• 제목/요약/키워드: Neurocognitive deficits

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기분 장애 소아 청소년 환자에서 자살 행동, 공격 행동과 인지기능과의 관계 (Suicidal Behavior, Violent Behavior, and Neurocognitive Function in Child and Adolescent Mood Disorder Patients)

  • 윤희준;오윤혜;정유숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제27권1호
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    • pp.39-47
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    • 2016
  • Objectives: The aim of this study was to examine the association between current suicidal or violent behavior and deficits of specific neurocognitive variables in child and adolescent inpatient samples diagnosed with mood disorder. Methods: A retrospective review of the charts of mood disorder patients hospitalized at Samsung Medical Center between April 2004 and April 2015 was conducted. Child and adolescent patients aged between 10 and 18 years old and those who finished neurocognitive function testing during their hospitalization were included. Among them patients whose full scale IQ was between 85 and 115 were selected (N=111). Participants were first divided into two age-groups-group Y ($10{\leq}age{\leq}15$, N=54) and group O ($16{\leq}age{\leq}18$, N=57)-because neurocognitive function test tools were different according to age [Wechsler Intelligence Scale for Children (WISC) for 10 to 15-year-old patients, Wechsler Adult Intelligence Scale (WAIS) for 16 to 18-year-old patients]. They were then divided according to their suicidal or violent behavior-non suicidal/violent group (NG), suicidal group (SG), violent group (VG), and both suicidal/violent group (BG). The Child Behavior Checklist (CBCL) was checked for measurement of participants' behavior and the Gordon Diagnostic System was checked for measurement of their attention efficiency. Kruskal-Wallis Test and Tukey test was used to determine the differences in neurocognitive function between groups. Results: O-SG patients showed lower scores on the comprehension subscale of WAIS-III than O-NG patients (${\chi}^2=8.454$, p=.015). O-VG patients showed lower scores on the block design subscales of WAIS than O-SG patients (${\chi}^2=7.496$, p=.024). Y-VG patients showed higher scores in aggressive behavior, externalizing problems, and total problems scores of CBCL. Conclusion: This study showed relationship between specific neurocognitive deficits and suicidal or violent behavior. These relationships were significant in relatively older adolescents.

기분부전장애 환자군과 주요우울장애 환자군의 신경인지학적 기능 비교 (The Comparison of the Neurocognitive Functions between Dysthymic Disorder and Major Depressive Disorder)

  • 강이헌;함병주;차지현;이민수
    • 생물정신의학
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    • 제9권2호
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    • pp.103-111
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    • 2002
  • Neurocognitive research focusing on cognitive deficits in Depression has resulted in several important but yet potentially contradictory findings. Much literature documents the presence of significant neurocognitive impairments in depressive patients. Studies have shown that dysthymic disorder patients demonstrate a diffuse pattern of cognitive impairment which is frequently indistinguishable from that of focal braindamaged patients. Some reports have suggested that there is a focal pattern of deficit, such as anterior cingulate dysfunction, frontal lobe impairment, or dysfunction of the temporal-limbic cortex. The aim of this study is to evaluate the neurocognitive functions in dysthymic disorder patients, and to compare the functions with those of major depressive disorder patients. The subjects are 17 dysthymic disorder patients. And their neurocognitive functions are compared with those of 23 major depressive episode patients. Patients with a history of neurologic disease, alcohol dependence, substance abuse and mental retardation are excluded. They are assessed with a part of Vienna Test System which is computerized neurocognitive function tests and can evaluate attention, eductive ability, reproductive ability, visuoperceptual analysis, vigilance, visual immediate memory, the speed of information-processing, judgement, and fine motor coordinations. There are no other specific difference between two groups, except the result of cognitrone test. This study provides information about the neurocognitive functions and some difference between major depressive disorder patients and carefully diagnosed dysthymic disorder patients.

