• 대한통합의학회지
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• 제8권4호
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• pp.213-221
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• 2020

Purpose : This study aimed to evaluate the changes in visual perception and daily life activities after simultaneously applying the visual perception training program and transcranial DC stimulation. Particularly, this study tried to understand what changes in abilities among daily life activities influenced cognition. Methods : This study selected 50 dementia patients to achieve the objective. This study applied transcranial DC stimulation and a visual perception training program to a treatment group (n=25) and a visual perception training program to a control group (n=25). The intervention was applied five times per week and 30 minutes per session (total of 30 intervention sessions). This study measured visual perception functions and daily life activities using MVPT and FIM before and after applying the intervention. Results : The visual perception, mobility of daily life activities, cognition, and total score of the treatment group (n=25), which received the visual perception training program and transcranial DC at the same time, were significantly (p<.05) different between before and after the intervention. Moreover, when the visual perception and daily life activities of the treatment group and those of the control group after implementing the intervention were compared, they were significantly (p<.05) different between the two groups. Conclusion : The results of this study showed that the simultaneous application of the visual perception training program and transcranial DC stimulation was an effective means to enhance the visual perception and daily life activities of dementia patients. The results implied that transcranial DC stimulation, as well as the application of visual perception training program, as well as a visual perception training program, was effective for improving the visual perception functions and daily life activities dementia patients and simultaneous application of the two interventions would increase the effect even further.

• 대한통합의학회지
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• 제10권2호
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• pp.105-113
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• 2022

Purpose: The purpose of this study is to investigate the effect of non-invasive transcranial direct current stimulation (tDCS) on muscle activity, including 10 m WT, TUG, and BBS, in hemiplegic stroke patients. Methods: This study was conducted on 42 inpatients diagnosed with hemiplegia due to stroke at hospital B in Daejeon for more than 6 months. Walking training was conducted for six weeks, five times a week for 30 minutes, with a general walking group (14 people), tDCS walking group (14 people), and tDCS (sham) walking group (14 people). Results: As a result of the study, the change in the muscle activity before and after tDCS intervention was significantly increased in the tibialis anterior muscle in the CG group. In the EG group, the erector spine (lumbar), rectus femoris, and tibialis anterior muscles significantly increased. In the SEG group, significant increases were observed in the rectus femoris and tibialis anterior muscles. Significant differences were found in the rectus femoris and tibialis anterior muscles in the comparison between groups after intervention according to tDCS application. Also, 10 m WT, TUG, and BBS were significantly increased in the CG, EG, and SEG groups after intervention, and there were significant differences in 10 m WT, TUG, and BBS in comparison between groups after intervention according to tDCS application. Conclusion: As a result, tDCS is an effective in improving the walking ability of stroke patients, and in particular, it effectively increases the muscle activity of the rectus femoris and tibialis anterior muscles, which act directly on walking, and also improves the speed and stability of walking. It is considered being an effective method to increase the gait of stroke patients by combining it with the existing gait training.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.79-87
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• 2022

Background: The purpose of this study was to examine the effect of transcranial direct current stimulation (tDCS) on the pain and balance of patients who receive total knee arthroplasty (TKA). Methods: This study subjects were 24 patients in Hospital T, located in Daegu, South Korea who received TKA after being diagnosed with degenerative arthritis. The subjects were randomly divided into and experimental group and a control group, with each group including 12 patients. Both group received superfical thermal therapy, interferential current therapy (ICT), and continue passive motion (CPM), which are conventional knee therapy on the knee joint. The experimental group received the tDCS treatment three times a week for three weeks, from October 1st to October 20th. The visual analogue scale and Wii Balance Board system were used to measure the pain and balancing ability, respectively, of both groups. In the statistical result analysis, to compare about pre and post test difference in each groups was accomplished. Statistical analysis of independent t-test and paired t-test were conducted using SPSS version 23.0. Results: After three weeks of intervation, there were significantly difference in balance ability in pre and post test in the tDCS group. VAS decreased significantly in both groups(p<.05), There was a significantly difference in pain, balance ability in the tDCS group compared to the sham group. Conclusion: These results indicate that applying tDCS together with conventional knee joint therapy for TKA patients is effective in promoting the patients' recovery.

