• Dementia and Neurocognitive Disorders
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• 제21권4호
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• pp.117-125
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• 2022

Background and Purpose: Medication adherence is essential for effective medical treatment. However, it is challenging for cognitively impaired patients. We investigated whether an automated telephone reminder service improves medication adherence and reduces the decline of cognitive function in isolated patients with cognitive impairment. Methods: This was a single-center, randomized clinical trial. We enrolled mild cognitive impairment (MCI) or Alzheimer's disease (AD) patients who lived alone or with a cognitively impaired spouse. We provided an automated telephone reminder service for taking medication to the intervention group for 6 months. The control group was provided with general guidelines for taking the medication every month. The participants underwent neuropsychological assessment at the beginning and end of the study. Statistical significance was tested using nonparametric Wilcoxon rank sum and Wilcoxon matched-pairs signed-rank tests. Results: Thirty participants were allocated randomly to groups, and data for 29 participants were analyzed. The mean age was 79.6 (standard deviation, 6.0) years and 79.3% of the participants were female. There was no significant difference in medication adherence between the 2 groups. However, a subgroup analysis among participants with more than 70% response rates showed better medication adherence compared to the control group (intervention: 94.6%; control: 90.2%, p=0.0478). There was no significant difference in the change in cognitive function between the 2 groups. Conclusions: If a patient's compliance is good, telephone reminders might be effective in improving medication adherence. It is necessary to develop reminder tools that can improve compliance for cognitively impaired patients.

• Korean Journal of Cognitive Science
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• 제19권4호
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• pp.331-367
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• 2008

This study aims to validate a web-based neuropsychological testing tool developed by Kwak(2007) and to suggest solutions to potential problems that can deteriorate its validity. When it targets a wider range of subjects, a web-based neuropsychological testing tool is challenged by high drop-out rates, lack of motivation, lack of interactivity with the experimenter, fear of computer, etc. As a possible solution to these threats, this study aims to redesign the user interface of a web-based attention testing tool through three phases of study. In Study 1, an extensive analysis of Kwak's(2007) attention testing tool was conducted to identify potential usability problems. The Heuristic Walkthrough(HW) method was used by three usability experts to review various design features. As a result, many problems were found throughout the tool. The findings concluded that the design of instructions, user information survey forms, task screen, results screen, etc. did not conform to the needs of users and their tasks. In Study 2, 11 guidelines for the design of web-based attention testing tools were established based on the findings from Study 1. The guidelines were used to optimize the design and organization of the tool so that it fits to the user and task needs. The resulting new design alternative was then implemented as a working prototype using the JAVA programming language. In Study 3, a comparative study was conducted to demonstrate the excellence of the new design of attention testing tool(named graphic style tool) over the existing design(named text style tool). A total of 60 subjects participated in user testing sessions where their error frequency, error patterns, and subjective satisfaction were measured through performance observation and questionnaires. Through the task performance measurement, a number of user errors in various types were observed in the existing text style tool. The questionnaire results were also in support of the new graphic style tool, users rated the new graphic style tool higher than the existing text style tool in terms of overall satisfaction, screen design, terms and system information, ease of learning, and system performance.

• Investigative Magnetic Resonance Imaging
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• 제17권4호
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• pp.294-307
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• 2013

Purpose : To investigate the correlations between Seoul Neuropsychological Screening Battery (SNSB) scores and the gray matter volumes (GMV) in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and cognitively normal (CN) elderly subjects with correcting the genotypes. Materials and Methods: Total 75 subjects were enrolled with 25 subjects for each group. The apolipoprotein E (APOE) epsilon genotypes, SNSB scores, and the 3D T1-weighted images were obtained from all subjects. Correlations between SNSB scores and GMV were investigated with the multiple regression method for each subject group using both voxel-based and region-of-interest-based analyses with covariates of age, gender, and the genotype. Results: In the AD group, Rey Complex Figure Test (RCFT) delayed recall scores were positively correlated with GMV. In the MCI group, Seoul Verbal Learning Test (SVLT) scores were positively correlated with GMV. In the CN group, GMV negatively correlated with Boston Naming Test (K-BNT) scores and Mini-Mental State Examimation (K-MMSE) scores, but positively correlated with RCFT scores. Conclusion: When we used covariates of age, gender, and the genotype, we found statistically significant correlations between some SNSB scores and GMV at some brain regions. It may be necessary to further investigate a longitudinal study to understand the correlation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.70-82
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• 1994

