• 생물정신의학
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• 제18권4호
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• pp.232-238
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• 2011

Objectives Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in the brain morphology between a group of patients with mild cognitive impairment (MCI) and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume change measured by optimized VBM in MCI subjects compared to controls. Methods Twenty patients with MCI and 20 control subjects with normal cognition were recruited for this study. We applied the optimized VBM protocol to the image data including study-specific template and the modulation of the data with the Jacobian determinants. GM volume differences between the MCI subjects and the control subjects and their correlations with the neuropsychological performances were investigated. Results Optimized VBM analysis revealed GM volume reduction in hippocampus, precentral gyrus, insula and parietal operculum in the MCI group compared to the control group (family wise error corrected p < 0.05). Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) word list recall scores were significantly correlated with the GM volumes of hippocampus, precuneus and posterior cingulate in the MCI group (FWE corrected p < 0.05). Conclusions The results confirm previous findings of atrophic changes in medial temporal lobe and parietal lobe in the MCI group and suggest that these abnormalities may be related with cognitive decline and prognosis in patients with MCI.

• 한국정보통신학회논문지
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• 제20권11호
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• pp.2054-2060
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• 2016

최근 인구 고령화가 급속히 진행되면서 치매인구가 빠른 속도로 증가하고 있다. 치매는 완벽한 치료법이 없기 때문에 경도인지 장애 평가를 통해 조기 발견하여 예방 훈련하는 것이 중요하다. 기존의 경도인지 장애 평가는 수기형태로 이루어지며, 피검자와 검사자의 1:1 대면 평가가 원칙이다. 이는 검사자의 피로도 증가와 이로 인한 평가오류의 가능성을 증가시킨다. 또한 도출된 데이터도 수기 형태이기에 다양한 방식으로 분석 및 활용하기에는 한계가 있다. 따라서 기존 방식의 제한점을 극복 수 있는 시스템화가 가능한 어플리케이션을 활용하여 평가하고, 그 결과를 저장 및 분석할 수 있는 시스템 개발이 필요하다. 본 논문은 경도인지 장애를 평가할 수 있는 피검자와 검사자용 어플리케이션과 평가 데이터를 저장 및 분석할 수 있는 시스템을 개발하고자 한다.

• Investigative Magnetic Resonance Imaging
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• 제25권3호
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• pp.164-171
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• 2021

Purpose: Mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD). Brain atrophy in this disease spectrum begins in the medial temporal lobe structure, which can be recognized by magnetic resonance imaging. To overcome the unsatisfactory inter-observer reliability of visual evaluation, quantitative brain volumetry has been developed and widely investigated for the diagnosis of MCI and AD. The aim of this study was to assess the prediction accuracy of quantitative brain volumetry using a fully automated segmentation software package, NeuroQuant^®, for the diagnosis of MCI. Materials and Methods: A total of 418 subjects from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease cohort were included in our study. Each participant was allocated to either a cognitively normal old group (n = 285) or an MCI group (n = 133). Brain volumetric data were obtained from T1-weighted images using the NeuroQuant software package. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to investigate relevant brain regions and their prediction accuracies. Results: Multivariate logistic regression analysis revealed that normative percentiles of the hippocampus (P < 0.001), amygdala (P = 0.003), frontal lobe (P = 0.049), medial parietal lobe (P = 0.023), and third ventricle (P = 0.012) were independent predictive factors for MCI. In ROC analysis, normative percentiles of the hippocampus and amygdala showed fair accuracies in the diagnosis of MCI (area under the curve: 0.739 and 0.727, respectively). Conclusion: Normative percentiles of the hippocampus and amygdala provided by the fully automated segmentation software could be used for screening MCI with a reasonable post-processing time. This information might help us interpret structural MRI in patients with cognitive impairment.

