• 제목/요약/키워드: Neuropsychological

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Diagnostic Tools for Alzheimer's Disease: A Narrative Review Based on Our Own Research Experience

  • So-Hee Park;Kyoung Ja Kwon;Min Young Kim;Jae-Hun Kim;Won-Jin Moon;Hui Jin Ryu;Jae Won Jang;Yeonsil Moon;K-ARPI
    • 대한치매학회지
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    • 제22권1호
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    • pp.16-27
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    • 2023
  • Alzheimer's disease (AD), one of the most representative neurodegenerative diseases, has diverse neurobiological and pathophysiological mechanisms. Treatment strategies targeting a single mechanism have repeated faced failures because the mechanism of neuronal cell death is very complex that is not fully understood yet. Since complex mechanisms exist to explain AD, a variety of diagnostic biomarkers for diagnosing AD are required. Moreover, standardized evaluations for comprehensive diagnosis using neuropsychological, imaging, and laboratory tools are needed. In this review, we summarize the latest clinical, neuropsychological, imaging, and laboratory evaluations to diagnose patients with AD based on our own experience in conducting a prospective study.

월남전 참전 재향군인들에서 외상 후 스트레스 장애가 기억기능에 미치는 영향 (Effects of Combat Related PTSD on Memory Function : in Vietnam Veterans)

  • 우덕구;강현숙;최영안
    • 정신신체의학
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    • 제6권2호
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    • pp.136-146
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    • 1998
  • Objectives : This study was performed to evaluate the effects of PTSD on memory function, to investigate the difference of memory function between PTSD and non-PTSD patients, and to identify major variables correlated to PTSD scale and Memory Assessment Scale. Methods: The authors used PTSD-scale(Mississippi scale and Combat Exposure Scale) for measuring PTSD severity. And, Beck Depression Inventory was also used. Memory assessment scale was assessed by well trained psychologist. Thirty one Vietnam veterans who had been hospitalized were collected consecutively. These patients were evaluated by psychiatrists with interview and measurement for fifteen months since March, 1997. The collected data were analyzed by SPSS and the stastistic methods used for analysis Chi-square, t-test, and Pearson's correlation. Results : 1) There were significant differences in short-term memory and verbal memory between PTSD and non-PTSD in Vietnam veterans. 2) Mississippi scale and Combat Exposure Scale were negatively correlated to short-term memory and verbal memory(Pearson's correlation). 3) Religion status was a significant variable between PTSD and non-PTSD in Vietnam veterans. 4) There is no significant difference in visual memory and total memory scale between PTSD and Non-PTSD in Vietnam veterans Conclusions : Neuropsychological changes were found in the posttraumatic stress disorder. There were significant differences in short-term memory and verbal memory between PTSD and non-PTSD in Vietnam veterans. Mississippi scale and Combat Exposure Scale were negatively correlated to short-term memory and verbal memory. We suggest that neuropsychological test might be used for an objective assessment of patients with the combat related PTSD and be considered helpful in the assessment of patients with the diagnosis. And we also suggest rehabilitation strategies would be used to compensate for memory deficits in PTSD patients.

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주의력 결핍 과잉 행동 환자에서 OROS-Methylphenidate 투여 후 신경심리학적 변화에 대한 개방 연구 (An Open-Label Study of OROS-Methylphenidate for Neuropsychological Changes in Children and Adolescents with Attention-Deficit Hyperactivity Disorder)

  • 국소담;김주영;천근아;정경운;송동호
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제24권3호
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    • pp.157-163
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    • 2013
  • Objectives : Previous studies reported that attention-deficit hyperactivity disorder (ADHD) resulted from a deficit of selective attention and sustained attention. In this study, we assessed the result of methylphenidate-induced changes of the cerebral frontal executive functions in patients with ADHD. Methods : The subjects in this study consisted of 16 ADHD patients whose age ranged from 7 to 12. We used ADHD Diagnostic System (ADS) for the attention improvement, and the Stroop Test for the executive function response to pharmacotherapy with MPH. Results : After pharmacotherapy with methylphenidate for 12 weeks, the study group showed improvement in the clinical aspects through Clinical Global Impression-Severity, ADHD-rating scale and Inattention/Overactivity With Aggression Conner's Parents Rating Scale. In the ADS test, only in auditory task there was a decrease of both the response time and the standard deviation of the response time significantly. In the Stroop Test, there was a decrease in the word task, color task and color-word task significantly. Conclusion : Our results show that psychostimulant medication improves neuropsychological function, including the cerebral frontal executive function. This study implies that we have to consider the improvement of executive function, as well as attention when evaluating the efficacy of treatment.

