Hitoshi Mochizuki

Publications (45)129.65 Total impact

• Article: Cortical hemoglobin concentration changes underneath the coil after single-pulse transcranial magnetic stimulation: A near-infrared spectroscopy (NIRS) study.

  Toshiaki Furubayashi, Hitoshi Mochizuki, Yasuo Terao, Noritoshi Arai, Ritsuko Hanajima, Masashi Hamada, Hideyuki Matsumoto, Setsu Nakatani-Enomoto, Shingo Okabe, Akihiro Yugeta, Satomi Inomata-Terada, Yoshikazu Ugawa
  [show abstract] [hide abstract]
  ABSTRACT: Using NIRS (near-infrared spectroscopy) and multi-channel probes, we studied hemoglobin (Hb) concentration changes when single-pulse transcranial magnetic stimulation (TMS) was applied over the left hemisphere primary motor cortex (M1). Seventeen measurement probes were centered over left M1. Subjects were studied both in the active and relaxed conditions, with the TMS intensity set at 100%, 120%, and 140% of the active motor threshold. The magnetic coils were placed so as to induce anteromedially directed currents in the brain. Hb concentration changes were more prominent at channels over M1 and posterior to it. Importantly, Hb concentration changes at M1 after TMS differed depending on whether the target muscle was in an active or relaxed condition. In the relaxed condition, Hb concentration increased up to 3-6 s after TMS, peaking at around 6 s, and returned to the baseline. In the active condition, a smaller increase in Hb concentrations continued up to 3-6 s after TMS (early activation), followed by a decrease in Hb concentration from 9-12 s after TMS (delayed deactivation). Hb concentration changes in the active condition at higher stimulus intensities were more pronounced at locations posterior to M1 than at M1. We conclude that early activation occurs when M1 is activated trans-synaptically. The relatively late deactivation may result from the prolonged inhibition of the cerebral cortex after activation. The posterior dominant activation at higher intensities under the active condition may result from an additional activation of the sensory cortex due to afferent inputs from muscle contraction evoked by the TMS.
  Journal of Neurophysiology 12/2012; · 3.32 Impact Factor
• Article: Quadri-pulse stimulation induces stimulation frequency dependent cortical hemoglobin concentration changes within the ipsilateral motor cortical network.

  Stefan Jun Groiss, Hitoshi Mochizuki, Toshiaki Furubayashi, Shunsuke Kobayashi, Setsu Nakatani-Enomoto, Koichiro Nakamura, Yoshikazu Ugawa
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  ABSTRACT: BACKGROUND: Imaging studies investigating repetitive transcranial magnetic stimulation (rTMS) mediated hemodynamic consequences revealed inconsistent results, mainly due to differences in rTMS parameters and technical difficulties with simultaneous recordings during rTMS. OBJECTIVE: /Hypothesis: Quadri-pulse rTMS (QPS) induces bidirectional long-term plasticity of the human primary motor cortex (M1). To evaluate its on-line effects, near infrared spectroscopy (NIRS) recordings were performed during QPS. We hypothesized that on-line effects during QPS are different from long-term aftereffects. METHODS: Using a novel TMS - on-line multi-channel NIRS setup we recorded hemoglobin concentration [Hb] changes at the stimulated M1 and adjacent sensory-motor areas during QPS protocols inducing oppositely directed aftereffects (QPS-5: interstimulus interval (ISI) 5 ms, potentiation; QPS-50: ISI 50 ms, depression). In two experiments we studied NIRS changes during either single or repeated QPS bursts. RESULTS: The repetitive QPS-5 bursts significantly decreased oxyhemoglobin concentration ([oxy-Hb]) in the ipsilateral M1. A single QPS-5 burst decreased [oxy-Hb] in the M1 and premotor cortex. QPS-50 induced no significant NIRS changes at any sites. CONCLUSIONS: QPS can significantly alter cortical hemodynamics depending on the stimulation frequency. While bidirectional long-term aftereffects of QPS reflect synaptic efficacy changes, unidirectional on-line effects during QPS may represent pure electrophysiological property changes within the cell membrane or synapse. Since neuronal postexcitatory inhibitory postsynaptic potentials typically peak within the first 10-20 ms, only pulses delivered at higher frequencies may lead to summation of the inhibitory effects, resulting in [oxy-Hb] decrease only after QPS-5. Our new TMS-NIRS setup may be valuable to investigate TMS induced neurovascular coupling mechanisms in humans.
  Brain Stimulation 02/2012; · 3.76 Impact Factor
• Article: Bidirectional modulation of sensory cortical excitability by quadripulse transcranial magnetic stimulation (QPS) in humans.

