• The Korean Journal of Pain
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• v.27 no.3
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• pp.285-289
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• 2014

Transcranial magnetic stimulation (TMS) is a noninvasive and safe technique for motor cortex stimulation. TMS is used to treat neurological and psychiatric disorders, including mood and movement disorders. TMS can also treat several types of chronic neuropathic pain. The pain relief mechanism of cortical stimulation is caused by modifications in neuronal excitability. Depression is a common co-morbidity with chronic pain. Pain and depression should be treated concurrently to achieve a positive outcome. Insomnia also frequently occurs with chronic lower back pain. Several studies have proposed hypotheses for TMS pain management. Herein, we report two cases with positive results for the treatment of depression and insomnia with chronic low back pain by TMS.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.103-108
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• 2010

Purpose: The aim of this study is to investigate whether motor cortex excitability by transcranial direct current stimulation (tDCS) over primary motor cortex (M1) affects motor performance of serial reaction task. Methods: Cathodal, anodal and sham tDCS (1 mA) are applied over right M1 of 24 subjects for 30 minutes including 11minutes for task period time. We applied two electrodes at the same position to both an experimental group and a sham-controlled group, and we made 2 groups recognize to be applicated of stimulation. Flexion, extension of wrist and thumb flexion are carried out following colors of arrows on the monitor. Serial reaction time task was applied to confirm the difference of the reaction time between 2 groups. Results: Reaction time is decreased in both tDCS-group and Sham-controlled tDCS group, and the degree of reduction is much greater in the post-test than pre-test. Reduction of reaction time between groupsis statistically significant. Conclusion: We consider that anodal tDCS increased the cortical excitability of the underlying motor cortex and it can be helpful to modulate motor performance. It seems that tDCS is an effective modality to modulate brain function, and it will be great help to mediate strategy for the brain injury patients.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.1-12
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• 2011

Transcranial magnetic stimulation (TMS) is a non-invasive tool used to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders. A brief electric current passed through a magnetic coil produces a high-intensity magnetic field, which can excite or inhibit the cerebral cortex. Although various brain regions can be evaluated by TMS, most studies have focused on the motor cortex where motor evoked potentials (MEPs) are produced. Single-pulse and paired-pulse TMS can be used to measure the excitability of the motor cortex via various parameters, while repetitive TMS induces cortical plasticity via long-term potentiation or long-term depression-like mechanisms. Therefore, TMS is useful in the evaluation of physiological mechanisms of various neurological diseases, including movement disorders and epilepsy. In addition, it has diagnostic utility in spinal cord diseases, amyotrophic lateral sclerosis and demyelinating diseases. The therapeutic effects of repetitive TMS on stroke, Parkinson disease and focal hand dystonia are limited since the duration and clinical benefits seem to be temporary. New TMS techniques, which may improve clinical utility, are being developed to enhance clinical utilities in various neurological diseases.

• Journal of Korean Neuropsychiatric Association
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• v.57 no.2
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• pp.119-132
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• 2018

Despite the fact that pharmacotherapy depressive disorders have proven efficacy, a substantial number of patients are resistant to conventional management. As neuroscientific research about pathophysiology of depression have accumulated, repeated transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have emerged as an important mechanism-based treatment modality. This overview provides a review of therapeutic application of rTMS and tDCS in patients with depression. The clinical and basic studies of rTMS and tDCS in depression were reviewed and integrated using a literature review and interview with experts. rTMS is a noninvasive procedure of a localized pulsed magnetic field to the surface of the head to cause a depolarization of neurons in the brain cortex. tDCS has a mechanism of modulating cortical excitability in a polarity-specific manner without eliciting action potentials. rTMS and tDCS seem promising for treating depression. Although therapeutic parameters and further technical improvement remain to be systematically investigated, rTMS and tDCS would be a safe and effective intervention to treat depression.

