• Title/Summary/Keyword: Cognitive Impairment

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The Role of Tc-99m HMPAO Brain Perfusion SPECT in the Psychiatric Disability Evaluation of Patients with Chronic Traumatic Brain Injury (만성 외상성 뇌 손상 환자의 정신의학적 후유 장애 평가에서 Tc-99m HMPAO 뇌혈류 SPECT의 역할)

  • So, Young;Lee, Kang-Wook;Lee, Sun-Woo;Ghi, Ick-Sung;Song, Chang-June
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.232-243
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    • 2002
  • Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

Decreased Attention in Narcolepsy Patients is not Related with Excessive Daytime Sleepiness (기면병 환자의 주의집중 저하와 주간졸음증 간의 상관관계 부재)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Lee, Yu-Jin;Lee, Ju-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.122-132
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    • 2005
  • Objectives: The objective of this study is to assess cognitive functions and their relationship with sleep symptoms in young narcoleptic patients. Methods: Eighteen young narcolepsy patients and 18 normal controls (age: 17-35 years old) were recruited. All narcolepsy patients had HLA $DQB_1$ *0602 allele and cataplexy. Several important areas of cognition were assessed by a battery of neuropsychological tests consisting of 13 tests: executive functions (e.g. cognitive set shifting, inhibition, and selective attention) through Wisconsin card sorting test, Trail Making A/B, Stroop test, Ruff test, Digit Symbol, Controlled Oral Word Association and Boston Naming Test; alertness and sustained attention through paced auditory serial addition test; verbal/nonverbal short-term memory and working memory through Digit Span and Spatial Span; visuospatial memory through Rey-Osterrieth complex figure test; verbal learning and memory through California verbal learning test; and fine motor activity through grooved pegboard test. Sleep symptoms in narcolepsy patients were assessed with Epworth sleepiness scale, Ullanlinna narcolepsy scale, multiple sleep latency test, and nocturnal polysomnography. Relationship between cognitive functions and sleep symptoms in narcolepsy patients was also explored. Results: Compared with normal controls, narcolepsy patients showed poor performance in paced auditory serial addition (2.0 s and 2.4 s), digit symbol tests, and spatial span (forward)(t=3.86, p<0.01; t=-2.47, p=0.02; t=-3.95, p<0.01; t=-2.22, p=0.03, respectively). There were no significant between-group differences in other neuropsychological tests. In addition, results of neuropsychological test in narcolepsy patients were not correlated with Epworth sleepiness scale score, Ullanlinna narcolepsy scale score and sleep variables in multiple sleep latency test or nocturnal polysomnography. Conclusion: The current findings suggest that young narcolepsy patients have impaired attention. In addition, impairment of attention in narcolepsy might not be solely due to sleep symptoms such as excessive daytime sleepiness.

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An event-related potential study of global-local visual perception in female college students with binge drinking (폭음 여자대학생의 전체-세부 시지각 처리에 관한 사건관련전위 연구)

  • So-yeon Lim;Myung-Sun Kim
    • Korean Journal of Cognitive Science
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    • v.34 no.2
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    • pp.111-151
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    • 2023
  • It is reported that binge drinkers show cognitive impairment similar to alcohol use disorder patients. A previous studies using neuropsychological tests and brain imaging techniques to investigate the visual perception of alcohol use disorder patients reported that they had global-local visual perception defects. Although the neurological basis for the global-local visual perception deficit in the heavy drinking group has been presented, there are no studies to date that have investigated the global-local visual perception in the heavy drinking group. This study investigated local-biased visual perception in female college students with binge drinking (BD) using event-related potentials (ERPs). Based on the scores of the Korean version of Alcohol Use Disorder Identification Test and the Alcohol Use Questionnaire, participants were assigned into BD (n=25) and non-BD (n=25) groups. Local-global visual processing was assessed using a local-global paradigm, in which large stimuli (global level) composed of small stimuli (local level) were presented. The stimuli presented at global and local levels were either congruent or incongruent. The behavioral results exhibited that the BD and non-BD groups did not differ in terms of accuracy and response time. In terms of ERPs, the BD and non-BD groups did not show difference in N100, P150 and N200 amplitude. However, the BD group showed significantly smaller P300 amplitude than non-BD group especially in the local condition. In addition, a negative correlation between P300 amplitude and binge drinking score was observed, i.e., severer binge drinking smaller P300 amplitude. The P300 is known to reflect cognitive inhibition and attentional allocation. In the global-local paradigm, the local condition required to attend to local target while ignoring global non-target. Therefore, the present results indicate that female college students with BD do not have local-biased visual processing, instead they seem to have difficulties in inhibition of irrelevant stimuli.

