• 생물정신의학
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• 제18권1호
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• pp.36-45
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• 2011

Objectives : Though a proportion of Alzheimer's disease(AD) patients treated with donepezil have shown positive response on cognition, but the responders' characteristics are still uncertain. This study attempts to identify whether a single oral dose of donepezil(5mg) can change cognition and the relationship between single dose responder items and long-term responder are examined. Methods : Twenty-three AD patients for single donepezil challenge study group and eleven AD patients for controls were participated in the study. Seven days after baseline study for neuropsychological test and EEG, same studies were rechecked after donepezil medication in study group. In donepezil study groups, 12 weeks after donepezil medication, neuropsychological test and EEG were rechecked. Results : After single donepezil challenge, forward digit span, Rey-Osterrieth Complex Figure Test copy, SVLT delayed recall were significantly improved, and beta spectra power in anterior, theta spectra power in posterior field were significantly decreased. According to linear regression analysis, forward digit span after single donepezil challenge was significantly positive correlated with long-term responders. Conclusions : This study suggests that single donepezil medication can significantly change cognitive functions and EEG in AD patients. Among these responsive items, forward digit span was significantly correlated with long-term responder.

• 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.

• 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.

• Parasites, Hosts and Diseases
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• 제60권5호
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• pp.353-355
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• 2022

We report a case of an 80-year-old Korean man with chronic cerebral paragonimiasis who presented with progressive memory impairment. He suffered from pulmonary paragonimiasis 60 years ago and has been experiencing epilepsy since the age of 45. He began experiencing memory and cognitive deterioration 3 years ago. He visited the neuropsychiatric department of our hospital to check his symptoms and health from a year ago. Contrast-enhanced brain magnetic resonance imaging study revealed calcifications and cystic lesions encompassing the right temporo-occipital region. Encephalomalatic changes were also observed in the right occipital and temporal areas. The anti-Paragonimus specific IgG antibodies in his serum showed a strong positive response. The neuropsychological test results showed a Global Deterioration Scale of 4 and a Clinical Dementia Rating Scale of 1. The chronic cerebral paragonimiasis lesions in the patient's right temporo-occipital region might induce the dementic change.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.162-168
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• 2007

Objectives : This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. Methods : The baseline and follow-up surveys were conducted in 1998 and 2003, respectively, Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. Results : Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. Conclusions : Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.

• 한국방사선학회논문지
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• 제8권5호
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• pp.231-240
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• 2014

본 연구는 경도인지장애가 동반된 파킨슨병 환자에 대하여 인지 기능 평가를 위한 서울신경심리검사와 뇌 자기공명 영상에서 영역별 뇌실에 대한 체적 변화를 분석하여 경도인지장애가 동반된 파킨슨병에 대한 진단적 기준을 판단할 수 있는 가이드라인을 제시하고자 하였다. 이를 위하여 파킨슨병으로 진단 받은 환자(경도인지장애군: 34명, 비인지장애군: 34명)를 대상으로 주의력, 언어, 기억력, 시공간, 그리고 전두엽 집행 기능에 대한 서울신경심리검사와 뇌 자기공명영상 검사를 시행하였다. 또한 영역별 뇌실에 대한 체적 변화를 비교하기 위하여 정상인 32명(정상 대조군)을 추가 선정하여 추가적으로 뇌 자기공명영상 검사를 시행하였으며 영역별 뇌실에 대한 체적 분석은 프리서퍼(Freesurfer Ver. 5.1, Boston MA, USA)를 통해 수행되었다. 결과적으로 경도인지장애군은 시공간 및 기억력에 대한 수행 능력이 비인지장애군과 비교하여 통계적으로 유의하게 감소되었다(p<0.05). 영역별 뇌실에 대한 체적 변화는 좌 우측뇌실, 좌 우하측뇌실, 제3뇌실에서 통계적으로 유의한 체적 변화를 나타내었으며 객관화된 비교를 위하여 정규화한 백분율을 적용한 체적의 변화는 비인지장애군보다 경도인도장애군에서 확장되어 나타났다. 특히 경도인지장애를 동반한 파킨슨병 환자의 좌 우측뇌실의 확장은 서울신경심리검사에서 시공간 및 기억력 영역에 대하여 뚜렷한 양적 선형관계를 보였다(r>0.5, p<0.05). 따라서 뇌 자기공명영상에서 프리서퍼를 이용하여 영역별 뇌실의 체적 변화를 관찰하고 서울 신경심리검사와 상관관계를 분석함으로써 경도인지장애를 동반한 파킨슨병 환자의 진단적 기준을 마련할 수 있을 것으로 판단되었다.

• 생물정신의학
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• 제20권3호
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• pp.104-110
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• 2013

Objectives : The aim of this study was to examine the prospective impact of the apolipoprotein E (APOE) ${\varepsilon}4$ on cognitive performance in the community-dwelling elderly individuals with Alzheimer's disease (AD). Methods : The total number of subjects was 30 (12 men and 18 women) who were diagnosed with AD from a Korean project of "Early Detection of Dementia". People aged 65-85 years were included in the analysis. The eight neuropsychological domains from the Korean version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were conducted to test subjects. They have been followed at 24-month intervals with the same assessments at each interval. Their cognitive performance at 2 year intervals was compared by the occurrence of the APOE ${\varepsilon}4$. Results : The impact of ${\varepsilon}4$ allele was significant in the Word List Memory Test (WLMT, F = 4.345, df = 1, p = 0.021) and Word List Recall Test (WLRT, F = 5.569, df = 1, p = 0.033). Conclusions : The APOE ${\varepsilon}4$ allele was significantly correlated especially with verbal episodic memory domain in community-dwelling elders diagnosed with AD.

• Journal of Medicine and Life Science
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• 제15권2호
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• pp.89-94
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• 2018

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds(CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

• 대한간호학회지
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• 제45권1호
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• pp.118-128
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• 2015

Purpose: Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy. Methods: Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses. Results: At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function. Conclusion: These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

• 생물정신의학
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• 제18권4호
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• pp.232-238
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• 2011

Objectives Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in the brain morphology between a group of patients with mild cognitive impairment (MCI) and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume change measured by optimized VBM in MCI subjects compared to controls. Methods Twenty patients with MCI and 20 control subjects with normal cognition were recruited for this study. We applied the optimized VBM protocol to the image data including study-specific template and the modulation of the data with the Jacobian determinants. GM volume differences between the MCI subjects and the control subjects and their correlations with the neuropsychological performances were investigated. Results Optimized VBM analysis revealed GM volume reduction in hippocampus, precentral gyrus, insula and parietal operculum in the MCI group compared to the control group (family wise error corrected p < 0.05). Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) word list recall scores were significantly correlated with the GM volumes of hippocampus, precuneus and posterior cingulate in the MCI group (FWE corrected p < 0.05). Conclusions The results confirm previous findings of atrophic changes in medial temporal lobe and parietal lobe in the MCI group and suggest that these abnormalities may be related with cognitive decline and prognosis in patients with MCI.