Hung‐Yu Liu

Taipei Veterans General Hospital

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Shuu‐Jiun Wang

National Yang Ming Chiao Tung University

Shih‐Pin Chen

National Yang Ming Chiao Tung University

Wei‐Ta Chen

National Yang Ming Chiao Tung University

Kuan‐Lin Lai

National Yang Ming Chiao Tung University

Yen-Feng Wang

National Yang Ming Chiao Tung University

Li‐Ling Hope Pan

National Yang Ming Chiao Tung University

Fu‐Jung Hsiao

National Yang Ming Chiao Tung University

Chih‐Ping Chung

Taipei Veterans General Hospital

I‐Hui Lee

Taipei Veterans General Hospital

Li‐Chi Hsu

Taipei Veterans General Hospital

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National Yang Ming Chiao Tung University

Taipei Veterans General Hospital

National Taiwan University Hospital

National Yang Ming University Hospital

National Taiwan University

National Taipei University

Taipei Medical University

Neurological Surgery

Taichung Veterans General Hospital

China Medical University

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Journal of Stroke and Cerebrovascular Diseases (2020)

Jared Cooper Anubhav G. Amin Michael G. Kim Alan Stein José Manuel García‐Domínguez

Table (database)

10.1016/s1052-3057(20)30698-4

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Transient visual disturbances in adolescents: Migrainous feature or headache-accompanied phenomenon?

Cephalalgia (2012)

Hung‐Yu Liu Jong‐Ling Fuh Shiang‐Ru Lu Shih‐Pin Chen Chi-Hsiang Chou

Objectives: To investigate the prevalence, characteristics and clinical correlates of transient visual disturbances (TVDs) in adolescents with headaches. Methods: We surveyed headache-related TVDs in the past three months in two middle schools. All the ninth-grade students filled-in the questionnaires including demographics, a validated headache questionnaire, and visual phenomenon questions embedding the Visual Aura Rating Scale (VARS). TVDs were defined as transient visual phenomena corresponding to a headache attack, but not visual aura, i.e. VARS <four. Results: Six hundred and sixty-three adolescents (341 boys and 322 girls; mean age 15.1 ± 0.3 years old) participated in this study. In subjects reporting at least one headache during the past three months ( N = 371), 33.4% reported TVDs, which accounted for 18.7% in total participants. TVDs were described mainly as flickering lights or scotoma, movable, monochromatic, occurring over bilateral visual fields, developing and lasting <30 seconds, and experienced during the headache phase. Subjects with migraines reported a higher frequency of TVDs than those with non-migraine headaches (67.1% vs. 31.2%, p < 0.001). TVDs were independently associated with photophobia (OR = 12.6, p < 0.001) and pulsatile headache (OR = 2.1, p = 0.012). Conclusions: The major features of TVDs were distinguishable from visual aura. TVDs were common in adolescents with headaches, especially in migraineurs.

Photophobia

Phonophobia

10.1177/0333102412460777

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Citations (9)

Thin-film interactions in Si/SiO2/W-Ti/Al-1% Si system

Journal of Applied Physics (1987)

Peng‐Heng Chang Hung‐Yu Liu J. A. Keenan J. Anthony J. G. Bohlman

The thin-film metal-metal interactions in the Si/SiO2/W-Ti/Al-1% Si system have been studied by transmission electron microscopy, glancing angle x-ray diffraction, Rutherford backscattering spectrometry, and secondary ion mass spectrometry techniques. The reaction is predominantly controlled by the diffusion of tungsten into the Al–1% Si layer and the sequence of the compound formation follows the prediction of the binary Al-W phase diagram. It was shown that Al12W forms first after sintering for 30 min at 450 °C. The Al12W phase then grows from the W-Ti/Al-1% Si interface into the Al layer. At a temperature somewhere between 500 and 520 °C the entire Al layer is transformed to Al12W and then a more tungsten-rich phase, Al5W, starts to form at the W/Al12W interface. As the sintering temperature is increased, the Al5W phase grows into the Al12W layer. The transformation of Al to Al12W is accompanied by a significant deterioration of the top surface quality. The internal morphology of the Al-W phase is highly twinned. Its formation is accompanied by a drastic increase in the sheet resistance. The Ti in the W-Ti layer also out-diffuses into the top Al layer. Titanium forms Al3Ti particles which are dispersed inside as well as at the grain boundaries of the Al12W grains. The differences in the compound formation between the present system and other systems, such as Si/W-Ti/Al and Si/PtAl/W-Ti/Al, are discussed.

