• Dementia and Neurocognitive Disorders
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• v.21 no.1
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• pp.17-29
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• 2022

Background and Purpose: Verbal and nonverbal fluency tests are the conventional methods for examining executive function in the elderly population. However, differences in impairments result in fluency tests in patients with mild cognitive impairments (MCIs) and Alzheimer's disease (AD) and in neural correlates underlying the tests still necessitate concrete evidence. Methods: We compared the test performances in 27 normal controls, 28 patients with MCI, and 20 with AD, and investigated morphological changes in association with the test performances using structural magnetic imaging. Results: Patients with AD performed poorly across all the fluency tests, and a receiver operating characteristics curve analysis revealed that only category fluency test discriminated all the 3 groups. Association, category, and design fluency tests involved temporal and frontal regions, while letter fluency involved the cerebellum and caudate. Conclusions: Category fluency is a reliable measure for screening patients with AD and MCI, and this efficacy might be related to morphological correlates that underlie semantic and executive processing.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.139-152
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• 2002

Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.147-152
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• 2010

Objectives : The purpose of this study was to investigate the deficits in executive function in children with ADHD and anxiety disorder, and further, to characterize executive function deficits among the two groups. Methods : Subjects consisted of 60 children between the ages of 5 and 14 (16 Normal, 24 ADHD, 20 Anxiety Disorder). Neuropsychological tests (KEDI-WISC, CCTT, STROOP, WCST, ROCF) for assessing cognitive and executive function were individually administered to all subjects. Results : There were no significant differences in FSIQ or PIQ among the three groups. However, the ADHD group tended to score lower on the VIQ and subtest of similarity, vocabulary, and digit span tests. The three groups did not significantly differ with respect to CCTT test results. On the STROOP test, the ADHD group showed poor performance on the word, color, and color-word subtests. The three groups did not exhibit significant differences in WCST test results ; however, the anxiety group performed poorly belonging to below 25 percentile rank on perseverative response. On the ROCF test, the ADHD group performed poorly with respect to their organization score and in particular, regarding copy and immediate recall. The anxiety group also performed poorly with regard to organization ; however, this was limited only to immediate recall. Conclusion : Children with ADHD displayed poor inhibition and organizational abilities compared to children with anxiety and normal controls. Further, children with anxiety disorder exhibited low cognitive flexibility and voluntary problem-solving abilities compared to ADHD children and normal controls. Based on these results, we suggest that the characteristics of executive dysfunction in ADHD and anxiety disorder in children are different.

• Journal of Korean Neurosurgical Society
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• v.56 no.3
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• pp.188-193
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• 2014

Objective : Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease of unknown etiology. In addition, the neurocognitive impairment of adults with MMD is infrequently reported and, to date, has not been well described. We attempted to determine both the neurocognitive profile of adult moyamoya disease and whether a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis can improve the neurocognitive impairment in exhibiting hemodynamic disturbance without stroke. Methods : From September 2010 through November 2012, 12 patients with angiographically diagnosed MMD underwent STA-MCA anastomosis for hemodynamic impairment. Patients with hypoperfusion and impaired cerebrovascular reserve (CVR) capacity but without evidence of ischemic stroke underwent a cognitive function test, the Seoul Neuropsychological Screening Battery (SNSB). Five patients agreed to undergo a follow-up SNSB test. Data from preoperative and postoperative neurocognitive function tests were compared and analyzed. Results : Five of 12 patients were enrolled. The median age was 45 years (range, 24-55 years). A comparison of preoperative to postoperative status of SNSB, memory domain, especially delayed recall showed significant improvement. Although most of the domains showed improvement after surgery, the results were not statistically significant. Conclusion : In our preliminary study, large proportions of adult patients with MMD demonstrate disruption of cognitive function. This suggests the possibility of chronic hypoperfusion as a primary cause of the neurocognitive impairment. When preoperative and postoperative status of cognitive function was compared, memory domain showed remarkable improvement. Although further study is needed, neurocognitive impairment may be an indication for earlier intervention with reperfusion procedures that can improve cognitive function.

• Journal of The Korean Association For Science Education
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• v.17 no.4
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• pp.525-540
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• 1997