• Toxicological Research
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• v.23 no.1
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• pp.33-38
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• 2007

Zinc is an endogenous transition metal that can be synaptically released during neuronal activity. However, zinc may contribute to the neuropathology associated with a variety of conditions. Carnosine expressed in glial cells can modulate the effects of zinc on neuronal excitability as a zinc chelator. We hypothesize that carnosine may protect against neurotoxicity of zinc in cortical neuronal cells. The cortical neuronal cells from newborn rats were prepared and exposed to zinc chloride and/or carnosine at various concentrations. Zinc at the doses of 0 to $500{\mu}M$ decreased neuronal cell viability in a dose-dependent manner. Additionally, at the concentrations of 100 and $200{\mu}M$, it significantly decreased cell viability in an exposed time-dependent manner (p < 0.05). Treatment with carnosine at the concentrations of 20 and $200{\mu}M$ significantly increased neuronal cell proliferation by approximately 14% and 20%, respectively, compared to the control (p < 0.05). At the concentrations of 100 and $200{\mu}M$ zinc, $20{\mu}M$ carnosine significantly increased the viability of neuronal cells by 18.3% and 12.1 %, and $200{\mu}M$ carnosine also increased it by 33.5% and 28.6%, respectively, compared to the normal control group (p < 0.01). These results suggest that carnosine at a physiologically relevant level may protect against zinc-mediated toxicity in neuronal cells as an endogenous neuroprotective agent.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.171-180
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• 2019

Purpose : The purpose of this study was to investigate the difference in motor cortical excitability during mental practice and action observation in subjects with forward head posture. Methods : This study was performed in two groups, a forward head posture group (n=17) and a normal posture group (n=17). Electroencephalography (EEG) was conducted to investigate cerebral cortex activity, and six electrodes were attached to Fp1, Fp2, C1, C2, C3, and C4 to measure the relative alpha power, relative beta power, relative gamma power, and mu rhythms. The subjects were requested to perform the four different conditions, which were eye opening, eye closing, mental practice, and action observation for 300 seconds. Results : The results showed that the relative alpha waves showed a significant difference between the normal and forward head posture groups in the C1, C2, C3, and C4 regions with the eyes open (p<.05). The relative beta waves also showed a significant difference between the two groups in the Fp1 and Fp2 regions during action observation (p<.05). The relative gamma waves were significantly different between the normal and forward head posture groups in the Fp1 and Fp2 regions during action observation (p<.05) in C1, C2, and C3 with eyes closed (p<.05) and in C1, C2, C3, and C4 with eyes open (p<.05). Conclusion : The results of this study showed that EEG change in the forward head posture group was different from that in the normal control group in action observation rather than in mental practice. Therefore, we are expected to provide a neurophysiological basis for applying action observation to motor skill learning during exercise for correcting forward head posture.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• Korean Journal of Biological Psychiatry
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• v.24 no.3
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• pp.95-109
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• 2017

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

• Therapeutic Science for Rehabilitation
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• v.7 no.3
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• pp.23-33
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• 2018

Objective : This systematic review aimed to investigate the effect of focal muscle vibration in patients with post-stroke spastic hemiplegia. Methods : We searched literature published between April 2009 and October 2017 using PubMed and RISS databases. The main search terms were Vibration therapy, Focal vibration, Somatosensory, Upper limb, and Spasticity after stroke. Based on inclusion/exclusion criteria, 6 articles were selected. Results : Articles on focal muscle vibration intervention ranged from evaluation of application-only vibration to muscle vibration with task-oriented activity. Intervention effects on upper extremity spasticity and function and activities of daily living were assessed. There were significant effects on upper extremity spasticity, function, and cortical excitability. Conclusions : This study can provide information on focal muscle vibration for use by clinical therapists. However, further studies are needed to identify the optimal stimulation site and frequency/amplitude of application to maximize the effects of focal muscle vibration.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.3
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• pp.194-201
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• 2020

Latency and amplitude are the measurement parameters of mismatch negativity (MMN). The values of the parameters vary sensitively with the stimulus paradigm. A paradigm using the frequency difference of sounds for the MMN study is well known. This study obtained the reference values of the parameters in healthy young adults by performing the MMN study using the frequency paradigm. The authors recruited ten healthy adults. Their average age was 25.5 years; three were female, and seven were male. On the auditory paradigm for the MMN study, the frequency of sound was 1000 Hz for the standard stimulus, and 1032 Hz for the deviant stimulus. The mean values of latency and amplitude of MMN were 202 ms and 1.88 ㎶ at Fz, 207 ms, and 1.46 ㎶ at Cz, 212 ms, and 1.10 ㎶ at C3, and 214 ms and 1.45 ㎶ at C4. There was no correlation between the latency and amplitude of MMN. This study presented the reference values of the latency and amplitude of the MMN using a standard paradigm that is easy to apply. This information may make the MMN useful for clinical applications and basic research.