研究者業績

桑原 聡

クワバラ サトシ  (Satoshi Kuwabara)

基本情報

所属
千葉大学 大学院医学研究院脳神経内科学 教授 (教授)
学位
医学博士(1993年3月 千葉大学)

J-GLOBAL ID
200901033727459280
researchmap会員ID
1000200574

論文

 938
  • Yukiko Ozawa, Akiyuki Uzawa, Yosuke Onishi, Manato Yasuda, Yuta Kojima, Satoshi Kuwabara
    Muscle & nerve 68(5) 798-804 2023年11月  
    INTRODUCTION/AIMS: Myasthenia gravis (MG) is an autoimmune disease affecting the neuromuscular junction (NMJ) of skeletal muscle. Complement activation is one of the mechanisms by which anti-acetylcholine receptor (anti-AChR) autoantibodies reduce synaptic transmission at the NMJ. In this study, we aimed to examine the activation of the complement pathways, including the classical pathway, as potential contributors to the pathogenesis of MG with anti-AChR antibodies. METHODS: In this single-center, observational study of 45 patients with anti-AChR-antibody-positive generalized MG, serum concentrations of major components of the complement pathways, including C1q, C5, C5a, soluble C5b-9 (sC5b-9), Ba, and complement factor H, were measured using an enzyme-linked immunosorbent assay. A total of 25 patients with a non-inflammatory neurological disorder served as controls. In addition, the relationships of complement activation with clinical characteristics were examined. RESULTS: The patients with MG exhibited lower serum levels of C5 (p = .0001) and higher serum levels of sC5b-9 (p = .004) compared with the control group. At about 6 months (range, 172-209 days) after the start of immunotherapy, serum levels of Ba were significantly higher than baseline levels (p = .002) and were associated with improvement in MG clinical scores. DISCUSSION: Herein, we provide evidence for the activation of the classical complement pathway and its association with disease activity in anti-AChR-antibody-positive generalized MG.
  • Naoko Matsui, Keiko Tanaka, Mitsuyo Ishida, Yohei Yamamoto, Yuri Matsubara, Reiko Saika, Takahiro Iizuka, Koshi Nakamura, Nagato Kuriyama, Makoto Matsui, Kokichi Arisawa, Yosikazu Nakamura, Ryuji Kaji, Satoshi Kuwabara, Yuishin Izumi
    Neurology(R) neuroimmunology & neuroinflammation 10(6) 2023年11月  
    BACKGROUND AND OBJECTIVES: To elucidate current epidemiologic, clinical, and immunologic profiles and treatments of stiff-person syndrome (SPS) in Japan. METHODS: A nationwide mail survey was conducted using an established method. Data processing sheets were sent to randomly selected departments of internal medicine, neurology, pediatrics, psychiatry, and neurosurgery in hospitals and clinics throughout Japan to identify patients with SPS who were seen between January 2015 and December 2017. RESULTS: Thirty cases were identified as glutamic acid decarboxylase 65 (GAD65)-positive SPS cases on the basis of detailed clinical data of 55 cases. Four patients had α1 subunit of glycine receptor (GlyR) antibodies, and 1 patient had both GAD65 and GlyR antibodies. The total estimated number of patients with GAD65-positive SPS was 140, and the estimated prevalence was 0.11 per 100,000 population. The median age at onset was 51 years (range, 26-83 years), and 23 (76%) were female. Of these, 70% had classic SPS, and 30% had stiff-limb syndrome. The median time from symptom onset to diagnosis was significantly longer in the high-titer GAD65 antibody group than in the low-titer group (13 months vs 2.5 months, p = 0.01). The median modified Rankin Scale (mRS) at baseline was 4, and the median mRS at the last follow-up was 2. Among the 29 GAD65-positive patients with ≥1 year follow-up, 7 received only symptomatic treatment, 9 underwent immunotherapy without long-term immunotherapy, and 13 received long-term immunotherapy such as oral prednisolone. The coexistence of type 1 diabetes mellitus and the lack of long-term immunotherapy were independent risk factors for poor outcome (mRS ≥3) in the GAD65-positive patients (odds ratio, 15.0; 95% CI 2.6-131.6; p = 0.001; odds ratio, 19.8; 95% CI 3.2-191.5; p = 0.001, respectively). DISCUSSION: This study provides the current epidemiologic and clinical status of SPS in Japan. The symptom onset to the diagnosis of SPS was longer in patients with high-titer GAD65 antibodies than in those with low-titer GAD65 antibodies. The outcome of patients with SPS was generally favorable, but more aggressive immunotherapies are necessary for GAD65-positive patients with SPS.
  • 大櫛 萌子, 荒木 信之, 鋸屋 悦子, 青墳 佑弥, 植田 光晴, 小池 春樹, 桑原 聡
    神経治療学 40(6) S249-S249 2023年10月  
  • 赤嶺 博行, 鵜沢 顕之, 桑原 聡, 大西 庸介, 安田 真人, 小澤 由希子, 川口 直樹, 久保田 智哉, 高橋 正紀, 鈴木 重明, 増田 眞之, 紺野 晋吾, 南 尚哉, 木村 卓, 村井 弘之, 渡辺 源也, 鈴木 靖士, 長根 百合子, 槍沢 公明
    神経治療学 40(6) S281-S281 2023年10月  
  • 安田 真人, 鵜沢 顕之, 大西 庸介, 赤嶺 博行, 鋸屋 悦子, 半田 秀雄, 小澤 由希子, 桑原 聡
    神経治療学 40(6) S282-S282 2023年10月  
  • Manato Yasuda, Akiyuki Uzawa, Yukiko Ozawa, Yuta Kojima, Yosuke Onishi, Hiroyuki Akamine, Satoshi Kuwabara
    Journal of neuroimmunology 384 578205-578205 2023年9月20日  
    This study measured the serum levels of of 15 cytokines in 15 patients with anti-muscle-specific kinase antibody-positive MG (MuSK-MG) using a multiplex suspension array system. Fifteen patients with non-inflammatory neurological diseases served as controls. Compared with controls, patients with MuSK-MG showed higher levels of Th1- (IFN-γ), Th2- (IL-25, IL-31, and IL-33), Th17- (IL-22), Treg-related cytokines (IL-10), and soluble CD40 ligand (sCD40L). Higher serum Th2-related cytokines (IL-25 and IL-31) levels were correlated with less MG Foundation of America (MGFA) class. These suggest that Th2-related cytokines have protective effects, whereas sCD40L and others may facilitate the disease.
  • Masahide Suzuki, Shigeki Hirano, Karen Otte, Tanja Schmitz-Hübsch, Michiko Izumi, Mitsuyoshi Tamura, Ryota Kuroiwa, Atsuhiko Sugiyama, Masahiro Mori, Hanna M Röhling, Alexander U Brandt, Atsushi Murata, Friedemann Paul, Satoshi Kuwabara
    Cerebellum (London, England) 2023年9月18日  
