• Perspectives in Nursing Science
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• 제2권1호
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• pp.76-91
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• 2005

Stroke patients often develop post stroke sequelae when they survive. Post stroke fatigue and emotional disturbances including depression are common along with motor dysfunction. However, medical personnel have paid relatively little attention to emotional changes and the presence of fatigue following strokes. Post-stroke fatigue was common, occurring in 57% of the patients in our series. The post-stroke fatigue appears to be related to the pre-stroke fatigue, physical disability and post stroke depression (PSD) although the relation to the lesion location remains elusive. The prevalence of post-stroke emotional disturbance has been reported to range from 12% to 64%. The wide variation in the frequency of post stroke depression may be related to methodological heterogeneity in items such as the criteria for depression, the timing of assessment, and the study population. Emotional incontinence, which is characterized by inappropriate or excessive laughing or crying is also common. The incidence of and factor related to this post-stroke emotional incontinence (PSEI) also remains unclear. We reported that out-patients with single, unilateral stroke, 18% had PSD and 34% had PSEI. Although both PSD and PSEI were related to motor dysfunction and location (anterior vs. posterior cortex) of the lesion, the latter was a stronger determinant for PSD. PSEI was more closely associated with subcortical strokes than was PSD. Another manifestation of post stroke patients is the occurrence of post stroke anger proneness (PSAP). They may become easily irritated, impulsive, less generous, and prone to be angry or aggressive at others. We also have reported the PSAP which seems to be closely associated with the presence of PSEI. The lesion distribution appears to be also similar. Both PSEI and PSAP respond well to serotonin reuptake inhibitors suggesting that these symptomsmay be possibly related to the alteration of serotonin after brain injury. Likewise, PSAP also produces a great deal of frustration and embarrassment among patients and caregivers. In summary, emotional disturbances such as depression, emotional incontinence, anger-proneness and fatigue are fairly common but under-recognized sequelae of stroke. These emotional disturbances decrease the quality of life of the patients and caregivers, and may adversely affect the overall prognosis. Therefore, these problems must be appropriately recognized and alleviated. Finding strategies to relieve the symptoms is imperative by understanding the causative factors in individual patient.

• Journal of Korean Neurosurgical Society
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• 제39권2호
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• pp.130-135
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• 2006

Objective : After ischemic stroke, partial recovery of function frequently occurs and may depend on the plasticity of axonal connections. Here, we examine whether blockade of the Nogo/NogoReceptor[NgR] pathway might enhance axonal sprouting and thereby recovery after focal brain infarction. Methods : Adult male Sprague Dawley rats weighing $250{\sim}350g$ were used. Left middle cerebral artery occlusion[MCAO] was induced with a intraluminal filament. An osmotic mini pump [Alzet 2ML4, Alza Scientific Products, Palo Alto, CA] for the infusion of NgR-Ecto[310]-Fc to block Nogo/NgR pathway was implanted 1 week after cerebral ischemia. Prior to induction of ischemia, all animals received training in the staircase and rotarod test. Two weeks after biotin dextran amine injection, animals were perfused transcardially with PBS, followed by 4% paraformadehyde/PBS solution. Brain and cervical spinal cord were dissected. Eight coronal sections spaced at 1mm intervals throughout the forebrain of each animal with cresyl violet acetate for determination of infarction size. Images of each section were digitized and the infarct area per section was measured with image analysis software. Results : Histological examination at 11 weeks post-MCAO demonstrates reproducible stroke lesions and no significant difference in the size of the stroke between the NgR[310]Ecto-Fc protein treated group and the control group. Behavioral recovery is significantly better and more rapid in the NgR-Ecto[310]-Fe treated group. Blockade of NgR enhances axonal sprouting from the uninjured cerebral cortex and improves the return of motor task performance. Conclusion : Pharmacological interruption of NgR allows a greater degree of axonal plasticity in response this is associated with improved functional recovery of complicated motor tasks.

