• Title/Summary/Keyword: Cognitive Dysfunction

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Quality of Life of Antipsychotic-Induced Hyperprolactinemia in Patients with Schizophrenia (항정신병약물로 유발된 고프로락틴혈증을 가진 조현병 환자의 삶의 질)

  • Woo, Seonjin;Jin, Bo-Hyun;Won, Seunghee
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.218-229
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    • 2018
  • Objectives : Antipsychotic-induced hyperprolactinemia causes physical symptoms, such as amenorrhea, galactorrhea, gynecomastia, sexual dysfunction, and bone density loss, as well as psychiatric symptoms, such as depression and cognitive impairments. This study aimed to clarify the associations among hyperprolactinemia caused by antipsychotics in patients with schizophrenia, psychiatric pathology, and psychosocial factors. Methods : Ninety-nine patients with schizophrenia in the psychiatry department of a university hospital were registered between 2015 and 2017. All participants were assessed using structured questionnaires to elucidate psychopathology, social function, quality of life, and hyperprolactinemia-related side effects. The standard levels for hyperprolactinemia were 24ng/mL for women and 20ng/mL for men. Results : The average prolactin levels were $73.45{\pm}49.37ng/mL$ in patients with hyperprolactinemia and $9.16{\pm}6.42ng/mL$ in those without hyperprolactinemia. The average prolactin level in women was significantly higher than that in men(p=0.04). Risperidone was most commonly administered in patients with hyperprolactinemia(58.1%, p<0.01), while aripiprazole was most commonly administered in those without hyperprolactinemia(44.7%, p<0.01). Patients with hyperprolactinemia had significantly higher Positive and Negative Syndrome Scale(p=0.03) and Patient Health Questionnaire-9(p=0.05) scores and had significantly lower Social and Occupational Functioning Assessment Scale(p=0.04) and Strauss-Carpenter Levels of Functioning Scale(p=0.03) scores than patients without hyperprolactinemia. There were no significant differences in side effects or quality of life between the two groups. Conclusion : These findings demonstrate that hyperprolactinemia confers negative effects on depression and social function, but does not directly affect the quality of life. These results suggest that patients with schizophrenia who take antipsychotics that increase prolactin or cause side effects of hyperprolactinemia need to be assessed and receive interventions for depression.

Joint Problems in Patients with Mucopolysaccharidosis Type II

  • Kim, Min-Sun;Kim, Jiyeon;Noh, Eu Seon;Kim, Chiwoo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.5 no.1
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    • pp.17-21
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    • 2021
  • Hunter syndrome or mucopolysaccharidosis type II (MPS-II) (OMIM 309900) is a rare lysosomal storage disorder caused by deficiency in the activity of the enzyme iduronate-2-sulfatase. This enzyme is responsible for the catabolism of the following two different glycosaminoglycans (GAGs): dermatan sulfate and heparan sulfate. The lysosomal accumulation of these GAG molecules results in cell, tissue, and organ dysfunction. Patients can be broadly classified as having one of the following two forms of MPS II: a severe form and an attenuated form. In the severe form of the disease, signs and symptoms (including neurological impairment) develop in early childhood, whereas in the attenuated form, signs and symptoms develop in adolescence or early adulthood, and patients do not experience significant cognitive impairment. The involvement of the skeletal-muscle system is because of essential accumulated GAGs in joints and connective tissue. MPS II has many clinical features and includes two recognized clinical entities (mild and severe) that represent two ends of a wide spectrum of clinical severities. However, enzyme replacement therapy is likely to have only a limited impact on bone and joint disease based on the results of MPS II studies. The aim of this study was to review the involvement of joints in MPS II.

