Publications by authors named "Satoshi Kuwabara"

Background: The efficacy of deep brain stimulation (DBS) in treating tremor symptoms in cerebellar disorders remains unclear.

Case Presentation: A 47-year-old woman presented with neck and arm tremor and ataxic speech/gait after four days of >40 °C fever due to septic shock attributed to lithiasis-pyelonephritis. Left ventral intermediate nucleus thalamus DBS alleviated contralateral postural arm tremor, although the action tremor and terminal oscillation remained unchanged.

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Background: Spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph disease, is an autosomal dominant neurodegenerative disorder caused by CAG repeat expansion in exon 10 of ATXN3. Extra-cerebellar manifestations, including external ophthalmoplegia, dystonia, Parkinsonism, and peripheral neuropathy, are predominantly present in SCA3 cases. Here, we report a case of SCA3 presenting with a split hand and minipolymyoclonus.

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Background: The copy number status (CNS) of the survival motor neuron (SMN) gene may influence the risk and prognosis of amyotrophic lateral sclerosis (ALS) and lower motor neuron diseases (LMND) other than spinal muscular atrophy (SMA). However, previous studies of this association, mainly from Europe, have yielded controversial results, suggesting possible regional differences. Here, we investigated the effect of the SMN gene in Japanese patients with ALS and LMND.

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Introduction: Immunoadsorption plasmapheresis (IA) has been reported to have immunoregulatory effects, in addition to the removal of autoantibodies. This study aimed to investigate the effects of IA on the proportion of myeloid-derived suppressor cells (MDSCs) that potentially suppress autoimmune responses and regulate immunity.

Methods: The study included 21 patients with autoimmune neurological diseases and 8 healthy participants.

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Article Synopsis
  • The study aimed to differentiate and analyze the epidemiological characteristics of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) in Japan, as previous surveys had not distinctly categorized these two conditions.
  • A nationwide survey in 2017 gathered data from 3,799 medical departments, revealing that the estimated total of MS and NMOSD patients had increased significantly to 24,800, with notable improvements in patient care and treatment since the last survey in 2003.
  • Results showed that patients with MS reported milder disability and better treatment adherence, while NMOSD patients had less severe symptoms and shorter disease duration compared to earlier classifications, indicating positive trends in management and outcomes.
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Objective Dysphagia is a common and disabling symptom in patients with myasthenia gravis (MG). Moreover, it is caused by muscle weakness or fatigability in the pharynx, swallowing, and respiration discoordination. The current study aimed to establish a novel method for evaluating swallowing difficulty in patients with MG.

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  • The study investigates bladder dysfunction in patients with multiple system atrophy (MSA), focusing on the relationship between bladder contractility, post-void residuals (PVR), and voided percentage (VOID%).
  • Researchers analyzed data from 133 MSA patients to determine the best value of "k" (a variable in the contractility formula) that correlates with PVR and VOID%.
  • The findings suggest that a "k" value of over 5.0 is suitable for males, but a higher value (over 6.0) may lead to overestimation in females, indicating a need for improved formulas for female patients.
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Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disease of the peripheral nervous system that can lead to severe disability from muscle weakness and sensory disturbances. Around a third of patients do not respond to currently available treatments, and many patients with a partial response have residual neurological impairment, highlighting the need for effective alternatives. Efgartigimod alfa, a human IgG1 antibody Fc fragment, has demonstrated efficacy and safety in patients with generalised myasthenia gravis.

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  • * Research showed that serum CAF levels are significantly higher in patients with acetylcholine receptor antibody-positive myasthenia gravis (AChR-MG) compared to healthy individuals, but not in those with muscle-specific kinase antibody-positive myasthenia gravis.
  • * In AChR-MG patients, higher CAF levels were linked to better daily living activities post-treatment, suggesting that elevated CAF may be beneficial for NMJ regeneration and could indicate protective responses against the disease.
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Neuromyelitis optica (NMO) spectrum disorder (NMOSD) is a relapsing inflammatory disease of the CNS, characterized by the presence of serum aquaporin 4 (AQP4) autoantibodies (AQP4-IgGs) and core clinical manifestations such as optic neuritis, myelitis, and brain or brainstem syndromes. Some people exhibit clinical characteristics of NMOSD but test negative for AQP4-IgG, and a subset of these individuals are now recognized to have serum autoantibodies against myelin oligodendrocyte glycoprotein (MOG) - a condition termed MOG antibody-associated disease (MOGAD). Therefore, the concept of NMOSD is changing, with a disease spectrum emerging that includes AQP4-IgG-seropositive NMOSD, MOGAD and double-seronegative NMOSD.

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Objective: Although psychological distress is a prevalent issue among patients with amyotrophic lateral sclerosis (ALS) and can impact survival, the risk factors contributing to this distress remain insufficiently understood.

Methods: Patients with ALS who completed the Profile of Mood States (POMS) between June 2017 and March 2022 were included. Participants with moderate to severe cognitive decline were excluded, resulting in the recruitment of 121 patients.

