Publications by authors named "I-Ching Chou"

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) affects patients after recovering from acute coronavirus disease 2019 (COVID-19). This study investigates the impact of SARS-CoV-2 vaccination on PASC symptoms in children in Taiwan during the Omicron pandemic.

Methods: We enrolled children under 18 years with PASC symptoms persisting for more than 4 weeks.

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Osteoporosis, a condition defined by low BMD (typically < -2.5 SD), causes a higher fracture risk and leads to significant economic, social, and clinical impacts. Genome-wide studies mainly in Caucasians have found many genetic links to osteoporosis, fractures, and BMD, with limited research in East Asians (EAS).

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Background: Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. Several susceptibility loci associated with TS have been identified previously in populations of European descent using genome-wide association studies (GWAS). However, the exact pathogenic mechanism underlying TS is unknown; additionally, the results of previous GWAS for TS were based on Western populations, which may not translate to other populations.

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Study Question: Are there associations of age at menarche (AAM) with health-related outcomes in East Asians?

Summary Answer: AAM is associated with osteoporosis, Type 2 diabetes (T2D), glaucoma, and uterine fibroids, as demonstrated through observational studies, polygenic risk scores, genetic correlations, and Mendelian randomization (MR), with additional findings indicating a causal effect of BMI and T2D on earlier AAM.

What Is Known Already: Puberty timing is linked to adult disease risk, but research predominantly focuses on European populations, with limited studies in other groups.

Study Design, Size, Duration: We performed an AAM genome-wide association study (GWAS) with 57 890 Han Taiwanese females and examined the association between AAM and 154 disease outcomes using the Taiwanese database.

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Background: This study aimed to investigate the demographic and clinical characteristics, types of seizure disorders, and antiepileptic drug usage among individuals with different types of corpus callosum disorders.

Methods: A total of 73 individuals were included in the study and divided into three groups based on the type of corpus callosum abnormality: hypoplasia (H), agenesis (A), and dysgenesis (D). Demographic data, including gender and preterm birth, as well as clinical characteristics such as seizure disorders, attention deficit hyperactivity disorder (ADHD), severe developmental delay/intellectual disability, and other brain malformations, were analyzed.

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Heterogeneous neurocognitive impairment remains an important issue, even in the era of combination antiretroviral therapy (cART), with an incidence ranging from 15% to 65%. Although ART drugs with higher penetration scores to the central nervous system (CNS) show better HIV replication control in the CNS, the association between CNS penetration effectiveness (CPE) scores and neurocognitive impairment remains inconclusive. To explore whether ART exposure is associated with the risk of neurological diseases among patients with HIV/AIDS, this study in Taiwan involved 2,571 patients with neurological diseases and 10,284 matched, randomly selected patients without neurological diseases between 2010 and 2017.

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Article Synopsis
  • - Advances in epilepsy genetics have led to the discovery of genetic mutations causing epileptic encephalopathies, paving the way for targeted therapies.
  • - Clinical testing using gene panels and genomic sequencing has improved diagnosis rates and deepened the understanding of the underlying mechanisms of epilepsy.
  • - Children with developmental disabilities are at higher risk for epilepsy, and enhanced knowledge of genetic factors may lead to personalized treatment approaches in the future.
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Long-term living with human immunodeficiency virus (HIV) and/or antiretroviral therapy (ART) is associated with various adverse effects, including neurocognitive impairment. Heterogeneous neurocognitive impairment remains an important issue, affecting between 15-65% of human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) patients and resulting in work performance, safety, and health-related outcomes that have a heavy economic burden. We identified 1,209 HIV/AIDS patients with neurological diseases during 2010-2017.

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Epilepsy is a chronic neurological disorder that presents as recurrent, unprovoked seizures. Pharmacotherapy is the main treatment for epilepsy, but at least 30% of patients with epilepsy have pharmacoresistant epilepsy. Therefore, non-pharmacological treatments are still required.

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Rare copy number variations have been linked to an important source of mutation in many psychopathological traits and neurodevelopmental disorders. In this study, we describe a Taiwanese girl with mental retardation and mild macrocephaly who underwent a childhood psychological evaluation for several years first. When she was 5 years old, she came to our hospital for further diagnosis.

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Background: Psychological burdens can affect the quality of life among parents of children with epilepsy, especially parents of children with poor seizure control. The impact of stress on the parents of children with epilepsy is significantly comorbid with their children's cognitive dysfunction and the severity of epilepsy. The aim of this study was to assess the stress levels of parents of school-age children with drug-resistant epilepsy (DRE) and controlled-epilepsy after considering the children's cognitive ability.

