Publications by authors named "Hirofumi Komaki"

Objectives: Physical function assessments in patients with spinal muscular atrophy (SMA) are important indicators for assessing the effectiveness of treatment and changes over time in rehabilitation therapy. However, few reports exist on this indicator. This study calculated the minimal clinically important difference (MCID) for assessing motor function in the upper and lower limbs of individuals with SMA to estimate the degree of change within a functional score that is considered clinically meaningful.

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Background And Objectives: Becker muscular dystrophy (BMD) is an allelic disorder of Duchenne muscular dystrophy (DMD) in which pathogenic variants in cause progressive worsening of motor dysfunction, muscle weakness and atrophy, and death due to respiratory and cardiac failure. BMD often has in-frame deletions that preserve the amino acid reading frame, but there are some cases with microvariants or duplications. In recent years, the importance of therapeutic development and care for BMD has been emphasized.

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Myotonic dystrophy type 1 (DM1) is a dominantly inherited multi-system disease caused by expanded CTG repeats in the 3' untranslated region of the dystrophia myotonica protein kinase (DMPK) gene. Similar to other repeat disorders, the expanded trinucleotide repeat is unstable and demonstrates a tendency to increase repeat size with age in affected tissues. DNA mismatch repair system is implicated in somatic instability.

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Background: Becker muscular dystrophy (BMD) is a dystrophinopathy caused by a pathological variant of the DMD gene. Urinary titin, a degradation product of the giant protein titin present in muscle sarcomeres, has been used as a biomarker to reflect muscle degradation in Duchenne muscular dystrophy, a more severe dystrophinopathy. However, the clinical significance of urinary titin levels in BMD remains unclear.

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Objective And Rationale: To investigate the longitudinal incidence of kidney/urinary stones in patients with severe motor and intellectual disabilities and explore health burden events in patients with stone formation.

Methods: This was a retrospective, observational study. We identified patients with severe motor and intellectual disabilities who had the following: 1) admission to our hospital wards for >10 years; 2) two or more assessments for stone formation by ultrasonography or computed tomography; and 3) absence of kidney/urinary stones in the first imaging study.

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Article Synopsis
  • - Duchenne muscular dystrophy (DMD) is a serious genetic condition linked to the absence of a protein called dystrophin, leading to severe mobility and respiratory problems, and is evaluated in the phase 3 EMBARK trial using a gene therapy called delandistrogene moxeparvovec.
  • - The trial involved boys aged 4 to 8 with DMD who received either the gene therapy or a placebo, but results showed no significant improvement in the primary measure of motor function (NSAA score) after 52 weeks.
  • - Although the primary endpoint wasn't met, some secondary measures did show improvement in muscle function and expression of micro-dystrophin, with a notable number of adverse events recorded but
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  • Current research on febrile infection-related epilepsy syndrome (FIRES) focuses primarily on acute management, with limited evidence for chronic phase treatment.
  • A 19-year-old woman with longstanding FIRES showed significant improvement in seizure control and respiratory stabilization after starting a ketogenic diet (KD) 15 years post-diagnosis.
  • This case suggests that KD could be an effective treatment option for patients with FIRES in the chronic phase, similar to its benefits in the acute phase.
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Background: Past research has suggested a cross-sectional association between COVID-19-related discrimination and PTSD symptom severity. However, no cohort study has examined the longitudinal association that better supports causal interpretation. Also, even if such an association genuinely exists, the specific pathway remains unclear.

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Heterozygous transmembrane protein 63A (TMEM63A) variants cause transient infantile hypomyelinating leukodystrophy-19, which features remarkable natural resolution of clinical and imaging findings during childhood. Previous reports have mainly described de novo variants lacking detailed familial cases. Herein, we describe the clinical course of familial cases with a TMEM63A variant.

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  • The study investigated pediatric-onset dystonia in Japan, focusing on diagnostic challenges due to various symptoms and causes.
  • It involved surveys sent to child neurologists, resulting in data from 736 patients and insights into distinctive clinical features based on the age of onset.
  • The findings revealed that most cases were inherited with specific genetic disorders being prevalent, highlighting the need for comprehensive examinations like genetic testing for better diagnosis and treatment.
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Pneumatosis cystoides intestinalis (PCI) is a rare disease wherein air accumulates in the intestinal subserosa and submucosa, causing multiple gaseous cysts within the gastrointestinal wall. While PCI has various known risk factors, reports identifying muscular diseases as a factor are scarce. The aim of this study is to elucidate the clinical characteristics of PCI in muscle disease.

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Febrile infection-related epilepsy syndrome (FIRES) is a rare epileptic encephalopathy that occurs in children or adolescents. To date, evidence for the management of the post-acute phase of FIRES is focused on drug-resistant epilepsy that continues from the acute phase. Information on involuntary movements, which are newly developed in the chronic phase, is limited.

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Objective: To elucidate the patient's journey to epilepsy surgery and identify the risk factors contributing to surgical delay in pediatric patients with drug-resistant epilepsy (DRE) due to focal cortical dysplasia (FCD).