Present study was to evaluate the validity and the clinical utility of the Korean version of Luria-Nebraska Neuropsychological Battery for Children(LNNB-C) in various groups including normal, brain damaged attention deficit hyperactivity disordered(ADHD), and psychiatrically disordered. The Korean version of LNNB-C and BGT were administered to clinical groups consisted of 51 patients(19 brain damaged, 16 ADHD. and 16 psychiatric controls), and to normal group composed of 147 children between the age of 8 and It Also KEDI-WISC was administered D clinical groups as a part of comprehensive psychological assessment There were significant differences between the brain damaged and the normals on all scales of LNNB-C, and between the normals and the ADHD on 11 clinical scales and 3 summary scales, which indicate the clinical validity for the scales of the Korean version of LNNB-C. The significant differences between the ADHD and the brain damaged on 3 summary scales were found, suggesting that the summary scales might play an important role id discriminating between two groups. Multiple discriminant analysis showed that the Korean version of LNNB-C significantly discriminates 3 groups - normals, ADHD, and brain damaged. Percentages of correct classification were ranged from 62.5% in the ADHD to 98.6Ta in the normals. For further evaluating the discriminant validity of the LNNB-C, the discriminant power of each items were calculated, and 131 of the 147 items discriminated significantly between the brain damaged and the normals. The scales of LNNB-C significantly correlated with the error scores of BGT and the most of scales of KEDI-WISC. These results put together : strongly support the concurrent and the discriminant validity of the Korean version of LNNB-C in diagnosing brain damage. The limitations of present study and several issues for the luther study were discussed.

• The Korean Journal of Nuclear Medicine
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• 제36권4호
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• pp.232-243
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• 2002

Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

• Korean Journal of Radiology
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• 제23권2호
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• pp.226-236
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• 2022

Objective: This study aimed to explore the myelin volume change in patients with mild traumatic brain injury (mTBI) with post-concussion syndrome (PCS) using a multidynamic multiecho (MDME) sequence and automatic whole-brain segmentation. Materials and Methods: Forty-one consecutive mTBI patients with PCS and 29 controls, who had undergone MRI including the MDME sequence between October 2016 and April 2018, were included. Myelin volume fraction (MVF) maps were derived from the MDME sequence. After three dimensional T1-based brain segmentation, the average MVF was analyzed at the bilateral cerebral white matter (WM), bilateral cerebral gray matter (GM), corpus callosum, and brainstem. The Mann-Whitney U-test was performed to compare MVF and myelin volume between patients with mTBI and controls. Myelin volume was correlated with neuropsychological test scores using the Spearman rank correlation test. Results: The average MVF at the bilateral cerebral WM was lower in mTBI patients with PCS (median [interquartile range], 25.2% [22.6%-26.4%]) than that in controls (26.8% [25.6%-27.8%]) (p = 0.004). The region-of-interest myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (1.87 cm³ [1.70-2.05 cm³] vs. 2.21 cm³ [1.86-3.46 cm³]; p = 0.003) and brainstem (9.98 cm³ [9.45-11.00 cm³] vs. 11.05 cm³ [10.10-11.53 cm³]; p = 0.015). The total myelin volume was lower in mTBI patients with PCS than that in controls at the corpus callosum (0.45 cm³ [0.39-0.48 cm³] vs. 0.48 cm³ [0.45-0.54 cm³]; p = 0.004) and brainstem (1.45 cm³ [1.28-1.59 cm³] vs. 1.54 cm³ [1.42-1.67 cm³]; p = 0.042). No significant correlation was observed between myelin volume parameters and neuropsychological test scores, except for the total myelin volume at the bilateral cerebral WM and verbal learning test (delayed recall) (r = 0.425; p = 0.048). Conclusion: MVF quantified from the MDME sequence was decreased at the bilateral cerebral WM in mTBI patients with PCS. The total myelin volumes at the corpus callosum and brainstem were decreased in mTBI patients with PCS due to atrophic changes.

• Sleep Medicine and Psychophysiology
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• 제5권1호
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• pp.54-70
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• 1998

Objectives : The purpose of this study is to evaluate the role of structural and functional changes of the brain in the pathophysiology of schizophrenia. Methods : The authors measured the regions of interest on the magnetic resonance imaging of the brain in 20 patients with paranoid schizophrenia(15 men and 5 women) and 23 control subjects(15 men and 8 women). We also assessed the neurocognitive functions with the Wisconsin Card Sorting Test, the Benton Neuropsychological Assessment, and the Weschler IQ test-Korean version, soft neurologic signs, and psychiatric symptoms in the patient group. Results : In the patient group, all ventricles and basal ganglia including caudate nucleus and globus pallidus were significantly enlarged. Although there were no significant differences between the two groups in the values of right frontal lobe and left temporal lobe, there was a tendency of decrease in the values of right frontal lobe and left temporal lobe. There were significant positive correlations between the values of ventricles and the frequency of previous hospitalization. However, there were no significant correlations between other values of regions of interest and clinical data. The value of the right frontal lobe was significantly correlated with the score of soft neurologic signs, which is suggestive of the neurodevelopmental abnormalities. There were significant correlations between the value of frontal lobe and the scores of the various subscales of Benton Neuropsychiatric Inventory. In contrast, the value of left amygdala and putamen showed significant correlation with the score of verbal IQ on the Weschler IQ test. Structural changes of the temporal lobe areas were related with the positive and general symptom scores on PANSS, while those of the basal ganglia were related with the negative symptom scores. Conclusions : These results suggest that the structural changes of the brain in the patients with schizophrenia show the dual process, which is suggestive that the enlarged ventricle show the neurodegenerative process, while enlarged basal ganglia, and shrinked right frontal and left temporal lobe show the neurodevelopmental abnormalities. Among these changes, structural changes of the frontal lobe related with various neuropsychological deficits, while those of left temporal lobe related with language abnormality. Relative to the relation between structural changes and psychiatric symptoms, structural changes of the temporal lobe areas were related with the positive and general symptoms, while those of the basal ganglia were related with the negative symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제17권2호
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• pp.131-140
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• 2006