  Setsu Nakatani-Enomoto, Ritstuko Hanajima, Masashi Hamada, Yasuo Terao, Hideyuki Matsumoto, Yuichiro Shirota, Shingo Okabe, Masaki Hirose, Koichiro Nakamura, Toshiaki Furubayashi, Shunsuke Kobayashi, Hitoshi Mochizuki, Hiroyuki Enomoto, Yoshikazu Ugawa
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  ABSTRACT: Quadripulse transcranial magnetic stimulation (QPS) is a newly designed patterned repetitive transcranial magnetic stimulation (TMS). Previous studies of QPS showed bidirectional effects on the primary motor cortex (M1), which depended on its inter-stimulus interval (ISI): motor evoked potentials (MEPs) were potentiated at short ISIs and depressed at long ISIs (homotopic effects). These physiological characters were compatible with synaptic plasticity. In this research, we studied effects of QPS on the primary sensory cortex (S1). One burst consisted of four monophasic TMS pulses at an intensity of 90% active motor threshold. The ISI of four pulses was set at 5 ms (QPS-5) or at 50 ms (QPS-50). Same bursts were given every 5s for 30 min. QPS-5 and QPS-50 were performed over three areas (M1, S1 and dorsal premotor cortex (dPMC)). One sham stimulation session was also performed. Excitability changes of S1 were evaluated by timeline of somatosensory evoked potentials (SEPs). QPS-5 over M1 or dPMC enhanced the P25-N33 component of SEP, and QPS-50 over M1 depressed it. By contrast, QPSs over S1 had no effects on SEPs. QPSs over motor cortices modulated the S1 cortical excitability (heterotopic effects). Mutual connections between dPMC or M1 and S1 might be responsible for these modulations. QPSs induced heterotopic LTP or LTD-like cortical excitability changes.
  Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 01/2012; 123(7):1415-21. · 3.12 Impact Factor
• Article: Some evidence supporting the safety of quadripulse stimulation (QPS).

  Setsu Nakatani-Enomoto, Ritsuko Hanajima, Masashi Hamada, Hitoshi Mochizuki, Shunsuke Kobayashi, Hiroyuki Enomoto, Yoshihiro Sugiura, Hideyuki Matsumoto, Toshiaki Furubayashi, Yasuo Terao, Fumio Sato, Yoshikazu Ugawa
  Brain Stimulation 10/2011; 4(4):303-5. · 3.76 Impact Factor
• Article: On-line effects of quadripulse transcranial magnetic stimulation (QPS) on the contralateral hemisphere studied with somatosensory evoked potentials and near infrared spectroscopy.

