Publications by authors named "Akio Ikeda"

Objective: Although the negative motor area (NMA) is defined as the area where electrical cortical stimulation inhibits voluntary movements, detail functions of NMA on praxis have not been elucidated. We investigated its role in praxis by motion analysis during stimulation at a smaller intensity.

Methods: Patients were six intractable partial epilepsy patients undergoing implantation of intracranial electrodes.

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Objective: Seizure suppression using the neurofeedback (NFB) method by self-regulation of scalp-recorded slow cortical potential (SCP) is effective for patients with refractory focal epilepsy. However, the prolonged training period required prevents it from wider implementation as the standard treatment in clinical practice. Therefore, we examined whether it would be appropriate to shorten the training period, in spite of the small number of patients.

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The interaction between basic science epilepsy researchers and clinical epileptologists is a longstanding issue. Efforts to provide opportunities for a dialogue between preclinical and clinical epilepsy professionals are crucial to reduce the knowledge gap between them and improve the translational success of neurobiology-based research. The International League Against Epilepsy (ILAE) Research and Innovation Task Force circulated a survey to investigate the need for an update on new clinical epilepsy concepts within the basic science community.

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Article Synopsis
  • The study compared EEG findings in patients with Alzheimer's disease (AD) versus dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD) to identify differences in brain activity patterns.
  • Visual analysis showed that patients with DLB/PDD had a lower posterior dominant rhythm (PDR) frequency and certain EEG patterns strongly indicated DLB/PDD while ruling out AD.
  • Both visual and automated EEG analyses yielded similar results regarding PDR, demonstrating that visual assessment effectively distinguishes between AD and DLB/PDD, with automated analysis acting as a supportive tool, particularly for Parkinson's-related dementia.
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Objective: Cortical spreading depolarization is one possible pathogenesis of migraine, of which slow neurophysiological change is barely recorded in conventional EEG settings. Using wide-band EEG conditions, we reappraised the features of EEG in migraineurs, including subdelta-band EEG changes.

Methods: This retrospective study included 144 patients with migraine.

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Introduction: Epilepsy surgery is the only curative treatment for patients with drug-resistant focal epilepsy. Stereoelectroencephalography (SEEG) is the gold standard to delineate the seizure-onset zone (SOZ). However, up to 40% of patients are subsequently not operated as no focal non-eloquent SOZ can be identified.

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  • Giant somatosensory evoked potentials (SEPs) are associated with cortical myoclonus, and this study focused on understanding the middle-latency component (MLC) and its relevance alongside the short-latency components (SLC) observed.
  • Twenty-two patients with cortical myoclonus and 15 healthy controls participated; differences in SEPs before and after treatment with perampanel (PER) were analyzed.
  • Results indicated that after PER treatment, SLCs showed a correlation with PER dosage, highlighting their excitatory nature, while MLCs, which indicated inhibitory processes, did not show such correlation, suggesting that giant SEPs reflect a balance of excitatory and inhibitory epileptic activities.
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  • This study revisits the basal temporal language area (BTLA) using electrical cortical stimulation (ECS) to analyze its role in the Japanese language among 11 patients with focal epilepsy.
  • It creates a functional density map highlighting the BTLA's anatomical features and found that spoken-word tasks were more affected by ECS than reading tasks, indicating different levels of language processing.
  • The findings suggest a functional gradient in the BTLA, with the front involved in broader semantic processing and the back, particularly the middle fusiform gyrus, focused on specific types of input.
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Migraine attacks, especially ones with aura, have symptoms similar to epileptic seizures, and the two may sometimes be difficult to differentiate clinically. However, the characteristic minute-by-minute symptom development and progress within 60 ‍min is useful for diagnosis. Although the details of its pathophysiology remain unsolved, cortical spreading depolarization (CSD) is one of the main pathogenetic factors.

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Poststroke epilepsy (PSE) is associated with higher mortality and poor functional and cognitive outcomes in patients with stroke. With the remarkable development of acute stroke treatment, there is a growing number of survivors with PSE. Although approximately 10% of patients with stroke develop PSE, given the significant burden of stroke worldwide, PSE is a significant problem in stroke survivors.

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Scalp video-electroencephalography (video-EEG) monitoring should be analyzed thoroughly to preoperatively evaluate stereoelectroencephalography (SEEG). Formulating the working hypotheses for the epileptogenic zone (EZ) considering "anatomo-electroclinical correlations" is the most crucial step, which determines the placement of SEEG electrodes. If these hypotheses are insufficient, precise EZ identification may not be achieved during SEEG recording.

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Purpose: While spikes and sharp waves are considered as markers of epilepsy in conventional electroencephalography, ictal direct current (DC) shifts and high-frequency oscillations (HFOs) appear to be useful biomarkers for epileptogenicity. We analyzed how ictal DC shifts and HFOs were affected by focal status epilepticus and antiseizure medications (ASMs).

Methods: A 20-year-old female patient who underwent long-term intracranial electrode implantation for epilepsy surgery presented with 72 habitual seizures and a focal status epilepticus episode lasting for 4 h.

