Journal of Clinical Neurology (Seoul, Korea)最新文献

{"title":"Collateral Flow in Magnetic Resonance Angiography: Prognostic Value for Vertebrobasilar Stenosis With Stroke Recurrence.","authors":"Long Yan,&nbsp;Ying Yu,&nbsp;Kaijiang Kang,&nbsp;Zhikai Hou,&nbsp;Min Wan,&nbsp;Weilun Fu,&nbsp;Rongrong Cui,&nbsp;Yongjun Wang,&nbsp;Zhongrong Miao,&nbsp;Xin Lou,&nbsp;Ning Ma","doi":"10.3988/jcn.2022.18.5.507","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.5.507","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS.</p><p><strong>Methods: </strong>We retrospectively enrolled patients with severe IVBAS (70%-99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2-4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences.</p><p><strong>Results: </strong>From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]=4.134, 95% confidence interval [CI]=1.822-9.380, <i>p</i>=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489-19.092, <i>p</i><0.001) were more likely to have poor primary collaterals than those with no stroke recurrence.</p><p><strong>Conclusions: </strong>The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"507-513"},"PeriodicalIF":3.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/53/jcn-18-507.PMC9444559.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Individualized Neuromuscular Quality of Life Questionnaire in Korean Patients With Genetic Neuromuscular Diseases.","authors":"Hee Jo Han,&nbsp;Seung-Ah Lee,&nbsp;Young-Chul Choi,&nbsp;Michael R Rose,&nbsp;Hyung Jun Park","doi":"10.3988/jcn.2022.18.5.514","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.5.514","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Individualized Neuromuscular Quality of Life questionnaire (INQoL) is a widely used measure of the quality of life in patients with neuromuscular diseases. The purpose of this study was to translate and validate the Korean version of INQoL in Korean patients with neuromuscular diseases.</p><p><strong>Methods: </strong>We translated the original INQoL version into Korean while applying appropriate language adaptations. The internal consistency, known-group validity, and test-retest reliability were also assessed. Construct validity was measured using the modified Rankin Scale (mRS) score and the manual muscle testing (MMT)-sum score based on the Medical Research Council scale, and concurrent validity was measured using the 36-item Short Form Survey (SF-36) questionnaire.</p><p><strong>Results: </strong>This study enrolled 193 patients. The coefficients for internal consistency (Cronbach's α=0.805 to 0.987) and test-retest reliability (Spearman's ρ=0.453 to 0.886) were adequately high for all subscales except in the 'treatment effects' dimension. INQoL subscales other than those for locking, droopy eyelids, double vision, and swallowing difficulties were significantly associated with their relevant SF-36 domains (Spearman's ρ=-0.274 to -0.833). Functional status and muscle strength were most strongly associated with independence (Spearman's ρ=0.753 and <i>p</i><0.001 for mRS score, Spearman's ρ=-0.741 and <i>p</i><0.001 for MMT-sum score).</p><p><strong>Conclusions: </strong>The Korean INQoL is a reliable and validated measurement tool for Korean patients with neuromuscular diseases.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"514-521"},"PeriodicalIF":3.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/0a/jcn-18-514.PMC9444564.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pineal Apoplexy Presenting With Recurrent Migraine-Like Headache and Transitory Neurological Dysfunction During Pregnancy.","authors":"Gonçalo Cabral,&nbsp;Marlene Saraiva,&nbsp;Inês Freire,&nbsp;Inês Gil","doi":"10.3988/jcn.2022.18.5.594","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.5.594","url":null,"abstract":"that slight psychomotor slowing. brisk reflexes in the left arm an ipsilateral Babinski sign with a slight left pronator drift, but muscle strength was preserved. She also exhibited a decreased response to pinprick on the left side. There no oculomotor nerve palsy or papilledema. a cystic pineal gland with a maximum diameter of 1.2 cm, which hyperintense in T2-weighted/fluid-attenuated inversion recovery (FLAIR) images, without significant locoregional mass effect associated acute hydrocephalus. This lesion internal blood–fluid level was slightly hyperintense T1-weighted in T2-weighted/FLAIR images, with early sub-acute hemorrhage. In susceptibility-weighted angiography (SWAN) image the hematic component was demonstrated by an area of a signal void (blooming These fea-tures were compatible with the diagnosis of in previously cystic","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"594-596"},"PeriodicalIF":3.