• 생물정신의학
• /
• 제22권1호
• /
• pp.20-27
• /
• 2015

Objectives It is increasingly thought that the human cerebellum plays an important role in emotion and cognition. Although recent evidence suggests that the cerebellum may also be implicated in fear learning, only a limited number of studies have investigated the cerebellar abnormalities in panic disorder. The aim of this study was to evaluate the cerebellar gray matter deficits and their clinical correlations among patients with panic disorder. Methods Using a voxel-based morphometry approach with a high-resolution spatially unbiased infratentorial template, regional cerebellar gray matter density was compared between 23 patients with panic disorder and 33 healthy individuals. Results The gray matter density in the right posterior-superior (lobule Crus I) and left posterior-inferior (lobules Crus II, VIIb, VIIIa) cerebellum was significantly reduced in the panic disorder group compared to healthy individuals (p < 0.05, false discovery rate corrected, extent threshold = 100 voxels). Additionally, the gray matter reduction in the left posterior-inferior cerebellum (lobule VIIIa) was significantly associated with greater panic symptom severity (r = -0.55, p = 0.007). Conclusions Our findings suggest that the gray matter deficits in the posterior cerebellum may be involved in the pathogenesis of panic disorder. Further studies are needed to provide a comprehensive understanding of the cerebro-cerebellar network in panic disorder.

• 생물정신의학
• /
• 제25권3호
• /
• pp.60-71
• /
• 2018

Objectives A growing body of evidence has suggested that morphologic changes in cerebellum may be implicated with pathophysiology of major depressive disorder (MDD). The aim of this study is to investigate a difference in the volume and cortical thickness of the specific region of cerebellum between patients with MDD and healthy controls (HC). Methods A total of 127 patients with MDD and 105 HC participated in this study and underwent T1-weighted structural magnetic resonance imaging. We analyzed volume and cortical thickness of each twelve cerebellum regions divided by left and right and the volume and cortical thickness of the whole cerebellum from T1-weigted image of participants. One-way analysis of covariance was used to investigate the volume and cortical thickness difference of total and specific regions between two groups adjusting for age, gender, medication, and total intracranial cavity volume. Results We found that the patients with MDD had significantly greater volume in the left cerebellum lobule III region [false discovery rate (FDR)-corrected p = 0.034] compared to HC. Also, our findings indicate that cortical thickness of left lobule VIIB (FDR-corrected p = 0.032) and lobule VIIIB (FDR-corrected p = 0.032) are significantly thinner in the patients with MDD compared with the HC. No significant volume and cortical thickness differences were observed in other sub-regions of the cerebellum. The volumes and cortical thickness of whole cerebellum between patients with MDD and HC did not differ significantly. Conclusions We observed the region-specific volume and cortical thickness difference in cerebellum between the patients with MDD and HC. The results of our study implicate that the information about structural alterations in cerebellum with further replicative studies might provide a stepping stone toward a specific marker to diagnose MDD.

• PNF and Movement
• /
• 제11권1호
• /
• pp.79-88
• /
• 2013

Purpose : Currently, ICF to describe the functions and disability in the world has been used as a universal language. ICF tools based on ICF, the rehabilitation management of clients have been developed to be efficient. This study was designed to describe clinical decision for functional goal of clients to used ICF tools. Methods : In the following the utilization of all developed ICF tools will be described within a case example of a 53-year-old women, suffering from cerebellum disorder. As problems in the subject's functional activities was difficulties in changes sitting postures, standing postures and maintaining standing postures. Activity limitation was determined change sitting, standing posture as a goal through discussion with the patient. Results : After setting the identified problems as the purpose of intervention through the assessment, we find out the outcomes using the ICF evaluation display. Consequently, with functional activities limitation that discovered from assessment(categorical profile, assessment sheet), sitting postures to standing postures and maintaining standing postures were improved. Conclusion : This study was showed ICF tools based on Rehab-cycle for the patient's functional goals clinical practice. The future study, the ICF in clinical practical tools for effective use will require more attempt.

• Journal of Genetic Medicine
• /
• 제21권1호
• /
• pp.36-40
• /
• 2024

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome is a maternally inherited mitochondrial disorder that usually affects the cerebral cortex and prevents high-energy demands from being met. Herein, we present the case of a male patient who rapidly developed multiple seizures, headaches, and altered mentality accompanied by severe metabolic acidosis and lactic acidosis. Initially, a brain imaging study confirmed stroke-like lesions (SLLs) only in the cerebellum. During follow-up, newly developed SLLs with lactic acidosis were observed in the basal ganglia (BG), cerebellum, and occipital lobe. The m.3243A>G variant had been found in the patient and MELAS was diagnosed, despite the BG and cerebellum being atypical locations for SLLs in MELAS. Since most cases of m.3243A>G variant MELAS show SLLs in the cerebral cortex, this case is unusual considering the location of the lesion. We emphasize that in the case of lactic acidosis accompanied by neurological symptoms, such as seizures, as in this case, MELAS should be included in the differential diagnosis, even if SLLs are observed in areas other than the cerebral cortex.

