63 results on '"Morito Inouchi"'
Search Results
2. Adrenal gland size in obstructive sleep apnea: Morphological assessment of hypothalamic pituitary adrenal axis activity.
- Author
-
Takuma Minami, Ryo Tachikawa, Takeshi Matsumoto, Kimihiko Murase, Kiminobu Tanizawa, Morito Inouchi, Tomohiro Handa, Toru Oga, Toyohiro Hirai, and Kazuo Chin
- Subjects
Medicine ,Science - Abstract
ObjectivesThe association of obstructive sleep apnea (OSA) with hypothalamic pituitary adrenal (HPA) axis activation has not been fully understood from results of previous studies using hormonal assessments. We aimed to investigate the relationship between adrenal size, a potential marker reflecting HPA axis activity, and sleep parameters related to OSA.MethodsWe retrospectively reviewed data on 284 consecutive adult patients aged 20 to 80 y who had undergone polysomnography and abdominal computed tomography (CT). OSA was defined as none/mild (apnea-hypopnea index [AHI] ResultsAdrenal size was greater in participants with severe OSA than in those with none/mild or moderate OSA (adrenal body width: 6.03 mm, none/mild OSA; 6.09 mm, moderate OSA; 6.78 mm, severe OSA; p ConclusionsResults indicated that adrenal glands may enlarge in response to longstanding sleep fragmentation, suggesting the involvement of OSA in HPA axis augmentation.
- Published
- 2019
- Full Text
- View/download PDF
3. [A case of Creutzfeldt-Jakob disease presenting with nonconvulsive status epilepticus in the early stages]
- Author
-
Masato Kinboshi, Yu Tamura, Hiroki Yoshida, Ryota Matsunari, Jumpei Togawa, and Morito Inouchi
- Subjects
Cerebral Cortex ,Status Epilepticus ,Humans ,Electroencephalography ,Female ,Neurology (clinical) ,Middle Aged ,Magnetic Resonance Imaging ,Creutzfeldt-Jakob Syndrome - Abstract
A 64-year-old Japanese woman presented with 1 week of recurrent convulsive seizures. At the time of admission, she was in a coma and did not present with convulsions. Intravenous diazepam administration improved her consciousness, although severe psychomotor excitement developed. Brain MRI demonstrated diffusion restriction in the cerebral cortex of the right hemisphere. Electroencephalography (EEG) showed periodic discharges centered around the parietal regions with right-sided dominance. Nonconvulsive status epilepticus (NCSE) was suspected, and the patient was actively treated with anti-epileptic drugs. She developed akinetic mutism and generalized myoclonus 1 month after admission. Follow-up EEG studies disclosed periodic synchronous discharges. Abnormal prion protein in the cerebral fluid was detected using a real-time quaking-induced conversion assay. The clinical diagnosis in the present case was sporadic Creutzfeldt-Jakob disease (CJD). Seizures as an initial symptom in patients with CJD are relatively rare. Our case suggests that CJD should be considered as a differential diagnosis when a patient presents with refractory NCSE.
- Published
- 2022
4. Ictal direct current shifts contribute to defining the core ictal focus in epilepsy surgery
- Author
-
Mitsuyoshi Nakatani, Morito Inouchi, Masako Daifu-Kobayashi, Tomohiko Murai, Jumpei Togawa, Shunsuke Kajikawa, Katsuya Kobayashi, Takefumi Hitomi, Takeharu Kunieda, Satoka Hashimoto, Motoki Inaji, Hiroshi Shirozu, Kyoko Kanazawa, Masaki Iwasaki, Naotaka Usui, Yushi Inoue, Taketoshi Maehara, and Akio Ikeda
- Subjects
presurgical evaluation ,surgical outcome ,General Engineering ,ictal direct-current (DC) shifts ,intractable focal epilepsy ,ictal high-frequency oscillations (HFOs) - Abstract
Identifying the minimal and optimal epileptogenic area to resect and cure is the goal of epilepsy surgery. To achieve this, EEG analysis is recognized as the most direct way to detect epileptogenic lesions from spatiotemporal perspectives. Although ictal direct-current shifts (icDCs; below 1 Hz) and ictal high-frequency oscillations (icHFOs; above 80 Hz) have received increasing attention as good indicators that can add more specific information to the conventionally defined seizure-onset zone, large cohort studies on postoperative outcomes are still lacking. This work aimed to clarify whether this additional information, particularly icDCs which is assumed to reflect extracellular potassium concentration, really improve postoperative outcomes. To assess the usefulness in epilepsy surgery, we collected unique EEG datasets recorded with a longer time constant of 10 sec using an alternate current amplifier. 61 patients [15 with mesial temporal lobe epilepsy and 46 with neocortical epilepsy] who had undergone invasive presurgical evaluation for medically refractory seizures at five institutes in Japan, were retrospectively enrolled in this study. Among intracranially implanted electrodes, the two core electrodes of both icDCs and icHFOs were independently identified by board-certified clinicians based on unified methods. The occurrence patterns, such as their onset time, duration, and amplitude (power) were evaluated to extract the features of both icDCs and icHFOs. Additionally, we examined whether the resection ratio of the core electrodes of icDCs and icHFOs independently correlated with favorable outcomes. A total of 53 patients with 327 seizures were analyzed for wide-band EEG analysis, and 49 patients were analyzed for outcome analysis. icDCs were detected in the seizure-onset zone more frequently than icHFOs among both patients (92% vs. 71%) and seizures (86% vs. 62%). Additionally, icDCs significantly preceded icHFOs in patients exhibiting both biomarkers, and icDCs occurred more frequently in neocortical epilepsy patients than in mesial temporal lobe epilepsy patients. Finally, although a low corresponding rate was observed for icDCs and icHFOs (39%) at the electrode level, complete resection of the core area of icDCs significantly correlated with favorable outcomes, similar to icHFO outcomes. Our results provide a proof of concept that the independent significance of icDCs from icHFOs should be considered as reliable biomarkers to achieve favorable outcomes in epilepsy surgery. Moreover, the different distribution of the core areas of icDCs and icHFOs may provide new insights into the underlying mechanisms of epilepsy, in which not only neurons but also glial cells may be actively involved via extracellular potassium levels., 難治てんかん焦点の新しいバイオマーカー「発作時DC電位」 --国内5施設の共同研究での世界初の成果--. 京都大学プレスリリース. 2022-09-05.
- Published
- 2022
5. Electrical cortical stimulations modulate spike and post-spike slow-related high-frequency activities in human epileptic foci
- Author
-
Ryosuke Takahashi, Takefumi Hitomi, Nobutaka Hattori, Masako Kinoshita, Morito Inouchi, Takayuki Kikuchi, Katsuya Kobayashi, Masao Matsuhashi, Takeharu Kunieda, Susumu Miyamoto, Kazumichi Yoshida, Riki Matsumoto, Mitsuyoshi Nakatani, and Akio Ikeda
- Subjects
Adult ,Male ,Adolescent ,Stimulation ,Electrical Cortical Stimulation ,Inhibitory postsynaptic potential ,Interictal Epileptiform Discharges ,050105 experimental psychology ,Young Adult ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Physiology (medical) ,medicine ,Humans ,0501 psychology and cognitive sciences ,Ictal ,High Frequency Oscillation/Activity ,Chemistry ,Neuromodulation ,05 social sciences ,Brain ,Electroencephalography ,medicine.disease ,Brain Waves ,Transcranial Magnetic Stimulation ,Electric Stimulation ,Sensory Systems ,Amplitude ratio ,Neurology ,Intractable Focal Epilepsy ,Epilepsies, Partial ,Neurology (clinical) ,Epileptic foci ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Objective Using interictal epileptiform discharges (IEDs), consisting of spikes and post-spike slow waves (PSSs), and IED-related high-frequency activities (HFAs), we elucidated inhibitory effects of electrical cortical stimulation (ECS) on human epileptic foci. Methods We recruited 8 patients with intractable focal epilepsy, and 50-Hz ECS was applied to the seizure-onset zone (SOZ) and non-SOZ. Before (5-min) and after (20-min) ECS, we evaluated the number of IED, the amplitudes of spikes and PSSs, spike-related HFA power, and PSS-related low gamma (30–50 Hz) activities. Results SOZ stimulation significantly decreased the number of IEDs and amplitude of spikes. Spike-related HFA power values in fast ripple (200–300 Hz) and ripple (80–150 Hz) bands were significantly suppressed only by SOZ stimulation in 4 and 3 patients, respectively. Among 4 patients with discrete PSSs, the amplitude ratio of spike/PSS decreased and the PSS-related low gamma activity power increased significantly in 2 patients and marginally in 1 patient. Conclusions ECS potentially modulates cortical excitability by reducing excitation and increasing inhibition, and monitoring IED-related HFAs may help achieve the optimal effects of ECS. Significance IED and IED-related HFAs are dynamic, potential surrogate markers for epileptic excitability during the interictal period.
- Published
- 2020
6. Enhanced phase-amplitude coupling of human electrocorticography selectively in the posterior cortical region during rapid eye movement sleep
- Author
-
Jumpei Togawa, Riki Matsumoto, Kiyohide Usami, Masao Matsuhashi, Morito Inouchi, Katsuya Kobayashi, Takefumi Hitomi, Takuro Nakae, Akihiro Shimotake, Yukihiro Yamao, Takayuki Kikuchi, Kazumichi Yoshida, Takeharu Kunieda, Susumu Miyamoto, Ryosuke Takahashi, and Akio Ikeda
- Subjects
Cellular and Molecular Neuroscience ,Cognitive Neuroscience ,psychological phenomena and processes - Abstract
The spatiotemporal dynamics of interaction between slow (delta or infraslow) waves and fast (gamma) activities during wakefulness and sleep are yet to be elucidated in human electrocorticography (ECoG). We evaluated phase-amplitude coupling (PAC), which reflects neuronal coding in information processing, using ECoG in 11 patients with intractable focal epilepsy. PAC was observed between slow waves of 0.5–0.6 Hz and gamma activities, not only during light sleep and slow-wave sleep (SWS) but even during wakefulness and rapid eye movement (REM) sleep. While PAC was high over a large region during SWS, it was stronger in the posterior cortical region around the temporoparietal junction than in the frontal cortical region during REM sleep. PAC tended to be higher in the posterior cortical region than in the frontal cortical region even during wakefulness. Our findings suggest that the posterior cortical region has a functional role in REM sleep and may contribute to the maintenance of the dreaming experience.
- Published
- 2021
7. Sleep is associated with reduction of epileptiform discharges in benign adult familial myoclonus epilepsy
- Author
-
Morito Inouchi, Kazuo Chin, Yuko Nakayama, Riki Matsumoto, Hirofumi Takeyama, Shamima Sultana, Masao Matsuhashi, Akihiro Shimotake, Takefumi Hitomi, Akio Ikeda, Ryosuke Takahashi, Takeshi Inoue, and Katsuya Kobayashi
- Subjects
0301 basic medicine ,nCPAP, nasal continuous positive airway pressure ,REM, rapid eye movement ,EMG - Electromyography ,Polysomnography ,ADCME, autosomal dominant cortical tremor, myoclonus, and epilepsy ,Irritability ,Article ,lcsh:RC321-571 ,03 medical and health sciences ,Behavioral Neuroscience ,BAFME, benign adult familial myoclonus epilepsy ,0302 clinical medicine ,Benign adult familial myoclonus epilepsy ,Benign adult familial myoclonus epilepsy (BAFME) ,medicine ,PSG, polysomnography ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,ULD, Unverricht-Lundborg disease ,Light sleep ,Sleep Stages ,medicine.diagnostic_test ,business.industry ,Epileptiform discharges ,Mean age ,Sleep in non-human animals ,nervous system diseases ,030104 developmental biology ,Neurology ,Anesthesia ,FCMTE, familial cortical myoclonic tremor with epilepsy ,Neurology (clinical) ,medicine.symptom ,Effects of sleep modification on cortical irritability ,business ,EMG, electromyography ,EEG, electroencephalography ,030217 neurology & neurosurgery - Abstract
To clarify the effects of sleep on cortical irritability in benign adult familial myoclonus epilepsy (BAFME), we retrospectively compared epileptiform discharges of electroencephalographies (EEGs) between awake and sleep periods in 5 patients (mean age: 49.6 ± 20.3 years). We also analyzed polysomnography (PSG) of 1 patient. Epileptiform discharges were significantly more frequent during the awake period (1.3 ± 1.2/min) than those during light sleep stages (0.02 ± 0.04/min) (P, Highlights • We retrospectively analyzed the number of epileptiform discharges in BAFME. • Epileptiform discharges were more frequent during awake period in BAFME. • Our study indicated a reduction in cortical irritability during sleep in BAFME. • BAFME and Unverricht-Lundborg disease may share a similar phenomenological mechanism.
