• Journal of Korea Multimedia Society
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• v.20 no.2
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• pp.205-215
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• 2017

The brain magnetic resonance images (MRI) is an important imaging biomarker in Alzheimer's disease (AD) as the cerebral atrophy has been shown to strongly associate with cognitive symptoms. The decrease of volume estimates in different structures of the medial temporal lobe related to memory correlates with the decline of cognitive functions in neurodegenerative diseases. During the past decades several methods have been developed for quantifying the disease related atrophy of hippocampus from MRI. Special effort has been dedicated to separate AD and mild cognitive impairment (MCI) related modifications from normal aging for the purpose of early detection and prediction. We trained a multi-class support vector machine (SVM) with probabilistic outputs on a sample (n = 58) of 20 normal controls (NC), 19 individuals with MCI, and 19 individuals with AD. The model was then applied to the cross-validation of same data set which no labels were known and the predictions. This study presents data on the association between MRI quantitative parameters of hippocampus and its quantitative structural changes examination use on the classification of the diseases.

• Korean Journal of Radiology
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• v.24 no.11
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• pp.1131-1141
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• 2023

Objective: Cortical iron deposition has recently been shown to occur in Alzheimer's disease (AD). In this study, we aimed to evaluate how cortical gray matter iron, measured using quantitative susceptibility mapping (QSM), differs in the clinical cognitive impairment spectrum. Materials and Methods: This retrospective study evaluated 73 participants (mean age ± standard deviation, 66.7 ± 7.6 years; 52 females and 21 males) with normal cognition (NC), 158 patients with mild cognitive impairment (MCI), and 48 patients with AD dementia. The participants underwent brain magnetic resonance imaging using a three-dimensional multi-dynamic multi-echo sequence on a 3-T scanner. We employed a deep neural network (QSMnet+) and used automatic segmentation software based on FreeSurfer v6.0 to extract anatomical labels and volumes of interest in the cortex. We used analysis of covariance to investigate the differences in susceptibility among the clinical diagnostic groups in each brain region. Multivariable linear regression analysis was performed to study the association between susceptibility values and cognitive scores including the Mini-Mental State Examination (MMSE). Results: Among the three groups, the frontal (P < 0.001), temporal (P = 0.004), parietal (P = 0.001), occipital (P < 0.001), and cingulate cortices (P < 0.001) showed a higher mean susceptibility in patients with MCI and AD than in NC subjects. In the combined MCI and AD group, the mean susceptibility in the cingulate cortex (β = -216.21, P = 0.019) and insular cortex (β = -276.65, P = 0.001) were significant independent predictors of MMSE scores after correcting for age, sex, education, regional volume, and APOE4 carrier status. Conclusion: Iron deposition in the cortex, as measured by QSMnet+, was higher in patients with AD and MCI than in NC participants. Iron deposition in the cingulate and insular cortices may be an early imaging marker of cognitive impairment related neurodegeneration.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.184-190
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• 2016

Objectives : This study analyzed the differences of body mass index(BMI) in Korean patients with Alzheimer's diseases(AD), Mild Cognitive Impairment(MCI), and healthy controls to verify whether low BMI is associated with cognitive impairment. Furthermore, this study also sought to examine any association between BMI and Mini Mental State Examination-Korean version(MMSE-K), Clinical Dementia Rating(CDR), and Global Deterioration Scale(GDS). Methods : A total of 257 subjects were included in the study. History taking, mental status examination, physical examination and neurocognitive function test were carried out for the diagnosis of AD and MCI. The subjects' demographic data and presence of diseases were also surveyed. The overall cognitive function and severity of diseases were assessed using MMSE-K, GDS, and CDR. Results : The order of BMI was found to be healthy controls>MCI>AD, with statistically significant differences among the groups. The order of MMSE-K scores was similar, with healthy controls>MCI>AD in statistically significant differences. The healthy controls had the lowest CDR and GDS scores, and AD patients had the highest scores. There was a significant positive correlation between BMI and MMSE scores(r=0.238, p=0.000). BMI was negatively correlated with CDR(r=-0.174, p=0.008) as well as with GDS(r=-0.233, p= 0.000). Conclusions : Measuring BMI of patients with AD or MCI is expected to be meaningful in that BMI could be a clinical indicator of AD. We expect this to be beneficial for the diagnosis, prevention, and therapeutic approach of AD and also expect large-scale, long-term longitudinal studies to follow.

