Details of a Researcher - Takizawa, Tsubasa

Papers - Takizawa, Tsubasa

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Correction: Vertebral artery dissection in a patient with migraine treated with calcitonin gene-related peptide monoclonal antibody: a case report and FAERS database analysis.

Tokuyasu D, Imai S, Chen SP, Ihara K, Watanabe N, Izawa Y, Nakahara J, Hori S, Takizawa T

BMC neurology 25 ( 1 ) 40 2025.01

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Vertebral artery dissection in a patient with migraine treated with calcitonin gene-related peptide monoclonal antibody: a case report and FAERS database analysis

Daiki Tokuyasu, Shungo Imai, Shin-Pin Chen, Keiko Ihara, Narumi Watanabe, Yoshikane Izawa, Jin Nakahara, Satoko Hori, Tsubasa Takizawa

BMC Neurology (Springer Science and Business Media LLC) 25 ( 1 ) 1 - 1 2025.01

Abstract

Background

Migraine is associated with cervical artery dissection (CeAD). Calcitonin gene-related peptide (CGRP) is a multifunctional neuropeptide with vasodilatory effects. The use of anti-CGRP monoclonal antibodies (CGRP mAb) may affect cerebrovascular disease risk; however, no reports have associated CGRP mAb with CeAD.

Case presentation and FAERS database analysis

We report a case of vertebral artery dissection in a 39-year-old woman with migraine treated with galcanezumab. We searched the number of cases where cerebral and cervical artery dissection were reported as adverse effects of CGRP mAb using the FDA Adverse Event Reporting System (FAERS) database. Six and ten such cases were reported regarding galcanezumab and CGRP mAbs use, respectively. The reporting odds ratios for galcanezumab and CGRP mAbs were elevated.

Conclusion

Although migraine is reported to be associated with CeAD, the use of CGRP mAb might be related to CeAD and warrant further investigation.

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Efficacy and Safety of Switching Between Anti-CGRP Monoclonal Antibodies: A Detailed Monthly and Long-term Follow-up Study and Literature Review

Oshima Kota, Ihara Keiko, Watanabe Narumi, Takemura Ryo, Ishizuchi Kei, Takahashi Nobuyuki, Shibata Mamoru, Nakahara Jin, Takizawa Tsubasa

Internal Medicine (The Japanese Society of Internal Medicine) advpub ( 0 ) 2025

ISSN 09182918

Objective Switching from one anti-calcitonin gene-related peptide monoclonal antibody (CGRP mAb) to another can be beneficial for treating patients with migraine who do not respond well to the first CGRP mAb. However, detailed and long-term follow-up reports of both efficacy and safety remain insufficient. We conducted a case-series analysis of patients with migraine who switched from galcanezumab to erenumab, both belonging to the class of CGRP mAbs. Methods We conducted a single-center retrospective real-world study. Patients with migraine who first received galcanezumab for ≥3 months and then switched to erenumab at Keio University Hospital were enrolled to investigate changes in monthly migraine days (MMD), response rate, and adverse effects (e.g., injection-site reactions). Additionally, we performed a narrative review of the literature on switching CGRP mAbs. Results Among the nine patients enrolled, the 50% response rate for MMD was 33% at 3 months after switching. Two patients (22%) initially responded at the 3-month assessment, but later reverted to baseline MMD levels. Switching from galcanezumab to erenumab increased the frequency of constipation, which was typically managed using laxatives. Participants who experienced injection-site reactions tended to exhibit similar reactions regardless of the type of CGRP mAb used. Five patients (56%) demonstrated an improvement in satisfaction after erenumab initiation at least once. A literature review revealed that the characteristics of the cohorts varied among studies. Conclusions Switching from galcanezumab to erenumab was effective in some patients, while it was associated with some tolerable side effects, and it improved patient satisfaction in approximately half of the patients, despite interindividual diversity in responses and fluctuating responses after switching, which warrants further investigation.

Treatment patterns and characteristics of patients with migraine: results from a retrospective database study in Japan.

