• Title/Summary/Keyword: Cognitive diagnosis

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A Survey of the Recognition on the Practice Pattern, Diagnosis, and Treatment of Korean Medicine of Dementia and Mild Cognitive Impairment - Focusing on the Differences between Neuropsychiatrists of Korean Medicine and General Physicians - (치매, 경도인지장애의 한의진료 현황, 진단 및 치료에 대한 한의사의 인식도 조사 연구 - 한방신경정신과 전문의와 일반의의 차이를 중심으로 -)

  • Seo, Young Kyung;You, Dong Keun;Kim, Hwan;Kim, Siyeon;Lee, Go eun;Kim, Sang-Ho;Kang, Hyung-Won;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.3
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    • pp.263-274
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    • 2017
  • Objectives: To identify the current status of Korean medical practice pattern, diagnosis and treatment of dementia through recognition survey, and to use it as a preliminary data for various dementia research. Methods: Questionnaires were developed through expert meetings. The disease was defined as dementia and mild cognitive impairment, and areas were designated to practice pattern, diagnosis and treatment. From December 18, 2016-January 18, 2017, 221 respondents, including 36 neuropsychiatrists of Korean Medicine and 185 general physicians (including other medical specialists) were included. Results: 1. In both groups, the most commonly used KCD (Korean standard classification of disease and cause of death) were in the order of Unspecified Alzheimer's Dementia (F00.9), Mild Cognitive Impairment (F06.7), and Unspecified Dementia (F03). 2. The most commonly used pattern identification were zang-fu and qi-blood-yin-yang in both groups. 3. Diagnostic evaluation tools were mainly conducted by MMSE, radiologic examination, K-DRS, GDS and CDR in both groups. 4. Both groups reported using acupuncture and herbal medicine mainly. 5. In both groups, the acupuncture method was used extensively in the order of Body, Scalp, and Sa-Am. 6. Neuropsychiatrists used a variety of herbal medicines such as Wonjiseokchangpo-san (Yuanzhushichangpu-san), Yukmijihwang-tang (Liuweidihuang-tang), Palmijihwang-won (Baweidihuang-won), Sunghyangjungki-san (Xingxiang Zhengqi-san) and Ondam-tanggami (Wendan-tangjiawei). General physicians used a variety of herbal medicines such as Ondam-tanggami (Wendan-tangjiawei), Bojungikgi-tang (Buzhongyiqi-tang), Yukmijihwang-tang (Liuweidihuang-tang). 7. Neuropsychiatrists used a variety of Korean herbal preparation products (benefit and non-benefit) such as Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Yukmijihwang-tang (Liuweidihuang-tang), Jodeung-san (houteng-san), Palmijihwang-won (Baweidihuang-won). General physicians used a variety of Korean herbal preparation products such as Bojungikgi-tang (Buzhongyiqi-tang), Banhabaegchulcheonma-tang (banxiabaizhutianma-tang), Yukmijihwang-tang (Liuweidihuang-tang), Ekgan-sangajinpibanha (Yigan-sanjiachenpibanxia), Palmijihwang-won (Baweidihuang-won). Conclusions: By confirming awareness of Korean medical doctors treating dementia in clinical fields and understanding differences between neuropsychiatrists of Korean medicine and general physicians, it can be used to understand guideline users' needs and confirm clinical questions during development of future clinical practice guidelines for dementia.

Recent Advances in Diagnosis and Treatment of Alzheimer's Disease (알츠하이머병의 최신지견)

  • Lee, Jung Jae;Lee, Seok Bum
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

Diagnosis of Alzheimer's Disease using Wrapper Feature Selection Method

  • Vyshnavi Ramineni;Goo-Rak Kwon
    • Smart Media Journal
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    • v.12 no.3
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    • pp.30-37
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    • 2023
  • Alzheimer's disease (AD) symptoms are being treated by early diagnosis, where we can only slow the symptoms and research is still undergoing. In consideration, using T1-weighted images several classification models are proposed in Machine learning to identify AD. In this paper, we consider the improvised feature selection, to reduce the complexity by using wrapping techniques and Restricted Boltzmann Machine (RBM). This present work used the subcortical and cortical features of 278 subjects from the ADNI dataset to identify AD and sMRI. Multi-class classification is used for the experiment i.e., AD, EMCI, LMCI, HC. The proposed feature selection consists of Forward feature selection, Backward feature selection, and Combined PCA & RBM. Forward and backward feature selection methods use an iterative method starting being no features in the forward feature selection and backward feature selection with all features included in the technique. PCA is used to reduce the dimensions and RBM is used to select the best feature without interpreting the features. We have compared the three models with PCA to analysis. The following experiment shows that combined PCA &RBM, and backward feature selection give the best accuracy with respective classification model RF i.e., 88.65, 88.56% respectively.

Diagnosis of neonatal seizures (신생아 경련의 진단)

  • Chung, Hee Jung;Hur, Yun Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.964-970
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    • 2009
  • Neonatal seizures are generally not only brief and subtle but also not easily recognized and are usually untreated. In sick neonates, seizures are frequently not manifested clinically but are detected only by electroencephalography (subclinical EEG seizures). This phenomenon of electroclinical dissociation is fairly common in neonates. On the other hand, neonates frequently show clinical behaviors such as stiffening, apnea, or autonomic manifestations that mimic seizures, which is usually associated with underlying encephalopathy and non-epileptic seizures. Therefore, it might be difficult to confirm the diagnosis of neonatal seizures. Early recognition of neonatal seizures is important to minimize poor neurodevelopmental outcomes, including cognitive, behavioral, and learning disabilities, as well as the development of postnatal epilepsy. EEG is a reliable tool in the determination of neonatal seizures. Continuous EEG monitoring is essential for the identification of seizures, evaluation of treatment efficacy, and prediction of the neurodevelopmental outcome. However, there is not yet a wide consensus on the optimal "standard" lead montage for the continuous EEG monitoring.

