• 한국산학기술학회논문지
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• 제17권7호
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• pp.459-466
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• 2016

본 연구는 아급성기 뇌졸중 환자에서 로봇 보조치료법이 운동능력 및 기능적인 회복에 미치는 효과를 알아보고자 하였다. 환자 53명이 연구에 참여하였다. 로봇보조 보행치료군은 고식적인 치료에 추가로 Lokomat$^{(R)}$ 이용하여 하루에 삼십분씩, 일주일에 5회, 4주 동안 시행하였으며, 대조군은 고식적인 치료에 추가로 하루에 삼십분씩 고식적인 치료를 시행 받았다. 모든 환자들은 임상지표의 비교를 위해, 치료 전과 4주간의 치료 후 Fugl-Meyer assessment, Motricity index, functional ambulation category, Berg balance scale, 10m 보행검사, 한국판 수정 바델지수, 한국판 간이 정신 상태검사와 벡 우울증 척도를 평가 받았다. 환자들은 기능회복과 체성 감각 유발전위 검사 결과의 관계를 알아보기 위해 유발 전위 검사를 시행하였다. 아급성기 뇌졸중 환자에서 로봇 보조 보행치료군에서 대조군에 비해 하지의 운동기능, 보행 능력, 일상생활능력의 유의한 호전이 나타났다. 체성 감각 유발 전위 검사의 결과는 임상 지표들의 관련성 분석에서 Motricity index와 한국판 수정 바델지수와 관련이 있는 것으로 나타나 아급성기 뇌졸중 환자의 기능을 예측하는데 유용할 것으로 생각된다. 로봇 보조 보행치료는 아급성기 뇌졸중 환자의 운동기능과 보행기능의 회복을 촉진하는 것으로 생각된다.

• Journal of Magnetics
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• 제19권1호
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• pp.28-31
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• 2014

The aim of the present study was to examine whether mirror therapy, in conjunction with repetitive transcranial magnetic stimulation (rTMS), can improve the upper extremity function of stroke patient. This study was conducted with 35 subjects, who were diagnosed as a hemiparesis by stroke. The Mirror plus rTMS group was of 12 members who undertook mirror therapy in conjunction with rTMS, the Mirror group was of 11 members who undertook mirror therapy, and the control group was of 12 members who undertook sham therapy. A motor cortex excitability was performed by motor evoked potential, and upper limb function was evaluated by Fugl-Meyer Assessment, and Box and Block Test. Significant difference was shown after the experiment, in comparison of the groups in terms of latency, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and control group, and between the Mirror group and control group, respectively. Significant difference was shown after the experiment in comparison of the groups in amplitude, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and Mirror group, and between the Mirror plus rTMS group and control group. Significant difference was shown after the experiment, in comparison of the groups in FMA and BBT, and as the result of post hoc test, significant difference was shown between the Mirror plus rTMS group and Mirror group, and between the Mirror group and control group. The study showed that mirror therapy in conjunction with rTMS is more effective to improve upper extremity function, than mirror therapy and sham therapy.

• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.954-958
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• 2000

In the removal of small subcortical lesion in the eloquent area like sensory-motor cortex, the prevention of neurologic deficit is important. We present our technique of identification of M-1, S-1 cortex in a case of subcortical granuloma located in sensorymotor cortex. To accurately localize mass, stereotactic craniotomy was planned. At the beginning of procedure, functional MRI of motor cortex was done with stereotactic headframe in place. Next, the stereotactic craniotomy about 4 cm was done under propofol anesthesia for cortical mapping. After reflection of dura, central sulcus was identified with phase-reversal response of intraoperative SEP(somatosensory evoked potential) of contralateral median nerve. Then the patient was awakened, and direct cortical stimulation was done. We observed the muscle contractions of elbow, hand and fingers and the paresthesia over forearm, hand, fingers on the M-1 and S-1 cortex. Through cortical mapping and stereotactic guidance, we concluded that the mass lie immediately posterior to central sulcus, then the mass was carefully removed through small transsulcal approach, opening about 1 cm of rolandic sulcus.