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Facial Emotion Recognition in Older Adults With Cognitive Complaints

  • YongSoo Shim
    • 대한치매학회지
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    • 제22권4호
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    • pp.158-168
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    • 2023
  • Background and Purpose: Facial emotion recognition deficits impact the daily life, particularly of Alzheimer's disease patients. We aimed to assess these deficits in the following three groups: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and mild Alzheimer's dementia (AD). Additionally, we explored the associations between facial emotion recognition and cognitive performance. Methods: We used the Korean version of the Florida Facial Affect Battery (K-FAB) in 72 SCD, 76 MCI, and 76 mild AD subjects. The comparison was conducted using the analysis of covariance (ANCOVA), with adjustments being made for age and sex. The Mini-Mental State Examination (MMSE) was utilized to gauge the overall cognitive status, while the Seoul Neuropsychological Screening Battery (SNSB) was employed to evaluate the performance in the following five cognitive domains: attention, language, visuospatial abilities, memory, and frontal executive functions. Results: The ANCOVA results showed significant differences in K-FAB subtests 3, 4, and 5 (p=0.001, p=0.003, and p=0.004, respectively), especially for anger and fearful emotions. Recognition of 'anger' in the FAB subtest 5 declined from SCD to MCI to mild AD. Correlations were observed with age and education, and after controlling for these factors, MMSE and frontal executive function were associated with FAB tests, particularly in the FAB subtest 5 (r=0.507, p<0.001 and r=-0.288, p=0.026, respectively). Conclusions: Emotion recognition deficits worsened from SCD to MCI to mild AD, especially for negative emotions. Complex tasks, such as matching, selection, and naming, showed greater deficits, with a connection to cognitive impairment, especially frontal executive dysfunction.

주요우울장애 환자의 증상 심각도에 따른 신경인지적 특성 (Neurocognitive Characteristics According to Depression Severity in Patients with Major Depressive Disorder)

  • 황선희;이헌정;김명선
    • 생물정신의학
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    • 제24권3호
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    • pp.149-154
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    • 2017
  • Objectives This study investigated associations between symptom severity and neurocognitive functions in patients with major depressive disorder using comprehensive neuropsychological tests. Methods Ten patients with low depression (LD) and 22 patients with high depression (HD) participated. Symptom severity was determined by both the Beck Depression Inventory and the Hamilton Depression Rating Scale. Additionally, anxiety was measured by the Korean version of the State-Trait Anxiety Inventory (STAI-KYZ). Ten subtests of the Korean-Wechsler Adult Intelligence scale (K-WAIS), Stroop test, the word/design fluency tests were administered to assess cognition. Results The LD and HD groups did not differ in any of cognitive measures but anxiety level. Namely, the HD group obtained significantly higher scores on the state (U = 29.50, p < 0.01) and trait (U = 28.50, p < 0.001) anxiety scales than the LD group. A significant interaction effect between trait anxiety and depression severity was observed on the picture arrangement subtest of the K-WAIS [F (1, 27) = 5.09, p < 0.05]. Conclusions Cognitive deficits observed in patients with major depressive disorder may be related to other factors rather than current symptom severity. Trait anxiety possibly moderates the effect of current symptom severity on social judgment in these patients.

주요 정신장애에서의 주의력 장애 (Attentional Dysfunction in Major Psychiatric Disorders)

  • 하규섭
    • 수면정신생리
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    • 제5권2호
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    • pp.155-169
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    • 1998
  • Attentional dysfunction is considered as one of the core deficits in schizophrenic process. The findings, pathophysiological mechanisms, and their clinical implications of clinical and experimental neurocognitive tests for the attentional impairment in schizophrenics are reviewed. The influences of psychopathology, antipsychotic treatment, and chronic institutionalization are also included in the review. In contrast, there are only a few evidences that attentional dysfunction would be a core deficit of depressive, manic, and anxiety disorders. Some recent findings of attentional impairment in these disorders are reviewed.

