研究者詳細 - 滝沢　翼

論文 - 滝沢　翼

分割表示 91 件中 41 - 60 件目／全件表示 >>

Prevalence of Primary Headache in Nurses in Japan: A Cross-sectional Single-center Study

Sekiguchi K., Huh S., Watanabe N., Miyazaki N., Ishizuchi K., Iba C., Tagashira Y., Shibata M., Takemura R., Nakahara J., Takizawa T.

Internal Medicine （一般社団法人日本内科学会） advpub （ 0 ） 1217 - 1222 2023年

ISSN 09182918

Objective This study examined the prevalence of migraine in nurses in Japan, which, to our knowledge, has not been documented in English. Methods From April to May 2021, we administered a questionnaire to 229 nurses working at Keio University Hospital to investigate the prevalence and characteristics of headache among nurses in Japan. Headaches were classified as migraine or tension-type headache (TTH) based on the International Classification of Headache Disorders 3rd edition (ICHD-3). Results In total, 80 patients (34.9%) had primary headaches, including 47 (20.5%) with migraine and probable migraine and 33 (14.4%) with TTH and probable TTH. We found a significant difference in the Numerical Rating Scale score, nausea and vomiting, photophobia, phonophobia, and aggravation by routine physical activity between migraine and TTH. The specificities for a migraine diagnosis were 100% and 93.9% for nausea/vomiting and photophobia, respectively. Only 8.8% of patients had their headaches diagnosed by a physician. Conclusion Migraines have a high prevalence (>20%) among nurses and are often under-diagnosed. In many cases, headache-associated symptoms are more important than laterality or other characteristics for the diagnosis. Many nurses are treated for headaches without a correct diagnosis. Further education regarding primary headaches may be necessary for health practitioners as well as society.

Cerebral Venous Thrombosis Mimicking Limbic Encephalitis

Tezuka T., Takahashi N., Tokuyasu D., Azami S., Sekiguchi K., Takizawa T., Izawa Y., Nakahara J., Katsumata M.

Internal Medicine （一般社団法人日本内科学会） advpub （ 0 ） 1277 - 1280 2023年

ISSN 09182918

Cerebral venous thrombosis (CVT) is challenging to diagnose, as it presents with variable symptoms. We encountered a complicated case of CVT that mimicked limbic encephalitis due to sensory aphasia. Based on the characteristic magnetic resonance imaging findings, this 72-year-old Japanese man was later confirmed to have CVT, the cause of which was periodontitis due to Eikenella corrodens, a Gram-negative facultative anaerobic that is part of the mouth’s normal flora. The symptoms improved without sequelae following anticoagulation treatment and antibiotics. Clinicians should consider CVT as a differential diagnosis when unexplainable neurological symptoms suggesting limbic encephalitis are observed.

Serious Bacterial Infections Associated with Eculizumab: A Pharmacovigilance Study

Shohei Okusa, Tsubasa Takizawa, Shungo Imai, Munenori Oyama, Kei Ishizuchi, Jin Nakahara, Satoko Hori, Shigeaki Suzuki

Internal Medicine （Japanese Society of Internal Medicine） 2023年

ISSN 0918-2918

Access to Document (DOI)

私の留学体験談　～Massachusetts General Hospital～

滝沢翼

日本頭痛学会誌（一般社団法人日本頭痛学会） 50 （ 1 ） 117 - 119 2023年

ISSN 13456547

ガルカネズマブ，フレマネズマブ，エレヌマブ : リアルワールドデータ

滝沢翼, 大谷星也, 井原慶子

日本頭痛学会誌（一般社団法人日本頭痛学会） 50 （ 1 ） 33 - 37 2023年

ISSN 13456547

TACsの疫学，症状の特徴について～群発頭痛を中心に～

滝沢翼, 石鎚啓

日本頭痛学会誌（一般社団法人日本頭痛学会） 50 （ 1 ） 59 - 63 2023年

ISSN 13456547

Metabolic and toxicological considerations regarding CGRP mAbs and CGRP antagonists to treat migraine in COVID-19 patients: a narrative review

Takizawa T., Ihara K., Uno S., Ohtani S., Watanabe N., Imai N., Nakahara J., Hori S., Garcia-Azorin D., Martelletti P.

