• Title/Summary/Keyword: cognitive deficits

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Whole Brain Radiation-Induced Cognitive Impairment: Pathophysiological Mechanisms and Therapeutic Targets

  • Lee, Yong-Woo;Cho, Hyung-Joon;Lee, Won-Hee;Sonntag, William E.
    • Biomolecules & Therapeutics
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    • v.20 no.4
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    • pp.357-370
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    • 2012
  • Radiation therapy, the most commonly used for the treatment of brain tumors, has been shown to be of major significance in tumor control and survival rate of brain tumor patients. About 200,000 patients with brain tumor are treated with either partial large field or whole brain radiation every year in the United States. The use of radiation therapy for treatment of brain tumors, however, may lead to devastating functional deficits in brain several months to years after treatment. In particular, whole brain radiation therapy results in a significant reduction in learning and memory in brain tumor patients as long-term consequences of treatment. Although a number of in vitro and in vivo studies have demonstrated the pathogenesis of radiation-mediated brain injury, the cellular and molecular mechanisms by which radiation induces damage to normal tissue in brain remain largely unknown. Therefore, this review focuses on the pathophysiological mechanisms of whole brain radiation-induced cognitive impairment and the identification of novel therapeutic targets. Specifically, we review the current knowledge about the effects of whole brain radiation on pro-oxidative and pro-inflammatory pathways, matrix metalloproteinases (MMPs)/tissue inhibitors of metalloproteinases (TIMPs) system and extracellular matrix (ECM), and physiological angiogenesis in brain. These studies may provide a foundation for defining a new cellular and molecular basis related to the etiology of cognitive impairment that occurs among patients in response to whole brain radiation therapy. It may also lead to new opportunities for therapeutic interventions for brain tumor patients who are undergoing whole brain radiation therapy.

Effect of Education on Discriminability of Montreal Cognitive Assessment Compared to Mini-Mental State Examination

  • Haeyoon Kim;Seonyeong Yang;Jaesel Park;Byeong Chae Kim;Kyung-Ho Yu; Yeonwook Kang
    • Dementia and Neurocognitive Disorders
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    • v.22 no.2
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    • pp.69-77
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    • 2023
  • Background and Purpose: The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. Methods: Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer's type. The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. Results: In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. Conclusions: These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.

COGNITIVE CHARACTERISTICS OF ADHD CHILDREN ASSESSED BY KEDI-WISC (주의력결핍과잉활동장애 아동의 인지적특성)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.55-64
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    • 1990
  • The purpose of the present study is to investigate cognitive characteristics of ADHD children by comparing their performances on KEDI-WISC according to age and EEG variables. Subjects were 56 ADHD children who visited Seoul National University Children's Hospital during the period from January, 1988 to March, 1989. Group differences on age and EEG variables were tested by ANOVA, and Hierarchical Cluster Analysis was performed to investigate how ADHD children were classified based on their performances on KEDI-WISC. The results Indicated that ADHD children showed low scores on Coding, Digit Span, and Comprehension subtests, suggesting their attention deficits and impulsivity. ADHD children were clustered Into three groups based on only FSIQ. In post-hoc tests three groups showed different cognitive strengths and weaknesses on KEDI-WISC. Group differences on age were not significant, and abnormal EEG group showed lower PIQ than normal EEG group, suggesting the possibility that their attention deficits were related to neurological factors.

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INHIBITION, PLANNING, AND WORKING MEMORY IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력 결핍 과잉행동 장애 아동의 억제능력, 계획능력, 그리고 작업기억 능력)

  • Kim, Gui-Ae;Kim, Sang-Heop;Hong, Chang-Hee;Lee, Myoung-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.82-90
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    • 2004
  • Objectives:The study was performed to compare the executive function(EF;Inhibition, Planning and Working memory) between ADHD and normal group, and to controll the effect of age and intelligence. And the function of inhibition was assessed in two dimensions(cognitive inhibition and motor inhibition). Methods:K-WISC III and EF test(Go-No-Go, Stroop test, Tower of Hanoi, Digit) was administered to both 25 children with ADHD and 25 normal control participants, all aged between 7 and 12. The results were analyzed after statistically controlled for age and intelligence. Results:Children in the ADHD group had significantly lower IQ score than those in the control group and consistent relations were found between the child's age and the study's major variables. Once IQ and age were controlled, results indicated that children with ADHD had deficit only cognitive inhibition and motor inhibition. There was no significant difference in planning and working memory. Conclusion:These results suggested that specific deficits in inhibition control rather than general EF deficits are associated with ADHD. So inhibition is the core problem of children with ADHD. Thus, the therapeutic approach focused on cognitive inhibition and motor inhibition is required.