• Journal of Korea Multimedia Society
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• v.18 no.2
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• pp.120-127
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• 2015

Mild Cognitive Impairment(MCI) is a prior step to Alzheimer's Disease(AD). It is different from AD which is seriously affecting daily life. Particularly, the hippocampus could be charged a crucial function for forming memory. MCI has a high risk about progress to AD. Our investigated research for a relationship between hippocampus and AD has been studied. The measurement of hippocampus volumetric is one of the most commonly used method. The three dimensional reconstructed medical images could be passible to interpret and its examination in various aspects but the cost of brain research with the medical equipment is very high. In this study, 3D visualization was performed from a series of brain Magnetic Resonance Images(MRI) and we have designed and implemented a competitive software tool based on the open libraries of Visualization ToolKit(VTK). Consequently, our visualization software tool could be useful to various medical fields and specially prognosis and diagnosis for MCI patients.

• The Journal of Korean Medicine
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• v.34 no.3
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• pp.106-118
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• 2013

Objectives: The aim of this study was to evaluate the effect of a mild cognitive impairment (MCI) management program on traditional Korean medicine in a public health center. Methods: In order to examine the effect of the MCI management program, we investigated MCI patients who participated in the program. MCI patients were treated with Jodeung-san (JDS) or Dangguijagyag-san (DGJYS) for 6 weeks. Mini Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Quality of Life-Dementia (GQOL-D), Geriatric Depression Scale in Korea (GDS-K), and biochemical examination of blood were conducted at intervals of 6 weeks. A satisfaction survey was collected after this program. Results: MMSE-DS mean score increased significantly, by 4.09 (p=0.000) in the JDS group and by 4.15 (p=0.000) in the DGJYS group. GQOL-D mean score also increased significantly, by 5.90 (p=0.000) in the JDS group and by 5.07 (p=0.000) in the DGJYS group. GDS-K mean score decreased significantly, by 10.63 (p=0.000) in the JDS group and by 9.69 (p=0.000) in the DGJYS group. MMSE-DS, GDS-K and GQOL-D scores were not significantly different between the JDS and DGJYS groups. All of the participants were satisfied with the program, and 90% of the participants expressed a high intention to participate in the program again. Conclusions: Both Jodeung-san and Dangguijagyag-san treatment showed improvement on cognitive function, depression and quality of life in this program. Additional studies with more subjects will be required to prove credibility and validity more clearly.

• Journal of Digital Convergence
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• v.19 no.3
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• pp.471-482
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• 2021

We aimed to provide evidences for developing non-pharmacological intervention in older adults with Mild Cognitive Impairment(MCI) by integrated literature review. The final 16 papers were selected as a result of an integrated literature analysis. All of them are focused on strengthening cognitive activities, while Korean studies have often merged emotional activities such as music therapy and laughter therapy rather than physical activities such as exercise therapy, international studies have combined physical activities rather than emotional activities. The effects of non-pharmacological intervention differed according to the outcome variables. The primary variables were cognitive function and depression, and secondary variables were found to have effects on physical function, activities of daily living (ADL), and self-efficacy. This study contributes to a multidisciplinary approach that can be applied in the clinical field through the development of various non-pharmaceutical intervention for the prevention of dementia in the older adults with MCI.

• 한국노년학
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• v.38 no.1
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• pp.1-14
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• 2018

Everyday hearing handicap caused by presbycusis ultimately reduces quality of life in older adults. The aim of this study was to explore effects of cognitive impairment on self-reported hearing handicap in older adults with early-stage presbycusis. We compared K-HHIE scores between 40 elderly subjects with mild cognitive impairment (MCI) and age- and hearing-threshold matched 40 cognitively normal elderly (CNE) subjects. The results are as follows: 1) The MCI group scored significantly higher than the CNE group on the social/situational and emotional sections, and in total. 2) The MCI group scored significantly higher than the CNE group on all four subscales, and the most significant group difference was on the first subscale relating to interpersonal relationships and social handicaps. 3) Both groups scored highest on the item 8 (problems hearing whispering sounds) and item 15 (problems hearing TV or radio sounds). Besides those two items, the MCI group also scored high on the item 21 (problems hearing in a restaurant), item 6 (problems hearing when attending a party), item 3 (avoiding groups of people), and item 20 (personal or social restrictions). Our findings suggest that, among older adults with early-stage presbycusis, older adults with cognitive impairment tend to report greater everyday hearing handicap than their peers with normal cognitive function. Especially, they show significant problems hearing in background noise or multi-talker situations, which cause social restrictions and social/emotional loneliness.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.119-126
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• 2018

