto H, Okata S, Tanaka A, Aizawa Y, Murata M, Aiba T, Makita N, Furukawa T, Shimizu W, Kodama I, Ogawa S, Kokubun N, Horigome H, Horie M, Kamiya K, Fukuda K. Flecainide ameliorates arrhythmogenicity through NCX flux in Andersen-Tawil syndrome-iPS cell-derived cardiomyocytes. Biochem Biophys Rep 2017; 9:245-256. [PMID: 28956012 PMCID: PMC5614591 DOI: 10.1016/j.bbrep.2017.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 08/23/2016] [Revised: 12/09/2016] [Accepted: 01/10/2017] [Indexed: 12/15/2022] Open
Abstract
Andersen-Tawil syndrome (ATS) is a rare inherited channelopathy. The cardiac phenotype in ATS is typified by a prominent U wave and ventricular arrhythmia. An effective treatment for this disease remains to be established. We reprogrammed somatic cells from three ATS patients to generate induced pluripotent stem cells (iPSCs). Multi-electrode arrays (MEAs) were used to record extracellular electrograms of iPSC-derived cardiomyocytes, revealing strong arrhythmic events in the ATS-iPSC-derived cardiomyocytes. Ca2+ imaging of cells loaded with the Ca2+ indicator Fluo-4 enabled us to examine intracellular Ca2+ handling properties, and we found a significantly higher incidence of irregular Ca2+ release in the ATS-iPSC-derived cardiomyocytes than in control-iPSC-derived cardiomyocytes. Drug testing using ATS-iPSC-derived cardiomyocytes further revealed that antiarrhythmic agent, flecainide, but not the sodium channel blocker, pilsicainide, significantly suppressed these irregular Ca2+ release and arrhythmic events, suggesting that flecainide's effect in these cardiac cells was not via sodium channels blocking. A reverse-mode Na+/Ca2+exchanger (NCX) inhibitor, KB-R7943, was also found to suppress the irregular Ca2+ release, and whole-cell voltage clamping of isolated guinea-pig cardiac ventricular myocytes confirmed that flecainide could directly affect the NCX current (INCX). ATS-iPSC-derived cardiomyocytes recapitulate abnormal electrophysiological phenotypes and flecainide suppresses the arrhythmic events through the modulation of INCX. iPS cells are generated from three patients with ATS. ATS-iPS cell-derived cardiomyocytes show abnormal electrophysiological phenotypes. Flecainide suppresses abnormal electrophysiological phenotypes in ATS-iPS cell-derived cardiomyocytes.
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Affiliation(s)
- Yusuke Kuroda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.,Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Aichi, Japan.,Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Shinsuke Yuasa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuhide Watanabe
- Division of Pharmacological Science, Department of Health Science, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shogo Ito
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Toru Egashira
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Tomohisa Seki
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuhisa Hattori
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Seiko Ohno
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan.,Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Masaki Kodaira
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyuki Suzuki
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.,Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Aichi, Japan.,Department of Cardiology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hisayuki Hashimoto
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Okata
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Atsushi Tanaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiyasu Aizawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Mitsushige Murata
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.,Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Aiba
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Naomasa Makita
- Department of Molecular Pathophysiology-1, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tetsushi Furukawa
- Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Itsuo Kodama
- Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Aichi, Japan
| | - Satoshi Ogawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Hitoshi Horigome
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Kaichiro Kamiya
- Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Aichi, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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32
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Kimachi T, Yuki N, Kokubun N, Yamaguchi S, Wakerley BR. Paraparetic Guillain-Barré syndrome: Nondemyelinating reversible conduction failure restricted to the lower limbs. Muscle Nerve 2016; 55:281-285. [DOI: 10.1002/mus.25242] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Takeshi Kimachi
- Department of Neurology; University of Shimane; Shimane Japan
| | - Nobuhiro Yuki
- Department of Neurology; Mishima Hospital; Niigata Japan
| | - Norito Kokubun
- Department of Neurology; Dokkyo Medical University; Tochigi Japan
