Publications by authors named "Takashi Komori"

Multiple system atrophy (MSA) is a major neurodegenerative disorder characterized by phosphorylated α-synuclein-positive oligodendroglial cytoplasmic inclusions. The presence of phosphorylated τ-positive granular glia (pTGrG) in the cerebral white matter and putamen has recently been reported, and it has been suggested that pTGrG pathology may be a common pathological feature of MSA. However, its spreading pattern and relationship with clinical features remain unclear.

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The Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumor Taxonomy (cIMPACT-NOW) updates provide guidelines for the diagnosis of central nervous system (CNS) tumors and suggestions for future World Health Organization (WHO) classification. Following publication of the fifth edition WHO Classification of CNS Tumors (WHO CNS5) in 2021, the cIMPACT-NOW working group "Clarification" reviewed WHO CNS5 and prioritized two topics for further elucidation: (a) distinction of Glioblastoma, IDH-wildtype from Diffuse pediatric-type high-grade glioma, H3-wildtype, and IDH-wildtype and (b) clarification of subgroups of posterior fossa (PF) ependymal tumors. Recommendations regarding the IDH- and H3-wildtype diffuse high-grade gliomas include: (1) use caution assigning CNS WHO grade 4 (diagnosis of Glioblastoma, IDH-wildtype) to a "TERT promoter only", histologically low-grade, IDH-wildtype tumor; (2) EGFR gene amplification and +7/-10 chromosome copy number alterations should not be used as solitary defining features for diagnosing high-grade gliomas as Glioblastoma, IDH-wildtype in patients <40 years of age; (3) Diffuse pediatric-type high-grade glioma, H3-wildtype, and IDH-wildtype should be considered in the differential diagnosis in adults, especially those <40 years of age; (4) PDGFRA alteration, EGFR alteration, or MYCN amplification count as key molecular features of Diffuse pediatric-type high-grade glioma, H3-wildtype, and IDH-wildtype only in patients <25 years.

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Glioblastoma (GBM) is a primary brain tumor, characterized by rapid progression, high recurrence rates, and resistance to standard therapies. Current treatment modalities provide limited survival benefits, highlighting the need for novel therapeutic strategies. This retrospective study evaluated the efficacy of autologous formalin-fixed tumor vaccine (AFTV) in 375 patients with newly diagnosed GBM.

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Myositis associated with antimitochondrial M2 antibodies (AMA) is a distinct subtype of inflammatory myopathy characterized by axial muscle weakness and, occasionally, respiratory failure. This report highlights two cases involving patients presenting with severe respiratory failure while ambulant. Patient 1: An 82-year-old man was referred to our hospital for respiratory failure and truncal muscle weakness.

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Unlabelled: This multi-institutional, double-blind, randomized, placebo-controlled phase III trial was designed to evaluate the efficacy and safety of Cellm-001, an autologous formalin-fixed brain tumor immunostimulant, for newly diagnosed glioblastoma with gross total resection to prolong overall survival (OS) and prevent recurrence after surgery. One hundred twelve patients are to be randomized 1:1 to either Cellm-001 with standard chemoradiotherapy (CRT) or saline solution with standard CRT. Randomization is based on the following stratified randomization criteria: age, Karnofsky Performance Status, and the presence or absence of photodynamic therapy (PDT).

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The latest World Health Organization (WHO) classification of central nervous system tumors (WHO2021/5th) has incorporated molecular information into the diagnosis of each brain tumor type including diffuse glioma. Therefore, an artificial intelligence (AI) framework for learning histological patterns and predicting important genetic events would be useful for future studies and applications. Using the concept of multiple-instance learning, we developed an AI framework named GLioma Image-level and Slide-level gene Predictor (GLISP) to predict nine genetic abnormalities in hematoxylin and eosin sections: , , mutations, promoter mutations, homozygous deletion (CHD), amplification (amp), 7 gain/10 loss (7+/10-), 1p/19q co-deletion, and promoter methylation.