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조현병 환자와 발병하지 않은 일차친족에서 신경인지의 결함 (Neurocognitive Deficits in Patients with Schizophrenia and Unaffected First-Degree Relatives)

  • 김도훈;김지우;황선영;김병수;원승희
    • 생물정신의학
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    • 제21권2호
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    • pp.65-73
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    • 2014
  • Objectives This study aimed to identify the differences and the profiles of cognitive deficits in remitted patients with schizophrenia and first-degree relatives of schizophrenic probands. Methods A total of 26 remitted states of schizophrenia patients were included in the study and the same number of unaffected first-degree relatives of schizophrenic probands and healthy controls were matched for age, sex, years of education. Cognitive function of all participants was measured by using the Digit span test, the Continuous performance test, the Rey auditory & visual learning test, the Complex figure test, the Verbal fluency test, the Wisconsin card sorting test and the Finger tapping test. The effects of subsyndromal symptomatology and general intelligence score were controlled. Results Schizophrenia patients' group showed more significant impairment than other groups in verbal memory (learning, immediate recall, delayed recall), visual memory (copy, immediate recall, delayed recall) and cognitive flexibility domains. The family group and the patient group commonly performed significantly worse than healthy controls in working memory and verbal fluency (category) tests. There were no differences in sustained attention, psychomotor performance. Conclusions Our research shows that the deficit in working memory and verbal fluency could be strong candidates of endophenotypic marker in schizophrenia.

Neurodevelopmental Aspects of RASopathies

  • Kim, Ye Eun;Baek, Seung Tae
    • Molecules and Cells
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    • 제42권6호
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    • pp.441-447
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    • 2019
  • RAS gene mutations are frequently found in one third of human cancers. Affecting approximately 1 in 1,000 newborns, germline and somatic gain-of-function mutations in the components of RAS/mitogen-activated protein kinase (RAS/MAPK) pathway has been shown to cause developmental disorders, known as RASopathies. Since RAS-MAPK pathway plays essential roles in proliferation, differentiation and migration involving developmental processes, individuals with RASopathies show abnormalities in various organ systems including central nervous system. The frequently seen neurological defects are developmental delay, macrocephaly, seizures, neurocognitive deficits, and structural malformations. Some of the defects stemmed from dysregulation of molecular and cellular processes affecting early neurodevelopmental processes. In this review, we will discuss the implications of RAS-MAPK pathway components in neurodevelopmental processes and pathogenesis of RASopathies.

주정의존 환자에서 7분선별검사를 이용한 인지장애의 평가 (Assessment of Cognitive Disorders in Alcoholics Using the 7 Minute Screening Battery)

  • 전진숙;윤한철;이광영;오병훈
    • 생물정신의학
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    • 제8권2호
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    • pp.258-265
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    • 2001
  • Objectives : Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function, learning and short-term memory, visuospatial performance function, perceptuo-motor skills, and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. Methods : The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=3 : as well as in age and education level matched healthy male controls(N=30). Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. Results : 1) The average scores of four individual test of the 7MS for the alcoholics were $2.77{\pm}4.38$ for the Benton Temporal Orientation Test, $13.90{\pm}2.02$ for the Memory Test(the Cued Recall $6.77{\pm}1.94$, the Uncued Recall $7.10{\pm}2.45$), $5.84{\pm}1.86$ for the Clock Drawing, and $12.58{\pm}3.29$ for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score <24 were 9.68%. The average(${\pm}S.D.$) score of the MMSE-K for the patient group($27.23{\pm}2.62$) was significantly(p<0.001) lower than that of the healthy controls($29.20{\pm}1.24$). There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score <24(N=3) and those of alcoholics with the MMSE-K score ${\geq}24$(N=28). 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking, blood magnesium concentration, liver function and thyroid function. Conclusion : Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.