Expert Opinion on Drug Metabolism and Toxicology （Expert Opinion on Drug Metabolism and Toxicology） 19 （ 12 ） 951 - 967 2023年

ISSN 17425255

Introduction: Migraine pharmacological therapies targeting calcitonin gene-related peptide (CGRP), including monoclonal antibodies and gepants, have shown clinical effect and optimal tolerability. Interactions between treatments of COVID-19 and CGRP-related drugs have not been reviewed. Areas covered: An overview of CGRP, a description of the characteristics of each CGRP-related drug and its response predictors, COVID-19 and its treatment, the interactions between CGRP-related drugs and COVID-19 treatment, COVID-19 and vaccination-induced headache, and the neurological consequences of Covid-19. Expert opinion: Clinicians should be careful about using gepants for COVID-19 patients, due to the potential drug interactions with drugs metabolized via CYP3A4 cytochrome. In particular, COVID-19 treatment (especially nirmatrelvir packaged with ritonavir, as Paxlovid) should be considered cautiously. It is advisable to stop or adjust the dose (10 mg atogepant when used for episodic migraine) of gepants when using Paxlovid (except for zavegepant). CGRP moncolconal antibodies (CGRP-mAbs) do not have drug–drug interactions, but a few days’ interval between a COVID-19 vaccination and the use of CGRP mAbs is recommended to allow the accurate identification of the possible adverse effects, such as injection site reaction. Covid-19- and vaccination-related headache are known to occur. Whether CGRP-related drugs would be of benefit in these circumstances is not yet known.

Access to Document (DOI)

特集令和の頭痛診療-プライマリ・ケア医のためのガイド頭痛診療Start-Up 頭痛患者の問診と身体診察のコツ

石鎚啓, 滝沢翼

medicina （株式会社医学書院） 59 （ 13 ） 2350 - 2353 2022年12月

ISSN 00257699

Efficacy profile of noninvasive vagus nerve stimulation on cortical spreading depression susceptibility and the tissue response in a rat model

Liu T.T., Morais A., Takizawa T., Mulder I., Simon B.J., Chen S.P., Wang S.J., Ayata C., Yen J.C.

Journal of Headache and Pain （Journal of Headache and Pain） 23 （ 1 ） 12 - 12 2022年12月

ISSN 11292369

Background: Noninvasive vagus nerve stimulation (nVNS) has recently emerged as a promising therapy for migraine. We previously demonstrated that vagus nerve stimulation inhibits cortical spreading depression (CSD), the electrophysiological event underlying migraine aura and triggering headache; however, the optimal nVNS paradigm has not been defined. Methods: Various intensities and doses of nVNS were tested to improve efficacy on KCl-evoked CSD frequency and electrical threshold of CSD in a validated rat model. Chronic efficacy was evaluated by daily nVNS delivery for four weeks. We also examined the effects of nVNS on neuroinflammation and trigeminovascular activation by western blot and immunohistochemistry. Results: nVNS suppressed susceptibility to CSD in an intensity-dependent manner. Two 2-minute nVNS 5 min apart afforded the highest efficacy on electrical CSD threshold and frequency of KCl-evoked CSD. Daily nVNS for four weeks did not further enhance efficacy over a single nVNS 20 min prior to CSD. The optimal nVNS also attenuated CSD-induced upregulation of cortical cyclooxygenase-2, calcitonin gene-related peptide in trigeminal ganglia, and c-Fos expression in trigeminal nucleus caudalis. Conclusions: Our study provides insight on optimal nVNS parameters to suppress CSD and suggests its benefit on CSD-induced neuroinflammation and trigeminovascular activation in migraine treatment.