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Correlation of Cognitive Function and Fall-risk Related Behavioral Factors (노인의 인지기능과 낙상유발 행동요인과의 상관분석)

  • Ju, Yumi;Lee, Heon-Joo
    • Therapeutic Science for Rehabilitation
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    • v.7 no.2
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    • pp.41-50
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    • 2018
  • Objective: This study was conducted to investigate the correlation of cognitive function and fall-risk behavioral factors. Methods: The elderly over than 65 year-old with and without cognitive impairment were recruited in four different regional areas. Total 43 data of K-MoCA and FaB were collected. Pearson correlation of total scores of K-MoCA and FaB was analyzed using SPSS 22. Correlation between total score of K-MoCA and each item of FaB which describes the fall-risk behaviors was analyzed as well. Results: The cognitive function was statistically positive correlated with the fall-related behaviors in pearson correlation analysis (p<.01). Nine items of total 30 items of FaB was significantly correlated with total score of K-MoCA. Conclusion: Fall-risk behaviors were decreased as the cognitive level was improved. If the cognitive function was vulnerable, the insight to fall-risk behaviors deficits and various fall-related behavioral factors exits. The high fall-risk behaviors were correlated with cognitive function, so that the cognitive level should be considered in fall prevention intervention in Occupational Therapy.

Neuropretective effect of Kupunggibodan, Gamisamul-tang and Whangryunhaedok-tang on the ischemia-induced learning and memory deficits by MCAO in the rats (중풍 한방처방전의 효능비교 연구 ; 황련해독탕, 거풍지보단, 가미사물탕이 국소 전뇌허혈에 의한 학습과 기억에 미치는 효과)

  • Lee Bom-Bi;Chung Jin-Yong;Kim Sun-Yeou;Kim Ho-Cheol;Kwon Youn-Jun;Hahm Dae-Hyun;Lee Hae-Jeong;Shim In-Sup
    • Korean Journal of Acupuncture
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    • v.19 no.2
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    • pp.63-78
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    • 2002
  • Kupunggibodan(KU), Gamisamul-tang(GA) and Whangryunhaedok-tang(WH) are clinically the most popular prescriptions as an herbal medicine in the treatment of ischemia. In order to compare and evaluate their protective effects on the ischema-induced cognitive deficits by middle cerebral artery occlusion (MCAO), we examined its ability to improve ischemia-induced cell loss and impairements of learning and memory in the Morris water maze and eight-arm radial arm maze. Focal cerebral ischemia produced a marked cell loss, decrease in acetylcholinesterase(AchE) reactivity in the hippocampus, and learning and memory deficits in two behavioral tasks. Pretreatment with WH (100 mg/kg, p.o.) produced a substantial increase in acquisition in the Morris water maze. Pretreatment with KU increased the perfomance of the resention test in the Morris water maze. WH, KU and GA caused a significant improvement in choice accuracy in radial arm maze test. WH was superior to KU and GA in perfomance of the radial arm maze test. Consistent with behavioral data, staining with cresyl violet showed that pretreatments with WH, but not KU and GA significantly recovered the ischemia-induced cell loss in the hippcampal CA1 area. In addition, pretreatments with WH and KU recovered the ischemia-induced reduction of AchE reactivity in the hippocampal CA1 area. These results demonstrated that KU, GA and WH have protective effects against ischimea-induced learning and memory impairments and that the efficacy was the order of WH>KU>GA in tratment of ischemia induced memory deficits. The present studies provide an evidence of KU, GA and WH as putative treatment of vascular dementia. Supported by a fund from the Ministry of Health and Welfare(HMP-00-OO-04-0004), and the Brain Korea 21 Project from Korean Ministry of Education, Korea.

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Attention Deficits and Characteristics of Polysomnograms in Patients with Obstructive Sleep Apnea (폐쇄성 수면무호흡증 환자의 주의력 결함 및 수면다원검사 특징)

  • Lee, Yu-kyoung;Chang, Mun-Seon;Lee, Ho-Won;Kwak, Ho-Wan
    • Korean Journal of Health Psychology
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    • v.16 no.3
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    • pp.557-575
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    • 2011
  • This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.

