Background We aimed to identify any differences in the structural covariance network
based on structural volume and those in the functional network based on cerebral blood flow between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura.
Methods We prospectively enrolled 27 patients with migraine without aura, all of whom had unilateral migraine pain. We defined the ipsilateral hemisphere as the side of migraine pain. We measured structural volumes on three-dimensional T1-weighted images and cerebral blood flow using arterial spin labeling magnetic resonance imaging. We then analyzed the structural covariance network based on structural volume and the functional network based on cerebral blood flow using graph theory.
Results There were no significant differences in structural volume or cerebral blood flow
between the ipsilateral and contralateral hemispheres. However, there were significant differences between the hemispheres in the structural covariance network and the functional network. In the structural covariance network, the betweenness centrality of the thalamus was lower in the ipsilateral hemisphere than in the contralateral hemisphere. In the functional network, the betweenness centrality of the anterior cingulate and paracingulate gyrus was lower in the ipsilateral hemisphere than in the contralateral hemisphere, while that of the opercular part of the inferior frontal gyrus was higher in the former hemisphere.
Conclusions The present findings indicate that there are significant differences in the structural covariance network and the functional network between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura.
Posterior reversible encephalopathy syndrome (PRES) is a rare condition manifested by inflammation in certain areas of the brain. Rhabdomyolysis with acute kidney injury (AKI) complicated by PRES is rarely reported. A 26-year-old female presented with neurological symptoms, high blood pressure, and AKI. Her symptoms improved with blood pressure control, anticonvulsant drug medications, and renal replacement therapy. This case demonstrates that PRES should be considered in the differential diagnosis of patients who have rhabdomyolysis with AKI accompanied by neurological symptoms, including headaches and convulsions.
Background The purpose of this study was to identify the top-100 cited articles on genetic generalized epilepsy (GGE) published in journals that have made key contributions to the field of epilepsy.
Methods We searched the Web of Science website produced by Clarivate Analytics for articles on GGE, and sorted them according to the number of citations to identify the top-100 cited articles. We then manually reviewed the contents of the top-100 cited articles, which were designated as “citation classics”.
Results The top-100 cited articles were published in 27 journals, with the largest proportion appearing in Epilepsia (19 articles). The articles originated from institutions in 17 countries, with 31 articles from the USA. The institution associated with the largest numbers of articles in the field of GGE was the University of Melbourne, Australia (9 articles). Panayiotopoulos C. P. was the first author of three articles, and was listed most frequently in the GGE citation classics. The publication years were concentrated in the 2000s, when 56 articles were published. The most-common study topics were genetics (35 articles) and neuroimaging (17 articles).
Conclusions This study has identified the top-100 cited articles on GGE. These citation classics represent the landmark articles on GGE, and they provide useful insights into international research leaders and the research trends in the field.
Gross and Micro-Anatomical Study of the Cavernous Segment of the Abducens Nerve and Its Relationships to Internal Carotid Plexus: Application to Skull Base Surgery Grzegorz Wysiadecki, Maciej Radek, R. Shane Tubbs, Joe Iwanaga, Jerzy Walocha, Piotr Brzeziński, Michał Polguj Brain Sciences.2021; 11(5): 649. CrossRef
Nonconvulsive status epilepticus (NCSE) is an unusual complication in patients treated with cefepime. An 82-year-old woman on maintenance hemodialysis was given cefepime for pneumonia. Her level of consciousness decreased since the administration of cefepime, and
she was diagnosed with NCSE based on electroencephalography (EEG) findings. After discontinuation of cefepime, improvement was seen both in the level of consciousness and EEG findings. Clinicians should be aware of cefepime-induced NCSE, particularly in patients with renal failure.
Reversible conduction block (RCB) was rare in patients with acute motor sensory axonal neuropathy (AMSAN). A-46-year-old man presented with paresthesia, weakness, diplopia, and dysarthria. Nerve conduction study (NCS) exhibited axonal changes with conduction block in motor and sensory nerves. His symptoms were rapidly progressed and recovered. Conduction block was disappeared in the follow-up NCS performed after 2 weeks. The AMSAN case with RCB showed rapid progress and rapid recovery of clinical symptoms as acute motor axonal neuropathy patients with RCB.