- Published
- 2019
8. [Paradoxical effect of levetiracetam on seizure suppression: three cases showing U curve association between dose and effect]
- Author
-
Akio Ikeda, Morito Inouchi, Ryosuke Takahashi, Akihiro Shimotake, Tatsuya Sakai, Kiyohide Usami, Takeshi Inoue, and Katsuya Kobayashi
- Subjects
Adult ,Male ,Levetiracetam ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Seizures ,Seizure control ,Medicine ,Humans ,Seizure frequency ,Adult patients ,Dose-Response Relationship, Drug ,business.industry ,Electroencephalography ,Serum concentration ,medicine.disease ,Magnetic Resonance Imaging ,Seizure suppression ,Treatment Outcome ,Anesthesia ,Anticonvulsants ,Drug Therapy, Combination ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
We experienced 3 adult patients with intractable focal epilepsy treated by levetiracetam (LEV) as polytherapy, who showed paradoxical effect (PE). Starting dose of LEV was small (62.5, 250 mg/day) and we gradually increased by less than 250 mg/day, every more than 2 weeks. Within 6 months after LEV was added, LEV of 750 to 1,000 mg/day brought reduction of seizure frequency. Serum concentration of LEV was 13.3 and 14.0 μg/ml. In order to obtain better seizure control, LEV was increased up to 1,000-2,500 mg/day (19.3-35.0 μg/ml) within one year, and they developed PE. They all showed increased habitual seizures, occurring in cluster. Once dose of LEV deceased down to what produced the maximum seizure suppression, all of the patients regained the better seizure control. It is most likely that at least in some patients like present 3 cases, PE of LEV may express U curve association between dose and effect and that it was only delineated by slow titration.
- Published
- 2021
9. [A case of refractory generalized atonic seizure and hemifacial spasm with the possible causative pontocerebellar lesion]
- Author
-
Akio Ikeda, Morito Inouchi, Nobukatsu Sawamoto, Masaya Togo, Riki Matsumoto, and Ryosuke Takahashi
- Subjects
Adult ,business.industry ,Brain Neoplasms ,Orbicularis oris muscle ,Electroencephalography ,medicine.disease ,Reticular formation ,Magnetic Resonance Imaging ,Lesion ,Epilepsy ,Seizures ,Gelastic seizure ,Anesthesia ,Pons ,medicine ,Humans ,Ictal ,Female ,Hemifacial Spasm ,Neurology (clinical) ,medicine.symptom ,business ,Atonic seizure ,Hemifacial spasm - Abstract
The patient was a 35-year-old woman. At the age of 1, she had undergone resection and radiation therapy for neoplastic lesions in the pons. She had a history of gelastic seizures when she was in elementary school, and brief lapses of the neck and truncal muscular tone and convulsions on the left face occurred at the age of 23. After a generalized sharp wave in the ictal electroencephalogram and electromyogram recording, left orbicularis oris muscle contraction was observed followed by sudden cervical extensor atonia. Seizure propagation was noted in the cerebral cortex, left facial nerve nucleus, and brainstem reticular formation. In a simultaneous electroencephalography with functional MRI, the blood oxygen level-dependent effect related to generalized sharp waves was observed in the vicinity of brainstem lesions in addition to a decrease in bilateral frontal and parietal lobes signals, as detected in generalized seizures. These findings suggest that the lesion could be a part of the epilepsy network. Although most epileptic seizures are derived from the cerebral cortex, it is important to note that brainstem lesions are involved in seizures in the patient presented in this study.
- Published
- 2020
10. Relationship between obstructive sleep apnea and endogenous carbon monoxide
- Author
-
Masanori Azuma, Takeshi Matsumoto, Satoshi Hamada, Ryo Tachikawa, Kazuo Chin, T. Minami, Kimihiko Murase, Kiminobu Tanizawa, Toru Oga, Michiaki Mishima, Morito Inouchi, and Tomohiro Handa
- Subjects
Male ,Physiology ,medicine.medical_treatment ,Endogeny ,030204 cardiovascular system & hematology ,medicine.disease_cause ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Physiology (medical) ,medicine ,Humans ,Prospective Studies ,Continuous positive airway pressure ,Hypoxia ,Carbon Monoxide ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,Pulmonary Gas Exchange ,business.industry ,Surrogate endpoint ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Oxygen ,Heme oxygenase ,Obstructive sleep apnea ,Oxidative Stress ,030228 respiratory system ,chemistry ,Exhalation ,Anesthesia ,Female ,Sleep ,business ,Biomarkers ,Heme Oxygenase-1 ,Oxidative stress ,Carbon monoxide - Abstract
Endogenous carbon monoxide (CO) levels are recognized as a surrogate marker for activity of heme oxygenase-1, which is induced by various factors, including hypoxia and oxidative stress. Few reports have evaluated endogenous CO in patients with obstructive sleep apnea (OSA). Whether OSA more greatly affects exhaled or blood CO is not known. Sixty-nine patients with suspected OSA were prospectively included in this study. Exhaled and blood CO were evaluated at night and morning. Blood and exhaled CO levels were well correlated both at night and morning ( r = 0.52, P < 0.0001 and r = 0.61, P < 0.0001, respectively). Although exhaled CO levels both at night and morning significantly correlated with total sleep time with arterial oxygen saturation < 90% (ρ = 0.41, P = 0.0005 and ρ = 0.27, P = 0.024, respectively), blood CO levels did not correlate with any sleep parameter. Seventeen patients with an apnea and hypopnea index (AHI) < 15 (control group) were compared with 52 patients with AHI ≥ 15 (OSA group). Exhaled CO levels at night in the OSA group were significantly higher than in the control group (3.64 ± 1.2 vs. 2.99 ± 0.70 ppm, P < 0.05). Exhaled CO levels at night decreased after 3 mo of continuous positive airway pressure (CPAP) therapy in OSA patients ( n = 36; P = 0.016) to become nearly the same level as in the control group ( P = 0.21). Blood CO levels did not significantly change after CPAP therapy. Exhaled CO was positively related to hypoxia during sleep in OSA patients, but blood CO was not. Exhaled CO might better correlate with oxidative stress associated with OSA than blood CO. NEW & NOTEWORTHY Endogenous carbon monoxide (CO) levels are recognized to be a surrogate marker of oxidative stress. No study has evaluated both exhaled and blood CO at the same time in obstructive sleep apnea (OSA) patients. Here we provide evidence that exhaled CO levels positively correlated with hypoxia during sleep in OSA patients, but blood CO levels did not, and that continuous positive airway pressure therapy significantly decreased exhaled CO levels in the OSA group, but did not significantly affect blood CO.
- Published
- 2017
11. Engagement of cortico-cortical and cortico-subcortical networks in a patient with epileptic spasms: An integrated neurophysiological study
- Author
-
Takeshi Inoue, Takeharu Kunieda, Kiyohide Usami, Takayuki Kikuchi, Katsuya Kobayashi, Masaya Togo, Jumpei Togawa, Riki Matsumoto, Akio Ikeda, Masao Matsuhashi, Morito Inouchi, Kazumichi Yoshida, Hisashi Kawawaki, Nobukatsu Sawamoto, Akihiro Shimotake, Susumu Miyamoto, and Ryosuke Takahashi
- Subjects
Male ,EEG with functional MRI (EEG-fMRI) ,Adolescent ,Thalamus ,Electroencephalography ,050105 experimental psychology ,Midbrain ,03 medical and health sciences ,0302 clinical medicine ,Seizures ,Physiology (medical) ,mental disorders ,medicine ,Humans ,0501 psychology and cognitive sciences ,Ictal ,Evoked Potentials ,Cortico-cortical evoked potential ,Cerebral Cortex ,Brain Mapping ,medicine.diagnostic_test ,business.industry ,musculoskeletal, neural, and ocular physiology ,05 social sciences ,Magnetoencephalography ,Neurophysiology ,medicine.disease ,Brain Waves ,Magnetic Resonance Imaging ,Sensory Systems ,High frequency oscillation ,Epileptic spasms ,Neurology ,nervous system ,Epileptic spasm ,Neurology (clinical) ,Nerve Net ,Functional magnetic resonance imaging ,business ,Neuroscience ,030217 neurology & neurosurgery ,psychological phenomena and processes - Abstract
Objective We aimed to delineate the engagement of cortico-cortical and cortico-subcortical networks in the generation of epileptic spasms (ES) using integrated neurophysiological techniques. Methods Seventeen-year-old male patient with intractable ES underwent chronic subdural electrode implantation for presurgical evaluation. Networks were evaluated in ictal periods using high-frequency oscillation (HFO) analysis and in interictal periods using magnetoencephalography (MEG) and simultaneous electroencephalography, and functional magnetic resonance imaging (EEG-fMRI). Cortico-cortical evoked potentials (CCEPs) were recorded to trace connections among the networks. Results Ictal HFO revealed a network comprising multilobar cortical regions (frontal, parietal, and temporal), but sparing the positive motor area. Interictally, MEG and EEG-fMRI revealed spike-and-wave-related activation in these cortical regions. Analysis of CCEPs provided evidence of connectivity within the cortico-cortical network. Additionally, EEG-fMRI results indicate the involvement of subcortical structures, such as bilateral thalamus (predominantly right) and midbrain. Conclusions In this case study, integrated neurophysiological techniques provided converging evidence for the involvement of a cortico-cortical network (sparing the positive motor area) and a cortico-subcortical network in the generation of ES in the patient. Significance Cortico-cortical and cortico-subcortical pathways, with the exception of the direct descending corticospinal pathway from the positive motor area, may play important roles in the generation of ES.
- Published
- 2019
12. Adrenal gland size in obstructive sleep apnea: Morphological assessment of hypothalamic pituitary adrenal axis activity
- Author
-
T. Minami, Takeshi Matsumoto, Kiminobu Tanizawa, Tomohiro Handa, Toyohiro Hirai, Toru Oga, Kimihiko Murase, Kazuo Chin, Ryo Tachikawa, and Morito Inouchi
- Subjects
Male ,Physiology ,Polysomnography ,Biochemistry ,Cortisol ,030218 nuclear medicine & medical imaging ,Diagnostic Radiology ,Fats ,0302 clinical medicine ,Adrenal Glands ,Medicine and Health Sciences ,Medicine ,Lipid Hormones ,Tomography ,Aged, 80 and over ,Metabolic Syndrome ,Sleep Apnea, Obstructive ,Multidisciplinary ,medicine.diagnostic_test ,Adrenal gland ,Radiology and Imaging ,Sleep apnea ,Organ Size ,Middle Aged ,Lipids ,medicine.anatomical_structure ,Physiological Parameters ,Neurology ,Cardiology ,Female ,Anatomy ,Hypothalamic–pituitary–adrenal axis ,Research Article ,Adult ,medicine.medical_specialty ,Hypothalamo-Hypophyseal System ,Imaging Techniques ,Science ,Neuroimaging ,Endocrine System ,Research and Analysis Methods ,03 medical and health sciences ,Young Adult ,stomatognathic system ,Diagnostic Medicine ,Internal medicine ,Humans ,Obesity ,Aged ,Retrospective Studies ,Steroid Hormones ,business.industry ,Body Weight ,Biology and Life Sciences ,medicine.disease ,Hormones ,nervous system diseases ,respiratory tract diseases ,Computed Axial Tomography ,Obstructive sleep apnea ,Metabolic Disorders ,Metabolic syndrome ,business ,Tomography, X-Ray Computed ,Physiological Processes ,Sleep ,Sleep Disorders ,030217 neurology & neurosurgery ,Biomarkers ,Hormone ,Neuroscience - Abstract
ObjectivesThe association of obstructive sleep apnea (OSA) with hypothalamic pituitary adrenal (HPA) axis activation has not been fully understood from results of previous studies using hormonal assessments. We aimed to investigate the relationship between adrenal size, a potential marker reflecting HPA axis activity, and sleep parameters related to OSA.MethodsWe retrospectively reviewed data on 284 consecutive adult patients aged 20 to 80 y who had undergone polysomnography and abdominal computed tomography (CT). OSA was defined as none/mild (apnea-hypopnea index [AHI] ResultsAdrenal size was greater in participants with severe OSA than in those with none/mild or moderate OSA (adrenal body width: 6.03 mm, none/mild OSA; 6.09 mm, moderate OSA; 6.78 mm, severe OSA; p ConclusionsResults indicated that adrenal glands may enlarge in response to longstanding sleep fragmentation, suggesting the involvement of OSA in HPA axis augmentation.
