• 대한예방한의학회지
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• 제14권3호
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• pp.63-75
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• 2010

Vascular dementia(VaD) is currently considered to be the second most common type of dementia. VaD is not a single diagnostic entity, but a heterogeneous syndrome which encompasses several clinicopathological forms of dementia resulting from cerebrovascular diseases. A common form of VaD is subcortical VaD which is characterized by lacunar infarcts and deep white matter changes, leading to a progressive decline in memory and cognitive function. The neuropsychological and cognitive profiles of subcortical VaD have been reported relatively homogeneous. At present, subcortical vascular dementia is regarded as the most important subtype of VaD with getting the attention of vascular dementia. The aims of this study are to discuss the concept of subcortical VaD and its importance focusing on diagnosis, prevention and treatment with a case report.

• 대한핵의학회:학술대회논문집
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• 대한핵의학회 2004년도 추계학술대회 및 총회
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• pp.395.2-395.2
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• 2004

• Nuclear Medicine and Molecular Imaging
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• 제41권6호
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• pp.530-537
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• 2007

목적: 본 연구는 초기의 피질하 혈관성치매와 알쯔하이머병 환자에서 Tc-99m HMPAO 단일광자방출단층촬영술을 이용하여 국소 뇌 혈류 흐름의 특징적인 양상을 평가하고 두 질환에서의 차이를 비교하고자 하였다. 대상 및 방법: 피질하 혈관성치매 환자 16명, 알쯔하이머병 46명, 12명의 대조군이 포함되었다. 피질하 혈관성치매와 알쯔하이머병은 NINCDS-ADRDA 와 NINDS-AIREN 기준에 합당하였고, 이들의 연령, 교육연수, 한국형 간이정신상태검사 점수와 치매임상척도 점수를 일치시켰다. 세 군에서 국소 뇌혈류 흐름을 측정하고자 SPM 분석을 이용한 TG-99m HMPAO 단일 광자방출단층촬영술을 실시하였다. 피질하 혈관성치매와 알쯔하이머병에서의 단일광자방출단층촬영술 결과를 정상 대조군과 비교하였고, 이어서 두 질환 간의 차이를 비교하였다. 결과: 대조군과의 SPM분석 결과 피질하 혈관성치매에서는 우측 관자엽, 시상, 좌측 뇌섬엽, 상부 관자이랑, 양측 띠이랑, 이마엽에서 의미 있는 관류저하가 있었고, 알쯔하이머병에서는 좌측 모서리위이랑, 상부 관자이랑, 중심뒤이랑, 하부 마루소엽, 우측 뒤통수관자이랑, 양측 띠이랑에서 관류저하을 보였다(uncorrected p<0.01). 피질하 혈관성치매 환자에서 알쯔하이머병 환자에 비해 우측 해마이랑, 띠이랑, 좌측 뇌섬엽, 양측 이마소이랑 부위에 의미있는 관류저하를 보였다(uncorrected p<0.01). 결론: 본 연구는 피질하 혈관성치매와 알쯔하이머병 환자에서의 관류의 특징과 차이를 보여주었고, 이러한 결과는 질병의 초기단계에서 두 질환을 구별하는데 도움을 줄 수 있을 것으로 생각한다.

• Journal of Medicine and Life Science
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• 제17권3호
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• pp.65-73
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• 2020

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease of the cerebral small blood vessels caused by mutations in the NOTCH3 gene on chromosome 19. Although CADASIL was known as a rare disease, recent research has suggested that the NOTCH variants could be found frequently even in the general population. The main clinical features included recurrent stroke, migraine, psychiatric symptoms, and progressive cognitive decline. On brain magnetic resonance imaging, patients with CADASIL showed multifocal white matter hyperintensity lesions, lacunar infarcts, microbleeds, and brain atrophy. Among them, lacunar infarcts and brain atrophy are important in predicting the clinical outcomes of patients with CADASIL. In the Jeju National University Hospital, we have diagnosed 213 CADASIL patients from 2004 to 2020. Most NOTCH3 mutations were located in exon 11 (94.4%), and p.Arg544Cys was the most common mutation. The mean age at diagnosis was 61.0±12.8 years. The most common presenting symptoms were ischemic stroke (24.4%), followed by cognitive impairment(15.0%), headache (8.9%), and dizziness(8.0%). Although the exact prevalence of CADASIL in Jeju is still unknown, the disease prevalence could be as high as 1% of the population considering the prevalence reported in Taiwan. Therefore, it is necessary to discover efficient biomarkers and genetic tests that can accurately screen and diagnose patients suspected of having CADASIL in this region. Ultimately, it is urgent to explore the exact pathogenesis of the disease to identify leading substances of treatment potential, and for this, multi-disciplinary research through active support from the Jeju provincial government as well as the national government is essential.