• 보험의학회지
• /
• 제27권1호
• /
• pp.37-38
• /
• 2008

The concept of Chiari malformations emerged toward the end of $19^{th}$ century from Chiari's initial descriptions of "alterations in the cerebellum resulting from cerebral hydrocephalus." In 1891, Hans Chiari(1851-1916) suggested cerebellar ectopia in which he classified Type I as "elongation of the tonsils and medial parts of the inferior lobes of the cerebellum into cone-shaped projections, which accompany the medulla oblongata into the spinal canal. The incidence of Chiari malformation has been found to be between 0.56% and 0.77% on MR imaging studies, as well as 0.62% in brain dissection studies. the definition of the adult Chiari malformation has varied with the evolution of neurodiagnositic capabilities and knowledge of physiopathology. This disorder can be associated with significant symptomatology, risk of secondary injury due to trauma, and the risk of progression and damage of the spinal cord due to associated Syringomyelia. Syringomyelia is found in 50 to 70% of Chiari I malformation. It is the clinical judgment of the physicians evaluating this disorder that is of the importance to avoid the therapeutic extremes of pursuing unnecessary surgery or withholding necessary treatment from patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제16권2호
• /
• pp.153-159
• /
• 2005

본 고에서는 지금까지 자폐 장애 및 PDD에서 행해졌던 신경발달학적 병리 소견들에 대하여 살펴보고자 하였다. 자폐 장애에서 전형적으로 관찰되는 신경병리학적 소견들은 소뇌에서의 Purkinje 세포 수의 감소, 변연계에서의 증가된 세포 밀도 및 축소된 신경원 크기, 피질의 이형성 및 이동 장애 등이라고 할 수 있겠다. 그러나, 일부 문헌들은 일관되고 일치된 결과를 보인 반면, 대부분의 연구결과들이 아직까지는 불확실한 상태로 남아있다. 이것은 매우 적은 대상군과 자폐 장애의 이질성(heterogeneity), 기타 공존 질환 통제의 어려움, 연구 디자인의 비정교성에 기인한 통계량의 부족과 관련이 있다. 따라서 향후 좀더 정교한 디자인에 의하여 자폐 환자 대상군을 많이 확보하여 다양한 혼란 변인들을 통제한 후 신경발달학적 소견들을 연구한다면 자폐 장애의 원인론을 확립하는데 많은 공헌을 할것으로 기대된다.

• Journal of Yeungnam Medical Science
• /
• 제39권1호
• /
• pp.58-61
• /
• 2022

Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.

• Animal cells and systems
• /
• 제1권4호
• /
• pp.589-594
• /
• 1997

The neuronal voltage-sensitive calcium channels (VSCCs) are multisubunit complexes consisting of $\alpha_1,\;\alpha_2-\delta$ and $\beta$ subunits. Heterologous expression and biochemical studies have shown that the activity of VSCCs is regulated by their $\beta$ subunits in a $\beta$ subunit isoform-specific manner. To elucidate the $\beta$ subunit identity of the P/Q-type calcium channel encoded by an $\alpha_{1A}$ subunit, which is exclusively expressed in the Purkinje and granule cell of the cerebellum, we have examined the spatial and temporal expression patterns of $\beta$ subunits and compared them with those of $\alpha_{1A}$ subunit in the developing rat cerebellum. Reverse transcriptase- polymerase chain reaction (RT-PCR) and Northern blot analysis have shown that $\beta_4$ subunit mRNA was prominently expressed in the cerebellum and much more abundant than any other distinct $\beta$ subunits. RNase protection assay has further demonstrated that the expression of $\alpha_{1A}$ and $\beta_4$ subunits increased during cerebellar development, while the amount of $\beta_2$ and $\beta_3$ mRNAs did not significantly change. In addition, a $\beta_4$ transcript was present in cultured cerebellar granule cells, but not in astrocyte cells, and the level of $\beta_4$ mRNA expression increased gradually in vitro seen as in vivo. Based on the spatial and temporal expression patterns of $\beta_4$ subunit, we conclude that $\beta_4$ may predominantly associate, but probably not exclusively, with the $\alpha_{1A}$ subunit in rat cerebellar granule cells.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제8권2호
• /
• pp.256-265
• /
• 1997

전반적발달장애 환자와 발달성언어장애 환자의 뇌혈류량의 분포를 조사하여 각 질환의 국소적 뇌기능의 특성을 알아보고자 한다. 14명의 전반적발달장애 환자와 13명의 발달성언어장애 환자를 대상으로 뇌 technetium-99m-EDC SPECT를 촬영하여 2명의 핵의학 전문의가 판독하고, 대뇌의 측두엽, 두정엽, 기저핵, 시상, 소뇌를 관심 영역(region of interest)으로 하여 뇌혈류량을 양적으로 측정하여 양군을 비교한다. 뇌 SPECT 소견상 전반적발달장애와 발달성언어장애에서 모두 측두엽, 두정엽, 기저핵, 시상, 소뇌의 혈류량의 감소를 보였고, 혈류량을 양적으로 측정한 결과, 상기부위의 혈류량이 전반적발달장애군과 발달성언어장애군에서 유의한 차이를 보이지 않았다. 이는 전반적발달장애와 발달성언어장애는 뇌기능의 특정 국소부위의 이상이 아니고, 대뇌피질과 피질하부위의 신경발달-신경연결(interneural connection)-상의 이상에 의한 질환이며, 두 질환이 스펙트럼장애일 가능성을 시사한다.

• 동의생리병리학회지
• /
• 제18권2호
• /
• pp.621-625
• /
• 2004

Bilateral striopallidodentate calcinosis, popularly referred to as Fahr's disease, is a disorder radiologically characterized by bilateral calcifications of the basal ganglia, thalami, dentate nuclei of the cerebellum, and the white matter of the cerebral hemisphere without serum calcium-phosphorus metabolism and related endocrinologic abnormalities. Intracranial calcifications are easily visible as high-density on CT. On magnetic resonance images, the calcifications exhibit different signal intensities. The differences in signal intensity are thought to be related to the stage of the disease, differences in calcium metabolism, and the volume of the calcium deposit. Based on literature review, I report the case of a 63 year man with bilateral symmetrical calcification in the basal ganglia, dentate nuclei of the cerebellum, and the white matter of the cerebral hemisphere who present a 5 year history of progressive dysarthria associated with left thalamic infarction.