  Masaki Hirose, Hitoshi Mochizuki, Stefan Jun Groiss, Yumiko Tanji, Koichiro Nakamura, Setsu Nakatani-Enomoto, Hiroyuki Enomoto, Masatoyo Nishizawa, Yoshikazu Ugawa
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  ABSTRACT: To evaluate on-line effects of quadripulse stimulation (QPS) over the primary motor cortex (M1) on cortical areas in the contralateral hemisphere. QPS consisted of 24 bursts of transcranial magnetic stimulation (TMS) pulses with an inter-burst interval of 5 s for 2 min (for on-line effect study) or 360 bursts for 30 min (for after-effect study). Each burst consisted of four TMS pulses (i.e. QPS) separated by an interstimulus interval of 5 or 50 ms (QPS-5 or QPS-50). QPSs were delivered over the left M1. Experiment 1 [on-line effect on somatosensory evoked potential (SEP)]: Left median nerve SEPs were recorded before, during and after QPS. Experiment 2 (after effect on SEP): After-effects of QPS were evaluated by following up SEPs after the QPS sessions. Experiment 3 (on-line effect on NIRS): Near infrared spectroscopy (NIRS) was also recorded at the right hemisphere during all QPS paradigms. Both QPS-5 and QPS-50 enlarged a cortical component of the contralateral SEP during stimulation. On the other hand, concerning the after effects, QPS-5 over M1 potentiated the contralateral SEP and QPS-50 tended to depress it. In NIRS study, both QPS-5 and QPS-50 induced a significant oxy-Hb decrease (deactivation pattern) at the right hemisphere during stimulation whereas sham stimulations unaffected them. We have shown the unidirectional on-line effects evoked by QPS-5 and QPS-50 on both SEP and NIRS, and bidirectional after effects on SEP at the contralateral hemisphere. The discrepancy between on-line effect and after effect may be explained by the differences in the underlying mechanisms between them. The former may be mainly explained by pure electrophysiological property changes in the membrane or synapses. The latter may be explained by synaptic efficacy changes which need some protein syntheses at least partly. Another discrepancy shown here is the direction of on-line effects. Electrophysiological (SEP) function was potentiated by both QPSs whereas hemodynamic (NIRS) function was depressed. This may be explained by which sensory areas contribute to NIRS or SEP generation.
  Experimental Brain Research 09/2011; 214(4):577-86. · 2.39 Impact Factor
• Article: [Two cases of posterior spinal artery syndrome (PSAS)].

  Arata Moriya, Suguru Kadowaki, Saeko Kikuchi, Setsu Nakatani-Enomoto, Hitoshi Mochizuki, Yoshikazu Ugawa
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  ABSTRACT: We have reported two patients with posterior spinal artery syndrome. Both of them had sudden onset back pain, paraparesis, loss of deep sensation and bladder-bowel disturbances. MRI disclosed spinal cord lesions positioned at its posterior part including the posterior column or posterior horn at thoracic levels. Spinal artery syndrome is a rare disorder, especially the posterior spinal artery syndrome (PSAS). In our department, only ten patients had spinal artery syndrome out of 2,064 patients admitted to our hospital these 20 years. All the other 8 patients had anterior spinal artery syndrome. It supports the notion that PSAS is rare. The detection rate of PSAS may increase after the routine use of spinal MRI in clinical practice. Our two patients had bilateral, symmetric symptoms. These symmetric signs and symptoms are usually seen in PSAS. The bilateral posterior spinal arteries connect with each other through many complex anastomoses. Moderate blood flow insufficiency may produce no clinical symptoms because of compensation by these anastomoses. When symptoms appear, these anastomoses do not compensate blood flow deficit and may produce bilateral symptoms.
  Rinsho shinkeigaku = Clinical neurology 09/2011; 51(9):699-702.
• Article: Ataxic hemiparesis: neurophysiological analysis by cerebellar transcranial magnetic stimulation.