Methods: A retrospective review was conducted of 93 pediatric patients who underwent curative epilepsy surgery for FCD between January 2012 and March 2023 at a tertiary epilepsy center. The Odyssey plot demonstrated the treatment process before epilepsy surgery, including key milestones of epilepsy onset, first hospital visit, epilepsy diagnosis, MRI diagnosis, DRE diagnosis, and surgery.

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  • - The study evaluates the Functional Classification of the Upper Extremities (FCUE) for measuring upper-limb function in boys with Duchenne muscular dystrophy (DMD), comparing it to other assessment methods like the Performance of Upper Limb (PUL) and the Brooke Upper Extremity Scale.
  • - Using data from 39 boys with DMD, the researchers found strong concurrent validity between FCUE and PUL, with a Spearman correlation of -0.914, and a slightly lower correlation of -0.854 with the Brooke scale.
  • - The results suggest that FCUE is a reliable tool for assessing upper-limb function in DMD and highlight the importance of choosing the right assessment method based on the patient's condition and
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  • This study investigated how COVID-19 preventive behaviors and job-related stress impact sleep quality among healthcare workers in Japan.
  • Out of 586 participants, 38.1% reported poor sleep quality, despite high adherence to safety measures like mask-wearing and handwashing.
  • The analysis found work-related stress, financial instability, and low remote work adherence significantly contributed to poor sleep quality, even after adjusting for factors like age and psychological distress.
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Background: Myotonic dystrophy type 1 (DM1) is a devastating multisystemic disorder caused by a CTG repeat expansion in the gene, which subsequently triggers toxic RNA expression and dysregulated splicing. In a preclinical study, we demonstrated that erythromycin reduces the toxicity of abnormal RNA and ameliorates the aberrant splicing and motor phenotype in DM1 model mice.

Methods: This multicentre, randomised, double-blind, placebo-controlled, phase 2 trial was conducted at three centres in Japan to translate preclinical findings into practical applications in patients with DM1 by evaluating the safety and efficacy of erythromycin.

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Duchenne muscular dystrophy (DMD) is the most common type of neuromuscular disease caused by mutations in the gene encoding dystrophin protein. To quantitively assess human dystrophin protein in muscle biopsy samples, it is imperative to consistently detect as low as 0.003% of the dystrophin protein relative to the total muscle protein content.

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  • Health anxiety (HA) during the COVID-19 pandemic can influence how individuals, particularly healthcare workers, engage in preventive behaviors against the virus.
  • The study found that feeling awful about potential illnesses led to decreased adherence to recommended preventive measures, while perceived likelihood of getting sick did not show the same effect.
  • Emphasizing the awfulness dimension of HA could improve self-protection strategies during health crises, benefiting both public health and healthcare workers' well-being.
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Introduction/aims: Merosin is a protein complex located in the basement membrane of skeletal muscles and laminin α2-containing regions of the central and peripheral nervous systems. However, because of the prominence of muscle-related symptoms, peripheral neuropathy associated with merosin-deficient congenital muscular dystrophy type 1A (MDC1A) has received little clinical attention. This study aimed to present pathological changes in intramuscular nerves of three patients with MDC1A and discuss their relationship with electrophysiological findings to provide new evidence of peripheral nerve involvement in MDC1A.

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Objectives: This study investigated the outcomes of the early introduction of a standing program for patients with Duchenne muscular dystrophy (DMD).

Methods: This was a retrospective observational study of 41 outpatients with DMD aged 15-20 years. We introduced the standing program using knee-ankle-foot orthoses (KAFO) to slow the progression of scoliosis when ankle dorsiflexion became less than 0° in the ambulatory period.

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  • - This study investigates the clinical aspects of Becker muscular dystrophy (BMD), a milder form of Duchenne muscular dystrophy (DMD), focusing on muscle, respiratory, cardiac, and central nervous system involvement in 225 patients.
  • - Most patients presented initial muscular symptoms, with gait disturbances noted in over half, and a small percentage requiring ventilators or showing heart complications, with specific genotype correlations found.
  • - The findings are significant for guiding treatment and preventive measures for BMD, offering crucial insights for both patients and healthcare professionals.
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Introduction/aims: Nutritional management of adults with Duchenne muscular dystrophy (DMD) is an important clinical issue. However, it is not clear which dysphagia-related factors should prompt introduction of alternative nutrition (AN). We aimed to determine which patients with DMD were introduced to AN.

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Aim: The purpose of this study is to evaluate the safety and pharmacokinetics of the novel morpholino oligomer NS-089/NCNP-02 which can induce exon 44 skipping, in patients with DMD. Additionally, we aimed to identify markers predictive of therapeutic efficacy and determine the optimal dosing for future studies.

Methods: This is an open-label, dose-escalation, two-center phase I/II trial in ambulant patients with DMD, presence of an out-of-frame deletion, and a mutation amenable to exon 44 skipping.

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At the neuromuscular junction, the downstream of tyrosine kinase 7 (DOK7) enhances the phosphorylation of muscle-specific kinase (MuSK) and induces clustering of acetylcholine receptors (AChRs). We identified a patient with congenital myasthenic syndrome (CMS) with two heteroallelic mutations in DOK7, c.653-1G>C in intron 5 and c.

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