• Title/Summary/Keyword: 신경심리 검사

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Nerve Blocks for Diagnosis and Prognosis of Chronic Pain (만성통증의 진단과 예후판정을 위한 신경차단)

  • Lee, Doo-Ik
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.173-181
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    • 1998
  • 감별신경차단이 주의깊은 병력 청취, 이학적검사, 신경학적검사를 대체할 수는 없으며 적절한 검사실 또는 심리학적 연구를 줄이는데 의도되서는 안된다. 그러나 이들의 진단적 노력에서도 환자 통증의 원인을 규명할 수 없고 따라서 적절한 치료를 지침해줄 수 없을 때 감별신경차단이 상당한 도움이 될 수 있다. 감별신경차단이 통상적인 진단방법의 결과와 다른 기전을 말해 줄 수 있으나 그런 결과들이 사전의 치료방법이 환자 통증의 제거 실패한 점을 설명해줄 수 있으며, 나아가 특이한 증후군에 대한 적절한 치료방법을 결정해줄 수 있다. 발표된 논문들을 기본으로 고찰한 바, 진단과 예후판정을 위한 도루로써의 신경차단의 이론적 배경을 위축시키는 많은 제한성들이 있음을 알 수 있다. 추가해서 이들 수기들은 임상적 유용성을 증명하기에는 미흡하다. 그러므로 이상적인 진단적 신경차단을 위해서는, 수기관리와 호과의 입증 뿐만 아니라 결과의 분석과 적용에 있어서도 주의가 필요하다. 연구자들은 어떤 경우들에 있어 이들 수기가 계속되는 치료의 지침에 도움이 되는 정보를 제공한다고 보고 있으며, 그러므로 수행자들의 축적된 판단을 조급하게 일축할 필요는 없다. 끝으로 만성통증의 진단적 분류가 혼동되고 복잡하기 때문에 비록 유효성의 증명이 미흡하지만 해부학적 및 생리학적 감각을 얻기 위해서는 진단적 차단의 선별적인 사용의 필요서을 합리화해주고 있다.

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STANDARDIZATION STUDY FOR THE KOREAN VERSION OF THE LURIA-NEBRASKA NEUROPSYCHOLOGICAL BATTERY FOR CHILDREN I : SCALE CONSTRUCTION, RELIABILITY & NORMS FOR THE KOREAN VERSION OF LNNB-C (한국판 아동용 Luria-Nebraska 신경심리 검사의 표준화 연구 I: 척도 제작, 신뢰도 및 뇌손상 진단을 위한 규준 산출)

  • Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.54-69
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    • 1994
  • The purpose of present study was to develop the Korean Version of Luria-Nebraska Neuropsychological Battery for Children(LNNB-C), to examine the reliability of it, and to establish the norms for determining the probability of brain damage. The normative group used to standardize the Korean version of LNNB-C was composed of 147 children between the age of 8 and 12(body 74, girl 73). The clinical group consisted of 19 brain damaged, 16 ADHD, and 16 psychiatric controls. The inter-scorer reliability was 96.3%, indicating that the stability of the scoring system for the Korean version of LNNB-C is good. The reliability coefficients(Cronbach's ${\alpha}$) of LNNB-C scales were ranged .51 to .91, which are similar to those of original LNNB-C. To establish the norms for detecting brain damage, the means and standard deviations for normative group were used to calculate T-scores for each scale. To determine a critical level that could successfully predict a normal child's average score at a given age, first the average score of normative group was calculated, and this score was then entered a regression equation with age to predict the average(baseline) acore. Finally, some issues on constructing the Korean version of LNNB-C and the cultural differences between Korean and American children in performing LNNB-C were discussed.

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Navigation Learning Ability and Visuospatial Functioning of Mild Cognitive Impairment Patients in Virtual Environments (경도인지장애환자의 가상환경 내 길찾기 학습능력과 시공간 기능에 관한 연구)

  • Park, Su-Mi;Lee, Jang-Han
    • 한국HCI학회:학술대회논문집
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    • 2008.02b
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    • pp.507-512
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    • 2008
  • This study investigated the navigation ability of patients with MCI in Virtual Environments(VE) and on the visual functioning. The participants consisted of elderly adults with/without MCI. Neuropsychological tests(RCFT, BVRT, TMT, and Digit Span), the Groton Maze Learning Test(12trials), and the VE navigation learning task(6 trials) were performed. As a result, there were significant group differences for the RCFT and BVRT, but not for the GMLT. For the VE task, there was a significant difference between the MCI and normal group and no interactions between the groups and trials were found. The VE task was correlated with The RCFT, the BVRT, and the GMLT and omnibus the RCFT and the BVRT accounted for 45% of VE performances. Thus, we concluded that patients with MCI are inferior to VE navigation and visual retention/memory play a role in navigation abilities.