Brain Metabolite Changes in Insomnia and Obstructive Sleep Apnea (수면장애에서 나타나는 뇌 대사물질의 변화 : 불면증과 폐쇄수면무호흡증을 중심으로)

  • Hong, Haejin;Lee, Hyangwon;Yoon, Sujung;Kim, Jungyoon
    • Sleep Medicine and Psychophysiology
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    • v.28 no.1
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    • pp.18-26
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    • 2021
  • Sleep is essential to brain function and mental health. Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders, and are major public health concerns. Proton magnetic resonance spectroscopy (1H-MRS) is a non-invasive method of quantifying neurometabolite concentrations. Therefore, 1H-MRS studies on individuals with sleep disorders may enhance our understanding of the pathophysiology of these disorders. In this article, we reviewed 1H-MRS studies in insomnia and OSA that reported changes in neurometabolite concentrations. Previous studies have consistently reported insomnia-related reductions in γ-aminobutyric acid (GABA) levels in the frontal and occipital regions, which suggest that changes in GABA are important to the etiology of insomnia. These results may support the hyperarousal theory that insomnia is associated with increased cognitive and physiological arousal. In addition, the severity of insomnia was associated with low glutamate and glutamine levels. Previous studies of OSA have consistently reported reduced N-acetylaspartate (NAA) levels in the frontal, parieto-occipital, and temporal regions. In addition, OSA was associated with increased myo-inositol levels. These results may provide evidence that intermittent hypoxia induced by OSA may result in neuronal damage in the brain, which can be related to neurocognitive dysfunction in patients with OSA. The current review summarizes findings related to neurochemical changes in insomnia and OSA. Future well-designed studies using 1H-MRS have the potential to enhance our understanding of the pathophysiology of sleep disorders including insomnia and OSA.

Correlation Analysis Between Gait Pattern and Structural Features of Cerebral Cortex in Patients with Idiopathic Normal Pressure Hydrocephalus (특발정상압수두증 환자의 보행 패턴과 대뇌피질의 구조적인 특징의 상관관계 분석)

  • Yun, EunKyeong;Kang, Kyunghun;Yoon, Uicheul
    • Journal of Biomedical Engineering Research
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    • v.42 no.6
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    • pp.295-303
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    • 2021
  • Idiopathic normal-pressure hydrocephalus (INPH) is considered a potentially treatable neurological disorder by shunt surgery and characterized by a triad of symptoms including gait disturbance, cognitive impairment and urinary dysfunction. Although disorders of white matter are generally viewed as the principal pathological features of INPH, analysis of cortical features are important since the destruction of neural tracts could be associated with cortical structural changing. The aim of the study was to determine whether there was any relationship between gait parameter and structural features of cerebral cortex in INPH patients. Gait parameters were measured as follows: step width, toe in/out angle, coefficient of variation (CV) value of stride length, CV value of stride time. After obtaining individual brain MRI of patients with INPH and hemispheric cortical surfaces were automatically extracted from each MR volume, which reconstructed the inner and outer cortical surface. Then, cortical thickness, surface area, and volume were calculated from the cortical surface. As a result, step width was positively correlated with bilateral postcentral gyrus and left precentral gyrus, and toe in/out was positively correlated with left posterior parietal cortex and left insula. Also, the CV value of stride length showed positive correlation in the right superior frontal sulcus, left insula, and the CV value of stride time showed positive correlation in the right superior frontal sulcus. Unique parameter of cerebral cortical changes, as measured using MRI, might underline impairments in distinct gait parameters in patients with INPH.

A novel HDAC6 inhibitor, CKD-504, is effective in treating preclinical models of huntington's disease