    This study aimed to identify quantitative biomarkers of motor function for cerebellar ataxia by evaluating gait and postural control using an RGB-depth camera-based motion analysis system. In 28 patients with degenerative cerebellar ataxia and 33 age- and sex-matched healthy controls, motor tasks (short-distance walk, closed feet stance, and stepping in place) were selected from a previously reported protocol, and scanned using Kinect V2 and customized software. The Clinical Assessment Scale for the Assessment and Rating of Ataxia (SARA) was also evaluated. Compared with the normal control group, the cerebellar ataxia group had slower gait speed and shorter step lengths, increased step width, and mediolateral trunk sway in the walk test (all P < 0.001). Lateral sway increased in the stance test in the ataxia group (P < 0.001). When stepping in place, the ataxia group showed higher arrhythmicity of stepping and increased stance time (P < 0.001). In the correlation analyses, the ataxia group showed a positive correlation between the total SARA score and arrhythmicity of stepping in place (r = 0.587, P = 0.001). SARA total score (r = 0.561, P = 0.002) and gait subscore (ρ = 0.556, P = 0.002) correlated with mediolateral truncal sway during walking. These results suggest that the RGB-depth camera-based motion analyses on mediolateral truncal sway during walking and arrhythmicity of stepping in place are useful digital motor biomarkers for the assessment of cerebellar ataxia, and could be utilized in future clinical trials.
  • 北山 仁久, 平野 成樹, 仲野 義和, 和泉 未知子, 小泉 湧芽, 青木 玲二, 石川 愛, 柏戸 孝一, 吉山 容正, 森 雅裕, 桑原 聡
    臨床神経学 63(Suppl.) S203-S203 2023年9月  
  • 和泉 未知子, 平野 成樹, 杉山 淳比古, 仲野 義和, 焼山 正嗣, 北山 仁久, 小泉 湧芽, 飯森 隆志, 堀越 琢郎, 桑原 聡
    臨床神経学 63(Suppl.) S234-S234 2023年9月  
  • 樋口 拓哉, 山中 義崇, 桑原 聡
    臨床神経学 63(Suppl.) S375-S375 2023年9月  
  • 半田 秀雄, 鵜沢 顕之, 杉山 淳比古, 安田 真人, 横田 元, 桑原 聡
    神経免疫学 28(1) 203-203 2023年9月  
  • 安田 真人, 鵜沢 顕之, 半田 秀雄, 大西 庸介, 赤嶺 博行, 鋸屋 悦子, 小澤 由希子, 桑原 聡
    神経免疫学 28(1) 233-233 2023年9月  
  • Hiroki Masuda, Masahiro Mori, Shigeki Hirano, Akiyuki Uzawa, Tomohiko Uchida, Mayumi Muto, Ryohei Ohtani, Reiji Aoki, Yoshiyuki Hirano, Takeshi Iwatsubo, Takashi Asada, Hiroyuki Arai, Morihiro Sugishita, Hiroshi Matsuda, Kengo Ito, Michio Senda, Kenji Ishii, Ryozo Kuwano, Takeshi Ikeuchi, Noriko Sato, Hajime Sato, Shun Shimohama, Masaki Saitoh, Rika Yamauchi, Takashi Hayashi, Seiju Kobayashi, Norihito Nakano, Junichiro Kanazawa, Takeshi Ando, Chiyoko Takanami, Masato Hareyama, Masamitsu Hatakenaka, Eriko Tsukamoto, Shinji Ochi, Mikio Shoji, Etsuro Matsubara, Takeshi Kawarabayashi, Yasuhito Wakasaya, Takashi Nakata, Naoko Nakahata, Shuichi Ono, Yoshihiro Takai, Satoshi Takahashi, Hisashi Yonezawa, Junko Takahashi, Masako Kudoh, Makoto Sasaki, Yutaka Matsumura, Yohsuke Hirata, Tsuyoshi Metoki, Susumu Hayakawa, Yuichi Sato, Masayuki Takeda, Toshiaki Sasaki, Koichiro Sera, Kazunori Terasaki, Yoshihiro Saitoh, Shoko Goto, Kuniko Ueno, Hiromi Sakashita, Kuniko Watanabe, Ken Nagata, Yuichi Sato, Tetsuya Maeda, Yasushi Kondoh, Takashi Yamazaki, Daiki Takano, Mio Miyata, Hiromi Komatsu, Mayumi Watanabe, Tomomi Sinoda, Rena Muraoka, Kayoko Kikuchi, Hitomi Ito, Aki Sato, Toshibumi Kinoshita, Hideyo Toyoshima, Kaoru Sato, Shigeki Sugawara, Isao Ito, Fumiko Kumagai, Katsutoshi Furukawa, Masaaki Waragai, Naoki Tomita, Nobuyuki Okamura, Mari Ootsuki, Katsumi Sugawara, Satomi Sugawara, Shunji Mugikura, Atsushi Umetsu, Takanori Murata, Tatsuo Nagasaka, Yukitsuka Kudo, Manabu Tashiro, Shoichi Watanuki, Masatoyo Nishizawa, Takayoshi Tokutake, Saeri Ishikawa, Emiko Kishida, Nozomi Sato, Mieko Hagiwara, Kumi Yamanaka, Takeyuki Watanabe, Taeko Takasugi, Shoichi Inagawa, Kenichi Naito, Masanori Awaji, Tsutomu Kanazawa, Kouiti Okamoto, Masaki Ikeda, Tsuneo Yamazaki, Yuiti Tasiro, Syunn Nagamine, Shiori Katsuyama, Sathiko Kurose, Sayuri Fukushima, Etsuko Koya, Makoto Amanuma, Noboru Oriuti, Kouiti Ujita, Kazuhiro Kishi, Kazuhisa Tuda, Katsuyoshi Mizukami, Tetsuaki Arai, Etsuko Nakajima, Katsumi Miyamoto, Kousaku Saotome, Tomoya Kobayashi, Saori Itoya, Jun Ookubo, Toshiya Akatsu, Yoshiko Anzai, Junya Ikegaki, Yuuichi Katou, Kaori Kimura, Ryou Kuchii, Hajime Saitou, Kazuya Shinoda, Satoka Someya, Hiroko Taguchi, Kazuya Tashiro, Masaya Tanaka, Tatsuya Nemoto, Ryou Wakabayashi, Daisuke Watanabe, Harumasa Takano, Tetsuya Suhara, Hitoshi Shinoto, Hitoshi Shimada, Makoto Higuchi, Takaaki Mori, Hiroshi Ito, Takayuki Obata, Yoshiko Fukushima, Kazuko Suzuki, Izumi Izumida, Katsuyuki Tanimoto, Takahiro Shiraishi, Junko Shiba, Hiroaki Yano, Miki Satake, Aimi Nakui, Yae Ebihara, Tomomi Hasegawa, Yasumasa Yoshiyama, Mami Kato, Yuki Ogata, Hiroyuki Fujikawa, Nobuo Araki, Yoshihiko Nakazato, Takahiro Sasaki, Tomokazu Shimadu, Kimiko Yoshimaru, Hiroshi Matsuda, Etsuko Imabayashi, Asako Yasuda, Etuko Yamamoto, Natsumi Nakamata, Noriko Miyauchi, Keiko Ozawa, Rieko Hashimoto, Taishi Unezawa, Takafumi Ichikawa, Hiroki Hayashi, Masakazu Yamagishi, Tunemichi Mihara, Masaya Hirano, Shinichi Watanabe, Junichiro Fukuhara, Hajime Matsudo, Nobuyuki Saito, Atsushi Iwata, Hisatomo Kowa, Toshihiro Hayashi, Ryoko Ihara, Toji Miyagawa, Mizuho Yoshida, Yuri Koide, Eriko Samura, Kurumi Fujii, Kaori Watanabe, Nagae Orihara, Toshimitsu Momose, Akira Kunimatsu, Harushi Mori, Miwako Takahashi, Takuya Arai, Yoshiki Kojima, Masami Goto, Takeo Sarashina, Syuichi Uzuki, Seiji Katou, Yoshiharu Sekine, Yukihiro Takauchi, Chiine Kagami, Kazutomi Kanemaru, Shigeo Murayama, Yasushi Nishina, Maria Sakaibara, Yumiko Okazaki, Rieko Okada, Maki Obata, Yuko Iwata, Mizuho Minami, Yasuko Hanabusa, Hanae Shingyouji, Kyoko Tottori, Aya Tokumaru, Makoto Ichinose, Kazuya Kume, Syunsuke Kahashi, Kunimasa Arima, Tadashi Tukamoto, Shin Tanaka, Yuko Nagahusa, Masuhiro Sakata, Mitsutoshi Okazaki, Yuko Saito, Maki Yamada, Tiine Kodama, Maki Obata, Tomoko Takeuchi, Keiichiro Ozawa, Yuko Iwata, Hanae Shingyouji, Yasuko Hanabusa, Yoshiko Kawaji, Kyouko Tottori, Noriko Sato, Yasuhiro Nakata, Satoshi Sawada, Makoto Mimatsu, Daisuke Nakkamura, Takeshi Tamaru, Shunichirou Horiuchi, Heii Arai, Tsuneyoshi Ota, Aiko Kodaka, Yuko Tagata, Tomoko Nakada, Eizo Iseki, Kiyoshi Sato, Hiroshige Fujishiro, Norio Murayama, Masaru Suzuki, Satoshi Kimura, Masanobu Takahashi, Haruo Hanyu, Hirofumi Sakurai, Takahiko Umahara, Hidekazu Kanetaka, Kaori Arashino, Mikako Murakami, Ai Kito, Seiko Miyagi, Kaori Doi, Kazuyoshi Sasaki, Mineo Yamazaki, Akiko Ishiwata, Yasushi Arai, Akane Nogami, Sumiko Fukuda, Kyouko Tottori, Mizuho Minami, Yuko Iwata, Koichi Kozaki, Yukiko Yamada, Sayaka Kimura, Ayako Machida, Kuninori Kobayashi, Hidehiro Mizusawa, Nobuo Sanjo, Mutsufusa Watanabe, Takuya Ohkubo, Hiromi Utashiro, Yukiko Matsumoto, Kumiko Hagiya, Yoshiko Miyama, Takako Shinozaki, Haruko Hiraki, Hitoshi