Access to Document (DOI)

Real-world evidence of galcanezumab for migraine treatment in Japan: a retrospective analysis

Takizawa T., Ohtani S., Watanabe N., Miyazaki N., Ishizuchi K., Sekiguchi K., Iba C., Shibata M., Takemura R., Hori S., Nakahara J.

BMC Neurology （BMC Neurology） 22 （ 1 ） 512 - 512 2022年12月

Objective: To evaluate the efficacy and safety of galcanezumab in patients with migraine in a real-world setting in Japan. Background: Galcanezumab is the first anti-calcitonin gene-related peptide monoclonal antibody approved in Japan. To the best of our knowledge, no real-world studies on galcanezumab have been published in any international journal from Japan. Methods: We retrospectively examined patients with migraine who received three doses of galcanezumab between August 2021 and February 2022 at the Keio University Hospital. We assessed changes in monthly migraine days, responder rate, and migraine-associated and premonitory symptoms. We also investigated injection site reactions and adverse events. Results: Fifty-two patients received three doses of galcanezumab during the study period. Compared with those at baseline, the monthly migraine days decreased by 5.9 days (95% confidence interval, 4.2–7.7) at 3 months. The 50% responder rate was 61.5% at 3 months. A total of 64.9%, 50.0%, and 63.9% of patients showed improvement in the severity of photophobia, phonophobia, and nausea/vomiting, respectively. Premonitory symptoms without subsequent headache were reported in 62.5% of patients. Moreover, injection site reaction was the most common adverse event (34.6%). Conclusion: This study revealed the efficacy and safety of galcanezumab for migraineurs in Japan. Galcanezumab also improved migraine-associated symptoms. However, despite a reduction in headaches, premonitory symptoms without subsequent headache were reported in > 50% of the patients at 3 months.

Access to Document (DOI)

Effect of Goreisan, a Japanese Traditional Medicine, on Cortical Spreading Depolarization in Mice

Iba C., Unekawa M., Izawa Y., Nakahara J., Takizawa T.

International Journal of Molecular Sciences （International Journal of Molecular Sciences） 23 （ 22 ） 2022年11月

ISSN 16616596

Goreisan, a traditional Japanese Kampo medicine, is often used to treat headaches, including migraines; however, the underlying mechanisms remain unknown. Therefore, we investigated whether chronic treatment with Goreisan affects cortical spreading depolarization (CSD) in migraines. CSD susceptibility was assessed in male and female C57BL/6 mice by comparing CSD threshold, propagation velocity, and CSD frequency between animals treated with Goreisan for approximately 3 weeks and the corresponding controls with a potassium-induced CSD model. No significant differences were observed in CSD susceptibility between mice that were chronically treated with Goreisan and the control mice. Additionally, no significant differences were observed in other physiological parameters, including body weight, blood gases, and blood pressure. CSD susceptibility was not affected by chronic treatment with Goreisan, which suggests that the drug treats headaches via mechanisms that do not involve CSD modulation.

Access to Document (DOI)

Immunodeficiency in patients with thymoma-associated myasthenia gravis

Ishizuchi K., Takizawa T., Ohnuki Y., Sekiguchi K., Motegi H., Oyama M., Nakahara J., Shiina T., Suzuki S.

Journal of Neuroimmunology （Journal of Neuroimmunology） 371 577950 - 577950 2022年10月

ISSN 01655728

Thymoma with immunodeficiency is sometimes accompanied by myasthenia gravis (MG), but the clinical characteristics have not been elucidated. This study aimed to characterize its clinical and immunological features. Of the 132 thymoma-associated MG patients, 9 patients presented with immunodeficiency. All suffered from severe pneumonia, and most had invasive thymoma and autoimmune disorders. DRB1*08:03 and DQB1*06:01 alleles were frequently detected. Compared to group without immunodeficiency, they showed no significant differences in the severity of MG, significantly lower IgG concentrations and higher mortality rate. Thymoma-associated MG with immunodeficiency is a distinct subset requiring special attention to prevent infection during the follow-up period.