Tsubasa Takizawa, Takahiro Kitano, Masahiro Iijima, Kanae Togo, Naohiro Yonemoto

The journal of headache and pain (Journal of Headache and Pain) 25 ( 1 ) 19 - 19 2024.12

ISSN 11292369

BACKGROUND: Clinical characteristics and treatment practice of patients with migraine in Japan in real-world setting have not been fully investigated. We conducted a retrospective cohort study using claims database to understand the clinical practice of migraine in recent years and to characterize patients potentially not managed well by current treatment options. METHODS: Our study used data from the large claims database maintained by JMDC Inc. Patients with diagnosis of headache or migraine between January 1, 2018, and July 31, 2022, were defined as the headache cohort, and those with migraine diagnosis and prescription of migraine treatments among the headache cohort were included in the migraine cohort. In the headache cohort, characteristics of medical facilities and status of imaging tests to distinguish secondary headache were examined. Treatment patterns and characteristics of patients potentially not managed well by acute/preventive treatment were described in migraine cohort. RESULTS: In the headache cohort, 989,514 patients were included with 57.0% females and mean age of 40.3 years; 77.0% patients visited clinics (with ≤ 19 bed capacities) for their primary diagnosis, and 30.3% patients underwent imaging tests (computed tomography and/or magnetic resonance imaging). In the migraine cohort, 165,339 patients were included with 65.0% females and mean age of 38.8 years. In the migraine cohort, 95.6% received acute treatment while 20.8% received preventive treatment. Acetaminophen/non-steroidal anti-inflammatory drugs were most common (54.8%) as the initial prescription for migraine treatment followed by triptan (51.4%). First treatment prescription included preventive treatment in 15.6%, while the proportion increased to 82.2% in the fourth treatment prescription. Among patients with more than 12 months of follow-up, 3.7% had prescription patterns suggestive of risk of medication-overuse headache, and these patients were characterized by a higher percentage of females and a higher prevalence of comorbidities. CONCLUSIONS: This study revealed that approximately one-fifth of the patients with migraine visiting medical facilities use preventive drugs. The presence of potential patients at risk of medication-overuse headache and the role of clinics in migraine treatment were also described.

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CGRP-monoclonal antibodies in Japan: insights from an online survey of physician members of the Japanese headache society.

Tsubasa Takizawa, Keiko Ihara, Narumi Watanabe, Ryo Takemura, Nobuyuki Takahashi, Naoki Miyazaki, Mamoru Shibata, Keisuke Suzuki, Noboru Imai, Norihiro Suzuki, Koichi Hirata, Takao Takeshima, Jin Nakahara

The journal of headache and pain (Journal of Headache and Pain) 25 ( 1 ) 39 - 39 2024.12

ISSN 11292369

BACKGROUND: Anti-calcitonin gene-related peptide monoclonal antibodies (CGRPmAbs) have greatly changed migraine treatment options. In Japan, although CGRPmAb guidelines (≥ 4 monthly migraine days (MMDs) and ≥ 1 previous preventive failure) are well-acknowledged, the actual use of CGRPmAbs and the circumstances of the related headache care are unknown. METHODS: We conducted an online survey of Japanese Headache Society members, inquiring about the physicians' experience with CGRPmAbs and how they make decisions related to their use. RESULTS: Of the 397 respondents, 320 had prescribed CGRPmAbs. The threshold number of previous preventive failures for recommending a CGRPmAb was two for the majority of the respondents (n = 170, 54.5%), followed by one (n = 64, 20.5%). The MMD threshold was ≥ 4 for 71 respondents (22.8%), ≥ 6 for 68 (21.8%), ≥ 8 for 76 (24.4%), and ≥ 10 for 81 (26.0%). The respondents tended to assess treatment efficacy after 3 months (episodic migraine: n = 217, 69.6%, chronic migraine: n = 188, 60.3%). The cost of CGRPmAbs was described by many respondents in two questions: (i) any request for a CGRPmAb (27.7%), and (ii) the most frequently reported reason for responders to discontinue CGRPmAbs (24.4%). CONCLUSIONS: Most of the respondents recommended CGRPmAbs to patients with ≥ 2 preventive failures, followed by ≥ 1. The MMD threshold ranged mostly from ≥ 4 to ≥ 10. The concern for costs was raised as a major limiting factor for prescribing CGRPmAbs.

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The impact of primary headaches on disability outcomes: a literature review and meta-analysis to inform future iterations of the Global Burden of Disease study.