  • Endan Li;Jiwoo Choi;Hye-Ri Sim;Jiyeon Kim;Jae Hyun Jun;Jangbeen Kyung;Nina Ha;Semi Kim;Keun Ho Ryu;Seung Soo Chung;Hyun Sook Kim;Sungsu Lee;Wongi Seol;Jihwan Song
    • BMB Reports
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    • v.56 no.3
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    • pp.178-183
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    • 2023
  • Huntington's disease (HD) is a neurodegenerative disorder, of which pathogenesis is caused by a polyglutamine expansion in the amino-terminus of huntingtin gene that resulted in the aggregation of mutant HTT proteins. HD is characterized by progressive motor dysfunction, cognitive impairment and neuropsychiatric disturbances. Histone deacetylase 6 (HDAC6), a microtubule-associated deacetylase, has been shown to induce transport- and release-defect phenotypes in HD models, whilst treatment with HDAC6 inhibitors ameliorates the phenotypic effects of HD by increasing the levels of α-tubulin acetylation, as well as decreasing the accumulation of mutant huntingtin (mHTT) aggregates, suggesting HDAC6 inhibitor as a HD therapeutics. In this study, we employed in vitro neural stem cell (NSC) model and in vivo YAC128 transgenic (TG) mouse model of HD to test the effect of a novel HDAC6 selective inhibitor, CKD-504, developed by Chong Kun Dang (CKD Pharmaceutical Corp., Korea). We found that treatment of CKD-504 increased tubulin acetylation, microtubule stabilization, axonal transport, and the decrease of mutant huntingtin protein in vitro. From in vivo study, we observed CKD-504 improved the pathology of Huntington's disease: alleviated behavioral deficits, increased axonal transport and number of neurons, restored synaptic function in corticostriatal (CS) circuit, reduced mHTT accumulation, inflammation and tau hyperphosphorylation in YAC128 TG mouse model. These novel results highlight CKD-504 as a potential therapeutic strategy in HD.

Antioxidant effects of Cirsium japonicum var. maackii on oxidative stress in C6 glial cells and mice

  • Min Jeong Kim;Byeong Wook Noh;Qi Qi Pang;Sanghyun Lee;Ji-Hyun Kim;Eun Ju Cho
    • Korean Journal of Agricultural Science
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    • v.49 no.1
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    • pp.137-149
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    • 2022
  • We investigated the effects of Cirsium japonicum var. maackii (CJM) against oxidative stress-induced C6 glial cells and cognitive impairment in mice. To evaluate the anti-oxidative effect of the extract and fractions from CJM, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), reactive oxygen species (ROS), and nitric oxide (NO) assays were conducted in H2O2-treated C6 glial cells. Furthermore, we identified the protective mechanisms of CJM with a scopolamine-treated mice model. The results revealed that H2O2 decreased the cell viability in C6 glial cells, indicating that H2O2 induced oxidative stress in glial cells. However, CJM fractions significantly increased cell viability in H2O2-treated C6 glial cells, which suggested that CJM protected against oxidative stress. CJM extract and fractions also reduced ROS and NO production, which were increased by H2O2 in C6 glial cells. In particular, the EtOAc fraction from CJM (EACJM) effectively protected against oxidative stress by increasing the cell viability and decreasing ROS and NO. Therefore, we carried out further in vivo experiments with EACJM. Scopolamine caused increases of ROS, thiobarbituric acid reactive substances (TBARS), and NO production. However, EACJM effectively alleviated ROS, TBARS, and NO levels compared to scopolamine-injected mice. In addition, EACJM up-regulated protein expressions of superoxide dismutase and glutathione peroxidase, indicating that EACJM enhanced the antioxidative system. Our results demonstrated that CJM had protective effects against oxidative stress in glial cells and memory dysfunction in mice. Based on these results, we propose that CJM could be a potential AD preventive and therapeutic agent.

The Efficacy of Oriental Medicine on Memory in Menopause: A Systemic Review (폐경기 기억력에 대한 한약의 효과 : 체계적 문헌고찰)

  • Soo-Hyung Lee;Ha-Rin Kwon;In-Jeong Jo;Se-Eun Chun;Song-Baek Kim
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.20-35
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    • 2023
  • Objectives: The purpose of this study is to review clinical studies and investigate the efficacy and safety of oriental medicine on memory in menopausal women. Methods: 'menopause', 'memory', 'oriental medicine' were searched on 4 online databases (Cochrane Library, Pubmed, CNKI, OASIS). Randomized controlled trials (RCTs) that evaluated menopausal memory with oriental medicine treatment were included. The methodological quality of each RCT was assessed by using Cochrane risk of bias tool. Results: 8 RCTs were selected among 1067 articles. The overall risk of bias was evaluated as uncertain. 5 studies showed that oriental medicine alone was significant effective, but 1 long-term study with the same oriental medicine did not sustain the effect, and 2 studied were not statistically significant. Conclusions: Oriental medicine can be an effective option for improving memory in menopausal women. but considering the small number and quality of studies, inconsistent and insufficient evidence, further well-designed studies are needed to confirm the efficacy and safety of this treatment.

