• 제목/요약/키워드: Functional neurology

검색결과 120건 처리시간 0.022초

본태성 진전증의 임상 및 전기생리학적 분석 (Clinical and Electrophysiologic Analysis of Essential tremor)

  • 유성용;서만욱;정슬기
    • Annals of Clinical Neurophysiology
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    • 제7권1호
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    • pp.7-12
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    • 2005
  • Background: Essential tremor (ET) is a common movement disorder that often causes functional disability. There have been very few investigations about the clinical characteristics of ET in Korea. Therefore, we performed a study showing the clinical features and electrophysiological findings of ET. Methods: We analyzed medical records and accelerometry data of 152 patients (male vs female; 79 vs 73) with ET, who visited the Neurology Clinic of Hospital from 2000 to 2003. Clinical characteristics of ET were summarized including the age of onset, family history, tremor type, body part involved, and associated symptoms. The frequency of tremor was recorded and the spectral analysis of tremor was performed. Results: The age of tremor onset showed bimodal distribution with peaks in the 2nd and 5th decades. Family history was found in 46 patients (30.3%). The patients with the family history presented earlier onset of tremor than patients without the history (mean age of onset, y: 35.2 vs. 49.9, P < 0.001). Tremor appeared most frequently in hands (94%), and followed by head (25%). In head tremor, "no-no" pattern was mainly observed and the head tremor was more frequently observed in female. The frequency of tremor was negatively correlated with age (r=-0.49, P<0.001). Conclusions: The present study indicated some important findings about ET: (1) bimodal distribution for an age of onset, (2) younger age of onset in patients with a family history, (3) decreasing frequency of the tremor according to age, and (4) higher prevalence of head tremor in female patients.

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복잡한 사고에 의해 유발되는 간질발작 2예 (Two Patients with Epilepsy Induced by Complex Thinking)

  • 김재문;이경목;손은희;정기영
    • Annals of Clinical Neurophysiology
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    • 제2권1호
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    • pp.27-30
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    • 2000
  • Reflex epilepsies are distinct but not clearly understood clinical entity. Various cerebral activities induced by simple stimulation including visual, auditory, somatosensory stimulation, as well as diverse functional tasks such as reading, calculation, complex thinking are believed to be seizure-inducing factors. We experienced two patients whose seizures were readily precipitated by complex, strenuous thinking. Both patients was teen-aged boy at the onset of seizure(13, and 15 years of age each) with normal physical and mental growth. Although first seizure was precipitated by watching TV and playing puzzles in each patient, initial diagnosis was idiopathic generalized epilepsy, possibly juvenile myoclonic epilepsy( JME). For the first few years, seizures were infrequent but mostly precipitated by the tasks needs concentration such as playing computer games, decision-making, mathematics, reading, or during the examination. EEG revealed various thinking process including reading hard books, drawing complex figure, complex calculation induced epileptic discharges even if it usually needs certain period of concentration. Phenytoin, valproic acid, clonazepam, vigabatrin, and lamotrigine sometimes abated their seizures but none of these made them seizure-free. Complex reflex epilepsy induced by thinking was proposed to be a separate type of epilepsy or a variant of JME. Age, sex, stereotypic seizure-inducing factors, clinical course, and refractory epilepsies in these patients highly suggested this type of epilepsy as a variant of JME but its refractoriness and unique provocation still needs more speculation.

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Associations between Brain Perfusion and Sleep Disturbance in Patients with Alzheimer's Disease

  • Im, Jooyeon J.;Jeong, Hyeonseok S.;Park, Jong-Sik;Na, Seung-Hee;Chung, Yong-An;Yang, YoungSoon;Song, In-Uk
    • 대한치매학회지
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    • 제16권3호
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    • pp.72-77
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    • 2017
  • Background and Purpose Although sleep disturbances are common and considered a major burden for patients with Alzheimer's disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT). Methods A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A whole-brain voxel-wise analysis of brain SPECT data was conducted to compare the rCBF between the two groups. Results The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group. Conclusions The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.

Clinical and anatomic description of patients with arteriovenous malformation treated with endovascular therapy in a Mexican population

  • Mallyolo Eliezer Pelayo-Salazar;Hector Alfredo Montenegro-Rosales;Jorge Luis Balderrama-Banares;Pablo Martinez-Arellano;Omar Andres Campos-Flota;Laura Mestre-Orozco;Julio Cesar Lopez-Valdes
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • 제25권1호
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    • pp.36-49
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    • 2023
  • Objective: Arteriovenous malformations (AVMs) are benign congenital lesions. The estimated prevalence is 10-18 per 100,000 individuals, with an incidence rate of 1.1-1.4 per 100,000 person-year; only 12% of AVMs present symptoms during life. It is important to study different characteristics associated with AVMs because these patients require multidisciplinary treatment. Methods: A descriptive, observational, longitudinal, and retrospective study was carried out from January 15, 2016 to October 19, 2021. Convenience sampling was used on patients diagnosed with arteriovenous malformation. Sociodemographic data was obtained, such as: sex, age, site, predominant symptoms, clinical debut, type of malformation, data associated with post therapy evolution, type of embolizing agent used, associated complications, Rankin scale, and death. Results: Data from 535 procedures was collected, we calculated an incidence of 4.4 cases per million inhabitants. Ninety procedures in 56 patients that used endovascular therapy were obtained with a female-male ratio of 0.75 and an age distribution of 35±14 (SD). A 36.3±11.5 (SD) mm diameter was registered. There was a 33% success rate for endovascular surgery. Conclusions: The multidisciplinary treatment of AVMs is made up of three pillar techniques: microsurgical resection, embolization, and radio-neurosurgery. It is extremely important to make an appropriate decision, with an emphasis on achieving better functional outcomes for the patient. Although neurological endovascular therapy was initially used as an adjuvant treatment for neurosurgery and radio-neurosurgery, it has been used more and more frequently as the first line of treatment.