Rutherford backscattering spectrometry

10.1063/1.339459

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Citations (56)

Neural Substrates Associated With Fatigue Symptom In Fibromyalgia

Research Square (Research Square) (2022)

Hung‐Yu Liu Pei‐Lin Lee Kun‐Hsien Chou Yen-Feng Wang Shih‐Pin Chen

Abstract Many patients with fibromyalgia (FM) experience fatigue, but the associated biological mechanisms have not been delineated. We aimed to investigate the neural signatures associated with fatigue severity in patients with FM using MRI. We consecutively recruited 138 patients with FM and collected their clinical profiles and brain-MRI data. We categorized the patients into 3 groups based on their fatigue severity. Using voxel-based morphometry analysis and trend analysis, we first identified neural structures showing volumetric changes associated with fatigue severity, and further explored their seed-to-voxel structural covariance networks (SCNs). Results showed decreased bilateral thalamic volumes were associated with higher severity of fatigue. There was a more widespread distribution of the thalamic SCNs to the frontal, parietal, subcortical, and limbic regions in patients with higher fatigue severity. In addition, increased right inferior temporal cortex volumes were associated with higher severity of fatigue. The right inferior temporal seed showed more SCNs distributions over the temporal cortex and a higher strength of SCNs to the bilateral occipital cortex in patients with higher fatigue severity. The thalamus and the right inferior temporal cortex as well as their altered interactions with cortical and subcortical regions comprise the neural signatures of fatigue in FM.

Supplementary motor area

Temporal cortex

Frontal cortex

10.21203/rs.3.rs-1225198/v1

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Non-aura visual disturbance with high visual aura rating scale scores has stronger association with migraine chronification than typical aura

Cephalalgia (2022)

Yu-Chien Tsao Yen‐Feng Wang Jong‐Ling Fuh Wei‐Ta Chen Kuan‐Lin Lai

Objectives To investigate the clinical correlates of visual symptoms in patients with migraine. Method Patients with migraine that attended our headache clinics were enrolled. Headache profiles, disability, and comorbidities were acquired with structured questionnaires. A semi-structured visual phenomenon questionnaire was also used to assess the characteristics of visual symptoms, including visual aura in patients with migraine with aura and transient visual disturbance in patients with migraine without aura. Headache specialists interviewed with the participants for the ascertainment of diagnosis and verification of the questionnaires. Result Migraine with aura patients with visual aura (n = 743, female/male = 2.3, mean age: 34.7 ± 12.2 years) and migraine without aura patients with non-aura transient visual disturbance (n = 1,808, female/male = 4.4, mean age: 39.4 ± 12.6 years) were enrolled. Patients with transient visual disturbance had higher headache-related disability and more psychiatric comorbidities. Chronic migraine was more common in migraine without aura than migraine with aura patients (41.9% vs. 11.8%, OR = 5.48 [95% CI: 4.33–7.02], p < 0.001). The associations remained after adjusting confounding factors. Conclusion Presence of non-aura transient visual disturbance may suggest a higher migraine-related disability and is linked to higher risk of chronic migraine than typical migraine aura in migraine patients. Further studies are needed to elucidate the potential mechanism.

Visual Disturbance

10.1177/03331024221123074

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Transient visual disturbances are associated with disability and suicide risk in patients with migraine without aura

Journal of the Chinese Medical Association (2023)