Clinical Utility of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form in the Assessment of Internalizing and Externalizing Disorders in Adolescents: A Preliminary Approach

  • Hye Ji Yun;Eun Hee Park;Hyun Ju Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.4
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    • pp.268-274
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    • 2023
  • Objectives: This study investigated whether the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-ARF) can differentiate between two groups of adolescents, one diagnosed with internalizing disorders and another with externalizing disorders, and examined the clinical utility of the MMPI-A-RF by examining which subscales can significantly discriminate between these two groups. Methods: A total of 105 adolescents aged 13-18 years completed the MMPI-A-RF (53 internalizing disorder and 52 externalizing disorder groups). Independent t-test, chi-square test (χ2), and discriminant analysis were used to examine whether MMPI-A-RF can distinguish between the two groups. Results: Sixteen MMPI-A-RF scales best predicted differences between the groups with internalizing and externalizing disorders. Fourteen scales (Higher-Order Scale [Emotional/Internalizing Dysfunction], Restructured Clinical [RC] Scale [RC demoralization, Somatic Complaints (RC1), and Low Positive Emotions (RC2)], Personality Psychopathology Five Scale [Introversion/Low Positive Emotionality-Revised, Negative Emotionality/Neuroticism-Revised], Somatic/Cognitive Scale [Malaise, Head Pain Complaints, and Gastrointestinal Complaints], Internalizing Scale [Stress/Worry, Self-Doubt], Externalizing Scale [Negative School Attitudes], Interpersonal Scale [Social Avoidance, Shyness]) were associated with the internalizing disorder group, whereas two scales (Externalizing Scale [Conduct Problems, Negative Peer Influence]) were associated with the externalizing disorder group. Conclusion: The MMPI-A-RF can be an efficient assessment tool for a quick diagnosis as it can classify individuals with internalizing and externalizing disorders in clinical settings that lack a variety of assessment tools for children and adolescents.

Symptoms, Mental Health, and Quality of Life Among Patients After COVID-19 Infection: A Cross-sectional Study in Vietnam

  • Hai Nguyen Thanh;Duc Cap Minh;Hien Hoang Thu;Duc Nguyen Quang
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.2
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    • pp.128-137
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    • 2024
  • Objectives: This study was conducted to characterize the symptoms, mental health, quality of life (QoL), and associated factors following the coronavirus disease 2019 (COVID-19) infection. Methods: This cross-sectional study included 394 participants previously infected with COVID-19 in Ho Chi Minh City, Vietnam. Mental health was assessed using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Participants self-reported health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale. Results: Among the participants, 76.4% reported experiencing at least one symptom following COVID-19 infection. The most common symptoms were fatigue (42.1%), cognitive dysfunction (42.9%), and hair loss (27.9%). According to the DASS-21 results, the proportions of depression, anxiety, and stress were 28.7%, 26.4%, and 20.6%, respectively. The mean scores on the EQ-5D-5L and the EuroQol Visual Analog Scale were 0.94±0.11 and 84.20±13.11, respectively. Regarding QoL issues, the highest proportion of participants (32.7%) reported experiencing anxiety or depression, followed by pain or discomfort (25.4%). Multivariable logistic regression analysis revealed that factors associated with the presence of symptoms following COVID-19 infection included female (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.65 to 4.91) and having QoL issues (OR, 3.25; 95% CI, 1.71 to 6.19). Conclusions: The study investigated the prevalence rates of various symptoms following COVID-19 infection. These findings underscore the need to prioritize comprehensive care for individuals recovering from COVID-19 and to implement strategies to mitigate the long-term impact of the disease on mental health and QoL.

Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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