Shibuya, Isamu Ohashi, Akira Toriihara, Shinichi Ohtani, Toshifumi Matsui, Yu Hayasaka, Tomomi Toyama, Hideki Sakurai, Kumiko Sugiura, Hirofumi Taguchi, Shizuo Hatashita, Akari Imuta, Akiko Matsudo, Daichi Wakebe, Hideki Hayakawa, Mitsuhiro Ono, Takayoshi Ohara, Yukihiko Washimi, Yutaka Arahata, Akinori Takeda, Yoko Konagaya, Akiko Yamaoka, Masashi Tsujimoto, Hideyuki Hattori, Takashi Sakurai, Miura Hisayuki, Hidetoshi Endou, Syousuke Satake, Young Jae Hong, Katsunari Iwai, Kenji Yoshiyama, Masaki Suenaga, Sumiko Morita, Teruhiko Kachi, Kenji Toba, Rina Miura, Takiko Kawai, Ai Honda, Takashi Kato, Ken Fujiwara, Rikio Katou, Mariko Koyama, Naohiko Fukaya, Akira Tsuji, Hitomi Shimizu, Hiroyuki Fujisawa, Tomoko Nakazawa, Satoshi Koyama, Takanori Sakata, Masahito Yamada, Mitsuhiro Yoshita, Miharu Samuraki, Kenjiro Ono, Moeko Shinohara, Yuki Soshi, Kozue Niwa, Chiaki Doumoto, Mariko Hata, Miyuki Matsushita, Mai Tsukiyama, Nozomi Takeda, Sachiko Yonezawa, Ichiro Matsunari, Osamu Matsui, Fumiaki Ueda, Yasuji Ryu, Masanobu Sakamoto, Yasuomi Ouchi, Madoka Chita, Yumiko Fujita, Rika Majima, Hiromi Tsubota, Umeo Shirasawa, Masashi Sugimori, Wataru Ariya, Yuuzou Hagiwara, Yasuo Tanizaki, Hidenao Fukuyama, Ryosuke Takahashi, Hajime Takechi, Chihiro Namiki, Kengo Uemura, Takeshi Kihara, Hiroshi Yamauchi, Shizuko Tanaka-Urayama, Emiko Maeda, Natsu Saito, Shiho Satomi, Konomi Kabata, Shin-Ichi Urayama, Tomohisa Okada, Koichi Ishizu, Shigeto Kawase, Satoshi Fukumoto, Masanori Nakagawa, Takahiko Tokuda, Masaki Kondo, Fumitoshi Niwa, Toshiki Mizuno, Yoko Oishi, Mariko Yamazaki, Daisuke Yamaguchi, Kyoko Ito, Yoku Asano, Chizuru Hamaguchi, Kei Yamada, Chio Okuyama, Kentaro Akazawa, Shigenori Matsushima, Takamasa Matsuo, Toshiaki Nakagawa, Takeshi Nii, Takuji Nishida, Kuniaki Kiuchi, Masami Fukusumi, Hideyuki Watanabe, Toshiaki Taoka, Akihiro Nogi, Masatoshi Takeda, Toshihisa Tanaka, Naoyuki Sato, Hiroaki Kazui, Kenji Yoshiyama, Takashi Kudo, Masayasu Okochi, Takashi Morihara, Shinji Tagami, Noriyuki Hayashi, Masahiko Takaya, Tamiki Wada, Mikiko Yokokoji, Hiromichi Sugiyama, Daisuke Yamamoto, Shuko Takeda, Keiko Nomura, Mutsumi Tomioka, Eiichi Uchida, Yoshiyuki Ikeda, Mineto Murakami, Takami Miki, Hiroyuki Shimada, Suzuka Ataka, Motokatsu Kanemoto, Jun Takeuchi, Akitoshi Takeda, Rie Azuma, Yuki Iwamoto, Naomi Tagawa, Junko Masao, Yuka Matsumoto, Yuko Kikukawa, Hisako Fujii, Junko Matsumura, Susumu Shiomi, Joji Kawabe, Yoshihiro Shimonishi, Yukio Miki, Mitsuji Higashida, Tomohiro Sahara, Takashi Yamanaga, Shinichi Sakamoto, Hiroyuki Tsushima, Kiyoshi Maeda, Yasuji Yamamoto, Toshio Kawamata, Kazuo Sakai, Haruhiko Oda, Takashi Sakurai, Taichi Akisaki, Mizuho Adachi, Masako Kuranaga, Sachi Takegawa, Yoshihiko Tahara, Seishi Terada, Takeshi Ishihara, Hajime Honda, Osamu Yokota, Yuki Kishimoto, Naoya Takeda, Nao Imai, Mayumi Yabe, Kentaro Ida, Daigo Anami, Seiji Inoue, Toshi Matsushita, Reiko Wada, Shinsuke Hiramatsu, Hiromi Tonbara, Reiko Yamamoto, Kenji Nakashima, Kenji Wada-Isoe, Saori Yamasaki, Eijiro Yamashita, Yu Nakamura, Ichiro Ishikawa, Sonoko Danjo, Tomomi Shinohara, Miyuki Ueno, Yuka Kashimoto, Yoshihiro Nishiyama, Yuka Yamamoto, Narihide Kimura, Kazuo Ogawa, Yasuhiro Sasakawa, Takashi Ishimori, Yukito Maeda, Tatsuo Yamada, Shinji Ouma, Aika Fukuhara-Kaneumi, Nami Sakamoto, Rie Nagao, Kengo Yoshimitsu, Yasuo Kuwabara, Ryuji Nakamuta, Minoru Tanaka, Manabu Ikeda, Mamoru Hashimoto, Keiichirou Kaneda, Yuusuke Yatabe, Kazuki Honda, Naoko Ichimi, Fumi Akatuka, Mariko Morinaga, Miyako Noda, Mika Kitajima, Toshinori Hirai, Shinya Shiraishi, Naoji Amano, Shinsuke Washizuka, Toru Takahashi, Shin Inuzuka, Tetsuya Hagiwara, Nobuhiro Sugiyama, Yatsuka Okada, Tomomi Ogihara, Takehiko Yasaki, Minori Kitayama, Tomonori Owa, Akiko Ryokawa, Rie Takeuchi, Satoe Goto, Keiko Yamauchi, Mie Ito, Tomoki Kaneko, Hitoshi Ueda, Shuichi Ikeda, Masaki Takao, Ban Mihara, Hirofumi Kubo, Akiko Takano, Gou Yasui, Masami Akuzawa, Kaori Yamaguchi, Toshinari Odawara, Megumi Shimamura, Mikiko Sugiyama, Atsushi Watanabe, Naomi Oota, Shigeo Takebayashi, Yoshigazu Hayakawa, Mitsuhiro Idegawa, Noriko Toya, Kazunari Ishii, Satoshi Kuwabara
    Scientific Reports 13(1) 2023年8月3日  
    Abstract We aimed to compare longitudinal brain atrophy in patients with neuromyelitis optica spectrum disorder (NMOSD) with healthy controls (HCs). The atrophy rate in patients with anti-aquaporin-4 antibody-positive NMOSD (AQP4 + NMOSD) was compared with age-sex-matched HCs recruited from the Japanese Alzheimer’s Disease Neuroimaging Initiative study and another study performed at Chiba University. Twenty-nine patients with AQP4 + NMOSD and 29 HCs were enrolled in the study. The time between magnetic resonance imaging (MRI) scans was longer in the AQP4 + NMOSD group compared with the HCs (median; 3.2 vs. 2.9 years, P = 0.009). The annualized normalized white matter volume (NWV) atrophy rate was higher in the AQP4 + NMOSD group compared with the HCs (median; 0.37 vs. − 0.14, P = 0.018). The maximum spinal cord lesion length negatively correlated with NWV at baseline MRI in patients with AQP4 + NMOSD (Spearman’s rho =  − 0.41, P = 0.027). The annualized NWV atrophy rate negatively correlated with the time between initiation of persistent prednisolone usage and baseline MRI in patients with AQP4 + NMOSD (Spearman’s rho =  − 0.43, P = 0.019). Patients with AQP4 + NMOSD had a greater annualized NWV atrophy rate than HCs. Suppressing disease activity may prevent brain atrophy in patients with AQP4 + NMOSD.
  • Yuki Nakagawa, Atsuhiko Sugiyama, Shigeki Hirano, Takayuki Ishige, Satoshi Kuwabara
    Journal of the Neurological Sciences 451 120717-120717 2023年8月  
  • Eiko Murakami, Akiyuki Uzawa, Yoshihito Ozawa, Manato Yasuda, Yosuke Onishi, Yukiko Ozawa, Hiroyuki Akamine, Mariko Kawamoto, Yuki Shiko, Yohei Kawasaki, Satoshi Kuwabara
    Journal of neuroimmunology 382 578165-578165 2023年7月28日  
    The purpose of this study was to evaluate the safety and efficacy of BL 23 (Shenshu) acupuncture on serum cytokine levels. Sixteen healthy adults were randomized into the BL 23 acupuncture group or pseudo-acupuncture group and changes of serum cytokines were analyzed. The changes in IL-13, TNF-α, and GM-CSF levels were different between the BL 23 acupuncture group and pseudo-acupuncture group (P < 0.05). No adverse events associated with acupuncture were observed. In conclusion, BL 23 acupuncture can suppress immune responses via decreases in TNF-α and suppression of increases in IL-13 and GM-CSF. This study elucidated some of the mechanisms of the acupuncture effect.