Yu-Chien Tsao Yen-Feng Wang Jong‐Ling Fuh Wei‐Ta Chen Kuan‐Lin Lai

Background: To investigate the characteristics and clinical correlates of transient visual disturbances (TVDs) in patients with migraine without aura (MO). Patients with MO frequently report TVDs, which differ from typical visual aura, but the clinical significance of these TVDs has not been determined. Methods: Patients with MO who attended our headache clinics were enrolled. Structured questionnaires were used to acquire data on participants’ headache profiles, disability, comorbidities, and lifetime suicidal ideation and suicide attempts. A semistructured visual phenomenon questionnaire was used to characterize TVDs. Headache specialists interviewed the participants for diagnosis and the verification of questionnaire responses. Results: Patients with MO (n = 7200; female/male ratio = 3.56, mean age 40.1 ± 13.4 years) were divided into two groups based on the presence (n = 2488) or absence (n = 4712) of TVDs. Patients with TVDs had more headache-related disability, psychiatric comorbidities, and photophobia than did those without TVDs. Suicidal ideation and suicide attempts were more common among patients with than among those without TVDs [ideation: odds ratio (OR) = 1.92, 95% confidence interval (CI) 1.71-2.15, p < 0.001; suicide attempt: OR = 2.23, 95% CI 1.80-2.75, p < 0.001]. Conclusion: The presence of TVDs may imply greater migraine-related disability, photophobia, and suicidal ideation/suicide attempt risk in patients with MO.

Photophobia

Phonophobia

10.1097/jcma.0000000000000912

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Heart Rate Variability Predicts Treatment Efficacy in Patients with Chronic Migraine: An Exploratory Study

Research Square (Research Square) (2021)

Chun‐Hsiang Chuang Kuan‐Lin Lai Jhe-Yu Li Jung‐Tai King Wei‐Ta Chen

Abstract Background : Chronic migraine (CM) is a disabling headache disorder. Autonomic nervous system (ANS) disturbance, as evidenced from heart rate variability (HRV) studies, has been documented in patients with episodic migraine and other pain disorders but not specifically in patients with CM. This study aimed to explore whether the HRV in patients with CM was impaired and whether it could be used to predict treatment outcomes.Methods : Patients with CM were recruited, along with age- and gender-matched healthy controls (CTLs). The time-domain, frequency-domain, and nonlinear metrics of HRV were calculated to evaluate the sympathetic and parasympathetic aspects of ANS function in patients with CM before and after 3-month (12 weeks) treatment with flunarizine as well as in CTLs. The patients were asked to keep a headache diary throughout the study period to determine the treatment efficacy.Results : A total of 81 patients with CM and 58 CTLs completed the study. Most HRV values in patients with CM were significantly lower than those in CTLs, suggesting decreased overall autonomic modulation and parasympathetic hypofunction but not sympathetic dysfunction. By unsupervised clustering analysis, patients with CM were divided into two cluster groups with high and low HRV at baseline. Patients with high baseline HRV, which was comparable to that of CTLs, showed significantly higher absolute and relative reductions in averaged monthly headache days across a 3-month preventive treatment compared with patients with low baseline HRV (-9.1 days vs. -6.4 days or -43.2% vs. -30.1%, both p < 0.05). The HRV increased after preventive treatment in the low-HRV group but not in the high-HRV group.Conclusions : HRV could distinguish patients with CM from CTLs, indicating the involvement of ANS dysfunction. Moreover, patients with CM having a near-normal baseline HRV, indicating a preserved parasympathetic function and overall ANS modulation reservoir, predicted a better outcome to preventive treatment with flunarizine than those with low HRV.Trial registration: Neurologic Signatures of Chronic Pain Disorders, NCT02747940.Registered 22 April 2016, https://clinicaltrials.gov/ct2/show/NCT02747940

Cluster headache

10.21203/rs.3.rs-841353/v1

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Internal Carotid Artery Hypoplasia

Journal of Ultrasound in Medicine (2015)

