• 턱관절균형의학회지
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• 제7권1호
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• pp.17-23
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• 2017

Functional neurology is a function-oriented clinical neurology with a focus on the viability, functionality, and balance of the neurologic system, which may be considered as a form of yin-yang balance medicine like Korean medicine. While it incorporates knowledge systems such as developmental neurology, neuropsychology, comparative neuroanatomy, and others, it views the neurologic system and the body as an individually different, self-regulating mechanism with the help of the active balancing mechanism within the nervous system and between the individual and the environment, which view is at the core of its effort to improve and serve the human dignity based on the best possible functioning nervous system. This article reviews core concepts of the functional neurology, discusses yin-yang balance medicine perspectives and clinical applications of it.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.176-183
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• 2018

Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (${\geq}65$ years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.160-163
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• 2001

Mirror movements in adult is usually accompanied with various clinical syndromes. But the pathogenesis of mirror movement is not clearly understood. A 20-year-old man visited with complaining of mirror movements in both hands, ophthalmoplegia and sensorineural hearing loss. He underwent through electromyography, transcranial magnetic stimulation, and functional magnetic resonance image. And we concluded that the mechanisms of his mirror movements were both ipsilateral innervated corticospinal tract and simultaneous activation of both motor cortex.

• Journal of Medicine and Life Science
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• 제19권3호
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• pp.130-133
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• 2022

Several studies have reported a possible link between anti-aquaporin-4 antibody and vitamin B12 deficiency in neuromyelitis optica spectrum disorder (NMOSD). Bilaterally symmetric hyperintense signals on magnetic resonance imaging (MRI) of the posterior columns, called the inverted V sign, are a characteristic feature of subacute combined degeneration associated with vitamin B12 deficiency. We report a patient with anti-aquaporin-4 antibody-positive NMOSD and an inverted V sign on MRI of the spinal cord and address the association between anti-aquaporin-4 antibody and functional vitamin B12 deficiency.

• Annals of Clinical Neurophysiology
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• 제25권2호
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• pp.93-102
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• 2023

Background: We aimed to identify any differences in the structural covariance network based on structural volume and those in the functional network based on cerebral blood flow between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura. Methods: We prospectively enrolled 27 patients with migraine without aura, all of whom had unilateral migraine pain. We defined the ipsilateral hemisphere as the side of migraine pain. We measured structural volumes on three-dimensional T1-weighted images and cerebral blood flow using arterial spin labeling magnetic resonance imaging. We then analyzed the structural covariance network based on structural volume and the functional network based on cerebral blood flow using graph theory. Results: There were no significant differences in structural volume or cerebral blood flow between the ipsilateral and contralateral hemispheres. However, there were significant differences between the hemispheres in the structural covariance network and the functional network. In the structural covariance network, the betweenness centrality of the thalamus was lower in the ipsilateral hemisphere than in the contralateral hemisphere. In the functional network, the betweenness centrality of the anterior cingulate and paracingulate gyrus was lower in the ipsilateral hemisphere than in the contralateral hemisphere, while that of the opercular part of the inferior frontal gyrus was higher in the former hemisphere. Conclusions: The present findings indicate that there are significant differences in the structural covariance network and the functional network between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura.

• Annals of Clinical Neurophysiology
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• 제1권2호
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• pp.154-159
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• 1999

Magnetoencephalography (MEG), the measurement of magnetic fields produced by neuronal current associated with normal and pathologic brain activities, is a totally noninvasive method for localizing functional regions of the brain. During the past several years, many clinical research centers are working to expand various fundamental functional brain regions, which can be easily localized, as well as to characterize magnetic abnormalities which accompany a wide variety of cerebral disease. At present, MEG is used in a number of clinical centers throughout the world for the presurgical functional localization of eloquent cortex, and for the non-invasive localization of epileptiform activity. And also, non-invasiveness means that it can be used for screening and repetitive follow-up measurement without concern for adverse effects. As procedures for activating various functional brain regions are standardized, and as the effects of specific cerebral diseases on the MEG are carefully documented in controlled studies, the number of routine neurological applications for MEG will increase significantly. In this paper, the basic principles of MEG are reviewed briefly with its clinical application to neurologic disease.