• BMB Reports
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• 제55권4호
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• pp.181-186
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• 2022

Ventriculomegaly induced by the abnormal accumulation of cerebrospinal fluid (CSF) leads to hydrocephalus, which is accompanied by neuroinflammation and mitochondrial oxidative stress. The mitochondrial stress activates mitochondrial unfolded protein response (UPRmt), which is essential for mitochondrial protein homeostasis. However, the association of inflammatory response and UPRmt in the pathogenesis of hydrocephalus is still unclear. To assess their relevance in the pathogenesis of hydrocephalus, we established a kaolin-induced hydrocephalus model in 8-week-old male C57BL/6J mice and evaluated it over time. We found that kaolin-injected mice showed prominent ventricular dilation, motor behavior defects at the 3-day, followed by the activation of microglia and UPRmt in the motor cortex at the 5-day. In addition, PARP-1/NF-κB signaling and apoptotic cell death appeared at the 5-day. Taken together, our findings demonstrate that activation of microglia and UPRmt occurs after hydrocephalic ventricular expansion and behavioral abnormalities which could be lead to apoptotic neuronal cell death, providing a new perspective on the pathogenic mechanism of hydrocephalus.

• Investigative Magnetic Resonance Imaging
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• 제1권1호
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• pp.114-118
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• 1997

목적: 기능적 MR 영상은 외부자극에 따라, 이에 상응하는 특정한 뇌피질 부위의 혈류량의 변화를 신호강도의 차이로 나타내는 방법이다. 시각피질에 대한 기능적 MR은 환자가 광자극을 응시함으로써 수행될 수 있는 것으로, 이의 수행에는 적절한 형태의 광자극원이 필수적이다. 이에 저자는 광자극원의 크기가 시각피질 활성화에 영향을 미칠 수 있는지 알아보기 위하여 본 연구를 하였다. 대상 및 방법: 정상적인 시력을 가진 자원자 5명을 대상으로 시각활성화 기능적 MR을 시행하였다. 광자극원은 $11{\times}8cm$ 크기의 기판에 적색 LED(light-emitting diodes) 39개를 박고 직류전원을 사용하도록 만들었다. 이를 크기에 따라 full field, half field 및 focal central field의 3가지로 구분하고 8Hz로 점멸하였다. EPI 기법으로 6회의 광자극 기간과 6회의 휴식기간을 번갈아 3차례 시행하여 총 36회의 검사를 하고, Z-score로 통계처리하였다. 이 때 얻은 활성화 영상을 같은 부위의 T1강조영상에 결합시켰다. 각 경우에서 시각피질에서 활성화된 pixel의 수를 full field, half field 및 focal central field에서 얻어진 pixel 수의 합으로 나누어 활성화지수를 구하였다. 이 활성화지수를 토대로 광원크기와의 관계를 분석하였다. 결과: Full field로 자극을 주었을 때 시각피질의 평균 신호강도의 증가는 약 9.6%였다. 4명에서 활성화지수는 full field, half field, focal central field의 순으로 감소하였으며, 나머지 1명에서는 half field 시의 값이 full field 시의 값보다 컸다. 광원크기에 따른 활성화지수의 범위는 full field 43-73%(평균 55%), half field 22-40%(평균 32%), focal central field 5-24%(평균 13%)였다. 결론: 기능적 MR영상을 이용하여 시각피질의 활성화를 용이하게 확인할 수 있었으며 광자극원의 크기에 따라 증가되는 시각피질 활성화를 입증할 수 있었다.

