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[Genetic Counseling and Interprofessional Collaboration in Intractable Diseases]. [难治性疾病的遗传咨询和跨专业合作]。
Brain and Nerve Pub Date : 2026-06-01 DOI: 10.11477/mf.188160960780060673
Tomoko Sekiya
{"title":"[Genetic Counseling and Interprofessional Collaboration in Intractable Diseases].","authors":"Tomoko Sekiya","doi":"10.11477/mf.188160960780060673","DOIUrl":"10.11477/mf.188160960780060673","url":null,"abstract":"<p><p>In recent years, with the advancement of genetic medicine for intractable diseases, opportunities for genetic testing and diagnosis have increased. Because genetic information is shared among blood relatives, cases in which a patient's diagnosis leads to the diagnosis of other relatives are increasing. It is important to establish support systems that enable patients with hereditary intractable diseases and their families to understand and adapt to their conditions and genetic risks, as well as consultation systems tailored to life events. Healthcare professionals who are close to patients and their families should collaborate in their care and refer them for genetic counseling as needed.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 6","pages":"673-676"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Disaster Countermeasures for Intractable Neurological Disease]. [顽固性神经系统疾病的灾害对策]。
Brain and Nerve Pub Date : 2026-06-01 DOI: 10.11477/mf.188160960780060728
Takafumi Miyachi
{"title":"[Disaster Countermeasures for Intractable Neurological Disease].","authors":"Takafumi Miyachi","doi":"10.11477/mf.188160960780060728","DOIUrl":"10.11477/mf.188160960780060728","url":null,"abstract":"<p><p>Disasters can strike anywhere in Japan at any time. For patients who rely on life-sustaining equipment such as ventilators, disruption of essential services, including electricity, directly threatens their lives. Many patients with neurological disorders require specialized evacuation support during disasters, making preparedness during peacetime critical. It is desirable for relevant stakeholders to collaborate in developing individualized evacuation plans that address the securing of evacuation support personnel, evacuation methods, and post-evacuation living arrangements. The Japanese Society of Neurology has developed a disaster response manual, utilizes a disaster support network bulletin board, and has appointed network leaders and liaisons for intractable neurological diseases.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 6","pages":"728-731"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Support to Balancing Treatment and Work or Study for People with Intractable Diseases]. [对疑难杂症患者平衡治疗与工作学习的支持]。
Brain and Nerve Pub Date : 2026-06-01 DOI: 10.11477/mf.188160960780060706
Michiko Nakai
{"title":"[Support to Balancing Treatment and Work or Study for People with Intractable Diseases].","authors":"Michiko Nakai","doi":"10.11477/mf.188160960780060706","DOIUrl":"10.11477/mf.188160960780060706","url":null,"abstract":"<p><p>People with intractable diseases often experience various symptoms and fluctuating physical conditions, making it difficult to balance treatment with work and studies. Creating an environment that allows continued treatment while supporting social participation and age-appropriate growth and development remains essential. Using consultation services and support personnel, as well as improving health literacy, further helps individuals manage their treatment and daily life effectively.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 6","pages":"706-710"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Medical and Welfare Support for Intractable Disease in Japan]. [日本难治性疾病的医疗和福利支持]。
Brain and Nerve Pub Date : 2026-06-01 DOI: 10.11477/mf.188160960780060649
Tetsuo Komori
{"title":"[Medical and Welfare Support for Intractable Disease in Japan].","authors":"Tetsuo Komori","doi":"10.11477/mf.188160960780060649","DOIUrl":"10.11477/mf.188160960780060649","url":null,"abstract":"<p><p>Support measures for intractable diseases in Japan began in 1972 and, since 2015, have been implemented under the Act on Medical Care for Patients with Intractable Diseases. This article provides an overview of key activities and achievements of designated research groups that contribute to intractable disease policy, focusing on (1)challenges in developing healthcare delivery systems; (2)rehabilitation for patients with intractable diseases; (3)the roles of Intractable Disease Consultation and Support Centers and public health centers at the community level; (4)intractable disease care management by certified care managers; (5)support for balancing work and medical treatment; (6)inter facility and inter-professional collaboration, including disability welfare services; (7)ensuring the quality of home-visit nursing; (8)disaster preparedness; and (9)the development of e-learning environments for training human resources engaged in intractable disease support.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 6","pages":"649-653"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Antibiotic Penetration into the Central Nervous System: Decoding the Blood: Brain Barrier and Antibiotics through "Structure" to Inform Therapeutic Strategy]. [抗生素渗透到中枢神经系统：解码血液：脑屏障和抗生素通过“结构”告知治疗策略]。
Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050417
Yukio Takeshita
{"title":"[Antibiotic Penetration into the Central Nervous System: Decoding the Blood: Brain Barrier and Antibiotics through \"Structure\" to Inform Therapeutic Strategy].","authors":"Yukio Takeshita","doi":"10.11477/mf.188160960780050417","DOIUrl":"10.11477/mf.188160960780050417","url":null,"abstract":"<p><p>Clinical outcomes of central nervous system (CNS) infections are determined by not only pathogen coverage but also whether an antibiotic can cross the blood-brain barrier (BBB) to achieve sufficient exposure at the target site. The BBB is a prototypical example of \"organ-specific vascular specialization\" established by (1) the non-fenestrated nature and tight junctions of cerebral capillary endothelial cells and (2) endothelial cell regulation by pericytes and astrocytes. Therefore, CNS penetration of antibiotics should be understood as an interaction between physicochemical properties of drugs (lipophilicity, molecular weight, ionization state, and polarity) and the BBB state throughout the disease course (from the acute inflammatory phase to post-resolution). To assist readers in estimating passive BBB permeability simply by inspecting structural formulas, we provide a practical workflow-from identifying key functional groups (red-circle annotation) to a three-tier (\"likely to pass,\" \"may pass during inflammation,\" and \"unlikely to pass under usual conditions\") classification-and demonstrate workflow efficacy using four representative compounds. Reasons why meningeal gadolinium enhancement on magnetic resonance imaging cannot be taken as direct \"proof\" of antibiotic penetration are summarized, and treatment strategies from acute phase through recovery are discussed.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"417-425"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Pathophysiology of Influenza Encephalopathy]. [流感脑病的病理生理学]。
Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050562
Hideki Hasegawa
{"title":"[Pathophysiology of Influenza Encephalopathy].","authors":"Hideki Hasegawa","doi":"10.11477/mf.188160960780050562","DOIUrl":"10.11477/mf.188160960780050562","url":null,"abstract":"<p><p>Influenza is an acute respiratory infection that can cause influenza encephalopathy through a systemic inflammatory response mediated by the host immune system. This condition does not involve direct viral invasion of the brain and its pathogenesis is primarily driven by dysregulated host immune and inflammatory responses, including excessive cytokine production, leading to blood-brain barrier disruption, severe cerebral edema, and microcirculatory disturbances. Influenza encephalopathy is a multifactorial disorder to which metabolic factors and genetic predispositions may also contribute, highlighting the need to establish early diagnostic markers and develop effective therapeutic strategies.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"562-566"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[COVID-19-Associated Encephalitis and Encephalopathy: Current Status]. [covid -19相关脑炎和脑病：现状]。
Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050567
Takayoshi Shimohata
{"title":"[COVID-19-Associated Encephalitis and Encephalopathy: Current Status].","authors":"Takayoshi Shimohata","doi":"10.11477/mf.188160960780050567","DOIUrl":"10.11477/mf.188160960780050567","url":null,"abstract":"<p><p>In recent years, the incidence of COVID-19-associated encephalitis and encephalopathy has decreased due to viral mutations and the acquisition of population immunity. The underlying mechanisms are now thought to involve immune-mediated pathology and cerebral microvascular injury, rather than direct viral invasion. In adults, encephalitis and encephalopathy are independent predictors of disease severity and mortality. In children, acute necrotizing encephalopathy is associated with high mortality rates and long-term neurological sequelae. Regarding treatment, correction of reversible factors and timely immunotherapy are essential, and favorable responses to high-dose corticosteroids and interleukin-6 receptor blockade have been reported.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"567-572"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[HTLV-1-Associated Myelopathy]. [HTLV-1-Associated脊髓病)。
Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050514
Makoto Nakashima, Yoshihisa Yamano
{"title":"[HTLV-1-Associated Myelopathy].","authors":"Makoto Nakashima, Yoshihisa Yamano","doi":"10.11477/mf.188160960780050514","DOIUrl":"10.11477/mf.188160960780050514","url":null,"abstract":"<p><p>Human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy (HAM) is a neuroimmunological disorder in which the infiltration of HTLV-1-infected T cells into the spinal cord triggers chronic inflammation and neurological damage. HAM predominantly affects the mid-to-lower thoracic cords. Improving long-term outcomes requires accurate assessment of disease activity and timely initiation of therapy. Activity stratification based on cerebrospinal fluid biomarkers is clinically useful.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"514-518"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Lyme Disease: Spirochaetota]. [莱姆病：螺旋体]。
Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050604
Yukiko Inamori, Mitsuru Watanabe
{"title":"[Lyme Disease: Spirochaetota].","authors":"Yukiko Inamori, Mitsuru Watanabe","doi":"10.11477/mf.188160960780050604","DOIUrl":"10.11477/mf.188160960780050604","url":null,"abstract":"<p><p>Lyme disease is a multisystemic zoonotic infection transmitted by the bite of infected Ixodes ticks. It displays highly diverse clinical manifestations, potentially affecting a wide array of organ systems. An infection that involves the nervous system is specifically categorized as Lyme neuroborreliosis, which can compromise both the peripheral and central nervous systems. Clinical diagnosis is often challenging and time-consuming because some patients do not present with the easily identifiable pathognomonic skin lesion, erythema migrans, during physical examination. Therefore, when clinical suspicion arises, patients should be carefully evaluated for other systemic findings that support the diagnosis. Given the risk for long-term sequelae, clinicians should maintain a high index of suspicion and initiate appropriate antimicrobial therapy without delay when clinical presentation supports this diagnosis.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"604-606"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Tsutsugamushi Disease]. 恙虫病。
Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050607
Yasuo Harigaya
{"title":"[Tsutsugamushi Disease].","authors":"Yasuo Harigaya","doi":"10.11477/mf.188160960780050607","DOIUrl":"10.11477/mf.188160960780050607","url":null,"abstract":"<p><p>Tsutsugamushi disease is an infectious disease caused by Orientia tsutsugamushi and transmitted by chiggers. The ancient classical form (summer onset) has almost disappeared, but the new form (spring and autumn onset) occurs in 300-500 cases annually. Symptoms include fever, rash, and bites. If the disease worsens, it can lead to meningoencephalitis, disseminated intravascular coagulation, and become fatal. Diagnosis involves confirming an increase in specific serum antibodies or detecting the gene in crusts. Prompt tetracycline treatment is important.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"607-610"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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