• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.987-998
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• 2023

The purpose of this case study is to report the effectiveness of scalp acupuncture and Cheungsindodam-tang on Wernicke's aphasia in patients with left middle cerebral territory infarction. Scalp acupuncture, herbal medicine (Cheungsindodam-tang), and moxibustion were administered for 66 days to improve the patient's symptoms. The degree of improvement in symptoms was evaluated using the Korean version of the Western Aphasia Battery (K-WAB) and Mini-Mental State Examination-Korea (MMSE-K). Quality of life was evaluated with the Korean version of the Stroke and Aphasia Quality of Life Scale-39 (K-SAQOL-39). After 66 days of treatment, the aphasia quotient score of the K-WAB test increased from 19 to 34.6 after treatment. The K-SAQOL-3 score increased from 2.77 to 3.18, and the MMSE-K score increased from 4 to 21. This case report suggests that Korean medical therapy can be effective in improving the language functions of patients with Wernicke's aphasia.

• Journal of Ginseng Research
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• v.47 no.6
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• pp.735-742
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• 2023

Background: Gintonin is a new material of ginseng that acts through the ginseng-derived lysophosphatidic acid (LPA) receptor ligand. The gintonin-enriched fraction (GEF) inhibits amyloid plaque accumulation in the cortex and hippocampus, improves cognitive dysfunction by increasing acetylcholine levels, and promoted hippocampal neurogenesis in an animal model of Alzheimer's disease. We evaluated the effect of the GEF on the cognitive performance of subjects with subjective memory impairment (SMI). Methods: In this eight-week, randomized, assessor- and participant-blinded, placebo-controlled study, participants with SMI were assigned to three groups receiving placebo, GEF 300 mg/day or GEF 600 mg/day. The Korean versions of the Alzheimer's Disease Assessment Scale (K-ADAS), Mini-Mental State Examination (K-MMSE), and Stroop color-word test (K-SCWT) were also evaluated along with the safety profiles. Results: One hundred thirty-six participants completed the study. After eight weeks, we analyzed intergroup differences in primary or secondary outcome score changes. When we compared the GEF group with the placebo group, we observed significant improvements in the K-ADAS and K-SCWT scores. The GEF group did not show a significant improvement in K-MMSE and BDI scores compared to the placebo group. No adverse events were observed in the gintonin and placebo groups for eight weeks. Conclusion: The GEF is safe and effective in improving subjective cognitive impairment related to both the K-ADAS and K-SCWT in this study. However, further large-scale and randomized controlled studies are warranted to secure other cognitive function tests besides the K-ADAS and K-SCWT, and to confirm the findings of the current study.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.1050-1061
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• 2023

This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health's Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.433-444
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• 2023

Objectives: This case study aimed to provide evidence of the combined use of Korean Medicine treatments, including electroacupuncture (EA) on scalp acupoints, as a useful intervention for post-stroke delirium. Methods: The patient in this study was diagnosed with Cerebral Infarction in Right Corpus Callosum and post-stroke delirium. The patient received eight sessions of EA on scalp acupoints, rehabilitation medicine treatment, and other Korean Medicine treatments such as acupuncture and herbal medicine. Evaluation of treatment effectiveness was done mainly through the Memorial Delirium Assessment Scale Korean (MDAS-K) and Mini-Mental State Examination Korean (MMSE-K). Results: MDAS-K score dropped from 20 to 9 and MMSE-K score increased from 15 to 21 during hospitalization, showing improvement in symptoms. Conclusions: Combined use of Korean medicine treatments including EA on scalp acupoints may be an effective treatment for post-stroke delirium.