성격검사 및 신경심리검사를 이용한 사상체질간 성격 및 인지 특성 연구 (A Study on Personality Traits and Cognitive Characteristics of the Sasang Constitution using Neuropsychological and Personality Tests)

  • 강문수;유경;김락형
    • 동의신경정신과학회지
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    • 제26권2호
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    • pp.131-142
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    • 2015
  • Objectives: The purpose of this study is to evaluate the personality traits and cognitive characteristics of the Sasang constitution by comparing the Eysenck Personality Questionnaire (EPQ), Temperament and Character Inventory (TCI), Continuous Performance Test (CPT) and Stroop Test. Methods: One hundred and six healthy subjects (age 20 to 40) were analyzed; 45 Taeeumin, 30 Soyangin and 31 Soeumin. The Sasang constitution was diagnosed by a sasang constitutional medicine specialist based on the results of a Two Step Questionnaire for Sasang Constitution Diagnosis (TS-QSCD), the external appearance, temperament and symptoms. The results of the EPQ, TCI, CPT and Stroop Test were compared between Sasang constitutions. Results: Among the seven dimensions of EPQ, Taeeumin and Soyangin scored significantly higher than Soeumin in Extraversion. Soyangin scored significantly higher than Soeumin in Impulsiveness. Among the four temperament dimensions of TCI, Taeeumin and Soyangin scored significantly higher than Soeumin in novelty seeking, reward dependence and persistence. Soeumin scored significantly higher than Taeeumin and Soyangin in harm avoidance. Among the three character dimensions of TCI, Soyangin scored significantly higher than Taeeumin in self transcendence. The results for CPT showed no significant differences between sasang constitutions. Taeeumin had a significantly higher color score in the stroop test than Soeumin. Conclusions: The personality tests showed significant differences between Sasang constitutions, but the neuropsychological test did not show any differences. Further studies should be performed to identify neuropsychological differences between Sasang constitutions.

Neurocognitive Function Differentiation from the Effect of Psychopathologic Symptoms in the Disability Evaluation of Patients with Mild Traumatic Brain Injury

  • Kim, Jin-Sung;Kim, Oh-Lyong;Koo, Bon-Hoon;Kim, Min-Su;Kim, Soon-Sub;Cheon, Eun-Jin
    • Journal of Korean Neurosurgical Society
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    • 제54권5호
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    • pp.390-398
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    • 2013
  • Objective : We determined whether the relationship between the neuropsychological performance of patients with mild traumatic brain injury (TBI) and their psychopathological characteristics measured by disability evaluation are interrelated. In addition, we assessed which psychopathological variable was most influential on neuropsychological performance via statistical clustering of the same characteristics of mild TBI. Methods : A total of 219 disability evaluation participants with mild brain injury were selected. All participants were classified into three groups, based on their psychopathological characteristics, via a two-step cluster analysis using validity and clinical scales from the Minnesota Multiphasic Personality Inventory (MMPI) and Symptom Checklist-90-revised (SCL-90-R). The Korean Wechsler Adult Intelligence Scale (K-WAIS), Korean Memory Assessment Scale (K-MAS) and the Korean Boston Naming Test (K-BNT) were used to evaluate the neurocognitive functions of mild TBI patients. Results : Over a quarter (26.9%) experienced severe psychopathological symptoms and 43.4% experienced mild or moderate psychopathological symptoms, and all of the mild TBI patients showed a significant relationship between neurocognitive functions and subjective and/or objective psychopathic symptoms, but the degree of this relationship was moderate. Variances of neurocognitive function were explained by neurotic and psychotic symptoms, but the role of these factors were different to each other and participants did not show intelligence and other cognitive domain decrement except for global memory abilities compared to the non-psychopathology group. Conclusion : Certain patients with mild TBI showed psychopathological symptoms, but these were not directly related to cognitive decrement. Psychopathology and cognitive decrement are discrete aspects in patients with mild TBI. Furthermore, the neurotic symptoms of mild TBI patients made positive complements to decrements or impairments of neurocognitive functions, but the psychotic symptoms had a negative effect on neurocognitive functions.

복합부위통증증후군 환자의 인지기능 평가 (Cognitive Assessment in Complex Regional Pain Syndrome Patients)

  • 문지연;김용철;박미정;이평복;이상철;강도형;신민섭;권태명
    • The Korean Journal of Pain
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    • 제22권1호
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    • pp.28-32
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    • 2009
  • Background: Complex regional pain syndrome (CRPS) is characterized by severe neuropathic pain and disability, which can result in psychological and behavioral dysfunction. The goal of the present study was to evaluate neurocognitive disability, and to assess the relationship between clinical variables and neuropsychological features in CRPS patients. Methods: We investigated the neuropsychological features of 15 CRPS I patients. The neuropsychological tests that we made comprised of a full intelligence quotient, memory quotient, trail-making test A, trail-making test B (TMT-B), and MMPI (Minnesota multiphasic personality inventory). Results: The results showed severe disability in performance on TMT-B. There was no significant correlation between specific cognitive variables and MMPI scales. Conclusions: Decreased performance on TMT-B which shows mental flexibility in the prefrontal lobe exists independently from depressive disorders in CRPS patients.