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/9c/jcn-18-594.PMC9444565.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Choroidal Thickness in Multiple Sclerosis: An Optical Coherence Tomography Study.","authors":"Alessandro Masala,&nbsp;Ilaria Di Mola,&nbsp;Maria Cellerino,&nbsp;Valentina Pera,&nbsp;Aldo Vagge,&nbsp;Antonio Uccelli,&nbsp;Christian Cordano,&nbsp;Carlo E Traverso,&nbsp;Michele Iester","doi":"10.3988/jcn.2022.18.5.601","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.5.601","url":null,"abstract":"<p><p>This corrects the article on p. 334 in vol. 18, PMID: 35589321.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"601"},"PeriodicalIF":3.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/99/jcn-18-601.PMC9444557.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence Rates of Primary Headache Disorders and Evaluation and Treatment Patterns Among Korean Neurologists.","authors":"Byung-Kun Kim,&nbsp;Min Kyung Chu,&nbsp;Soo Jin Yu,&nbsp;Grazia Dell'Agnello,&nbsp;Hans-Peter Hundemer,&nbsp;Tommaso Panni,&nbsp;Sara Prada Alonso,&nbsp;Sarah Louise Roche,&nbsp;Jeong Hee Han,&nbsp;Soo-Jin Cho","doi":"10.3988/jcn.2022.18.5.571","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.5.571","url":null,"abstract":"<p><strong>Background and purpose: </strong>Several studies have found that the prevalence of migraine is higher among healthcare professionals than in the general population. Furthermore, several investigations have suggested that the personal experiences of neurologists with migraine can influence their perception and treatment of the disease. This study assessed these relationships in Korea.</p><p><strong>Methods: </strong>A survey was used to investigate the following characteristics among neurologists: 1) the prevalence rates of migraine, primary stabbing headache, and cluster headache, and 2) their perceptions of migraine and the pain severity experienced by patients, diagnosing migraine, evaluation and treatment patterns, and satisfaction and difficulties with treatment.</p><p><strong>Results: </strong>The survey was completed by 442 actively practicing board-certified Korean neurologists. The self-reported lifetime prevalence rates of migraine, migraine with aura, primary stabbing headache, and cluster headache were 49.8%, 12.7%, 26.7%, and 1.4%, respectively. Few of the neurologists used a headache diary or validated scales with their patients, and approximately half were satisfied with the effectiveness of preventive medications. Significant differences were observed between neurologists who had and had not experienced migraine, regarding certain perceptions of migraine, but no differences were found between these groups in the evaluation and preventive treatment of migraine.</p><p><strong>Conclusions: </strong>The high self-reported lifetime prevalence rates of migraine and other primary headache disorders among Korean neurologists may indicate that these rates are underreported in the general population, although potential population biases must be considered. From the perspective of neurologists, there is an unmet need for the proper application of headache diaries, validated scales, and effective preventive treatments for patients. While the past experiences of neurologists with migraine might not influence how they evaluate or apply preventive treatments to migraine, they may influence certain perceptions of the disease.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"571-580"},"PeriodicalIF":3.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/ac/jcn-18-571.PMC9444561.