  Saeko Kikuchi, Hitoshi Mochizuki, Arata Moriya, Setsu Nakatani-Enomoto, Koichiro Nakamura, Ritsuko Hanajima, Yoshikazu Ugawa
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  ABSTRACT: The aim of this study was to investigate physiological mechanisms underlying ataxia in patients with ataxic hemiparesis. Subjects were three patients with ataxic hemiparesis, whose responsible lesion was located at the posterior limb of internal capsule (case 1), thalamus (case 2), or pre- and post-central gyri (case 3). Paired-pulse transcranial magnetic stimulation (TMS) technique was used to evaluate connectivity between the cerebellum and contralateral motor cortex. The conditioning cerebellar stimulus was given over the cerebellum and the test stimulus over the primary motor cortex. We studied how the conditioning stimulus modulated motor evoked potentials (MEPs) to the cortical test stimulus. In non-ataxic limbs, the cerebellar stimulus normally suppressed cortical MEPs. In ataxic limbs, the cerebellar inhibition was not elicited in patients with a lesion at the posterior limb of internal capsule (case 1) or thalamus (case 2). In contrast, normal cerebellar inhibition was elicited in the ataxic limb in a patient with a lesion at sensori-motor cortex (case 3). Lesions at the internal capsule and thalamus involved the cerebello-thalamo-cortical pathways and reduced the cerebellar suppression effect. On the other hand, a lesion at the pre- and post-central gyri should affect cortico-pontine pathway but not involve the cerebello-thalamo-cortical pathways. This lack of cerebello-talamo-cortical pathway involvement may explain normal suppression in this patient. The cerebellar TMS method can differentiate cerebellar efferent ataxic hemiparesis from cerebellar afferent ataxic hemiparesis.
  The Cerebellum 07/2011; 11(1):259-63. · 3.21 Impact Factor
• Article: Decreased resting energy expenditure in patients with Duchenne muscular dystrophy.

  Mami Shimizu-Fujiwara, Hirofumi Komaki, Eiji Nakagawa, Madoka Mori-Yoshimura, Yasushi Oya, Toshiyuki Fujisaki, Yasuko Tokita, Norika Kubota, Rie Shimazaki, Kimiko Sato, [......], Katsumasa Goto, Hitoshi Mochizuki, Satoko Takanoha, Katsuhisa Ogata, Mitsuru Kawai, Masaaki Konagaya, Tatsushi Miyazaki, Katsunori Tatara, Kenji Sugai, Masayuki Sasaki
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  ABSTRACT: Skeletal muscle metabolism is a major determinant of resting energy expenditure (REE). Although the severe muscle loss that characterizes Duchenne muscular dystrophy (DMD) may alter REE, this has not been extensively investigated. We studied REE in 77 patients with DMD ranging in age from 10 to 37 years using a portable indirect calorimeter, together with several clinical parameters (age, height, body weight (BW), body mass index (BMI), vital capacity (VC), creatine kinase, creatinine, albumin, cholinesterase, prealbumin), and assessed their influence on REE. In addition, in 12 patients maintaining a stable body weight, the ratio of energy intake to REE was calculated and defined as an alternative index for the physical activity level (aPAL). REE (kcal/day, mean±SD) in DMD patients was 1123 (10-11 years), 1186±188 (12-14 years), 1146±214 (15-17 years), 1006±136 (18-29 years) and 1023±97 (≥30 years), each of these values being significantly lower than the corresponding control (p<0.0001). VC (p<0.001) was the parameter most strongly associated with REE, followed by BMI (p<0.01) and BW (p<0.05). The calculated aPAL values were 1.61 (10-11 years), 1.19 (12-14 years), 1.16 (15-17 years), and 1.57 (18-29 years). The REE in DMD patients was significantly lower than the normal value in every age group, and strongly associated with VC. Both the low REE and PAL values during the early teens, resulting in a low energy requirement, might be related to the obesity that frequently occurs in this age group. In contrast, the high PAL value in the late stage of the disease, possibly due to the presence of respiratory failure, may lead to a high energy requirement, and thus become one of the risk factors for development of malnutrition.
  Brain & development 05/2011; 34(3):206-12. · 1.74 Impact Factor
• Article: Disappearance of essential tremor after stroke: which fiber of cerebellar loops is involved in posterior limb of the internal capsule?

  Hitoshi Mochizuki, Yoshikazu Ugawa
  Movement Disorders 04/2011; 26(8):1577. · 4.51 Impact Factor
• Article: [Infliximab treatment trial in a patient with neuro-Behçet's disease unresponsive to other treatments].