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Atypical Asymmetric Guillain-Barré Syndrome Overlapping with Miller-Fisher Syndrome: A Case Report Hwi Jung Kim, Gyu Seok Oh, Ju Kang Lee, Oh Kyung Lim, Ki Deok Park Journal of Electrodiagnosis and Neuromuscular Dise.2021; 23(2): 49. CrossRef
Background Although postural instability is one of the major symptoms of Parkinson’s disease (PD), dopaminergic treatment is ineffective for treating postural instability. Recent reports have shown that somatosensory deficit is associated with postural instability, and that somatosensory input improved postural instability. The purpose of this study is to evaluate the effects of lateral wedges for quiet standing postural control in people with PD.
Methods Twenty-two patients who were diagnosed with PD were enrolled in this study. The participants stood on a force plate under two conditions (wedge and no wedge) with or without having their eyes open or closed. The center of pressure (COP) range and velocity were analyzed using a two-way repeated-measures analysis of variance.
Results The range and velocity of COP in the anterioposterior and mediolateral (ML) directions were significantly improved after the patients stood on the lateral wedge with their eyes closed (p < 0.05). The range in ML direction and velocity in both directions of COP were significantly decreased when their eyes were open (p < 0.05).
Conclusions Regardless of vision, standing on lateral wedges improved postural sway in people with PD.
In this article, we review the differences of the brain morphology according to age, sex, and handedness. Age is a well-known factor affecting brain morphology. With aging, progressive reduction of brain volume is driven. Sex also has great effects on brain morphology. Although there are some reports that the differences of brain morphology may originate from the differences of weight between the 2 sexes, studies have demonstrated that there are regional differences even after the correction for weight. Handedness has long been regarded as a behavioral marker of functional asymmetry. Although there have been debates about the effect of handedness on brain morphology, previous well-established studies suggest there are differences in some regions according to handedness. Even with the studies done so far, normal brain morphology is not fully understood. Therefore, studies specific for the each ethnic group and standardized methods are needed to establish a more reliable database of healthy subjects’ brain morphology.
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Distinct multivariate structural brain profiles are related to variations in short- and long-delay memory consolidation across children and young adults Iryna Schommartz, Philip F. Lembcke, Francesco Pupillo, Henriette Schuetz, Nina Wald de Chamorro, Martin Bauer, Angela M. Kaindl, Claudia Buss, Yee Lee Shing Developmental Cognitive Neuroscience.2023; 59: 101192. CrossRef
Genome‐wide association and replication studies for handedness in a Korean community‐based cohort Youhyun Song, Dasom Lee, Ja‐Eun Choi, Ji Won Lee, Kyung‐Won Hong Brain and Behavior.2023;[Epub] CrossRef
Changes in the volumes and asymmetry of subcortical structures in healthy individuals according to gender Nihal Gurlek Celik, Saban Tiryaki Anatomical Science International.2023; 98(4): 506. CrossRef
Social support modulates the association between PTSD diagnosis and medial frontal volume in Chinese adults who lost their only child Rongfeng Qi, Yifeng Luo, Li Zhang, Yifei Weng, Wesley Surento, Neda Jahanshad, Qiang Xu, Yan Yin, Lingjiang Li, Zhihong Cao, Paul M. Thompson, Guang Ming Lu Neurobiology of Stress.2020; 13: 100227. CrossRef
Background We evaluated whether eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy.
Methods Thirty patients with epilepsy of unknown cause as well as age- and sex-matched normal controls were enrolled in this study. We divided the patients into drug-controlled epilepsy (n = 22) and drug-resistant epilepsy (n = 8) groups according to their seizure controls. We analyzed the differences in the parameters of the eye movements in these two groups compared with normal controls using video-based electro-oculography. In addition, we investigated the differences in the cerebellar volumes of these two groups using whole-brain T1-weighted images.
Results The latency and accuracy of saccade in patients with epilepsy were significantly different from normal controls, but they were not different between patients with drug-controlled epilepsy and drug-resistant epilepsy. However, the gain of pursuit was significantly decreased in patients with drug-resistant epilepsy compared with normal controls (p = 0.0010), whereas it was not different between patients with drug-controlled epilepsy and normal controls (p = 0.9646). In addition, the patients with drug-resistant epilepsy had lower cerebellar volumes than normal controls (p = 0.0052), whereas the cerebellar volumes in patients with drug-controlled epilepsy were not different from normal controls (p = 0.5050).
Conclusions We demonstrated that pursuit eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy, a finding that may be related to cerebellar dysfunction.
Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.