Access to Document (DOI)

Anemia in female patients with myasthenia gravis

Sekiguchi K., Ishizuchi K., Takizawa T., Motegi H., Oyama M., Nakahara J., Suzuki S.

PLoS ONE （PLoS ONE） 17 （ 9 September ） e0273720 2022年09月

Myasthenia gravis (MG) is the most common autoimmune neuromuscular disorder, and is more common in women than in men. Anemia is also more common in women. The purpose of this study was to investigate factors associated with anemia and the negative impact of anemia in female MG patients. We investigated factors related to MG and anemia in 215 female patients with MG, who were attending the MG clinic of Keio Hospital between January and December 2021. We statistically evaluated clinical factors related to anemia in patients with and without anemia. Eighty-five patients (40%) had anemia in the past, and 130 patients did not have anemia in the past. There were no significant differences in age at study, age at MG onset, body mass index, or frequency of autoantibodies between the anemia and non-anemia groups. MG severity evaluated by the MG Foundation of America classification was greater in the anemia group than in the non-anemia group. History of anemia was associated with immunosuppressive treatment, such as prednisolone and calcineurin inhibitor treatment. There was a correlation between hemoglobin levels and the MG-quality of life score. Long term immunosuppressive therapy can cause anemia in female MG patients. Anemia may negatively affect the quality of life of female MG patients.

Access to Document (DOI)

早朝頭痛を認めた片頭痛患者における閉塞性睡眠時無呼吸症候群の検討

関口耕史, 渡邊成美, 渡辺理沙, 臼田頌, 山澤稚子, 柴田護, 福永興壱, 中原仁, 滝沢翼

日本頭痛学会誌（(一社)日本頭痛学会） 48 （ 3 ） 566 - 570 2022年04月

ISSN 1345-6547

早朝に頭痛が集中している片頭痛患者を臨床において経験することがある.慶應義塾大学病院神経内科頭痛外来を通院している片頭痛患者のうち,頭痛ダイアリーや問診上,早朝頭痛が目立った8例について,特徴および閉塞性睡眠時無呼吸症候群(OSAS)との関連を検討した.8例中7例においてOSAS(6例が軽症,1例が中等症)を認めた.Apnea hypopnea indexと頭痛が早朝に生じる割合には正の相関傾向を示していた.OSASは片頭痛増悪因子となっている可能性もあり,早朝頭痛を認める片頭痛患者でOSAS合併例に対しての治療は今後の研究課題である.(著者抄録)

Incidence of headache after COVID-19 vaccination in patients with history of headache: A cross-sectional study

Sekiguchi K., Watanabe N., Miyazaki N., Ishizuchi K., Iba C., Tagashira Y., Uno S., Shibata M., Hasegawa N., Takemura R., Nakahara J., Takizawa T.

Cephalalgia （Cephalalgia） 42 （ 3 ） 266 - 272 2022年03月

ISSN 03331024

Background: Headache is an adverse event of coronavirus 2019 (COVID-19) vaccination. Whether patients with history of headache suffer more from vaccination-induced headaches is unknown. We aimed to uncover if headache patients develop more headaches after COVID-19 mRNA vaccination than healthy controls. Methods: We performed a questionnaire survey for nursing staff in our hospital from April to May 2021. Based on baseline characteristics, we divided the participants into migraine, non-migrainous headache, and healthy control, and examined the occurrence and features of headache after COVID-19 vaccinations. Results: We included 171 participants (15.2% migraine and 24.6% non-migrainous headache). Headache incidence after vaccinations was significantly higher in the migraine (69.2%) and non-migrainous headache (71.4%) groups than in the healthy control (37.9%) group. The incidence of headaches was significantly higher after the second dose compared to the first (45.6% vs. 20.5%). Conclusion: Migraineurs and non-migrainous headache participants developed more headaches compared to the healthy controls after COVID-19 vaccination.