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological, Physical, and Psychological Interventions in Young-Onset Stiff-Person Syndrome.","authors":"Chun Seng Phua,&nbsp;Shalini Bhaskar","doi":"10.3988/jcn.2022.18.4.487","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.4.487","url":null,"abstract":"Dear Editor, Young-onset stiff-person syndrome (SPS) is rare, with most patients presenting initially to non-neurology doctors, and the majority not being diagnosed until adulthood.1 A 16-year-old female presented with progressively unsteady gait that first appeared at the age of 13 years. At 12 years old she noticed generalized body aches when remaining in one position for too long, and at 14 years old she started experiencing recurrent falls, leading to worsening basophobia. At home, she was extremely anxious about climbing stairs or taking a shower, and she feared crossing roads when outside. She was easily startled by sound and touch sensations, which triggered painful muscle spasms. She had a normal intellect and no relevant family history. She first sought medical help at 15 years old, and was diagnosed with anxiety and depression. After receiving a third opinion, the patient consulted a neurologist. A physical examination revealed prominent axial stiffness and rigidity (Supplementary Video 1, Section 1 in the online-only Data Supplement). She had a forward-leaning posture with thoracic and cervical hyperlordosis. Her gait was stiff, wide-based, and high-stepping due to stiffness. She had an exaggerated startle response and a positive head-retraction reflex. Laboratory investigations revealed elevated creatinine kinase (302 U/L; normal, 29–168 U/L) and lactate dehydrogenase (275 U/L; normal, 130–250 U/L). Antinuclear antibodies were positive, and extractable nuclear antigens were negative. Serum anti-glutamic-acid decarboxylase (anti-GAD) antibodies were strongly positive, at &gt;2,000 IU/mL (normal, &lt;10 IU/mL). CSF demonstrated five unique intrathecal oligoclonal bands. Brain MRI was unremarkable, while whole-spine MRI demonstrated premature scoliosis. Serology tests for type 1 diabetes and autoimmune thyroid disease were negative. Surface EMG revealed continuous motorunit activity of the paraspinal muscles, which increased during spontaneous painful muscle spasms (Supplementary Video 1, Section 2 in the online-only Data Supplement). Treatment with clonazepam (0.5 mg TDS) and baclofen (10 mg BDS) was inadequate, and so two cycles of IVIG at 0.5 mg/kg were administered over 5 days. Repeat EMG demonstrated a significant reduction in motor-unit activity, and her gait visibly improved (Supplementary Video 1, Section 3 in the online-only Data Supplement). Weekly physical therapy sessions comprising massage and stretching exercises significantly relieved the muscle stiffness, while psychotherapy and cognitive behavioral therapy (CBT) alleviated her anxiety and basophobia. The clinical improvement was sustained at 3 months post-IVIG, and the patient resumed participating in sports at school. Her anti-GAD antibody had decreased to 250 IU/mL. Symptom progression was reviewed at 3-monthly follow-ups. Young-onset SPS accounts for 5% of SPS cases. The median age at symptom onset is 11 years (range, 1–15 years).1 The most commonly associated antibody is a","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"487-488"},"PeriodicalIF":3.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/64/jcn-18-487.PMC9262462.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-on-Aspirin Platelet Reactivity Differs Between Recurrent Ischemic Stroke Associated With Extracranial and Intracranial Atherosclerosis.","authors":"Kyung Chul Noh,&nbsp;Hye-Yeon Choi,&nbsp;Ho Geol Woo,&nbsp;Jun Young Chang,&nbsp;Sung Hyuk Heo,&nbsp;Dae-Il Chang,&nbsp;Bum Joon Kim","doi":"10.3988/jcn.2022.18.4.421","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.4.421","url":null,"abstract":"<p><strong>Background and purpose: </strong>Ischemic stroke recurs despite the use of antiplatelet agents. Various mechanisms are involved in recurrence due to intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS). High-on-aspirin platelet reactivity (HAPR) may differ between recurrent stroke due to ICAS and ECAS.