  • Hirotaka Yokouchi, Daisuke Nagasato, Yoshinori Mitamura, Mariko Egawa, Hitoshi Tabuchi, Sonoko Misawa, Satoshi Kuwabara, Takayuki Baba
    Scientific reports 13(1) 10650-10650 2023年6月30日  
    A higher serum vascular endothelial growth factor (VEGF) level can cause choroidal thickening in the choroid of patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. We aimed to determine whether fluctuations in serum VEGF levels affect choroidal vascular structures in patients with POEMS syndrome. This retrospective observational case series examined 17 left eyes of 17 patients with POEMS syndrome. Enhanced depth imaging optical coherence tomography (EDI-OCT) images were obtained, and serum VEGF levels were measured at baseline and 6 months after transplantation with dexamethasone (n = 6), thalidomide (n = 8), or lenalidomide (n = 3). EDI-OCT images were binarized using ImageJ software, and we calculated the areas of the whole choroid and the luminal and stromal areas. Subsequently, we determined whether the choroidal vascular structure had changed significantly between baseline and 6 months after treatment. Six months after treatment, serum VEGF levels and the whole choroid, luminal, and stromal areas had decreased significantly compared to the baseline values (all, P < 0.001). The mean luminal area to the whole choroidal area ratio at 6 months after treatment was 0.70 ± 0.03, which was significantly smaller than the ratio at baseline (0.72 ± 0.03; P < 0.001). Whole choroid and luminal area fluctuations were significantly positively correlated with fluctuations in serum VEGF levels (r = 0.626, P = 0.007 and r = 0.585, P = 0.014, respectively). Choroidal thickening induced by VEGF might be caused by increases in the choroidal vessel lumen area. These results may offer insights into the pathogenesis of POEMS syndrome and the role of serum VEGF in choroidal vascular structure, which may apply to other ocular diseases.
  • Jun Hashiba, Hajime Yokota, Kota Abe, Yukari Sekiguchi, Shinobu Ikeda, Atsuhiko Sugiyama, Satoshi Kuwabara, Takashi Uno
    Acta Radiologica 2023年6月27日  
    Background Demyelinating peripheral neuropathy is characteristic of both polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP). We hypothesized that the different pathogeneses underlying these entities would affect the sonographic imaging features. Purpose To investigate whether ultrasound (US)-based radiomic analysis could extract features to describe the differences between CIDP and POEMS syndrome. Material and Methods In this retrospective study, we evaluated nerve US images from 26 with typical CIDP and 34 patients with POEMS syndrome. Cross-sectional area (CSA) and echogenicity of the median and ulnar nerves were evaluated in each US image of the wrist, forearm, elbow, and mid-arm. Radiomic analysis was performed on these US images. All radiomic features were examined using receiver operating characteristic analysis. Optimal features were selected using a three-step feature selection method and were inputted into XGBoost to build predictive machine-learning models. Results The CSAs were more enlarged in patients with CIDP than in those with POEMS syndrome without significant differences, except for that of the ulnar nerve at the wrist. Nerve echogenicity was significantly more heterogeneous in patients with CIDP than in those with POEMS syndrome. The radiomic analysis yielded four features with the highest area under the curve (AUC) value of 0.83. The machine-learning model showed an AUC of 0.90. Conclusion US-based radiomic analysis has high AUC values in differentiating POEM syndrome from CIDP. Machine-learning algorithms further improved the discriminative ability.
  • Matei Bolborea, Pauline Vercruysse, Tselmen Daria, Johanna C Reiners, Najwa Ouali Alami, Simon J Guillot, Stéphane Dieterlé, Jérôme Sinniger, Jelena Scekic-Zahirovic, Amela Londo, Hippolyte Arcay, Marc-Antoine Goy, Claudia Nelson de Tapia, Dietmar R Thal, Kazumoto Shibuya, Ryo Otani, Kimihito Arai, Satoshi Kuwabara, Albert C Ludolph, Francesco Roselli, Deniz Yilmazer-Hanke, Luc Dupuis
    Acta neuropathologica 145(6) 773-791 2023年6月  
    Amyotrophic lateral sclerosis (ALS) is associated with impaired energy metabolism, including weight loss and decreased appetite which are negatively correlated with survival. Neural mechanisms underlying metabolic impairment in ALS remain unknown. ALS patients and presymptomatic gene carriers have early hypothalamic atrophy. The lateral hypothalamic area (LHA) controls metabolic homeostasis through the secretion of neuropeptides such as orexin/hypocretin and melanin-concentrating hormone (MCH). Here, we show loss of MCH-positive neurons in three mouse models of ALS based on SOD1 or FUS mutations. Supplementation with MCH (1.2 µg/d) through continuous intracerebroventricular delivery led to weight gain in male mutant Sod1G86R mice. MCH supplementation increased food intake, rescued expression of the key appetite-related neuropeptide AgRP (agouti-related protein) and modified respiratory exchange ratio, suggesting increased carbohydrate usage during the inactive phase. Importantly, we document pTDP-43 pathology and neurodegeneration in the LHA of sporadic ALS patients. Neuronal cell loss was associated with pTDP-43-positive inclusions and signs of neurodegeneration in MCH-positive neurons. These results suggest that hypothalamic MCH is lost in ALS and contributes to the metabolic changes, including weight loss and decreased appetite.
  • Ryota Kuroiwa, Yoshihisa Tateishi, Taku Oshima, Kazumoto Shibuya, Takeshi Inagaki, Astushi Murata, Satoshi Kuwabara
    Respirology case reports 11(5) e01135 2023年5月  
