Hideyo Kasai

Association between the G252A Tumor Necrosis Factor-β Gene Polymorphism and Medication-Overuse Headache.

Background and Purpose Migraine patients are particularly prone to the complication of medication-overuse headache (MOH). Although it has been shown that A allele carriers for the tumor necrosis factor (TNF)-β gene G252A polymorphism are at high risk of the development of migraine without aura, the relationship between the TNF-β gene G252A polymorphism and MOH is unknown. We investigated whether the TNF-β gene G252A polymorphism is involved in the aggravation of migraine by overuse of medications. Methods Forty-seven migraine patients (6 males and 41 females; age 36.4±10.3 years, mean±SD) and 22 MOH patients (1 male and 21 females; age 39.6±9.9 years) who had migraine were included in this study. The genotype for the TNF-β gene G252A polymorphism was determined by polymerase-chain-reaction restriction-fragment-length polymorphism analysis. Results The distribution of TNF-β gene G252A genotype frequency differed significantly between migraine and MOH patients (p=0.013). The G/G genotype was carried by 23% of the migraine patients but it was absent in MOH patients. Conclusions G/G genotype carriers appear to be less susceptible to the aggravation of migraine by overuse of medications. The G252A TNF-β gene polymorphism may be one of the factors contributing to the complications of MOH in patients with migraine.

False-positive Results Obtained for Immunoglobulin M Antibody Tests of Cerebrospinal Fluid for Herpes Simplex Virus in a Patient with Varicella Zoster Virus Encephalitis

A 66-year-old man presented with a disturbed consciousness and seizure-like movements, followed by the initial symptoms of herpes zoster. Immunoglobulin (Ig) M antibodies to varicella zoster virus (VZV) as well as herpes simplex virus (HSV) were positive in the cerebrospinal fluid (CSF), whereas polymerase chain reaction of the CSF was positive for VZV-DNA but negative for HSV-DNA. The serum/CSF IgM ratio for VZV and HSV increased in association with a clinical improvement. This is a case report of a rare case of VZV encephalitis demonstrating false-positive results for IgM to HSV in the CSF. The increase in the serum/CSF IgM ratio possibly reflects a recovery from blood-brain barrier breakdown.

Sharing breathlessness: Investigating respiratory change during observation of breath-holding in another

Studies of empathy show that seeing another person in pain, fear or disgust elicits the same brain activations associated with pain, fear or disgust in oneself. Our interest is to know whether respiratory change can be observed in empathy, that is, whether respiration can be altered when observing emotions in others. A discomfort associated with respiration can be breathlessness. We investigated respiratory pattern and metabolic response during observation of a breath-holding subject. We found that breathlessness occurred in participants who observed breath-holding in another person. It is interesting to note that observers felt more breathlessness after breath-holding ended with an increase in respiratory rate consistent with the breath-holders respiratory pattern. In addition, observers with high trait anxiety felt more breathlessness accompanied with an increase in respiratory rate. An increase in respiratory rate may be involved in the perception of breathlessness, in addition to the effect of observing breath-holding, indicating shared negative emotion.

Negative predictors of clinical response to amitriptyline in Japanese patients with migraine

Migraine is the most common neurological disease. Recently, there is a wide variety of prophylactic drugs, but their effects differ among individuals.

Effects of word order and morphological information on Japanese sentence comprehension in nonfluent/agrammatic variant of primary progressive aphasia

Abstract A clinical feature of the nonfluent/agrammatic variant of primary progressive aphasia (naPPA) is asyntactic comprehension. Previous studies have suggested that patients with asyntactic comprehension will probably rely on heuristics, such as considering the first noun as the agent. Japanese is a subject–object–verb language with a flexible word order and overt morphology; therefore, as subject-initial word order can be reordered by a transformation termed as scrambling, the flexible word order and rich morphology in Japanese may affect the sentence comprehension deficits in naPPA. This study aims to clarify the effects of word order and morphological information, such as case particle or verb inflection, on the comprehension of Japanese sentences in naPPA. Four patients with naPPA and 14 age-matched healthy controls were tested. Sentence comprehension was assessed using picture–sentence verification tasks with semantically reversible sentences. Four different sentence types were tested: subject-initial active (agent-first), scrambled active (theme-first), subject-initial passive (theme-first), and scrambled passive (agent-first). Compared with healthy controls, all patients demonstrated lower performance accuracy for the noncanonical sentences; however, there were no significant differences in performance accuracy for the canonical sentences. For the noncanonical sentences, all patients performed at significantly above chance levels for both the subject-initial and scrambled passive sentences but performed at chance levels for the scrambled active sentences. These results indicated that patients with naPPA would not only resort to the heuristics based on word order but will also intermittently use morphological information, and the heuristics would conflict with morphological information for the scrambled active sentences, which affects sentence comprehension deficits in naPPA.