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전산화 신경인지기능검사를 이용한 주의력결핍/과잉운동 장애의 주의력결핍특성에 관한 연구 (CHARACTERISTICS OF ATTENTION DEFICIT OF ADHD ON COMPUTERIZED NEUROCOGNITIVE FUNCTION TESTS)

  • 정선주;신민섭;하규섭;홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제8권2호
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    • pp.242-255
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    • 1997
  • 본 연구는 비엔나 검사총집의 전산화된 검사를 포함한 다양한 주의력검사도구를 통해 주의력결핍/과잉운동장애의 특징적인 주의력결핍유형을 알아보기 위해 시행되었다. 총 9가지의 검사를 실시하여 얻어진 결과를 통해 다음과 같은 사실을 알 수 있었다. 주의력결핍/과잉운동장애아동들이 정상대조군에 비해 전반적인 경계도가 낮으며 시간이 흐름에 따른 경계도의 저하가 심하며 반응에 대한 준비도 역시 감퇴되어 있었다. 또한 감시력 검사를 통해 주의력결핍/과잉운동장애아동이 선택적 주의력의 결함을 가짐을 알 수 있었으나 지속적 주의력의 결함은 관찰되지 않았다. 이들은 정보처리용량을 초과하는 자극이 주어지는 상황에서 정상 아동들에 비해 충동적으로 반응하여 오경보오류수가 증가하였다. 전두엽기능부전에 민감한 세 가지 신경심리검사를 통하여 주의력결핍/과잉운동장애아동들의 실행능력에 결함이 있음을 알 수 있었다. 주의력결핍/과잉운동장애아동에서 나타나는 다양한 주의력의 측면에서의 결함은 이 장애가 뇌간 망상체 형성및 전두엽을 포함한 뇌의 여러 부위의 통합적인 기능이상에 의한 것이라는 가설을 지지하는 것이라고 하겠다.

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주의력결핍-과잉행동장애의 신경발달학적 고찰 (NEURODEVELOPMENTAL PERSPECTIVE OF ATTENTION-DEFICIT/HYPERACTIVITY DISORDER(ADHD))

  • 안동현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제16권2호
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    • pp.160-172
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    • 2005
  • ADHD는 소아정신질환 가운데 가장 흔한 신경발달학적 질환으로 간주되고 있다. ADHD의 원인은 아직 명확하게 밝혀지지는 않았지만 다양한 유전적 및 신경학적 요인들이 관여하는 것은 틀림없고, 이들이 신경계의 특정 부위와 경로에 이상을 초래하는 것으로 알려져 있다. 이 논문에서는 최근의 연구들을 중심으로 ADHD의 원인과 관련한 신경발달학적 측면을 고찰하고자 한다. 방법은 Medline검색을 통해 최근 발표된 논문들, ADHD관련 단행본, ADHD를 특집으로 한 몇 개의 잡지에 실린 종설 논문들 및 연관 참고문헌 등을 토대로 조사하였다. 결과는 ADHD의 신경발달학적 측면에서 일부 유전적인 요인과 임신 및 출생전후의 환경적 요인 등이 복합적으로 작용하여 발달하는 뇌를 변형시킴으로서 주로 대뇌의 prefrontal cortex-striatal network를 구조적으로 혹은 기능적으로 저하되어 발생하는 것으로 생각할 수 있다. 임신 2기에 ADHD의 발생과 관련한 대뇌 및 소뇌 이상을 초래한다는 주장을 하기도 하였으며, 이들 이상은 더 이상 진행하지 않고 고정된 것이라는 주장도 있지만, ADHD의 원인과 관련하여 신경발달학적으로 어떤 시기에, 어떤 손상이나 영향에 의해, 어떤 이상이 초래하여 발생하는지에 대해서는 아직 연구가 매우 부족하다. 결론적으로 주의력 체계와 관련한 신경전달회로의 차이, 도파민계와 노에피네프린계의 기능이나 증상과 관련한 차이 등 을 포함하여 신경발달학적인 면에 대한 보다 심도 있는 연구들이 시행되어야 할 것이다.

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