• 대한통합의학회지
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• 제11권1호
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• pp.53-62
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• 2023

Purpose : This study evaluated the effects of transcranial direct current stimulation and a virtual reality program on the depression, hand functions, cognitive function, and activities of daily living of patients with mild cognitive impairment by dividing 20 patients with mild cognitive impairment and depression. The 20 patients were divided into a treatment group (transcranial direct current stimulation + a virtual reality program) and a control group (placebo transcranial direct current stimulation + a placebo virtual reality program). Methods : This study allocated ten subjects to the treatment group and ten subjects to the control group. The treatment was given five times per week for six weeks (30 sessions), and each session was 30 minutes. This study screened depression by using SGDS-K, a short geriatric depression scale, to examine depression before and after treatment intervention. This study also used the box and block test, NCSE, and FIM to evaluate hand functions, cognitive function, and activities of daily living, respectively. Results : The results showed that depression significantly decreased, hand functions significantly increased, cognitive function significantly improved, and activities of daily living significantly increased after intervention in the treatment and control groups. The magnitude of changes in depression, hand functions, cognitive function, and activities of daily living was significantly different between the two groups after intervention (p>.05). Conclusion : The results showed that the application of transcranial direct current stimulation and a virtual reality program could improve cognitive function, hand functions, and activities of daily living by decreasing depression. Therefore, it can be concluded that the simultaneous application of transcranial direct current stimulation and a virtual reality program is an intervention method, which can be applied for decreasing depression, enhancing hand functions, improving cognitive function, and increasing activities of daily living in patients with mild cognitive impairment.

• 인지과학
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• 제26권4호
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• pp.393-433
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• 2015

창의성은 독창적이고 유용한 아이디어를 산출할 수 있는 능력을 말한다. 현대 사회의 많은 문제들을 해결하고 인류의 복지를 증진시키기 위해 창의성의 기전을 이해하고 이를 증진할 수 있는 방안에 대한 연구는 매우 중요하다. 창의성은 매우 이질적이고 복합적인 능력으로서 이를 하나의 능력으로 개념화하는 것은 적절하지 않다. 따라서 학계에서는 창의성의 개별 구성 요소를 중심으로 창의성의 기전에 대한 연구가 활발하게 이루어지고 있다. 본 개관 연구에서는 창의성의 주요한 구성 요소인 확산적 사고, 통찰, 관계적 사고 그리고 예술적 창의성에 대한 인지신경과학 연구들을 소개한다. 여러 연구 결과를 종합적으로 고려한 결과, 창의성의 인지신경학적 기전과 관련하여 우반구가 좌반구보다 우세하다는 가설은 실험적 증거에 의해 지지되지 않았다. 또한, 창의성과 관련하여 특정 뇌 영역의 중요성이 일관되게 보고되고 있지 않으며, 다양한 뇌 영역의 활동성이 창의성과 관계된다는 연구 결과가 혼재하고 있다. 이러한 상이한 연구 결과가 관찰되는 이유는 창의성의 각 구성 요소의 이질성 뿐 아니라, 연구에 사용된 과제의 특수성과 과제에 의해 유발된 인지적 전략의 차이에 의해 뇌 활동이 달라지기 때문인 것으로 해석할 수 있다. 본 개관 연구에서는 창의성의 요소 별 뇌기반과 창의성의 증진에 대하여 우수한 연구 방법을 사용하여 탁월한 연구 성과를 이룬 대표적인 사례들을 소개하고 현행 연구들의 제한점과 후속 연구의 방향을 제시한다.