  Suguru Kadowaki, Nozomu Matsuda, Arata Moriya, Masahiro Ebitani, Akioh Yoshihara, Kouichirou Nakamura, Hitoshi Mochizuki, Yoshikazu Ugawa
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  ABSTRACT: A 22-year-old man with a previous uveitis episode was admitted to our hospital because of persistent hiccup. On admission, he presented right-upper quadrantanopia, mydriasis and lack of the light reflex in the left eye, left-sided hemiplegia, and bilateral pathologic hyperreflexia. The MR fluid attenuated inversion recovery images showed left side dominant, high intensity lesions on the brainstem and the diencephalon. The HLA-B51 was positive. The CSF IL-6 was extremely elevated (998 pg/ml: reference value < = 6.0 pg/ml). Based on these, we concluded he had the neuro-Behçet's disease and treated him by high dose intravenous corticosteroids. This treatment improved his symptoms and MRI lesions, and decreased the CSF IL-6 levels initially. On 13th day after the first his discharge, however, dysarthria appeared and the CSF IL-6 levels elevated again. In addition to the high dose intravenous corticosteroids therapy for acute attack, 15 mg/week of methotrexate was started to prevent the recurrence. Even with this prevention, meningitis related to neuro-Behçet's disease occurred within six weeks. We administered 5 mg/kg of infliximab intravenously at 0, 2, 6, and 14 weeks. After the infliximab treatment, his symptoms improved and the IL-6 levels decreased, and no recurrence has occurred. This case supports that infliximab, anti-TNF-alpha agent, is a good candidate for neuro-Behçet's disease treatment when it is resistant to conventional immunosuppressive agents such as corticosteroids or methotrexate.
  Rinsho shinkeigaku = Clinical neurology 04/2011; 51(4):261-6.
• Article: Apraxia of lid opening due to a small lesion in basal ganglia: two case reports.

  Masaki Hirose, Hitoshi Mochizuki, Mari Honma, Toru Kobayashi, Masatoyo Nishizawa, Yoshikazu Ugawa
  Journal of neurology, neurosurgery, and psychiatry 12/2010; 81(12):1406-7. · 4.87 Impact Factor
• Article: [Cerebellar ataxic gait].

  Hitoshi Mochizuki, Yoshikazu Ugawa
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  ABSTRACT: In this review, we have mainly discussed the cerebellar ataxic gait. The cerebellum can be divided into 3 phylogenically different lobes: the archicerebellum, paleocerebellum, and neocerebellum. The main components of the cerebellar circuit are 2 types of neurons, i.e., the Purkinje cells and granule cells and 3 types of fibers, i.e., mossy fibers, climbing fibers (cerebellar afferent fibers), and parallel fibers (axons of granule cells) Theoretically, cerebellar ataxia is considered to be caused by any lesions that develop within this circuit. Before diagnosing any symptoms as ataxia, we should first exclude weakness, sensory disturbances or vestibular dysfunction to explain those symptoms. Cerebellar ataxia usually causes several neurological deficits such as antagonist hypotonia, asynergy, dysmetria, dyschronometria, and dysdiadochokinesia. Ataxic gait is one of the cardinal features of the cerebellar symptoms. The clinical features of cerebellar ataxic gait usually include a widened base, unsteadiness and irregularity of steps, and lateral veering. Locomotion in individuals with cerebellar ataxia is characterized by a significantly reduced step frequency with a prolonged stance and double limb support duration. All gait measurements are highly variable in cerebellar ataxia. The characteristic clinical features of several cerebellar diseases have been summarized in this review. Even though the rehabilitation for cerebellar ataxia is not fully supported by much enough clinical evidence, repeated motor training, bandages or light weights has sometimes beneficial effects on ataxic limbs.
  Brain and nerve = Shinkei kenkyū no shinpo 11/2010; 62(11):1203-10.
• Article: [Wernicke encephalopathy in a non-alcoholic patient with diabetic nephropathy under hemodialysis].