- Published
- 2019
13. Interictal Slow and High-Frequency Oscillations: Is it an Epileptic Slow or Red Slow?
- Author
-
Takefumi Hitomi, Ryosuke Takahashi, Masako Daifu-Kobayashi, Riki Matsumoto, Takeharu Kunieda, Akio Ikeda, Mitsuyoshi Nakatani, Takayuki Kikuchi, Masao Matsuhashi, Akihiro Shimotake, Kyoko Kanazawa, Susumu Miyamoto, Takeshi Inoue, Kazumichi Yoshida, Katsuya Kobayashi, and Morito Inouchi
- Subjects
Male ,Physiology ,050105 experimental psychology ,03 medical and health sciences ,0302 clinical medicine ,Nuclear magnetic resonance ,Seizures ,Physiology (medical) ,medicine ,Humans ,0501 psychology and cognitive sciences ,Ictal ,Temporal change ,Electrocorticography ,medicine.diagnostic_test ,Chemistry ,Brain Neoplasms ,05 social sciences ,Brain ,Middle Aged ,Epileptogenic zone ,Neurology ,Preoperative Period ,Neurology (clinical) ,Epilepsies, Partial ,030217 neurology & neurosurgery - Abstract
We reported the presence of interictal slow and high-frequency oscillations (HFOs) (IIS + HFO) and its temporal change so as to elucidate its clinical usefulness as a surrogate marker of epileptogenic zone in a patient with intractable focal epilepsy.We focused on one of the core electrodes of epileptogenicity, and investigated IIS + HFO in the pre- and post-segment of 30 minutes to all the 6 seizures. We adopted interictal slow in duration of 0.33 to 10 seconds, amplitude ≥50 μV and co-occurring with HFOs, and then divided into 5 groups depending on the amplitude of slow wave.Before and after all the 6 seizures, the number of IIS + HFO was 2,890 at one electrode in the core epileptogenic zone. The number of IIS + HFO significantly decreased for 30 minutes after seizures. Furthermore, the number of IIS + HFO with the amplitude of 200 to 399 μV significantly decreased after seizures.IIS + HFO with the amplitude of 200 to 399 μV was influenced by and decreased after seizures. It may reflect the core part of epileptogenic area as similarly as ictal direct current shifts and ictal HFOs do. IIS + HFO could be called as the term "red slow," which may be useful to delineate at least a part of the epileptogenic zone.
- Published
- 2018
14. Absence of an Autonomic Sign Assists in the Diagnosis of Extratemporal Lobe Epilepsy Manifesting Generalized Convulsion with Retained Awareness
- Author
-
Akihiro Shimotake, Ryosuke Takahashi, Hirofumi Maruyama, Riki Matsumoto, Akio Ikeda, Shuichiro Neshige, Katsuya Kobayashi, and Morito Inouchi
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Respiratory arrest ,Case Report ,030204 cardiovascular system & hematology ,Autonomic Nervous System ,consciousness ,insula ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Seizures ,Internal Medicine ,medicine ,Humans ,Cerebral Cortex ,business.industry ,Generalized convulsion ,autonomic symptoms ,Electroencephalography ,General Medicine ,Semiology ,Middle Aged ,medicine.disease ,generalized ,Lobe ,Autonomic signs ,medicine.anatomical_structure ,030211 gastroenterology & hepatology ,Female ,Epileptic seizure ,Epilepsies, Partial ,medicine.symptom ,business ,Insula ,non-dominant hemisphere - Abstract
We herein report two epilepsy patients with the seizure focus in the non-dominant hemisphere manifesting secondarily generalized convulsion (sGC) with retained awareness characterized by a lack of autonomic signs although GC was complicated by respiratory arrest. Given the semiology and electrophysiological findings, the seizure activity was considered to propagate to the supplementary-motor area and the bilateral primary-motor area, with a clinical manifestation of sGC. The absence of autonomic signs during GC can be a key indicator that the seizure remains in the bilateral suprasylvian area and thus does not involve the region necessary for awareness preservation, which may assist in the diagnosis of this atypical epileptic seizure.
- Published
- 2018
15. Microalbuminuria in Patients with Obstructive Sleep Apnea–Chronic Obstructive Pulmonary Disease Overlap Syndrome
- Author
-
T. Minami, Morito Inouchi, Kazuo Chin, Tomohiro Handa, Kimihiko Murase, Takeshi Matsumoto, Motoko Yanagita, Satoshi Hamada, Kiminobu Tanizawa, Michiaki Mishima, Ryo Tachikawa, and Toru Oga
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Polysomnography ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,Severity of illness ,Albuminuria ,Humans ,Medicine ,Continuous positive airway pressure ,Serum Albumin ,Aged ,Sleep Apnea, Obstructive ,COPD ,Continuous Positive Airway Pressure ,medicine.diagnostic_test ,business.industry ,Overlap syndrome ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Obstructive sleep apnea ,Logistic Models ,030228 respiratory system ,Multivariate Analysis ,Cardiology ,Physical therapy ,Female ,Microalbuminuria ,medicine.symptom ,business - Abstract
Microalbuminuria is said to reflect systemic vascular damage and endothelial dysfunction and is an established indicator of cardiovascular morbidity and mortality. Patients with obstructive sleep apnea (OSA)-chronic obstructive pulmonary disease (COPD) overlap syndrome have worse survival than those with OSA or COPD alone.This study evaluated the association between overlap syndrome and microalbuminuria.Data on patients in whom OSA was suspected and who underwent polysomnography between January 2010 and December 2012 were reviewed. Microalbuminuria was defined as an albumin-creatinine ratio between 20 and 299 mg/g in men and between 30 and 299 mg/g in women.Of 740 consecutive patients, 344 were analyzed. Sixty-four were control participants, 248 had OSA only, 4 had COPD only, and 28 had OSA-COPD overlap syndrome. Prevalence of microalbuminuria significantly increased in the order of control, OSA, and overlap syndrome groups (3.1, 12.9, and 32.1%, respectively; P = 0.0006). After adjusting for age and sex, multivariate logistic regression analysis demonstrated a significant association of overlap syndrome with microalbuminuria compared with OSA (odds ratio, 2.61; 95% confidence interval, 1.02-6.38; P = 0.047), but after adjusting for other confounding factors, the difference in the association did not reach significance (odds ratio, 2.54; 95% confidence interval, 0.93-6.72; P = 0.070). Of 63 patients reevaluated after 3 months of continuous positive airway pressure therapy, the logarithm of the albumin-creatinine ratio in 36 patients with good compliance significantly decreased, but there was no difference in patients with poor compliance.OSA-COPD overlap syndrome was more prevalent than OSA alone in patients with microalbuminuria, but the difference might be mediated by conventional risk factors rather than the addition of COPD itself.
- Published
- 2016
16. P1-02-01. Phase amplitude coupling of human electrocorticography reveals enhanced neuronal coding in posterior cortical regions during rapid eye movement sleep and wakefulness
- Author
-
Kiyohide Usami, Takuro Nakae, Ryosuke Takahashi, Takeharu Kunieda, Takayuki Kikuchi, Jumpei Togawa, Masao Matsuhashi, Susumu Miyamoto, Kazumichi Yoshida, Katsuya Kobayashi, Morito Inouchi, Riki Matsumoto, Akio Ikeda, and Takefumi Hitomi
- Subjects
Physics ,Neurology ,medicine.diagnostic_test ,Physiology (medical) ,medicine ,Rapid eye movement sleep ,Wakefulness ,Neurology (clinical) ,Electrocorticography ,Neuroscience ,Sensory Systems ,Phase amplitude coupling ,Neuronal coding - Published
- 2019
17. [(4)The Investigation of the Epileptic Focus by Means of Wide-band EEG:Approach from Glia and Neuron]
- Author
-
Mitsuyoshi, Nakatani, Morito, Inouchi, Taketoshi, Maehara, and Akio, Ikeda
- Subjects
Neurons ,Epilepsy ,Humans ,Electroencephalography ,Neuroglia - Published
- 2018
18. Associations of obstructive sleep apnea with truncal skeletal muscle mass and density
- Author
-
Ryo Tachikawa, Takeshi Matsumoto, Kimihiko Murase, Toru Oga, Tomohiro Handa, Toyohiro Hirai, Kazuo Chin, T. Minami, Morito Inouchi, and Kiminobu Tanizawa
- Subjects
Male ,medicine.medical_specialty ,Polysomnography ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Article ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Severity of illness ,medicine ,Humans ,Obesity ,lcsh:Science ,Muscle, Skeletal ,Adiposity ,Retrospective Studies ,Sleep Apnea, Obstructive ,Multidisciplinary ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Skeletal muscle ,Sleep apnea ,Middle Aged ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,medicine.anatomical_structure ,Sarcopenia ,Cardiology ,lcsh:Q ,Female ,business ,Body mass index ,030217 neurology & neurosurgery - Abstract
Sarcopenia has been associated with several conditions relevant to obstructive sleep apnea (OSA), such as aging and obesity, but a direct relationship between OSA and skeletal muscle alterations has not been identified. This study investigated associations between computed tomography (CT)-measured skeletal muscle indices and OSA severity. Analyzed were 334 patients who underwent polysomnography to diagnose OSA. Lumbar skeletal muscles were assessed with CT for the skeletal muscle mass index (SMI, cross-sectional area, normalized for height squared) and skeletal muscle density (SMD, fat infiltration). The apnea-hypopnea index (AHI) correlated positively with the SMI and negatively with SMD in both men and women. The AHI was weakly associated with SMI only in men (β = 0.11, P = 0.017) after adjustment for the body mass index (BMI) (BMI: β = 0.61, P P P P
- Published
- 2018
19. Obstructive sleep apnea and abdominal aortic calcification: Is there an association independent of comorbid risk factors?
- Author
-
Kazuo Chin, Kiminobu Tanizawa, Michiaki Mishima, Morito Inouchi, Kimihiko Murase, Satoshi Hamada, Ryo Tachikawa, Sho Koyasu, Takeshi Matsumoto, Kaori Togashi, Toru Oga, and Masanori Azuma
- Subjects
Adult ,Male ,medicine.medical_specialty ,Polysomnography ,Aortic Diseases ,Comorbidity ,Aortography ,Severity of Illness Index ,Japan ,stomatognathic system ,Risk Factors ,medicine.artery ,Diabetes mellitus ,Internal medicine ,Bayesian multivariate linear regression ,medicine ,Humans ,Aorta, Abdominal ,Vascular Calcification ,Aged ,Retrospective Studies ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,business.industry ,Abdominal aorta ,Middle Aged ,Atherosclerosis ,Prognosis ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Surgery ,Obstructive sleep apnea ,Arterial calcification ,Cross-Sectional Studies ,Asymptomatic Diseases ,Multivariate Analysis ,Linear Models ,Cardiology ,Female ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Dyslipidemia - Abstract
Background No studies have addressed the relationship between obstructive sleep apnea (OSA) and abdominal aortic calcification (AAC), a marker for subclinical atherosclerosis and future cardiovascular events. Objectives To investigate 1) the association between OSA severity and AAC, and 2) whether OSA can impact the extent of AAC independent of comorbid atherogenic risk factors. Methods 390 participants aged 40–70 years underwent polysomnography and abdominal computed tomography. AAC was separately quantified in the upper and lower abdominal aorta using the modified Agatston scoring method, and the total AAC score was calculated as a sum of the two scores. OSA was defined as none/mild (apnea-hypopnea index [AHI] Results Log-transformed total AAC score adjusted for age and body mass index (BMI) was greater in participants with an elevated AHI (3.4 for none/mild OSA, 3.7 for moderate OSA, and 4.2 for severe OSA, p = 0.04). Multivariate linear regression analysis including age and BMI as covariates showed that severe OSA was associated with higher scores for the lower and total AAC (β = 0.15 and 0.14, p = 0.01 and 0.01, respectively). The association did not persist after additionally adjusting for traditional atherogenic risk factors including visceral fat, smoking, hypertension, dyslipidemia, and diabetes. Conclusions Severe OSA was associated with a greater extent of AAC, which was dependent on coexisting atherogenic risk factors. Comorbid cardiometabolic disorders may largely mediate the association of OSA with subclinical atherosclerosis.
- Published
- 2015
20. Alpha-band desynchronization in human parietal area during reach planning
- Author
-
Ryosuke Takahashi, Hidenao Fukuyama, Tomoyuki Fumuro, Riki Matsumoto, Tomoko Miyazaki, Akio Ikeda, Takefumi Hitomi, Morito Inouchi, and Masao Matsuhashi
- Subjects
Adult ,Male ,Movement ,Posterior parietal cortex ,Intention ,Electroencephalography ,Wrist ,Young Adult ,Rhythm ,Parietal Lobe ,Physiology (medical) ,Parietal area ,medicine ,Humans ,Brain Mapping ,medicine.diagnostic_test ,Movement (music) ,Visually guided ,Healthy subjects ,Reaching ,Hand ,Sensory Systems ,Alpha Rhythm ,Alpha band ,medicine.anatomical_structure ,Neurology ,Female ,Neurology (clinical) ,Psychology ,Neuroscience ,Alpha-band desynchronization ,Motor planning - Abstract
Objective The symptoms with optic ataxia suggest that simple and visually guided hand movements are controlled by 2 different neural substrates. To assess the differential frequency-coded posterior parietal cortex (PPC) role in planning visuo-motor goal-directed tasks, we studied the action specificity of event-related desynchronization (ERD) in this area. Methods We investigated cortical activity by electroencephalography, while 16 healthy subjects performed self-paced reaching or wrist extension (control) movements. Time–frequency representations were calculated for each movement during the preparatory period. Results ERD dynamics in upper alpha-band indicated that preparing a goal-directed action activates contralateral PPC to the moving hand around 1.2 s before starting the movement, while this activation is later (around 0.7 s) in preparing a not-goal-directed action. The posterior dominant rhythm had peak frequency of lower alpha-band at bilateral parietal. Conclusions Posterior parietal cortex encodes goal-directed movement preparation through upper alpha-band activity, whereas general attention is processed via lower alpha-band oscillations. Significance Preparing to reach an object engages posterior parietal cortex earlier than a not-goal directed movement.