• Korean Journal of Radiology
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• v.24 no.11
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• pp.1131-1141
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• 2023

Objective: Cortical iron deposition has recently been shown to occur in Alzheimer's disease (AD). In this study, we aimed to evaluate how cortical gray matter iron, measured using quantitative susceptibility mapping (QSM), differs in the clinical cognitive impairment spectrum. Materials and Methods: This retrospective study evaluated 73 participants (mean age ± standard deviation, 66.7 ± 7.6 years; 52 females and 21 males) with normal cognition (NC), 158 patients with mild cognitive impairment (MCI), and 48 patients with AD dementia. The participants underwent brain magnetic resonance imaging using a three-dimensional multi-dynamic multi-echo sequence on a 3-T scanner. We employed a deep neural network (QSMnet+) and used automatic segmentation software based on FreeSurfer v6.0 to extract anatomical labels and volumes of interest in the cortex. We used analysis of covariance to investigate the differences in susceptibility among the clinical diagnostic groups in each brain region. Multivariable linear regression analysis was performed to study the association between susceptibility values and cognitive scores including the Mini-Mental State Examination (MMSE). Results: Among the three groups, the frontal (P < 0.001), temporal (P = 0.004), parietal (P = 0.001), occipital (P < 0.001), and cingulate cortices (P < 0.001) showed a higher mean susceptibility in patients with MCI and AD than in NC subjects. In the combined MCI and AD group, the mean susceptibility in the cingulate cortex (β = -216.21, P = 0.019) and insular cortex (β = -276.65, P = 0.001) were significant independent predictors of MMSE scores after correcting for age, sex, education, regional volume, and APOE4 carrier status. Conclusion: Iron deposition in the cortex, as measured by QSMnet+, was higher in patients with AD and MCI than in NC participants. Iron deposition in the cingulate and insular cortices may be an early imaging marker of cognitive impairment related neurodegeneration.

• The Journal of Korean Physical Therapy
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• v.36 no.2
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• pp.61-66
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• 2024

Purpose: The purpose of this study was to investigate the impact of action observation training (AOT) on the balance and cognition of the elderly with dementia. Methods: Twenty-four participants were randomly assigned to experimental and control groups (12 participants each). The 5-week intervention involved 45 minutes sessions, three times a week. Both groups did 30 minutes of general physical exercises, followed by the experimental group watching a 5 minutes video featuring functional movements and imitating them for 10 minutes. The control group watched a scenic video and did functional training for 10 minutes, mimicking the experimental group. All participants were evaluated using the Timed Up and Go (TUG) test, Functional Reaching Test (FRT), Berg's Balance Scale (BBS), and Korean version of Mini-Mental State Examination (K-MMSE) before and after the intervention. A paired t-test was conducted to compare the within-group change before and after the intervention. Two-way repeated measures ANOVA was performed to compare the between-group difference. The statistical significance level was set to p=0.05 for all variables. Results: The experimental group showed significant within-group changes in the TUG test, FRT, BBS, and K-MMSE (p<0.05). The control group showed a significant change in FRT and K-MMSE (p<0.05). A significant difference was observed between the experimental group and the control group regarding the change in the TUG test, BBS, and K-MMSE after the interventions (p<0.05). Conclusion: The findings of this study suggest that the AOT and repetition of actual movements, led to more significant improvements in balance and cognitive abilities compared to the control group that observed scenic landscapes.

• Journal of Oriental Neuropsychiatry
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• v.35 no.1
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• pp.37-68
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• 2024

Objectives: This study aimed to systematically review thread-embedding treatment studies for depression, anxiety, and dementia and examine the effectiveness and safety of thread-embedding treatment. Methods: Ten domestic and international search databases were used for study selection, including CNKI, PubMed, CENTRAL, EMBASE, CINAHL, AMED, PsycArticles, RISS, OASIS, and KCI. We included studies that presented diagnostic or appropriate criteria for depression, anxiety, and dementia, and randomized control studies using thread-embedding therapy. We searched papers published until October 10, 2023. Results: Twenty-one studies were selected, of which 11 studies were conducted on depression, nine on dementia, and one on anxiety disorders. The most commonly used acupoint for depression was Gansu (BL18), whereas zusanli (ST36) and fenglong (ST40) were used for dementia. The most commonly used type of thread was 1-0 United States pharmacopeia (USP) and 1 cm for depression and 2-0 USP and 1 cm for dementia. The treatment period for most of the studies was once every 2 weeks and for 8 weeks. Among the included studies, 17 showed significant improvements in depression scales, such as Hamilton depression rating scale and Self rating depression scale, activities of daily living scales, and cognitive function scales, such as Hasegawa dementia scale and Mini-mental state examination. Six studies reported adverse events, and no studies reported significant adverse events. Two studies reported follow-ups. Conclusions: This study presents limited evidence for the effectiveness and safety of thread-embedding therapy for depression, anxiety, and dementia. Well-designed studies are needed to review the clinical efficacy and safety of thread-embedding therapy in the future.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.246-258
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• 2024