The present study tested the hypothesis that maturation of the prefrontal lobes is a crucial factor determining the performance of scientific reasoning tasks, Functions of the prefrontal lobes, such as activating relevant information, sequential planning and monitoring, and inhibiting irrelevant information, are related thinking patterns with scientific reasoning. Therefore, we inferred the idea that the prefrontal lobes play an important role in scientific reasoning. To test the hypothesis. the present study investigated a prefrontal lobe patient's task solving procedures in scientific reasoning tasks and the correlation and regression analysis between a test of prefrontal lobe function and two scientific reasoning tasks, The perseverative errors in the Wisconsin Card Sorting Test(WCST) was used as a measure of the prefrontal lobe function, The Melinark Type Task and the Classroom Test of Scientific Reasoning were used as measures of scientific reasoning abilities. Ages and Group Embedded Figure Test were also used as measures of two alternative hypotheses, general maturation and field independency respectively. The prefrontal lobe patient showed a crucial deficiency in solving scientific reasoning tasks. In the tasks, the patient could not used the reasoning of If... and... then... therefore pattern. In correlation study, the perseveration errors of the WCST showed a significantly negative correlation with two scientific reasoning tasks. Multiple regression study also showed that the perseveration errors measured as a function of the prefrontal lobes have more contribution to scientific reasoning ability than contributions of alternative hypotheses. Therefore, the present study supported the hypothesis that prefrontal lobes play a crucial role in scientific reasoning ability, What function of the prefrontal lobes do play crucial role in scientific reasoning? The present study provided an explanation for the question, which inhibiting ability of the prefrontal lobes is responsible for the scientific reasoning ability, in a part at least. That is, perseverative tendency in task-solving procedures causes a deficiency of an ability to inhibit the wrong information to solve a task. The present study provided a possibility of neuropsychological approach in science education research. The present study also showed an importance of the prefrontal lobe development in the performance of scientific reasoning task.

• Korean Journal of Schizophrenia Research
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• v.21 no.2
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• pp.74-80
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• 2018

Objectives : This study investigated whether long-acting injectable (LAI) paliperidone is different from its oral form in terms of the effect on cognitive function in schizophrenia spectrum and other psychotic disorders. Methods : We reviewed the medical records of patients in Seoul National University Bundang Hospital who were diagnosed as having schizophrenia and/or other psychotic disorders based on DSM-5 from 2016 to 2017. Seven patients were treated with oral paliperidone and 11 were treated with paliperidone palmitate. All patients underwent clinical and neuropsychological assessment, including the Korean version of the MATRICS Consensus Cognitive Battery (MCCB) at their first visit or within one month of their initial treatment. MCCB was repeated within three to 12 months after the initial assessment. Results : There was no significant difference between the two groups in most cognitive domains including speed of processing, attention and vigilance, working memory, verbal learning, visual learning and reasoning and problem solving domain. However, patients treated with paliperidone palmitate showed better improvement in social cognition domain than those taking oral paliperidone. The standardized values of social cognition domain scores had significantly improved over time in patients under paliperidone palmitate, demonstrating a significant time-by-group interaction. Conclusion : Our results show that long-acting injectable paliperidone could be helpful in some aspects of improving cognitive function in schizophrenia spectrum and other psychotic disorders. Further studies with other antipsychotics are necessary to generalize the results.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.17-28
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• 2008

Purpose: It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Methods and Materials: Two hundred nineteen patients (M: 70, F: 149, mean age: $62.9{\pm}6.9$ y/o) who were diagnosed as PD without dementia clinically and 55 patients (M:15, F:40, mean age: $61.4{\pm}9.2$ y/o) as normal controls who had no past illness history were performed $^{99m}Tc$-HMP AO brain perfusion SPECT and neuropsychological test. Results: At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal cerebral blood perfusion in 32 (14.7%) of 219 patients with PD, decreased perfusion on the frontal lobe in 45 patients (20.6%), the temporal lobe in 39 patients (17.4%), the parietal lobe in 39 patients (17.9%), the occipital lobe in 40 patients (18.3%), diffuse area in 14 patients (6.4%) and unclassified in 10 patients (4.6%). Fifthly, we compared the results of the neuropsychological test and cerebral perfusion pattern. There was no correlation between two tests except visuospatial function. Conclusion: Various perfusion state were found in patients with PD according to the age and sex. Also we were able to classify perfusion state into several groups and compare the neuropsychological test with cerebral perfusion.

• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.261-267
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• 2020

Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

• Journal of Digital Convergence
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• v.18 no.3
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• pp.195-205
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• 2020

The purpose of this study was to investigate the effects of early cognitive training and tailored telephone coaching program for ischemic stroke. Among 28 participants, assigned into the experimental(n=15) and control group(n=13). Only the experimental group was received a 4-week cognitive training and 11 session of tailored telephone coaching. The effect ot the program was evaluated four times(baseline, 4weeks, 8weeks, 12months) using the tool on Depression, Mini Mental State Examination(MMSE), Neuropsychological battery, Activities of Daily Living(ADL). The repeated measures ANOVA showed that the experimental group showed improvement in MMSE, verbal memory and executive function compared to the control group. Especially, the improvement of executive function which is related to ADL was a remarkable result. This suggests that early intervention is very important for recovery cognitive function and independent daliy life after stroke, and periodic telephone coaching should be done together for mid-to long term effects.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.3
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• pp.190-196
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• 2015

Objectives : The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. Methods : From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. Results : No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. Conclusion : Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.