- Published
- 2015
21. Association Between Endothelial Function (Assessed on Reactive Hyperemia Peripheral Arterial Tonometry) and Obstructive Sleep Apnea, Visceral Fat Accumulation, and Serum Adiponectin
- Author
-
Morito Inouchi, Kimihiko Murase, Yuichi Chihara, Takeshi Matsumoto, Tomohiro Handa, Satoshi Hamada, Kazuo Chin, Chikara Yoshimura, Toru Oga, Kiminobu Tanizawa, Michiaki Mishima, Ryo Tachikawa, and Masanori Azuma
- Subjects
Adult ,Male ,medicine.medical_specialty ,Manometry ,Polysomnography ,medicine.medical_treatment ,Subcutaneous Fat ,Hyperemia ,Comorbidity ,Intra-Abdominal Fat ,Risk Factors ,Internal medicine ,Multidetector Computed Tomography ,medicine ,Humans ,Continuous positive airway pressure ,Endothelial dysfunction ,Reactive hyperemia ,Aged ,Dyslipidemias ,Metabolic Syndrome ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,medicine.diagnostic_test ,Adiponectin ,business.industry ,Sleep apnea ,General Medicine ,Middle Aged ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,Treatment Outcome ,Endocrinology ,Apnea–hypopnea index ,Hyperglycemia ,Hypertension ,Cardiology ,Female ,Endothelium, Vascular ,Cardiology and Cardiovascular Medicine ,business - Abstract
BACKGROUND Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known. METHODS AND RESULTS Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia peripheral arterial tonometry. Visceral obesity was defined as visceral fat area ≥100 cm(2)on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI ≥30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R(2)=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78±0.40 before CPAP vs. 2.00±0.53 after CPAP, P=0.013), similarly to those with AHI
- Published
- 2015
22. Association between sleep disordered breathing and objective sleep duration: the Nagahama study
- Author
-
Kiminobu Tanizawa, Takeshi Matsumoto, Shunsuke Nagashima, Kazuya Setoh, Toyohiro Hirai, Naoko Komenami, Takeo Nakayama, Ryo Tachikawa, Morito Inouchi, Tomoko Wakamura, Takahisa Kawaguchi, T. Minami, Yasuharu Tabara, Kimihiko Murase, Toru Oga, Yoshimitsu Takahashi, Kazuo Chin, and Fumihiko Matsuda
- Subjects
medicine.medical_specialty ,business.industry ,Sleep disordered breathing ,Medicine ,Audiology ,Association (psychology) ,business ,Sleep duration - Published
- 2017
23. Changes in Habitual Sleep Duration after Continuous Positive Airway Pressure for Obstructive Sleep Apnea
- Author
-
Morito Inouchi, Ryo Tachikawa, T. Minami, Toru Oga, Kiminobu Tanizawa, Kimihiko Murase, Takeshi Matsumoto, and Kazuo Chin
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Polysomnography ,Anxiety ,Severity of Illness Index ,Pittsburgh Sleep Quality Index ,03 medical and health sciences ,0302 clinical medicine ,Sleep debt ,Japan ,Surveys and Questionnaires ,medicine ,Humans ,Continuous positive airway pressure ,Prospective Studies ,Aged ,Psychiatric Status Rating Scales ,Sleep disorder ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,Continuous Positive Airway Pressure ,business.industry ,Depression ,Epworth Sleepiness Scale ,Middle Aged ,medicine.disease ,Actigraphy ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,030228 respiratory system ,Anesthesia ,Multivariate Analysis ,Physical therapy ,Linear Models ,Quality of Life ,Sleep diary ,Female ,Sleep Stages ,business ,Sleep ,030217 neurology & neurosurgery - Abstract
Obstructive sleep apnea (OSA) can affect not only sleep quality but also sleep duration. Determining the therapeutic effects of continuous positive airway pressure (CPAP) on habitual sleep profiles may shed light on the impact of OSA on sleep duration.To determine whether and how CPAP affects habitual sleep duration in patients with OSA.Assessments of sleep duration and sleep quality were performed on 57 newly diagnosed study subjects with OSA (46 men; median age, 63 yr; apnea-hypopnea index,20 hActigraphic night sleep time did not change after CPAP (from 354.0 ± 64.5 min to 353.0 ± 57.0 min; P = 0.87) in the entire group, despite improvements in sleep efficiency and sleep fragmentation. Changes in habitual night sleep duration varied among the participants; habitual night sleep duration increased by 33 minutes (interquartile range, 14-45 min) in 28 participants (sleep time restorers) and decreased by 23 minutes (interquartile range, -48 to -11 min) in 29 participants (sleep time nonrestorers). Subgroup analyses revealed that sleep time restorers were characterized at baseline as having shorter and more fragmented sleep with frequent daytime napping. Nonrestorers were characterized by frequent use of hypnotic drugs and comorbid insomnia, despite longer habitual sleep duration. Actigraphic sleep fragmentation, sleep efficiency, daytime sleepiness, and the frequency of daytime napping were improved after CPAP only in the sleep time restorers, whereas subjective sleep quality was improved in the nonrestorers. Multivariate linear regression showed that shorter baseline night sleep time, baseline daytime napping, and percentage of sleep time under CPAP were positive predictors of the restoration of actigraphic night sleep time, whereas hypnotic use was a negative predictor.Short-term CPAP did not affect habitual night sleep duration in the group as a whole but induced intraindividual changes in relation to phenotypic features of OSA. Clinical trial registered with www.umin.ac.jp (UMIN000012639).
- Published
- 2017
24. Network hyperexcitability in a patient with partial reading epilepsy: converging evidence from magnetoencephalography, diffusion tractography, and functional magnetic resonance imaging
- Author
-
Riki Matsumoto, Masao Matsuhashi, Ryosuke Takahashi, Tomoyuki Fumuro, Shin-ichi Urayama, Hidenao Fukuyama, Nobukatsu Sawamoto, Akihiro Shimotake, Morito Inouchi, and Akio Ikeda
- Subjects
Adult ,Male ,Katakana ,Functional magnetic resonance imaging ,White matter ,Reflex Epilepsy ,Physiology (medical) ,medicine ,Arcuate fasciculus ,Humans ,Diffusion Tractography ,Diffusion tractography ,medicine.diagnostic_test ,Precentral gyrus ,Magnetoencephalography ,Magnetic Resonance Imaging ,Sensory Systems ,Reading epilepsy ,medicine.anatomical_structure ,Diffusion Tensor Imaging ,Neurology ,Reading ,Japanese ,Neurology (clinical) ,Epilepsies, Partial ,Nerve Net ,Psychology ,Neuroscience - Abstract
Objective The pathophysiological mechanisms of partial reading epilepsy are still unclear. We delineated the spatial–temporal characteristics of reading-induced epileptic spikes and hemodynamic activation in a patient with partial reading epilepsy. Methods Magnetoencephalography (MEG) was recorded during silent letter-by-letter reading, and the source of reading-induced spikes was estimated using equivalent current dipole (ECD) analysis. Diffusion tractography was employed to determine if the white matter pathway connected spike initiation and termination sites. Functional magnetic resonance imaging (fMRI) was employed to determine the spatial pattern of hemodynamic activation elicited by reading. Results In 91 spike events, ECDs were clustered in the left posterior basal temporal area (pBTA) during Katakana reading. In 8 of these 91 events, when the patient continued to read >30 min, another ECD cluster appeared in the left ventral precentral gyrus/frontal operculum with a time-difference of ∼24 ms. Probabilistic diffusion tractography revealed that the long segment of the arcuate fasciculus connected these two regions. fMRI conjunction analysis indicated that both Katakana and Kanji reading activated the left pBTA, but Katakana activated the left lateral frontal areas more extensively than Kanji. Conclusions Prolonged reading of Katakana induced hyper-activation of the cortical network involved in normal language function, concurrently serving as the seizure onset and symptomatogenic zones. Significance Reflex epilepsy is believed to result from intrinsic hyper-excitability in the cortical regions recruited during behavioral states that trigger seizures. Our case shows that reading epilepsy can arise from a hyperexcitable network of cortical regions. Physiological activation of this network can have cumulative effects, resulting in greater reciprocal network propagation and electroclinical seizures. These effects, in turn, may give insights into the brain networks recruited by reading.
- Published
- 2014
25. Impact of Obstructive Sleep Apnea on Abdominal Aortic Diameters
- Author
-
Morito Inouchi, Tomohiro Handa, Kiminobu Tanizawa, Michiaki Mishima, Satoshi Hamada, Yoshiro Toyama, Kazuo Chin, Ryo Tachikawa, Masanori Azuma, Toru Oga, and Kimihiko Murase
- Subjects
Male ,medicine.medical_specialty ,Polysomnography ,Severity of Illness Index ,stomatognathic system ,Risk Factors ,medicine.artery ,Internal medicine ,medicine ,Humans ,Aorta, Abdominal ,Obesity ,Retrospective Studies ,Aortic dilatation ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,business.industry ,Potential risk ,Abdominal aorta ,Middle Aged ,Prognosis ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Surgery ,Obstructive sleep apnea ,Cross-Sectional Studies ,cardiovascular system ,Cardiology ,Female ,Aortic diameter ,Abdominal computed tomography ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal ,Follow-Up Studies - Abstract
Although obesity has been reported to be a potential risk factor for abdominal aortic dilatation, the impact of obstructive sleep apnea (OSA) on the abdominal aortic diameter remains unknown. We retrospectively reviewed 427 patients aged45 years who underwent polysomnography and abdominal computed tomography from November 2008 to February 2012. Aortic diameters were measured at 3 locations: upper, infrarenal, and lower abdominal aorta. OSA was defined as non-OSA (apnea-hypopnea index [AHI]10, n = 58), mild to moderate (AHI 10 to 30, n = 167), and severe (AHI ≥30, n = 202). Adjusted diameter was not significantly different among OSA severity categories at the upper (21.0, 21.3, and 21.4 mm, respectively) and infrarenal aorta (19.5, 20.2, and 19.9 mm, respectively) but was significantly different at the lower abdominal aorta (17.3, 18.2, and 18.2 mm, respectively, p = 0.006) with larger diameters in patients with OSA. Multivariate linear regression analyses revealed that risk profiles for aortic dilatation varied according to the location and gender and that OSA (AHI ≥10) was an independent risk factor for infrarenal and lower abdominal aortic dilatation only in men (β = 0.10 and 0.18, p = 0.049 and 0.001, respectively). In conclusion, OSA may enhance dilatation of the distal abdominal aorta in men.
- Published
- 2014
26. Role of posterior parietal cortex in reaching movements in humans: Clinical implication for ‘optic ataxia’
- Author
-
Lewis A. Wheaton, Junya Taki, Akio Ikeda, Nobuhiro Mikuni, Hidenao Fukuyama, Ryosuke Takahashi, Morito Inouchi, Takahiro Mitsueda-Ono, Mark Hallett, Hiroshi Shibasaki, Takayuki Kikuchi, and Riki Matsumoto
- Subjects
Adult ,Male ,Adolescent ,genetic structures ,Movement ,Precuneus ,Posterior parietal cortex ,Intraparietal sulcus ,Superior parietal lobule ,Electroencephalography ,Brain mapping ,Functional Laterality ,Article ,Young Adult ,Parietal Lobe ,Terminology as Topic ,Physiology (medical) ,Task Performance and Analysis ,medicine ,Humans ,Brain Mapping ,medicine.diagnostic_test ,Parietal lobe ,Electric Stimulation ,Sensory Systems ,Electrodes, Implanted ,medicine.anatomical_structure ,Neurology ,Bereitschaftspotential ,Female ,Epilepsies, Partial ,Neurology (clinical) ,Psychology ,Neuroscience ,Psychomotor Performance ,psychological phenomena and processes - Abstract
Objective To clarify the spatio-temporal profile of cortical activity related to reaching movement in the posterior parietal cortex (PPC) in humans. Methods Four patients with intractable partial epilepsy who underwent subdural electrode implantation were studied as a part of pre-surgical evaluation. We investigated the Bereitschaftspotential (BP) associated with reaching and correlated the findings with the effect of electrical stimulation of the same cortical area. Results BPs specific for reaching, as compared with BPs for simple movements by the hand or arm contralateral to the implanted hemisphere, were recognized in all patients, mainly around the intraparietal sulcus (IPS), the superior parietal lobule (SPL) and the precuneus. BPs near the IPS had the earlier onset than BPs in the SPL. Electrical stimulation of a part of the PPC, where the reach-specific BPs were recorded, selectively impaired reaching. Conclusions Intracranial BP recording and cortical electrical stimulation delineated human reach-related areas in the PPC. Significance The present study for the first time by direct cortical recording in humans demonstrates that parts of the cortices around the IPS and SPL play a crucial role in visually-guided reaching.
