- Email: [email protected]
54. The relationship between the Parkinson’s disease sleep scale and polysomnography
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Japanese Society of Clinical Neurophysiology / Clinical Neurophysiology 119 (2008) e75–e93
by the damage of blood–brain barrier/blood–nerve barrier at the most proximal site. doi:10.1016/j.clinph.2008.01.077
53. Is the facial nerve injured by a vascular compression in hemifacial spasm?: Stimulating single-fiber EMG study— Sonoko Misawa, Satoshi Kuwabara, Takamichi Hattori Chiba University School of Medicine, Chiba, Japan) Primary hemifacial spasm (HFS) is usually related to a vascular compression of the facial nerve at its root exit zone from the brainstem, and it may result in latent facial nerve injury. Axonal stimulating single-fiber EMG (a-SFEMG) was used to investigate whether facial axons are affected in HFS patients. Facial nerve conduction and a-SFEMG of the orbicularis oculi were performed in 30 patients with HFS and 20 patients with blepharospasm (BS). All the patients had not received prior botulinum toxin treatment. Amplitudes of compound muscle action potentials did not significantly differ between the affected side and non-affected side in HFS patients, and between patients with HFS and those with BS. However, jitter (mean consecutive difference) was significantly greater in the HFS group than in the BS group (p = 0.005). After an initial botulinum toxin injection (10 IU) in the O. oculi, 20% of the HFS patients and 5% of the BS patients presented lagophthalmos. These results suggest that HFS is associated with mild facial nerve injury, and this can lead to vulnerability to botulinum injection.
55. Clinical characteristics of narcolepsy without cataplexy focusing on HLA-DRB1*1501/DQB1*0602 finding—Taeko Sasai, Yoko Komada, Yuichi Inoue Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan) The aim of this study is to clarify the clinical characteristics of narcolepsy without cataplexy (NA w/o CA) especially focusing on the existence of HLA-DRB1*1501/DQB1*0602 finding. Comparisons of clinical symptoms, MSLT variables, and changes in Epworth Sleepiness Scale (ESS) after psychostimulant medication were made among the four groups {NA-CA, NA w/o CA HLA positive, NA w/o CA HLA negative and idiopathic hypersomnia without long sleep time (IHS w/o LST)}. Mean sleep latency on MSLT was significantly shorter and the reduction rate of ESS after medication was lower in both NACA group and NA w/o CA HLA positive group compared with those in the IHS w/o LST group. However, no significant differences of those variables were found between the NA w/o CA HLA negative group and the IHS w/o LST group. Mean REM latency was significantly shorter in the NA-CA group than in the two groups of NA w/o CA. These results suggested that NA w/o CA HLA positive group had second highest disease severity next to NA-CA, and NA w/o CA HLA negative group could be a distinct milder subgroup of NA. We speculated that existence of HLA-DRB1*1501/DQB1*0602 could affect both the severity of hypersomnia and REM propensity in narcolepsy. doi:10.1016/j.clinph.2008.01.080
doi:10.1016/j.clinph.2008.01.078
54. The relationship between the Parkinson’s disease sleep scale and polysomnography—Yusuke Uemura, Takashi Nomura, Yuichi Inoue, Kenichi Yasui, Mika Yamawaki, Kenji Nakashima Tottori University, Yonago, Japan)
56. Development of seizure detection system for the implantable focal cooling device to treat intractable epilepsies—Joji Uchiyama, Kimihiko Nakano, Takashi Saito, Masami Fujii, Nobuhiro Tanaka, Hirochika Imoto, Michiyasu Suzuki Graduate School, Yamaguchi University, Yamaguchi, Japan)
Objective: The Parkinson’s disease sleep scale (PDSS) is a subjective questionnaire that evaluates sleep disturbance of patients with Parkinson’s disease (PD). We examined the relationship between scales of PDSS and variables of polysomnography. Subject: Subjects were 36 patients with PD (71.0 ± 9.5 years old, 12 men and 24 women) and 76 age- and sex-matched controls. The length of morbidity of their PD was 7.6 ± 7.2 years, and their Hoehn and Yahr grade was 2.6 ± 1.1. All subjects completed the PDSS; we compared the PDSS between patients with PD and controls. Moreover, we examined PD patients with polysomnography (PSG), and the correlation between scales of PDSS and variables of PSG. Results: Total score and subscales of PDSS in patients with PD were significantly lower than those in controls except for items 2, 3, and 8. Total score of PDSS was correlated with sleep efficacy in PSG. Night psychosis (item 6 + 7) of PDSS was negatively correlated with the amount of REM sleep without atonia in PSG. Discussion: PDSS is a useful scale for determining sleep disturbance in patients with PD. Night psychosis in PDSS might reflect the occurrence of REM sleep behaviour disorders in patients with PD.
It has recently been noted that epileptic discharges are suppressed when the epileptic cortex is locally cooled. We focused our attention on this phenomenon and started to develop a system for an implantable cooling device that is able to suppress epileptic discharges before the onset of seizures. We herein propose a simple analytic method for detecting seizures in advance, which is required for the miniaturization of a system to be implanted in the future. The tenet of these calculations is as follows: let the peak-to-peak amplitude be defined as Y, and the time to amplitude be X. Then, the sharpness of each epileptic wave is determined by calculating Y/X. The difference in the values of Y/X during the epileptic/non-epileptic state is used for predicting seizures. This simple algorithm was actually applied to analyze the ictal EEGs in 22 epileptic patients with chronically-implanted multi-channel electrodes. It could detect the occurrence of seizures an average of 12.9 ± 15.4 s before their onset. This method is therefore useful and easy to be incorporated into a miniaturized cooling system for the treatment of intractable epilepsies.
