• 한국인터넷방송통신학회논문지
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• 제19권3호
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• pp.83-90
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• 2019

최근 들어 노년기의 인지기능장애에 대한 예방 또는 치료의 필요성이 대두되고 있다. 특히 알츠하이머 치매의 전단계로서 경도인지장애(Mild Cognitive Impairment) 여부를 조기에 진단하고, 인지기능 훈련을 통하여 치매로의 진행을 지연시키고자 노력하고 있다. 대부분의 인지기능 훈련은 여러 가지 인지능력과 관련한 게임 콘텐츠로 제작되지만, 피험자들이 인지기능 훈련에 집중하고 있는 지에 대한 정량적 검증이 필요하다. 그래서 본 논문에서는 제작된 주의력 훈련 게임 콘텐츠를 수행하는 동안 뇌 활성화에 대한 EEG 신호를 측정하여 분석하였다. 분석 방법으로는 게임 콘텐츠에 얼마나 집중하고 있는 지를 나타내는 주의집중 지표(Concentration Index)와 휴식 상태에서의 안정을 나타내는 이완 지표(Relaxation Index)를 사용하였다. 이에 대한 본 연구에서의 결과는 피험자들의 CI는 모두 증가하는 것으로 나타났으며, 이것은 피험자들이 집중하여 게임 콘텐츠를 수행하였다고 볼 수 있는 것이다.

• Genomics & Informatics
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• 제21권3호
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• pp.28.1-28.13
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• 2023

Mild cognitive impairment (MCI) is a clinical syndrome characterized by the onset and evolution of cognitive impairments, often considered a transitional stage to Alzheimer's disease (AD). The genetic traits of MCI patients who experience a rapid progression to AD can enhance early diagnosis capabilities and facilitate drug discovery for AD. While a genome-wide association study (GWAS) is a standard tool for identifying single nucleotide polymorphisms (SNPs) related to a disease, it fails to detect SNPs with small effect sizes due to stringent control for multiple testing. Additionally, the method does not consider the group structures of SNPs, such as genes or linkage disequilibrium blocks, which can provide valuable insights into the genetic architecture. To address the limitations, we propose a Bayesian bi-level variable selection method that detects SNPs associated with time of conversion from MCI to AD. Our approach integrates group inclusion indicators into an accelerated failure time model to identify important SNP groups. Additionally, we employ data augmentation techniques to impute censored time values using a predictive posterior. We adapt Dirichlet-Laplace shrinkage priors to incorporate the group structure for SNP-level variable selection. In the simulation study, our method outperformed other competing methods regarding variable selection. The analysis of Alzheimer's Disease Neuroimaging Initiative (ADNI) data revealed several genes directly or indirectly related to AD, whereas a classical GWAS did not identify any significant SNPs.

• 대한통합의학회지
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• 제9권3호
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• pp.37-45
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• 2021

Purpose : This study aimed to present normative data and cut-off points for older Korean adults completing the Montreal Cognitive Assessment - Korean (MoCA-K), which is used as a screening test for mild cognitive impairment in Korea. Methods : A total of 195 healthy adults ≥60 years were recruited. All participants completed the MoCA-K and the Korean - Mini-Mental State Examination (MMSE-K) to assess their cognitive function. Participants were divided into six groups based on their age: 60-64 years, 65~69 years, 70~74 years, 75~79 years, 80~84 years, and 85~89 years. Results : The results revealed that MoCA-K score decreased significantly with age (mean score ± standard deviation [SD]; 27.63±2.80 in subjects aged 60~64 years; 27.00±2.39 in subjects aged 65~69 years; 24.94±2.96 in subjects aged 70~74 years; 24.74±3.37 in subjects aged 75~79 years; 22.59±4.72 in subjects aged 80~84 years; and 18.83±5.38 in subjects aged 85~89 years; p<.001). Additionally, MoCA-K score also increased significantly with educational level (mean score±standard deviation [SD]; 19.95±4.78 in no formal education group; 24.95±2.22 in elementary school graduated group; 26.35±2.72 in middle school graduated group; 28.32±1.36 in high school graduated group; and 28.50±1.51 in more than college graduated group; p<.001). The optimal cut-off points were 24/25 for 60~69 years old group, 21/22 for 70~79 years old group, 17/18 for 80~84 years old group, and 13/14 for 85~89 years old group. The optimal cut-off points were 15/16 for individuals who were illiterate, 22/23 for individuals with 6 years of education, 22/24 for individuals with 9 years of education, and 26/27 for individuals with 12 or more years of education. Conclusions : This study presents normative data and cut-off points for the MoCA-K in older Korean adults. This data will facilitate more accurate detection and follow-up of the risk of mild cognitive impairment in this population, taking into consideration age and education. Future studies are required that should focus on the cut-off score on the level of education according to age.

• 대한의용생체공학회:의공학회지
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• 제39권6호
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• pp.237-242
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• 2018

$^{18}F$-fludeoxyglucose PET (FDG-PET) can help finding an abnormal metabolic activity in brain. In this study, we evaluated an efficiency of volume- and cortical surface-based analysis which were used to determine whether standardized uptake value ratio (SUVR) of FDG-PET was different among Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy control (HC). Each PET image was rigidly co-registered to the corresponding magnetic resonance imaging (MRI) using mutual information. All voxels of the co-registered PET images were divided by the mean FDG uptake of the cerebellum cortex which was thresholded by partial volume effect (>0.9). Also, the SUVR value of each vertex was linearly interpolated from volumetric SUVR image which was thresholded by gray matter partial volume effect (>0.1). Lobar mean values were calculated from both volume- and cortical surface-based SUVRs. Statistical analysis was conducted to compare two measures for AD, MCI and HC groups. Even though the results of volume (SUVR_vol) and cortical surface-based SUVR (SUVR_surf) analysis were not significantly different from each other, the latter would be better for detecting group differences in SUVR of PET.

• 한국융합학회논문지
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• 제10권5호
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• pp.103-110
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• 2019

알츠하이머형 치매(Alzheimer's disease, AD)가 입체시 지각에 영향을 미치는지를 규명하고자 정상노인, AD환자, 경도인지장애(mild cognitive impairment, MCI)환자 각각 20명을 대상으로 입체시 지각능력을 검사했다. 화면 좌우에 두 개의 정육면체가 제시되었으며, 참가자들은 둘 중 자신에게 더 가까운 물체를 지적하였다. 이 때 물체들 간의 상대적 거리를 절대부등과 상대부등으로 분리하여 조작하였으며, 각 부등 유형에서 교차부등과 비교차부등으로 부등의 방향도 함께 변화시켰다. 그 결과 MCI환자들과 AD환자들이 정상노인 못지않게 정확하게 수행한 것으로 나타났다. 이런 결과는 입체시 지각과정이 AD의 영향을 거의 받지 않는 증거로 볼 수 있다. 이런 결과를 AD로 인해 영향을 받는 고차원 시각 과정과 비교하면서 논의하였다.

• 동의생리병리학회지
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• 제34권5호
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• pp.222-228
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• 2020

The purpose of this article was to investigate the current state of studies on clinical trials of acupuncture treatment for Alzheimer's disease using neuroimaging method. We searched for clinical trials of acupuncture treatment for Alzheimer's disease(AD) and mild cognitive impairment(MCI) using neuroimaging method in the MEDLINE (Pubmed) database on March 18, 2020. Once the online search was finished, studies were selected manually by the inclusion criteria. Finally, we analyzed the characteristics of selected articles and reviewed the neural substrates of acupuncture treatment in AD. Total ten studies were included in this study. The most frequently applied modality for AD was functional MRI. The most frequently selected acupoints for AD were KI3, LR3 and LI4. One of studies showed that acupuncture treatment could improve the symptoms of MCI. Through the analysis, we demonstrated that neuroimaging method could capture the neural substrates associated with AD. Moreover, acupuncture may induce differential response according to the disease status. Finally, real acupuncture could produce more extensive activation/deactivation than sham acupuncture. We hope that neuroimaging method can contribute to the clinical research of acupuncture treatment for AD through large-scale RCT and diverse imaging modality.

• 대한간호학회지
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• 제51권3호
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• pp.294-304
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• 2021

Purpose: This study aimed to investigate objectively measured physical activity (PA) in institutionalized older adults with mild cognitive impairment (MCI) and to elucidate the influence of autonomic nervous function, salivary cortisol, and PA on cognitive functions based on neurovisceral integration model. Methods: Overall cognitive function was evaluated using the mini-mental state examination (MMSE) and executive function was evaluated using semantic verbal fluency test and clock drawing test. Actigraph for PA, HRV and sAA for autonomous function, and the geriatric depression scale for depression were used. Saliva specimens were collected in the morning for sAA and cortisol. Results: Ninety-eight older adults from four regional geriatric hospitals participated in the study. They took 4,499 steps per day on average. They spent 753.93 minutes and 23.12 minutes on average in sedentary and moderate-to-vigorous activity, respectively. In the multiple regression analysis, lower salivary cortisol level (β = - .33, p = .041) and greater step counts (β = .37, p = .029) significantly improved MMSE score. Greater step count (β = .27, p = .016) also exerted a significant influence on verbal fluency, and greater sAA (β= .35, p = .026) was significantly associated with a better clock drawing test result. Conclusion: Salivary cortisol, sAA and physical activity were significantly associated with cognitive functions. To prevent older adults from developing dementia, strategies are needed to increase their overall PA amount by decreasing sedentary time and to decrease salivary cortisol for cognitive function, and to maintain their sympathetic nervous activity for executive function.

• 재활치료과학
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• 제10권4호
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• pp.81-94
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• 2021

목적 : 반응시간은 인지 능력과 노화에 대한 연구에서 중요한 역할을 한다. 본 연구는 컴퓨터 프로그램을 이용한 인지반응시간(Cognitive response time: CRT) 검사를 실시하여 정보처리에 대한 인지 능력의 영향을 확인하는 것을 목적으로 한다. 연구방법 : 대구 및 경북 지역에 거주하고 있는 65~79세의 일반 노인(Normal elderly: NE) 30명과 기억성 경도인지장애(Amnestic mild cognitive impairment: aMCI) 노인 30명을 대상으로 하였다. 결과 분석은 통계 분석 프로그램 R 4.0.2(University of Auckland, Auckland, New Zealand)를 사용하였다. 결과 : CRT 검사의 세 개 하위 영역에서의 총 반응시간은 집단 및 연령에 따라 유의한 차이를 보였고, 오류율은 일부 하위 영역에서 연령 또는 집단에 따라 유의한 차이를 보였다. aMCI 집단의 CRT 검사 수행력은 전반적인 인지 및 기억 검사의 수행력과 유의한 상관성을 갖는 것으로 나타났다. 결론 : 인지반응시간을 측정하는 CRT 검사를 통해 노화 및 인지 능력에 따른 정보처리과정과 처리속도의 변별적 수행을 관찰할 수 있었다. 또한, 이 검사의 수행력이 전반적인 인지 및 기억 검사와 유의한 상관성을 갖고 있음을 확인하였다. 따라서 지역사회 일반 노인의 초기 인지장애를 예측하는 간편 도구로써 CRT 검사가 의미있게 사용될 수 있기를 기대한다.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.32-42
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• 2022