- Published
- 2013
27. Co-occurrence of slow and high frequency oscillations (HFOs) in invasively recorded, interictal state in epilepsy patients: Is it a red slow?
- Author
-
Takefumi Hitomi, Masako Daifu, Kentaro Yoshida, Akihiro Shimotake, Masao Matsuhashi, Akio Ikeda, Katsuhiro Kobayashi, Riki Matsumoto, Takayuki Kikuchi, Takeharu Kunieda, Ryosuke Takahashi, and Morito Inouchi
- Subjects
Epilepsy ,Nuclear magnetic resonance ,Neurology ,Chemistry ,medicine ,Ictal ,Neurology (clinical) ,medicine.disease - Published
- 2017
28. Invasive 3D source localization by wide-band electroencephalography findings
- Author
-
Masao Matsuhashi, Ryosuke Takahashi, Kentaro Yoshida, Takeharu Kunieda, Akihiro Shimotake, Morito Inouchi, Takayuki Kikuchi, Tomohiko Murai, Akio Ikeda, Riki Matsumoto, Katsuhiro Kobayashi, and Takefumi Hitomi
- Subjects
Physics ,Nuclear magnetic resonance ,Neurology ,medicine.diagnostic_test ,Source localization ,medicine ,Neurology (clinical) ,Wide band ,Electroencephalography - Published
- 2017
29. Bereitschaftspotential augmentation by neuro-feedback training in Parkinson’s disease
- Author
-
Haruhisa Inoue, Akio Ikeda, Tomokazu Nakagawa, Morito Inouchi, Ryosuke Takahashi, Takahiro Mitsueda, Tomoyuki Fumuro, Riki Matsumoto, Masao Matsuhashi, Takefumi Hitomi, Tatsuya Mima, and Jun Kawamata
- Subjects
Adult ,Male ,medicine.medical_specialty ,Parkinson's disease ,Movement ,Contingent Negative Variation ,Electromyography ,Audiology ,Electroencephalography ,Physiology (medical) ,Reaction Time ,medicine ,Humans ,Aged ,Analysis of Variance ,medicine.diagnostic_test ,Parkinson Disease ,Electrooculography ,Middle Aged ,Neurofeedback ,medicine.disease ,Sensory Systems ,Electrophysiology ,Neurology ,Case-Control Studies ,Bereitschaftspotential ,Female ,Neurology (clinical) ,Analysis of variance ,Psychology ,Neuroscience ,Psychomotor Performance - Abstract
Objective Decreased early Bereitschaftspotential (BP) is one of the electrophysiological characteristics in patients with Parkinson's disease (PD). We examined whether PD patients could increase BP amplitude by means of neuro-feedback (NFB) training for their slow cortical potentials (SCPs). Methods We worked with 10 PD patients and 11 age-matched controls. BP was measured for self-paced button pressing by their right thumb. The subjects were instructed to make the introspective efforts to produce negative SCPs (negativation). The one-day session consisted of three trials, that is, the first BP, NFB training and the second BP, and each patient performed this routine for 2–4days. Amplitudes of the first and second BPs were compared between the two groups that were divided depending on NFB performance. Results Good NFB performance had the tendency of larger early BP in the second BP recording than in the first one, whereas in the poor NFB performance the early BP was smaller in the second BP recording than in the first one in both patient and normal groups ( p Conclusions Good NFB performance of negativation could increase excitatory field potentials of pyramidal cells for the generation of early BP. Significance Voluntary regulation of SCPs could enhance BP in PD patients and in aged controls.
- Published
- 2013
30. Adrenal size in patients with obstructive sleep apnea
- Author
-
Morito Inouchi, Ryo Tachikawa, Tomohiro Handa, Kimihiko Murase, T. Minami, Kazuo Chin, Kiminobu Tanizawa, Michiaki Mishima, Toru Oga, Takeshi Matsumoto, and Satoshi Hamada
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Adrenal gland ,business.industry ,Polysomnography ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Hypoxemia ,Arousal ,Obstructive sleep apnea ,medicine.anatomical_structure ,stomatognathic system ,Apnea–hypopnea index ,Internal medicine ,Anesthesia ,medicine ,Catecholamine ,Cardiology ,Endocrine system ,medicine.symptom ,business ,medicine.drug - Abstract
Introduction: Size of adrenal glands is affected by gender, obesity, somatic and psychiatric stresses, and an abnormal adrenal endocrine system. Most patients with obstructive sleep apnea (OSA) are obese males who might experience several stresses through OSA-induced intermittent, sustained hypoxemia, arousals, and fragmentation during sleep. Although the size of adrenal glands in OSA patients is expected to be abnormal, this issue has not been investigated. Aims: We hypothesized that the adrenal gland is enlarged in OSA patients, and investigated the association between adrenal size and sleep parameters. Methods: We retrospectively reviewed 133 consecutive patients who underwent polysomnography and abdominal computed tomography (CT) from November 2008 to December 2009. OSA was defined as none/mild (apnea hypopnea index [AHI] Results: The mean of the adrenal limbs was larger in moderate and severe OSA patients than in none/mild OSA patients (3.64, 4.11, and 4.27 mm, respectively, p = 0.005). There was no correlation between plasma catecholamine and adrenal size. Multivariate regression analysis revealed that the arousal index was an independent factor that positively correlated with adrenal size (β = 0.28, p Conclusions: Since not AHI but the arousal index was significantly associated with adrenal size in patients with OSA, elevation in sympathetic nerve activity, which is said to be influenced by arousal and/or fragmentation during sleep, might be associated with adrenal size in patients with OSA.
- Published
- 2016
31. Does CPAP therapy affect sleep time in patients with obstructive sleep apnea? A prospective study
- Author
-
Ryo Tachikawa, Kazuo Chin, Kimihiko Murase, Takeshi Matsumoto, Satoshi Hamada, T. Minami, Toru Oga, Kiminobu Tanizawa, Michiaki Mishima, and Morito Inouchi
- Subjects
medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Epworth Sleepiness Scale ,Actigraphy ,Polysomnography ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Pittsburgh Sleep Quality Index ,Obstructive sleep apnea ,Anesthesia ,medicine ,Sleep diary ,Continuous positive airway pressure ,business ,Slow-wave sleep - Abstract
Background: It is currently unknown whether and how treating obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) affects habitual sleep time. Objectives: To investigate the effect of CPAP on habitual sleep time. Methods: Fifty-seven OSA patients (AHI >20) were prospectively enrolled and were evaluated before and after 3 mo of CPAP. Measurements included polysomnography, habitual sleep on 7 consecutive days assessed by actigraphy with sleep diary, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index (PSQI). Results: Post-CPAP habitual night sleep time did not change compared to the baseline (pre 352 ± 65, post 351 ± 57 min, p = 0.94). The responses to CPAP varied among the participants; sleep time increased by 34 ± 25 min in 27 participants and decreased by 31 ± 29 min in 30. In the exploratory analysis comparing sleep time restorers with non-restorers, the former group was characterized by shorter habitual sleep time (328 ± 68 vs 372 ± 55 min, p = 0.01), more frequent daytime napping (79 vs 40%, p = 0.04), lower sleep efficiency (76.7 ± 10.8 vs 82.7 ± 5.8%, p = 0.01), and higher arousal index (43.5 ± 22.2 vs 34.0 ± 13.9, p = 0.06) in the baseline whereas the latter was associated with more frequent hypnotics use (11 vs 40%, p = 0.02). CPAP mainly improved daytime symptoms (reduced daytime sleepiness and napping) in the sleep time restorers whereas improvements in sleep quality (increased deep sleep and reduced PSQI) were noted in the non-restorers. Conclusions: CPAP therapy did not prolong habitual night sleep in OSA patients in the entire group. However, responses to CPAP differed among OSA patients with different clinical phenotypes.
- Published
- 2016
32. Plasma Incretin Levels and Dipeptidyl Peptidase-4 Activity in Patients with Obstructive Sleep Apnea
- Author
-
Takeshi Matsumoto, Satoshi Hamada, Kimihiko Murase, Kiminobu Tanizawa, Michiaki Mishima, Ryo Tachikawa, Toru Oga, T. Minami, Norio Harada, Masanori Azuma, Morito Inouchi, Kazuo Chin, and Yuichi Chihara
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,endocrine system ,medicine.medical_specialty ,medicine.medical_treatment ,Dipeptidyl Peptidase 4 ,Incretin ,030209 endocrinology & metabolism ,Gastric Inhibitory Polypeptide ,Incretins ,Impaired glucose tolerance ,03 medical and health sciences ,0302 clinical medicine ,Gastric inhibitory polypeptide ,Japan ,Glucagon-Like Peptide 1 ,Diabetes mellitus ,Internal medicine ,Glucose Intolerance ,medicine ,Humans ,Continuous positive airway pressure ,Dipeptidyl peptidase-4 ,Aged ,Sleep Apnea, Obstructive ,business.industry ,digestive, oral, and skin physiology ,Fasting ,Middle Aged ,medicine.disease ,Glucagon-like peptide-1 ,respiratory tract diseases ,Obstructive sleep apnea ,Endocrinology ,030228 respiratory system ,Regression Analysis ,Female ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Incretin hormones, namely glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide/glucose-dependent insulinotropic polypeptide (GIP), and dipeptidyl peptidase-4 (DPP-4) activity are important factors in glucose metabolism and have not been investigated in patients with obstructive sleep apnea (OSA).The objective of this study was to investigate the association between OSA and incretin and DPP-4 activity.This study included 96 consecutive patients without diabetes who were suspected of having OSA. We investigated the fasting and post-prandial incremental area under the curve (IAUC) of GLP-1, GIP serum levels, and serum DPP-4 activity levels, as well as their association with OSA. Changes in clinical variables were evaluated in the 43 patients who continued continuous positive airway pressure therapy for 3 months.Apnea-hypopnea index was an independent determining factor for fasting GLP-1 (β = 0.31; P = 0.0019) and IAUC GIP (β = -0.21; P = 0.037) after adjusting for known confounding factors. In those with very severe OSA (apnea-hypopnea index ≥50), the IAUCs for GLP-1 and GIP were significantly decreased, while fasting GLP-1 and fasting GIP were significantly increased. DPP-4 activity had no relation to OSA parameters or severity, while body mass index was significantly higher in those with severe OSA. Although significant changes in incretin secretion were not seen for 3 months after onset of continuous positive airway pressure therapy, the fasting GLP-1 level in the treated patients with severe OSA decreased to the same level as in untreated patients with normal to moderately severe OSA.OSA is associated with elevated serum levels of the incretin hormones GLP-1 (fasting) and GIP (post-prandial) in patients without diabetes. A significant association between body mass index and DPP-4, which is said to exist in healthy persons, was not found in the patients with OSA. Fasting GLP-1 in patients without diabetes with OSA may influence fasting glucose levels.
