• Title/Summary/Keyword: 신경인지장애

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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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Correlation of the Neuropsychological Screening Battery (NSB) and Neuroanatomy for the Parkinson's Disease with Mild Cognitive Impairment by Using the Analysis of Cerebral Cortex Thickness in the Brain MRI (뇌 자기공명영상에서 대뇌 피질 두께 분석법을 이용한 파킨슨병의 경도인지장애 신경심리검사와 신경해부학적 상관관계)

  • Lee, Hyeonyong;Park, Hyonghu;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.4
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    • pp.163-170
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    • 2014
  • This study is to investigate neuro-anatomical correlation between neuropsychological results and cerebral cortex thickness of cognitive ability in the brain MRI targeting the patients with mild cognitive impairment. It was that 78 people who were diagnosed as first Parkinson's disease followed by neuropsychological screening battery(Parkinson's disease with mild cognitive impairment: 39 people; Parkinson's disease with normal cognition: 39 people) and 32 people of normal group were selected. Correlation between mild cognitive impairment and normal cognitive impairment and correlation between neuropsychological screening battery and cerebral cortex thickness in the brain MRI were performed by independent sample t-test or Pearson correlation coefficient and then level of significance of collected data was verified in p<0.05. As a result, cerebral cortex thickness of the Parkinson's disease with mild cognitive impairment in both side precuneas and right inferiortemporal lobe had statistically significant decrease. In addition, function of visuospatial ability, verbal and visual memory was reduced in neuropsychological screening battery for cognitive assessment. Especially, there was correlation between neuropsychological screening battery of verbal and visual memory anatomical left precuneus.

Prediction of Cognitive Impairment Using Blood Gene Expression Based on Machine Learning (혈액 유전자 발현을 이용한 기계학습 기반 인지장애 예측)

  • Lee, Seungeun;Zhou, Yu;Kang, Kyungtae
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2022.07a
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    • pp.61-62
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    • 2022
  • 알츠하이머성 치매는 현존하는 치료법이 없어 경도인지장애 단계에서의 예방이 중요하다. 지금까지의 알츠하이머 연구는 대부분이 뇌영상 마커와 뇌척수액 마커에 집중되어 있었으며, 경도 인지 장애 단계에서의 탐색은 더욱 적었다. 이러한 점에서 혈액 유전자 발현을 이용한 경도 인지장애 단계 예측은 인지 능력에 따른 관련 유전자 식별과 접근 가능한 진단 및 치료 바이오 마커 탐색에 기여할 수 있다. 그러나 유전자 발현 데이터의 경우 환자 수에 비해 높은 차원을 가지기 때문에 과적합을 막고 질병 관련 유전자를 식별하기 위해서는 데이터에서의 의미 있는 차원만을 뽑아내는 차원 축소가 선행되야 한다. 본 연구는 유전자 발현데이터에서의 인지장애 분류를 위해 차원 축소기법과 신경망을 적용하여 인지 장애 정도를 예측하였다. 그 결과, Lasso 이용 차원축소와 신경망을 이용하여 97%의 정확도로 정상과 조기 경도 인지장애, 후기 경도 인지장애 환자를 분류 할 수 있었으며, 더 적은 차원에서도 분류가 가능했다. 이는 혈액 유전자 발현을 이용해 경도 인지장애 단계를 예측한 첫 번째 연구이며, 인지능력 저하에 따른 혈액 유전자 발현의 연관성을 확인하고 향후 조기 진단, 치료 표적 탐색에 기여한다.

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Correlation between the Seoul Neuropsychological Screening Battery of the Parkinson's Disease Patient with Mild Cognitive Impairment and Change of the Cerebral Ventricle Volume in the Brain MRI (경도인지장애를 동반한 파킨슨병 환자의 서울신경심리검사와 뇌 자기공명영상에서 뇌실 체적 변화에 대한 상관관계)

  • Lee, Hyunyong;Kim, Hyeonjin;Im, Inchul;Lee, Jaeseung
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.231-240
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    • 2014
  • The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.

Cognitive Impairment in the Patients with Mildly Active Systemic Lupus Erythematosus (경증 전신성 홍반성 루프스 환자의 인지기능장애)