Ethyl acetate fraction from Pteridium aquilinum ameliorates cognitive impairment in high-fat diet-induced diabetic mice (고지방 식이로 유도된 실험동물의 당뇨성 인지기능 장애에 대한 고사리 아세트산에틸 분획물의 개선효과)

  • Kwon, Bong Seok;Guo, Tian Jiao;Park, Seon Kyeong;Kim, Jong Min;Kang, Jin Yong;Park, Sang Hyun;Kang, Jeong Eun;Lee, Chang Jun;Lee, Uk;Heo, Ho Jin
    • Korean Journal of Food Science and Technology
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    • v.49 no.6
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    • pp.649-658
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    • 2017
  • The potential of the ethyl acetate fraction from Pteridium aquilinum (EFPA) to improve the cognitive function in high-fat diet (HFD)-induced diabetic mice was investigated. EFPA-treatment resulted in a significant improvement in the spatial, learning, and memory abilities compared to the HFD group in behavioral tests, including the Y-maze, passive avoidance, and Morris water maze. The diabetic symptoms of the EFPA-treated groups, such as fasting glucose and glucose tolerance, were alleviated. The administration of EFPA reduced the acetylcholinesterase (AChE) activity and malondialdehyde (MDA) content in mice brains, but increased the acetylcholine (ACh) and superoxide dismutase (SOD) levels. Finally, kaempferol-3-o-glucoside, a major physiological component of EFPA, was identified by using high-performance liquid chromatography coupled with a hybrid triple quadrupole-linear ion trap mass spectrometer (QTRAP LC-MS/MS).

Tc-99m ECD Brain SPECT in Patients with Traumatic Brain Injury: Evaluating Distribution of Hypoperfusion and Assesment of Cognitive and Behavioral Impairment in Relation to Thalamic Hypoperfusion (뇌외상 환자의 Tc-99m ECD 뇌 SPECT에서 뇌 혈류감소의 분포 및 시상의 혈류감소에 대한 인지 및 행동장애 평가)

  • Park, Soon-Ah;Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.445-455
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    • 2000
  • Purpose: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. Materials and Methods: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age $34.7{\pm}15.4$ yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. Results: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe ($24{\sim}26%$) thalami ($21{\sim}22.4%$), parietal and occipital lobe (${\leq}10%$). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former $4.7{\pm}1.5$ and the latter $3.2{\pm}1.4\;in\;G1,\;5.0{\pm}1.1\;and\;4.8{\pm}1.2\;in\;G2,\;6.8{\pm}1.8\;and\;6.3{\pm}1.1\;in\;G3$, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. Conclusion: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.

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Analysis of newborn hearing screening using automated auditory brainstem response (자동화 청성뇌간반응을 이용한 신생아 청력선별검사 결과 분석)

  • Park, Sung Won;Yun, Byung Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon;Hong, Sung Hwa
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1056-1060
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    • 2006
  • Purpose : As hearing ability affects language and cognitive development, early detection and intervention of congenital hearing defects is very important. We analyzed the result of newborn hearing screening using automated auditory brainstem response and estimated the incidence of congenital hearing defects in newborn infants in Korea. Methods : Hearing screening tests were done on 7,218 newborn infants who were delivered at Cheil General Hospital from July 1, 2004 to June 30, 2005. The first screening test was done on the second day of life with automated auditory brainstem response(AABR) using $ALGO{\bigcirc}^{(3)}$ Newborn hearing screener($Natus^{(R)}$ Medical Incorporated, San Carlos, USA) with 35 dB sound level. The newborn infants who did not pass the initial screening test took the second screening AABR test before discharge from the nursery. Infants who did not pass these screenings at the nursery were followed up at the Department of Otorhinolaryngology, Samsung Seoul Hospital. Results : Total 7,218 infants(83.3 percent of total 8,664 live births of the Cheil General Hospital) were screened in the nursery, and 55 of them failed to pass the newborn screening. Among 55 infants who were referred, six were lost during follow-up, and 14 were confirmed as hearing impaired. Six of them(42.8 percent) do not have any risk factors for hearing impairment. We can estimate that the incidence of hearing defects is about 1.9-2.8 per 1,000 live births. Conclusion : Automated auditory brainstem response is an effective tool to screen the hearing of newborn infants. Congenital hearing loss is more frequent than metabolic diseases on which screening tests are available in the newborn period. About 40 percent of infants who have hearing defects do not have any risk factors for hearing impairment. Therefore, universal newborn hearing screening must be recommended to all neonates.