• Annals of Clinical Neurophysiology
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• 제23권2호
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• pp.69-81
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• 2021

Cortico-cortical evoked potential (CCEP) mapping is a rapidly developing method for visualizing the brain network and estimating cortical excitability. The CCEP comprises the early N1 component the occurs at 10-30 ms poststimulation, indicating anatomic connectivity, and the late N2 component that appears at < 200 ms poststimulation, suggesting long-lasting effective connectivity. A later component at 200-1,000 ms poststimulation can also appear as a delayed response in some studied areas. Such delayed responses occur in areas with changed excitability, such as an epileptogenic zone. CCEP mapping has been used to examine the brain connections causally in functional systems such as the language, auditory, and visual systems as well as in anatomic regions including the frontoparietal neocortices and hippocampal limbic areas. Task-based CCEPs can be used to measure behavior. In addition to evaluations of the brain connectome, single-pulse electrical stimulation (SPES) can reflect cortical excitability, and so it could be used to predict a seizure onset zone. CCEP brain mapping and SPES investigations could be applied both extraoperatively and intraoperatively. These underused electrophysiologic tools in basic and clinical neuroscience might be powerful methods for providing insight into measures of brain connectivity and dynamics. Analyses of CCEPs might enable us to identify causal relationships between brain areas during cortical processing, and to develop a new paradigm of effective therapeutic neuromodulation in the future.

• 대한한방내과학회지
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• 제42권2호
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• pp.75-85
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• 2021

Objectives: This study reported about a patient with a right middle cerebral artery infarction whose gait disturbance was improved by Korean medicine treatment. Methods: The patient was treated with a Korean herbal medicine (Gami-yukmijihwang-tang) along with acupuncture, electroacupuncture, moxibustion, cupping, and physical therapy. The treatment effect was evaluated with the manual muscle test (MMT) and the Korean version of the modified Barthel index (K-MBI). The gait of the patient was evaluated by a 10-m walk test (10MWT), the timed up and go (TUG) test, the functional ambulation profile (FAP) score, and the functional ambulatory category (FAC) score. Spatiotemporal parameters were evaluated using a walkway system (GAITRite®, CIR Systems, Inc., USA). Results: After 83 days of traditional Korean medicine treatment, the K-MBI and FAC scores improved from 50 to 70 and from 1 to 4, respectively. The 10MWT and TUG tests also improved from 24.86 to 16.66 sec and from 22.35 to 17.62 sec, respectively. GAITRite® measurements reflected gait improvements: the FAP score improved from 55 to 86 sec; the step time improved from 0.72 to 0.669 sec; the step length improved from 31.076 cm to 41.284 cm; the gait velocity improved from 42.8 cm/sec to 64.1 cm/sec; the cadence improved from 93.6 steps/min to 90.8 steps/min. No adverse effects resulting from treatment or evaluation occurred during the admission period. Conclusions: This study suggests that traditional Korean medicine treatment may reduce symptoms and improve the quality of life in patients with cerebral infarction.

• 대한한방내과학회지
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• 제41권5호
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• pp.811-820
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• 2020

Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment of a gait disturbance in a patient with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism. Methods: The patient was treated with Korean herbal medicine (Yukmijihwang-tang-gami), acupuncture, moxibustion, and rehabilitation exercise. The gait of the patient was evaluated by the 10 m Walk Test, Timed Up and Go (TUG) test, 360° turning test, Functional Ambulatory Category (FAC), and GAITRite. Results: After 20 days of traditional Korean medicine treatment, we observed improvement in the symptoms of the gait disturbance. Conclusion: Traditional Korean medicine treatment might be effective in the treatment of gait disturbance in patients with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism.

• Annals of Clinical Neurophysiology
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• 제22권2호
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• pp.82-91
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• 2020

Electroencephalography (EEG) produces time-series data of neural oscillations in the brain, and is one of the most commonly used methods for investigating both normal brain functions and brain disorders. Quantitative EEG analysis enables identification of frequencies and brain activity that are activated or impaired. With studies on the structural and functional networks of the brain, the concept of the brain as a complex network has been fundamental to understand normal brain functions and the pathophysiology of various neurological disorders. Functional connectivity is a measure of neural synchrony in the brain network that refers to the statistical interdependency between neural oscillations over time. In this review, we first discuss the basic methods of EEG analysis, including preprocessing, spectral analysis, and functional-connectivity and graph-theory measures. We then review previous EEG studies of brain network characterization in several neurological disorders, including epilepsy, Alzheimer's disease, dementia with Lewy bodies, and idiopathic rapid eye movement sleep behavior disorder. Identifying the EEG-based network characteristics might improve the understanding of disease processes and aid the development of novel therapeutic approaches for various neurological disorders.