• Progress in Medical Physics
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• v.14 no.2
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• pp.108-123
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• 2003

The purpose of this study is to evaluate the contribution of $^{18}$ F-FDG brain PET in the differentiating Idiopathic parkinson's diesease (IPD), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA). We studied 24 patients with parkinsonism : 8 patients (mean age 67.9$\pm$10.7 y: M/F : 3/5) with IPD, 9 patients (57.9$\pm$9.2 y : M/F : 4/5) with MSA and 7 patients (67.6$\pm$4.8 y : M/F 3/4) with PSP. All patients with parkinsonism and 22 age-matched normal controls underwent $^{18}$ F FDG PET in 3D mode after the injection of 370 MBq $^{118}$ F FDG. The patients with IPD, MSh and PSP were compared with a normal control group by a two-sided t-test of SPM99 (uncorrected P<0.001, extent threshold>100 voxel). All three parkinsonism groups, showed significant hypometabolism in the cerebral neocortex compared to the normal control group. However, the three groups displayed different metabolism in the subcortical structure, brain stem, and cerebellum. In IPD, there was no significant hypometabolism in the putamen, brain stem and cerebellum. However, MSA patients showed significant hypometabolism in the striatum, pons, and cerebellum compared to the normal controls and IPD patients. In addition, PSP showed significant hypometabolism in the caudate nuclei, the thalamus, midbrain, and the cingulate gyrus compared to the normal controls, the IPD, and MSA groups (IPD vs Normal sensitivity/specificity : 75%/l00%, MSA vs Normal sensitivity/specificity :100%/87%, PSP vs Normal sensitivity/specificity : 86%/94%). Our results show that the regional metabolism of IPD, MSA, and PSP is different mainly in the striatum, thalamus, brain stem and cerebellum. An assessment of the $^{18}$ F-FDG PET scan images using SPM may be a useful adjunct to a clinical examination in making a differential diagnosis of Parkinsonism.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.183-198
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• 2000

Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

• Korean Journal of Biological Psychiatry
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• v.19 no.2
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• pp.77-83
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• 2012

Objectives : Although there have been studies that examine sex differences of the brain structures using magnetic resonance imaging, studies that specifically investigate cerebellar structural differences between men and women are scarce. The purpose of current study was to examine sex differences in structures of the cerebellum using cerebellar template and cerebellum analysis methods. Methods : Sixteen men and twenty women were included in the study. A MATLAB based program (MathWorks, Natick, MA, USA), Statistical Parametric Mapping 5 (SPM5) using the spatially unbiased infra-tentorial atlas template (SUIT) as the cerebellum template, was used to analyze the brain imaging data. Results : There was no significant difference in age between men (mean age=28.1) and women (mean age=27.2). Men showed higher gray matter density than women in two left cerebellar areas including the clusters in the lobules IV and V (a cluster located across the lobules IV and V), and the lobule VIIIb (lobules IV and V, t=4.75, p<0.001 ; lobule VIIIb, t=3.08, p=0.004). Conclusions : The current study found differences in cerebellar gray matter density between men and women. The current study holds its significance for applying the template specifically developed for the analysis of cerebellum.

• Anxiety and mood
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• v.4 no.2
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• pp.148-156
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• 2008

Objective : Although cognitive-behavior therapy (CBT) is effective in patients with panic disorder, its the-rapeutic mechanism of action in the brain remains unclear. This study was performed to investigate regional blood flow changes associated with successful completion of CBT in drug-naive patients with panic disorder. Method : The regional blood flow in 4 patients with panic disorder was compared to that in 11 healthy controls before and after a 12-week group CBT using $^{99m}Tc$-ECD SPECT imaging. Psychopathology was assessed using Panic Disorder Severity Scale. Data were analyzed using software for statistical parametric mapping (SPM2). Results : Before CBT, significantly decreased blood flow was found in the parietal and occipital area in panic patients than normal volunteers. In all the patients who showed remission after CBT, increased blood flow was detected in the right cingulate gyrus, left lingual gyrus, and left superior parietal lobule, whereas decreased blood flow was seen in the left inferior temporal gyrus. Conclusion : These results suggested that CBT is effective for panic disorder and change the activity of cingulate gyrus and left temporal gyrus, a part of the brain areas associated with fear in panic disorder.

• Proceedings of the KSMRM Conference
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• 2002.11a
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• pp.111-111
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• 2002

Purpose： This study is to compare the distinct brain activation between implicit and explicit memory retrieval tasks using a non-invasive blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging(fMRI). Materials ＆ Methods： We studied seven right-handed, healthy volunteers aged 21-25 years(mean；22 years) were scanned under a 1.5T Signa Horizon Echospeed MR imager(GE Medical Systems, Milwaukee, U.S.A.). During the implicit and explicit memory retrieval tasks of previously teamed words under the conceptual processing, we acquired fMRI data using gradient-echo EPI with 50ms TE, 3000ms TR, 26cm${\times}$26cm field-of-view, 128${\times}$128 matrix, and ten slices(6mm slice thickness, 1 mm gap) parallel to the AC-PC(anterior commissure and posterior commissure) line. By using the program of statistical parametric mapping(SPM99), functional activation maps were reconstructed and quantified.