- Published
- 2016
33. Changes in Energy Metabolism after Continuous Positive Airway Pressure for Obstructive Sleep Apnea
- Author
-
Satoshi Hamada, Kiminobu Tanizawa, Michiaki Mishima, Kimihiko Murase, Ryo Tachikawa, Kazuo Chin, Morito Inouchi, Kaori Ikeda, Takeshi Matsumoto, Takashi Akamizu, Toru Oga, and T. Minami
- Subjects
Pulmonary and Respiratory Medicine ,Leptin ,Male ,medicine.medical_specialty ,Hydrocortisone ,medicine.medical_treatment ,Polysomnography ,Critical Care and Intensive Care Medicine ,Energy homeostasis ,03 medical and health sciences ,Norepinephrine ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Continuous positive airway pressure ,Insulin-Like Growth Factor I ,Exercise ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,Continuous Positive Airway Pressure ,business.industry ,Middle Aged ,medicine.disease ,Ghrelin ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,Endocrinology ,030228 respiratory system ,Basal metabolic rate ,Female ,Basal Metabolism ,medicine.symptom ,business ,Energy Intake ,Energy Metabolism ,Weight gain ,030217 neurology & neurosurgery - Abstract
Disrupted energy homeostasis in obstructive sleep apnea (OSA) may lead to weight gain. Paradoxically, treating OSA with continuous positive airway pressure (CPAP) may also promote weight gain, although the underlying mechanism remains unclear.To explore the underlying mechanism by which patients with OSA gain weight after CPAP.A comprehensive assessment of energy metabolism was performed in 63 newly diagnosed OSA study participants (51 men; 60.8 ± 10.1 yr; apnea-hypopnea index20 h(-1)) at baseline, CPAP initiation, and at a 3-month follow-up. Measurements included polysomnography, body weight, body composition, basal metabolic rate (BMR), hormones (norepinephrine, cortisol, leptin, ghrelin, insulin-like growth factor-1), dietary intake, eating behavior, and physical activity.BMR significantly decreased after CPAP (1,584 kcal/d at baseline, 1,561 kcal/d at CPAP initiation, and 1,508 kcal/d at follow-up; P 0.001), whereas physical activity and total caloric intake did not significantly change. In multivariate regression, baseline apnea-hypopnea index, Δurine norepinephrine, and CPAP adherence were significant predictors of ΔBMR. The weight gainers had higher leptin levels, lower ghrelin levels, and higher eating behavior scores than the non-weight gainers, indicating a positive energy balance and disordered eating behavior among the weight gainers. Among the parameters related to energy metabolism, increased caloric intake was a particularly significant predictor of weight gain.Although a reduction in BMR after CPAP predisposes to a positive energy balance, dietary intake and eating behavior had greater impacts on weight change. These findings highlight the importance of lifestyle modifications combined with CPAP. Clinical trial registered with http://www.umin.ac.jp/english/ (UMIN000012639).
- Published
- 2016
34. Role of mitochondrial hydrogen peroxide induced by intermittent hypoxia in airway epithelial wound repair in vitro
- Author
-
Hiroki Satooka, Morito Inouchi, Kiminobu Tanizawa, Michiaki Mishima, Koichi Hasegawa, Satoshi Hamada, Atsuyasu Sato, Toru Oga, Shigeo Muro, Kazuya Tanimura, Kazuo Chin, Mariko Hara-Chikuma, and Tomohiro Handa
- Subjects
0301 basic medicine ,RHOA ,Biology ,Cell Line ,03 medical and health sciences ,Cell Movement ,medicine ,Cell Adhesion ,Humans ,Lung ,chemistry.chemical_classification ,Reactive oxygen species ,Focal Adhesions ,Wound Healing ,030102 biochemistry & molecular biology ,Intermittent hypoxia ,Epithelial Cells ,Cell Biology ,Anatomy ,Hydrogen Peroxide ,Hypoxia (medical) ,Actin cytoskeleton ,Cell Hypoxia ,Cell biology ,Mitochondria ,Enzyme Activation ,Actin Cytoskeleton ,030104 developmental biology ,chemistry ,Catalase ,biology.protein ,Respiratory epithelium ,medicine.symptom ,rhoA GTP-Binding Protein ,Intracellular - Abstract
The airway epithelium acts as a frontline barrier against various environmental insults and its repair process after airway injury is critical for the lung homeostasis restoration. Recently, the role of intracellular reactive oxygen species (ROS) as transcription-independent damage signaling has been highlighted in the wound repair process. Both conditions of continuous hypoxia and intermittent hypoxia (IH) induce ROS. Although IH is important in clinical settings, the roles of IH-induced ROS in the airway repair process have not been investigated. In this study, we firstly showed that IH induced mitochondrial hydrogen peroxide (H2O2) production and significantly decreased bronchial epithelial cell migration, prevented by catalase treatment in a wound scratch assay. RhoA activity was higher during repair process in the IH condition compared to in the normoxic condition, resulting in the cellular morphological changes shown by immunofluorescence staining: round cells, reduced central stress fiber numbers, pronounced cortical actin filament distributions, and punctate focal adhesions. These phenotypes were replicated by exogenous H2O2 treatment under the normoxic condition. Our findings confirmed the transcription-independent role of IH-induced intracellular ROS in the bronchial epithelial cell repair process and might have significant implications for impaired bronchial epithelial cell regeneration.
- Published
- 2016
35. Temporal Lobe Epilepsy with Amygdala Enlargement: A Morphologic and Functional Study
- Author
-
Koichi Ishizu, Hidenao Fukuyama, Nobuhiro Mikuni, Takahiro Mitsueda-Ono, Ryosuke Takahashi, Morito Inouchi, Chihiro Namiki, Riki Matsumoto, Naoya Oishi, Akio Ikeda, and Shigetoshi Takaya
- Subjects
Hippocampal sclerosis ,Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hippocampus ,Magnetic resonance imaging ,medicine.disease ,computer.software_genre ,behavioral disciplines and activities ,Amygdala ,nervous system diseases ,Temporal lobe ,Epilepsy ,medicine.anatomical_structure ,nervous system ,Positron emission tomography ,Voxel ,medicine ,Radiology, Nuclear Medicine and imaging ,Neurology (clinical) ,business ,computer ,psychological phenomena and processes - Abstract
BACKGROUND AND PURPOSE Temporal lobe epilepsy (TLE) with nontumoral amygdala enlargement (AE) has been reported to be a possible subtype of TLE without hippocampal sclerosis (HS). The purpose of this study was to clarify morphologic and functional characteristics of TLE with AE (TLE + AE). METHODS We evaluated gray matter volume and cerebral glucose hypometabolism using magnetic resonance imaging (MRI) voxel-based morphometry (VBM) and voxel-based statistical analysis of ( 18 F)-fluorodeoxyglucose positron emission tomography (FDG-PET) images in 9 patients with TLE + AE as compared with controls. For VBM analysis, we recruited 30 age- and sex-matched healthy volunteers as controls. For the comparison of FDG-PET analysis, 9 patients with definite mesial TLE with HS (MTLE + HS), and 16 age- and sex-matched healthy controls were recruited. RESULTS In patients with TLE + AE, a significant increase in gray matter volume was found only in the affected amygdala, and no significant decrease in gray matter volume was detected. In addition, significant glucose hypometabolism was observed in the affected amygdala, whereas significant glucose hypometabolism in the hippocampus, a prominent feature of definite MTLE+HS, was not observed. CONCLUSIONS TLE + AE is different from MTLE + HS from morphologic and functional points of view, and the enlarged amygdala per se is potentially an epileptic focus in patients with partial epilepsy.
- Published
- 2012
36. Epileptic network of hypothalamic hamartoma: An EEG-fMRI study
- Author
-
Morito Inouchi, Takeo Kato, Ryosuke Takahashi, Shigeki Kameyama, Nobukatsu Sawamoto, Riki Matsumoto, Tatsuya Mima, Hiroatsu Murakami, Akio Ikeda, Hidenao Fukuyama, Tomoyuki Fumuro, Hiroshi Masuda, Hiroshi Shirozu, Akihiro Shimotake, and Kiyohide Usami
- Subjects
0301 basic medicine ,Adult ,Male ,Adolescent ,Hamartoma ,Electroencephalography ,EEG-fMRI ,Ictal-Interictal SPECT Analysis by SPM ,Epileptogenesis ,Multimodal Imaging ,Sensitivity and Specificity ,Ictal SPECT ,03 medical and health sciences ,Epilepsy ,Young Adult ,0302 clinical medicine ,Hypothalamic hamartoma ,Gelastic seizure ,Neural Pathways ,medicine ,Humans ,Child ,Default mode network ,Tomography, Emission-Computed, Single-Photon ,Brain Mapping ,medicine.diagnostic_test ,Epileptic encephalopathy ,Subcortical epilepsy ,Brain ,Infant ,medicine.disease ,Magnetic Resonance Imaging ,030104 developmental biology ,nervous system ,Neurology ,Child, Preschool ,Linear Models ,Female ,Neurology (clinical) ,medicine.symptom ,Psychology ,Neuroscience ,030217 neurology & neurosurgery ,Hypothalamic Diseases - Abstract
Objective To investigate the brain networks involved in epileptogenesis/encephalopathy associated with hypothalamic hamartoma (HH) by EEG with functional MRI (EEG-fMRI), and evaluate its efficacy in locating the HH interface in comparison with subtraction ictal SPECT coregistered to MRI (SISCOM). Methods Eight HH patients underwent EEG-fMRI. All had gelastic seizures (GS) and 7 developed other seizure types. Using a general linear model, spike-related activation/deactivation was analyzed individually by applying a hemodynamic response function before, at, and after spike onset (time-shift model=−8–+4s). Group analysis was also performed. The sensitivity of EEG-fMRI in identifying the HH interface was compared with SISCOM in HH patients having unilateral hypothalamic attachment. Results EEG-fMRI revealed activation and/or deactivation in subcortical structures and neocortices in all patients. 6/8 patients showed activation in or around the hypothalamus with the HH interface with time-shift model before spike onset. Group analysis showed common activation in the ipsilateral hypothalamus, brainstem tegmentum, and contralateral cerebellum. Deactivation occurred in the default mode network (DMN) and bilateral hippocampi. Among 5 patients with unilateral hypothalamic attachment, activation in or around the ipsilateral hypothalamus was seen in 3 using EEG-fMRI, whereas hyperperfusion was seen in 1 by SISCOM. Significance Group analysis of this preliminary study may suggest that the commonly activated subcortical network is related to generation of GS and that frequent spikes lead to deactivation of the DMN and hippocampi, and eventually to a form of epileptic encephalopathy. Inter-individual variance in neocortex activation explains various seizure types among patients. EEG-fMRI enhances sensitivity in detecting the HH interface compared with SISCOM.
- Published
- 2015
37. Ictal wideband ECoG: Direct comparison between ictal slow shifts and high frequency oscillations
- Author
-
Nobuhiro Mikuni, Hisaji Imamura, Ryosuke Takahashi, Morito Inouchi, Masao Matsuhashi, Riki Matsumoto, and Akio Ikeda
- Subjects
Oligodendroglioma ,High frequency oscillation ,Electroencephalography ,Epileptogenesis ,Brain mapping ,Young Adult ,Epilepsy ,Nuclear magnetic resonance ,Physiology (medical) ,medicine ,Humans ,Ictal ,Wideband ,Brain Mapping ,medicine.diagnostic_test ,Brain Neoplasms ,medicine.disease ,Brain Waves ,Sensory Systems ,Epilepsy, Temporal Lobe ,Neurology ,Anesthesia ,Female ,sense organs ,Neurology (clinical) ,Subdural electrodes ,Psychology - Abstract
Objective With advanced electroencephalography (EEG) technology, ‘wideband EEG’ ranging from slow shift to high frequency oscillation (HFO) is clinically available to study human epileptogenesis. The purpose of our study is to clarify the relationship between slow shift, HFO and conventional electrocorticographic (ECoG) change. Methods A patient with right temporal lobe epilepsy who underwent presurgical evaluation with subdural electrodes was studied. Slow shift and HFO were evaluated in 16 habitual seizures with wideband EEG technique (bandpass filter of 0.016–600 Hz). Results Upon seizure occurrence in wideband ECoG, negative slow shifts coexisted with HFO (100–300 Hz) in the ictal onset zone in all investigated seizures. The former always preceded HFO and conventional initial EEG changes by mean value of 1.6 and 20.4 s, respectively. The slow shifts and HFOs were observed only in the restricted ictal onset zone. Conclusions In this particular patient, wideband EEG could delineate both ictal slow shift and HFO to define ictal onset zone, and the earliest occurrence of slow shifts may suggest an early role of glia in slow EEG shift generation than neurons. Significance The time difference of the onset between ictal HFO and slow shift may help to understand epileptogenesis.
- Published
- 2011
38. Decreased cortical excitability in Unverricht–Lundborg disease in the long-term follow-up: A consecutive SEP study
- Author
-
Ryosuke Takahashi, Morito Inouchi, Jun Kawamata, Takefumi Hitomi, Masao Matsuhashi, Riki Matsumoto, Takayuki Kondo, Katsuya Kobayashi, and Akio Ikeda
- Subjects
Male ,Long term follow up ,Progressive myoclonus epilepsy ,Unverricht-Lundborg Syndrome ,Evoked Potentials, Somatosensory ,Physiology (medical) ,Reaction Time ,otorhinolaryngologic diseases ,medicine ,Humans ,In patient ,Cystatin B ,Longitudinal Studies ,Cerebral Cortex ,Median nerve stimulation ,Cortical myoclonus ,Electroencephalography ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Electric Stimulation ,Sensory Systems ,Median Nerve ,Unverricht–Lundborg disease ,Neurology ,Somatosensory evoked potential ,Anesthesia ,Neurology (clinical) ,medicine.symptom ,Psychology ,Myoclonus - Abstract
Objective To delineate long-term change of cortical excitability by measuring somatosensory evoked potentials (SEPs) in patients with Unverricht–Lundborg disease (ULD). Methods SEPs to median nerve stimulation were repeatedly examined in two genetically proven ULD patients manifesting stable condition over 16 years, namely disabling but non-progressive myoclonus and cessation of generalised tonic–clonic seizures. Results In both patients, five sets of early cortical components were identified 16 years ago: two tangential components of N20–P20 and P30–N30 and three radial components of P25, N35 and N40. Cortical SEPs were regarded as abnormally enhanced ‘giant’ based on the N35 amplitude (>mean + 3 SD of normal controls). The bimodal negative peaks of N35 and N40 showed different spatial distribution: N35 maximum in the central area and N40 in the centro-parietal area. At present, N35 remained giant while N40 disappeared in both patients. Conclusions It is possible that currently preserved giant SEPs at least at N35 reflect disabling cortical myoclonus and that disappearance of N40 might reflect a lesser degree of increased cortico-cortical connectivity and/or decreased cortical hyperexcitability in the association cortices. It might possibly have resulted in the disappearance of GTCSs. Significance We delineated long-term change of giant SEP in ULD.