한국형 파킨슨 환자의 역학적 기능수행지수 개발 (Developing an Biomechanical Functional Performance Index for Parkinson's Disease Patients)

  • Shin, Sunghoon;Han, Byungin;Chung, Chulmin;Lee, Yungon
    • 한국운동역학회지
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    • 제30권1호
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    • pp.83-91
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    • 2020
  • Objective: The study aimed to develop a functional performance index that evaluates the functional performance of Parkinson's patients, i.e., to integrate biomechanical measurements of walking, balance, muscle strength and tremor, and to use multiple linear regression with stepwise methods to identify the most suitable predictors for the progression of disease. Method: A total of 60 subjects were tested for sub-variables of four factors: walking, balance, isometric strength and hand tremors. Potential independet variables were extracted through correlation analysis of the sub-variables and dependent variables, Hoehn & Yahr scale. And then, a stepwise multiple regression analysis using the potential independent variables was performed to identify predictor of Hoehn & Yahr scale. Results: First, the results of the study showed that physical composition and gait had a relatively more correlated with the progression of the disease, compared to balance and hand tremor. Second, Parkinson's functional performance is characterized by dynamic pattern of walking, such as foot clearance and turning angle (TA) of walking, and a high-explained regression model is completed. Conclusion: The study emphasized the importance of walking variables and body composition in minor pathological features compared to Parkinson's patient's balancing ability and hand tremor. Specifically, it revealed that dynamic walking patterns functionally characterize patients. The results are worth considering when assessing functional performance related to the progression of the disease at the site.

근위축성 측삭경화증 환자의 삶의 질 (Quality of Life in Patients with Amyotrophic Lateral Sclerosis)

  • 허현숙;최스미
    • 재활간호학회지
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    • 제16권2호
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    • pp.122-132
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    • 2013
  • Purpose: This study measured the quality of life in patients with amyotrophic lateral sclerosis (ALS). Methods: The participants consisted of consecutive patients with ALS who visited the neurology outpatient department from January to July, 2008. To collect the data, face-to-face interviews were applied at S national university hospital in Seoul. Using multivariate analysis, factors to predict QOL in ALS patients including demographic factors, functional independence, depression, anxiety, social support and quality of life were analyzed. Results: The final analysis included 69 patients. The mean score for the physical health and mental health components was $34.4{\pm}21.3$ and $44.7{\pm}20.6$, respectively. The mean score for the ALS functional rating scale was $24.3{\pm}10.8$ out of 40. Anxious and depressed patients accounted for 44.9% and 71%, respectively. Quality of life in ALS patients was significantly affected by functional independence, depression and anxiety level. Conclusion: To improve the quality of life in ALS patients with declining functional independence, comprehensive interventions are necessary to manage depression and anxiety.

Attenuation of Postischemic Genomic Alteration by Mesenchymal Stem Cells: a Microarray Study

  • Choi, Chunggab;Oh, Seung-Hun;Noh, Jeong-Eun;Jeong, Yong-Woo;Kim, Soonhag;Ko, Jung Jae;Kim, Ok-Joon;Song, Jihwan
    • Molecules and Cells
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    • 제39권4호
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    • pp.337-344
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    • 2016
  • Intravenous administration of mesenchymal stem cells (IV-MSC) protects the ischemic rat brain in a stroke model, but the molecular mechanism underlying its therapeutic effect is unclear. We compared genomic profiles using the mRNA microarray technique in a rodent stroke model. Rats were treated with $1{\times}10^6$ IV-MSC or saline (sham group) 2 h after transient middle cerebral artery occlusion (MCAo). mRNA microarray was conducted 72 h after MCAo using brain tissue from normal rats (normal group) and the sham and MSC groups. Predicted pathway analysis was performed in differentially expressed genes (DEGs), and functional tests and immunohistochemistry for inflammation-related proteins were performed. We identified 857 DEGs between the sham and normal groups, with the majority of them (88.7%) upregulated in sham group. Predicted pathway analysis revealed that cerebral ischemia activated 10 signaling pathways mainly related to inflammation and cell cycle. IV-MSC attenuated the numbers of dysregulated genes in cerebral ischemia (118 DEGs between the MSC and normal groups). In addition, a total of 218 transcripts were differentially expressed between the MSC and sham groups, and most of them (175/218 DEGs, 80.2%) were downregulated in the MSC group. IV-MSC reduced the number of Iba-$1^+$ cells in the peri-infarct area, reduced the overall infarct size, and improved functional deficits in MCAo rats. In conclusion, transcriptome analysis revealed that IV-MSC attenuated postischemic genomic alterations in the ischemic brain. Amelioration of dysregulated inflammation- and cell cycle-related gene expression in the host brain is one of the molecular mechanisms of IV-MSC therapy for cerebral ischemia.