| | | | - Benjamin R. Wakerley
- Department of Neurology; Gloucestershire Royal Hospital; Gloucester United Kingdom
- Nuffield Department of Clinical Neurosciences; University of Oxford; Oxford United Kingdom
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33
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Sone J, Mori K, Inagaki T, Katsumata R, Takagi S, Yokoi S, Araki K, Kato T, Nakamura T, Koike H, Takashima H, Hashiguchi A, Kohno Y, Kurashige T, Kuriyama M, Takiyama Y, Tsuchiya M, Kitagawa N, Kawamoto M, Yoshimura H, Suto Y, Nakayasu H, Uehara N, Sugiyama H, Takahashi M, Kokubun N, Konno T, Katsuno M, Tanaka F, Iwasaki Y, Yoshida M, Sobue G. Clinicopathological features of adult-onset neuronal intranuclear inclusion disease. Brain 2016; 139:3170-3186. [PMID: 27797808 PMCID: PMC5382941 DOI: 10.1093/brain/aww249] [Citation(s) in RCA: 236] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/30/2016] [Accepted: 08/24/2016] [Indexed: 12/11/2022] Open
Abstract
Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous system, and also in the visceral organs. NIID has been considered to be a heterogeneous disease because of the highly variable clinical manifestations, and ante-mortem diagnosis has been difficult. However, since we reported the usefulness of skin biopsy for the diagnosis of NIID, the number of NIID diagnoses has increased, in particular adult-onset NIID. In this study, we studied 57 cases of adult-onset NIID and described their clinical and pathological features. We analysed both NIID cases diagnosed by post-mortem dissection and by ante-mortem skin biopsy based on the presence of characteristic eosinophilic, hyaline and ubiquitin-positive intanuclear inclusion: 38 sporadic cases and 19 familial cases, from six families. In the sporadic NIID cases with onset age from 51 to 76, dementia was the most prominent initial symptom (94.7%) as designated 'dementia dominant group', followed by miosis, ataxia and unconsciousness. Muscle weakness and sensory disturbance were also observed. It was observed that, in familial NIID cases with onset age less than 40 years, muscle weakness was seen most frequently (100%), as designated 'limb weakness group', followed by sensory disturbance, miosis, bladder dysfunction, and dementia. In familial cases with more than 40 years of onset age, dementia was most prominent (100%). Elevated cerebrospinal fluid protein and abnormal nerve conduction were frequently observed in both sporadic and familial NIID cases. Head magnetic resonance imaging showed high intensity signal in corticomedullary junction in diffusion-weighted image in both sporadic and familial NIID cases, a strong clue to the diagnosis. All of the dementia dominant cases presented with this type of leukoencephalopathy on head magnetic resonance imaging. Both sporadic and familial NIID cases presented with a decline in Mini-Mental State Examination and Frontal Assessment Battery scores. Based on these clinicopathological features, we proposed a diagnosis flow chart of adult-onset NIID. Our study suggested that the prevalence rate of adult-onset NIID may be higher than previously thought, and that NIID may be underdiagnosed. We should take NIID into account for differential diagnosis of leukoencephalopathy and neuropathy.
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Affiliation(s)
- Jun Sone
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,2 Department of Therapeutics for Intractable Neurological Disorders, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Keiko Mori
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,3 Department of Neurology, Oyamada Memorial Spa Hospital, Yokkaichi, Mie, Japan
| | - Tomonori Inagaki
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Ryu Katsumata
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shinnosuke Takagi
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Satoshi Yokoi
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kunihiko Araki
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Toshiyasu Kato
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tomohiko Nakamura
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Haruki Koike
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroshi Takashima
- 4 Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihiro Hashiguchi
- 4 Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yutaka Kohno
- 5 Department of Neurology, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, Japan
| | - Takashi Kurashige
- 6 Department of Neurology, National Hospital Organization Kure Medical Centre, Kure, Hiroshima, Japan
| | - Masaru Kuriyama
- 7 Department of Neurology, Ota Memorial Hospital, Fukuyama, Hiroshima, Japan
| | - Yoshihisa Takiyama
- 8 Department of Neurology, University of Yamanashi, Kofu, Yamanashi, Japan
| | - Mai Tsuchiya
- 8 Department of Neurology, University of Yamanashi, Kofu, Yamanashi, Japan
| | - Naoyuki Kitagawa
- 9 Department of Neurology, Kosei Chuo General Hospital, Tokyo, Japan
| | - Michi Kawamoto