- Published
- 2011
39. Increased cortical hyperexcitability and exaggerated myoclonus with aging in benign adult familial myoclonus epilepsy
- Author
-
Hiroshi Shibasaki, Takashi Nagamine, Masao Matsuhashi, Hisaji Imamura, Akio Ikeda, Riki Matsumoto, Takefumi Hitomi, Kiyohito Terada, Morito Inouchi, Takayuki Kondo, Ryosuke Takahashi, and Masutaro Kanda
- Subjects
Adult ,Male ,Myoclonus ,giant somatosensory evoked potential ,Epilepsies, Myoclonic ,Stimulation ,Electroencephalography ,Severity of Illness Index ,cortical myoclonic tremor ,Evoked Potentials, Somatosensory ,Severity of illness ,Reaction Time ,medicine ,Humans ,Aged ,medicine.diagnostic_test ,aging ,Somatosensory Cortex ,Giant somatosensory evoked potentials ,Middle Aged ,Median nerve ,Pathophysiology ,Neurology ,Somatosensory evoked potential ,Anesthesia ,benign adult familial myoclonus epilepsy ,Female ,Neurology (clinical) ,medicine.symptom ,Psychology - Abstract
The clinical implications of enlarged early cortical components of somatosensory evoked potentials in benign adult familial myoclonus epilepsy remain unknown. Somatosensory evoked potentials following electrical stimulation of the median nerve at the wrist were studied in 16 patients with a clinical diagnosis of benign adult familial myoclonus epilepsy (7 men and 9 women; mean age, 51 ± 18 years) and 19 age-matched apparently healthy control subjects (11 men and 8 women; mean age, 49 ± 18 years). Giant somatosensory evoked potentials were observed in 13 of the 16 patients. P25 and N35 amplitudes in the patient group were 11.4 ± 6.1 and 19.2 ± 11.5 μV, respectively, and both were significantly larger compared with those in control subjects (P = 0.008 for P25 and P < 0.0001 for N35). There was a significant positive relationship between age at somatosensory evoked potential examination and N20, P25, and N35 amplitudes, both in the patient and in the control groups (P < 0.05). The linear regression gradient of the N35 amplitude with respect to age was significantly larger in the patient group than in the control group (P = 0.04). Furthermore, regression analysis showed a significant positive relationship between the myoclonus rating scale and age at time of somatosensory evoked potential examination (R = 0.645, P = 0.007). Somatosensory evoked potential amplitude increased with age in patients with benign adult familial myoclonus epilepsy to a greater extent than in the control subjects, which suggests a progressive increase in cortical excitability based on progressive pathophysiology in benign adult familial myoclonus epilepsy.
- Published
- 2011
40. Inhibitory effects of electric cortical stimulation on interictal epileptiform discharges in human epileptic focus
- Author
-
Riki Matsumoto, Naoya Hattori, Masao Matsuhashi, K. Kobayshi, Takeharu Kunieda, Akio Ikeda, Masako Kinoshita, Takefumi Hitomi, Takayuki Kikuchi, Morito Inouchi, Ryosuke Takahashi, Kentaro Yoshida, and Mitsuyoshi Nakatani
- Subjects
Focus (computing) ,Neurology ,business.industry ,Medicine ,Stimulation ,Ictal ,Neurology (clinical) ,Inhibitory postsynaptic potential ,business ,Neuroscience - Published
- 2017
41. Evaluation of Bone Mineral Density by Computed Tomography in Patients with Obstructive Sleep Apnea
- Author
-
Toru Oga, Tsuyoshi Oguma, Morito Inouchi, Kohei Ikezoe, Kiminobu Tanizawa, Michiaki Mishima, Toyohiro Hirai, Kazuo Chin, Tomohiro Handa, and Satoshi Hamada
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,Pathology ,medicine.medical_specialty ,Computed tomography ,Bone remodeling ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Sex Factors ,Bone Density ,Risk Factors ,medicine ,Humans ,In patient ,Aged ,Bone mineral ,Aged, 80 and over ,Sleep Apnea, Obstructive ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Scientific Investigations ,respiratory tract diseases ,Obstructive sleep apnea ,030228 respiratory system ,Neurology ,Osteoporosis ,Female ,Neurology (clinical) ,Radiology ,business ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
Clinical studies have investigated whether obstructive sleep apnea (OSA) can modulate bone metabolism but data are conflicting. Bone mineral density (BMD) measured by dual-energy x-ray absorptiometry is the standard technique for quantifying bone strength but has limitations in overweight patients (body mass index [BMI] ≥ 25 kg/m(2)). The aim of this study was to examine the association between OSA and BMD by examining CT images that allow true volumetric measurements of the bone regardless of BMI.Lumbar vertebrae BMD was evaluated in 234 persons (180 males and 54 females) by CT scan. The method was calibrated by a phantom containing a known concentration of hydroxyapatite.BMD was lower in male patients with severe OSA (apnea-hypopnea index [AHI] ≥ 30/h) than non OSA (AHI5; p0.05), while OSA and BMD had no association in females. Linear and multiple regression analyses revealed that age (p0.0001, β = -0.52), hypertension (p = 0.0068, β = -0.17), and the alveolar-arterial oxygen pressure difference (A-aDO2) (p = 0.012, β = -0.15) in males were associated with BMD, while only age (p0.0001, β = -0.68) was associated with BMD in females.Males with severe OSA had a significantly lower BMD than non OSA participants. Age, hypertension, and elevation of A-aDO2 were significant factors for BMD by CT imaging. The usefulness of measuring BMD in OSA patients by CT scanning should be studied in future.
- Published
- 2014
42. P2-63. Functional connectivity from the dorso-lateral and medial parts of the parietal lobe: a cortico-cortical evoked potential study
- Author
-
Takuro Nakae, Ryosuke Takahashi, Morito Inouchi, Hirofumi Takeyama, Akihiro Shimotake, Takeharu Kunieda, Katsuya Kobayashi, Riki Matsumoto, Akio Ikeda, Susumu Miyamoto, Kiyohide Usami, and Masaya Togo
- Subjects
Cingulate cortex ,business.industry ,Precuneus ,Parietal lobe ,Posterior parietal cortex ,Inferior parietal lobule ,Superior parietal lobule ,behavioral disciplines and activities ,Sensory Systems ,medicine.anatomical_structure ,Neurology ,Physiology (medical) ,Posterior cingulate ,Cortex (anatomy) ,medicine ,sense organs ,Neurology (clinical) ,business ,Neuroscience ,psychological phenomena and processes - Abstract
The superior parietal lobule (SPL) and the medial parietal cortex are associated with integration of various kinds of information. Little is known about connections from the superior and medial parietal cortices in humans. Our objective is to delineate their connectivity by means of cortico-cortical evoked potential (CCEP). Subjects were eight patients who underwent chronic subdural electrode placement covering the dorso-lateral (SPL) or medial parietal cortices. Single-pulse electrical stimuli were delivered and CCEPs were obtained from the frontal and parietal areas by averaging electrocorticograms time-locked to stimuli. SPL stimulation elicited 75 CCEPs at the precuneus, precentral gyrus, the dorsal premotor area (dorsal PM). The precuneus elicited 66 CCEPs in the inferior parietal lobule (IPL), dorsal premotor area (PM) and SPL. The posterior cingulate cortex elicited 36 CCEPs at the middle cingulate cortex, SPL and the precuneus. This study demonstrated reciprocal connections between the superior and medial parietal cortices. While the precuneus tends to connect with the lateral frontal area, posterior cingulate cortex with medial frontal area. These findings would account for functional differentiation between these areas, and may help us understand seizure propagation in patients with parietal lobe epilepsy.
- Published
- 2017
43. 1-1-06. Repeated, cortical stimulation can modify the wideband cortical activity correlates of interictal epileptiform discharge
- Author
-
Masako Kinoshita, Takefumi Hitomi, Takayuki, Riki Matsumoto, Masao Matsuhashi, Katsuya Kobayashi, Mitsuyoshi Nakatani, and Morito Inouchi
- Subjects
Neurology ,Pulse (signal processing) ,Chemistry ,Physiology (medical) ,Ictal ,Stimulation ,Neurology (clinical) ,Seizure onset zone ,Inhibitory postsynaptic potential ,Subdural electrodes ,Neuroscience ,Sensory Systems ,Partial epilepsy - Abstract
Electric cortical stimulation (ECS) is known to have suppressive effects on epileptic focus. However, the inhibitory mechanism remains to be elucidated. We investigated the effect of ECS on human epileptic focus by evaluating wideband cortical activities accompanied with interictal epileptiform discharges (IEDs). We recruited 9 patients with intractable partial epilepsy who underwent invasive pre-surgical evaluation with subdural electrodes. 50-Hz stimulation (0.3 ms pulse, 1–15 mA, 1–5 s) was applied at seizure onset zone (SOZ) as a part of functional cortical mapping. By performing Hilbert transform, we calculated the power of 4 frequency bands: fast ripple (200–300 Hz), ripple (80–200 Hz), low gamma (30–50 Hz) and beta (15–30 Hz). We compared them between pre- and post ECS at the timing of spike peak of IEDs. 2 patients were excluded due to artifacts or no examinations. In 3 patients, the power decreased after ECS in all frequency bands. The power did not change in 1, and the power change varied depending on the frequency band or the time after ECS in 3. We demonstrated that 50-Hz ECS on epileptic focus can suppress wide-band activities accompanied with IEDs, suggesting its potential ability to modulate cortical excitability toward less excitation and more inhibition.
- Published
- 2017
44. Temporal lobe epilepsy with amygdala enlargement: a morphologic and functional study
- Author
-
Shigetoshi, Takaya, Akio, Ikeda, Takahiro, Mitsueda-Ono, Riki, Matsumoto, Morito, Inouchi, Chihiro, Namiki, Naoya, Oishi, Nobuhiro, Mikuni, Koichi, Ishizu, Ryosuke, Takahashi, and Hidenao, Fukuyama
- Subjects
Adult ,Male ,Brain Mapping ,Reproducibility of Results ,Hypertrophy ,Middle Aged ,Amygdala ,Sensitivity and Specificity ,Young Adult ,Glucose ,Epilepsy, Temporal Lobe ,Humans ,Female ,Gray Matter ,Aged - Abstract
Temporal lobe epilepsy (TLE) with nontumoral amygdala enlargement (AE) has been reported to be a possible subtype of TLE without hippocampal sclerosis (HS). The purpose of this study was to clarify morphologic and functional characteristics of TLE with AE (TLE + AE).We evaluated gray matter volume and cerebral glucose hypometabolism using magnetic resonance imaging (MRI) voxel-based morphometry (VBM) and voxel-based statistical analysis of [(18) F]-fluorodeoxyglucose positron emission tomography (FDG-PET) images in 9 patients with TLE + AE as compared with controls. For VBM analysis, we recruited 30 age- and sex-matched healthy volunteers as controls. For the comparison of FDG-PET analysis, 9 patients with definite mesial TLE with HS (MTLE + HS), and 16 age- and sex-matched healthy controls were recruited.In patients with TLE + AE, a significant increase in gray matter volume was found only in the affected amygdala, and no significant decrease in gray matter volume was detected. In addition, significant glucose hypometabolism was observed in the affected amygdala, whereas significant glucose hypometabolism in the hippocampus, a prominent feature of definite MTLE+HS, was not observed.TLE + AE is different from MTLE + HS from morphologic and functional points of view, and the enlarged amygdala per se is potentially an epileptic focus in patients with partial epilepsy.
