• Title/Summary/Keyword: 신경인지장애

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Long-Term Observations of Korean Medicine Treatment in Patients with Mild Cognitive Impairment: Two Case Reports (경도인지장애 환자의 장기간 한의약 치료 경과관찰 증례보고 2례)

  • Son, Sung-Eun;Lee, Go eun;Lee, Na-hyun;Lyu, Yeoung-Su;Cheong, Moon Joo;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.3
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    • pp.285-302
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    • 2021
  • Objectives: To examine the effect of long-term Korean medicine treatment on mild cognitive impairment (MCI). Methods: This study was conducted on two patients who were diagnosed with mild cognitive impairment and received long-term Korean medicine treatment. In order to evaluate the degree of cognitive decline, SNSB and K-MMSE were performed 2~3 times at the first visit and during the treatment process. Results: Both cases 1 and 2 were diagnosed with MCI with a high possibility of developing dementia. In case 1, MCI progressed to early dementia at one year after the diagnosis of MCI. However, in case 2, that MCI status was maintained without progressing to dementia for 4 years after the diagnosis of MCI. The cause of such difference in the course of MCI might be attributed to the fact that Case 1 had lower K-IADL level but higher SGDS level than Case 2 at the time of initial diagnosis, with weak family support and irregular herbal medicine intake. Conclusions: Korean medicine treatment could improve and manage symptoms of cognitive decline due to MCI.

Effects of Semi-structured DIRFloortime® Therapy Using Board Games on Verbal Comprehension and Processing Speed Index in Children With High Functioning Autism Spectrum Disorders (보드 게임을 활용한 반 구조화된 DIRFloortime® 치료가 고기능 자폐스펙트럼 장애 아동의 언어 이해 및 정보처리 지표 기능향상에 미치는 효과)

  • Chung, Hee-Seung
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.35-44
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    • 2018
  • This study was conducted to explore the effects of semi-structured $DIRFloortime^{(R)}$ treatment on the enhancement of language comprehension and information processing of children with high-performance autistic spectrum disabilities. We measured the general characteristics of the test subjects, which are level of autism, total intelligence, language comprehension and information processing indicators. The intervention method used was a semi-structured $DIRFloortime^{(R)}$ therapy using board game intervention program after revising and supplementing the expert content validity. A pre/post-test for a group was designed as a similar experiment and the pre/post test was initiated with the t certification at .05 of significance level. After initiating the program, the post test has shown that the language comprehension indicators showed statistically significant levels of difference (p<.001) and the information processing indicator also had a statistically significant effect (p<.001). There was a statistically significant difference (p<.001) in the level of verbal comprehension index after the program implementation, and statistically significant differences in the information processing index (p<.001). The semi-structured $DIRFloortime^{(R)}$ treatment using boardgames for enhancing the language comprehension and information processing indicators of children with high performance autistic spectrum disorder had a significant effect.

NEUROPSYCHIATRIC SEQUELAE AND ITS EVALUATION IN CHILDREN AND ADOLESCENTS WITH TRAUMATIC BRAIN INJURY (외상성 뇌손상 아동의 신경정신과적 후유증 평가)

  • Kim, Hae-Gyoung;Bhang, Hyung-Suk;Park, Gwang-Soo;Wang, Mi-Rhan;Min, Seong-Ho;Park, Ki-Chang;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.212-219
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    • 1999
  • Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

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Neurocognitive Dysfunction in Patients with Obsessive-Compulsive Disorder in Association of Duration of Untreated Illness : A Preliminary Study (강박장애의 치료받지 않은 유병기간에 따른 신경인지기능 이상 : 예비연구)

  • Oh, Sang Hoon;Kim, Sung Nyun;Han, Jaewook;Lee, Junhee;Lee, Tae Young;Shin, Min-Sup;Kwon, Jun Soo
    • Korean Journal of Biological Psychiatry
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    • v.24 no.2
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    • pp.75-81
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    • 2017
  • Objectives Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. Methods Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. Results Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. Conclusions Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.