Marta Waliszewska-Prosół, Danilo Antonio Montisano, Mariola Antolak, Federico Bighiani, Francescantonio Cammarota, Ilaria Cetta, Michele Corrado, Keiko Ihara, Regina Kartamysheva, Igor Petrušić, Maria Magdalena Pocora, Tsubasa Takizawa, Gloria Vaghi, Paolo Martelletti, Barbara Corso, Alberto Raggi

The journal of headache and pain (Journal of Headache and Pain) 25 ( 1 ) 27 - 27 2024.12

ISSN 11292369

BACKGROUND: The burden and disability associated with headaches are conceptualized and measured differently at patients' and populations' levels. At the patients' level, through patient-reported outcome measures (PROMs); at population level, through disability weights (DW) and years lived with a disability (YLDs) developed by the Global Burden of Disease Study (GBD). DW are 0-1 coefficients that address health loss and have been defined through lay descriptions. With this literature review, we aimed to provide a comprehensive analysis of disability in headache disorders, and to present a coefficient referring to patients' disability which might inform future GBD definitions of DW for headache disorders. METHODS: We searched SCOPUS and PubMed for papers published between 2015 and 2023 addressing disability in headache disorders. The selected manuscript included a reference to headache frequency and at least one PROM. A meta-analytic approach was carried out to address relevant differences for the most commonly used PROMs (by headache type, tertiles of medication intake, tertiles of females' percentage in the sample, and age). We developed a 0-1 coefficient based on the MIDAS, on the HIT-6, and on MIDAS + HIT-6 which was intended to promote future DW iterations by the GBD consortium. RESULTS: A total of 366 studies, 596 sub-samples, and more than 133,000 single patients were available, mostly referred to cases with migraine. Almost all PROMs showed the ability to differentiate disability severity across conditions and tertiles of medication intake. The indexes we developed can be used to inform future iterations of DW, in particular considering their ability to differentiate across age and tertiles of medication intake. CONCLUSIONS: Our review provides reference values for the most commonly used PROMS and a data-driven coefficient whose main added value is its ability to differentiate across tertiles of age and medication intake which underlie on one side the increased burden due to aging (it is likely connected to the increased impact of common comorbidities), and by the other side the increased burden due to medication consumption, which can be considered as a proxy for headache severity. Both elements should be considered when describing disability of headache disorders at population levels.

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Effects of passive smoking on cortical spreading depolarization in male and female mice.

Tsubasa Takizawa, Keiko Ihara, Miyuki Unekawa, Chisato Iba, Shizuko Kagawa, Narumi Watanabe, Shingo Nakayama, Kaori Sakurai, Naoki Miyazaki, Noriyuki Ishida, Ryo Takemura, Mamoru Shibata, Yoshikane Izawa, Shotaro Chubachi, Koichi Fukunaga, Jin Nakahara

The journal of headache and pain 25 ( 1 ) 162 - 162 2024.12

ISSN 11292369

BACKGROUND: Patients with migraine are typically advised to avoid passive smoking because it may aggravate headaches and other health conditions. However, there is insufficient high-quality evidence on the association between passive smoking and migraine, which warrants further investigation using animal models. Therefore, using a mouse model, we examined the effect of passive smoking on susceptibility to cortical spreading depolarization (CSD), the biological basis of migraine with aura. FINDINGS: Fifty C57BL/6 mice (25 males and 25 females) were exposed for one hour to cigarette smoke or room air. Subsequently, potassium chloride (KCl) was administered under isoflurane anesthesia to induce CSD, and the CSD threshold, frequency of induction, and propagation velocity were determined. The threshold to induce CSD (median [interquartile range (IQR)]) was significantly lower in female mice (adjusted p = 0.01) in the smoking group (0.05 [0.05, 0.088]) than in the sham group (0.125 [0.1, 0.15]); however, there was no significant difference in the male mice (adjusted p = 0.77). CSD frequency or propagation velocity did not differ significantly between the two groups for either sex. CONCLUSIONS: Female mice in the smoking group showed lower CSD threshold compared to the sham group, suggesting a potential sex-specific difference in the effect of smoking on the pathogenesis of CSD and migraine with aura. This finding may contribute to the understanding of migraine pathophysiology in association with passive smoking and sex difference.

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Hallmarks of primary headache: part 1 - migraine.

Alberto Raggi, Matilde Leonardi, Marco Arruda, Valeria Caponnetto, Matteo Castaldo, Gianluca Coppola, Adriana Della Pietra, Xiangning Fan, David Garcia-Azorin, Parisa Gazerani, Lou Grangeon, Licia Grazzi, Fu-Jung Hsiao, Keiko Ihara, Alejandro Labastida-Ramirez, Kristin Sophie Lange, Marco Lisicki, Alessia Marcassoli, Danilo Antonio Montisano, Dilara Onan, Agnese Onofri, Lanfranco Pellesi, Mario Peres, Igor Petrušić, Bianca Raffaelli, Eloisa Rubio-Beltran, Andreas Straube, Sebastian Straube, Tsubasa Takizawa, Claudio Tana, Michela Tinelli, Massimiliano Valeriani, Simone Vigneri, Doga Vuralli, Marta Waliszewska-Prosół, Wei Wang, Yonggang Wang, William Wells-Gatnik, Tissa Wijeratne, Paolo Martelletti

