Does Pramipexole Treatment Improve Headache in Patients with Concomitant Migraine and Restless Legs Syndrome?

Background: Recent studies have suggested a strong link between migraines and restless legs syndrome (RLS). It is possible that these disorders share a dopaminergic dysfunction in the hypothalamic A11 nucleus that contributes to this association. However, there have been no clinical studies to evaluate the effect of dopaminergic treatment on migraine symptoms in patients with concomitant migraines and RLS. Methods: We present an illustrative patient with concomitant RLS and migraine who showed improvement in her headache frequency and RLS symptoms following immediate‐release pramipexole (P‐IR) treatment and provide review results from the medical records of patients who experienced both migraines and RLS in our previous cross‐sectional study. Results: Ten patients (nine patients from the previously completed single‐center study) received P‐IR treatment were included in the study. RLS symptoms improved markedly in all of the subjects. Five out of the 10 patients (50%) reported improvement in migraine headaches. Of these five patients, four (80%) had reported morning headaches before P‐IR treatment. Discussion: Our results indicate that the identification of RLS in migraine patients is clinically significant and that dopaminergic treatment may improve both migraines, particularly morning headache (80% improvement in this study), and RLS symptoms. However, further clinical studies are warranted to verify our results

キョウセン ヒテイケイテキ カルチノイド ノ 1セツジョレイ

Background. Thymic carcinoids are rare disease to account for ２-４％ of anterior mediastinal tumors. So, the clinicopathologic characters are not known enough. Case. A ６７ years old man was followed up old myocardial infarction, and he was taken chest CT scan for evaluate coronary artery. It revealed three anterior mediastinal tumors and we diagnosed thymoma by needle biopsy. We treated by neoadjuvant chemotherapy（CAMP therapy）, but it was ineffective. We performed thoracoscopic thymothymomectomy, and the pathological diagnosis was thymic atypical carcinoid. He is free of clinically event recurrence one year and a half after treatment. Conclusions. When we found an anterior mediastinal tumor, and if the clinical course is usually different, we should consider the possibility of a thymic carcinoid

A Multifunctional Hybrid Nanocarrier for Non-Invasive siRNA Delivery to the Retina

Drug therapy for retinal diseases (e.g., age-related macular degeneration, the leading cause of blindness) is generally performed by invasive intravitreal injection because of poor drug delivery caused by the blood–retinal barrier (BRB). This study aimed to develop a nanocarrier for the non-invasive delivery of small interfering RNA (siRNA) to the posterior segment of the eye (i.e., the retina) by eyedrops. To this end, we prepared a hybrid nanocarrier based on a multifunctional peptide and liposomes, and the composition was optimized. A cytoplasm-responsive stearylated peptide (STR-CH2R4H2C) was used as the multifunctional peptide because of its superior ability to enhance the complexation, cell permeation, and intracellular dynamics of siRNA. By adding STR-CH2R4H2C to the surface of liposomes, intracellular uptake increased regardless of the liposome surface charge. The STR-CH2R4H2C-modified cationic nanocarrier demonstrated significant siRNA transfection efficiency with no cytotoxicity, enhanced siRNA release from endosomes, and effectively suppressed vascular endothelial growth factor expression in rat retinal pigment epithelium cells. The 2.0 mol% STR-CH2R4H2C-modified cationic nanocarrier enhanced intraocular migration into the retina after instillation into rat eyes

Evaluation of Electroencephalogram Using Exact Low-Resolution Electromagnetic Tomography During Photic Driving Response in Patients with Migraine

Background: Photophobia is a common feature of migraine, which may involve abnormal cortical information processing. In electroencephalograms (EEG), photic driving is known as a reaction to visual stimulation. Both photophobia and photic driving response are present during light stimulation. We hypothesized that cortical response to photic stimulation would differ between migraine patients with and without aura. Methods: We recruited 50 migraine patients (migraine with aura [MWA] = 21; migraine without aura [MWOA] = 29). Spontaneous eyes-closed resting EEG from 20 electrodes on the scalp during the interictal phase was recorded. After recording, each photic stimulation was separately selected. We analyzed EEG by fast Fourier transform and observed the spectrum frequency peaks and topographies in response to photic stimulation. Exact low-resolution electromagnetic tomography (eLORETA) was used to compute the 3-dimensional intracerebral distribution of EEG activity. Results: Photic stimulation at frequencies 5, 8, 15, and 20 Hz showed significant differences between migraine patients with and without aura. MWOA patients consistently had a stronger response to photic stimulation than MWA patients. In all patients, the differential response was located in the visual cortex, except for the stimulation at 20 Hz, where the difference at subharmonic 10 Hz was located in the parietal cortex (Brodmann Area 7). Conclusion: We confirmed high incidences of photic hypersensitivity and photic driving responses in migraine patients. We suggest that repeated occurrences of cortical spreading depression in MWA may suppress cortical function, thus contributing to a weaker visual cortical response to photic stimulation in MWA patients compared with MWOA patients