• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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• pp.275-282
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• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• 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 Korean Neurosurgical Society
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• 제65권2호
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• pp.315-324
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• 2022

Objective : The aim of this study was to verify the equivalence and effectiveness of the tablet-administered Korean Repeatable Battery for the Assessment of Neuropsychological Status (K-RBANS) for the prevention and early detection of dementia. Methods : Data from 88 psychiatry and neurology patient samples were examined to evaluate the equivalence between tablet and paper administrations of the K-RBANS using a non-randomly equivalent group design. We calculated the prediction scores of the tablet-administered K-RBANS based on demographics and covariate-test scores for focal tests using norm samples and tested format effects. In addition, we compared the receiver operating characteristic curves to confirm the effectiveness of the K-RBANS for preventing and detecting dementia. Results : In the analysis of raw scores, line orientation showed a significant difference (t=-2.94, p<0.001), and subtests showed small to large effect sizes (0.04-0.86) between paper- and tablet-administered K-RBANS. To investigate the format effect, we compared the predicted scaled scores of the tablet sample to the scaled scores of the norm sample. Consequently, a small effect size (d≤0.20) was observed in most of the subtests, except word list and story recall, which showed a medium effect size (d=0.21), while picture naming and subtests of delayed memory showed significant differences in the one-sample t-test. In addition, the area under the curve of the total scale index (TSI) (0.827; 95% confidence interval, 0.738-0.916) was higher than that of the five indices, ranging from 0.688 to 0.820. The sensitivity and specificity of TSI were 80% and 76%, respectively. Conclusion : The overall results of this study suggest that the tablet-administered K-RBANS showed significant equivalence to the norm sample, although some subtests showed format effects, and it may be used as a valid tool for the brief screening of patients with neuropsychological disorders in Korea.

• 한국전문물리치료학회지
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• 제21권3호
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• pp.80-88
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• 2014

Previous studies have reported that decreased cognitive ability has been consistently associated with significant declines in performance of one or both tasks under a dual-task walking condition. This study examined the relationship between specific cognitive abilities and the dual-task costs (DTCs) of spatio-temporal gait parameters in stroke patients. The spatio-temporal gait parameters were measured among 30 stroke patients while walking with and without a cognitive task (Stroop Word-Color Task) at the study participant's preferred walking speed. Cognitive abilities were measured using Computerized Neuropsychological Testing. Pearson's correlation coefficients (r) were calculated to quantify the associations between the neuropsychological measures and the DTCs in the spatio-temporal gait parameters. Moderate to strong correlations were found between the Auditory Continuous Performance test (ACPT) and the DTCs of the Single Support Time of Non-paretic (r=.37), the Trail Making A (TMA) test and the DTCs of Velocity (r=.71), TMA test and the DTCs of the Step Length of Paretic (r=.37), TMA test and the DTCs of the Step Length Non-paretic (r=.36), the Trail Making B (TMB) test and the DTCs of Velocity (r=.70), the Stroop Word-Color test and the DTCs of Velocity (r=-.40), Visual-span Backward (V-span B) test and the DTCs of Velocity (r=-.41), V-span B test and the DTCs of the Double Support Time of Non-paretic (r=.38), Digit-span Forward test and the DTCs of the Step Time of Non-paretic (r=-.39), and Digit-span Backward test and the DTCs of the Single Support Time of Paretic (r=.36). Especially TMA test and TMB test were found to be more strongly correlated to the DTCs of gait velocity than the other correlations. Understanding these cognitive features will provide guidance for identifying dual- task walking ability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.33-46
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• 2005

본고에서는 인간의 뇌 발달과 주의력, 지각, 기억, 언어 등 다양한 인지기능의 발달과의 관계를 살펴본 후, Luria의 발달 신경심리 이론 및 그에 입각하여 개발된 아동용 Luria-Nebraska신경심리검사를 간략하게 소개하였다. 마지막으로, 현재 국내, 외에서 널리 사용되는 주의력 검사, 시-지각 검사, 시각-운동 협응 능력 검사, 그리고 전두엽의 집행기능검사 등을 포함한 아동용 신경심리 평가도구에 대해 고찰해보았다.

• 수면정신생리
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• 제4권1호
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• pp.1-14
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• 1997

This paper reviewed models to explain memory and neuropsychological tests to assess memory. Memory was explained in cognitive and neuroanatomical perspectives, Cognitive model describes memory as structure and process. In structure model, memory is divided into three systems: sensory memory, short-term memory(working memory), and long-term memory. In process model, there are broadly three categories of memory process: encoding, storage, and retrieval. Memory process work in memory structure. There are two prominent models of the neuroanatomy of memory, derived from the work of Mishkin and Appenzeller and that of Squire and Zola-Morgan. These two models are the most useful for the clinician in part because they take into account the connections between the limbic and frontal cortical regions. The major difference between the two models concerns the role of the amygdala in memory processess. Mishkin and his colleagues believe that the amygdala plays a significant role while Squire and his colleagues do not. The most popular and widely used tests of memory ability such as WMS-R, AVLT, CVLT, HVLT. RBMT, CFT, and BVRT-R, were reviewed.