The journal of headache and pain 25 ( 1 ) 189 - 189 2024.12

ISSN 11292369

BACKGROUND AND AIM: Migraine is a common disabling conditions which, globally, affects 15.2% of the population. It is the second cause of health loss in terms of years lived with disability, the first among women. Despite being so common, it is poorly recognised and too often undertreated. Specialty centres and neurologists with specific expertise on headache disorders have the knowledge to provide specific care: however, those who do not regularly treat patients with migraine will benefit from a synopsis on the most relevant and updated information about this condition. This paper presents a comprehensive view on the hallmarks of migraine, from genetics and diagnostic markers, up to treatments and societal impact, and reports the elements that identify migraine specific features. MAIN RESULTS: The most relevant hallmark of migraine is that it has common and individual features together. Besides the known clinical manifestations, migraine presentation is heterogeneous with regard to frequency of attacks, presence of aura, response to therapy, associated comorbidities or other symptoms, which likely reflect migraine heterogeneous genetic and molecular basis. The amount of therapies for acute and for prophylactic treatment is really wide, and one of the difficulties is with finding the best treatment for the single patient. In addition to this, patients carry out different daily life activities, and might show lifestyle habits which are not entirely adequate to manage migraine day by day. Education will be more and more important as a strategy of brain health promotion, because this will enable reducing the amount of subjects needing specialty care, thus leaving it to those who require it in reason of refractory condition or presence of comorbidities. CONCLUSIONS: Recognizing the hallmarks of migraine and the features of single patients enables prescribing specific pharmacological and non-pharmacological treatments. Medical research on headaches today particularly suffers from the syndrome of single-disease approach, but it is important to have a cross-sectional and joint vision with other close specialties, in order to treat our patients with a comprehensive approach that a heterogeneous condition like migraine requires.

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Clinical practice for migraine treatment and characteristics of medical facilities and physicians treating migraine: Insights from a retrospective cohort study using a Japanese claims database.

Tsubasa Takizawa, Takahiro Kitano, Kanae Togo, Reiko Yoshikawa, Masahiro Iijima

PloS one 19 ( 12 December ) e0315610 2024.12

The real-world treatment patterns at medical facilities and their physicians' specialties treating migraine have not been fully investigated in Japan. Therefore, a retrospective cohort study aimed to describe real-world clinical practice and treatment patterns in Japanese patients with migraine according to medical facilities and physicians' specialties. Anonymized claims data of patients with migraine was obtained from JMDC Inc (January 2018-June 2023). Patient characteristics and treatment pattern according to medical facilities and physicians' specialties treating migraine were evaluated. Of 231,156 patients with migraine (mean age [SD], 38.8 [11.8] years; females, 65.3%), 81.8% had the first prescription at clinics (CPs), 42.5% underwent imaging tests, 44.4% visited general internal medicine, and 25.9% consulted neurosurgery at initial diagnosis. Imaging tests were carried out at CPs with specialists (59.4%), hospitals (HPs) with specialists (59.1%), HPs (32.9%), and CPs (26.9%) without specialists. Overall, 95.6% received acute treatment while 21.8% received preventive treatment. At facilities with specialists compared to without specialists, triptans were more frequently prescribed (67.9% vs 44.9%) whereas acetaminophen and nonsteroidal anti-inflammatory drugs were less frequently prescribed (52.4% vs 69.2%). Preventive treatment use was higher at facilities with specialists (27.4%) than without specialists (15.7%) and increased annually regardless of the type of medical institution. In Japan, only half of patients with migraine visited facilities with specialists at their first diagnosis, and specialists are more likely use migraine-specific and preventive drugs than nonspecialists. Therefore, there is a need for awareness among migraine patients that they should consult specialists and for enhancement of medical collaboration between specialists and nonspecialists.

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Is Intraoperative Blood Loss Volume in Elderly Cervical Spine Injury Surgery Greater in Patients with Ankylosis? A Multicenter Survey.