- 10 Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hajime Yoshimura
- 10 Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yutaka Suto
- 11 Department of Neurology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Hiroyuki Nakayasu
- 11 Department of Neurology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Naoko Uehara
- 12 Department of Neurology, National Hospital Organization Utano Hospital, Kyoto, Japan
| | - Hiroshi Sugiyama
- 12 Department of Neurology, National Hospital Organization Utano Hospital, Kyoto, Japan
| | - Makoto Takahashi
- 13 Department of Neurology, Kanto Central Hospital, Tokyo, Japan
| | - Norito Kokubun
- 14 Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Takuya Konno
- 15 Department of Neurology, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan
| | - Masahisa Katsuno
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Fumiaki Tanaka
- 16 Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yasushi Iwasaki
- 17 Department of Neuropathology, Institute for Medical Sciences of Aging, Aichi Medical University, Nagakute, Aichi, Japan
| | - Mari Yoshida
- 17 Department of Neuropathology, Institute for Medical Sciences of Aging, Aichi Medical University, Nagakute, Aichi, Japan
| | - Gen Sobue
- 1 Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan .,18 Brain and Mind Research Center, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Kimachi T, Yuki N, Kokubun N, Yamaguchi S, Wakerley BR. Reply. Muscle Nerve 2016; 55:446-447. [PMID: 27699798 DOI: 10.1002/mus.25424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 09/22/2016] [Accepted: 09/28/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Takeshi Kimachi
- Department of Neurology, University of Shimane, Shimane, Japan
| | - Nobuhiro Yuki
- Department of Neurology, Mishima Hospital, Niigata, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | | | - Benjamin R Wakerley
- Department of Neurology, Gloucestershire Royal Hospital, Gloucester, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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35
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Tsukahara Y, Suzuki K, Kokubun N, Nakamura T, Takekawa H, Hirata K. An elderly man with progressive ataxia and palatal tremor presenting with dizziness and oculopalatal tremor. Rinsho Shinkeigaku 2016; 56:560-4. [PMID: 27477579 DOI: 10.5692/clinicalneurol.cn-000894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 74-year-old man was referred to our department for dizziness and progressive unsteady gait over 6 years. His family history was unremarkable. Neurological examination showed dysarthria, saccadic eye movement, palatal tremor (1.7 Hz)-synchronous with rotational ocular movement, and truncal ataxia. T2-weighted magnetic resonance imaging (MRI) of the brain revealed hyperintense and hypertrophic bilateral inferior olivary nuclei at the medulla and mild cerebellar atrophy. On the basis of neurological findings of oculopalatal tremor and cerebellar ataxia with brain MRI findings, the diagnosis of progressive ataxia and palatal tremor (PAPT) was made. PAPT should be included in differential diagnosis of dizziness observed in elderly individuals.
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Wakerley BR, Kokubun N, Funakoshi K, Nagashima T, Hirata K, Yuki N. Clinical classification of 103 Japanese patients with Guillain-Barré syndrome. J Neurol Sci 2016; 369:43-47. [PMID: 27653863 DOI: 10.1016/j.jns.2016.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 07/17/2016] [Accepted: 08/01/2016] [Indexed: 11/30/2022]
Abstract
Guillain-Barré syndrome (GBS) is the commonest cause of flaccid paralysis worldwide. Miller Fisher syndrome (MFS) is a variant of GBS characterized by ophthalmoplegia and ataxia. Together GBS and MFS form a continuum of discrete and overlapping subtypes, the frequency of which remains unknown. We retrospectively analysed the clinical features (antecedent symptoms, pattern of neurological weakness or ataxia, presence of hypersomnolence) of 103 patients at a single hospital in Japan. Patients were then classified according to new diagnostic criteria (Wakerley et al., 2014). Laboratory data (neurophysiology and anti-ganglioside antibody profiles) were also analysed. According to the new diagnostic criteria, the 103 patients could be classified as follows: classic GBS 73 (71%), pharyngeal-cervical-brachial weakness 2 (2%), acute pharyngeal weakness 0 (0%), paraparetic GBS 1 (1%), bifacial weakness with paraesthesias 1 (1%), polyneuritis cranialis 0 (0%), classic MFS 18 (17%), acute ophthalmoparesis 1 (1%), acute ptosis 0 (0%), acute mydriasis 0 (0%), acute ataxic neuropathy 1 (1%), Bickerstaff brainstem encephalitis 3 (3%), acute ataxic hypersomnolence 0 (0%), GBS and MFS overlap 1 (1%), GBS and Bickerstaff brainstem encephalitis overlap 1 (1%), MFS and pharyngeal-cervical-brachial weakness overlap 1 (1%). Application of the new clinical diagnostic criteria allowed accurate retrospective diagnosis and classification of GBS and MFS subtypes.