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Objective: Degree of indication for epilepsy surgery is determined by taking multiple factors into account. This study aimed to investigate the usefulness of the Specific Consistency Score (SCS), a proposed score for focal epilepsy to rate the indication for epilepsy focal resection.

Methods: This retrospective cohort study included patients considered for resective epilepsy surgery in Kyoto University Hospital from 2011 to 2022.

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Objective: This study was undertaken to develop a standardized grading system based on expert consensus for evaluating the level of confidence in the localization of the epileptogenic zone (EZ) as reported in published studies, to harmonize and facilitate systematic reviews in the field of epilepsy surgery.

Methods: We conducted a Delphi study involving 22 experts from 18 countries, who were asked to rate their level of confidence in the localization of the EZ for various theoretical clinical scenarios, using different scales. Information provided in these scenarios included one or several of the following data: magnetic resonance imaging (MRI) findings, invasive electroencephalography summary, and postoperative seizure outcome.

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A 30-year-old man who received infliximab for treatment of Crohn's disease developed Epstein-Barr virus (EBV) encephalitis, which responded well to therapy; however, he had left lower visual field loss following treatment. The patient noticed peculiar symptoms 9 months after recovery from encephalitis; objects in his view appeared smaller or larger than their actual size (micropsia/macropsia). Moreover, it appeared that objects outside moved faster or slower than their actual speed of movements and moving objects appeared as a series of many consecutive snap shots.

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Objective: Ictal direct current shifts (icDCs) and ictal high-frequency oscillations (icHFOs) have been reported as surrogate markers for better surgical outcomes in epilepsy surgery. icDCs have been classified into two types: rapid and slow development. icDCs have been investigated with a time constant of 10 s (TC10s); however, many institutes use electroencephalography with a time constant of 2 s (TC2s).

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Hippocampal hyperexcitability is a promising therapeutic target to prevent Aβ deposition in AD since enhanced neuronal activity promotes presynaptic Aβ production and release. This article highlights the potential application of perampanel (PER), an AMPA receptor (AMPAR) antagonist approved for partial seizures, as a therapeutic agent for AD. Using transgenic AD mice combined with in vivo brain microdialysis and primary neurons under oligomeric Aβ-evoked neuronal hyperexcitability, the acute effects of PER on Aβ metabolism were investigated.

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In July 2020, The Special Committee for Measures Against Transition from Pediatric to Adult Health Care of the Japanese Society of Neurology was established to address transitional care for patients with childhood-onset neurological disorders. One of the measures used was a questionnaire regarding transitional medicine given to the 129 board members in the Kinki area. Of the 46 respondents, 42 answered that they would "generally examine such patients" or "judge on a case-by-case basis" for patients referred from a pediatric physician.

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Objective: Postseizure functional decline is a concern in poststroke epilepsy (PSE). However, data on electroencephalogram (EEG) markers associated with functional decline are scarce. Thus, we investigated whether periodic discharges (PDs) and their specific characteristics are associated with functional decline in patients with PSE.

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() was identified as a causative gene of autosomal dominant lateral temporal lobe epilepsy. We previously reported that -mutant rats carrying a missense mutation (L385R) showed audiogenic seizure-susceptibility. To explore the pathophysiological mechanisms underlying Lgi1-related epilepsy, we evaluated changes in glutamate and GABA release in -mutant rats.

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The excitatory glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors (AMPARs) contribute to epileptogenesis. Thirty patients with epilepsy and 31 healthy controls are scanned using positron emission tomography with our recently developed radiotracer for AMPARs, [C]K-2, which measures the density of cell-surface AMPARs. In patients with focal-onset seizures, an increase in AMPAR trafficking augments the amplitude of abnormal gamma activity detected by electroencephalography.

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Objective: We evaluated adherence to and 1-year persistence of two third-generation anti-seizure medications (ASMs), lacosamide and perampanel, in adult patients with focal epilepsy, compared with lamotrigine and levetiracetam.

Methods: A cohort study was conducted using a Japanese health insurance claims database (JMDC Inc.).

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Familial adult myoclonus epilepsy (FAME) is an autosomal dominant condition characterized by the association of myoclonic tremor and epilepsy mainly with onset in adulthood. The clinical course is non-progressive or slowly progressive, as epilepsy is commonly controlled with appropriate antiseizure medication and individuals have a normal life expectancy. However, the myoclonus severity increases with age and leads to some degree of disability in the elderly.

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Article Synopsis
  • The report examines the clinical features of supplementary motor area seizures in two patients, both experiencing nocturnal seizures without impaired awareness.
  • The first patient is a 13-year-old boy with a history of hand shaking to alleviate seizure stiffness, while the second is a 43-year-old man who involuntarily moved his hand during seizures.
  • The findings highlight the importance of recognizing these seizures in conjunction with voluntary movements, which can help differentiate them from non-epileptic events like psychogenic seizures.
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