• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권2호
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• pp.217-231
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• 1997

본 연구에서는 ADHD의 원인론에 대한 다양한 신경학적 이론들을 살펴본 후, ADHD 진단에 널리 사용되는 신경심리학적 평가방법들에 대한 국내, 외 연구결과들을 고찰하였다. ADHD 아동들이 여러 주의력 검사상에서 일관성있게 경계력, 지속적 주의력, 주의산만성, 주의력의 분할과 조절에 문제를 보이고 있고, 실행 능력과 작동기억외에 연합기억에서도 어려움을 보이는 것으로 나타났다. 이러한 신경심리학적 검사결과는 ADHD 아동이 전두엽외에 망상활성체계 등 두뇌의 여러 부위를 포함하는 신경망에 장애가 있을 가능성을 시사해주는 것으로 생각된다. 그러나 국내에서 ADHD 아동들에게 널리 사용되고 있는 신경심리검사들은 대부분 외국에서 제작된 것이므로, ADHD 아동들의 수행결과를 보다 정확하게 비교하고 해석하기 위해서는 ADHD와 정상 아동, 그리고 기타 소아정신과장애 아동들을 대상으로 그러한 신경심리검사들에 대한 연령별 규준 확립과 타당도 검증을 위한 한국 표준화연구가 조만간 이루어져야 하겠다.

• 수면정신생리
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• 제6권2호
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• pp.143-148
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• 1999

목 적: 지각 장애가 어떤 뇌의 부위와 기능에 장애가 있을 때 발생되는지를 알아보기 위해 정신과와 뇌손상 환자에서 신경심리 검사와 지각 장애와 관계성을 조사하였다. 방 법: 정신과 환자 69명, 뇌손상 환자 50명, 총 119명에서 Halstead Reitan 신경 심리 검사와 K-WAIS, MMPI를 시행하였다. MMPI 항목 중 지각 장애와 관계되는 9개 항목에서 산출된 점수와 신경심리 검사의 결과와의 상관 관계를 조사하였다. 또 정신과 환자에서 지각 장애 점수가 높은 지각 장애군 21명과 지각 장애가 없는 지각 장애 17명을 t-test로 비교하였다. 결 과: 뇌손상 환자군에서 지각 장애가 전두엽 기능을 보는 범주화 검사, 선로 잇기 검사, 촉각 수행 검사, 손끝 숫자 쓰기 검사와 우측 반구 기능을 보는 촉각 수행 검사의 위치, 동작성 점수, 빠진곳 찾기, 차례 맞추기, 토막 짜기 등과 유의한 상관 관계를 보였다. 또 피질하 기능을 보는 숫자 상징, 산수, 숫자 외우기와 유의한 상관 관계를 보였다. 정신과 환자의 높은 지각 장애군은 우측 반구 편측화 지수와 빠진 곳 찾기, 토막 짜기와 같은 우측 반구 기능에서 유의한 차이가 있었고, 또 이해, 어휘, 공통성과 같은 좌측 반구 기능에서도 유의한 차이가 있었다. 결 론: 지각 장애는 전두엽, 우측 반구, 피질하 구조의 기능과 깊은 연관성을 가지고 발생이 되며, 정신과 환자군에서는 좌측 반구의 기능도 영향을 주는 것으로 생각된다.

• 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.

• 한국방사선학회논문지
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• 제8권4호
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• pp.163-170
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• 2014

본 연구는 경도인지장애가 동반된 환자를 대상으로 뇌 자기공명영상에서 인지 영역에 대한 대뇌 피질 두께를 측정하고 신경심리검사 결과와 비교하여 신경해부학적 상관관계를 규명하고자 하였다. 이를 위하여 파킨슨병으로 최초 진단 받고 신경심리검사를 시행한 78명(경도인지장애군: 39명; 비인지장애군: 39명)과 정상인 그룹 32명을 선정하였다. 신경심리검사에서 경도인지장애군과 비인지장애군의 상관관계와 신경심리검사와 뇌 자기공명영상에서 대뇌 피질 두께의 상관관계는 독립표본 T 검증 또는 피어슨 상관분석을 실시하였으며 수집된 자료의 유의 수준은 p<0.05에서 검증하였다. 결론적으로 경도인지장애를 동반한 파킨슨병 환자는 뇌 자기공명영상에서 양측 쐐기압소엽과 우하측두엽의 대뇌 피질 두께가 통계적으로 유의하게 감소하였으며 인지 기능 평가를 위한 신경심리검사에서 시공간 기능, 언어 및 시각 기억력 기능이 저하되었다. 특히 언어 및 시각 기억력 영역에 대한 신경심리검사와 신경해부학적으로 좌측 쐐기앞소엽에서 상관관계가 있었다.