  Setsu Nakatani-Enomoto, Arata Moriya, Saeko Kikuchi, Hitoshi Mochizuki, Yoshihiro Sugiura, Yoshikazu Ugawa
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  ABSTRACT: A 75-year-old man with diabetic nephropathy treated with hemodialysis visited to a medical office because of slight fever, and received intravenous glucose infusion without any vitamins. Thereafter, he noticed gait disturbance and began to tell inconsistent stories. He was admitted to our hospital due to aggravation of these symptoms. On admission, he was disoriented and not able to sit by himself because of severe truncal ataxia without weakness. He had also gaze direction nystagmus. Based on clinical features, we considered him as having Wernicke's encephalopathy (WE) and treated him with 100 mg thiamine per day. The thiamine supply diminished these symptoms soon. Plasma thiamine level prior to the administration was 7 ng/ml, which confirmed the diagnosis. MRI did not disclose any abnormalities frequently seen in WE. WE is a life-threatening disease, and 'early detection, early cure' is important for recovering without sequelae. The thiamine deficiency is often seen in dialysis patients because of dietary restrictions as well as its loss during dialysis. This case gives us the caution; when hemodialysis patients present acute/subacute gait disturbance and/ or abnormal mental state, we should consider WE. Furthermore, high-risk patients, such as elderly patients under hemodialysis may need some supplement including thiamine even at preclinical stage.
  Rinsho shinkeigaku = Clinical neurology 06/2010; 50(6):409-11.
• Article: Micturitional disturbance due to bilateral medial frontal lobe lesions in a patient with multiple sclerosis.

  Sachiko Namatame, Hitoshi Mochizuki, Masahiro Ebitani, Nozomu Matsuda, Yoshikazu Ugawa
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  ABSTRACT: A 41-year-old man with multiple sclerosis (MS) complained of nocturnal enuresis at the third exacerbation. Neurological examination revealed echopraxia, forced grasp reflexes and palmo-mental reflexes. The urodynamic studies showed neither spinal cord nor peripheral nerve involvements. His brain magnetic resonance images (MRIs) revealed new lesions at the bilateral medial frontal lobes. The intravenous methylprednisolone therapy improved nocturnal enuresis and made brain MRI lesions smaller and gone. In addition to frequently observed spinal cord lesions, we should consider some medial frontal lesions to be responsible for micturitional disturbance in patients with MS.
  Neurological Sciences 11/2009; 31(2):205-7. · 1.32 Impact Factor
• Article: Brain volume analyses and somatosensory evoked potentials in multiple system atrophy.

  Satoko Miyatake, Hitoshi Mochizuki, Tetsuji Naka, Yoshikazu Ugawa, Hajime Tanabe, Daisuke Kuzume, Mikiya Suzuki, Katsuhisa Ogata, Mitsuru Kawai
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  ABSTRACT: We investigated a progression of brain atrophy and somatosensory system dysfunction in multiple system atrophy (MSA). Subjects were 21 MSA patients [12 MSA-C (cerebellar type) and 9 MSA-P (parkinsonism type)]. The relative volumes of cerebrum, brainstem and cerebellum to the intracranial volume were obtained from three-dimensional computed tomography (3D-CT) of the brain. The median nerve somatosensory evoked potentials (SEPs) were recorded, and the latencies and amplitudes of N9, N11, P13/14, N20 and P25 components were measured. We studied correlations between brain volumes, SEP and clinical features. The brainstem and cerebellar atrophies were aggravated with progression of the disease. The central sensory conduction time (CSCT) was progressively prolonged in parallel with the disease duration irrespective of the actual age of the patients. In MSA patients, the volume reductions of cerebellum and brainstem could be one of structural markers of disease progression, and the sensory pathway is progressively involved with the progression of disease processes.
  Journal of Neurology 09/2009; 257(3):419-25. · 3.47 Impact Factor
• Article: Nodular cutaneous amyloidosis and carpal tDnnel syndrome due to the amyloidogenic transthyretin His 114 variant