    Mechanical insufflation-exsufflation (MI-E) is an effective airway clearance device for impaired cough associated with respiratory muscle weakness caused by neuromuscular disease. Its complications on the respiratory system, such as pneumothorax, are well-recognized, but the association of the autonomic nervous system dysfunction with MI-E has never been reported. We herein describe two cases of Guillain-Barré syndrome with cardiovascular autonomic dysfunction during MI-E: a 22-year-old man who developed transient asystole and an 83-year-old man who presented with prominent fluctuation of blood pressure. These episodes occurred during the use of MI-E with abnormal cardiac autonomic testing, such as heart rate variability in both patients. While Guillain-Barré syndrome itself may cause cardiac autonomic dysfunction, MI-E possibly caused or enhanced the autonomic dysfunction by an alternation of thoracic cavity pressure. The possibility of MI-E-related cardiovascular complications should be recognized, and its appropriate monitoring and management are necessary, particularly when used for Guillain-Barré syndrome patients.
  • Masashi Nakamura, Ryo Ogawa, Juichi Fujimori, Akiyuki Uzawa, Yasunori Sato, Kengo Nagashima, Nagato Kuriyama, Satoshi Kuwabara, Ichiro Nakashima
    Multiple sclerosis (Houndmills, Basingstoke, England) 29(4-5) 13524585231156736-13524585231156736 2023年3月10日  
    BACKGROUND: To our knowledge, no nationwide epidemiological study of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has been conducted. OBJECTIVE: We examined the epidemiology and clinical features of MOGAD in Japan. METHODS: We distributed questionnaires on the clinical characteristics of patients with MOGAD to neurology, pediatric-neurology, and neuro-ophthalmology facilities throughout Japan. RESULTS: In total, 887 patients were identified. The estimated number of total and newly diagnosed MOGAD patients was 1,695 [95% confidence interval (CI): 1483-1907] and 487 (95% CI: 414-560), respectively. The estimated prevalence and incidence were 1.34/100,000 (95% CI: 1.18-1.51) and 0.39/100,000 (95% CI: 0.32-0.44), respectively. The median age at onset was 28 years (range: 0-84 years). At onset, optic neuritis was present in approximately 40% of patients, irrespective of the onset age. Acute disseminated encephalomyelitis was more frequent in younger patients, whereas brainstem encephalitis, encephalitis, and myelitis were more frequent in elderly patients. Immunotherapy was highly effective. CONCLUSION: The prevalence and incidence rates of MOGAD in Japan are similar to those in other countries. Notable characteristics such as the preferential occurrence of acute disseminated encephalomyelitis in children exist; however, general characteristics including symptoms and treatment response are common irrespective of the onset age.
  • Hiroki Masuda, Masahiro Mori, Akiyuki Uzawa, Tomohiko Uchida, Mayumi Muto, Ryohei Ohtani, Reiji Aoki, Satoshi Kuwabara
    Scientific reports 13(1) 3538-3538 2023年3月2日  
    Lymphatic drainage in the central nervous system is regulated by meningeal lymphatic vasculature, and recurrent neuroinflammation alters lymphatic vessel remodeling. Patients with aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4 + NMOSD) were reported to demonstrate worse outcomes compared with patients with anti-myelin oligodendrocyte glycoprotein-associated disorders (MOGAD). This study aimed to investigate the serum cytokines relevant to vascular remodeling after attacks and their prognostic role in patients with AQP4 + NMOSD. This study measured the serum levels of 12 cytokines relevant to vascular remodeling, including bone morphogenetic protein-9 (BMP-9) and leptin, in 20 patients with AQP4 + NMOSD and 17 healthy controls (HCs). Disease controls included 18 patients with MOGAD. Serum and cerebrospinal fluid interleukin-6 levels were also measured. Clinical severity was evaluated with Kurtzke's Expanded Disability Status Scale (EDSS). Compared with HCs, patients with AQP4 + NMOSD showed higher BMP-9 (median; 127 vs. 80.7 pg/mL; P = 0.0499) and leptin levels (median; 16,081 vs. 6770 pg/mL; P = 0.0224), but not those with MOGAD. Better improvement in EDSS at 6 months was associated with baseline BMP-9 levels in patients with AQP4 + NMOSD (Spearman's rho =  - 0.47; P = 0.037). Serum BMP-9 is upregulated at relapse and may contribute to vascular remodeling in AQP4 + NMOSD. Serum BMP-9 levels could predict clinical recovery 6 months after the attack.
  • Shuuichi Mori, Shigeaki Suzuki, Tetsuro Konishi, Naoki Kawaguchi, Masahiko Kishi, Satoshi Kuwabara, Kei Ishizuchi, Heying Zhou, Futoshi Shibasaki, Hiroki Tsumoto, Takuya Omura, Yuri Miura, Seijiro Mori, Mana Higashihara, Shigeo Murayama, Kazuhiro Shigemoto
    Experimental neurology 361 114300-114300 2023年3月  
    Autoantibodies to muscle-specific tyrosine kinase (MuSK) proteins at the neuromuscular junction (NMJ) cause refractory generalized myasthenia gravis (MG) with dyspnea more frequently than other MG subtypes. However, the mechanisms via which MuSK, a membrane protein locally expressed on the NMJ of skeletal muscle, is supplied to the immune system as an autoantigen remains unknown. Here, we identified MuSK in both mouse and human serum, with the amount of MuSK dramatically increasing in mice with motor nerve denervation and in MG model mice. Peptide analysis by liquid chromatography-tandem-mass spectrometry (LC-MS/MS) confirmed the presence of MuSK in both human and mouse serum. Furthermore, some patients with MG have significantly higher amounts of MuSK in serum than healthy controls. Our results indicated that the secretion of MuSK proteins from muscles into the bloodstream was induced by ectodomain shedding triggered by neuromuscular junction failure. The results may explain why MuSK-MG is refractory to treatments and causes rapid muscle atrophy in some patients due to the denervation associated with Ab-induced disruption of neuromuscular transmission at the NMJ. Such discoveries pave the way for new MG treatments, and MuSK may be used as a biomarker for other neuromuscular diseases in preclinical studies, clinical diagnostics, therapeutics, and drug discovery.
  • Akiyuki Uzawa, Shigeaki Suzuki, Satoshi Kuwabara, Hiroyuki Akamine, Yosuke Onishi, Manato Yasuda, Yukiko Ozawa, Naoki Kawaguchi, Tomoya Kubota, Masanori P Takahashi, Yasushi Suzuki, Genya Watanabe, Takashi Kimura, Takamichi Sugimoto, Makoto Samukawa, Naoya Minami, Masayuki Masuda, Shingo Konno, Yuriko Nagane, Kimiaki Utsugisawa
    Journal of neurology, neurosurgery, and psychiatry 94(6) 467-473 2023年1月24日  