doi:10.1016/j.clinph.2008.01.079
doi:10.1016/j.clinph.2008.01.081
Japanese Society of Clinical Neurophysiology / Clinical Neurophysiology 119 (2008) e75–e93
by the damage of blood–brain barrier/blood–nerve barrier at the most proximal site. doi:10.1016/j.clinph.2008.01.077
53. Is the facial nerve injured by a vascular compression in hemifacial spasm?: Stimulating single-fiber EMG study— Sonoko Misawa, Satoshi Kuwabara, Takamichi Hattori Chiba University School of Medicine, Chiba, Japan) Primary hemifacial spasm (HFS) is usually related to a vascular compression of the facial nerve at its root exit zone from the brainstem, and it may result in latent facial nerve injury. Axonal stimulating single-fiber EMG (a-SFEMG) was used to investigate whether facial axons are affected in HFS patients. Facial nerve conduction and a-SFEMG of the orbicularis oculi were performed in 30 patients with HFS and 20 patients with blepharospasm (BS). All the patients had not received prior botulinum toxin treatment. Amplitudes of compound muscle action potentials did not significantly differ between the affected side and non-affected side in HFS patients, and between patients with HFS and those with BS. However, jitter (mean consecutive difference) was significantly greater in the HFS group than in the BS group (p = 0.005). After an initial botulinum toxin injection (10 IU) in the O. oculi, 20% of the HFS patients and 5% of the BS patients presented lagophthalmos. These results suggest that HFS is associated with mild facial nerve injury, and this can lead to vulnerability to botulinum injection.
55. Clinical characteristics of narcolepsy without cataplexy focusing on HLA-DRB1*1501/DQB1*0602 finding—Taeko Sasai, Yoko Komada, Yuichi Inoue Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan) The aim of this study is to clarify the clinical characteristics of narcolepsy without cataplexy (NA w/o CA) especially focusing on the existence of HLA-DRB1*1501/DQB1*0602 finding. Comparisons of clinical symptoms, MSLT variables, and changes in Epworth Sleepiness Scale (ESS) after psychostimulant medication were made among the four groups {NA-CA, NA w/o CA HLA positive, NA w/o CA HLA negative and idiopathic hypersomnia without long sleep time (IHS w/o LST)}. Mean sleep latency on MSLT was significantly shorter and the reduction rate of ESS after medication was lower in both NACA group and NA w/o CA HLA positive group compared with those in the IHS w/o LST group. However, no significant differences of those variables were found between the NA w/o CA HLA negative group and the IHS w/o LST group. Mean REM latency was significantly shorter in the NA-CA group than in the two groups of NA w/o CA. These results suggested that NA w/o CA HLA positive group had second highest disease severity next to NA-CA, and NA w/o CA HLA negative group could be a distinct milder subgroup of NA. We speculated that existence of HLA-DRB1*1501/DQB1*0602 could affect both the severity of hypersomnia and REM propensity in narcolepsy. doi:10.1016/j.clinph.2008.01.080
doi:10.1016/j.clinph.2008.01.078
54. The relationship between the Parkinson’s disease sleep scale and polysomnography—Yusuke Uemura, Takashi Nomura, Yuichi Inoue, Kenichi Yasui, Mika Yamawaki, Kenji Nakashima Tottori University, Yonago, Japan)
56. Development of seizure detection system for the implantable focal cooling device to treat intractable epilepsies—Joji Uchiyama, Kimihiko Nakano, Takashi Saito, Masami Fujii, Nobuhiro Tanaka, Hirochika Imoto, Michiyasu Suzuki Graduate School, Yamaguchi University, Yamaguchi, Japan)
Objective: The Parkinson’s disease sleep scale (PDSS) is a subjective questionnaire that evaluates sleep disturbance of patients with Parkinson’s disease (PD). We examined the relationship between scales of PDSS and variables of polysomnography. Subject: Subjects were 36 patients with PD (71.0 ± 9.5 years old, 12 men and 24 women) and 76 age- and sex-matched controls. The length of morbidity of their PD was 7.6 ± 7.2 years, and their Hoehn and Yahr grade was 2.6 ± 1.1. All subjects completed the PDSS; we compared the PDSS between patients with PD and controls. Moreover, we examined PD patients with polysomnography (PSG), and the correlation between scales of PDSS and variables of PSG. Results: Total score and subscales of PDSS in patients with PD were significantly lower than those in controls except for items 2, 3, and 8. Total score of PDSS was correlated with sleep efficacy in PSG. Night psychosis (item 6 + 7) of PDSS was negatively correlated with the amount of REM sleep without atonia in PSG. Discussion: PDSS is a useful scale for determining sleep disturbance in patients with PD. Night psychosis in PDSS might reflect the occurrence of REM sleep behaviour disorders in patients with PD.
It has recently been noted that epileptic discharges are suppressed when the epileptic cortex is locally cooled. We focused our attention on this phenomenon and started to develop a system for an implantable cooling device that is able to suppress epileptic discharges before the onset of seizures. We herein propose a simple analytic method for detecting seizures in advance, which is required for the miniaturization of a system to be implanted in the future. The tenet of these calculations is as follows: let the peak-to-peak amplitude be defined as Y, and the time to amplitude be X. Then, the sharpness of each epileptic wave is determined by calculating Y/X. The difference in the values of Y/X during the epileptic/non-epileptic state is used for predicting seizures. This simple algorithm was actually applied to analyze the ictal EEGs in 22 epileptic patients with chronically-implanted multi-channel electrodes. It could detect the occurrence of seizures an average of 12.9 ± 15.4 s before their onset. This method is therefore useful and easy to be incorporated into a miniaturized cooling system for the treatment of intractable epilepsies.
doi:10.1016/j.clinph.2008.01.079
doi:10.1016/j.clinph.2008.01.081