Uehara M, Ikegami S, Takizawa T, Oba H, Yokogawa N, Sasagawa T, Nakashima H, Segi N, Ito S, Funayama T, Eto F, Yamaji A, Watanabe K, Nori S, Takeda K, Furuya T, Yunde A, Nakajima H, Yamada T, Hasegawa T, Terashima Y, Hirota R, Suzuki H, Imajo Y, Tonomura H, Sakata M, Hashimoto K, Onoda Y, Kawaguchi K, Haruta Y, Suzuki N, Kato K, Uei H, Sawada H, Nakanishi K, Misaki K, Terai H, Tamai K, Kuroda A, Inoue G, Kakutani K, Kakiuchi Y, Kiyasu K, Tominaga H, Tokumoto H, Iizuka Y, Takasawa E, Akeda K, Takegami N, Funao H, Oshima Y, Kaito T, Sakai D, Yoshii T, Ohba T, Otsuki B, Seki S, Miyazaki M, Ishihara M, Okada S, Imagama S, Kato S

Spine surgery and related research 8 ( 6 ) 575 - 582 2024.11

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Clinical characteristics of 2378 patients presenting with headache disorders to headache clinics in Japan: A clinic-based multicenter study.

Noboru Imai, Tsubasa Takizawa, Narumi Watanabe, Yasuhiko Matsumori

Clinical neurology and neurosurgery 246 108588 - 108588 2024.11

ISSN 03038467

BACKGROUND: There are reports from single-center studies on patients visiting headache clinics; however, few multicenter studies have been conducted in Japan. This study aims to address this gap by conducting a multicenter analysis of the clinical characteristics, headache types, severity, and psychiatric comorbidities of patients attending headache clinics. METHODS: We prospectively evaluated the clinical characteristics of 2378 patients with headache disorders visiting three headache clinics. Baseline demographics, such as the visual analog scale (VAS), and psychiatric assessments, such as the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), were evaluated. Headache types were classified as migraine, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs), other primary headache disorders (OPHDs), and secondary headache. Parameters were compared between headache types using the Kruskal-Wallis test or analysis of covariance, as appropriate. RESULTS: The most common headache type was migraine (78.8 %), followed by TTH (12.2 %), secondary headache (5.5 %), OPHDs (2.1 %), and TACs (1.6 %). Patients with migraine were significantly younger at first consultation (median age 32.0) than those with other headache types (TTH; 47.0, TACs; 39.0, OPHDs; 49.5, and secondary headache; 47.0). Patients with TACs exhibited the highest severity and psychiatric symptoms, with VAS (median 90.0), GAD-7 (7.0), and PHQ-9 (7.5) scores significantly higher than those of other headache type (migraine; 70.0, 5.0, 5.0, TTH; 50.0, 4.0, 4.0, OPHDs; 65.0, 4.0, 3.5, and secondary headache; 60.0, 3.0, 3.5: p<0.001, p=0.019, p<0.001). CONCLUSION: Most patients visiting headache clinics had migraine; patients with TACs showed significantly higher headache severity and psychiatric symptoms than those with other headache types.

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International Headache Society Global Practice Recommendations for Preventive Pharmacological Treatment of Migraine.

Francesca Puledda, Simona Sacco, Hans-Christoph Diener, Messoud Ashina, Haidar M Al-Khazali, Sait Ashina, Rami Burstein, Eric Liebler, Andrea Cipriani, Min Kyung Chu, Alexandra Cocores, Freda Dodd-Glover, Esme Ekizoğlu, David Garcia-Azorin, Carl H Göbel, Maria Teresa Goicochea, Amr Hassan, Koichi Hirata, Jan Hoffmann, Bronwyn Jenkins, Katharina Kamm, Mi Ji Lee, Yu-Hsiang Ling, Marco Lisicki, Daniele Martinelli, Teshamae S Monteith, Raffaele Ornello, Aynur Özge, Mario Fernando Prieto Peres, Patricia Pozo-Rosich, Volodymyr Romanenko, Todd J Schwedt, Marcio Nattan P Souza, Tsubasa Takizawa, Gisela M Terwindt, Janu Thuraiaiyah, Mansoureh Togha, Nicolas Vandenbussche, Shuu-Jiun Wang, Shenguan Yu, Cristina Tassorelli

Cephalalgia : an international journal of headache 44 ( 9 ) 3331024241269735 - 3331024241269735 2024.09

ISSN 0333-1024

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International Headache Society global practice recommendations for the acute pharmacological treatment of migraine.