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Article Synopsis
  • Migraine is linked to an increased risk of dementia, prompting a study that analyzed data from Taiwan's National Health Insurance Research Database to examine this relationship among patients receiving acupuncture versus those who did not.
  • The study matched 4,813 patients using a 1:1 propensity score method, assessing various factors and employing Cox proportional hazards models to quantify the risk of developing dementia.
  • Results indicated that migraine patients who received acupuncture had a significantly lower risk of dementia (adjusted hazard ratio = 0.51) and a much lower cumulative incidence compared to those who did not receive acupuncture.
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  • Gilles de la Tourette's Syndrome (TS) is a childhood disorder characterized by motor and vocal tics, and the study explored the effects of Yi-Gan-san (YGS), a traditional Chinese medicine, on TS symptoms in children and adolescents.
  • A double-blind, randomized, controlled trial with 38 patients assessed the impact of YGS compared to a placebo over 4 weeks, focusing on changes in tic severity using the Yale Global Tic Severity Scale (YGTSS).
  • Results indicated that after one week, YGS significantly reduced the intensity of phonic tics compared to the placebo, but longer-term effects were less clear, warranting further research on dosage, placebo selection, and extended observations.
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Gilles de la Tourette syndrome (TS) is a common, childhood-onset psychiatric disorder characterized by persistent motor and vocal tics. It is a heterogeneous disorder in which the phenotypic expression may be affected by environmental factors, such as immune responses. Furthermore, several studies have shown that genetic factors play a vital role in the etiology of TS, as well as its comorbidity with other disorders, including attention deficit hyperactivity disorder, obsessive-compulsive disorder, and autism spectrum disorder.

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Article Synopsis
  • * In this study, data from over 8,400 children with KD and more than 33,800 matched non-KD children were analyzed over a 12-year period to compare the incidence rates of cerebrovascular disease.
  • * Results indicated that children with KD faced a significantly higher risk of developing cerebrovascular disease—3.19 times more likely—particularly in those under 5 years old.
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Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed.

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Cytomegalovirus (CMV) is a ubiquitous virus, and CMV-associated diseases range from mild illness in immunologically normal hosts to life-threatening diseases in newborns and immunocompromised children. This study investigated the association between childhood CMV infection and subsequent epilepsy or neurodevelopmental disorders, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). A retrospective analysis was performed on data for 69 children with confirmed CMV infections (CMV infection group) and 292 patients with other infections (control group) between 1 January 2006 to 31 December 2012.

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In this study, we collected and analyzed polysomnography (PSG) data to investigate the value of PSG in diagnosing sleep problems in children. The results of PSG studies of children (<18 years old) with sleep problems conducted from April 2015 to May 2017 at a children's hospital in Taiwan were collected and analyzed retrospectively. Data for 310 patients (209 males and 101 females) who underwent PSG were collected.

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Rationale: Progressive encephalopathy with brain edema and/or leukoencephalopathy-1 is an infantile, lethal neurometabolic disorder caused by a NAD(P)HX epimerase (NAXE) gene mutation. It is characterized by a fluctuating disease course with repeated episodes of improvement and regression. In this report, we present a rare case of NAXE gene mutation-related encephalopathy with unexpected neurological recovery and long survival time.

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Dravet syndrome (DS) is an uncommon epilepsy syndrome that may negatively affect the patients and their caregivers. However, reliable and valid measures of its impact on caregivers and the characteristics of patients with DS in Taiwan are lacking. This study aimed to describe the characteristics of patients with DS and concerns of their caregivers and establish a baseline frequency of disease characteristics using a cross-sectional survey in Taiwan.

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Article Synopsis
  • * A study analyzed data from 426 children under 5 years old who experienced FS, dividing them into preterm and full-term groups to compare the incidence of epilepsy, ASD, and ADHD.
  • * Results showed that preterm children with FS had significantly higher odds of developing epilepsy (2.52 times), ADHD (6.41 times), and ASD (16.9 times) compared to full-term peers, suggesting preterm birth is a potential risk factor for these conditions.
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Ethnopharmacological Relevance: Muscular dystrophies are a rare, severe, and genetically inherited group of disorders characterized by progressive loss of muscle fibers, leading to muscle weakness. The current treatment plan for muscular dystrophies includes the use of steroids to slow muscle deterioration by dampening the inflammatory response.

Aim Of The Study: Chinese herbal medicine (CHM) has been offered as an adjunctive therapy in Taiwan's medical healthcare plan, making it possible to track CHM usage in patients with muscular dystrophic disease.

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  • The study examines severe cases of influenza in children, focusing on those with and without central nervous system (CNS) involvement, to understand differences in clinical features and outcomes.
  • Researchers analyzed data from 32 pediatric patients in Taiwan, dividing them into a non-CNS group and a CNS group, with a notable emphasis on complications and mortality rates.
  • The findings revealed a significantly higher mortality rate in the CNS group (37.5%) compared to the non-CNS group (6.25%), with specific risks identified for children with underlying health issues and those previously healthy developing CNS complications.
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Kawasaki disease is a common vasculitis of childhood in East Asia. The complications following Kawasaki disease mostly included cardiovascular sequelae; non-cardiac complications have been reported but less studied. This study investigated potential epilepsy following Kawasaki disease in Taiwanese children.

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Article Synopsis
  • Drug-resistant epilepsy (DRE) affects 7% to 20% of children with epilepsy, and while some risk factors have been noted, they are inconsistent, especially in children aged 0 to 2 years.
  • A study analyzed data from 96 patients, showing that children with genetic defects had a 6.5 times higher risk of developing DRE compared to those without genetic defects.
  • A meta-analysis of 1308 DRE patients indicated that 22.8% had genetic factors, highlighting the importance of genetic defects in the development of DRE and suggesting potential avenues for future research and treatment strategies.
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