This case report describes a patient diagnosed with central post-stroke pain (CPSP) and hemiparesis due to anterior cerebral artery and middle cerebral artery infarction. The patient was treated with Korean medicines, including moxibustion, acupuncture, electroacupuncture, herbal medicine, Western medicine, and rehabilitation therapy for 67 days. CPSP improved based on scores on the Numeric Rating Scale (NRS) (from 8 to 0), paresthesia NRS (7 to 0), Manual Muscle Test (4/1 to 4+/4-),4+/4-), Korean version of the modified Barthel Index (24 to 73), National Institute of Health's Stroke Scale (7 to 0), Global Deterioration Scale (1 to 1), and Korean version of the Mini-Mental State Examination (27 to 29). No seizures, shocks, recurrent ischemic stroke, and liver dysfunction were recorded during the treatment. A moxibustion-induced burn healed within 7 days. This case suggests that moxibustion, combined with other treatments, has the potential to improve CPSP, without severe side effects.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.149-158
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• 2024

Introduction: In this case report, we describe the clinical effectiveness of Yigan-san-gami in improving symptoms in a patient with worsening Alzheimer's dementia after COVID-19 infection. Case presentation: Symptoms of dementia worsened in a patient with Alzheimer's disease after COVID-19 infection. Western medicines were added following neurological consultation. However, there was no medicinal effect. The patient was treated with Korean medicine (Yigan-san-gami) three times a day. We used daily charts, the Korean Mini-Mental State Examination-2 (K-MMSE-2), Clinical Dementia Rating (CDR), and Short Version Geriatric Depression Scale (SGDS) to assess the patient's symptoms. Cognitive decline and behavioral and psychological symptoms of dementia (BPSD) improved following the treatment with Yigan-san-gami. Conclusion: The results suggest that Yigan-san-gami may be effective in improving symptoms of Alzheimer's disease that worsen after COVID-19 infection.

• Dementia and Neurocognitive Disorders
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• v.21 no.2
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• pp.59-70
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• 2022

Background and Purpose: Neurofilament light chain (NfL) has been considered as a biomarker for neurodegenerative diseases including Alzheimer's disease (AD). We measured plasma NfL levels in older adults with cognitive complaints and evaluated their clinical usefulness in AD. Methods: Plasma levels of NfL, measured by using the single molecule array method, were acquired in a total of 113 subjects consisting of subjective cognitive decline (SCD; n=14), mild cognitive impairment (MCI; n=37), or dementia of Alzheimer type (DAT; n=62). Plasma NfL level was compared among three groups, and its association with cognitive and functional status was also analyzed. Results: After adjusting for age, plasma NfL level was higher in subjects with DAT (65.98±84.96 pg/mL), compared to in subjects with SCD (16.90±2.54 pg/mL) or MCI (25.53±10.42 pg/mL, p=0.004). NfL levels were correlated with scores of the mini-mental state examination (r=-0.242, p=0.021), clinical dementia rating (CDR) (r=0.291, p=0.005), or CDR-sum of boxes (r=0.276, p=0.008). Just for participants who performed amyloid positron emission tomography (PET), the levels were different between subjects with PET (-) (n=17, 25.95±13.25 pg/mL) and PET (+) (n=16, 63.65±81.90 pg/mL, p=0.010). Additionally, plasma NfL levels were different between vascular dementia and vascular MCI, and between Parkinson's disease- dementia and no dementia. Conclusions: This pilot study shows that in subjects with DAT, plasma NfL levels increase. Plasma NfL level correlated with cognitive and functional status. Further longitudinal studies may help to apply the plasma NfL levels to AD, as a potential biomarker for the diagnosis and predicting progression.