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Affiliation(s)
- Benjamin R Wakerley
- Department of Neurology, Gloucestershire Royal Hospital, Gloucester GL13NN, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - N Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - K Funakoshi
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - T Nagashima
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - K Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - N Yuki
- Department of Neurology, Mishima Hospital, Niigata, Japan.
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Wong AHY, Kokubun N, Fukami Y, Miyaji K, Yuki N. Chronic inflammatory demyelinating polyneuropathy with membranous nephropathy. J Peripher Nerv Syst 2016; 20:63-6. [PMID: 25977098 DOI: 10.1111/jns.12113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/12/2015] [Accepted: 04/17/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Anna Hiu Yi Wong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yuki Fukami
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kazuki Miyaji
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nobuhiro Yuki
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Brain & Mind Research Institute, University of Sydney, Sydney, Sydney, New South Wales, Australia
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38
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Affiliation(s)
- Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Japan
| | | | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Japan
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Wong AHY, Fukami Y, Sudo M, Kokubun N, Hamada S, Yuki N. Sialylated IgG-Fc: a novel biomarker of chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry 2016; 87:275-9. [PMID: 25814494 DOI: 10.1136/jnnp-2014-309964] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/02/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Sialylation in Fc portion of IgG plays a crucial role in the pathogenesis of autoimmune diseases and the working mechanism of intravenous immunoglobulin (IVIG). We aim to test whether IgG-Fc sialylation is a biomarker of disease activity for chronic inflammatory demyelinating polyneuropathy (CIDP). METHODS By using specific lectins for sialylation, galactosylation and agalactosylation, lectin-enzyme assay and lectin blotting with pretreatment of IgG degradating enzyme of Streptococcus pyogenes were performed to compare the glycosylation levels of serum IgG-Fc (1) between patients of untreated CIDP (n=107) and normal control subjects (n=27), (2) among patients with untreated CIDP of different clinical severities and (3) before and after IVIG treatment of patients with CIDP (n=12). RESULTS Sialylation and galactosylation of IgG-Fc were significantly reduced in patients with CIDP than normal control subjects (p=0.003 and 0.033, respectively), whereas agalactosylation was increased in CIDP (p=0.21). Ratios of sialylated/agalactosylated IgG-Fc levels were significantly reduced in CIDP (p<0.001) and inversely related to disease severity (p=0.044). After IVIG treatment, levels of sialylated IgG-Fc significantly increased (p=0.003). CONCLUSIONS Sialylation of IgG-Fc is reduced in CIDP. Its level correlated with clinical severity and increased after IVIG treatment. Sialylated as well as ratio of sialylated/agalactosylated IgG-Fc could be new measures to monitor the disease severity and treatment status in CIDP.
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Affiliation(s)
- Anna Hiu Yi Wong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yuki Fukami
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Makoto Sudo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Shinsuke Hamada
- Department of Neurology, Hokuyukai Neurological Hospital, Sapporo, Japan
| | - Nobuhiro Yuki
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Devaux JJ, Miura Y, Fukami Y, Inoue T, Manso C, Belghazi M, Sekiguchi K, Kokubun N, Ichikawa H, Wong AHY, Yuki N. Neurofascin-155 IgG4 in chronic inflammatory demyelinating polyneuropathy. Neurology 2016; 86:800-7. [PMID: 26843559 DOI: 10.1212/wnl.0000000000002418] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 10/01/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We report the clinical and serologic features of Japanese patients with chronic inflammatory demyelinating polyneuropathy (CIDP) displaying anti-neurofascin-155 (NF155) immunoglobulin G4 (IgG4) antibodies. METHODS In sera from 533 patients with CIDP, anti-NF155 IgG4 antibodies were detected by ELISA. Binding of IgG antibodies to central and peripheral nerves was tested. RESULTS Anti-NF155 IgG4 antibodies were identified in 38 patients (7%) with CIDP, but not in disease controls or normal participants. These patients were younger at onset as compared to 100 anti-NF155-negative patients with CIDP. Twenty-eight patients (74%) presented with sensory ataxia, 16 (42%) showed tremor, 5 (13%) presented with cerebellar ataxia associated with nystagmus, 3 (8%) had demyelinating lesions in the CNS, and 20 of 25 (80%) had poor response to IV immunoglobulin. The clinical features of the antibody-positive patients were statistically more frequent as compared to negative patients with CIDP (n = 100). Anti-NF155 IgG antibodies targeted similarly central and peripheral paranodes. CONCLUSION Anti-NF155 IgG4 antibodies were associated with a subgroup of patients with CIDP showing a younger age at onset, ataxia, tremor, CNS demyelination, and a poor response to IV immunoglobulin. The autoantibodies may serve as a biomarker to improve patients' diagnosis and guide treatments.