Effects of Dual Tasks on Balance Ability in Patients with Cerebellar Ataxia

  • Kang, Bangsoo;Park, Jin-Hoon
    • The Journal of Korean Physical Therapy
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    • v.27 no.5
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    • pp.292-298
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of dual tasks on balance and postural control during standing in patients with cerebellar ataxia (CA). It was hypothesized that CA patients would exhibit different sway characteristics of the center of mass (COM) depending on the complexity of the secondary cognitive tasks compared with normal control subjects. Methods: A total of 8 patients with CA and age-matched healthy control subjects participated in this study. They were instructed to perform two balance tasks (non-dual and dual movement) with 3 different complexity of dual tasks. Range, variability, and velocity of COMs were measured. Results: According to the results CA patients showed deficits in balance and postural control with increased dual-task complexity during the static balance task in saggital sway movements. However, there was no significant difference in static balance in frontal sway. With higher difficulty in the cognitive task, CA patients took longer to stabilize their body center, while normal control subjects showed no change between conditions. In addition, CA patients had a greater COM resultant velocity during recovery in the dual-task condition compared with the single-task condition. These findings indicate that CA patients had defendable compensatory strategies in performing dual tasks. Conclusion: In conclusion, CA patients appeared to manage the priority to balance and postural control. Particularly in a situation with a postural threat such as when potential consequences of the loss of stability increase, they appeared to prioritize the control of balance and posture over the performance of the secondary task.

Neurocognitive Characteristics According to Depression Severity in Patients with Major Depressive Disorder (주요우울장애 환자의 증상 심각도에 따른 신경인지적 특성)

  • Hwang, Seon-Hee;Lee, Heon-Jeong;Kim, Myung-Sun
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.149-154
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    • 2017
  • Objectives This study investigated associations between symptom severity and neurocognitive functions in patients with major depressive disorder using comprehensive neuropsychological tests. Methods Ten patients with low depression (LD) and 22 patients with high depression (HD) participated. Symptom severity was determined by both the Beck Depression Inventory and the Hamilton Depression Rating Scale. Additionally, anxiety was measured by the Korean version of the State-Trait Anxiety Inventory (STAI-KYZ). Ten subtests of the Korean-Wechsler Adult Intelligence scale (K-WAIS), Stroop test, the word/design fluency tests were administered to assess cognition. Results The LD and HD groups did not differ in any of cognitive measures but anxiety level. Namely, the HD group obtained significantly higher scores on the state (U = 29.50, p < 0.01) and trait (U = 28.50, p < 0.001) anxiety scales than the LD group. A significant interaction effect between trait anxiety and depression severity was observed on the picture arrangement subtest of the K-WAIS [F (1, 27) = 5.09, p < 0.05]. Conclusions Cognitive deficits observed in patients with major depressive disorder may be related to other factors rather than current symptom severity. Trait anxiety possibly moderates the effect of current symptom severity on social judgment in these patients.

Connecting the dots between SHP2 and glutamate receptors

  • Ryu, Hyun-Hee;Kim, Sun Yong;Lee, Yong-Seok
    • The Korean Journal of Physiology and Pharmacology
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    • v.24 no.2
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    • pp.129-135
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    • 2020
  • SHP2 is an unusual protein phosphatase that functions as an activator for several signaling pathways, including the RAS pathway, while most other phosphatases suppress their downstream signaling cascades. The physiological and pathophysiological roles of SHP2 have been extensively studied in the field of cancer research. Mutations in the PTPN11 gene which encodes SHP2 are also highly associated with developmental disorders, such as Noonan syndrome (NS), and cognitive deficits including learning disabilities are common among NS patients. However, the molecular and cellular mechanism by which SHP2 is involved in cognitive functions is not well understood. Recent studies using SHP2 mutant mice or pharmacological inhibitors have shown that SHP2 plays critical role in learning and memory and synaptic plasticity. Here, we review the recent studies demonstrating that SHP2 is involved in synaptic plasticity, and learning and memory, by the regulation of the expression and/or function of glutamate receptors. We suggest that each cell type may have distinct paths connecting the dots between SHP2 and glutamate receptors, and these paths may also change with aging.