근위축성측삭경화증 환자를 돌보는 가족의 우울과 간병 부담감 (Depression and Caregiving Burden in Families of Patients with Amyotrophic Lateral Sclerosis)

  • 오주연;안지원;오기욱;오성일;김정아;김승현;이정섭
    • 대한간호학회지
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    • 제45권2호
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    • pp.202-210
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    • 2015
  • Purpose: The purpose of this study was to describe depression, caregiving burden and the correlation of the two variables in the families of patients with amyotrophic lateral sclerosis (ALS) and to clarify factors predicting caregiving burden. Methods: A descriptive and cross-sectional study was conducted with 139 family members who provided care to patients with ALS. The characteristics of patients and families, Korean-Beck Depression Inventory (K-BDI), Korean version of Zarit Burden Interview (K-ZBI) and Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (K-ALSFRS-R) were used as study measures. Results: The mean score for K-BDI was 19.39 out of 63 suggesting sub-clinical depression and 38.2% of the family members exhibited depression. The mean score for K-ZBI was 66.03 out of 88. The predictors for K-ZBI were K-BDI, age of family member, length of time spent per day in caring, relationship to patient and K-ALSFRS-R. Conclusion: The results of this study suggest that levels of depression and caregiving burden are high among family members caring for patients with ALS. As depression is associated with caregiving burden, screening and emotional supports should be provided to reduce the burden of care for these family. Support programs to alleviate the care burden are also needed, considering family demographics, time per day in caring giving and K-ALSFRS-R.

파킨슨성 완서증의 손가락 마주치기 속도와 크기에 대한 약물과 뇌심부자극의 효과 (Effects of Medication and Deep Brain Stimulation on the Finger-tapping Speed and Amplitude of Parkinsonian Bradykinesia)

  • 김지원;권유리;박상훈;엄광문;고성범;장지완;이혜미
    • 대한의용생체공학회:의공학회지
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    • 제33권1호
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    • pp.47-52
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    • 2012
  • The purpose of this study is to investigate whether medication and deep brain stimulation (DBS) have differential effects on the speed and amplitude of bradykinesia in patients with Parkinson's disease (PD). Five PD patients with implanted DBS electrodes (age: $60.6{\pm}7.4yrs$, H&Y stage: $3.1{\pm}0.2$) participated in this study. FT (finger tapping) movement was measured using a gyrosensor system in four treatment conditions: Med (Medication)-off/DBS-off, Med-off/DBS-on, Med-on/DBS-off and Med-on/DBS-on. Quantitative measures representing average speed and amplitude of FT movement included root-mean-squared (RMS) angular velocity and RMS angle. One-way repeated measures ANOVA showed that RMS angular velocity of Med-on/DBS-on was significantly greater than those of Med-off/DBS-off and Med-off/DBS-on (p < 0.01) whereas RMS angle was not different among conditions (p = 0.06). Two way repeated measures ANOVA showed that only medication improved RMS angular velocity (p < 0.01), whereas both medication and DBS had no significant effect on RMS angle (p > 0.02). Effect size of RMS angular velocity was greater than that of RMS angle in both medication and DBS. This suggests that medication and DBS have differential effects on FT bradykinesia and velocity and amplitude impairments may be associated with different functional aspects in PD.

두부충동 검사 (Head Thrust Test)

  • 최광동;오선영;김지수
    • Annals of Clinical Neurophysiology
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    • 제8권1호
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    • pp.1-5
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    • 2006
  • The head thrust maneuver is a simple bedside test of the higher frequency vestibulo-ocular reflex, which is based on Ewald's second law. It is performed by grasping the patient's head and applying a brief, small-amplitude, high-acceleration head turn, first to one side and then to the other. The patient fixates on the examiner's nose and the examiner watches for corrective rapid eye movements (saccades), which are a sign of decreased vestibular response. The "catch-up" saccades after a head thrust in one direction indicate a peripheral vestibular lesion on that side (in the labyrinth or the $8^{th}$ nerve including the root's entry zone in the brain stem). An individual pair of vertical semicircular canals can also be stimulated by turning the head to the right or left by $45^{\circ}$ and then by rotating the head in the pitch plane relative to the body. Recent studies have suggested that assessment of individual semicircular canal function by head thrust test may provide useful information for anatomical and functional details of a variety of peripheral vestibulopathies and for predicting the prognosis of vestibular neuritis. In central vestibulopathy, the head thrust test may also be valuable sign to determine dysfunction of the central pathways from individual semicircular canals and its role for the development of diverse central nystagmus.

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