Predictors of response to galcanezumab in patients with chronic migraine: a real-world prospective observational study.

BACKGROUND: Despite high efficacy and tolerability, not all patients with chronic migraine benefit from anti-CGRP monoclonal antibodies. We aimed to identify the clinical predictors of the response to galcanezumab treatment in patients with chronic migraine from real-world data. METHODS: We prospectively recruited patients with CM who underwent galcanezumab injections between December 2019 and February 2022. Treatment response was determined after three months of follow-up and was defined as ≥ 50% reduction in monthly headache days. The migraine characteristics, comorbidities, and other treatment responses were compared between the responder and non-responder groups. RESULTS: Of 238 patients with CM, 153 (64.3%) showed treatment response. The responder group was younger, had lower frequency of baseline headache days, and had more accompanying symptoms such as nausea, vomiting, and photophobia. Better triptan response and less depression were also observed in the responder group. Multivariable regression analysis revealed that the everyday headache (OR = 0.351, 95% CI = 0.133-0.874, p = 0.017), depression (OR = 0.439, 95% CI = 0.216-0.896, p = 0.024) and absence of accompanying symptoms (OR = 0.314, 95% CI = 0.118-0.834, p = 0.020) were significantly associated with response to galcanezumab treatment. CONCLUSIONS: Our real-world data showed the efficacy of galcanezumab in patients with CM, regardless of medication overuse. Everyday headache, presence of depression, and absence of accompanying symptoms of migraine were significant predictors of a poor response.

Patient with Epilepsy Showing Psychiatric Symptoms after Remission of Seizures and Normalization of Electroencephalography: The Phenomenon of Forced Normalization?

Psychiatric disorders are commonly observed in patients with epilepsy. Among them, the phenomenon known as forced normalization is scarce. Herein, we report the case of a 41-year-old patient who showed long-term first-onset psychiatric symptoms after seizure remission and normalization of electroencephalography. After changing the antiepileptic drug regimen and psychiatric treatment, the patient's symptoms regressed. However, the exact pathological mechanisms remain to be elucidated. Changing the regimen of antiepileptic drugs and long-term psychiatric treatment may help control this phenomenon.

Aphasic Status Epilepticus Associated with Alzheimer's Disease: Clinical and Electrographic Characteristics.

In aphasic status epilepticus (ASE), aphasia is the sole manifestation of seizure in patients with this disorder. Alzheimer's disease (AD) is one of neurological disorders causing ASE. Herein, we report two cases of ASE associated with AD, and discuss their clinical characteristics. Patient 1 presented Broca's aphasia, and patient 2 presented global aphasia during the ictal period. Both patients exhibited atypical ictal electroencephalographic (EEG) patterns, which improved after antiepileptic drug administration. ASE was the presenting symptom of AD in patient 1. ASE can develop at any stage of AD. Alterations in clinical symptoms and EEG patterns after treatment with antiepileptic drug are the key to diagnosis. Prompt diagnosis and treatment are critical for preventing further consciousness dysfunction.

Anti-N-Methyl-D-Aspartate Receptor Encephalitis after BNT162b2 COVID-19 Vaccination.

After the coronavirus disease 2019 (COVID-19) pandemic emerged, the development of vaccines was accelerated. Neurologic complications of COVID-19 vaccination had been reported, which included encephalitis. In this study, we report a very rare case of a female with anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma that would be triggered by BNT162b2 m-RNA COVID-19 vaccination.

Effect of multi-polar magnetic field on the properties of nanocrystalline silicon thin film deposited by internal-type inductively coupled plasma.

An internal linear-type inductively coupled plasma (ICP) source with multi-polar permanent magnets was used to deposit nanocrystalline silicon thin films on a large-area substrate (470 mm x 370 mm), and the effects of a magnetic field on the characteristics of the plasma and deposited film were investigated. By applying the magnetic field, it was possible to obtain a high-density plasma of 2.8 x 10(11) cm(-3) at 15 mTorr Ar and 4000 W of RF power, which is about 50% higher than was obtained for the source without the magnetic field. The application of the multi-polar magnet field to the ICP source during the deposition of silicon film using SiH4/H2 also increased the deposition rates of the silicon thin films and the ratio Halpha*/SiH*, which transformed the structure of the silicon films deposited on the glass substrates from amorphous to nanocrystalline. Furthermore, the use of the magnetic field increased crystalline volume fraction and dark conductivity while decreasing the absorption coefficient. The improved characteristics were related to the increase in the ionization rate and the dissociation rate of SiH4/H2, which confined the plasma to the chamber volume and avoided losses to the chamber wall. The decrease in the absorption coefficient of the nanocrystalline silicon film deposited with a higher H2 percentage and with the magnetic field present is also related to the increase in the crystallization volume fraction. At 70% H2 with the magnetic field present, the nanocrystalline silicon thin films had a high crystalline volume fraction (68%), a dark conductivity of 3.4E-7 omega(-1) cm(-1), a deposition rate of 10 angstroms/s, and grain sizes of approximately 15 nm.

Enhanced inhibitory effect of ultra-fine granules of red ginseng on LPS-induced cytokine expression in the monocyte-derived macrophage THP-1 cells.

Red ginseng is one of the most popular traditional medicines in Korea because its soluble hot-water extract is known to be very effective on enhancing immunity as well as inhibiting inflammation. Recently, we developed a new technique, called the HAC-gearshift system, which can pulverize red ginseng into the ultra-fine granules ranging from 0.2 to 7.0 microm in size. In this study, the soluble hot-water extract of those ultra-fine granules of red ginseng (URG) was investigated and compared to that of the normal-sized granules of red ginseng (RG). The high pressure liquid chromatographic analyses of the soluble hot-water extracts of both URG and RG revealed that URG had about 2-fold higher amounts of the ginsenosides, the biologically active components in red ginseng, than RG did. Using quantitative RT-PCR, cytokine profiling against the Escherichia coli lipopolysaccharide (LPS) in the monocyte-derived macrophage THP-1 cells demonstrated that the URG-treated cells showed a significant reduction in cytokine expression than the RG-treated ones. Transcription expression of the LPS-induced cytokines such as TNF-alpha, IL-1beta, IL-6, IL-8, IL-10, and TGF-beta was significantly inhibited by URG compared to RG. These results suggest that some biologically active and soluble components in red ginseng can be more effectively extracted from URG than RG by standard hot-water extraction.