Platelets as a Source of Peripheral Aβ Production and Its Potential as a Blood-based Biomarker for Alzheimer's Disease (말초 아밀로이드 베타 원천으로서의 혈소판과 알츠하이머병의 혈액 바이오마커로서의 가능성)

  • Kang, Jae Seon;Choi, Yun-Sik
    • Journal of Life Science
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    • v.30 no.12
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    • pp.1118-1127
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    • 2020
  • Alzheimer's disease causes progressive neuronal loss that leads to cognitive disturbances. It is not currently curable, and there is no way to stop its progression. However, since medical treatment for Alzheimer's disease is most effective in the early stages, early detection can provide the best chance for symptom management. Biomarkers for the diagnosis of Alzheimer's disease include amyloid β (Aβ) deposition, pathologic tau, and neurodegeneration. Aβ deposition and phosphorylated tau can be detected by cerebrospinal fluid (CSF) analysis or positron emission tomography (PET). However, CSF sampling is quite invasive, and PET analysis needs specialized and expensive equipment. During the last decades, blood-based biomarker analysis has been studied to develop fast and minimally invasive biomarker analysis method. And one of the remarkable findings is the involvement of platelets as a primary source of Aβ in plasma. Aβ can be transported across the blood - brain barrier, creating an equilibrium of Aβ levels between the brain and blood under normal condition. Interestingly, a number of clinical studies have unequivocally demonstrated that plasma Aβ42/Aβ40 ratios are reduced in mild cognitive impairment and Alzheimer's disease. Together, these recent findings may lead to the development of a fast and minimally invasive early diagnostic approach to Alzheimer's disease. In this review, we summarize recent advances in the biomarkers of Alzheimer's disease, especially the involvement of platelets as a source of peripheral Aβ production and its potential as a blood-based biomarker.

Influences of the Global Deterioration Scale according to Routine Blood Chemistry Results (통상적 혈액화학 결과에서 전반적 퇴화 척도의 영향성)

  • Kim, Sun-Gyu;Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.3
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    • pp.351-359
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    • 2019
  • Neurocognitive testing commonly uses the MMSE (Mini-Mental State Examination) to evaluate the overall cognitive function of patients at outpatient clinics, but the MMSE has recently been extensively used in the SNSB II (Seoul Neuropsychological Screening Battery II) for making diagnoses. We retrospectively investigated the results of routine neurocognitive tests and the results of the blood tests of 120 elderly patients who had been referred to a South Central Medical Center from 2017 to 2018 and who had been examined at a public health center. These subjects' space-time capability was high on the sub-region of the global deterioration scale (GDS). GDS showed a significant increase as the Na decreased on the electrolyte analysis. The subjects' concentration, their language-based orientation for space and time, their memory, and their scores for the frontal lobe function on GDS showed statistically significant reductions (P<0.001) For the normal and abnormal groups according to the ALT and creatinine levels, the frontal/execute function areas showed statistically significant differences (P<0.001) as well as negative correlation between GDS and ALT (P<0.01). In conclusion, this study provides basic information to develop test items that are important for patient screening and diagnosis, and several routine blood chemistry factors provide basic information for diagnosing and assessing the status and progress of cognitively impaired patients.

Evaluation of Cognitive Functions in Patients with Narcolepsy (기면병 환자의 인지기능 평가)

  • Jin, You-Yang;Yoon, Jin-Sang;Chung, Eun-Kyung
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.97-107
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    • 2013
  • Objective: This study aimed to evaluate attention, memory and executive function in patients with narcolepsy. Methods: This study included 23 narcoleptic patients whose diagnosis were confirmed by the International Classification of Sleep Disorders(ICSD) at Chonnam National University Hospital Sleep Disorders Clinic or an other hospital in Korea, from 2005 to 2008, as well as 23 normal controls. All participants were given an IQ test for Korean-Wechsler Adult Intelligence Scale and several neuropsychological function tests (the d2 test for attention function, the Rey Complex Figure Test for nonverbal memory, the Korean-California Verbal Learning Test [K-CVLT] for verbal memory, and the Wisconsin Card Sorting Test for executive function). Clinical features of narcoleptic patients, including the frequency of excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucination, were investigated by a structured clinical interview administered by a neuropsychiatist. Excessive daytime sleepiness was evaluated by the Epworth sleepiness scale. Results: Characteristic symptoms of narcolepsy observed in this study included excessive daytime sleepiness (n=23, 100.0%), cataplexy (n=19, 82.6%), hypnagogic hallucination (n=5, 21.7%) and sleep paralysis (n=12, 52.2%). In nocturnal polysomnographic findings, stage 2 sleep and REM latency were found to be significantly decreased in narcoleptic patients compared with the control group, and were accompanied by significant increases in stage 1 sleep. Narcoleptic patients had lower scores than the control group on total number, Total Number-Total Error, Concentration Performance and Fluctuation Rate on the d2 test, which measures attention. Also, there were significant differences between the performance of patient and control groups on the B list of the K-CVLT, which measures verbal memory. Conclusion: Narcoleptic patients showed decreased attention and verbal memory performance compared to the control group; however, in many areas, narcoleptic patients still demonstrated normal cognitive function.