    BACKGROUND: Early fast-acting treatment (EFT) is the aggressive use of fast-acting therapies such as plasmapheresis, intravenous immunoglobulin and/or intravenous high-dose methylprednisolone (IVMP) from the early phases of treatment. EFT is reportedly beneficial for early achievement of minimal manifestations (MM) or better status with ≤5 mg/day prednisolone (MM5mg), a practical therapeutic target for myasthenia gravis (MG). OBJECTIVE: The current study aimed to clarify which specific EFT regimen is efficacious and the patient characteristics that confer sensitivity to EFT. METHODS: We recruited a total of 1710 consecutive patients with MG who enrolled in the Japan MG Registry for this large-cohort study. Among them, 1066 with generalised MG who had received immunotherapy were analysed. Prognostic background factors were matched in a 1:1 ratio using propensity score matching analysis between patients treated with EFT (n=350) and those treated without EFT (n=350). The clinical course and time to first achieve MM5mg after starting immunotherapy was analysed in relation to treatment combinations and patient characteristics. RESULTS: Kaplan-Meier analyses showed that EFT had a significant effect on the achievement of MM5mg (p<0.0001, log-rank test; HR 1.82, p<0.0001). Notably, EFT was efficacious for any type of MG, and the inclusion of IVMP resulted in earlier and more frequent achievement of MM5mg (p=0.0352, log-rank test; HR 1.46, p=0.0380). In addition, early administration of calcineurin inhibitors also promoted MM5mg achievement. CONCLUSION: Early cycles of intervention with EFT and early use of calcineurin inhibitors provides long-term benefits in terms of achieving therapeutic targets for generalised MG, regardless of clinical subtype.
  • Akiyuki Uzawa, Shigeaki Suzuki, Satoshi Kuwabara, Hiroyuki Akamine, Yosuke Onishi, Manato Yasuda, Yukiko Ozawa, Naoki Kawaguchi, Tomoya Kubota, Masanori P Takahashi, Yasushi Suzuki, Genya Watanabe, Takashi Kimura, Takamichi Sugimoto, Makoto Samukawa, Naoya Minami, Masayuki Masuda, Shingo Konno, Yuriko Nagane, Kimiaki Utsugisawa
    Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 20(2) 518-523 2023年1月6日  
    The efficacy of intravenous high-dose methylprednisolone (IVMP) in ocular myasthenia gravis (MG) has not been fully established. This study aimed to elucidate the effects of early intervention with IVMP for achieving the therapeutic targets (minimal manifestations [MM] or MM or better status with prednisolone ≤ 5 mg/day [MM5mg]) in ocular MG. In this observational study, we included a total of 1710 consecutive patients with MG enrolled in the Japan MG Registry in 2021. Of these, 204 patients with ocular MG who received immunotherapy were analyzed. The clinical course and time to first achieve MM or MM5mg after starting immunotherapy were compared between the early IVMP group (treated with IVMP within 3 months of treatment initiation) and the non-early IVMP group. Despite having greater clinical severity before immunotherapy and lower oral prednisolone doses throughout the course, the early IVMP group (n = 55) showed a higher rate of achievement of MM (P = 0.0040, log-rank test; hazard ratio 1.58, 95% confidence interval [CI] 1.13-2.20, P < 0.0001) and MM5mg (P = 0.0005, log-rank test; hazard ratio 1.78, 95% CI 1.27-2.51, P < 0.0001) compared with the non-early IVMP group (n = 149). In conclusion, an early intervention with IVMP is likely to increase the probability of achieving a better long-term outcome and reducing the total dose of corticosteroids in ocular MG.
  • Akiyuki Uzawa, Yukiko Ozawa, Manato Yasuda, Yosuke Onishi, Hiroyuki Akamine, Satoshi Kuwabara
    Acta neurologica Belgica 123(3) 979-982 2023年1月2日  
    OBJECTIVES: Minimal symptom expression (MSE), defined as myasthenia gravis (MG) activities of daily living profile (MGADL) score 0 or 1, has been recently used as an indicator of treatment goal in MG. However, no study has determined when MSE is achieved. The current study aimed to investigate the timing and incidence of MSE achievement in generalized MG patients. METHODS: Eighty-five patients with acetylcholine receptor antibody-positive generalized MG were included. They were followed-up maximum 3 years after starting immunotherapy, and we reviewed the MGADL score, prednisolone dose, and achievement of MSE and minimal manifestations (MM) or better status. RESULTS: MSE was achieved in 37.6, 45.2, 55.8, 60.3, and 57.1% of the patients at 3, 6, 12, 24, and 36 months after treatment, respectively. Most patients who achieved MSE showed MM or better status at any phase. In addition, more than 2 years after the starting treatment, about 80% of patients who achieved MSE showed MM or better status with an oral prednisolone dose of 5 mg/day or less (MM-5 mg). Noteworthy, during the early stage of treatment, the proportion of patients who achieved MSE was higher than that who achieved MM-5 mg. CONCLUSION: From the early phases of immunotherapy, MSE is a good marker of therapeutic goal in patients with generalized MG.
  • Hiroyuki Akamine, Akiyuki Uzawa, Yuta Kojima, Yukiko Ozawa, Manato Yasuda, Yosuke Onishi, Satoshi Kuwabara
    Journal of neuroimmunology 375 578014-578014 2023年1月2日  
    This study examined the role of Tfh and Treg associated molecules also known as checkpoint molecules, their ligands, and IL-21 in myasthenia gravis (MG) pathogenesis. Serum levels of sPD-1, sPD-L1, sICOS, sICOSLG, sCTLA4, and IL-21 were measured in 39 patients with acetylcholine receptor (AChR) antibody-positive generalized MG and 27 controls. sPD-1 and IL-21 levels were higher in MG patients than in controls. Additionally, sPD-1 levels correlated positively with the levels of IL-21, sICOSLG, sCTLA4, and AChR antibody titers. sICOS are correlated with MGADL and AChR antibody titers. These Tfh associated molecules could be used as biomarkers of MG disease activity.
  • Mitsuyoshi Tamura, Takahiro Takeda, Yoshihisa Kitayama, Tomoki Suichi, Kazumoto Shibuya, Sakurako Harada-Kagitani, Takashi Kishimoto, Satoshi Kuwabara, Shigeki Hirano
    Frontiers in neurology 14 1293732-1293732 2023年  
