Objective: To localize the neuroanatomical substrate of rapid eye movement sleep behavior disorder (RBD) and to investigate the neuroanatomical locational relationship between RBD and α-synucleinopathy neurodegenerative diseases. Materials and Methods: Using a systematic PubMed search, we identified 19 patients with lesions in different brain regions that caused RBD. First, lesion network mapping was applied to confirm whether the lesion locations causing RBD corresponded to a common brain network. Second, the literature-based RBD lesion network map was validated using neuroimaging findings and locations of brain pathologies at post-mortem in patients with idiopathic RBD (iRBD) who were identified by independent systematic literature search using PubMed. Finally, we assessed the locational relationship between the sites of pathological alterations at the preclinical stage in α-synucleinopathy neurodegenerative diseases and the brain network for RBD. Results: The lesion network mapping showed lesions causing RBD to be localized to a common brain network defined by connectivity to the pons (including the locus coeruleus, dorsal raphe nucleus, central superior nucleus, and ventrolateral periaqueductal gray), regardless of the lesion location. The positive regions in the pons were replicated by the neuroimaging findings in an independent group of patients with iRBD and it coincided with the reported pathological alterations at post-mortem in patients with iRBD. Furthermore, all brain pathological sites at preclinical stages (Braak stages 1-2) in Parkinson's disease (PD) and at brainstem Lewy body disease in dementia with Lewy bodies (DLB) were involved in the brain network identified for RBD. Conclusion: The brain network defined by connectivity to positive pons regions might be the regulatory network loop inducing RBD in humans. In addition, our results suggested that the underlying cause of high phenoconversion rate from iRBD to neurodegenerative α-synucleinopathy might be pathological changes in the preclinical stage of α-synucleinopathy located at the regulatory network loop of RBD.
Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.
This study was conducted to investigate whether Stroop-related cognitive task will be affected according to the preceding affective valence factored by matchedness in response time(RT) and whether facial recognition will be indexed by specific event-related potentials(ERPs) signature in normal person as in patients suffering from affective disorder. ERPs primed by subliminal(30ms) facial stimuli were recorded when presented with four pairs of affect(positive or negative) and cognitive task(matched or mismatched) to get ERP effects(N2 and P300) in terms of its amplitude and peak latency variations. Behavioral response analysis based on RTs confirmed that subliminal affective stimuli primed the target processing in all affective condition except for the neutral stimulus. Additional results for the ERPs performed in the negative affect with mismatched condition reached significance of emotional-face specificity named N2 showing more amplitude and delayed peak latency compared to the positive counterpart. Furthermore the condition shows more positive amplitude and earlier peak latency of P300 effect denoting cognitive closure than the corresponding positive affect condition. These results are suggested to reflect that negative affect stimulus in subliminal level is automatically inhibited such that this effect had influence on accelerating detection of the affect and facilitating response allowing adequate reallocation of attentional resources. The functional and cognitive significance with these findings was implied in terms of subliminal effect and affect-related recognition modulating the cognitive tasks.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.3
no.1
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pp.26-45
/
1992
This study presents the behavioral and cognitive changes by administration of methylphenidate(MPH) and imipramine(IMI) for the treatment of attention-deficit hyperactivity disorder(ADHD) in $5_{1/2}{\sim}12$ years old children referred to child psychiatric clinics. Behavioral changes are assessed with parent's and teacher's ratings. Drug effects on attention. short-term memory, and impulsivity are evaluated with psychological tests in laboratory. The changes were assessed twice in a 8-week periods. The data were analyzed seperately for 15 subjects each drug using repeated measured analysis of variance(ANOVA). The findings indicates that behavioral and cognitive impairments are improved by both drugs, but impulsivity is not. And MPH is superior to IMI on the improvement of attentional problem ; especially the findings indicates important differences between simple task and complex. perceptual-search task. These data confirm the effectiveness of MPH for treatment of ADHD, also raise questions regarding assessment method of attention and impulsivity as fell as importance of impulsivity in ADHD.
The purpose of this study, which has its focus on the utilization of single-system design for practice evaluation, is to evaluate the effectiveness of cognitive behavioral therapy of depression by using a AB design. 3 inpatients in a local hospital with a diagnosis of major depressive disorder agreed to participate in this study. The AB design includes a 2weeks of the baseline phase and 3 weeks of the intervention phase. More than one outcome measures were used in order to validate the results of the measurement. Data were analyzed statistically as well as visually. Tools such as trend line and trend index were used to improve the accuracy of the visual analysis and the 3 standard deviation approach was used for statistical significance test. The results showed that all clients improved. This study lists some advantages of using single-system design for evaluating clinical practice: monitoring, encouraging clients' active role in social work process, and easy data analysis.
