• The Korean Journal of Nuclear Medicine
• /
• v.36 no.4
• /
• pp.232-243
• /
• 2002

Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

• Korean Journal of Psychosomatic Medicine
• /
• v.9 no.1
• /
• pp.37-48
• /
• 2001

Objectives : The purpose of this study was to evaluate the difference of psychometric analysis among patients with Post-traumatic organic mental disorder according to the lesion of MRI finding of traumatic brain injury. Methods : We divided 35 patients into 4 groups according to the lesion of MRI finding of brain injury. We evaluated the difference of the subscales of MMPI and K-WAIS among 4 groups with Post-traumatic organic mental disorder by ANOVA. Results : We found no significant difference of all subscales of MMPI and K -WAIS among 4 groups by ANOVA. Compared Rt hemispheric injury group with Lt hemispheric injury group by independent t-test, the depression scale in MMPI scored significantly higher in Lt hemispheric injury group, and the block design in K-WAIS scored significantly lower in Rt hemispheric injury group. Conclusion : This study suggests that Lt hemispheric injury be significantly related to depression, and Rt hemispheric injury be significantly related to visuospatial ability.

• Journal of Korean Society of Neurocognitive Rehabilitation
• /
• v.10 no.2
• /
• pp.9-18
• /
• 2018

The research has sought to examine the effect of cognition training using smart device application games on the cognition function of traumatic brain injury patients. The research was conducted to the seventeen traumatic brain injury patients with slight symptoms who were treated with occupational therapy. The patients were divided into the two groups, nine for the experimental group and eight for the control group. The experimental group was assigned to conduct cognition training using smart device application games and traditional cognition training for fifteen minutes each, and the control group has conducted the traditional cognition training for 30 minutes. All arbitrations were conducted for 30 minutes a day, five times a week and for four weeks. To assess the cognitive function, Korean Mini-Mental State Examination (K-MMSE), Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and visual memory 1 and 2 of Motor-free Visual Perception Test-3 (MVPT-3) were measured before and after the intervention. In the comparison of the change between the two groups, the experimental groups showed a significant improvement in the visual memory of Motor-free Visual Perception Test-3 and remembrance section of the Korean Mini-Mental State Examination (p<.05). The result of this research has confirmed that the cognition training using the smart device application game can make the positive change to the visual memory of the traumatic brain injury patients more than the traditional cognition training.

• Journal of Music and Human Behavior
• /
• v.12 no.2
• /
• pp.19-36
• /
• 2015

The purpose of this study was to examine the effects of rhythmic auditory stimulation (RAS) on gait parameters, with and without the presence of a melody, for adolescents with traumatic brain injury (TBI). Three adolescents with TBI received a total of ten individual RAS training sessions. At pre and posttest, spatiotemporal parameters including cadence, velocity and kinematic parameters were measured using the VICON 370 Motion Analysis System. The results showed no significant difference in gait velocity between the two conditions, thus the presence of the melody condition did not impact the outcome of RAS gait training. On the other hand, all participants showed improvement in gait function after RAS training. The cadence, velocity, stride length, and symmetry were increased and the stride time was reduced after training. The motion analysis demonstrated that the movement patterns of hip and knee joints improved, as they were more similar to normal gait, which indicates that the walkings tance became more stable. The research findings indicate that rhythm is the primary factor in mediating gait functions via RAS training. This study also supports that RAS training can effectively improve the gait function for adolescents with TBI.

• The Journal of the Korea Contents Association
• /
• v.9 no.1
• /
• pp.348-358
• /
• 2009

Diffuse axonal injury(DAI) is a common form of traumatic brain injury and thought to be a major contributor to cognitive dysfunction. Physical activity has been shown to beneficial effects on physical health and influences in hippocampus which is an important location for memory and learning. The purpose of this study was to investigate the effect of motor training on motor performance and axonal regeneration in hippocampus through the immunoreactivity of GAP-43 after diffuse axonal injury in the rats. The experimental groups were applied motor training(beam-walking, rotarod, and Morris water maze) but control groups were not. The time performing the motor tasks and GAP-43 immunohistochemistry were used for the result of axonal recovery. There were meaningful differences between experimental groups and control groups on motor performance and GAP-43 immunohistochemistry. The control groups showed increasing tendency with the lapse of time, but experimental groups showed higher. Therefore, Motor training after DAI improve motor outcomes which are associated with dynamically altered immunoreactivity of GAP-43 in axonal injury regions, particularly hippocampus, and that is related with axonal regeneration.