    BACKGROUND: In typical patients with multiple system atrophy with predominant parkinsonism (MSA-P) levodopa is ineffective. However, there are some of these patients who respond well to levodopa treatment. Levodopa efficacy in MSA-P patients is thought to be related to the degree of putaminal damage, but the pathological causation between the putaminal involvement and levodopa efficacy has not been established in detail. OBJECTIVE: This study aimed to evaluate the neuropathological features of the nigrostriatal dopaminergic system in a "levodopa-responsive" MSA-P patient in comparison with "levodopa-unresponsive" conventional MSA-P patients. MATERIALS AND METHODS: Clinicopathological findings were assessed in a 53-year-old Japanese man with MSA who presented with asymmetric parkinsonism, levodopa response, and later wearing-off phenomenon. During autopsy, the nigrostriatal pathology of presynaptic and postsynaptic dopaminergic receptor density and α-synuclein status were investigated. The other two patients with MSA-P were examined using the same pathological protocol. RESULTS: Four years after the onset, the patient died of sudden cardiopulmonary arrest. On autopsy, numerous α-synuclein-positive glial cytoplasmic inclusions in the basal ganglia, pons, and cerebellum were identified. The number of neurons in the putamen and immunoreactivity for dopamine receptors were well-preserved. In contrast, significant neuronal loss and decreased dopamine receptor immunoreactivity in the putamen were observed in the "levodopa-unresponsive" MSA-P control patients. These putaminal pathology results were consistent with the findings of premortem magnetic resonance imaging (MRI). All three patients similarly exhibited severe neuronal loss in the substantia nigra and decreased immunoreactivity for dopamine transporter. CONCLUSION: Levodopa responsiveness in patients with MSA-P may be corroborated by the normal putamen on MRI and the preserved postsynaptic nigrostriatal dopaminergic system on pathological examination. The results presented in this study may provide a rationale for continuation of levodopa treatment in patients diagnosed with MSA-P.
  • Atsuhiko Sugiyama, Kazuho Kojima, Shigeki Hirano, Jun Sone, Satoshi Kuwabara
    Case reports in neurology 15(1) 126-130 2023年  
    Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disease with various neurological manifestations, including tremor. Here, we report a case involving a 68-year-old man with an 8-year history of tremor in his right arm. Subsequently, examination revealed that the patient was suffering from a low-frequency, high-amplitude, and posture-induced proximal arm tremor elicited by sustained arm abduction with flexed elbows (wing-beating tremor), which was partially improved by zonisamide treatment. Abnormal expansion of GGC repeats in the NOTCH2NLC gene confirmed the diagnosis of NIID. This case highlights the fact that unilateral wing-beating tremor can be a manifestation of NIID. Zonisamide may be effective for controlling tremors associated with NIID.
  • Atsuhiko Sugiyama, Hajime Yokota, Shigeki Hirano, Jiaqi Wang, Shoichi Ito, Satoshi Kuwabara
    Parkinson's disease 2023 8888255-8888255 2023年  
    This study aimed to explore morphological changes of hippocampal subfields in patients with multiple system atrophy (MSA) with and without cognitive impairment using FreeSurfer-automated segmentation of hippocampal subfield techniques and their relationship with cognitive function. We enrolled 75 patients with MSA classified as cognitively impaired MSA (MSA-CI, n = 40) and cognitively preserved MSA (MSA-CP, n = 35), as well as 68 healthy controls. All participants underwent three-dimensional volume T1-weighted magnetic resonance imaging. The hippocampal subfield volume was measured using FreeSurfer version 7.2 and compared among groups. Regression analyses were performed between the hippocampal subfield volumes and cognitive variables. Compared with healthy controls, the volume of the right cornu ammonis (CA) 2/3 was significantly lower in the MSA-CI group (P=0.029) and that of the left fimbria was significantly higher in the MSA-CP group (P=0.046). Results of linear regression analysis showed that the right CA2/3 volume was significantly correlated with the Frontal Assessment Battery score in patients with MSA (adjusted R 2 = 0.282, β = 0.227, and P=0.041). The hippocampal subfield volume decreased in patients with MSA-CI, even at the early disease stages. Specific structural changes in the hippocampus might be associated with cognitive deficits in MSA.
  • Katsunori Fujii, Tadashi Shiohama, Tomoko Uchida, Hajime Ikehara, Tomoyuki Fukuhara, Daisuke Sawada, Hiromi Aoyama, Hideki Uchikawa, Shoko Yoshii, Yukie Arahata, Naoki Shimojo, Sonoko Misawa, Satoshi Kuwabara
    Brain & development 45(1) 16-25 2023年1月  
    OBJECTIVE: Guillain-Barré syndrome (GBS), Fisher syndrome (FS), and Bickerstaff brainstem encephalitis (BBE) are immune-mediated neuropathies presenting with symptoms such as weakness, ophthalmoplegia, ataxia, and consciousness disturbances. Although the epidemiology of GBS and BBE in patients of all ages has been reported, childhood data have not been well-investigated. We aimed to determine the clinical features, therapeutics, and prognoses of childhood GBS, FS, and BBE in Japan. METHODS: We sent questionnaires to 1068 pediatric neurologists in Japan from 2014 to 2016 to determine the number of children less than 15 years old with GBS, FS, or BBE and their age and sex. We subsequently performed a secondary survey to investigate the clinical features, laboratory data, treatment, and prognosis. RESULTS: Five-hundred thirty-eight pediatric neurology specialists (50.4%) responded to the first survey. The total number of children with GBS, FS, and BBE in Japan from 2014 to 2016 were 87, 10, and 6, respectively. GBS was classified as acute inflammatory demyelinating neuropathy (35.6%), acute motor axonal neuropathy (20.7%), or acute motor-sensory axonal neuropathy (10.3%), with a male-to-female ratio of 1.29:1.0 and a wide distribution of onset ages. The disease severities of GBS, FS, and BBE were variable, but all children could walk within one year. CONCLUSION: The prognoses of childhood GBS, FS, and BBE were generally favorable, as long as the patient was promptly treated with either intravenous immunoglobulin or plasma exchange.
  • Shigeki Hirano, Akira Kojima, Yoko Nakayama, Takahiro Takeda, Takashi Kishimoto, Toshiyuki Takahashi, Satoshi Kuwabara, Masahiro Mori
    BMC neurology 22(1) 483-483 2022年12月15日  