• Journal of Acupuncture Research
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• 제18권5호
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• pp.60-69
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• 2001

Objective : Recent studies Suggested that there is a strong correlation between acupuncture stimulation and its related cortical activation. Anther study showed that either positive or negative BOLD effects could be observed depending on anatomical structure in acupuncture. Material and Methods : 1) Subjects and paradigms : Two separate stimulation paradigms were performed on five healthy (aged 22-23 yrs) in this study. First, the paradigm of acupuncture stimulation was that the acupuncture needle was inserted in acupoints KI6(照海), which is located in lateral side of the foot and then continuously twisted(補瀉를 除外한 捻轉法) for 70 seconds for 10 cycles of activation. During rest period (70 seconds), the needle was completed removed from acupoint. Total 60 cycles were performed and 10 images were obtained per cycle. Second, non-acupoint was randomly selected and the same paradigm was performed as acupoint stimulation. The stimulation protocol comprised 10 cycles of alternating activation and rest (10 images per cycle). Total 60 cycles were performed and each cycle take about 1.5 sec for motor task. Subjects take an at least 15 minutes break before starting anther paradigm. Conclusion : In this study, I investigated a new acupoint KI6(照海) which was known as motor - related acupoint and obtained an evidence that the stimulation of KI6(照海) resulted in negative BOLD response to stimulation.

• 대한한방부인과학회지
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• 제27권3호
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• pp.1-11
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• 2014

Objectives: Hwangryunhaedok-tang (HH) is a representative heat clearing multiherb prescription. We evaluated the protective effect of HH against heat stress exposure in mice. Methods: Six weeks old ICR mice were used for this study. After $43^{\circ}C$ heat stress for 15 minutes, we evaluated the changes of motor activity and c-fos expression level to determine the proper heat stress and evaluation time. The subjects were divided into 4 groups (1. control group, 2. heat stress group with normal saline, 3. heat stress group with administration of 100 mg/kg, and 4. heat stress group with administration of 1000 mg/kg). After oral administration of HH once a day for 3 days, 2, 3, 4 groups were exposed to $43^{\circ}C$ heat stress for 15 minutes. Then, we evaluated the motor activity for 120 minutes and analyzed the c-fos expression using western blot. We investigated the effect of HH and its ingredients on c-fos expressions after heat stress. The mice were administrated HH, Scutellariae Radix, Coptidis Rhizoma, Phellodendri Cortex, and Gardeniae Fructus for 3 days. After one hour of last treatment, the mice were exposed to heat stress at $43^{\circ}C$ for 15 min. After two hours, the hypothalamus was dissociated and lysed to measure c-fos expression. Results: After oral administration of HH for 3 days, motor activity was recovered insignificantly. 100 mg/kg HH treatment reduced the c-fos expression after heat stress but insignificantly. Among the ingredients of HH, Coptidis Rhizoma and Scutellariae Radix treatment groups significantly reduced the c-fos after stress. Conclusions: These results show that Hwangryunhaedok-tang may be effective to reduce the heat stress response.

• 대한본초학회지
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• 제24권1호
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• pp.179-189
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• 2009

Objectives : Coptidis Rhizoma (Coptis japonica MAKINO; CR) is a well known crude drug as antimicrobial, antibacterial, anti-inflammatory, antioxidant activity. However, there is no study of the effect of CR on brain infarction and it's mechanism. The aim of this study was to investigate the effects on ischemic stroke induced by photothrombotic infarction by evaluating the functional & neuronal recovery after brain infarction. Materials & Methods : Male Sprague-Dawley rats (250-300 g) were induced photothrombotic brain infarction on sensorimotor cortex, and brain infarction volume by image J software (NIH, USA) after Nissl stain, also single pellet reaching task as a functional motor recovery were observed. After orally pretreated by CR (500 mg/kg) or normal saline as a sham control before 7 days from the time of photothrombotic infarction, rats were sacrificed. After then we analysed anti-inflammatory cytokines (TNF-$\alpha$, IL-6, IL-1$\beta$), by RT-PCR and ELISA method, and immunohistochemistry (GFAP, connexin-43) as a marker of neural plasticity. Results : CR (100, 250, 500 mg/kg) decreased the infarction volume dose-dependently, however the effect of 500mg/kg of CR (CR 500) showed the best (P=0.051). Also, CR 500 decreased the infarction volume time-dependently, the most effective time was 3-7 days after stroke. Photothrombosis increased inflammatory cytokines after infarction, CR 500 suppressed significantly mRNA expression of IL-1$\beta$, IL-6 and TNF-$\alpha$. In serum, CR 500 decreased the amount of IL-1$\beta$, 12h, 24h and 48h respectively (p < 0.05), also decreased that of IL-6 and TNF-$\alpha$, 12h respectively (p < 0.05) after infarction. The more astrocytes were observed and neural plasticity was facilitated in the rat brain of CR 500 than that of sham control in immunohistochemistry. Conclusions : This results suggest that CR decrease infarction volume and improve functional motor recovery in acute stage in photothrombotic ischemic infarction model in the mechanism of anti-inflammation and promoting neural plasticity.