• Journal of The Korean Association For Science Education
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• v.27 no.1
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• pp.84-92
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• 2007

The purpose of this study was to investigate biologists' brain activation patterns during the generation of scientific questions on biological phenomena. Eight right-handed healthy biologists volunteered to be participants in the present study. The question-generation tasks were presented in a block design. The BOLD signals of the biologists' brain were measured by 3.0T fMRI system and data were analyzed using Statistical Parametric Mapping (SPM2). According to our results, the left inferior and middle frontal gyri, the medial prefrontal cortex, the bilateral hippocampus, the occipito-parietal route, the fusiform gyrus, and the cerebellum were activated significantly during the generation of scientific questions. Therefore, we suggested that generating scientific question is associated with analyzing observed situations, using verbal strategy, retrieving episodic memories for comparisons, and feeling cognitive conflicts.

• The Journal of Korean Medicine
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• v.27 no.3 s.67
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• pp.187-200
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• 2006

Objectives: Acupuncture has been applied in Asia for thousands of years, especially to rehabilitation after stroke. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells shown by using brain imaging techniques. This study was to evaluate the effect of GB 34-GB 39 electro-acupuncture (EA) on regional cerebral blood flow (rCBF) in stroke patients and normal volunteers using single photon emission computed tomography (SPECT). Methods: The study procedure was divided into two parts: patients and volunteers studies. For the patients study, ten ischemic stroke patients (3 males, 7 females, mean age $68.5{\pm}8.9$ years old) were selected. Baseline brain SPECT was done with triple head gamma camera (MultiSPECT3, Siemens, USA) after intravenous administration of 1,110 MBq of $^{99m}Tc-ECD$. Fifteen-minute EA at GB 34 and GB 39 were applied on the affected limb. The same dose of $^{99m}Tc-ECD$ was injected during the EA, and the second set of SPECT images wasobtained. Using the computer software (ICON 7.1, Siemens, USA), 3 SPECT slices (upper, middle, lower) surrounding the brain lesion were selected and each slice was divided into 10-16 brain regions. Asymmetry indexes (AI) were analyzed in each brain region. We regarded over 10% changes of AI between before and after EA as significance. For the volunteers study, 10 healthy human volunteers (5 males, 5 females, mean age $28.1{\pm}6$ years old) were selected. In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed. On the 7th day after the resting examination, 15 minute EA was applied at GB 34 and GB 39 on the right side of the subjects. Immediately after EA, the second SPECT images were obtained inthe same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: In stroke patients, six of the eight (75%) had significantly increased perfusion in post-acupuncture scans compared to their baseline state. In normal volunteers, GB 34-GB GB EA increased rCBF in both hemispheres including right ventral posterior cingulate (Brodmann area (BA) 23), left superior temporal, anterior transverse temporal (BA 22, 41), left parastriate, peristriate (BA 18, 19), right occipitotemporal, angular (BA 37, 39), left rostral postcentral, caudal postcentral and preparietal (BA 2, 3, 5). However GB 34-GB 39 EA decreased rCBF in the right hemisphere including triangular and middle frontal lobes. Conclusions: The results demonstrated that OB 34-GB 39 EA increased cerebral perfusion in ischemic stroke patients and increased rCBF grossly in temporal lobes of normal volunteers. It is also suggested that there may be a correlation between the GB meridian and the territory of the middle cerebral artery.

• The Journal of the Korea Contents Association
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• v.10 no.2
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• pp.286-294
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• 2010

This study was performed to identify the cerebral network associated with sensation through the tickling stimulation, which is distinctive from the rest of other networks processing normal stimulation and to investigate the difference of laughing mechanism which is closely related to tickling using functional MRI(fMRI). A 16 healthy volunteers (mean age: 28.9) on a 3.0T MR scanner during two sensation conditions. Counterbalanced stimulus were presented across the participants, and the stimulation was used block design. Acquired data was analyzed by the statistical parametric mapping (SPM 99). Subject and group analysis was performed. Individual analysis showed the activation of somatic sensation area in both tasks and the tickling sensation test showed more activated area in the Wernicke's area(BA40) compared to the normal sensation. The group analysis result shows that under normal stimulations, both sides of somatosensory cortices(BA 1,2 and 3) were activated and under tickling stimulation, not only the cortices but also those huge activation on thalamus, cingulate gyrus and insular lobe were detected. When the tickling was stopped, significant activations were shown in right cingulate gyrus, left MFG area and left insular lobe. A cerebral area responsible for recognizing tickling sensation was examined and the primitive stimulation such as tickling is much closely related to laugh, which is an important factor for various social activities.

• The Korean Journal of Nuclear Medicine
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• v.32 no.3
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• pp.238-249
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• 1998

Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.

• The Korean Journal of Nuclear Medicine
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• v.36 no.2
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• pp.91-101
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• 2002

Purpose : The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Materials and Methods : Tc-99m HMPAO brain SPECT was peformed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5 - 24) and the mean MMSE score of the follow-up was 8.1 (range: 0 - 17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was peformed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Results : Significant correlation was found between the blood-flow decrease in left inferior prefrontal region (BA 47) and left middle temporal legion (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed the similar trends. Conclusions : A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's disease(AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease.