• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.3-11
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• 2017

Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.47-55
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• 1996

Progressive supranuclear palsy (PSP) is a parkinson-plus syndrome characterized clinically by supranuclear ephthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormality and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using $^{99m}Tc$-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex.

• Journal of Haehwa Medicine
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• v.26 no.1
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• pp.58-67
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• 2017

Objectives:This study was designed to report treatment by Sasang Constitutional Medicine to the patients with Major Neurocognitive Disorder(Dementia) from various causes. Methods:These two patients were diagnosed as Taeeumin and Soyangin according to the result of Sasang constitutional diagnosis, and treated by Sasang constitutional medications. The progress was evaluated with the Korean version of Mini-Mentel State Exam(KMMSE) and Global Disorientation Scale(GDS). Result:The symptoms like wandering, insomnia, cognitive disorder was improved in these patients. Also, KMMSE and GDS score were highly improved. the one patient was cured with Cheongsimyeonja-tang and and the other was cured with Jihwangbaekho-tang and Yanggyuksanhwa-tang. Conclusion:This cases show that Sasang constitutional herbal medications are an effective treatment for the patients with Major Neurocognitive Disorder.

• Biomedical Science Letters
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• v.27 no.4
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• pp.208-215
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• 2021

The purpose of this study was to explain the pathology of Alzheimer's disease (AD) and to investigate the correlation between AD and microRNA. AD is the most common type of dementia, accounting for about 80% of all types of dementia, causing dysfunction in various daily activities such as memory loss, cognitive impairment, and behavioral impairment. The typical pathology of AD is explained by the accumulation of beta-amyloid peptide plaques and neurofibrillary tangles containing hyperphosphorylated tau protein. On the other hand, microRNA is small non-coding RNA 22~23 nucleotides in length that binds to the 3' untranslated region of messenger RNA to inhibit gene expression. Many reports explain that microRNAs found in circulating biofluids are abundant in the central nervous system, are involved in the pathogenic mechanism of AD, and act as important factors for early diagnosis and therapeutic agents of AD. Therefore, this paper aims to clarify the correlation between AD and microRNA. In this review, the basic mechanism of miRNAs is described, and the regulation of miRNAs in the pathological processes of AD are highlighted. Furthermore, we suggest that miRNA-based system in development of therapeutic and diagnostic agents of AD can be a promising tool.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.453-472
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• 2022

Over the past decades, the immense clinical need for early detection methods and treatments for dementia has become a priority worldwide. The advances in PET biomarkers play increasingly important roles in understanding disease mechanisms by demonstrating the protein pathology underlying dementia in the brain. Amyloid-β and tau deposition in PET images are now key diagnostic biomarkers for the Alzheimer's disease continuum. The inclusion of biomarkers in the diagnostic criteria has achieved a paradigm shift in facilitating early differential diagnosis, predicting disease prognosis, and influencing clinical management. Furthermore, in vivo images showing pathology could become prognostic as well as surrogate biomarkers in therapeutic trials. In this review, we focus on recent developments in radiotracers for amyloid-β and tau PET imaging in Alzheimer's disease and other neurodegenerative diseases. Further, we introduce their potential application as future perspectives.

• Biomedical Science Letters
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• v.18 no.4
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• pp.399-405
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• 2012

The brain is the body's most organized and controlled organ, and it governs various psychological and mental functions. A brain abnormality could greatly affect one's physical and mental abilities, and consequently one's social life. Brain disorders can be broadly categorized into three main afflictions: stroke, brain tumor, and dementia. Among these, stroke is a common disease that occurs owing to a disorder in blood flow, and it is accompanied by a sudden loss of consciousness and motor paralysis. The main types of strokes are infarction and hemorrhage. The exact diagnosis and early treatment of an infarction are very important for the patient's prognosis and for the determination of the treatment direction. In this study, texture features were analyzed in order to develop a prototype auto-diagnostic system for infarction using computer auto-diagnostic software. The analysis results indicate that of the six parameters measured, the average brightness, average contrast, flatness, and uniformity show a high cognition rate whereas the degree of skewness and entropy show a low cognition rate. On the basis of these results, it was suggested that a digital CT image obtained using the computer auto-diagnostic software can be used to provide valuable information for general CT image auto-detection and diagnosis for pre-reading. This system is highly advantageous because it can achieve early diagnosis of the disease and it can be used as supplementary data in image reading. Further, it is expected to enable accurate medical image detection and reduced diagnostic time in final-reading.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.71-78
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• 2014