Francesca Puledda, Simona Sacco, Hans-Christoph Diener, Messoud Ashina, Haidar M Al-Khazali, Sait Ashina, Rami Burstein, Eric Liebler, Andrea Cipriani, Min Kyung Chu, Alexandra Cocores, Freda Dodd-Glover, Esme Ekizoğlu, David Garcia-Azorin, Carl Göbel, Maria Teresa Goicochea, Amr Hassan, Koichi Hirata, Jan Hoffmann, Bronwyn Jenkins, Katharina Kamm, Mi Ji Lee, Yu-Hsiang Ling, Marco Lisicki, Daniele Martinelli, Teshamae S Monteith, Raffaele Ornello, Aynur Ozge, Mario Peres, Patricia Pozo-Rosich, Volodymyr Romanenko, Todd J Schwedt, Marcio Nattan P Souza, Tsubasa Takizawa, Gisela M Terwindt, Janu Thuraiaiyah, Mansoureh Togha, Nicolas Vandenbussche, Shuu-Jiun Wang, Shengyuan Yu, Cristina Tassorelli

Cephalalgia : an international journal of headache 44 ( 8 ) 3331024241252666 - 3331024241252666 2024.08

ISSN 0333-1024

BACKGROUND: In an effort to improve migraine management around the world, the International Headache Society (IHS) has here developed a list of practical recommendations for the acute pharmacological treatment of migraine. The recommendations are categorized into optimal and essential, in order to provide treatment options for all possible settings, including those with limited access to migraine medications. METHODS: An IHS steering committee developed a list of clinical questions based on practical issues in the management of migraine. A selected group of international senior and junior headache experts developed the recommendations, following expert consensus and the review of available national and international headache guidelines and guidance documents. Following the initial search, a bibliography of twenty-one national and international guidelines was created and reviewed by the working group. RESULTS: A total of seventeen questions addressing different aspects of acute migraine treatment have been outlined. For each of them we provide an optimal recommendation, to be used whenever possible, and an essential recommendation to be used when the optimal level cannot be attained. CONCLUSION: Adoption of these international recommendations will improve the quality of acute migraine treatment around the world, even where pharmacological options remain limited.

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Application of Artificial Intelligence in the Headache Field.

Keiko Ihara, Gina Dumkrieger, Pengfei Zhang, Tsubasa Takizawa, Todd J Schwedt, Chia-Chun Chiang

Current pain and headache reports 28 ( 10 ) 1049 - 1057 2024.07

ISSN 15313433

PURPOSE OF REVIEW: Headache disorders are highly prevalent worldwide. Rapidly advancing capabilities in artificial intelligence (AI) have expanded headache-related research with the potential to solve unmet needs in the headache field. We provide an overview of AI in headache research in this article. RECENT FINDINGS: We briefly introduce machine learning models and commonly used evaluation metrics. We then review studies that have utilized AI in the field to advance diagnostic accuracy and classification, predict treatment responses, gather insights from various data sources, and forecast migraine attacks. Furthermore, given the emergence of ChatGPT, a type of large language model (LLM), and the popularity it has gained, we also discuss how LLMs could be used to advance the field. Finally, we discuss the potential pitfalls, bias, and future directions of employing AI in headache medicine. Many recent studies on headache medicine incorporated machine learning, generative AI and LLMs. A comprehensive understanding of potential pitfalls and biases is crucial to using these novel techniques with minimum harm. When used appropriately, AI has the potential to revolutionize headache medicine.

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Efficacy and tolerability of 100 mg of lasmiditan for migraine: A multi-center, prospective observational real-world study in Japan.

Ryotaro Ishii, Kei Ishizuchi, Narumi Watanabe, Ryosuke Fukazawa, Meesha Trivedi, Jin Nakahara, Tsubasa Takizawa

Cephalalgia : an international journal of headache (Cephalalgia : an international journal of headache) 44 ( 6 ) 3331024241258695 - 3331024241258695 2024.06

ISSN 0333-1024

BACKGROUND: Real-world data on the effectiveness and safety of lasmiditan, a new medication for acute migraine attacks, is necessary. METHODS: We performed a prospective, observational, multi-center, real-world study. A total of 48 patients with migraine (44 females, 44.6 ± 12.9 years old) were included in this study. RESULTS: Twenty-three patients (47.9%) reported they were headache-free two hours after taking lasmiditan and were categorized into the responder group. In total, 44 patients (91.7%) experienced at least one side effect within two hours of taking the medication. Dizziness, somnolence, malaise, nausea, and palpitations were reported by 56.3% (n = 27), 45.8% (n = 22), 37.5% (n = 18), 20.8% (n = 10), and 14.6% (n = 7) of patients respectively. Of 48 patients, 20 (41.7%) indicated that they preferred lasmiditan to their previous acute treatment. There were no predictive factors for efficacy. CONCLUSION: This real-world study demonstrated the efficacy and safety of lasmiditan. More than 90% of patients experienced side effects from lasmiditan. Approximately 40% of patients preferred lasmiditan despite the occurrence of side effects.