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The shift toward a histo-molecular approach in World Health Organization classification of central nervous system tumors (WHO CNS5) emphasizes the critical role of molecular testing, such as next-generation sequencing (NGS) and DNA methylation profiling, for accurate diagnosis. However, implementing these advanced techniques is particularly challenging in resource-constrained countries. To address this, the Asian Oceanian Society of Neuropathology committee for Adapting Diagnostic Approaches for Practical Taxonomy in Resource-Restrained Regions (AOSNP-ADAPTR) was initiated to help pathologists in resource-limited regions to implement WHO CNS5 diagnoses using simpler diagnostic tools, mainly immunohistochemistry.

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Angiocentric glioma (AG) is a supratentorial diffuse low-grade glioma characterized by the MYB::QKI fusion gene, showing angiocentric growth of monomorphous spindle cells with astrocytic and ependymal immunophenotypes. We describe a rare case of MYB::QKI fusion-positive diffuse cerebellar glioma in a 54-year-old male. The patient initially presented with a T2/FLAIR hyperintense lesion in the left cerebellar hemisphere and slowly progressive neurological symptoms.

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Purpose: To re-evaluate images recovered from JCOG0911, a randomized phase 2 trial for newly diagnosed glioblastoma (nGBM) conducted by the Japan Clinical Oncology Group (JCOG) Brain Tumor Study Group.

Methods: The correlation between tumor volumes and survival was evaluated, followed by progression-free survival (PFS) analysis by independent central review based on Response Assessment in Neuro-Oncology (RANO) criteria using MRI recovered from 118 nGBM patients enrolled in the JCOG0911 trial. A radiomic analysis was also performed to identify radiomic features predictive of nGBM prognosis.

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Article Synopsis
  • - A 59-year-old woman developed complex regional pain syndrome in her right arm after surgery for cubital tunnel syndrome, leading to treatment with spinal cord stimulation (SCS) that initially helped her pain.
  • - Four years later, she experienced motor weakness on her left side and reduced effectiveness of the SCS therapy, which prompted an MRI revealing significant compression of her cervical spinal cord due to epidural granulation tissue.
  • - After surgically removing the granulation tissue, her motor weakness improved, and histological tests indicated that an allergic reaction to materials in the SCS setup caused the tissue fibrosis.
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Objective: Patients with spinal CSF leaks often have ventral dural abnormalities (type 1 CSF leaks); however, the pathological mechanism for developing dural abnormalities is unknown. The authors investigated whether calcified dural ligaments contribute to the development of ventral dural tears, which cause spinal CSF leaks.

Methods: Consecutive patients diagnosed with type 1 CSF leaks who had spiculated spinal lesions between 2010 and 2024 were included.

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We describe the case of a 70-year-old Japanese man with familial amyotrophic lateral sclerosis (fALS) associated with a p.Gly93Ser mutation in the copper/zinc superoxide dismutase (SOD1) gene. This mutation is one of the relatively rare SOD1 mutations, with only one previous autopsy report, and is known for its longer disease duration.

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In the fifth edition of the World Health Organization's (WHO) classification of tumors of the central nervous system (CNS), molecular analysis is required for not only determining each tumor type but assessing its prognosis based on malignancy (CNS WHO grade). A notable example is the loss of tumor suppressor gene cyclin-dependent kinase inhibitor 2A (CDKN2A), and CDKN2A homozygous deletion (HD) is a novel CNS WHO grade 4 marker in isocitrate dehydrogenase gene (IDH)-mutant astrocytoma. However, incorporating molecular workup into the "routine diagnostics" of each brain tumor type remains a major challenge, especially in resource-limited settings, including low- and middle-income countries.