• The Korean Journal of Physiology and Pharmacology
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• 제4권3호
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• pp.227-234
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• 2000

Many reports suggest that neurotensin (NT) in the gastrointestinal tract may play a possible role as a neurotransmitter, a circulating hormone, or a modulator of motor activity. NT exerts various actions in the intestine; it produces contractile and relaxant responses in intestinal smooth muscle. This study was designed to investigate the effect of NT on motility of antral circular muscle strips in guinea-pig stomach. To assess the role of $Ca^{2+}$ influx in underlying mechanism, slow waves were simultaneously recorded with spontaneous contractions using conventional intracellular microelectrode technique. At the concentration of $10^{-7}$ M, where NT showed maximum response, NT enhanced the magnitude $(863{\pm}198%,\;mean\;SEM,\;n=13)$ and the frequency $(154{\pm}10.3%,\;n=11)$ of spontaneous contractions. NT evoked a slight hyperpolarization of membrane potential, tall and steep slow waves with abortive spikes $(278{\pm}50%,\;n=4).$ These effects were not affected by atropine $(2\;{\mu}M),$ guanethidine $(2\;{\mu}M)$ and tetrodotoxin (0.2μM). NT-induced contractile responses were abolished in $Ca^{2+}-free$ solution and reduced greatly to near abolition by $10\;{\mu}M$ of verapamil or 0.2 mM of $CdCl_2.$ Verapamil attenuated the effects of NT on frequency and amplitude of the slow waves. Taken together, these results indicate that NT enhances contractility in guinea-pig gastric antral circular muscle and $Ca^{2+}$ influx through the voltage-operated $Ca^{2+}$ channel appears to play an important role in the NT-induced contractile mechanism.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.282-288
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• 2021

Objective : Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery. Methods : We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1-5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side. Results : Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40). Conclusion : This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.

• Clinical Pain
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• 제18권1호
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• pp.1-7
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• 2019

Objective: To investigate the cortical disinhibition in diabetic patients with neuropathic pain and without pain. In addition, we assessed the cortical disinhibition and pain relief after repetitive transcranial magnetic stimulation (rTMS). Method: We recruited diabetic patients with neuropathic pain (n = 15) and without pain (n = 15). We compared the TMS parameters such as motor evoked potential (MEP) amplitude, cortical silent period (CSP), intracortical inhibition (ICI %) and intracortical facilitation (ICF %) between two groups. Moreover, we evaluated the changes of pain and TMS parameters after five consecutive high frequency (10 Hz) rTMS sessions in diabetic patients with neuropathic pain. The neuropathic pain intensity (visual analog scale) and TMS parameters were assessed on pre-rTMS, post-rTMS 1day, and post-rTMS 5 day. Results: The comparison of the CSP, ICI % revealed significant differences between two groups (p<0.01). After rTMS sessions, the decrease in pain intensity across the three time points revealed a pattern of significant differences (p<0.01). The change of CSP and ICI % across the three test points revealed a pattern of significant differences (p<0.01). The ICI % revealed immediate increase after first rTMS application and significant increase after five rTMS application (p<0.01) in diabetic patients with neuropathic pain. The MEP amplitude and ICF % did not reveal any significant changes. Conclusion: Our findings demonstrate that cortical inhibition was decreased in diabetic patients with neuropathic pain compared with patients without pain. Furthermore, we also identified that five daily rTMS sessions restored the defective intracortical inhibition which related to improvement of neuropathic pain in diabetic patients.

• 한국지능시스템학회논문지
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• 제22권4호
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• pp.429-434
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• 2012

본 논문에서는 사지가 마비되어 신체를 움직이지 못하지만 뇌의 기능은 정상적인 대 마비 환자들을 위한, 생각만으로 외부의 장치를 제어할 수 있도록 하는 BCI(Brain-Computer Interface) 시스템 제어기술을 연구하였다. 사지를 움직이는 상상을 할 경우, 뇌의 운동 감각 피질 영역에서 발생하는 뮤리듬(${\mu}8$-12Hz)에서 증가되는 신호의 패턴인 Event-Related Synchronization (ERS)를 Short-Time Fourier Transform (STFT)과 Particle Swarm Optimization (PSO)를 이용하여 검출 하는 방법을 시도 하였다. ERS는 사람마다 다른 주파수 영역에서 발생하며, 본 논문에서는 ERS가 가장 많이 발현되고 전압이 큰 주파수를 검출하기 위해 8-12Hz 주파수영역의 EEG평균에서 PSO를 이용하여 가장 큰 진폭을 가지는 주파수를 확인 한 후, 해당 주파수를 사용하여 C3, C4채널에서 동작 상상 시 나타나는 ERS의 특징을 PSO를 이용하여 찾는 것이며. 개개인 마다 다른 주파수 영역에서 나타나는 ERS의 특징을 가장 많이 발현되는 주파수영역으로 고정하여 움직임 분석을 시도 하였다. 실험 결과에 사용된 data는 BCI competition IV data set의 실험자 b data를 사용 하였고, 하나의 주파수 대역만을 사용한 결과 왼손 40%, 오른손 38% 검출 정확도를 보였다.