• 한국자기공명학회논문지
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• 제13권2호
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• pp.84-95
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• 2009

The purpose of this study was to evaluate the usefulness of the measurement of corpus callosum (CC) size in the Alzheimer patient by using magnetic resonance (MR) midsagittal image. We performed MR scanning in 20 normal high age group, and in 20 mild cognitive impairment (MCI) group, and in 20 Alzheimer disease (AD) group. The following parameters were employed in AD group: TRITE/FA 6650ms/66ms/$90^{\circ}$, NEX 2, Thickness/Gap 2/0, FOV 220mm. The magnetic field strength was used at 3.0 Tesla. We selected midsagittal image of the brain by using view forum program, measured CC size, which were anteroposterior length, diameter of genu, body, narrowing portion, and splenium. The present study demonstrates that CC size of Alzheimer disease can be useful for clinical assessment concerning the diameter of genu, body, and splenium.

• 성인간호학회지
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• 제28권6호
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• pp.691-700
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• 2016

Purpose: The aim of this study was to evaluate the effects of a computerized cognitive training on older adults affected by mild cognitive impairment (MCI) in terms of cognitive function, depression, self-esteem, and activities of daily living (ADL). Methods: This study used a non-equivalent control group non-synchronized design. A total of 53 older adults who reside in long-term care facilities were recruited, 26 subjects for an experimental group and 27 subjects for a control group. A computerized cognitive training was performed for 20~40 minutes/day, three days/week for ten weeks. Data were analyzed using SPSS/WIN 21.0 with $x^2$ test, Fisher's exact test, and t-test. Results: Scores of MMSE (t=3.30, p=.002), depression (t=-2.15, p=.036), and self-esteem (t=2.76, p=.008) were significantly better in the experimental group than the control group. However, the difference in ADL (t=-1.01, p=.316) was not significant between the two groups. Conclusion: These findings suggest that the computerized cognitive training can be used as an effective nursing intervention to improve cognitive function and self-esteem and lower depression among older adults with MCI.

• 정신신체의학
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• 제22권1호
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• pp.40-45
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• 2014

연구목적 경도인지장애와 치매는 인지기능의 퇴행과 우울 등과 같은 신경정신증상을 나타낸다. 이들의 진단에 도움을 줄 수 있는 다양한 진단 도구 중 혈중 호모시스테인 농도를 측정하는 방법이 있으며, 연구에 따르면 혈중 호모시스테인 농도의 증가는 알쯔하이머병, 우울증 그리고 다른 신경정신질환의 발생위험을 증가시킨다. 본 연구는 혈중 호모시스테인이 인지기능장애와 연관된다는 사실을 기초로 경도인지장애와 알쯔하이머형 치매에서 우울증상 유무에 따른 혈중 호모시스테인 농도를 분석해보았다. 방법 경도인지장애, 알쯔하이머형 치매로 진단된 환자 86명이 참여하였고 혈액검사를 통해 혈중 호모시스테인 농도를 측정하였다. 환자들의 전반적인 인지기능 및 심각도의 단계 평가는 한국판 간이정신상태검사(MMSE-KC)와 전반적 퇴화척도(Global Deterioration Scale, GDS), 치매임상평가척도(Clinical dementia rating, CDR)를 이용하여 측정하였고, 우울증상 유무에 대한 평가는 한국판 노인우울척도(Korean version of Geriatric Depression Scale, K-GDS)를 통해 측정하였다. 결과 혈중 호모시스테인 농도는 경도인지장애군 중 우울증상이 있는 군에서 우울증상이 없는 군보다 통계적으로 유의한 높은 수치를 보였다. 치매환자군에서는 우울증상이 있는 군과 우울증상이 없는 군사이에 통계적으로 유의한 차이는 없었다. 상관분석에서 혈중 호모시스테인 농도와 MMSE-KC는 유의한 음의 상관 관계를 보였고, CDR, GDS는 유의한 양의 상관 관계를 보였다. 결론 이러한 결과는 혈중 호모시스테인 농도의 증가가 인지기능저하와 우울증의 위험인자라는 사실을 나타낸다. 특히 본 연구에서는 경도인지장애 환자군에서 혈중 호모시스테인 농도와 우울증상 간의 의미있는 연관성을 제시하였다. 본 연구 중의 몇 가지 제한점을 보완한 좀 더 대규모의 연구가 필요하다.