Access to Document (DOI)

大学での教育（卒後教育を中心に）

滝沢翼

日本頭痛学会誌（一般社団法人日本頭痛学会） 48 （ 3 ） 506 - 508 2022年

ISSN 13456547

頭痛が視野障害より2ヵ月先行した視神経脊髄炎関連疾患の1例

砂金瑛実, 石鎚啓, 滝沢翼, 藤原広和, 伊澤良兼, 中原仁

臨床神経学（(一社)日本神経学会） 61 （ 11 ） 722 - 726 2021年11月

ISSN 0009-918X

症例は50代女性で,2ヵ月前より持続する右上眼瞼周囲の頭痛のため受診となった.頭部MRI T2強調画像で脳梁,両側放線冠に多発性の高信号病変を認めた.自己免疫疾患を考えステロイドパルス療法を施行したが,右眼に下方水平性半盲と対光反射減弱が出現した.眼窩MRIのT2強調画像で右視神経腫大,視神経上半側の高信号,ガドリニウム造影増強効果を認め,抗AQP4抗体陽性と併せ視神経脊髄炎関連疾患(neuromyelitis opticaspectrum disorders,以下NMOSDと略記)と診断した.NMOSDの初発症状として頭痛がみられることがあるので,鑑別の際に念頭に置く必要がある.(著者抄録)

特集頭痛診療の基本から最新の知見まで最近の話題　片頭痛の最新の知見

滝沢翼, 伊庭知里

小児科診療（(株)診断と治療社） 84 （ 10 ） 1357 - 1362 2021年10月

ISSN 03869806

特集片頭痛　病態の理解と薬物療法の最前線片頭痛薬物療法の新たな潮流!新薬の最新エビデンス　抗CGRP抗体・抗CGRP受容体抗体

滝沢翼, 鈴木則宏

薬局（(株)南山堂） 72 （ 8 ） 2791 - 2797 2021年07月

ISSN 00440035

Rapid hematoma growth triggers spreading depolarizations in experimental intracortical hemorrhage

Fischer P., Sugimoto K., Chung D.Y., Tamim I., Morais A., Takizawa T., Qin T., Gomez C.A., Schlunk F., Endres M., Yaseen M.A., Sakadzic S., Ayata C.

Journal of Cerebral Blood Flow and Metabolism （Journal of Cerebral Blood Flow and Metabolism） 41 （ 6 ） 1264 - 1276 2021年06月

ISSN 0271678X

Recurrent waves of spreading depolarization (SD) occur in brain injury and are thought to affect outcomes. What triggers SD in intracerebral hemorrhage is poorly understood. We employed intrinsic optical signaling, laser speckle flowmetry, and electrocorticography to elucidate the mechanisms triggering SD in a collagenase model of intracortical hemorrhage in mice. Hematoma growth, SD occurrence, and cortical blood flow changes were tracked. During early hemorrhage (0–4 h), 17 out of 38 mice developed SDs, which always originated from the hematoma. No SD was detected at late time points (8–52 h). Neither hematoma size, nor peri-hematoma perfusion were associated with SD occurrence. Further, arguing against ischemia as a trigger factor, normobaric hyperoxia did not inhibit SD occurrence. Instead, SDs always occurred during periods of rapid hematoma growth, which was two-fold faster immediately preceding an SD compared with the peak growth rates in animals that did not develop any SDs. Induced hypertension accelerated hematoma growth and resulted in a four-fold increase in SD occurrence compared with normotensive animals. Altogether, our data suggest that spontaneous SDs in this intracortical hemorrhage model are triggered by the mechanical distortion of tissue by rapidly growing hematomas.

Access to Document (DOI)

　前のページ - 次のページ　

滝沢 翼

論文 - 滝沢 翼

滝沢　翼

論文 - 滝沢　翼