Effects of the Deer Antler Extract on Scopolamine-induced Memory Impairment and Its Related Enzyme Activities (녹용 추출물이 치매 동물모델의 기억력 개선과 관련효소 활성에 미치는 효과)

  • Lee, Mi-Ra;Sun, Bai-Shen;Gu, Li-Juan;Wang, Chun-Yan;Fang, Zhe-Ming;Wang, Zhen;Mo, Eun-Kyoung;Ly, Sun-Young;Sung, Chang-Keun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.4
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    • pp.409-414
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    • 2009
  • The aim of this study was to investigate the ameliorating effects of deer antler extract on the learning and memory impairments induced by the administration of scopolamine (2 mg/kg, i.p.) in rats. Tacrine was used as a positive control agent for evaluating the cognition enhancing activity of deer antler extract in scopolamine-induced amnesia models. The results showed that the deer antler extract-treated group (200 mg/kg, p.o.) and the tacrine-treated group (10 mg/kg, p.o.) significantly ameliorated scopolamine-induced amnesia based on the Morris water maze test. Although there was no statistical significance of brain ACh contents among the experimental groups, the brain ACh contents of the deer antler extract-treated group was slightly higher than that of the scopolamine-treated group. The inhibitory effect of deer antler extract on the acetylcholinesterase activity in the brain was significantly lower than that of scopolamine-treated group. The tacrine- and the deer antler-treated groups reduced the MAO-B activity compared to the scopolamine-treated group, but not significantly. These results suggest that the deer antler extract could be an effective agent for the prevention of the cognitive impairment induced by cholinergic dysfunction.

A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Repeated Neonatal Propofol Administration Induces Sex-Dependent Long-Term Impairments on Spatial and Recognition Memory in Rats

  • Gonzales, Edson Luck T.;Yang, Sung Min;Choi, Chang Soon;Mabunga, Darine Froy N.;Kim, Hee Jin;Cheong, Jae Hoon;Ryu, Jong Hoon;Koo, Bon-Nyeo;Shin, Chan Young
    • Biomolecules & Therapeutics
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    • v.23 no.3
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    • pp.251-260
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    • 2015
  • Propofol is an anesthetic agent that gained wide use because of its fast induction of anesthesia and rapid recovery post-anesthesia. However, previous studies have reported immediate neurodegeneration and long-term impairment in spatial learning and memory from repeated neonatal propofol administration in animals. Yet, none of those studies has explored the sex-specific long-term physical changes and behavioral alterations such as social (sociability and social preference), emotional (anxiety), and other cognitive functions (spatial working, recognition, and avoidance memory) after neonatal propofol treatment. Seven-day-old Wistar-Kyoto (WKY) rats underwent repeated daily intraperitoneal injections of propofol or normal saline for 7 days. Starting fourth week of age and onwards, rats were subjected to behavior tests including open-field, elevated-plus-maze, Y-maze, 3-chamber social interaction, novel-object-recognition, passive-avoidance, and rotarod. Rats were sacrificed at 9 weeks and hippocampal protein expressions were analyzed by Western blot. Results revealed long-term body weight gain alterations in the growing rats and sex-specific impairments in spatial (female) and recognition (male) learning and memory paradigms. A markedly decreased expression of hippocampal NMDA receptor GluN1 subunit in female- and increased expression of AMPA GluR1 subunit protein expression in male rats were also found. Other aspects of behaviors such as locomotor activity and coordination, anxiety, sociability, social preference and avoidance learning and memory were not generally affected. These results suggest that neonatal repeated propofol administration disrupts normal growth and some aspects of neurodevelopment in rats in a sex-specific manner.

The Korean Practice Parameter for the Treatment of Attention - Deficit Hyperactivity Disorder(II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안(II) - 진단 및 평가 -)

  • Cheon, Keun-Ah;Kim, Ji-Hoon;Kang, Hwa-Yeon;Kim, Bung-Nyun;Shin, Dong-Won;Ahn, Dong-Hyun;Yang, Su-Jin;Yoo, Han-Ik;Yoo, Hee-Jeong;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.10-15
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    • 2007
  • Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

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