The purpose of this study was to evaluate brain MRI distortion caused by orthodontic appliances. MRI was performed in 10 subjects and after insertion 3 kind of orthodontic appliances(type1-3), the MRI were compared. Type 1 used resin brackets in the incisor teeth, stainless steel brackets in the premolar teeth and stainless steel single tube in the molar teeth. Type2 used ceramic brackets in the incisor teeth, titanium brackets in the premolar teeth and titanium single tube in the molar teeth. Type3 used ceramic brackets with CoCr alloy clip in the incisor teeth, titanium brackets in the premolar teeth and titanium single tube in the molar teeth. Each MR sequence consisted of 6 sequences.: the Echo Planar Imaging method diffusion-weighted images(DWI), Spin Echo sequence(SE) T1-weighted images, Fast Field Echo sequence(FFE)T1-weighted images, Turbo Spin echo sequence(TSE)T2-weighted images, fat-supression image as Short Tau inversion recovery method(STIR), and Fluid attenuated-inversion recovery(FLAIR).Two neuro-surgeons examined the MRI for distortion in predetermined regions of the brain. In Type 1, MRI imaging by neither DWI nor FFE is feasible in these sites. SE-T1, TSE-T2, FLAIR and STIR are indicating the feasibility for MRI imaging. In Type 2 and Type 3, by all imaging types and at all of the anatomical sites, are indicating the feasibility for MRI imaging in the brain. The study showed that ceramic brackets, ceramic brackets with CoCr alloy clip, titanium brackets and titanium tubes do not always have to be removed before brain MRI.

[Purpose] Integrated volitional control electrical stimulation (IVES) is a type of electrical stimulation therapy that promotes agonist muscle contraction in limbs with motion paralysis. This case study describes the improvement in the paretic hand with stroke hemiplegia, eight years after the onset, with IVES for one month in the extrinsic and intrinsic muscles, including change of mode of stimulation based on the degree of improvement. [Participant and Methods] A 76 year-old male with hemiplegia for eight years. The patient was evaluated for two weeks and performed IVES in the right flexor pollicis brevis, abductor pollicis brevis, and extensor carpi ulnaris with the change of mode of IVES. [Results] The upper limb function improved in a short period of time. The hemiplegia test showed Brunnstrom stages II–III and II–IV for the right upper limb and right hand and fingers, respectively, 28 days after IVES initiation. [Conclusion] After one month of undergoing IVES, the patient showed improvement in hand and finger motor function, which was maintained even after IVES was completed. In this case, there was improvement with a short-term intervention using appropriately combined IVES modes.

Background Dimethyl fumarate (DMF) was the second oral disease-modifying drug to be approved for multiple sclerosis (MS) in Japan, after fingolimod. Switching from fingolimod to DMF treatment is becoming increasingly common, because DMF has shown a better risk-benefit profile and an equivalent efficacy to fingolimod. Case presentation We report a 35-year-old woman who was positive for anti-John Cunningham virus antibody and who developed severe rebound relapse of MS after switching from fingolimod to DMF. Five months after starting DMF treatment, she had a severe relapse attack with disseminated lesions in the cerebrum and cervical spinal cord. Furthermore, subsequent relapse attacks occurred with new lesions in the thoracic spinal cord, even during repeated steroid pulse therapies and plasma exchanges. The disease activity finally ceased after natalizumab administration. Conclusions Switching from fingolimod to DMF carries the risk of MS reactivation and rebound. Natalizumab treatment for a limited period might be recommended to treat MS rebound in anti-John Cunningham virus antibody-positive patients.

Objective Simultanagnosia is a rare neuropsychological symptom characterized by difficulty recognizing global structures while preserving perception of local detail. The condition is classified into ventral and dorsal types. Clinical presentation of ventral simultanagnosia includes a reduced ability to recognize multiple visual stimuli rapidly, that is, part-by-part recognition. Here, we report a case of ventral simultanagnosia with a unique presentation; when short-duration visual stimuli were presented, the patient could perform global recognition by improving his part-by-part approach. To investigate the relationship between local and global perception bias and the duration of the present stimulus, we conducted a visual perception test using hierarchically organized Navon figures. Methods/Results The patient was a 62-year-old right-handed man who suffered from cerebral infarction in the right occipitotemporal lobe. He had no language dysfunction but exhibited left unilateral neglect, prosopagnosia, and ventral-type simultanagnosia. We conducted a visual perception test using the Navon figures and control figures as a visual stimulus. We randomly presented the figures for intervals of 0.2 or 20 s and let the patient report all the letters (global and/or local element) that he recognized. Global elements of the Navon letter were recognized a rate of 0% and 78.3% at intervals of 20 and 0.2 s, respectively, indicating that shorter presentation made the part-by-part approach less likely to manifest. Conclusions We assumed that the simultanagnosia in this case was caused by failure to maintain the initially perceived global information for a long period of time during visual presentation, due to right occipitotemporal damage.

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