• 정신신체의학
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• 제18권1호
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• pp.11-18
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• 2010

대뇌 손상이 있는 환자에 대한 임상적 접근은 임상의에게 생각보다 쉽지 않다. 방대한 신경인지기능검사는 숙련된 기술을 요할 뿐 아니라 여러가지 도구들을 필요로 한다. 임상의가 대뇌의 부위에 따른 기능에 대하여 안다면 몇몇 간단한 평가로 대뇌 손상 부위를 추론해 낼 수 있다. 본고에서는 대뇌의 기능을 평가할 수 있는 여러가지 술기를 소개하고자 한다.

• 정신신체의학
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• 제5권1호
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• pp.89-96
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• 1997

SLE 환자들에서 인지기능의 장애가 있는지를 알아보기 위해서 신경정신과적 병력이 없는 내과 외래 SLE 환자 20명과 정상 대조군 20명을 대상으로 전산화 신경인지기능 검사인 Vienna test system을 시행하고 이를 인지기능에 영향을 미칠 수 있는 임상 변인들과의 연관성을 분석하여 다음과 같은 결과를 얻었다. 1) SLE 환자군과 정상 대조군의 신경인지기능 검사의 각 항목 비교 인식력 검사항목에서 SLE 환자군은 정상 대조군에 비해 정확하게 응답한 반응수가 적었으며 '예'와 '아니오' 중 '아니오'를 정확하게 반응한 수도 적었다. 또한 '예'와 '아니오'에 대해 각각 정확한 반응을 하는 평균 반응시간이 길었으며 검사소요 시간도 길었다. 주의력 검사항목에서는 SLE 환자군이 정상 대조군에 비해 정확하게 응답한 반응수가 적었고, 평균 반응시간이 길었다. 그러나, corsi단기 기억력 검사항목에서는 시각적 단기 기억력 범위와 정확하게 맞춘 총 응답수에서 두군 간에 유의한 차이가 없었다. 표준도형 지능검사항목에서 SLE 환자군은 정상 대조군에 비해 정확하게 응답한 반응수가 적었다. 신경행동학적 인지상태 검사중 기억력 항목에서 SLE 환자군은 정상 대조군에 비해 유의하게 낮은 점수를 보였다. 2) 신경인지기능의 각 항목과 환자군의 연령, 교육연한, SLE 질환 활성도(SLE Disease Activity Index), 우울 증상의 정도, 항 ds-DNA항체. 보체 C3/C4, 스테로이드의 용량 등의 임상 변인들과의 상관관계를 비교하였을 때 통계적으로 유의하지 않았다. 이상의 결과에서 질환 활성도가 낮은 SLE환자들은 과거 신경정신과적 증상의 병력이 없고 병의 이환 기간이 비교적 짧음에도 불구하고 인지기능의 장애를 나타내었다. 그리고 이는 기타 장기의 침범으로 인한 비특이적 영향이 아닌 중추신경계의 침범에 의한 것으로 보이며 우울정도나 스테로이드 용량에 영향을 받지 않는 것으로 생각된다.

• 생물정신의학
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• 제15권1호
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• pp.5-13
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• 2008

Objectives : It was the aim of the present paper to examine the impact of the apolipoprotein E(APOE) ${\varepsilon}4$ on cognitive performance in community-dwelling elderly samples with 'questionable dementia'. Methods : Total 295 samples who were diagnosed with 'questionable dementia' in the recent year and completed the Korean version of the Consortium Establish a Registry for Alzheimer's Disease(CERAD-K) neuropsychological assessment protocol, were recruited. The CDR test established score of 0.5. Genomic DNA was extracted from the venous blood and APOE genotyping was done in this group. Their cognitive performance was compared by the occurrence of the APOE ${\varepsilon}4$ allele. Results : The impact of ${\varepsilon}4$ allele was significant in the Word List Recall Test(WLRT, F=4.511, df=1, p=0.035). The 'young-old' group aged 75 years and under had a significantly lower performance on the Word List Recall Test(WLRT, F=5.090, df=1, p=0.015), but the 'old-old' group over 75 years of age had not significantly different performance on the all the item of tests in ${\varepsilon}4$+ allele group. Conclusion : The conclusion to be drawn here is that community-dwelling elderly samples with ${\varepsilon}4$ allele in 'questionable dementia' had a significantly lower performance on the Word List Recall Test in the CERAD-K neuropsychological test batteries and the effect was prominent in the 'young-old' age group.

• 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.