Clinical and Neuropsychological Factors Associated with Treatment Response and Adverse Events of Atomoxetine in Children with Attention-Deficit/Hyperactivity Disorder

  • Park, Kee Jeong;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제30권2호
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    • pp.74-82
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    • 2019
  • Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

급성 일산화탄소 중독 환자들에서 흡연과 지연성 신경정신과학적 후유증 발생의 상관관계 (Association between Smoking and Delayed Neuropsychological Sequelae in Acute Carbon Monoxide Poisoning)

  • 김학면;최성우;나상운;최효정;임훈;김기운;한상수;이영환
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.102-107
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    • 2018
  • Purpose: This study examined the association between smoking and delayed neuropsychological sequelae (DNS) in acute carbon monoxide (CO) poisoning. Methods: Patients admitted to the medical center emergency department from March 2016 to March 2017 because of CO poisoning were examined retrospectively. The patients were divided into two groups: DNS and Non-DNS group. Multiple factors were analyzed to explain DNS, which was assessed by motor disturbances, cognitive impairment, dysphagia, Parkinson-like syndromes, epilepsy, and emotional lability in CO poisoning. Results: A total of 120 patients were included. The factors related to DNS were smoking (pack-years) (p=0.002) and initial carbon monoxide-hemoglobin level (p=0.015). On the other hand, after multivariate logistic regression analysis, smoking (Odds ratio 1.07; 95% CI, 1.02-1.13; p=0.004) was the only factor associated with DNS. Conclusion: Smoking is a very reliable factor for predicting the occurrence of DNS. A history of smoking in patients who suffer from CO intoxication is important. If a patient smokes, treatment should be started actively and as soon as possible.

정신분열병 환자에서 손톱 주름 총 시도(叢 視度) (Nailfold Plexus Visibility)와 임상양상, 신경심리 기능과의 관계 (Relationships between Nailfold Plexus Visibility, and Clinical Variables and Neuropsychological Functions in Schizophrenic Patients)

  • 강대엽;장혜련
    • 생물정신의학
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    • 제9권1호
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    • pp.50-61
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    • 2002
  • 본 연구에서 저자들은 정신분열병 환자들의 손톱주름 총 시도와 발생연령, 정신 병리, 진행성, 병전 기능, 신경심리 기능과의 관련성을 알아보고자 DSM-IV의 진단기준에 맞는 정신분열병 환자 40명과 대조군 38명을 대상으로 연구하여 다음과 같은 결과를 얻었다. 첫째, 정신분열병 대상군($7.2{\pm}5.3$)과 정상 대조군($3.4{\pm}4.2$)간의 총 시도 점수(PVS)에서 통계적으로 유의한 차이가 있었고(t=-3.48, p=0.001), 고도의 PVS비율도 두 군간에 통계적으로 유의한 차이가 있었다($x^2$=10.12, p=0.001). 둘째, PVS와 PANSS의 양성증상 및 종합 점수 사이에 통계적으로 유의한 상관관계가 있었고(각각 r=-0.318, p=0.023 ; r=-0.411, p=0.004), 음성 증상, 일반 정신병리, PANSS 총점과의 상관 관계는 보이지 않았다. 셋째, 고도의 PVS군은 저도의 PVS군에 비해 PANSS의 양성 증상(t=2.179, p=0.036)과 종합 점수(t=2.379, p=0.022)가 통계적으로 유의하게 낮았다. 넷째, PVS는 신경심리검사에서 지속적 수행검사 중 반응 편향 항목과 역상관관계를 보였을 뿐(r=-0.290, p=0.035), 지능, WCST, 단어 유창성 검사 항목과는 연관성이 없었다. 단지 단어 유창성 검사에서 통계적으로 유의하지는 않았지만 각 항목과 총 시도 점수 사이에 역 상관관계의 경향을 보였다. 본 연구의 소견들은 총 시도가 정신분열병의 음성 증상의 경향이 있는 환자들과 연관성이 있다는 것을 보여주었으나, 정신병리에 있어 음성증상 자체와 직접적인 연관성이 있음을 보여주지 못했다. 또한 총 시도와 수행기능에 민감한 신경심리검사 소견들과도 연관성을 찾지 못하였다. 그럼에도 불구하고 이 연구는 손톱주름 총 시도가 정상인과 비교하여 정신분열병 환자들에서 더 많이 관찰된다는 사실을 보여 주었다. 이러한 소견은 일부 정신분열병의 원인에 있어서 기질적인 영향이 있을 수 있다는 것을 암시하는 것이다. 향후 정신 생리적, 신경발달학적, 신경심리학적 소견 등과 연관시켜 연구해 본다면 정신분열병의 원인을 이해하는데 도움이 되리라 생각한다.

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