  Hitoshi Mochizuki, Keiko Kamakura, Toshihiro Masaki, Akira Hirata, Takahiko Tokuda, Masahide Yazaki, Kazuo Motoyoshi, Shu-Ichi Ikeda
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  ABSTRACT: This is the second report of transthyretin (TTR) amyloidosis in a patient who had ATTR Tyr114His diagnosed bymass spectrometry and gene analysis. This case had some clinical features that differed from those of the first reported cases. The patient, 73-year-old man, complained of generalized cutaneous tubercula that had started at age 68. These tubercula gradually increased in size and became generalized. He felt a slight numbness in his extremities. Clinical and electrophysiological examinations revealed that he had bilateral carpal tunnel syndrome (CTS), whereas there was no clear evidence of sensoy and/or motor polyneuropathy. Autonomic symptoms were not present. Biopsy studies revealed that both his tuberculum and his sural nerve contained TTR-related amyloid. In his sural nerve, amyloid deposits were observed mainly in the perineurium, not in the endoneurium, and there was no significant depletion of myelinated fibers. The features of this patient were clinically characterized by generalized cutaneous amyloid deposits and late-onset CTS with a lack of overt polyneuropathy and autonomic dysfunction. The unique clinical features in this case seemed to be consistent with the distribution of amyloid deposits.
  07/2009; 8(2):105-110.
• Source

  Available from: Til Ole Bergmann

  Article: Consensus paper: combining transcranial stimulation with neuroimaging.

  Hartwig R Siebner, Til O Bergmann, Sven Bestmann, Marcello Massimini, Heidi Johansen-Berg, Hitoshi Mochizuki, Daryl E Bohning, Erie D Boorman, Sergiu Groppa, Carlo Miniussi, [......], Stephan A Brandt, Matthew F Rushworth, Ulf Ziemann, John C Rothwell, Nick Ward, Leonardo G Cohen, Jürgen Baudewig, Tomás Paus, Yoshikazu Ugawa, Paolo M Rossini
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  ABSTRACT: In the last decade, combined transcranial magnetic stimulation (TMS)-neuroimaging studies have greatly stimulated research in the field of TMS and neuroimaging. Here, we review how TMS can be combined with various neuroimaging techniques to investigate human brain function. When applied during neuroimaging (online approach), TMS can be used to test how focal cortex stimulation acutely modifies the activity and connectivity in the stimulated neuronal circuits. TMS and neuroimaging can also be separated in time (offline approach). A conditioning session of repetitive TMS (rTMS) may be used to induce rapid reorganization in functional brain networks. The temporospatial patterns of TMS-induced reorganization can be subsequently mapped by using neuroimaging methods. Alternatively, neuroimaging may be performed first to localize brain areas that are involved in a given task. The temporospatial information obtained by neuroimaging can be used to define the optimal site and time point of stimulation in a subsequent experiment in which TMS is used to probe the functional contribution of the stimulated area to a specific task. In this review, we first address some general methodologic issues that need to be taken into account when using TMS in the context of neuroimaging. We then discuss the use of specific brain mapping techniques in conjunction with TMS. We emphasize that the various neuroimaging techniques offer complementary information and have different methodologic strengths and weaknesses.
  Brain Stimulation 04/2009; 2(2):58-80. · 3.76 Impact Factor
• Article: Short and long duration transcranial direct current stimulation (tDCS) over the human hand motor area.