</p><p><strong>Methods: </strong>Patients with recurrent ischemic stroke as a result of large-artery atherosclerosis despite taking aspirin were enrolled consecutively. Ischemic stroke was classified as stroke due to ICAS or ECAS according to the location of the culprit stenosis. An aspirin reaction units (ARU) value of >550 IU was defined as HAPR. HAPR and its associated factors were compared between the two groups and also considering the mechanism of stroke.</p><p><strong>Results: </strong>Among the 190 patients with recurrent stroke (111 with ICAS and 79 with ECAS), 36 (18.3%) showed HAPR. The ARU value was higher in the ECAS than the ICAS group (492±83 vs. 465±78, mean±standard deviation; <i>p</i>=0.028), as was the proportion of patients with HAPR (27.8% vs. 12.6%, <i>p</i>=0.008). Being male and having stroke due to ECAS (reference=stroke due to ICAS: odds ratio=5.760; 95% confidence interval=2.154-15.403; <i>p</i><0.001) was independently associated with HAPR. The ARU value differed according to the stroke mechanism, and was highest in those with artery-to-artery embolism. Artery-to-artery embolism was independently associated with HAPR in both the ICAS and ECAS groups.</p><p><strong>Conclusions: </strong>Recurrent stroke due to ECAS was more strongly associated with HAPR and insufficient antiplatelet inhibition than was that due to ICAS. Artery-to-artery embolism was associated with HAPR in recurrent ischemic stroke as a result of ICAS or ECAS.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"421-427"},"PeriodicalIF":3.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/32/jcn-18-421.PMC9262451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[¹⁸F]THK-5351 PET Patterns in Patients With Alzheimer's Disease and Negative Amyloid PET Findings.","authors":"Minyoung Oh,&nbsp;Jungsu S Oh,&nbsp;Seung Jun Oh,&nbsp;Sang Ju Lee,&nbsp;Jee Hoon Roh,&nbsp;Woo Ram Kim,&nbsp;Ha-Eun Seo,&nbsp;Jae Myeong Kang,&nbsp;Sang Won Seo,&nbsp;Jae-Hong Lee,&nbsp;Duk L Na,&nbsp;Young Noh,&nbsp;Jae Seung Kim","doi":"10.3988/jcn.2022.18.4.437","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.4.437","url":null,"abstract":"<p><strong>Background and purpose: </strong>Alzheimer's disease (AD) does not always mean amyloid positivity. [¹⁸F]THK-5351 has been shown to be able to detect reactive astrogliosis as well as tau accompanied by neurodegenerative changes. We evaluated the [¹⁸F]THK-5351 retention patterns in positron-emission tomography (PET) and the clinical characteristics of patients clinically diagnosed with AD dementia who had negative amyloid PET findings.</p><p><strong>Methods: </strong>We performed 3.0-T magnetic resonance imaging, [¹⁸F]THK-5351 PET, and amyloid PET in 164 patients with AD dementia. Amyloid PET was visually scored as positive or negative. [¹⁸F]THK-5351 PET were visually classified as having an intratemporal or extratemporal spread pattern.</p><p><strong>Results: </strong>The 164 patients included 23 (14.0%) who were amyloid-negative (age 74.9±8.3 years, mean±standard deviation; 9 males, 14 females). Amyloid-negative patients were older, had a higher prevalence of diabetes mellitus, and had better visuospatial and memory functions. The frequency of the apolipoprotein E ε4 allele was higher and the hippocampal volume was smaller in amyloid-positive patients. [¹⁸F]THK-5351 uptake patterns of the amyloid-negative patients were classified into intratemporal spread (<i>n</i>=10) and extratemporal spread (<i>n</i>=13). Neuropsychological test results did not differ significantly between these two groups. The standardized uptake value ratio of [¹⁸F]THK-5351 was higher in the extratemporal spread group (2.01±0.26 vs. 1.61±0.15, <i>p</i>=0.001). After 1 year, Mini Mental State Examination (MMSE) scores decreased significantly in the extratemporal spread group (-3.5±3.2, <i>p</i>=0.006) but not in the intratemporal spread group (-0.5±2.8, <i>p</i>=0.916). The diagnosis remained as AD (<i>n</i>=5, 50%) or changed to other diagnoses (<i>n</i>=5, 50%) in the intratemporal group, whereas it remained as AD (<i>n</i>=8, 61.5%) or changed to frontotemporal dementia (<i>n</i>=4, 30.8%) and other diagnoses (<i>n</i>=1, 7.7%) in the extratemporal spread group.