• Title/Summary/Keyword: 인지기능 손상

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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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Occupational Therapy in Hypoxic-Ischemic Brain Injury Patient by Suicidal Attempt: Case Report (자살시도로 인한 저산소성 허혈성 뇌손상 환자의 재활치료 - 인지 재활과 연하 재활을 중심으로: 사례연구)

  • Lee, Eui-Yun;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.7 no.1
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    • pp.11-26
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    • 2018
  • Objective : This case study was to verify effects of cognitive rehabilitation and swallowing rehabilitation on Hypoxic-Ischemic Brain Injury patient by Suicidal Attempt. Methods : The subject was a 32-year old Hypoxic-ischemic brain injury patient by suicidal attempt. He received treatment once a day five times a week, for a half an hour for each session from September 8th to December 16th, 2016. Treatment were cognitive and swallowing rehabilitation. He was assessed based on Mini-Mental State Examination-Korean (MMSE-K), Korean-Modified Barthel Index (K-MBI), Computerized Neurocognitive Function Test (CNT), Videofluoroscopic Dysphagia Scale (VDS), American Speech-Language-Hearing Association National Outcomes Measurements System (ASHA-NOMS). Results : The patient's total MMSE-K score increased from 25 to 27. His K-MBI score increased from 74 to 88. His memory, attention span, and executive function (DST, VST, SWCT, WCST) by CNT scores were improved. VDS score has no changes to 34, 44.5 and 34. ASHA-NOMS score also has no change to 6, 2 and 6. Conclusion : The study showed that the application of the treatment of cognitive and swallowing in hypoxic-ischemic brain injury patient by suicidal attempt results has positive effects on cognitive functions, and swallowing function.

The Effect of Neuromuscular Reeducation on the Cognitive and Functional Assessment for Hemiplegic Patients (신경근 재교육이 편마비 환자의 인지와 기능에 미치는 효과)

  • Shin, Hong-Cheul;Kim, Woong-Gak;Lee, So-Joon;Kang, Jeong-Il;Peak, Heon-Hee
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.7-17
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    • 2002
  • 편마비 환자의 인지 기능과 운동 및 신체적 기능에 관련된 변인을 분석하고자 하였다. 본 연구는 인지 기능이 편마비 환자에게 미치는 영향과 인지 영역의 손상이 편마비 환자의 독립적 기능 및 수준 향상의 예언 인자로서의 고려해야 할 개념을 검사나 평가 척도로 비교, 분석 하였다. 연구 대상은 전라북도에 소재한 한방병원에 입원 및 통원하고 있는 52-73세의 연령 범위에 있는 편마비환자 20명 이다. 편마비 환자의 기능적 능력, 운동 회복, 신체적 기능 그리고 인지적 상태를 평가하기 위해 편마비 환자를 위한 임상적 결과 변인 척도, 운동 평가 척도와 바델 척도 그리고 기능적 독립성 측정 척도를 평가도구로 사용하였다. 편마비 환자의 신체적, 운동 그리고 기능적 능력 상태를 평가도구에 의해 측정된 결과를 분석한 바 운동, 신체적 그리고 인지적인 영역과 기능적 독립 측정 척도 및 바델 척도와 관련성이 있음을 보여주고 있다. 편마비 환자의 신체적, 인지적 결함이나 손상 부위, 손상의 본질에 따른 대상의 선정과 운동 조절 형태에 관한 지식 그리고 인지와 신경학적 결함 정도를 심도있게 다루어 기능적 능력 향상의 임상적 효과를 높이고자 하는데 연구의 의의가 있다.

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Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches (인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로)

  • Cha, Suna;Bae, Suyeong;Nam, Sanghun;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.61-77
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    • 2023
  • Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.

The Effect of Social Participation on Cognitive Impairment Degree among Korean Older Adults: Comparative Study between Urban and Rural Area (사회참여활동이 고령자 인지기능 손상 정도에 미치는 영향: 도시와 농촌 간 차이 분석)

  • Kang, Joo Young
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.326-337
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    • 2020
  • The purpose of this study is to analyze the effect of social participation types on cognitive impairment degree(normal, mild, severe cognitive function) by urban and rural difference. The research was performed by multinomial logistic regression with the data of elderly 5,668 over 55 years of age from the sixth wave(2016) and the seventh wave(2018) of the Korean Longitudinal Study of Ageing. Results show that social participation reduces the risk of cognitive impairment on both urban and rural older adults regardless of types, but the types of social participation, which are effective to reduce the risk of cognitive impairment, are different between urban and rural area. According to residential area, types of social participation, which are effective to decline the risk of being mild or severe cognitive impairment and the risk of being severe cognitive impairment relative to mild, are different. These findings suggest that, in order to prevent cognitive impairment and reduce the severity, social participation is strongly recommended and appropriate supports are required. This implies policy and intervention efforts considering the urban and rural difference are needed.

The Effects of Cognitive Training Using Application Games of Smart Device on Cognitive Function in Patients With Mild Traumatic Brain Injury (스마트기기 애플리케이션 게임을 이용한 인지훈련이 경미한 손상이 있는 외상성 뇌손상 환자의 인지기능에 미치는 영향)

  • Kang, Seon-Hwa;Kim, Young-Sil;Kang, So-La;Moon, Jong-Hoon
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.9-18
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    • 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.

Therapeutic Effect of Amantadine in Traumatic Brain Injury Patients : Two Cases and Review (외상성 뇌손상 환자에서 Amantadine의 치료적 효과 : 2증례 및 고찰)

  • Jung, Han Yong;Lee, Soyoung Irene;Kim, Yang Rae
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.156-161
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    • 2001
  • We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive deficit could occur following traumatic brain injury or other types of acquired brain injury. This report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed.

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Neuropsychological Tests in Consultation Neurology (자문 시 유용한 신경인지검사)

  • Oh, Jee-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.11-18
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    • 2010
  • The clinical assessment of a patient with a cerebral lesion is not easy to physicians. Extensive neuropsycho-logical tests often need both skilled experience and some special tools. Some bedside tests equally provide valuable clues to localize cerebral lesion, when a clinician knows functional anatomy of cerebral hemisphere. In this article, several techniques used to evaluate cerebral cortical function will be introduced.

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지혜 깊어지는 건강_50대를 지켜라 - 원인을 알면 예방할 수 있는 치매

  • Seo, Sang-Won
    • 건강소식
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    • v.35 no.10
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    • pp.18-20
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    • 2011
  • 치매(dementia)는 라틴에게서 유래된 말로서 '정신이 없어진 것' 이라는 의미를 갖고 있다. 태어날 때부터 지적 능력이 모자라는 경우를 정신지체(mental retardation)라고 부르는 반면, 치매는 후천적인 뇌질환이다. 즉, 정상적으로 생활해 오던 사함이 후천적인 뇌 손상으로 인하여 기억력, 언어능력, 방향감각, 판단력 등의 인지기능을 잃어가는 것이다. 또한 이런 인지 기능 장애가 심각하여 일상생활에 상당한 지장이 나타날 때 치매라고 한다.

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The Effects of Computer-Based Cognitive Rehabilitation and Traditional Cognitive Training on the Working Memory and Executive Function in Patients with Mild Traumatic Brain Injury (전산화 인지재활과 전통적 인지훈련이 경도 외상성 뇌손상 환자의 작업기억과 실행기능에 미치는 영향)

  • Moon, Jong-Hoon;Yang, Seung-Bum;Jeon, Min-Jae
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.6
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    • pp.277-286
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    • 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.