    BACKGROUND: We report a case of neuromyelitis optica spectrum disorders (NMOSD), who developed after the pembrolizumab treatment, an immune checkpoint inhibitor, against lung adenocarcinoma. The present case is discussed with the lung adenocarcinoma specimen which was stained by aquaporin-4 (AQP4) and with literature review of NMOSD linked to immune checkpoint inhibitors. CASE PRESENTATION: A 62-year-old Japanese man presented with acute diencephalic syndrome, left optic neuritis, and myelitis 5 months after initiation of pembrolizumab treatment for lung adenocarcinoma. He was diagnosed with NMOSD based on serum anti-aquaporin-4 (AQP4) antibody positivity. Immunohistochemistry of lung biopsy samples showed AQP4 expression on CD68+ cells. This is the fifth reported case of AQP4+ NMOSD triggered by an immune checkpoint inhibitor and the first with a brain lesion. Four out of five NMOSD cases, including the present case and one case with lung metastasis, had lung cancer. CONCLUSIONS: Immune checkpoint inhibitors may trigger AQP4+ NMOSD owing to their molecular similarity to AQP4 expressed in lung and glial tissues. Prompt brain/spinal cord imaging and anti-AQP4 antibody testing may facilitate early diagnosis of immune-mediated adverse event in central nervous system associated with immune checkpoint inhibitors.
  • 清水 文崇, 佐藤 亮太, 水上 洋一, 渡邊 健一, 三澤 園子, 松井 尚子, 竹下 幸男, 前田 敏彦, 和泉 唯信, 桑原 聡, 神田 隆, 古賀 道明
    末梢神経 33(2) 239-239 2022年12月  
  • 大谷 亮, 澁谷 和幹, 三澤 園子, 水地 智基, 青墳 佑弥, 狩野 裕樹, 諸岡 茉里恵, 大櫛 萌子, 桑原 聡
    末梢神経 33(2) 359-359 2022年12月  
  • Satoshi Kuwabara, Tomoki Suichi
    Journal of neurology, neurosurgery, and psychiatry 93(12) 1237-1238 2022年12月  
  • Akiyuki Hiraga, Yutaka Watabe, Satoshi Kuwabara
    Internal medicine (Tokyo, Japan) 2022年11月30日  
    The early diagnosis of cerebral venous thrombosis in the emergency department is challenging. A 70-year-old man presented to the emergency department after falling with new-onset convulsions. Brain unenhanced computed tomography (CT) revealed right frontal hemorrhage indicative of traumatic subarachnoid hemorrhage (SAH). Brain unenhanced CT on day 2 revealed increased density in the anterior superior sagittal sinus (SSS), namely 'dense inverted triangle sign.' Brain magnetic resonance venography showed a filling defect in the anterior SSS. When interpreting unenhanced brain CT findings in the setting of acute convulsions or cortical stroke, including SAH, cerebral sinus abnormalities near stroke foci should be evaluated carefully.
  • Yo-Ichi Suzuki, Makoto Kobayashi, Satoshi Kuwabara
    Internal medicine (Tokyo, Japan) 2022年11月23日  
  • Marie Morooka, Akiyuki Hiraga, Keiko Tanaka, Satoko Yoshizaki, Kyosuke Koide, Satoshi Kuwabara
    Internal medicine (Tokyo, Japan) 2022年11月2日  
    Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder sometimes accompanied by ovarian teratoma. However, the concept of encephalitis without anti-NMDAR antibodies successfully treated with ovarian teratoma resection and immunotherapy has not been established. We herein report two such cases. Case 1 exhibited delayed magnetic resonance imaging abnormalities in the thalamus and basal ganglia, despite clinical improvement. Case 2 presented with brainstem encephalitis similar to Bickerstaff's encephalitis. Although both patients tested negative for anti-NMDAR antibodies, the recovery of the neurological function and good prognosis following tumor resection with immunotherapy indicated a close association between these diseases and ovarian teratoma.
  • Manato Yasuda, Atsuhiko Sugiyama, Hideharu Hokkoku, Tomoki Suichi, Kimiko Ito, Katsuya Satoh, Tetsuyuki Kitamoto, Satoshi Kuwabara
    Neurology 99(16) 699-702 2022年10月18日  
    OBJECTIVES: Currently, no established biomarkers exist for presymptomatic sporadic Creutzfeldt-Jakob disease (sCJD). The purpose of this study was to raise awareness about sCJD cases showing abnormalities on brain MRI diffusion-weighted imaging (DWI) before symptom onset and demonstrate temporal changes in DWI abnormalities during the preclinical period. METHODS: We described the clinical presentation including the results of MRI-performed multiple times in the preclinical period-and the diagnostic workup of a middle-aged man with sCJD. RESULTS: MRI of the brain performed 27 months before symptom onset revealed an extremely localized lesion on DWI in the right occipital cortex. Follow-up MRI scans showed propagation of DWI abnormalities along the cortices without the appearance of neurologic symptoms/signs. After symptom onset, the patient's neuropsychiatric condition rapidly deteriorated. Elevated total tau protein levels and positive 14-3-3 protein were observed in the CSF, and periodic synchronous discharges using electroencephalography resulted in the diagnosis of sCJD. DISCUSSION: CJD should be considered in differential diagnoses when localized DWI signal abnormalities propagate along the cortices over time, even in the absence of typical CJD symptoms. DWI signal abnormalities on brain MRI scans may be highly sensitive diagnostic markers for CJD, even in the preclinical stage.
  • 和泉 唯信, 松井 尚子, 山本 遥平, 田中 惠子, 雑賀 玲子, 飯塚 高浩, 松井 真, 梶 龍兒, 桑原 聡
    神経免疫学 27(1) 145-145 2022年10月  
  • 山本 遥平, 松井 尚子, 田中 惠子, 松井 真, 桑原 聡, 和泉 唯信
    臨床神経学 62(Suppl.) S230-S230 2022年10月  
  • 杉山 淳比古, 田宮 亜堂, 横田 元, 向井 宏樹, 網野 寛, 桑原 聡
    神経治療学 39(6) S295-S295 2022年10月  
  • 鋸屋 悦子, 鵜沢 顕之, 小澤 由希子, 安田 真人, 大西 庸介, 赤嶺 博行, 半田 秀雄, 桑原 聡
    神経免疫学 27(1) 167-167 2022年10月  
  • 半田 秀雄, 鵜沢 顕之, 森 雅裕, 大西 庸介, 安田 真人, 鋸屋 悦子, 赤嶺 博行, 桑原 聡
    神経免疫学 27(1) 210-210 2022年10月  
  • 安田 真人, 鵜沢 顕之, 大西 庸介, 赤嶺 博行, 小澤 由希子, 氷室 圭一, 桑原 聡
    臨床神経学 62(Suppl.) S244-S244 2022年10月  
  • 村上 えい子, 鵜沢 顕之, 小澤 義人, 安田 真人, 大西 庸介, 小澤 由希子, 赤嶺 博行, 川本 麻理子, 仕子 優樹, 川崎 洋平, 桑原 聡
    臨床神経学 62(Suppl.) S262-S262 2022年10月  
  • 大西 庸介, 鵜沢 顕之, 安田 真人, 赤嶺 博行, 小澤 由希子, 氷室 圭一, 桑原 聡
    臨床神経学 62(Suppl.) S263-S263 2022年10月  
  • 鵜沢 顕之, 小澤 由希子, 安田 真人, 大西 庸介, 赤嶺 博行, 桑原 聡
    臨床神経学 62(Suppl.) S311-S311 2022年10月  
  • 赤嶺 博行, 鵜沢 顕之, 大西 庸介, 安田 真人, 小澤 由希子, 桑原 聡
    臨床神経学 62(Suppl.) S311-S311 2022年10月  
  • 清水 文崇, 佐藤 亮太, 水上 洋一, 渡邊 健司, 三澤 園子, 松井 尚子, 竹下 幸男, 前田 敏彦, 和泉 唯信, 桑原 聡, 神田 隆, 古賀 道明
    神経免疫学 27(1) 141-141 2022年10月  
  • 渡邉 充, 磯部 紀子, 新野 正明, 中島 一郎, 松下 拓也, 酒井 康成, 中原 仁, 河内 泉, 越智 博文, 中辻 裕司, 中村 好一, 中村 幸志, 坂田 清美, 松井 真, 桑原 聡, 吉良 潤一
    神経免疫学 27(1) 159-159 2022年10月  

MISC

 1029

書籍等出版物

 77

講演・口頭発表等

 84

担当経験のある科目(授業)

 3

共同研究・競争的資金等の研究課題

 64