• 가정∙방문간호학회지
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• 제18권1호
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• pp.40-47
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• 2011

Purpose: This study investigated changes in neurocognitive function over a 2-month period of board game therapy in patients with schizophrenia. Method: Twenty-one schizophrenic patients treated with board game therapy and nineteen control schizophrenic patients were evaluated with neuropsychological and clinical tests, such as the Wisconsin Card Shorting Test (WCST). The same tests were re-administered after 2 months of board game therapy. Results: At the first series of neuropsychological tests, no difference was seen in performance, demographical aspects, or clinical severity among both patient groups. After 2 months, the group receiving board game therapy showed significant improvement of WCST performances compared to the controls. However, no difference was observed in clinical symptoms between the groups. Conclusion: The results of cognitive enhancement in patients playing board games indicates that board game play, easily used in an inpatient setting, is a promising tool for executive function improvement in chronic schizophrenic patients.

• 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.

• 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.

• 대한한방소아과학회지
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• 제20권2호
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• pp.147-175
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• 2006

Objective : This study is to investigate the method for assesment and diagnosis of ADHD, especially focusing on behavior rating scales. Methods : We searched the recent date of the publication and paper in ADHD. Results : For Assesment and Diagnosis of ADHD, various method such as interview with parents, child and teacher, behavior observation, behavior rating scales and neuropsychological test are used. The structured interview consists of the restrictive questions and response, and then have diagnostic algorithm, consequently can be used by untrained clinicians. Of the structured interview, standardization of K-SADS in Korean version is finished. Behavior rating scales, the form of parent, teacher and self-report questionnaires, are used as diagnosis and treatment evaluation of ADHD. Behavior rating scales consist of both ADHD-specific scales and broad-band scales designed to screen for various symptoms (including ADHD symptoms). ADHD-specific scales are useful in differential diagnosis, discrimination of subtype, treatment evaluation, However, broad-band scales are useful in preliminary examination. The neuropsychological tests can evaluate attention deficit and effect of attention deficit on cognitive function and academic performance. The neuropsychological tests also used in diagnosis and treatment evaluation of ADHD. Conclusion : For Assesment and Diagnosis of ADHD, various method are used, especially behavior rating scales are both useful and simple tool for diagnosis and treatment evaluation.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.125-135
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• 2021

Objective : This study aimed to validate the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status Update (K-RBANS). Methods : We performed a retrospective analysis of 283 psychiatric and neurosurgery patients. To investigate the convergent validity of the K-RBANS, correlation analyses were performed for other intelligence and neuropsychological test results. Confirmatory factor analysis was used to test a series of alternative plausible models of the K-RBANS. To analyze the various capabilities of the K-RBANS, we compared the area under the receiver operating characteristic (ROC) curves (AUC). Results : Significant correlations were observed, confirming the convergent validity of the K-RBANS among the Total Scale Index (TSI) and indices of the K-RBANS and indices of intelligence (r=0.47-0.81; p<0.001) and other neuropsychological tests at moderate and above significance (r=0.41-0.63; p<0.001). Additionally, the results testing the construct validity of the K-RBANS showed that the second-order factor structure model (model 2, similar to an original factor structure of RBANS), which includes a first-order factor comprising five index scores (immediate memory, visuospatial capacity, language, attention, delayed memory) and one higher-order factor (TSI), was statistically acceptable. The comparative fit index (CFI) (CFI, 0.949) values and the goodness of fit index (GFI) (GFI, 0.942) values higher than 0.90 indicated an excellent fit. The root mean squared error of approximation (RMSEA) (RMSEA, 0.082) was considered an acceptable fit. Additionally, the factor structure of model 2 was found to be better and more valid than the other model in χ2 values (Δχ2=7.69, p<0.05). In the ROC analysis, the AUCs of the TSI and five indices were 0.716-0.837, and the AUC of TSI (AUC, 0.837; 95% confidence interval, 0.760-0.896) was higher than the AUCs of the other indices. The sensitivity and specificity of TSI were 77.66% and 78.12%, respectively. Conclusion : The overall results of this study suggest that the K-RBANS may be used as a valid tool for the brief screening of neuropsychological patients in Korea.