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The Effect of Long-term Treatment with Clozapine on Cognitive Functions in Chronic Schizophrenic Patients (만성 정신분열증 환자의 인지기능에 미치는 Clozapine 장기치료의 효과)

  • Lee, Hong-Shick;Kim, Ji-Hyeon;Jeon, Ji-Yong;Jeong, Min-Jung
    • Korean Journal of Biological Psychiatry
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    • v.1 no.1
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    • pp.109-116
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    • 1994
  • It is not known whether negative symptoms and cognitive functions are dissociable or improvements in symptoms are reflected in improvements in cognitive functions in chronic schizophrenic patients. We administered clozapine to evaluate its effect on cognitive functions in chronic schizophrenic patients and to show correlations between improvement in psychotic symptoms and in cognitive functions. Neuropsychological tests such as Wisconsin Card Sorting Test, Digit Span test and Judgment of Line Orientation Test were applied to 16 chronic schizophrenic patients at baseline and after 9 months of treatment with clozapine. Using BPRS we assessed psychopathology before initiation of clozapine and at 9 months. Clozapine improved both positive and negative symptoms in chronic schizophrenic patients significantly. After nine months of clozapine treatment, significant improvements occurred in attention, short-term memory and visual perception ability. And interestingly we noted the trend of improvement in executive functions even though they were not statistical significant. Any significant correlations between the clinical improvement and change in congnitive functions were not observed. Long-term treatment with clozapine improved parts of cognitive functions of chronic schizophrenics. The results of the study suggest that deficits in simple cognitive functions as well as psychotic symptoms are improved after 3 month period of short-term treatment, but executive functions requiring more sophisticated processing of information could be improved after more than 9 months of long-term treatment.

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Neurocognitive Function Assessment of Traumatic Brain Injury (외상후 뇌손상의 신경인지기능 평가)

  • Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.177-185
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    • 1995
  • 외상후 뇌손상은 대표적이며, 가장 중요한 신경정신계 질환의 하나이다. 더욱이 외상후 뇌손상 환자들은 각종의 사고 및 산업재해 등으로 인해 그 수가 급증하고 있으며, 특히 인지기능의 장애로 인한 다양한 기질성 정신장애로 고통을 겪게 된다. 따라서 외상후 뇌손상은 손상의 시점에서부터 정확하고 올바른 평가는 물론 손상후의 경과 및 치료대책의 수립에 있어서 체계적이며 종합적인 신경인지기능의 평가는 필수적이다. 왜냐하면 신경인지기능평가는 뇌의 손상부위와 이와 관련된 기능장애 및 행동의 변화에 대한 객관적인 자료를 제시해 주기 때문이다. 신경인지기능 평가의 영역은 지각, 운동기능은 물론 주요인지기능인 기억, 언어, 실행 및 감정조절능력에 이르기까지 다양하며, 외상후 뇌손상환자들은 손상부위 및 정도에 따라 신경인지기능의 장애를 초래하게 된다. 대표적인 신경인지기능평가 도구로는 KWIS, Halstead-Reitan, Luria-Nebraska batteries, 특히 전두엽기능검사인 Wisconsin Card Sorting Test (WCST)를 비롯하여, 현재는 PC/S Vienna Test System 및 Stim등의 각종 전산화 인지기능검사가 개발되어 임상에서 활발히 사용되고 있다. 즉 외상후 뇌손상환자를 위한 신경인지기능평가의 목적은 뇌손상과 관련된 신경인지기능장애를 정확히 평가하여, 환자 개개인에 적합한 인지재활치료 계획을 수립하는데 있다. 물론 여기에는 신경정신상태검사(neuropsychiatric mental status examination)를 통하여 외상 후 뇌손상의 경과 및 예후에 결정적인 영향을 미칠 수 있는 나이, 의식소실 및 외상후 기억 손상 시간의 정확한 측정은 물론 심리 사회 문화적인 상태와 두부외상전 환자의 지적수준 및 사회 적용기능이 함께 평가되어야 할 것이다.

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Clinical Applications of Neuropsychological Tests in Psychiatry - Focused on Neurosis - (정신과 영역에서의 신경심리학 - 신 경 증 -)

  • Kim, Chan-Hyung;Lee, Sung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.2 no.2
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    • pp.129-132
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    • 1995
  • The goal of neuropsychological tests is to identify the neuropsychological dysfunction in psychiatric disorders such as organic mental disorders and schizophrenia, to develop the exe-cutive and monitor treatment plan and to make a cognitive rehabilitation program. Also, it will provide a more useful information that neurpsychological tests will be applied to neurotic out-patients in combination with conventional psychological test. However, many researches should be performed to further clarify the usefulness of neuropsychological test in neurosis.

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Biological Mechanism of Somatization : Mainly Focused on the Neuropsychological Model of Somatization (신체화의 생물학적 기전 : 신체화의 신경심리학적 모델을 중심으로)

  • Lee, Young-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.122-140
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    • 2000
  • Somatization disorder is a chronic condition characterized by multiple somatic complaints that are not due to any apparent organic illness. Somatization disorder is related historically to hysteria and hysteria has been defined by the existence of somatic complaints for which no organic reason can be found. Therefore most theories of somatization have focused on the psychodynamic and sociological perspectives. However, the concept that the somatic presentation of emotional distress or psychiatric illness might have a neurobiological basis has also aroused considerable interest. Relative to this perspective, the case of Anna O. which has been considered the prototype of hysteria, was reformulated from a neuropsychological perspective. Several neurophysiological and neuropsychological studies, studies concerning hemispheric differences in symptom presentation of the patients with hysteria have been shown the evidences for the biological basis of somatization. Moreover, recent neuroimaging studies in somatization disorder also show that brain dysfunction in somatization. The author reviewed several candidate theories which could help to explain the process of somatization in the perspective of biological basis and proposed the new neuropsychological model of somatization. The author also examined the possible application of this model to the treatment of somatization disorder and discussed it's limitation and the future directions in this field.