  Toshiaki Furubayashi, Yasuo Terao, Noritoshi Arai, Shingo Okabe, Hitoshi Mochizuki, Ritsuko Hanajima, Masashi Hamada, Akihiro Yugeta, Satomi Inomata-Terada, Yoshikazu Ugawa
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  ABSTRACT: The aim of the present paper is to study effects of short and long duration transcranial direct current stimulation (tDCS) on the human motor cortex. In eight normal volunteers, motor evoked potentials (MEPs) induced by transcranial magnetic stimulation (TMS) were recorded from the right first dorsal interosseous muscle, and tDCS was given with electrodes over the left primary motor cortex (M1) and the contralateral orbit. We performed two experiments: one for short duration tDCS (100 ms, 1, 3 or 5 mA) and the other for long duration tDCS (10 min, 1 mA). The stimulus onset asynchrony (SOA) between the onset of tDCS and TMS were 1-7 and 10-120 ms for the former experiment. In the latter experiment, TMS was given 0-20 min after the end of 10 min tDCS. We evaluated the effect of tDCS on the motor cortex by comparing MEPs conditioned by tDCS with control MEPs. Cathodal short duration tDCS significantly reduced the size of responses to motor cortical stimulation at SOAs of 1-7 ms when the intensity was equal to or greater than 3 mA. Anodal short duration tDCS significantly increased MEPs when the intensity was 3 mA, but the enhancement did not occur when using 5 mA conditioning stimulus. Moreover, both anodal and cathodal short duration tDCS decreased responses to TMS significantly at SOAs of 20-50 ms and enhanced them at an SOA of 90 ms. Long duration cathodal tDCS decreased MEPs at 0 and 5 min after the offset of tDCS and anodal long duration tDCS increased them at 1 and 15 min. We conclude that the effect at SOAs less than 10 ms is mainly caused by acute changes in resting membrane potential induced by tDCS. The effect at SOAs of 20-100 ms is considered to be a nonspecific effect of a startle-like response produced by activation of skin sensation at the scalp. The effect provoked by long duration tDCS may be short-term potentiation or depression like effects.
  Experimental Brain Research 03/2008; 185(2):279-86. · 2.39 Impact Factor
• Article: Clinical features of opticospinal multiple sclerosis with anti-aquaporin 4 antibody.

  Mami Kanzaki, Hitoshi Mochizuki, Go Ogawa, Keiko Tanaka, Manabu Araki, Kazuo Motoyoshi, Graeme Hammond-Tooke, Keiko Kamakura
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  ABSTRACT: We have followed 9 Japanese patients with opticospinal multiple sclerosis (OSMS), some of whom showed longitudinally extensive spinal cord lesions, deep sensory disturbances and resistance to treatment. We investigated the patients for anti-aquaporin 4 (AQP4) antibodies and related this to their neuroimaging, clinical and laboratory features. We studied the clinical course, neurological findings, cerebrospinal fluid (CSF), and electrophysiological findings, and determined the presence of anti-AQP4 antibody and human leukocyte antigen DPB1 and DRB1 alleles. Five patients (56.6%) had anti-AQP4 antibody. Antibody-positive patients displayed female predominance, longitudinally extensive spinal cord lesions, higher frequency of exacerbations, severe disability, and higher cell counts and total protein content without IgG oligoclonal bands in the CSF. They also showed poor steroid responsiveness and poor therapeutic response to interferon beta(1b). The presence of anti-AQP4 antibodies correlates with clinical severity and poor prognosis in OSMS.
  European Neurology 02/2008; 60(1):37-42. · 1.81 Impact Factor
• Article: Mental retardation and lifetime events of Duchenne muscular dystrophy in Japan.

  Hitoshi Mochizuki, Satoko Miyatake, Mikiya Suzuki, Toshiki Shigeyama, Kana Yatabe, Katsuhisa Ogata, Takuhisa Tamura, Mitsuru Kawai
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  ABSTRACT: This study investigated the relationship between mental retardation and lifetime events in patients with Duchenne muscular dystrophy (DMD). The data on mental retardation and ages of lifetime events (first walking, loss of ambulation, introductions of ventilator support and tube nutrition and death) were collected retrospectively, and the relationships between the factors were analyzed. Among 194 DMD patients admitted to our hospital between 1995 and 2007, 74 patients underwent evaluation of their intelligence quotient (IQ). Twenty-eight patients (38%) demonstrated mental retardation (IQ<70). DMD patients with mental retardation started walking later, required ventilator and tube nutrition support earlier, and died earlier than those without mental retardation. Since the prognosis of DMD patients with mental retardation was worse than that of those without mental retardation, more careful treatment is necessary for DMD patients with mental retardation.
  Internal Medicine 01/2008; 47(13):1207-10. · 0.94 Impact Factor