• 동의신경정신과학회지
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• 제30권3호
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• pp.185-198
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• 2019

Objectives: The purpose of this study was to identify the effectiveness of Korean medicine treatment in mild cognitive impairment (MCI) among a group of community dwelling elderly. Methods: Two-hundred and twenty-nine elderly living in a community and diagnosed with MCI were recruited. Participants were evaluated with various instruments such as the Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Korean version of Montreal Cognitive Assessment (MoCA-K). Korean medicine treatment consisted of herbal medicine, acupuncture, and pharmacoacupuncture. The change in cognitive ability was assessed by using the MMSE-DS and the MoCA-K. Data were analyzed by SPSS/WIN 22.0 using the paired t-test, and the ANOVA. Results: The MMSE-DS and the MoCA-K score generally increased after six months of Korean medicine treatment and the differences in both instruments were statistically significant. Additionally, some consecutive participants maintained long-term cognitive improvement. When analyzed specifically by herbal medicine group based on syndrome differentiation and pharmacoacupuncture group, most showed improvement in the MMSE-DS and the MoCA-K but not all data were statistically significant. The satisfaction score was mostly high and most participants were willing to re-participate in the program. Conclusions: Korean medicine treatment may contribute to the improvement and prevention of cognitive decline in the elderly. However, further systematic research based on large scale sample data and standardized protocols is needed to uplift the welfare and mental health of the elderly.

• 대한물리의학회지
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• 제6권2호
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• pp.119-126
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• 2011

Purpose: The purpose of this study was to confirm whether the Swiss Ball exercise program is effective to improve lower extremity function and activity of daily living of elderly women with mild cognitive impairment (MCI). Methods: This study was a double blind control study. Subjects participated 34 female elderly women who were assigned to exercise group (n=17) and control group (n=17). The Swiss Ball exercise program was performed 2 times a week during the 12 weeks. Pre-and post-exercise various measurements were made: lower extremity function (OLS, TUG, STS). Results: In exercise group, There showed statically significance improve between pre-and post-exercise in OLS (7.29${\pm}$1.10 and 7.64${\pm}$1.32), TUG (10.47${\pm}$2.03 and 10.05${\pm}$2.04), STS (7.71${\pm}$1.04 and 7.94${\pm}$.82)(p<.05). ADL also showed statically significance improve between pre-and post-exercise (13.76${\pm}$3.54 and 12.82${\pm}$3.39, p<.05). There showed statically significance difference between two groups (p<.05). Conclusion: The Swiss Ball exercise program improved lower extremity function and ADL of elderly women with MCI. Further studies are required to examine the significance of the assessment of motor function of lower extremities.

• Journal of Ginseng Research
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• 제46권6호
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• pp.750-758
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• 2022

Background: Mild cognitive impairment (MCI) is a transitional condition between normality and dementia. Ginseng is known to have effects on attenuating cognitive deficits in neurogenerative diseases. Ginsenosides are the main bioactive component of ginseng, and their protein targets have not been fully understood. Furthermore, no thorough analysis is reported in ginsenoside-related protein targets in MCI. Methods: The candidate protein targets of ginsenosides in brain tissues were identified by drug affinity responsive target stability (DARTS) coupled with label-free liquid chromatography-mass spectrometry (LC-MS) analysis. Network pharmacology approach was used to collect the therapeutic targets for MCI. Based on the above-mentioned overlapping targets, we built up a proteineprotein interaction (PPI) network in STRING database and conducted gene ontology (GO) enrichment analysis. Finally, we assessed the effects of ginseng total saponins (GTS) and different ginsenosides on mitochondrial function by measuring the activity of the mitochondrial respiratory chain complex and performing molecular docking. Results: We screened 2526 MCI-related protein targets by databases and 349 ginsenoside-related protein targets by DARTS. On the basis of these 81 overlapping genes, enrichment analysis showed the mitochondria played an important role in GTS-mediated MCI pharmacological process. Mitochondrial function analysis showed GTS, protopanaxatriol (PPT), and Rd increased the activities of complex I in a dose-dependent manner. Molecular docking also predicted the docking pockets between PPT or Rd and mitochondrial respiratory chain complex I. Conclusion: This study indicated that ginsenosides might alleviate MCI by targeting respiratory chain complex I and regulating mitochondrial function, supporting ginseng's therapeutic application in cognitive deficits.

• Physical Therapy Rehabilitation Science
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• 제13권1호
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• pp.43-52
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• 2024

Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.