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Validity Analysis of Neck Circumference as a Screening Test for Hypoxia Occurrence in Patients Undergoing Sedative Endoscopy Hyun-Ji Song, Jiyun Kim Healthcare.2022; 10(4): 679. CrossRef
Background Viruses can cause either meningitis or encephalitis. It is unclear why some people suffer from aseptic meningitis, and others acquire aseptic encephalitis when infected with the same viral pathogens. The aim of this study was to compare demographic and laboratory factors between patients with aseptic meningitis and encephalitis. Methods: The demographic and laboratory differences were analyzed according to age, sex, diabetes, hypertension, C-reactive protein in the blood, white blood cell and protein in the cerebrospinal fluid, and glucose ratio (cerebrospinal fluid/blood). Additionally, we analyzed the nation-wide differencesin age between the patients with aseptic meningitis and those with encephalitis in Korea. Results: The patients with aseptic encephalitis were older, more likely to have hypertension, and had higher levels of C-reactive protein than did the patients with aseptic meningitis. However, the numbers of white blood cells in the cerebrospinal fluid were significantly higher in the patients with meningitis than in the patients with encephalitis. Multivariable analysis revealed that age >49 years, hypertension and a C-reactive protein level >5.81 mg/dL were independent and significant variables in the prediction of aseptic encephalitis. Additionally, the patients with aseptic encephalitis were older than those with aseptic meningitis in the nation-wide Korean database. Conclusions: Older age, hypertension, and higher levels of C-reactive protein are useful factors for the prediction of aseptic encephalitis.
A 77-year-old man developed acute vertigo and unsteady gait. Neurological examination revealed spontaneous left-beating nystagmus in the primary position. He fell to the left when walking without support. Magnetic resonance imaging showed an acute infarction involving the right parieto-temporal lobe. Although the vertigo and unsteady gait are most often associated with vestibular disorders involving the infratentorial structures, those may occur in cerebral infarction of the parieto-temporal lobe.
Background: Triphasic waves are one of the electroencephalographic patterns that can be usually seen in metabolic encephalopathy. The aim of this study is to compare the clinical and electrophysiologic profiles between patients with and without triphasic waves in metabolic encephalopathy, and reassess the significance of triphasic waves in metabolic encephalopathy. Methods: We recruited 127 patients with metabolic encephalopathy, who were admitted to our hospital. We divided these admitted patients into two groups; those with and without triphasic waves. We analyzed the difference of duration of hospitalization, mortality rate during admission, Glasgow Coma Scale, severity of electroencephalographic alteration, and presence of acute symptomatic seizures between these two groups. Results: Of the 127 patients with metabolic encephalopathy, we excluded 67 patients who did not have EEG, and 60 patients finally met the inclusion criteria for this study. Patients with triphasic waves had more severe electroencephalographic alterations, lower Glasgow Coma Scale, and more acute symptomatic seizures than those without triphasic waves. After adjusting the clinical variables, Glasgow Coma Scale and acute symptomatic seizures were only significantly different between patients with and without triphasic waves. Conclusions: We demonstrated that patients with triphasic waves in metabolic encephalopathy had more significant impairment of the brain function.
We encountered a case of pituitary apoplexy who presented with isolated headache and vomiting without visual disturbance or ophthalmoplegia. The cerebrospinal fluid examination was compatible with aseptic meningitis. A computed tomography revealed slightly high density in the pituitary fossa and suprasella area, but the signal change was very faint. Our case suggests that clinicians should take into account the possibility of pituitary apoplexy without visual disturbance or ophthalmoplegia, when aseptic meningitis is suspected.
It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.
Ischemic monomelic neuropathy and myopathy are rare complications of peripheral arterial occlusive disease. We reporta case of ischemic monomelic neuropathy of the right sural, common peroneal and posterior tibial nerves and ischemic myopathyof the right tibialis anterior resulting from the occlusion of the right common femoral arteries despite successfulrevascularization. Ischemic monomelic neuropathy and myopathy can occur as a result of occlusion of the specific peripheralartery.
The pathomechanisms involved in both restless legs syndrome (RLS) and complex regional pain syndrome type I(CRPS I) are still controversial whether they are central or peripheral origins. We recently encountered a patient whohad an unusual coexistence of both RLS and CRPS I, and both of which showed good responses to sympathetic block.These findings suggest the role of peripheral mechanisms, especially unmyelinated small autonomic fiber, in both RLSand CRPS I
Guillain-Barr? syndrome is a disorder of acute polyneuropathy that is described as progressive, symmetric muscle weakness. Many reports have documented the occurrence of Guillain-Barr? syndrome after vaccination. Here, we report a very rare case of patient with Guillain-Barr? syndrome who presents with unilateral foot drop after receiving tatanus toxoid injection. Four days after the symptom onset, limbs weakness developed, and the patient showed delayed right peripheral facial palsy.
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