• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.48-54
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• 2007

Objectives : This study aimed to examine the relationship between behavioral and psychological symptoms of dementia(BPSD) and patient and caregiver QOL in Alzheimer's disease(AD). Methods : Fifty-one AD patients and their caregivers participated. Measures about patients were Neuropsychiatric Inventory(NPI), Korean version of QOL-Alzheimer's Disease(KQOL-AD), Activities of Daily Living(ADL), Clinical Dementia Rating(CDR), and Korean version-Mini Mental State Examination(K-MMSE). Caregiver QOL was assessed with KQOL-AD and General Health Questionnaire/Quality of Life-12(GHQ/QOL-12). Results : Patient QOL-AD on patient ratings was negatively correlated with appetite/eating change and NPI scores. Patient QOL-AD on caregiver ratings was negatively correlated with hallucinations, depression/dysphoria, and NPI scores. Caregiver QOL assessed by the GHQ/QOL-12 was negatively correlated with agitation/aggression, depression/dysphoria, and NPI scores and was negatively correlated with distress related to agitation/aggression, depression/dysphoria, and NPI scores. Conclusion : BPSD of AD patients was associated with low QOL of both patients and caregivers. Thus, interventions of BPSD were needed to improve both patient and caregiver QOL.

• Therapeutic Science for Rehabilitation
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• v.11 no.2
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• pp.53-62
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• 2022

Objective : This study aimed to present basic data that could help in selecting or using evaluation tools in clinical settings. Methods : This study included 51 patients with stroke. The Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2), and Clinical Dementia Rating (CDR) were used as evaluation tools. The correlation between evaluation tool scores was analyzed using Spearman's rank correlation coefficient, and the comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores was analyzed using the Wilcoxon signed-rank test. Results : The correlation between the total CIST and K-MMSE~2 scores and global CDR scores was statistically significant (p<.01). The correlation between the sub-scores of the CIST and K-MMSE~2 showed a statistically significant correlation for all sub-scores (p<.01). The comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores showed no statistically significant differences in all global CDR scores. Conclusion : This study showed that there was a correlation between CIST, K-MMSE~2, and CDR in patients with stroke. In the future, we hope that the results of this study will help to select or use cognitive function evaluation tools in clinical settings.

• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.1
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• pp.477-486
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• 2020

This study was undertaken to analyze the correlation between depression and memory, by considering the occurrence of ApoE ɛ4 and clinical dementia rating in the elderly with Alzheimer's dementia. This study included 50 participants over 65 years of age, evaluated with CDR 0.5 to 2. We performed CDR, SVLT-E, RCFT, SGDS-K, and ApoE genotyping. Spearman's correlation analysis was used for determining the correlation between depression and memory. The results indicate a significant negative correlation between depression and immediate recall verbal memory in the CDR 1 and 2 without ApoE ɛ4 carrier group (p<0.05). Furthermore, a significant negative correlation was also determined between depression and delayed recall verbal memory in the CDR 1 of the same group. Ed. Notes: The previous sentence already shows this correlation. I suggest this should be deleted from this statement. However, no significant correlation was observed between depression and visual memory. This study found a significant correlation between depression and immediate recall verbal memory. Also, the presence of ApoE ɛ4 indicates a significant correlation between depression and delayed verbal recall memory. Taken together, our results indicate that verbal memory training rather than visual memory training can be more effective in early AD. Also, the treatment of depression will provide a complementary effect.

• Journal of Oriental Neuropsychiatry
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• v.14 no.1
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• pp.17-26
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• 2003

Objective : The clinical efficacy of Jowiseungchungtang(oriental herbal medication) over 6-month on the cognitive function in patients with mild Dementia of Alzheimer type(DAT) was investigated in this study. Method : The subjects for this study consisted of dementia patients who visited to the outpatient dementia department of Oriental Neuropsychiatry of the Kyunghee Oriental hospital. Patients were required to have at entry: a dignosis of mild DAT; Biochemical test, CBC, Urine analysis, Chest X -ray, EKG, Brain- MRI, Mini-Mental States-Korea(MMSE-K), Korean-Dementia Rating Scale(K-DRS), Samsung Dementia Questionaire(SDQ;to their caregiver). Patients(n=31) were assigned to treatment with Jowiseungchungtang (fourth/day for 6-month). The primary outcome measure was K-DRS. Result : 1. Patients' mean age was $71.4{\pm}6.6$ years(range 59 to 86 years). 2. Patients' mean education was $6.1{\pm}4.9$ years. K-DRS scores at baseline was $110.5{\pm}12.2$. K-DRS scores at 6-month was $109.0{\pm}17.0$. K-DRS scores at 6-month was not significantly different with K-DRS scores at baseline(t=.791 r=.435 p<.05). Conclusion : Treatment with Jowiseungchungtang for 6-month protected the cognitive function decline in patients with mild DAT.

• Journal of Oriental Neuropsychiatry
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• v.23 no.3
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• pp.99-116
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• 2012

Objectives : The purpose of this study is to evaluate the effects of Needle-Embedding Therapy on dementia patients. Methods : We recruited 3 dementia patients who have been experiencing memory disorder and orientation disorder. The patients had been evaluated with Mini-Mental State Examination-K (MMSE-K), Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR). The patients were treated with herbal medication (Sunghyangjunggi-san) and acupuncture. After 15 days, the patients were added to Needle-Embedding Therapy. We measured MMSE-K, GDS and CDR for every 15 days. The effects of additional Needle-Embedding Therapy were compared with the effects of acupuncture and herbal medicine. Results : After Needle-Embedding Therapy was added, Patients' memory and orientation have been improved and the score of MMSE-K ascended. The grade of GDS and CDR were maintained or decreased. Conclusions : This study suggests that Needle-Embedding Therapy is significantly effective on Dementia patients.