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Affiliation(s)
- Jérôme J Devaux
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Yumako Miura
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Yuki Fukami
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Takayuki Inoue
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Constance Manso
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Maya Belghazi
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Kenji Sekiguchi
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Norito Kokubun
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Hiroo Ichikawa
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Anna Hiu Yi Wong
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan
| | - Nobuhiro Yuki
- From Aix-Marseille Université (J.J.D., C.M., M.B.), CNRS, CRN2M-UMR 7286, Marseille, France; Departments of Medicine (Y.M., Y.F., T.I., A.H.Y.W., N.Y.) and Physiology (N.Y.), Yong Loo Lin School of Medicine, National University of Singapore; Brain and Mind Centre (N.Y.), University of Sydney, Australia; Division of Neurology (K.S.), Kobe University Graduate School of Medicine; Department of Neurology (N.K.), Dokkyo Medical University, Tochigi; and Department of Neurology (H.I.), Brain Nerve Center, Showa University Fujigaoka Hospital, Tokyo, Japan.
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Kokubun N. [Neurophysiology in Guillain-Barré syndrome]. Brain Nerve 2015; 67:1321-8. [PMID: 26560947 DOI: 10.11477/mf.1416200302] [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: 11/23/2022]
Abstract
The electrodiagnostic features for the demyelinating and axonal subtypes of Guillain-Barré syndrome (GBS) were described. In the early stage of demyelinating GBS, the most prominent neurophysiologic feature is the patchy demyelination in the peripheral nerves. Conduction slowing presents in the clinical recovery stage, which indicates the conduction slowing is due to mainly remyelination. Axonal GBS shows "reversible conduction failure", as well as primary axonal degeneration. "Reversible conduction failure" is thought to be the most common cause of the underestimation of axonal GBS. The electrodiagnostic criteria for GBS subtypes should be revised based on the knowledge acquired in recent years.
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Kokubun N, Nagashima T, Hirata K, Yuki N. 1-A-D-11. Electrodiagnosis for subtypes of Guillain–Barré syndrome: A single conduction study is not enough. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.02.016] [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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Nagashima T, Kokubun N, Okamura M, Komagamine T, Hirata K, Yuki N. 1-P-D-5. Anti-GT1a antibody characteristics in Miller Fisher syndrome with or without sensory nerve conduction abnormalities. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.02.038] [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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Uruha A, Hayashi YK, Oya Y, Mori-Yoshimura M, Kanai M, Murata M, Kawamura M, Ogata K, Matsumura T, Suzuki S, Takahashi Y, Kondo T, Kawarabayashi T, Ishii Y, Kokubun N, Yokoi S, Yasuda R, Kira JI, Mitsuhashi S, Noguchi S, Nonaka I, Nishino I. Necklace cytoplasmic bodies in hereditary myopathy with early respiratory failure. J Neurol Neurosurg Psychiatry 2015; 86:483-9. [PMID: 25253871 DOI: 10.1136/jnnp-2014-309009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/07/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND In hereditary myopathy with early respiratory failure (HMERF), cytoplasmic bodies (CBs) are often localised in subsarcolemmal regions, with necklace-like alignment (necklace CBs), in muscle fibres although their sensitivity and specificity are unknown. OBJECTIVE To elucidate the diagnostic value of the necklace CBs in the pathological diagnosis of HMERF among myofibrillar myopathies (MFMs). METHODS We sequenced the exon 343 of TTN gene (based on ENST00000589042), which encodes the fibronectin-3 (FN3) 119 domain of the A-band and is a mutational hot spot for HMERF, in genomic DNA from 187 patients from 175 unrelated families who were pathologically diagnosed as MFM. We assessed the sensitivity and specificity of the necklace CBs for HMERF by re-evaluating the muscle pathology of our patients with MFM. RESULTS TTN mutations were identified in 17 patients from 14 families, whose phenotypes were consistent with HMERF. Among them, 14 patients had necklace CBs. In contrast, none of other patients with MFM had necklace CBs except for one patient with reducing body myopathy. The sensitivity and specificity were 82% and 99%, respectively. Positive predictive value was 93% in the MFM cohort. CONCLUSIONS The necklace CB is a useful diagnostic marker for HMERF. When muscle pathology shows necklace CBs, sequencing the FN3 119 domain of A-band in TTN should be considered.