• Progress in Medical Physics
• /
• v.14 no.4
• /
• pp.259-267
• /
• 2003

In vivo $^1$H magnetic resonance spectroscopy (MRS) at 4.7 T was applied to investigate the cerebral metabolite changes of mice brain before and after experimental brain trauma. In vivo $^1$H MR spectra were acquired from a voxel covering right parietal cortex in normal brain, used as control subjects. After experimental brain trauma using the fluid percussion injury (FPI) method, $^1$H MR spectra were acquired from the same lesion three days after trauma. Metabolite ratios of the injured lesion were compared to those of controls. After trauma, N-acetylaspartate (NAA)/creatine (Cr) ratio, as a neuronal marker was decreased significantly versus controls, indicating neuronal loss. The ratio of NAA/Cr in traumatic brain contusion was 0.90$\pm$0.11, while that in normal control subjects was 1.13$\pm$0.12 (P=0.001). Choline (Cho)/Cr ratio had a tendency to rise in experimental brain contusion (P=0.02). Cho/Cr ratio after trauma was 0.91$\pm$0.17 while that before traumas was 0.76$\pm$0.15. Cho/Cr ratio was increased and this might indicate a inflammatory activity. However, no significant difference of [(glutamate＋glutamine) (Glx)]/Cr was established between experimental traumatic brain injury models and normal controls. Lactate (Lac)/Cr ratio was appeared as a sign of shifted posttraumatic energy metabolism and increased versus controls. These findings strongly suggest that in vivo $^1$H MRS may be a useful modality for clinical evaluation of traumatic contusion and could aid in better understanding the neuropathologic process of traumatic contusion induced by FPI. In the present study, in vivo $^1$H MRS was proved to be a useful non-invasive method for in vivo diagnosis and monitoring of posttraumatic metabolism in models of brain contusion.

• The Journal of the Korea Contents Association
• /
• v.13 no.2
• /
• pp.370-377
• /
• 2013

Traumatic brain injury(TBI) is a brain damage caused by an external physical force. TBI patients have disturbances of functioning including attention, memory, reasoning,, executive function, and pragmatic language. The aim of this study was to develop the cognitive-pragmatic language ability assessment protocol for traumatic brain injury(CAPTBI) and to evaluate reliability and validity. This study was also conducted to investigate domains that contributed to differentiate between the normal and TBI groups. The CAPTBI data were obtained from 226 normal adults and 62 TBI patients(mean age=$43.95{\pm}11.92$, $46.37{\pm}11.87$, M:F=110:116, 48:14). The CAPTBI had high item internal consistency, test-retest reliability, construct validity, and concurrent validity. The normal group performed significantly better than the TBI group in all domains of the CAPTBI and the separate scores for 9 domains. All 9 domains were found to be significant variables to discriminate between the two groups. The most powerful variable was executive function followed by memory, organization, pragmatic language, problem-solving, attention, orientation, reasoning, and visuoperception in order. The CAPTBI could discriminate between the two groups accurately by 95.5%. This result demonstrated that 97.3% of normal adults and 88.7% of TBI patients could be discriminated by CAPTBI. In conclusion, The CAPTBI is appropriate for evaluating and identifying cognitive-pragmatic language disorders in TBI patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.5
• /
• pp.3344-3352
• /
• 2015

The purpose of this study is to investigate the effects of Korean computer-based cognitive rehabilitation program (CoTras) on frontal-executive functions in patients with traumatic brain injury (TBI). This study was performed at C hospital in Changwon, Gyeongsangnam-do, Korea from August 2013 to March 2014. Ten patients with TBI were randomly divided into two groups. The experimental group had been given CoTras once a day, five times a week for four weeks, whereas the control group had performed self-cognitive training under the same conditions. To verify the effect of intervention, the following executive function measures were used: Korean Montreal Cognitive Assessment (K-MoCA), Executive Clock Drawing Test (ECDT), Trail Making Test (TMT), Rey-Complex Figure Test (RCFT). Intervention group showed significant increase in K-MoCA, TMT, RCFT-delayed recall (p<.05). However, control group showed no significant change in any test. There was significant difference of changed scores (post test-pre test) between two groups in K-MoCA, TMT and RCFT-delayed recall (p<.05). This study showed that CoTras is effective to improve frontal-executive functions in patients with traumatic brain injury.

• Journal of Korea Entertainment Industry Association
• /
• v.13 no.6
• /
• pp.277-286
• /
• 2019

The aim of this study was to investigate the effects of computer-based cognitive rehabilitation and traditional cognitive training on the working memory and executive function of patients with mild traumatic brain injury. The sample consisted of 20 patients with mild traumatic brain injury who had received rehabilitation treatment in a rehabilitation unit. The subjects were assigned to either the experimental (n = 10) or control group (n = 10). The experimental group received computer-based cognitive rehabilitation and traditional cognitive training for 60 minutes, whereas the control group received only traditional cognitive training for 60 minutes. Both the groups received their respective interventions for 60 minutes a day and 5 times per week across a period of 4 weeks. Working memory and executive function were assessed using the digit span test (forward and backward), visual memory 1 and 2 of the Motor-free Visual Perception Test-3, trail making test, and Stroop test (A and B) both before and after the intervention. The experimental group showed a significantly greater improvement in visual memory and performance on the Stroop test A than the control group. These findings suggest that computer-based cognitive rehabilitation and traditional cognitive training are more effective in promoting positive changes in the working memory and executive function of individuals with mild traumatic brain injury than traditional cognitive training.

• The Korean Journal of Nuclear Medicine
• /
• v.34 no.3
• /
• pp.183-198
• /
• 2000

Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.