• 의료법학
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• 제21권2호
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• pp.209-244
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• 2020

TMS와 tDCS는 자기와 전류를 통하여 뇌에 자극을 가함으로서 환자나 개별 이용자의 질병을 치료하고, 이외에도 건강을 관리하거나 증진시킬 수 있는 비침습적 기기를 말한다. 이들 기기의 효과와 안전성은 몇몇 질병에서 입증되고 있으나, 아직도 이에 대한 연구는 진행 중이다. 점차 증가하고 있는 이들 기기의 활용도에 비해 TMS와 tDCS를 직접 규율하는 입법례를 찾기는 어렵다. 미국, 독일, 일본의 TMS와 tDCS에 대한 법적 규율을 살펴보면, TMS는 중등도의 위해도를 가진 의료기기로 승인되어 있는 반면, tDCS는 아직 의료기기로 승인된 상태는 아니다. 하지만, 최근 FDA 가이드집이나 유럽 MDR 규정의 변화, 미국의 리콜사례, 독일과 일본의 관련 법 규정, 전문가 그룹의 제언 등을 검토하면, tDCS도 조만간 의료기기로 승인되어 규율될 것으로 보인다. 물론, tDCS를 의료기기가 아닌 일반제품으로 보더라도 다른 법률과 제도를 통하여 제품의 안전성과 효과를 규제할 수는 있다. 그러나 이 기기가 인간의 뇌에 미칠 수 있는 여러 영향을 고려할 때, 이를 독자적으로 규율할 필요성이 크다. 우리도 TMS와 tDCS를 규율하는 명시적 법률은 없으나, 이 두 기기는 식약처 고시에 따라 3등급 의료기기로 판정된다. 그리고 TMS는 가이드 라인에 따라 미국 FDA 지침에 의해 안전성과 성능을 평가하도록 하고 있다. 하지만, tDCS는 아직 이에 대한 구체적 지침은 존재하지 않는다. tDCS 기기가 일부 병원에서, 그리고 개별 구매자를 통하여 가정에서 사용되고 있는 현실을 고려하면, 이러한 규제의 공백은 신속히 보완되어야 한다. 장기적으로는 비침습적 뇌자극기기를 독자적으로 규율할 수 있는 법적 시스템의 정비가 필요하다.

• Journal of Sleep Medicine
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• 제15권2호
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• pp.37-42
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• 2018

Objectives: To assess the effect and safety of transcranial direct-current stimulation (tDCS) in primary chronic insomnia. Methods: A one-month, double-blind, randomized, sham-controlled trial was performed. A total of 7 patients with primary chronic insomnia received tDCS using anodal (n=3), cathodal (n=2), or sham stimulation (n=2). They were followed up at 1 week and 1 month after treatment. The primary outcome measures included improvement in total sleep time (TST), sleep latency (SL), and sleep efficiency (SE) at 1 month follow-up. Results: TST and SE were improved with tDCS at 1 month follow-up in all patients (100%) of the anodal group, one (50%) of the cathodal group, and one (50%) of the sham group. tDCS improved SL at 1 month follow-up in two patients (67%) of the anodal group, one (50%) of the cathodal group, and none (0%) of the sham group. With respect to adverse events, transient itching sensation occurred in one patient of the anodal group. None of the other groups reported adverse events. Conclusions: Our results suggest that tDCS may be effective and safe for treatment of primary chronic insomnia. A larger controlled study needs to be further investigated.

• 한국운동역학회지
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• 제32권3호
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• pp.94-102
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• 2022

Objective: The purpose of this study was to investigate the effect of acute transcranial direct current stimulation (tDCS) on the isokinetic muscular endurance of the lower extremity for young adults. Method: Thirteen young adults performed isokinetic fatigue tasks for two experimental conditions including real tDCS and sham stimulation protocols. Before and after the task, the tensiomyography was used for evaluating muscle contraction characteristics of vastus medialis and semitendinosus. Paired t-test was performed to compare the fatigue index, changes in maximum radial displacement (∆Dm), delay time (∆Tc), and velocity of contraction (∆Vc) between tDCS conditions. Results: We found no significant differences in the fatigue index between real and sham conditions. In addition, the analyses identified no significant different values of ∆Dm, ∆Tc, and ∆Vc in the vastus medialis and semitendinosus between real and sham conditions. Conclusion: These findings suggest that the tDCS protocols may have no acute effect on lower limb muscle endurance for young adults. Future studies should consider the long-term effects of repetitive tDCS sessions, various stimulation positions, exercise tasks, and participant characteristics to more clearly understand the effect of tDCS on muscle endurance of lower extremities.

• 대한통합의학회지
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• 제9권3호
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• pp.87-97
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• 2021

Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.