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Affiliation(s)
- Akinori Uruha
- Department of Clinical Development, Translational Medical Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan Department of Education, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
| | - Yukiko K Hayashi
- Department of Clinical Development, Translational Medical Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan Department of Neurophysiology, Tokyo Medical University, Tokyo, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, NCNP, Tokyo, Japan
| | | | - Masahiro Kanai
- Department of Neurology, National Center Hospital, NCNP, Tokyo, Japan
| | - Miho Murata
- Department of Neurology, National Center Hospital, NCNP, Tokyo, Japan
| | - Mayumi Kawamura
- Department of Neurology, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
| | - Katsuhisa Ogata
- Institute of Clinical Research/Department of Neurology, National Hospital Organization Higashisaitama Hospital, Saitama, Japan
| | - Tsuyoshi Matsumura
- Department of Neurology, National Hospital Organization Toneyama National Hospital, Osaka, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Yukako Takahashi
- Department of Neurology, Osaka Red Cross Hospital, Osaka, Japan Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takayuki Kondo
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Kawarabayashi
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yuko Ishii
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Satoshi Yokoi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rei Yasuda
- Department of Neurology, National Hospital Organization Maizuru Medical Center, Kyoto, Japan
| | - Jun-ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satomi Mitsuhashi
- Department of Clinical Development, Translational Medical Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan
| | - Satoru Noguchi
- Department of Clinical Development, Translational Medical Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan
| | - Ikuya Nonaka
- Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan Institute of Clinical Research/Department of Neurology, National Hospital Organization Higashisaitama Hospital, Saitama, Japan
| | - Ichizo Nishino
- Department of Clinical Development, Translational Medical Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan
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Tatsumoto M, Misawa S, Kokubun N, Sekiguchi Y, Hirata K, Kuwabara S, Yuki N. Delayed facial weakness in Guillain-Barré and Miller Fisher syndromes. Muscle Nerve 2015; 51:811-4. [PMID: 25287079 DOI: 10.1002/mus.24475] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/24/2014] [Accepted: 09/30/2014] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Dr. C. Miller Fisher described the appearance of unilateral facial palsy after resolution of ataxia in a patient with the eponymic Miller Fisher syndrome (MFS). However, there have been very few reports of delayed appearance of facial weakness in Guillain-Barré syndrome (GBS) and MFS when the other neurological signs reached nadir or started improving. METHODS In this study we reviewed the clinical and laboratory findings of consecutive patients with GBS (n=195) and MFS (n=68). RESULTS Delayed facial weakness occurred in 12 (6%) GBS and 4 (6%) MFS patients and was unilateral in 5 (42%) GBS and 2 (50%) MFS patients. In those patients with delayed facial weakness, neither limb weakness nor ataxia progressed, and facial weakness disappeared without immunotherapy. CONCLUSIONS Because facial weakness can lead to further morbidity, it would be prudent for clinicians to warn patients of this possibility, although additional immunotherapy is usually not required.
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Affiliation(s)
- Muneto Tatsumoto
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Sonoko Misawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Yukari Sekiguchi
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuhiro Yuki
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Medicine, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Unit 09-01, 14 Medical Drive, 117599, Singapore
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Iwasaki A, Kokubun N, Nishihira T, Nagashima T, Hirata K. Post-irradiation Skin Changes Associated with Lumbosacral Radiculopathy. Intern Med 2015; 54:1913-7. [PMID: 26234236 DOI: 10.2169/internalmedicine.54.4346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe the cases of two patients with post-irradiation lumbosacral radiculopathy. The patients underwent postoperative radiation therapy to the abdomen due to testicular neoplasms 20 and 25 years prior to the onset of weakness, respectively. On physical examinations, asymmetric lower limb weakness and areflexia without apparent sensory loss were observed in both patients. Interestingly, artificial and squared atrophy of the skin and subcutaneous tissue, thought to correspond to the radiation fields, were observed in the lower back, and electromyography revealed selective motor axon loss localized to the lower extremities. The detection of skin changes in the area being irradiated is a valuable clue for diagnosing post-irradiation lumbosacral radiculopathy.