Intelligent Software System for the Advanced Control Room of a Nuclear Power Plant

  • Chang, Soon-Heung;Park, Seong-Soo;Park, Jin-Kyun;Gyunyoung Heo;Kim, Han-Gon
    • Proceedings of the Korean Nuclear Society Conference
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    • 1997.10a
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    • pp.443-448
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    • 1997
  • The intelligent software system for nuclear power plants (NPPs) has been conceptually designed in this study. Its design goals are to operate NPPs in n improved manner and to support operators' cognitive tasks. It consists of six major modules such as "Information Processing," "Alarm Processing," "Procedure Tracking," "Performance Diagnosis," and "Event Diagnosis" modules for operators and "Malfunction Diagnosis" module for maintenance personnel. Most of the modules have been developed for several years and the others are under development. After the completion of development, they will be combined into one system that would be main parts of advanced control rooms in NPPs. that would be main parts of advanced control rooms in NPPs.

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Diagnosis and Assessment of Autism Spectrum Disorder in South Korea

  • Johanna Inhyang Kim;Hee Jeong Yoo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.35 no.1
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    • pp.15-21
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    • 2024
  • Autism spectrum disorder (ASD) is diagnosed by the clinical decision of a trained professional based on the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition or International Classification of Diseases 11th Revision diagnostic criteria. To obtain information for diagnostic formulation, professionals should explore detailed developmental history, and can use structured or semi-structured assessment tools to observe interaction between the child and parents or strangers. Diagnostic assessment should include a profile of the strength and weaknesses of the individual and should be conducted using an optimal approach by a multidisciplinary team with appropriate techniques and experience. Assessment of language, cognitive, neuropsychological, and adaptive functioning should be conducted in ASD individuals prior to establishing an individualized treatment plan. Genetic testing, brain magnetic resonance imaging or electroencephalogram testing can be considered for identification of underlying causes.

The Role of Quantitative Electroencephalogram in the Diagnosis and Subgrouping of Attention-Deficit/Hyperactivity Disorder

  • Bong, Su Hyun;Kim, Jun Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.3
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    • pp.85-92
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    • 2021
  • Attention-deficit/hyperactivity disorder (ADHD) leads to functional decline in academic performance, interpersonal relationships, and development in school-aged children. Early diagnosis and appropriate intervention can significantly reduce the functional decline caused by ADHD. Currently, there is no established biological marker for ADHD. Some studies have suggested that various indicators from the quantitative electroencephalogram (QEEG) may be useful biological markers for the diagnosis of ADHD. Until the 2010s, theta/beta ratio (TBR) was a biomarker candidate for ADHD that consistently showed high diagnostic value. However, limitations of TBR have recently been reported. Studies have demonstrated that phase-amplitude coupling, especially theta phase-gamma amplitude coupling, are related to cognitive dysfunction and may assist in the diagnosis of ADHD. As yet, the underlying mechanism is not clearly established, and the clinical efficacy of these biomarkers needs to be proven through well-controlled studies. Based on the heterogeneous characteristics of ADHD, subgrouping through QEEG plays a key role in diagnosis and treatment planning. Sophisticated, well-designed studies and meta-analyses are necessary to confirm these findings.

Developmental profiles of preschool children with delayed language development

  • Eun, Jeong Ji;Lee, Hyung Jik;Kim, Jin Kyung
    • Clinical and Experimental Pediatrics
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    • v.57 no.8
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    • pp.363-369
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    • 2014
  • Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.

A Case Report of a Patient with Mild Cognitive Impairment Treated with Gugijihwang-tang (구기지황탕 투여 후 호전된 경도인지장애 환자 1례에 대한 증례보고)

  • Park, Mi-so;Kang, Seock-man;Yoo, Dai-won;Chae, In-cheol;Kim, Gyeong-soon;Seong, Hyun-joo;Chung, Kwang-yeol;Yoo, Ho-ryong
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.1082-1093
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    • 2021
  • Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

Usefulness of 18F-Florbetaben in Alzheimer's Disease Diagnosis (알츠하이머병 진단에서 18F-Florbetaben의 유용성)

  • Lee, Hyo-Yeong;Im, In-Chul;Song, Min-jae;Shin, Seong-gyu
    • Journal of the Korean Society of Radiology
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    • v.10 no.5
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    • pp.307-312
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    • 2016
  • Alzheimer's disease is the most common degenerative brain diseases that causes dementia. ${\beta}$-amyloid neuritic plaque density that accumulates in the brain is difficult to perform daily living, such as memory loss, language ability deterioration. It is used to estimate ${\beta}$-amyloid neuritic plaque density in adult patients with cognitive impairment who are being evaluated for Alzheimer's disease and other causes of cognitive impairment. Using the $^{18}F$-Florbetaben with high sensitivity and specificity for the ${\beta}$-amyloid neuritic plaque density to evaluate the usefulness for the early diagnosis of Alzheimer's disease. In $^{18}F$-FDG Brain imaging shows no specific findings. And it appeared on the MR-Brain imaging without atrophy of the hippocampus. However, the intake of ${\beta}$-amyloid neuritic plaque density in $^{18}F$-Florbetaben informs that it is the progress of Alzheimer's disease. Therefore, $^{18}F$-Florobetaben is very useful for early diagnosis of Alzheimer's disease.