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This study aimed to determine the prevalence of lumbar ligamentum flavum lesions and identify correlations between radiological and pathological findings. We conducted an observational cross-sectional study of 349 patients (lumbar: n = 296, thoracic: n = 39, lumbar and thoracic: n = 14, mean age: 69 ± 12 years, male: 74%) who underwent posterior surgery for thoracolumbar spinal canal stenosis between January 2008 and April 2023 at our hospital.Computed tomography (CT) revealed that the prevalence of ligamentum flavum lesions defined as a high-density area with a CT value of 200 Hounsfield Unit or higher in the lumbar and thoracic spine was 47% (147/310) and 85% (45/53), respectively.

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Glioneuronal and neuronal tumors (GNTs) are slow-growing, lower-grade neuroepithelial tumors characterized by mature neuronal differentiation and, less consistently, glial differentiation. Their identification has traditionally relied on histological proof of neuronal differentiation, reflecting the well-differentiated nature of GNTs. However, after discovering genetic alterations in GNTs, particularly those in the MAP-kinase pathway, it became evident that histological diagnoses do not always correlate with genetic alterations and vice versa.

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Article Synopsis
  • - The study investigates how well conventional MRI can differentiate corticobasal degeneration (CBD) from its mimics due to similar clinical features.
  • - Researchers analyzed the degree of brain atrophy and asymmetry in MRI images of 19 CBD patients and 16 patients with conditions that mimic CBD, like Alzheimer's and progressive supranuclear palsy.
  • - Findings suggest that specific patterns of atrophy and the presence of white matter hyperintensity can be used as imaging biomarkers to help diagnose CBD more accurately.
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Aim: Adverse childhood experiences are potentially traumatic events with long-lasting effects on the health and well-being of patients with autism spectrum disorder (ASD). It is important to clarify which types of long-lasting autism-related symptoms are influenced by childhood experiences to design future intervention studies. However, few studies have examined the association between childhood experiences and autistic symptoms in large samples of adults with ASD and individuals with typical development (TD).

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Article Synopsis
  • The study explores how social isolation during critical development stages affects behavior and neuronal activity, focusing on the expression of specific proteins in the prefrontal cortex (PFC) of mice.
  • Researchers compared socially isolated mice with those kept in groups, observing changes in neuronal firing patterns and social behavior.
  • Results indicated that isolated mice struggled with social memory, and decreased NARP expression was found in humans with autism compared to typically developing individuals, suggesting a link between social isolation and behavioral outcomes.
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Multiple sclerosis (MS), the leading cause of disability in young adults, is an inflammatory disease of the central nervous system characterized by localized areas of demyelination. Apoptosis signal-regulating kinase 1 (ASK1) is a mitogen-activated protein kinase kinase kinase that has been shown to be implicated in the pathogenesis of experimental autoimmune encephalomyelitis (EAE), a mouse model of MS. Interestingly, ASK1 signaling regulates glial cell interactions and drives neuroinflammation in EAE mice.

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Article Synopsis
  • * In GBM with mutations in receptor tyrosine kinases, the mTORC2 complex suppresses the enzyme DNMT3A, leading to widespread DNA hypomethylation by redistributing EZH2 to the DNMT3A promoter, thus repressing its expression.
  • * This research shows that the hypomethylator phenotype alters glutamate metabolism and enhances GBM cell invasion and survival, highlighting mTORC2 as a promising target for cancer treatment through its role in epigenetic
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Article Synopsis
  • Neuronal intranuclear inclusion disease (NIID) is a neurodegenerative condition characterized by specific inclusions in cells due to genetic mutations, particularly in the NOTCH2NLC gene, affecting brain function.* -
  • Two adult cases of NIID revealed symptoms like severe dementia and encephalopathy, with brain biopsies showing unusual patterns and a predominance of inclusions in astrocytes rather than neurons, challenging previous understandings of the disease.* -
  • The findings suggest that astrocytic involvement ("gliopathy") plays a crucial role in the disease's progression and that future research should focus on the implications of astrocytes in NIID symptoms and pathology.*
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