In early 2006 touring expanded to the United States. The band performed in Austin, Texas at the South by Southwest festival, New York City at the Avalon Club and Los Angeles, California at the Wiltern Theatre, followed by the North American release of "Withering to Death." Again, all shows sold out within days. After more concerts and festival appearances in Germany during the summer, singer Kyo was again hospitalized due to inflamed vocal cords. While two concert dates in Japan had to be postponed, Dir En Grey was still able to join Korn's Family Values Tour 2006. In October, the band was back in Japan to perform at the Loudpark Festival, along with bands such as Megadeth, Slayer and Children of Bodom. Their 22nd single "Agitated Screams of Maggots" was released on 15 November during the Japanese leg of the Inward Scream tour. On 30 December, the music video for -Saku- was voted the No. 1 video of the year on the MTV2 show Headbanger's Ball.