Objective: This study was conducted to verify the effectiveness of a cognitive rehabilitation program consisting of physical exercises and mental activities for patients with chronic stroke with mild cognitive impairment (MCI). We aimed to investigate how this cognitive rehabilitation program affects patients' cognitive ability, depression, and sleep quality. Design: One group pretest-posttest design Methods: The study was conductedon 12 patients who participated in thecognitive rehabilitation complex exercise program for 16 weeks. The Korean version of the Montreal Cognitive Assessment (MoCA-K), Hamilton Depression Rating Scale (K-HDRS), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the measured variables before and after study participation. The cognitive rehabilitation complex exercise program included 30 minutes of cognitive exercise and 30 minutes of Brill Exercise. The Wilcoxon signed-rank test was used to compare the variables before and after program participation. Cronbach's ɑ was used to assess the reliability of the test variables. Results: The post-program assessment showed a statistically significant increase in the MoCA-K score, which measures cognitive function (Z=-2.628, P=0.009). For depression ratings, there was a statistically significant decrease in the K-HDRS score (Z=-2.041, P=0.041). For sleep quality, although there was a numerical increase in the PSQI score, the difference was not statistically significant (Z=-0.702, P=0.483). The reliability test confirmed that all the individual test variables exhibited high reliability (cognitive function, 0.859; depression, 0.872; sleep, 0.822). Conclusions: We found that cognitive rehabilitation program used in this study had a positive effect on the cognitive function and depression in patients with chronic stroke with MCI.

• 정신신체의학
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• 제27권1호
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• pp.60-68
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• 2019

연구목적 갑상선관련 호르몬과 인지기능의 상관 유무는 논란이 되고 있다. 알츠하이머병과 경도인지장애 환자에서 갑상선관련 호르몬 농도에 차이가 있는지 비교해 보고, 나아가 갑상선관련 호르몬 농도가 인지기능의 어떠한 영역과 관련이 있는지에 대해 연구해보고자 하였다. 방 법 2011년 1월부터 2018년 12월까지 기억력 저하를 주소로 일산백병원 정신건강의학과 치매클리닉을 방문하여 알츠하이머병(NINCDS-ADRDA 진단기준)과 경도인지장애(Petersen 진단기준) 으로 진단된 105명의 환자를 대상으로 한 후향적 연구이다. 갑상선관련 호르몬[삼요오드티로닌(Triiodothyronine, T3), 티록신(Thyroxine, T4), 갑상선 자극 호르몬(Thyroid stimulating hormone, TSH)]의 측정은 화학발광면역측정법을 사용하여 검사하였다. 알츠하이머병군과 경도인지장애군 간의 갑상선관련 호르몬의 평균치 분석을 위하여 독립표본 t-검정을 시행하였다. 갑상선관련 호르몬이 전반적 퇴화 척도(Global deterioration scale, GDS), 치매임상평가척도(Clinical dementia rating, CDR) 및 한국형 임상치매평가척도(The Korean version of the consortium to establish a registry for Alzheimer's disease, CERAD-K)의 각 항목 별 점수들과 유의한 상관이 있는지 알아보기 위하여 한국판 노인우울척도(Geriatric depression scale-Korean version, GDS-K)를 통제변수로하여 편상관분석을 시행하였다. 결 과 총 105명의 환자 중 알츠하이머병군은 74명, 경도인지장애군은 31명이었다. 알츠하이머병군과 경도인지장애군 간 혈청 T3, T4, TSH 농도의 평균은 모두 유의한 차이가 없었으나, CERAD-K 항목 중 구성행동 검사(Construction praxis test, CPT)가 혈청 TSH 농도와 유의한 양의 상관 관계를 보였다(p-value=0.004). 결 론 본 연구에서 실행기능과 연관된 CPT가 혈청 TSH 농도와 유의한 양의 상관 관계를 보인 것은 갑상선관련 호르몬과 치매의 병태생리와의 연관성에 대한 이해에 도움을 줄 수 있다고 생각한다. 향후 갑상선관련 호르몬이 인지기능에 미치는 병태생리 기전에 관한 전향적 연구들이 필요할 것으로 사료된다.