Objective Barometric pressure has been reported as a triggering and exacerbating factor in migraine headaches, although there are few reports concerning the association of weather change and migraine headache. The relationship between barometric pressure changes and migraine headaches was prospectively examined. Methods A total of 28 migraine patients who lived within 10 km of the Utsunomiya Local Meteorological Observatory kept a headache diary throughout the year. Daily and monthly mean barometric pressure data of the Utsunomiya Local Meteorological Observatory were obtained via the homepage of the Meteorological Office. Results The correlation between headache frequency obtained by the headache diaries for 1 year and changes in the barometric pressure during the period of 2 days before and 2 days after the headache onset were evaluated. The frequency of migraine increased when the difference in barometric pressure from the day the headache occurred to the day after was lower by more than 5 hPa, and decreased when the difference in barometric pressure from the day the headache occurred to 2 days later was higher by more than 5 hPa. Of 28 patients, weather change was associated with migraine headache development in 18 (64%) patients, 14 of which reported low barometric pressure to be a cause of headache. There was no association between the monthly mean barometric pressure and headache frequency throughout the year. Conclusion Barometric pressure change can be one of the exacerbating factors of migraine headaches.

Objective: To investigate the relationship between weather and headache occurrence using big data from an electronic headache diary smartphone application with recent statistical and deep learning (DL)‐based methods. Background: The relationship between weather and headache occurrence remains unknown. Methods: From a database of 1 million users, data from 4375 users with 336,951 hourly headache events and weather data from December 2020 to November 2021 were analyzed. We developed statistical and DL‐based models to predict the number of hourly headache occurrences mainly from weather factors. Temporal validation was performed using data from December 2019 to November 2020. Apart from the user dataset used in this model development, the physician‐diagnosed headache prevalence was gathered. Results: Of the 40,617 respondents, 15,127/40,617 (37.2%) users experienced physician‐diagnosed migraine, and 2458/40,617 (6.1%) users had physician‐diagnosed non‐migraine headaches. The mean (standard deviation) age of the 4375 filtered users was 34 (11.2) years, and 89.2% were female (3902/4375). Lower barometric pressure ( p < 0.001, gain = 3.9), higher humidity ( p < 0.001, gain = 7.1), more rainfall ( p < 0.001, gain = 3.1), a significant decrease in barometric pressure 6 h before ( p < 0.001, gain = 11.7), higher barometric pressure at 6:00 a.m. on the day ( p < 0.001, gain = 4.6), lower barometric pressure on the next day ( p < 0.001, gain = 6.7), and raw time‐series barometric type I (remaining low around headache attack, p < 0.001, gain = 10.1) and type II (decreasing around headache attack, p < 0.001, gain = 10.1) changes over 6 days, were significantly associated with headache occurrences in both the statistical and DL‐based models. For temporal validation, the root mean squared error (RMSE) was 13.4, and the determination coefficient ( R ² ) was 52.9% for the statistical model. The RMSE was 10.2, and the R ² was 53.7% for the DL‐based model. Conclusions: Using big data, we found that low barometric pressure, barometric pressure changes, higher humidity, and rainfall were associated with an increased number of headache occurrences.

Objective There are many reports regarding the course of migraines during pregnancy. However, the prevalence and characteristics of migraines during the postpartum period have not been adequately investigated. We prospectively investigated the patients suffering from migraines over a long postpartum period in an obstetrics department in Japan. Methods We investigated the course of migraines experienced during the postpartum period by patients in a postnatal ward. The patients were surveyed during the first postpartum week and 1, 3, 6 and 12 months after delivery. The patients were provided a headache diary to assess medication use and migraine attack frequency, severity (the faces pain scale) and duration. Results The migraine remission rate was 63%, 83% and 85% during the first, second and third trimesters, respectively. No patient experienced a worsening of headaches during pregnancy. Headache recurrence during the first month after delivery was more frequent in the patients >30 years of age than in those ≤30 years of age (p<0.05). The percentage of women experiencing recurrence at 1, 3, 6 and 12 months after delivery was 63%, 75%, 78% (n=60) and 87.5% (n=40), respectively. In breastfeeding patients, the rates were 50%, 65.8%, 71.1% and 91.7% and in bottle feeding patients, the rates were 86.4%, 90.9%, 95.5% and 81.3%, respectively. Conclusion We found that 85% of the patients with migraines experience remission during pregnancy and that more than 50% experience recurrence during the first month after delivery. Until six months after delivery, breastfeeding is associated with a lower recurrence rate than bottle feeding.

Background The Parkinson's Disease Sleep Scale (PDSS)‐2 is a recently developed tool for evaluating disease‐related nocturnal disturbances in patients with Parkinson's disease (PD). However, its cutoff score has not been clinically assessed. We determined the optimal cutoff score of the Japanese version of the PDSS‐2. Methods Patients with PD (n = 146) and controls (n = 100) completed the PDSS‐2 and the Pittsburgh Sleep Quality Index (PSQI). Poor sleepers were defined as having global PSQI scores >5. Optimal cutoff scores for determining poor sleepers were assessed using the receiver operating characteristic curve. Results A PDSS‐2 total score ≥14 exhibited 82.0% sensitivity and 70.6% specificity, whereas a PDSS‐2 total score ≥15 provided 72.1% sensitivity and 72.9% specificity in distinguishing poor sleepers (PSQI score >5) from good sleepers (PSQI ≤5). Nocturnal disturbances were more frequently observed in patients with PD than in controls (PDSS‐2 total score ≥14 or ≥15; 51.4% vs 20%; 45.9% vs 19%). Nocturnal disturbances were associated with higher Hoehn and Yahr stages and Unified Parkinson's Disease Rating Scale motor scores, impaired quality of life, daytime sleepiness, and depressive symptoms. Conclusion We suggest that PDSS‐2 total scores ≥15 are useful for detecting poor sleepers among patients with PD.

Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a heterogeneous disorder and both clinical course and response to treatment vary widely. Because of the propensity for relapse, CIDP requires maintenance therapy after the initial response to treatment. There is no consensus regarding this in the published literature. Present report: A patient with CIDP was treated with oral prednisolone and cyclophosphamide pulse therapy but required repeated plasma exchange and intravenous immunoglobulin (IVIg). Treatment with ciclosporin freed the patient from repeated IVIg administration. Therapeutic responses in 14 subsequent cases including three patients who showed improvement with ciclosporin are also presented along with an algorithm of the authors’ suggested protocol for treatment. Conclusion: Ciclosporin should be considered for patients with intractable CIDP who require repeated IVIg.