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Affiliation(s)
- Akio Iwasaki
- Department of Neurology, Dokkyo Medical University, Japan
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Abstract
We herein report a patient with demyelinating inferior alveolar nerve hypertrophy, which was initially suspected to have a nerve tumor. A 39-year-old woman with childhood-onset polyneuropathy presented with tooth pain and visited a dental clinic. An X-ray examination of the mandible revealed enlargement of the mandibular canal, and a nerve tumor was suspected. CT scan and MRI showed hypertrophy of the inferior alveolar nerve along its entire length. We diagnosed the patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which was supported by the spontaneous recovery reported in her childhood, the results from a nerve conduction study and MRI data. CIDP should be considered in the differential diagnosis of mandibular canal enlargement.
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Affiliation(s)
- Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Japan
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Kokubun N, Nagashima T, Okamura M, Hirata K, Yuki N. Timing is crucial for electrodiagnosis of Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 2014; 85:1289-90. [PMID: 25097218 DOI: 10.1136/jnnp-2014-308999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Norito Kokubun
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | | | - Madoka Okamura
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Koich Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Nobuhiro Yuki
- Departments of Medicine and Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Iwanami H, Iwasaki A, Okamura M, Kawasaki A, Sada T, Nakamura T, Kokubun N, Hirata K. [Isolated cerebellar hemiatrophy: a case report]. Brain Nerve 2014; 66:882-884. [PMID: 24998834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Hisatake Iwanami
- Department of Neurology, Dokkyo Medical University School of Medicine
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Wong AHY, Umapathi T, Shahrizaila N, Chan YC, Kokubun N, Fong MK, Chu YP, Lau PK, Yuki N. The value of comparing mortality of Guillain-Barré syndrome across different regions. J Neurol Sci 2014; 344:60-2. [PMID: 24993467 DOI: 10.1016/j.jns.2014.06.021] [Citation(s) in RCA: 23] [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] [Received: 01/20/2014] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study the clinical profile of Guillain-Barré syndrome (GBS) patients who died in 4 Asian countries in order to understand factors underlying any variation in mortality. METHODS Retrospectively reviewed medical records of GBS patients who died in 7 hospitals from 4 Asian countries between 2001 and 2012. Baseline characteristics, timing and causes of death were recorded. RESULTS A total of 16 out of 261 GBS patients died. The overall mortality rate was 6%, with a range of 0 to 13%. The leading causes of death were respiratory infections, followed by myocardial infarction. The median age of our patients was 77 years. Half of the patients required mechanical ventilation and almost all had significant concomitant illnesses. A disproportionate number of patients in the Hong Kong cohort died (13%). Patients with advanced age, fewer antecedent respiratory infections and need for mechanical ventilation were at most risk. Most deaths occurred during the plateau phase of GBS and on the general ward after having initially received intensive care. CONCLUSIONS There is considerable variability in mortality of GBS among different Asian cohorts. Although the risks factors for mortality were similar to Western cohorts, the timing and site of death differed. This allows specific measures to be implemented to improve GBS care in countries with higher mortality.
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Affiliation(s)
- A H Y Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region
| | - T Umapathi
- Department of Neurology, National Neuroscience Institute, Singapore
| | - N Shahrizaila
- Division of Neurology, Department of Medicine, University of Malaya, Malaysia
| | - Y C Chan
- Divison of Neurology, University Medicine Cluster, National University Hospital, Singapore
| | - N Kokubun
- Department of Neurology, Dokkyo Medical University, Japan
| | - M K Fong
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region
| | - Y P Chu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong Special Administrative Region
| | - P K Lau
- Department of Medicine and Geriatrics, Caritas Medical Center, Hong Kong Special Administrative Region
| | - N Yuki
- Departments of Medicine and Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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