Objectives : Behavioral and psychological symptoms of dementia(BPSD) represent significant clinical problems, resulting in functional decline, caregiver distress, institutionalization and increased mortality. A recent study showed gender differences have important role in the development of BPSD, but relationship between BPSD and gender has never been studied in Korea. This study was designed to examine whether patients with Alzheimer's disease show gender differences in behavioral and psychological symptoms of dementia(BPSD). Methods : Ninety-eight subjects with Alzheimer's disease were included in this study. We carried out history taking and cognitive assessment for the diagnosis of Alzheimer's disease based on DSM-IV. Cognitive impairment and BPSD were measured using the Mini Mental State Examination(MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating(CDR) and the Korean Neuropsychiatric Inventory(K-NPI). Independent samples t-test was used to examine the differences across gender in BPSD. Correlation analysis between MMSE, CDR, GDS and NPI was performed using Pearson's correlation coefficient. Results : There were no significant gender differences between the gender in BPSD. We found statistically significant negative correlations between MMSE with NPI total score, and with scores of several sub-domains such as hallucination. Conclusions : This study showed that gender differences in BPSD are not significant. Further research is necessary to identify whether BPSD affect gender differences or individual differences.

• Journal of mucopolysaccharidosis and rare diseases
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• v.5 no.1
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• pp.1-7
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• 2021

Gaucher disease (GD, OMIM #230800 OMIM#230800) is a rare, autosomal recessive inherited metabolic disorder caused by mutation in GBA1 encoding the lysosomal enzyme, glucocerebrosidase. The deficiency of glucocerebrosidase leads to an accumulation of its substrate, glucosylceramide in macrophages of various tissues. Common clinical manifestations include cytopenia, splenomegaly, hepatomegaly, and bone lesions. The phenotype of GD is classified into three clinical categories: Type 1 (non-neuronopathic) is characterized by involvements on the viscera, whereas types 2 and 3 (neuronopathic) are associated with not only visceral symptoms but also neurological impairment, either severe in type 2 or variable in type 3. A diagnosis of GD can be confirmed by demonstrating the deficiency of acid glucocerebrosidase activity in leukocytes. Mutations in the GBA1 should be identified as they may be of prognostic value in some cases. Biomarkers including Chitotriosidase, CCL18, and glucosylsphingosine (lyso-GL1) are useful in diagnosis and treatment monitoring. Currently available disease-specific treatment in Korea consists of intravenous enzyme replacement therapy and substrate reduction therapy. For enhancing long-term prognosis, the onset of Parkinson's disease and Lewy body dementia, or the occurrence of a blood disease or cancer (hepatocellular carcinoma) should be monitored in older patients. The development of new strategies that can modify the neurological phenotype are expected, especially in Asia including Korea, where the prevalence of neuronopathic GD is relatively higher than that in western countries.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.157-168
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• 1995

The neuropsychiatric sequelae of traumatic brain unjury(TBI) are effects on complex aspect of behavior, cognition and emotional expression. They include psychiatric disorders such as depression, psychosis, personality change, dementia, and postconcussion syndrome. The damage is done not only to the cortex of the brain but also to subcortical and axial structures. The diffuse degeneration of cerebral white mailer is axonal damage that is caused by mechanical forces shearing the neuronal fiber at the moment of impact(diffuse axonal injury, DAI). The DAI and the changed receptor-agonist mechanism ore the most important mechanisms in genesis of neuropsychiatric sequalae by mild TBI. The most important instrument for diagnosis of neuropsychiatric sequalae of TBI is a physician or psychiatrist with experience and knowledge. The most effective therapeutic tool is a professional who understands the nature of the problem.

• Journal of Biomedical Engineering Research
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• v.31 no.1
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• pp.27-32
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• 2010

Noninvasive detection of patients with probable Alzheimer's disease (AD) is of great importance for assisting a medical doctor's decision for early treatment of AD patients. In the present study, we have extracted quantitative electroencephalogram (qEEG) variables, which can be potentially used to diagnose AD, from resting eyes-closed continuous EEGs of 22 AD patients and 27 age-matched normal control (NC) subjects. We have extracted qEEG variables from mean phase coherence (MPC) and EEG coherence, evaluated for all possible combinations of electrode pairs. Preliminary trials to discriminate the two groups with the extracted qEEG variables demonstrated that the use of MPC as a supplementary or alternative measure for the EEG coherence may enhance the accuracy of noninvasive diagnosis of AD.