Objectives : This study was conducted to investigate the deficits of executive function in children with ADHD, Asperger's Disorder(AD), and teaming disorder (LD), and to identify the differential characteristics of executive function deficits among three groups. Methods : The clinical group consisted of 46 children between the ages of 7 and 15 (16 ADHD, 16 LD, 14 AD). Neuropsychological tests for measuring cognitive function, attention and executive function were individually administered to children, and their performance scores were calculated based on the age norm for each test. Results : There was no significant difference in FSIQ, VIQ, and PIQ among the three groups. However, the AD group tended to show higher scores on the subtests of Information, Vocabulary and Digit Span, and lower score on Comprehension subtest than the ADHD and LD groups, while the LD group tended to show the lowest scores on the Information and Vocabulary subtests. On ADS, the ADHD group showed the highest omission and commission errors. All groups showed poor performances belonging to below 25 percentile ranks on executive function tests when compared to the age norms of normative group. The number of completed category on WCST was the smallest in the ADHD group, while the working memory score was the lowest in the LD group. Conclusion : These results suggest that ADHD, LD, and AD children have executive function deficit in common. However, the specific deficit areas in executive function are different for each group.

• Journal of Physiology & Pathology in Korean Medicine
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• 제16권5호
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• pp.976-988
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• 2002

The aim of this study was to examine the memory and attention enhancement effect of YMG-1 and YMG-2, which are modified herbal extracts from Yukmijihwang-tang (YMJ). YMJ, composing six herbal medicine, has been used for restoring the normal functions of the body to consolidate the constitution, nourishing and invigorating the kidney functions for hundreds years in Asian countries. A series of studies reported that YMJ and its components enhance memory retention, protects neuronal cell from reactive oxygen attack and boost immune activities. Recently the microarray analysis suggested that YMG-1 protects neurodegeneration through modulating various neuron specific genes. A total of 55 subjects were divided into three groups according to the treatment of YMG-1 (n=20), YMG-2 (n=20) and control (C; n=15) groups. Before treatments, all of subjects were subjected to the assessments on neuropsychological tests of K-WAIS test, Rey-Kim memory test, and psychophysiological test of Event-Related Potential (ERP) during auditory oddball task and repeated word recognition task. They were repeatedly assessed with the same methods after drug treatment for 6 weeks. Although no significant effect of drug was found in Rey-Kim memory test, a significant interaction (P = .010, P < 0.05) between YMG-2 and C groups was identified in the scores digit span and block design, which are the subscales of K-WAIS. The very similar but marginal interaction (P = .064) between YMG-1 and C groups was found too. In ERP analysis, only YMG-1 group showed decreasing tendency of P300 latency during oddball task while the others tended to increase, and it caused significant interaction between session and group (p= .004). This result implies the enhancement of cognitive function in due to consideration of relationship between P300 latency and the speed of information processing. However, no evidence which could demonstrate the significant drug effect was found in neither amplitude or latency. These results come together suggest that YMG-1, 2 may enhance the attention, resulting in enhancement of memory processing. For elucidating detailed mechanism of YMG on learning and memory, the further studies are necessary.

• Korean Journal of Biological Psychiatry
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• 제22권2호
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• pp.78-86
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• 2015

Objectives Although ginseng has been reported to protect neuronal cells and improve various cognitive functions, relationship between ginseng supplementation and response inhibition, one of the important cognitive domains has not been explored. In addition, effects of ginseng on in vivo human brain have not been investigated using the diffusion tensor imaging (DTI). The purpose of the current study is to investigate changes in intrusion errors and white matter microstructure after Korean Red Ginseng supplementation using standardized neuropsychological tests and DTI. Methods Fifty-one healthy participants were randomly allocated to the Korean Red Ginseng (n = 26) or placebo (n = 25) groups for 8 weeks. The California Verbal Learning Test was used to assess the number of intrusion errors. Intelligence quotient (IQ) was measured with the Korean Wechsler Adult Intelligence Scale. Depressive and anxiety symptoms were evaluated using Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Hopkins Symptom Checklist-25. The fractional anisotropy (FA) was measured from the brain DTI data. Results After the 8-week intervention, Korean Red Ginseng supplementation significantly reduced intrusion errors after adjusting age, sex, IQ, and baseline score of the intrusion errors (p for interaction = 0.005). Change in FA values in the left anterior corona radiata was greater in the Korean Red Ginseng group compared to the placebo group (t = 4.29, p = 0.04). Conclusions Korean Red Ginseng supplementation may be efficacious for improving response inhibition and white matter microstructure integrity in the prefrontal cortex.