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特集患者さんからよく尋ねられる内科診療のQuestion 第9章　神経 [23歳女性,片頭痛]5年くらい前から片頭痛と言われていますが,最近薬を飲んでもあまり効かなくなってきて毎日のように頭が痛くなってしまいます.治療・生活では何に気をつけたらよいでしょうか?

加納裕也, 滝沢翼

内科 (南江堂) 133 ( 4 ) 902 - 904 2024.04

ISSN 00221961

Study Profile of the Tsuruoka Metabolomics Cohort Study (TMCS)

Harada Sei, Iida Miho, Miyagawa Naoko, Hirata Aya, Kuwabara Kazuyo, Matsumoto Minako, Okamura Tomonori, Edagawa Shun, Kawada Yoko, Miyake Atsuko, Toki Ryota, Akiyama Miki, Kawai Atsuki, Sugiyama Daisuke, Sato Yasunori, Takemura Ryo, Fukai Kota, Ishibashi Yoshiki, Kato Suzuka, Kurihara Ayako, Sata Mizuki, Shibuki Takuma, Takeuchi Ayano, Kohsaka Shun, Sawano Mitsuaki, Shoji Satoshi, Izawa Yoshikane, Katsumata Masahiro, Oki Koichi, Takahashi Shinichi, Takizawa Tsubasa, Maruya Hiroshi, Nishiwaki Yuji, Kawasaki Ryo, Hirayama Akiyoshi, Ishikawa Takamasa, Saito Rintaro, Sato Asako, Soga Tomoyoshi, Sugimoto Masahiro, Tomita Masaru, Komaki Shohei, Ohmomo Hideki, Ono Kanako, Otsuka-Yamasaki Yayoi, Shimizu Atsushi, Sutoh Yoichi, Hozawa Atsushi, Kinoshita Kengo, Koshiba Seizo, Kumada Kazuki, Ogishima Soichi, Sakurai-Yageta Mika, Tamiya Gen, Takebayashi Toru

Journal of Epidemiology (Japan Epidemiological Association) advpub ( 0 ) 393 - 401 2024

ISSN 09175040

The Tsuruoka Metabolomics Cohort Study (TMCS) is an ongoing population-based cohort study being conducted in the rural area of Yamagata Prefecture, Japan. This study aimed to enhance the precision prevention of multi-factorial, complex diseases, including non-communicable and aging-associated diseases, by improving risk stratification and prediction measures. At baseline, 11,002 participants aged 35–74 years were recruited in Tsuruoka City, Yamagata Prefecture, Japan, between 2012 and 2015, with an ongoing follow-up survey. Participants underwent various measurements, examinations, tests, and questionnaires on their health, lifestyle, and social factors. This study used an integrative approach with deep molecular profiling to identify potential biomarkers linked to phenotypes that underpin disease pathophysiology and provide better mechanistic insights into social health determinants. The TMCS incorporates multi-omics data, including genetic and metabolomic analyses of 10,933 participants and comprehensive data collection ranging from physical, psychological, behavioral, and social to biological data. The metabolome is used as a phenotypic probe because it is sensitive to changes in physiological and external conditions. The TMCS focuses on collecting outcomes for cardiovascular disease, cancer incidence and mortality, disability, functional decline due to aging and disease sequelae, and the variation in health status within the body represented by omics analysis that lies between exposure and disease. It contains several sub-studies on aging, heated tobacco products, and women's health. This study is notable for its robust design, high participation rate (89%), and long-term repeated surveys. Moreover, it contributes to precision prevention in Japan and East Asia as a well-established multi-omics platform.

Striatal Blood Flow Changes by Middle Cerebral Artery Occlusion and Its Effect on Neurological Deficits in Mice.