• Journal of Biomedical Engineering Research
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• v.40 no.5
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• pp.189-196
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• 2019

We investigated differences in ventricular and hippocampal volumes between CSF tap test (CSFTT) responders and non-responders in idiopathic normal-pressure hydrocephalus (INPH) patients and compared these parameters in INPH patients with that of age- and gender-matched healthy controls. We also evaluated relationships between ventricular and hippocampal volumes and clinical profiles in INPH patients. We enrolled 48 patients with INPH and 29 healthy controls. Ventricular and hippocampal volumes were measured on MRI, including 3-dimensional volumetric images. INPH patients, when compared to healthy controls, had significantly larger ventricular and smaller hippocampal volumes. No difference in ventricular and hippocampal volumes was found between CSFTT responders and non-responders in INPH patients. And hippocampal volumes showed significant negative correlations with Clinical Dementia Rating Scale scores, INPH grading scale cognitive scores, Timed Up and Go Test scores, and Unified Parkinson's Disease Rating Scale motor scores in INPH patients. Volumetric assessment of ventricular and hippocampal regions may have no predictive value in differentiating between CSFTT responders and non-responders in INPH patients. Our findings may help us understand the potential pathophysiology of unique symptoms associated with INPH.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.155-163
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• 2019

Objectives : The aim of this study was to compare severity, neurocognitive functions, and behavioral and psychological symptoms of dementia (BPSD) according to the degree of temporal lobe atrophy (MTA) in Korean patients with dementia due to Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Methods : Participants were 114 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. Severity was evaluated with Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Neurocognitive functions was evaluated with the Korean version of Short Blessed Test (SBT-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). BPSD was evaluated with the Korean version of the Neuropsychiatric Inventory (K-NPI). Independent t-test was performed to compare severity, neurocognitive functions, and BPSD between two groups. Results : The group with high severity of MTA showed significantly lower scores in CDR, SBT-K, MMSE-KC, modified Boston naming test, word list recognition, and word list memory (p<0.05). There were no differences in K-NPI scores between two groups. Conclusions : Severity and neurocognitive functions of dementia had significant positive association with MTA, but BPSD had no association with MTA. Evaluating MTA seems to have potential benefit in diagnosing and treating neurocognitive impairments in the elderly. Further evaluation is needed to confirm the association between certain brain structures and BPSD.

• YAKHAK HOEJI
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• v.37 no.5
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• pp.442-452
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• 1993

Previous experimental and clinical investigations suggest a possible role of new nootropic drug, oxiracetam, in improving cognitive performances in patients affected by organic brain syndrome. In this study, the cognitive and behavioral effects of oxiracetam treatment in patients with clinical symptoms of organic brain syndrome were evaluated. Sixty-six patients were enrolled and assigned to either oxiracetam or placebo, according to a randomized, double-blind design between two patient-groups. Either oxiracetam or placebo was orally given bid for 8 weeks ; daily dose of oxiracetam was 1600mg. All the patients, enrolled in this study, were diagnosed as having mild to moderate cognitive dysfunction as defined by a baseline Mini Mental State ExaminationKorean version (MMSE-K) score between 14 and 25. The patients under-went, at baseline, 4 weeks and 8 weeks after, routine laboratory study (CBC, SMA12, U/A, EKG) and the following neuropsychological tests ; MMSE-K, modified Korean Wechsler Intelligence Scale(MKWIS), Nurses' Observation Scale for Geriatric patients(NOSGER). Fifteen patients of whom were dropped out or excluded from the analysis because of poor compliance or violation of the protocol. Fiftyone patients (aged 54~78 years, male 25, female 26) were analyzed (vascular dementia, 30 ; senile dementia of Alzheimer type, 9 ; mixed type, 5 ; other cause, 7). Statistical analysis of the data demonstrated that the two groups were comparable at baseline. At the end of each study period the oxiracetam group scored significantly better on the majority of the tests evaluating cognitive function, psychometricity and the improvement rating scale of subjective symptoms than placebo group, in which worsening trends or no changes were seen on the whole. No side effects were noted during oxiracetam treatment. The present study, showing positive clinical findings after oxiracetam therapy, confirmed that this drug can be useful pharmacological treatment in organic brain syndrome.

• Journal of Oriental Neuropsychiatry
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• v.29 no.4
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• pp.255-266
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• 2018

Objectives: The objective of this study was to evaluate the reliability and validity of Pattern Identifications Tool for Cognitive Disorders (PIT-C) and verify the correlation with other related scales. Methods: The study in this protocol is a single group, prospective, observational one. The subjects of the study were men and women between the ages of 45 and 85, diagnosed with neurocognitive disorders by Diagnostic and Statistical Manual of Mental Disorder (fifth Edition) criteria (n=60, Clinical Dementia Rating (CDR)=0.5, Korean Version of Montreal Cognitive Assessment $(MoCA-K){\leq}22$). The reliability of PIT-C was evaluated as test-retest and inter-rater reliability. And correlation between PIT-C and other related scales was also assessed. Results: This study was approved by the Institutional Review Board (IRB) of Dunsan Korean Medicine Hospital of Daejeon University and registered in the Clinical Research Information Service (CRIS), and was made public in advance to ensure transparency of the research process and conduct ethical clinical trials. Conclusions: The results of this study can be used to classify neurocognitive disorders as Korean medicine and PIT-C will be helpful tool for primary health care.