Objectives : The aim of this study is to investigate correlation between degree of white matter hyperintensities (WMH) and neurocognitive function along with behavioral and psychological symptoms of dementia (BPSD) in Korean patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 115 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this retrospective study. WMH in brain MRI were rated with standardized visual rating scales (Fazekas scales) and the subjects were divided into two groups according to Fazekas scale. Cognitive function was evaluated with Korean version of the consortium to establish a registry for Alzheimer's Disease (CERAD-K), and BPSD was evaluated with Korean neuropsychiatric inventory (K-NPI). Independent t-test was performed to analyze the relationship between the degree of WMH and neurocognitive functions & BPSD. Results : Especially, the group with high severity of WMH showed significantly lower language fluency (p<0.05). In addition, the group with high severity of WMH showed significantly higher score in K-NPI. Conclusions : There was a significant association between WMH and neurocognitive test related with executive function. Moreover, WMH seems to affect BPSD severity. Evaluation of WMH would provide useful information in clinical settings.

• Journal of Integrative Natural Science
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• v.11 no.3
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• pp.139-147
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• 2018

Hippocampal atrophy is a well-established imaging biomarker of Alzheimer disease (AD). However, hippocampus is a non-homogenous structure with cytoarchitecturally and functionally distinct sub-regions or subfield, with each region performing distinct functions. Certain regions of the subfield have shown selective vulnerability to AD. Here, we are interested in studying the effects of normal aging and mild cognitive impairment on these sub-regional volumes. With a reliable automated segmentation technique, we segmented these subregions of the hippocampus in 101 cognitively normal (CN), 135 early mild cognitive impairment (EMCI), 67 late mild cognitive impairment (LMCI) and 48 AD subjects. Thereby, dividing the hippocampus into hippocampal tail (tail), subiculum (SUB), cornu ammonis 1 (CA1), hippocampal fissure (fissure), presubiculum (PSUB), parasubiculum (ParaSUB), molecular layer (ML), granule cells/molecular layer/dentate gyrus (GCMLDG), cornu ammonis 3(CA3), cornu ammonis 4(CA4), fimbria and hippocampal-amygdala transition area (HATA). In this cross sectional study of 351 ADNI subjects, no differences in terms of age, gender, and years of education were observed among the groups. Though, the groups had statistically significant differences (p < 0.05 after the multiple comparison correction) in the Mini-Mental State Examination (MMSE) scores. There was asymmetrical volume loss in the early stages of AD with the left hemisphere showing volume loss in regions that were unaffected in the right hemisphere. Bilateral parasubiculum, right cornu ammonis 1, 3 and 4, right fimbria and right HATA regions did not show any volume loss till the late MCI stages. Our findings suggest that the hippocampal subfield regions are selectively vulnerable to AD and also that these vulnerabilities are asymmetrical especially during the early stages of AD.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.306-315
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• 2023

Purpose: This study aimed to evaluate the rest-activity circadian rhythm (RAR) using data obtained from wearable actigraph devices in hospitalized older adults with mild cognitive impairment (MCI), and to investigate its relationship with salivary alpha amylase (sAA). Methods: This secondary data analysis used data from the Hospitalized Older Adults' Cognition and Physical Activity Study. Actigraph data for 3-4 days were analyzed for RAR. RAR indices such as interdaily stability (IS), intradaily variability (IV), activity level during the most active 10-hour period and during the most least active 5-hour period, and relative amplitude (RA) were calculated. Data on sAA collected in the morning and general characteristics, including body mass index (BMI), were analyzed. Results: Data from 92 hospitalized older adults with MCI were analyzed. The IS, IV, RA were 0.23, 0.73, 0.88, respectively. The average level of sAA was 77.02 U/mL, and a higher level of sAA was significantly associated with better IS and RA in the regression analysis, while age, BMI, and cognitive level were not. BMI showed positive correlations with IS and RA. Conclusion: RAR in the hospitalized older adults with MCI was attenuated, showing especially low IS, which implies they failed to maintain regular and repetitive 24-hour RAR. Increased sAA and BMI were associated with robust RAR. Nurses need to pay attention to maintain robust RAR in hospitalized older adults with MCI, and strategies should be developed to improve their RAR.