Miyuki Unekawa, Naoki Tsukada, Tsubasa Takizawa, Yutaka Tomita, Jin Nakahara, Yoshikane Izawa

Microcirculation (New York, N.Y. : 1994) (Microcirculation) 31 ( 6 ) e12861 2024

ISSN 10739688

OBJECTIVE: We attempted to record the regional cerebral blood flow (CBF) simultaneously at various regions of the cerebral cortex and the striatum during middle cerebral artery (MCA) occlusion and to evaluate neurological deficits and infarct formation. METHODS: In male C57BL/6J mice, CBF was recorded in three regions including the ipsilateral cerebral cortex and the striatum with laser Doppler flowmeters, and the origin of MCA was occluded with a monofilament suture for 15-90 min. After 48 h, neurological deficits were evaluated, and infarct was examined by triphenyltetrazolium chloride (TTC) staining. RESULTS: CBF decrease in the striatum was approximately two-thirds of the MCA-dominant region of the cortex during MCA occlusion. The characteristic CBF fluctuation because of spontaneously occurred spreading depolarization observed throughout the cortex was not found in the striatum. Ischemic foci with slight lower staining to TTC were found in the ipsilateral striatum in MCA-occluded mice for longer than 30 min (n = 54). Twenty-nine among 64 MCA-occluded mice exhibited neurological deficits even in the absence of apparent infarct with minimum staining to TTC in the cortex, and the severity of neurological deficits was not correlated with the size of the cortical infarct. CONCLUSION: Neurological deficits might be associated with the ischemic striatum rather than with cortical infarction.

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Repeated Intravenous Methylprednisolone May Prevent Deterioration of Hypertrophic Pachymeningitis in Rosai-Dorfman Disease

Tezuka Toshiki, Nukariya Tomonori, Takahashi Nobuyuki, Kufukihara Kenji, Tsuyama Naoko, Terui Yasuhito, Kameyama Kaori, Nakahara Jin, Takizawa Tsubasa

Internal Medicine (The Japanese Society of Internal Medicine) advpub ( 0 ) 2024

ISSN 09182918

Rosai-Dorfman disease (RDD) is a rare form of non-Langerhans cell histiocytosis. Although 20% of patients with RDD have spontaneous remission, some cases with central nervous system (CNS) involvement require surgery or systemic treatment. We encountered a case of RDD in which hypertrophic pachymeningitis was diffuse, eliminating the need for surgical intervention. A 72-year-old Japanese man was diagnosed with RDD based on pathological lymph node findings. Repeated intravenous methylprednisolone (IVMP) administration resolved and stabilized the hypertrophic pachymeningitis without any sequelae. If surgery or anticancer medications are contraindicated, repeated IVMP may be a good therapeutic option for CNS-associated RDD.

Real-world Efficacy of Erenumab on Migraine-associated Symptoms and Patient-reported Satisfaction Levels: A Retrospective Study in Japan

Ihara Keiko, Takahashi Nobuyuki, Ohtani Seiya, Watanabe Narumi, Ishizuchi Kei, Takemura Ryo, Tokuyasu Daiki, Sekiguchi Koji, Miyazaki Naoki, Imai Shungo, Hori Satoko, Nakahara Jin, Takizawa Tsubasa

Internal Medicine (The Japanese Society of Internal Medicine) advpub ( 0 ) 2024

ISSN 09182918

Objective In randomized clinical trials and real-world studies, calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs), including erenumab, have demonstrated efficacy for migraine prevention. However, there have been no real-world studies focusing on erenumab in East Asia that investigated its efficacy on migraine-associated symptoms and patient-reported satisfaction levels. Methods This single-center, observational, retrospective, real-world study examined patients who received at least three doses of erenumab at Keio University Hospital, Tokyo, Japan, between December 2021 and March 2023 as their first CGRP mAb treatment in a real-world setting. The patients were administered 70 mg of erenumab monthly. We assessed changes in monthly migraine days (MMDs), responder rates, migraine-associated symptoms including photophobia, phonophobia, nausea/vomiting, and patient-reported satisfaction levels. In addition, injection site reactions and other adverse events were recorded to investigate safety. Results Nineteen patients were considered eligible for the analysis. At 3 months, erenumab decreased MMDs by 6.6 (95% confidence interval, 2.3-10.8; p<0.01). The 50% responder rate was 42%. A total of 83% (n=15), 56% (n=10), and 71% (n=10) of patients reported either improvement in or disappearance of photophobia, phonophobia, and nausea/vomiting, respectively, and 44% (n=8) and 28% (n=5) answered "very satisfied" and "somewhat satisfied", respectively, with erenumab treatment, leaving only 28% (n=5) as "unsatisfied". Injection site reactions (n=6, 32%) and constipation (n=4, 21%) were frequent adverse events. Conclusion In a real-world setting in Japan, erenumab proved to be effective in not only reducing migraine and headache frequency but also improving migraine-associated symptoms and satisfying the majority of patients.

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