An event-related potential study of global-local visual perception in female college students with binge drinking (폭음 여자대학생의 전체-세부 시지각 처리에 관한 사건관련전위 연구)

  • So-yeon Lim;Myung-Sun Kim
    • Korean Journal of Cognitive Science
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    • v.34 no.2
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    • pp.111-151
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    • 2023
  • It is reported that binge drinkers show cognitive impairment similar to alcohol use disorder patients. A previous studies using neuropsychological tests and brain imaging techniques to investigate the visual perception of alcohol use disorder patients reported that they had global-local visual perception defects. Although the neurological basis for the global-local visual perception deficit in the heavy drinking group has been presented, there are no studies to date that have investigated the global-local visual perception in the heavy drinking group. This study investigated local-biased visual perception in female college students with binge drinking (BD) using event-related potentials (ERPs). Based on the scores of the Korean version of Alcohol Use Disorder Identification Test and the Alcohol Use Questionnaire, participants were assigned into BD (n=25) and non-BD (n=25) groups. Local-global visual processing was assessed using a local-global paradigm, in which large stimuli (global level) composed of small stimuli (local level) were presented. The stimuli presented at global and local levels were either congruent or incongruent. The behavioral results exhibited that the BD and non-BD groups did not differ in terms of accuracy and response time. In terms of ERPs, the BD and non-BD groups did not show difference in N100, P150 and N200 amplitude. However, the BD group showed significantly smaller P300 amplitude than non-BD group especially in the local condition. In addition, a negative correlation between P300 amplitude and binge drinking score was observed, i.e., severer binge drinking smaller P300 amplitude. The P300 is known to reflect cognitive inhibition and attentional allocation. In the global-local paradigm, the local condition required to attend to local target while ignoring global non-target. Therefore, the present results indicate that female college students with BD do not have local-biased visual processing, instead they seem to have difficulties in inhibition of irrelevant stimuli.

CHILDHOOD ONSET SCHIZOPHRENIA IN DEVELOPMENTAL ASPECT (소아 정신분열병의 발달학적 측면)

  • Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.173-182
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    • 2005
  • This review is a clinical and research update of recent literature related to childhood onset schizophrenia (with an onset of psychosis by age 12). Childhood onset schizophrenia(COS) is a rare disorder, but that may represent a more homogeneous patient population in which to search for risk or etiologic factors of schizophrenia. These overview data show that COS shares the same clinical and neurobiological features as later onset forms of the disorder. Compared with later onset schizophrenia, however, this subgroup of patients appear to have more severe premorbid neurodevelopmental abnormalities, more cytogenic abnormalies, poor outcome, and potentially greater family histories of schizophrenia and associated spectrum disorders. Future studies of this subgroup may provide important clues as to the genetic basis for schizophrenia and how gene products influence certain feature of the disease, such as age of onset and mode of inheritance.

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Survey for Needs of Bio-Signal Devices for the Diagnosis, Assessment, or Analysis of Neurocognitive Disorder in Korean Society of Oriental Neuropsychiatry (인지 장애 진단·평가·분석을 위한 생체신호 장비 개발에 대한 수요조사: 한방신경정신과학회 회원들을 대상으로)

  • Choi, Yujin;Kim, Ji Hye;Kim, Kahye;Kim, Jaeuk
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.2
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    • pp.89-99
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    • 2020
  • Objectives: The purpose of this study was to identify the needs of bio-signal devices for the diagnosis, assessment, and analysis of neurocognitive disorder in Korean medicine (KM) hospitals and clinics. Methods: A questionnaire was developed to survey the current status of medical device use, and diagnosis and interventions for patients with cognitive disorders in KM hospitals and clinics. November 11~December 2, 2019, 114 responses (71.9% completed) were collected by internet-based questionnaires from the members of the Korean society of Oriental Neuropsychiatry. Results: The clinical requests were in the descending order of hematology analyzer, ultrasound imaging system, and electroencephalography among the 15 most commonly used devices of which research would support for their clinical usability. The biosignal-based devices showed the highest research demands for patients with mild cognitive impairment rather than more severe stages of cognitive impairment. Prevention rather than diagnosis, or several treatment regimens was the strongest clinical area of the KM for patients with neurodegenerative cognitive impairment. Many responded that five to 10 minutes of test duration and 20,000 won to 30,000 won of cost would be appropriated for a new device to be developed. Conclusions: There were strong demands for the development of bio-signal devices for neurocognitive disorders among the KM doctors. Specifically, it showed high needs for the technology that can be used in the prevention area of cognitive disorders. Additionally, new medical devices to assess cognitive functions and to obtain KM pattern-related information were the high needs.