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Introduction/aims: Multifocal motor neuropathy (MMN) is a rare disease for which epidemiological and clinical data are limited. We conducted a nationwide survey to determine disease prevalence, incidence, clinical profile, and current treatment status in Japan.

Methods: A nationwide survey was conducted in 2021 using an established epidemiological method.

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  • CHCHD2 and CHCHD10 are mitochondrial proteins associated with diseases like Parkinson's and ALS, with this study focusing on the CHCHD2 P14L variant linked to ALS.
  • The P14L variant mislocalizes CHCHD2 to the cytoplasm, impairing mitochondrial function and leading to degeneration, unlike its wild-type counterpart.
  • Additionally, this variant disrupts calcium buffering in neurons, triggering abnormal calcium dynamics and TDP-43 aggregation, which are indicators of ALS pathology.
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Objective The efficacy of maintenance intravenous immunoglobulin (IVIg) therapy has been established to prevent relapse in chronic inflammatory demyelinating polyneuropathy (CIDP). This prospective post-marketing surveillance study evaluated the treatment duration, efficacy, and safety of maintenance IVIg therapy in Japanese patients with CIDP. Methods Patients were registered between June 2017 and December 2018.

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Background And Aims: Guillain-Barré syndrome (GBS) is an acute, self-limited, immune-mediated peripheral neuropathy. Current treatments for GBS include intravenous immunoglobulin (IVIg) and plasma exchange, which may not sufficiently benefit severely affected patients. This study evaluated the efficacy and safety of eculizumab add-on therapy to IVIg (standard-of-care treatment) in patients with severe GBS.

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  • Patients with neuroimmunological disorders often require glucocorticoids, which can lead to osteoporosis, but little research has been done on managing this complication in these patients.
  • A study compared the effectiveness of two treatments, denosumab and bisphosphonates, on bone mineral density (BMD) in 57 such patients receiving corticosteroids.
  • Results showed that denosumab significantly increased lumbar spine and hip BMD compared to bisphosphonates over a follow-up period of up to 6 years, making it the more effective option for these patients.
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Background And Purpose: Various electrodiagnostic criteria have been developed in Guillain-Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria.

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  • Decreased cough strength in myasthenia gravis (MG) increases the risk of aspiration and crisis, prompting this study on cough peak flow (CPF) measurements in MG patients.
  • The study included 26 MG patients who independently measured their CPF, and the results were compared with pulmonary function tests and MG assessments before and after treatment.
  • The findings revealed a high reliability for CPF measurements, with a cut-off value of 205 L/min for aspiration risk, showing good sensitivity and specificity as a useful biomarker for assessing MG symptoms.
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Background: Dementia with Lewy bodies (DLB) presents with various symptoms, posing challenges for early diagnosis challenging. Dopamine transporter (123I-FP-CIT) single-photon emission tomography (SPECT) and 123I-meta-iodobenzylguanidine (123I-MIBG) imaging are crucial diagnostic biomarkers. Hypothesis about body- and brain-first subtypes of DLB indicate that some DLB may show normal 123I-FP-CIT or 123I-MIBG results; but the characteristic expression of these two subtypes remains unclear.

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Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare neuroinflammatory disorder characterized by acute episodes of central nervous system (CNS) demyelination. Previous studies have reported elevated interleukin (IL)-6 in cerebrospinal fluid (CSF) of MOGAD patients.

Objective: We examined if CSF IL-6 level increase is associated with clinical parameters in MOGAD.

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Purpose: Clinical features of Wernicke's encephalopathy (WE) confirmed strictly through the low blood vitamin B1 (VB1) levels are limited. This study aimed to analyse magnetic resonance imaging (MRI) findings, and clinical characteristics, in patients with WE who have confirmed low blood VB1 levels.

Methods: Clinical and laboratory records of 12 consecutive patients with WE admitted to our hospital during the past 11 years were reviewed.

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common chronic immune-mediated demyelinating neuropathy and includes several clinical subtypes. The major phenotype is "typical CIDP," which is characterized by symmetric polyneuropathy and "proximal and distal" muscle weakness. In typical CIDP, the nerve roots and distal nerve terminals, where the blood-nerve barrier is anatomically deficient, are preferentially affected, and therefore antibody-mediated immune pathogenesis is likely to have a major role.

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Article Synopsis
  • Multiple system atrophy (MSA) is a challenging, incurable neurodegenerative disease, causing neurologists significant difficulty in delivering diagnoses due to its life-threatening implications, especially the risk of sudden death.
  • A study involving 194 neurologists in Japan found that 92.3% found it difficult to explain MSA diagnoses, while 82.8% struggled with discussing sudden death risks.
  • Factors contributing to these challenges include the emotional burden on neurologists, complexity of conveying crucial information, the family’s role in treatment decisions, and the inherent difficulties in diagnosing MSA.
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