- Published
- 2011
45. Transient myoclonic state with asterixis: primary motor cortex hyperexcitability is correlated with myoclonus
- Author
-
Takefumi Hitomi, Hisaji Imamura, Riki Matsumoto, Tomokazu Nakagawa, Morito Inouchi, Akio Ikeda, Ryosuke Takahashi, and Tomoyuki Fumuro
- Subjects
Male ,Myoclonus ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Myoclonic Jerk ,Audiology ,Asymptomatic ,Evoked Potentials, Somatosensory ,Internal Medicine ,medicine ,Humans ,Giant SEPS ,Asterixis ,Aged ,Aged, 80 and over ,Dyskinesias ,business.industry ,Motor Cortex ,General Medicine ,Control subjects ,Somatosensory evoked potential ,Anesthesia ,Female ,Primary motor cortex ,medicine.symptom ,business - Abstract
Objective To clarify the clinical features and mechanism of the transience of myoclonus in patients with a transient myoclonic state with asterixis (TMA). Methods We investigated the clinical and eletrophysiological profiles of 6 patients with TMA (age: 84±3 years). During an asymptomatic period, somatosensory evoked potentials (SEPs) were recorded in all 6 patients and motor evoked potentials (MEPs) were examined in 1 patient. SEPs were recorded and jerk-locked back averaging (JLA) was performed in 2 patients while symptomatic. SEPs were also recorded from 8 aged control subjects (age: 68±5 years). Results All TMA patients had mild chronic systemic diseases. During an asymptomatic period, SEP amplitudes were not significantly enlarged in comparison with control subjects, and MEPs were normal. Examination of 2 patients during symptomatic period indicated no enlargement of SEP amplitudes and JLA disclosed a positive spike preceding myoclonic jerks. In one of these patients, the amplitude of the positive spike decreased once myoclonus improved. Conclusion TMA occurred in aged patients with mild chronic systemic diseases. JLA findings and the absence of giant SEPs further support that TMA is a cortical non-reflex myoclonus. In addition, transient hyperexcitability at the primary motor cortex disclosed by JLA correlated well with its transient symptoms.
- Published
- 2011
46. Amygdalar enlargement in patients with temporal lobe epilepsy
- Author
-
Hidenao Fukuyama, Ryosuke Takahashi, Nobukatsu Sawamoto, Nobuhiro Mikuni, Shigetoshi Takaya, Akio Ikeda, Takashi Hanakawa, Takahiro Mitsueda-Ono, Morito Inouchi, and Riki Matsumoto
- Subjects
Male ,medicine.medical_specialty ,Fluid-attenuated inversion recovery ,Electroencephalography ,Hippocampus ,Temporal lobe ,Central nervous system disease ,Epilepsy ,Neuroimaging ,Fluorodeoxyglucose F18 ,medicine ,Humans ,Ictal ,Tomography, Emission-Computed, Single-Photon ,Hippocampal sclerosis ,Sclerosis ,medicine.diagnostic_test ,business.industry ,Brain ,Hypertrophy ,Middle Aged ,medicine.disease ,Amygdala ,Brain Waves ,Magnetic Resonance Imaging ,nervous system diseases ,Surgery ,Psychiatry and Mental health ,nervous system ,Epilepsy, Temporal Lobe ,Positron-Emission Tomography ,Female ,Neurology (clinical) ,Psychology ,Nuclear medicine ,business - Abstract
Objective The purpose of the study was to clarify the significance of amygdalar enlargement (AE) in patients with temporal lobe epilepsy (TLE) detected by MRI. Methods 11 TLE patients (eight men, mean age 45.3 (SD 18.2) years) with AE treated at Kyoto University Hospital were studied. Clinical history, ictal semiology, EEG, fluorodeoxyglucose–positron emission tomography (FDG-PET), interictal single photon emission CT (SPECT) and MRI were investigated. Amygdalar volume measured by 3 T MRI and its laterality index (LI) were compared with the three other groups: normal controls, patients with partial epilepsy of non-TLE and mesial TLE with hippocampal sclerosis (HS). Results Average age of onset was 39.8 years (SD 19.5). Eight had complex partial seizures and three had generalised seizures. Epileptiform discharges were found in the temporal area ipsilateral to the AE by EEG. Interictal FDG–PET/SPECT revealed regional hypometabolism or hypoperfusion in the ipsilateral temporal area. MRI showed AE on the right in five patients, on the left in five and bilateral in one, all without apparent HS. Ten of 11 patients were diagnosed as unilateral TLE ipsilateral to the AE by neurophysiological and neuroimaging methods. Enlarged amygdalae showed iso- to slightly high intensity in FLAIR images without enhancement. Unilateral AE was not seen in the other three groups for amygdalar volume and LI (p Discussion AE is most likely a subtype of TLE without ipsilateral HS. This possibility of AE should be considered in TLE patients if there is no apparent HS.
- Published
- 2010
47. Left anterior temporal cortex actively engages in speech perception: A direct cortical stimulation study
- Author
-
Susumu Miyamoto, Nobuhiro Mikuni, Masao Matsuhashi, Tomokazu Nakagawa, Hidenao Fukuyama, Riki Matsumoto, Ryosuke Takahashi, Yohei Yokoyama, Akio Ikeda, Hisaji Imamura, and Morito Inouchi
- Subjects
Adult ,Speech perception ,genetic structures ,Cognitive Neuroscience ,media_common.quotation_subject ,Semantic dementia ,Experimental and Cognitive Psychology ,behavioral disciplines and activities ,Vocabulary ,Functional Laterality ,Behavioral Neuroscience ,Neuroimaging ,Gyrus ,Epilepsy surgery ,Perception ,medicine ,Humans ,media_common ,Language ,Temporal cortex ,Cerebral Cortex ,Brain Mapping ,Superior temporal sulcus ,medicine.disease ,Electric Stimulation ,Temporal Lobe ,medicine.anatomical_structure ,Acoustic Stimulation ,Speech Perception ,Electrical cortical stimulation ,Female ,Psychology ,Comprehension ,Neuroscience - Abstract
Recent neuroimaging studies proposed the importance of the anterior auditory pathway for speech comprehension. Its clinical significance is implicated by semantic dementia or pure word deafness. Neurodegenerative or cerebrovascular nature, however, precluded precise localization of the cortex responsible for speech perception. Electrical cortical stimulation could delineate such localization by producing transient, functional impairment. We investigated engagement of the left anterior temporal cortex in speech perception by means of direct electrical cortical stimulation. Subjects were two partial epilepsy patients, who underwent direct cortical stimulation as a part of invasive presurgical evaluations. Stimulus sites were coregistered to presurgical 3D-MRI, and then to MNI standard space for anatomical localization. Separate from the posterior temporal language area, electrical cortical stimulation revealed a well-restricted language area in the anterior part of the superior temporal sulcus and gyrus (aSTS/STG) in both patients. Auditory sentence comprehension was impaired upon electrical stimulation of aSTS/STG. In one patient, additional investigation revealed that the functional impairment was restricted to auditory sentence comprehension with preserved visual sentence comprehension and perception of music and environmental sounds. Both patients reported that they could hear the voice but not understand the sentence well (e.g., heard as a series of meaningless utterance). The standard coordinates of this restricted area at left aSTS/STG well corresponded with the coordinates of speech perception reported in neuroimaging activation studies in healthy subjects. The present combined anatomo-functional case study, for the first time, demonstrated that aSTS/STG in the language dominant hemisphere actively engages in speech perception.
- Published
- 2010
48. Stimulus-response profile during single-pulse transcranial magnetic stimulation to the primary motor cortex
- Author
-
Manabu Honda, Kimitaka Anami, Riki Matsumoto, M. Abe, Hidenao Fukuyama, Takashi Hanakawa, Tatsuya Mima, Morito Inouchi, and Shin Ichi Urayama
- Subjects
Adult ,Male ,genetic structures ,Cognitive Neuroscience ,medicine.medical_treatment ,Electromyography ,Stimulus (physiology) ,Somatosensory system ,Cellular and Molecular Neuroscience ,Young Adult ,Neuroimaging ,medicine ,Humans ,Brain Mapping ,medicine.diagnostic_test ,Motor Cortex ,Evoked Potentials, Motor ,Transcranial Magnetic Stimulation ,Transcranial magnetic stimulation ,medicine.anatomical_structure ,Female ,Primary motor cortex ,Functional magnetic resonance imaging ,Psychology ,Neuroscience ,Motor cortex - Abstract
We examined the stimulus--response profile during single-pulse transcranial magnetic stimulation (TMS) by measuring motorevoked potentials (MEPs) with electromyographic monitoring and hemodynamic responses with functional magnetic resonance imaging (fMRI) at 3 Tesla. In 16 healthy subjects, single TMS pulses were irregularly delivered to the left primary motor cortex at a mean frequency of 0.15 Hz with a wide range of stimulus intensities. The measurement of MEP proved a typical relationship between stimulus intensity and MEP amplitude in the concurrent TMS-fMRI environment. In the population-level analysis of the suprathreshold stimulation conditions, significant increases in hemodynamic responses were detected in the motor/somatosensory network, reflecting both direct and remote effects of TMS, and also the auditory/cognitive areas, perhaps related to detection of clicks. The stimulus--response profile showed both linear and nonlinear components in the direct and remote motor/somatosensory network. A detailed analysis suggested that the nonlinear components of the motor/somatosensory network activity might be induced by nonlinear recruitment of neurons in addition to sensory afferents resulting from movement. These findings expand our basic knowledge of the quantitative relationship between TMSinduced neural activations and hemodynamic signals measured by neuroimaging techniques.
- Published
- 2009
49. Changes in Habitual Sleep Duration after Continuous Positive Airway Pressure for Obstructive Sleep Apnea.
- Author
-
Ryo Tachikawa, Takuma Minami, Takeshi Matsumoto, Kimihiko Murase, Kiminobu Tanizawa, Morito Inouchi, Toru Oga, Kazuo Chin, Tachikawa, Ryo, Minami, Takuma, Matsumoto, Takeshi, Murase, Kimihiko, Tanizawa, Kiminobu, Inouchi, Morito, Oga, Toru, and Chin, Kazuo
- Subjects
SLEEP apnea syndromes ,SLEEP apnea syndrome treatment ,ANXIETY ,MENTAL depression ,ACTIGRAPHY ,LONGITUDINAL method ,MULTIVARIATE analysis ,PSYCHOLOGICAL tests ,QUALITY of life ,REGRESSION analysis ,SLEEP ,SLEEP stages ,TIME ,POLYSOMNOGRAPHY ,SEVERITY of illness index ,CONTINUOUS positive airway pressure ,PSYCHOLOGY - Abstract
Rationale: Obstructive sleep apnea (OSA) can affect not only sleep quality but also sleep duration. Determining the therapeutic effects of continuous positive airway pressure (CPAP) on habitual sleep profiles may shed light on the impact of OSA on sleep duration.Objectives: To determine whether and how CPAP affects habitual sleep duration in patients with OSA.Methods: Assessments of sleep duration and sleep quality were performed on 57 newly diagnosed study subjects with OSA (46 men; median age, 63 yr; apnea-hypopnea index, >20 h-1) at baseline and 3 months after initiation of CPAP therapy. Measurements included in-laboratory sleep tests (polysomnography), assessments of habitual sleep (actigraphy with sleep diary for 7 d), and questionnaires on subjective symptoms (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale).Results: Actigraphic night sleep time did not change after CPAP (from 354.0 ± 64.5 min to 353.0 ± 57.0 min; P = 0.87) in the entire group, despite improvements in sleep efficiency and sleep fragmentation. Changes in habitual night sleep duration varied among the participants; habitual night sleep duration increased by 33 minutes (interquartile range, 14-45 min) in 28 participants (sleep time restorers) and decreased by 23 minutes (interquartile range, -48 to -11 min) in 29 participants (sleep time nonrestorers). Subgroup analyses revealed that sleep time restorers were characterized at baseline as having shorter and more fragmented sleep with frequent daytime napping. Nonrestorers were characterized by frequent use of hypnotic drugs and comorbid insomnia, despite longer habitual sleep duration. Actigraphic sleep fragmentation, sleep efficiency, daytime sleepiness, and the frequency of daytime napping were improved after CPAP only in the sleep time restorers, whereas subjective sleep quality was improved in the nonrestorers. Multivariate linear regression showed that shorter baseline night sleep time, baseline daytime napping, and percentage of sleep time under CPAP were positive predictors of the restoration of actigraphic night sleep time, whereas hypnotic use was a negative predictor.Conclusions: Short-term CPAP did not affect habitual night sleep duration in the group as a whole but induced intraindividual changes in relation to phenotypic features of OSA. Clinical trial registered with www.umin.ac.jp (UMIN000012639). [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
50. P23-13 Progression of benign adult familial myoclonus epilepsy (BAFME) with aging: clinical implication of somatosensory evoked potentials
- Author
-
Kiyohito Terada, Masao Matsuhashi, Takashi Nagamine, Hisaji Imamura, Hiroshi Shibasaki, A. Ikeda, Takefumi Hitomi, R. Takahashi, Takayuki Kondo, M. Kanda, and Morito Inouchi
- Subjects
Benign adult familial myoclonus epilepsy ,Neurology ,business.industry ,Somatosensory evoked potential ,Physiology (medical) ,Anesthesia ,Medicine ,Neurology (clinical) ,business ,Sensory Systems - Published
- 2010
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.