</p><p><strong>Conclusions: </strong>Approximately 70% of the patients with amyloid-negative AD showed abnormal [¹⁸F]THK-5351 retention. MMSE scores deteriorated rapidly in the patients with an extratemporal spread pattern.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"437-446"},"PeriodicalIF":3.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/74/jcn-18-437.PMC9262461.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Low-Dose Gamma-Aminobutyric Acid From Unpolished Rice Germ as a Health Functional Food for Promoting Sleep: A Randomized, Double-Blind, Placebo-Controlled Trial.","authors":"Seonmin Yoon,&nbsp;Jung-Ick Byun,&nbsp;Won Chul Shin","doi":"10.3988/jcn.2022.18.4.478","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.4.478","url":null,"abstract":"Gamma-aminobutyric acid (GABA)-enriched fermented foods have the potential to ame-liorate insomnia because of their inhibitory action on the central nervous system. 1 As functional foods, they are safe for oral intake, easily accessible, and can relieve anxiety and elevate mood. 2 We previously demonstrated that 4 weeks of natural GABA extracts (300 mg daily) can improve both subjective sleep quality and objective sleep efficacy. 3 Natural-GABA treatment reduced sleep latency and improved sleep questionnaire scores. However, two out of forty patients complained of abdominal discomfort, and one patient complained of headache after receiving the natural-GABA treatment. Also, since insomnia often requires long-term ther-apy, the adverse effects may have been underestimated. Accordingly, in the present study we explored whether low-dose natural GABA (75 mg) is as effective in improving sleep quality and sleep efficacy as is high-dose natural GABA (300 mg), and without adverse events. This study performed a double-blind, randomized, placebo-controlled trial of low-dose natural GABA (75 mg) in patients with insomnia. The study design was equivalent to that of our previous study. 3 The primary outcome was the changes in overnight polysomnogra-phy (PSG) sleep latency and sleep efficacy between baseline and after 4 weeks in the GABA-treatment population. The secondary endpoints were changes in other PSG parameters and sleep questionnaire scores between baseline and 4 weeks. Differences between the study groups at baseline were assessed using either the chi-square or Fisher’s exact test for categorical data, and the t -test for continuous data. Changes from baseline to 4 weeks after treatment in each treatment group were determined using the Wilcoxon signed-rank test.","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"478-480"},"PeriodicalIF":3.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/40/jcn-18-478.PMC9262463.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoantibody Encephalitis: Presentation, Diagnosis, and Management.","authors":"Eric Lancaster","doi":"10.3988/jcn.2022.18.4.373","DOIUrl":"https://doi.org/10.3988/jcn.2022.18.4.373","url":null,"abstract":"<p><p>Autoantibody encephalitis causes distinct clinical syndromes involving alterations in mentation, abnormal movements, seizures, psychiatric symptoms, sleep disruption, spasms, and neuromyotonia. The diagnoses can be confirmed by specific antibody tests, although some antibodies may be better detected in spinal fluid and others in serum. Each disorder conveys a risk of certain tumors which may inform diagnosis and be important for treatment. Autoantibodies to receptors and other neuronal membrane proteins are generally thought to be pathogenic and result in loss of function of the targets, so understanding the pharmacology of the receptors may inform our understanding of the syndromes. Patients may be profoundly ill but the syndromes usually respond to immune therapy, although there are differences in the types of immune therapy that are thought to be most effective for the various disorders.</p>","PeriodicalId":324902,"journal":{"name":"Journal of Clinical Neurology (Seoul, Korea)","volume":" ","pages":"373-390"},"PeriodicalIF":3.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/20/jcn-18-373.PMC9262450.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40477648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}