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Neuropsychological Approaches to Mathematical Learning Disabilities and Research on the Development of Diagnostic Test (신경심리학적 이론에 근거한 수학학습장애의 유형분류 및 심층진단검사의 개발을 위한 기초연구)

  • Kim, Yon-Mi
    • Education of Primary School Mathematics
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    • v.14 no.3
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    • pp.237-259
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    • 2011
  • Mathematics learning disabilities is a specific learning disorder affecting the normal acquisition of arithmetic and spatial skills. Reported prevalence rates range from 5 to 10 percent and show high rates of comorbid disabilities, such as dyslexia and ADHD. In this study, the characteristics and the causes of this disorder has been examined. The core cause of mathematics learning disabilities is not clear yet: it can come from general cognitive problems, or disorder of innate intuitive number module could be the cause. Recently, researchers try to subdivide mathematics learning disabilities as (1) semantic/memory type, (2) procedural/skill type, (3) visuospatial type, and (4) reasoning type. Each subtype is related to specific brain areas subserving mathematical cognition. Based on these findings, the author has performed a basic research to develop grade specific diagnostic tests: number processing test and math word problems for lower grades and comprehensive math knowledge tests for the upper grades. The results should help teachers to find out prior knowledge, specific weaknesses of students, and plan personalized intervention program. The author suggest diagnostic tests are organized into 6 components. They are number sense, conceptual knowledge, arithmetic facts retrieval, procedural skills, mathematical reasoning/word problem solving, and visuospatial perception tests. This grouping will also help the examiner to figure out the processing time for each component.

Decreased Attention in Narcolepsy Patients is not Related with Excessive Daytime Sleepiness (기면병 환자의 주의집중 저하와 주간졸음증 간의 상관관계 부재)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Lee, Yu-Jin;Lee, Ju-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.122-132
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    • 2005
  • Objectives: The objective of this study is to assess cognitive functions and their relationship with sleep symptoms in young narcoleptic patients. Methods: Eighteen young narcolepsy patients and 18 normal controls (age: 17-35 years old) were recruited. All narcolepsy patients had HLA $DQB_1$ *0602 allele and cataplexy. Several important areas of cognition were assessed by a battery of neuropsychological tests consisting of 13 tests: executive functions (e.g. cognitive set shifting, inhibition, and selective attention) through Wisconsin card sorting test, Trail Making A/B, Stroop test, Ruff test, Digit Symbol, Controlled Oral Word Association and Boston Naming Test; alertness and sustained attention through paced auditory serial addition test; verbal/nonverbal short-term memory and working memory through Digit Span and Spatial Span; visuospatial memory through Rey-Osterrieth complex figure test; verbal learning and memory through California verbal learning test; and fine motor activity through grooved pegboard test. Sleep symptoms in narcolepsy patients were assessed with Epworth sleepiness scale, Ullanlinna narcolepsy scale, multiple sleep latency test, and nocturnal polysomnography. Relationship between cognitive functions and sleep symptoms in narcolepsy patients was also explored. Results: Compared with normal controls, narcolepsy patients showed poor performance in paced auditory serial addition (2.0 s and 2.4 s), digit symbol tests, and spatial span (forward)(t=3.86, p<0.01; t=-2.47, p=0.02; t=-3.95, p<0.01; t=-2.22, p=0.03, respectively). There were no significant between-group differences in other neuropsychological tests. In addition, results of neuropsychological test in narcolepsy patients were not correlated with Epworth sleepiness scale score, Ullanlinna narcolepsy scale score and sleep variables in multiple sleep latency test or nocturnal polysomnography. Conclusion: The current findings suggest that young narcolepsy patients have impaired attention. In addition, impairment of attention in narcolepsy might not be solely due to sleep symptoms such as excessive daytime sleepiness.

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Neuropsychological Evaluation of Visual Perception and Construction (시지각 및 구성능력의 신경심리학적 평가)

  • Lee, Chang Uk;Oh, Byung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.24-28
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    • 1997
  • Visual perception is a complex process engaging many different aspects of brain functioning. Like other cognitive functions, the extensive cortical distribution and complexity of visual perceptional activites make them hihgly vulnerable to brain injury. Dectection and characterization of perceptual disorders require a careful clinical assessment as well as the application of selected neuropsychological tests. In this article we reviewed neuropsychological assessment of visual perception and constructional abilities. And the principal visuospatial disorders are discussed, the associated neuropsychiatric disorders are presented.

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