Objective: This study aims to recognize the risk of current traffic systems and to investigate a method to decrease risk by doing exercise using an elastic-band and cognitive rehabilitation. Background: The existing traffic system usually focuses on the ordinary citizens, which may not be appropriate to the elderly. It may affect the cognition and walking speed of the elderly. This study tries to examine whether cognition and muscle training is appropriate to improve their vulnerability. Therefore this study will provide human ergonomics - based basic data in relation to the elderly to identify the risk of current signal system and to mitigate the risk. Method: A total of 30 elderly participants were divided into two groups: experimental and control groups. Experimental group (n=15) was trained to strengthen their muscles and to promote cognition, whereas control group (n=15) was not. The training was conducted twice a week for three weeks. To strengthen muscles, a yellow colored elastic-band was used, and a computer program for cognitive rehabilitation was used to develop cognition. In the experimental group, there were significant differences between pre and post exercises However, the control group didn't show any significant difference. The increase in cognition and walking speed was found in the experimental group, whereas there were no differences in the control group. Statistically there was no significant difference between the two groups. Results: The results of this study show that the exercise program using the elastic-band gave a positive effect on gait training thanks to the development of muscle power and balance. Conclusion: This study did not show any statistical difference or significant differences between the two groups, since time was restricted, we believe. Application: The results of the walking speed will help to prevent traffic collision.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.27
no.2
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pp.109-118
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2016
Objectives: The aim of this study was to develop the computerized Comprehensive Learning Test-Reading (CLT-R) to evaluate the cognitive processes and achievements related to their basic reading ability and identify dyslexia in children and adolescents in South Korea. We also obtained the normative data and evaluated the reliability and validity of the test. Methods: We developed the CLT-R, including the word attack/nonword decoding, paragraph reading, sound blending, nonword repetition, rapid automatized naming, letter-sound matching, visual attention, orthography awareness, and digit span tests, for the purpose of diagnosing dyslexia. We investigated the reliability and validity of the tests and gathered the normative data from 399 subjects (male 48.9%), aged 5-14 years, from the last grade in kindergarten to middle school, dwelling in Seoul and Gyeonggi Province, South Korea. Results: No statistical differences were observed between the means of the tests and retests of the CAT. The mean of the correlation coefficient of the test-retest scores was 0.85. According to the construct validity test calculated by principal constant analysis using the oblique rotation method, 4 factors explained 70.0% of the cumulative variances. In addition, the normative data were obtained for all of the CLT-R subtests. Conclusion: The computerized CLT-R can be used as a reliable and valid tool to evaluate the reading achievement and reading related cognitive process in Korean children and adolescents in schools, clinics, and research institutes.
Background: Parkinson's disease is movement disorder due to dopaminergic deficiency. It has been noted that cognitive dysfunction also presented on Parkinson's disease patients. But, it is not clear whether such a cognitive dysfunction was a dopaminergic dysfunction or cholinergic dysfunction. Using linear and non-linear analyses, we analysed the effect of cognitive and motor symptom on EEG change. Methods: EEGs were recorded from patients with Parkinson's disease and essential tremor, and normal controls during rest. We calculated the power spectrum, correlation dimension and Lyapunov exponent by using 'Complexity'program. The power spectrum, correlation dimension, and Lyapunov exponent were compared between Parkinson's disease patients and essential tremor patients. Results: Theta power was increased in Parkinson's disease patient group. Correlation dimension was increased in Parkinson's disease patients. Positive correlation was noted between MMSE and correlation dimension, and negative correlation was noted between MMSE and Lyapunov exponent. Lyapunov exponent was decreased in Parkinson's disease patient. Conclusions: We conclude that the state of Parkinson's disease patient is characterized by increased correlation dimension and decreased Lyapunov exponent.
Depression is a major mood disorder. Abnormal expression of glial glutamate transporter-1 (GLT-1) is associated with depression. Schisantherin B (STB) is one bioactive of lignans isolated from Schisandra chinensis (Turcz.) Baill which has been commonly used as a traditional herbal medicine for thousands of years. This paper was designed to investigate the effects of STB on depressive mice induced by forced swimming test (FST). Additionally, we also assessed the impairment of FST on cognitive function in mice with different ages. FST and open field test (OFT) were used for assessing depressive symptoms, and Y-maze was used for evaluating cognition processes. Our study showed that STB acting as an antidepressant, which increased GLT-1 levels by promoting PI3K/AKT/mTOR pathway. Although the damage is reversible, short-term learning and memory impairment caused by FST test is more serious in the aged mice, and STB also exerts cognition improvement ability in the meanwhile. Our findings suggested that STB might be a promising therapeutic agent of depression by regulating the GLT-1 restoration as well as activating PI3K/AKT/mTOR pathway.
Lee, Jang Won;Yeo, Jin Ju;Kim, Kyung Sik;Hyun, Min Kyung
The Journal of Korean Medicine
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v.43
no.2
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pp.75-91
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2022
Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.
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