Pei-Ya Chen Hung‐Yu Liu Kun-Eng Lim Shinn-Kuang Lin

Objectives The purpose of this study was to determine the role of color‐coded carotid duplex sonography for diagnosis of internal carotid artery hypoplasia. Methods We retrospectively reviewed 25,000 color‐coded carotid duplex sonograms in our neurosonographic database to establish more diagnostic criteria for internal carotid artery hypoplasia. Results A definitive diagnosis of internal carotid artery hypoplasia was made in 9 patients. Diagnostic findings on color‐coded carotid duplex imaging include a long segmental small‐caliber lumen (52% diameter) with markedly decreased flow (13% flow volume) in the affected internal carotid artery relative to the contralateral side but without intraluminal lesions. Indirect findings included markedly increased total flow volume (an increase of 133%) in both vertebral arteries, antegrade ipsilateral ophthalmic arterial flow, and a reduced vessel diameter with increased flow resistance in the ipsilateral common carotid artery. Ten patients with distal internal carotid artery dissection showed a similar color‐coded duplex pattern, but the reductions in the internal and common carotid artery diameters and increase in collateral flow from the vertebral artery were less prominent than those in hypoplasia. The ipsilateral ophthalmic arterial flow was retrograde in 40% of patients with distal internal carotid artery dissection. In addition, thin‐section axial and sagittal computed tomograms of the skull base could show the small diameter of the carotid canal in internal carotid artery hypoplasia and help distinguish hypoplasia from distal internal carotid artery dissection. Conclusions Color‐coded carotid duplex sonography provides important clues for establishing a diagnosis of internal carotid artery hypoplasia. A hypoplastic carotid canal can be shown by thin‐section axial and sagittal skull base computed tomography to confirm the final diagnosis.

10.7863/ultra.14.08044

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Citations (7)

Neuromagnetic Amygdala Response to Pain-Related Fear as a Brain Signature of Fibromyalgia

Pain and Therapy (2020)

Fu‐Jung Hsiao Wei‐Ta Chen Yu‐Chieh Ko Hung‐Yu Liu Yen-Feng Wang

Fibromyalgia (FM) is a chronic pain condition characterized by impaired emotional regulation. This study explored the brain response to pain-related fear as a potential brain signature of FM. We used a conditioned fear task and magnetoencephalography to record pain-related fear responses in patients with FM. Two blocks of 30 fear responses were collected to compute the response strength in the first block and the strength difference between the first and second blocks (fear habituation). These measurements were investigated for their clinical relevance and compared with measurements obtained from healthy controls and patients with chronic migraine (CM), a different chronic pain condition often comorbid with FM. Pain-related fear clearly activated the bilateral amygdala and anterior insula in patients with FM (n = 52), patients with CM (n = 50), and the controls (n = 30); the response strength in the first block was consistent across groups. However, fear habituation in the right amygdala decreased in the FM group (vs. CM and control groups, both p ≤ 0.001, no difference between CM and control groups). At the 3-month follow-up, the patients with FM reporting < 30% improvement in pain severity (n = 15) after pregabalin treatment exhibited lower fear habituation in the left amygdala at baseline (vs. ≥ 30% improvement, n = 22, p = 0.019). Receiver operating characteristic analysis confirmed that amygdala fear habituation is a suitable predictor of diagnosis and treatment outcomes of FM (area under the curve > 0.7). Amygdala activation to pain-related fear is maladaptive and linked to treatment outcomes in patients with FM. Because the aberrant amygdala response was not observed in the CM group, this response is a potential brain signature of FM. ClinicalTrials.gov Identifier, NCT02747940.

10.1007/s40122-020-00206-z

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Varied responses to benzodiazepine treatment in cephalosporin‐related generalized periodic discharges

Epileptic Disorders (2016)

Hung‐Yu Liu Chien‐Chen Chou Der‐Jen Yen Hsiang‐Yu Yu

Abstract Although benzodiazepines (BZDs) are used as the first‐line treatment for status epilepticus, previous studies have shown inconsistent responses to BZDs in patients with cephalosporin‐related non‐convulsive status epilepticus. In this study, we investigated nine patients with cephalosporin‐related impaired consciousness and their EEGs all showed generalized periodic discharges (GPDs). One of the patients received repetitive BZD injections without discontinuing cephalosporins, and neither his clinical symptoms nor GPDs on EEG responded to BZDs. Seven of the patients received BZDs after discontinuation of cephalosporins, but only two of them responded immediately to BZD administration. One of the patients did not receive BZDs or antiepileptic drugs, and this patient spontaneously recovered consciousness in one day after cephalosporins were discontinued. The changes in consciousness were reversible in all of the nine patients after cephalosporins were withdrawn. The administration of intravenous BZDs in cases with impairment of consciousness and GPDs secondary to cephalosporins may help in only a small number of patients. Cephalosporin withdrawal is ultimately mandatory in these patients.

Discontinuation

10.1684/epd.2016.0867

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Citations (3)