• 재활복지공학회논문지
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• 제3권1호
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• pp.41-47
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• 2009

본 논문에서는 중추신경계나 대뇌피질의 운동 및 감각기능을 검사하는 근전도계 및 유발성응답기의 안전 요구사항 및 시헙방법을 기술한다. 국제 기준에 부합화하는 안전 요구사항을 설정하고, 국제 표준에 따른 시험방법 및 표준 시험절차서를 제시하였다. 그러나 장비의 개별 성능 요구사항은 특정하지 않고, 제조사에서 제시하는 성능이나 출력이 가능하도록 규정하였다. 시중에 유통되고 있는 근전도계 장비를 이용하여 제시된 시험방법에 대한 유효성을 확인하였다. 이 연구의 결과는 식품의약품안전청에서 의료기기 인허가시 적용되는 기준규격으로서 사용될 수 있을 것이다.

• Clinical and Experimental Pediatrics
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• 제63권3호
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• pp.88-95
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• 2020

Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone, particularly when it is interpreted by experienced neuroradiologists. Ultra-high-field imaging and postprocessing analysis with automated machine learning algorithms can detect subtle structural abnormalities in MRI-negative patients. Tractography derived from diffusion tensor imaging can delineate white matter connections associated with epilepsy or eloquent function, thus, preventing deficits after epilepsy surgery. Arterial spin-labeling perfusion MRI, simultaneous electroencephalography (EEG)-functional MRI (fMRI), and magnetoencephalography (MEG) are noinvasive imaging modalities that can be used to localize the epileptogenic foci and assist in planning epilepsy surgery with positron emission tomography, ictal single-photon emission computed tomography, and intracranial EEG monitoring. MEG and fMRI can localize and lateralize the area of the cortex that is essential for language, motor, and memory function and identify its relationship with planned surgical resection sites to reduce the risk of neurological impairments. These advanced structural and functional imaging modalities can be combined with postprocessing methods to better understand the epileptic network and obtain valuable clinical information for predicting long-term outcomes in pediatric epilepsy.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2003년도 제27회 추계학술대회
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• pp.74-74
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• 2003

Purpose: To investigate whether there are significant changes in regional brain metabolism in patients with Parkinson's disease after thalamotomy using proton magnetic resonance spectroscopy (lH MRS). Methods: Fifteen patients with Parkinson's disease of mean age 56.5 years (7 males and 8 females; mean age, 56.5 years) that have treated with levodopa were included. All patients with tremor experienced amelioration of their symptoms on the side contralateral to the thalamotomy. As a single-voxel technique, 1H MR spectra were obtained from the volume of interested regions in thalamus and primary motor cortex. Spectral parameters were: 20 ms TE, 2000 ms TR, 128 averages, 2500 Hz spectral width, and 2048 data points. Results: We found that NAA/Cho ratios showed generally low levels in thalamus in Parkinson's disease patients with clinical improvement following thalamotomy. Conclusions: 1H MRS may be a useful utility for the aid in better understanding the pathophy-siologic process in Parkinson's disease patients on the basis of the variation of NAA/Cho ratio. Acknowledgement: This study was supported by a grant of the Center for Functional and Metabolic Imaging Technology, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV07-0002).