  • Kim, Jin-Hee;Lee, Chul;Lee, Chang-Uk;Paik, In-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.89-96
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    • 1997
  • This study was designed to determine whether cognitive impairment was evident in patients with SLE. Also, it aimed to examine the association of cognitive impairment with other clinical variables. The subjects consisted of 20 patients with mildly active SLE and 20 healthy controls. Methods : A total of 20 SLE patients and 20 normal controls completed a computerized neuropsychological test battery using Vienna Test System. These included Cognitrone test, Continuous attention test, Corsi block tapping test, Standard progressive matrices. Also, neuro-behavioral cognitive status examination was done. The symptom severity of depression was measured with Beck Depression Inventory, Hamilton Depression Rating Scale, and current medications were documented. Disease activity was rated using the SLE diasease activity index (SLEDAI). Results : SLE patients had poorer performance than normal controls on the tests of Cognitrone, attention, nonverbal IQ and memory, independent of age, education, disease activity, steroid use and depression status. Conclusion : Cognitive dysfunction was not uncommon in ambulatory SLE patients as measured by standardized neuropsychological tests. It seemed to occur independently of various clinical variables. These findings would suggest that cognitive dysfunction in SLE may be explained by reflecting subclinical central nervous system(CNS) involvement, rather than coexisting psychological distress due to chronic illness or side effect of medication.

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Association between Cognitive Function, Behavioral and Psychological Symptoms of Dementia and White Matter Hyperintensities in Patients with Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병 및 경도인지장애 환자에서 인지기능 및 행동심리증상과 백질고강도신호와의 연관성)

  • Kwon, Ji Woong;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.119-126
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    • 2018
  • Objectives : The aim of this study is to investigate correlation between degree of white matter hyperintensities (WMH) and neurocognitive function along with behavioral and psychological symptoms of dementia (BPSD) in Korean patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 115 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this retrospective study. WMH in brain MRI were rated with standardized visual rating scales (Fazekas scales) and the subjects were divided into two groups according to Fazekas scale. Cognitive function was evaluated with Korean version of the consortium to establish a registry for Alzheimer's Disease (CERAD-K), and BPSD was evaluated with Korean neuropsychiatric inventory (K-NPI). Independent t-test was performed to analyze the relationship between the degree of WMH and neurocognitive functions & BPSD. Results : Especially, the group with high severity of WMH showed significantly lower language fluency (p<0.05). In addition, the group with high severity of WMH showed significantly higher score in K-NPI. Conclusions : There was a significant association between WMH and neurocognitive test related with executive function. Moreover, WMH seems to affect BPSD severity. Evaluation of WMH would provide useful information in clinical settings.

Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

Assessment Tools of Cognitive-communicative Ability for Traumatic Brain Injury and Right Hemisphere Damage: A Review (외상성 뇌손상 및 우반구 손상 환자의 인지-의사소통 능력 평가도구에 관한 문헌 고찰)

  • Lee, Mi-Sook;Kim, Hyang-Hee
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.253-262
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    • 2011
  • Cognitive-communicative disorders after traumatic brain injury(TBI) and right hemisphere damage(RHD) are different from other neurological disorders in nature. Therefore, it is not desirable to use aphasia tests in evaluating individuals with TBI or RHD. The aim of this study is to review assessment protocols on TBI and RHD, and literature related with them. As a result, it is recommended that individuals with TBI be examined in scope of the cognition including attention, memory, organization, reasoning, as well as the functional communication. Similarly, it is useful to consider high-order language related to various cognitive domains in assessing cognitive-communicative ability after RHD. In conclusion, we need to focus on the overall cognitive-communicative domains in an evaluative process of TBI and RHD. Furthermore, it is necessary to develop multiple items for individuals with cognitivecommunicative disorders for the purpose of differentiating these heterogeneous groups from other neurological disorders such as aphasia, and of making good use of them as a therapeutic manual.

The Differences of Serum Homocysteine Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type with or without Depressive Symptoms (경도인지장애, 알쯔하이머형 치매 환자에서 우울증상 유무에 따른 혈중 호모시스테인의 차이)

  • Hwangbo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.40-45
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    • 2014
  • Objectives : Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. Methods : A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). Results : The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. Conclusions : These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.

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A Study on the Relationship between Cognitive Processes and Emotion Regulations in Depression and Anxiety Disorder: Focused on the Neurocognitive Networks (우울 및 불안 장애에서의 인지적 처리와 정서조절 고찰: 신경인지 연결망을 중심으로)

  • Kim, Choong-Myung
    • Journal of Industrial Convergence
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    • v.19 no.6
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    • pp.177-186
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    • 2021
  • This review aims to propose a model that can reinterpret the abnormal and functional connections between cognitive processes and emotional regulations based on the neurocognitive networks for a comprehensive understanding of pathologic processes and treatment approach of depression and anxiety disorder. Through the processes of rebuilding the network model for depression and anxiety disorder, it was confirmed that depression can be said to be 'over-immersion in self-referencing' due to hyper-activation of default mode network (DMN), and anxiety disorders to be 'disconnection with self-referencing' due to hypo-activation of DMN. The attempts to link up between abnormal activation and pathological function of DMN which is thought to be involved in self-referential processing associated with self-consciousness and projection among neurocognitive networks may be another starting point that can afford to be suggestive in integrated interpretation and therapeutic approach to depression and anxiety disorder.