• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.2
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• pp.51-62
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• 2021

Objectives: Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. Methods: The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. Results: Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. Conclusion: Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

• Journal of Industrial Convergence
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• v.18 no.4
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• pp.51-59
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• 2020

The purpose of this study was to investigate the improvement of muscle strength and gait ability of paralyzed lower extremity through convergent stimulation of tDCS(transcranial direct current stimulation) during mirror therapy with resistance exercise in chronic stroke patients. 12 patients with stroke were randomly assigned and divided into groupI(n=6) and groupII(n=6). GroupI provided NDT(neurodevelopmental treatment) and mirror therapy with sham tDCS, and groupII provided NDT and mirror therapy with tDCS. Each convergent stimulation was conducted 5 times a week, 30 minutes per session for a total of 4 weeks. All evaluation was conducted before intervention and performed after 4 weeks. Lower extremity strength showed a significant improvement in groupII compared to groupI(p<.05), and in comparison between groups by variance, significant difference in the quadriceps(p<.01) and tibialis anterior(p<.01). Gait ability showed a significant improvement in both groupI(p<.05) and groupII(p<.05), and significant difference in comparison between groups by variance(p<.01). In conclusion, mirror therapy with tDCS convergent stimulation had a positive improvement effect on paralyzed lower extremity to strength and gait ability through the overlapping interaction.

• Clinical and Experimental Pediatrics
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• v.58 no.6
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• pp.224-229
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• 2015

Purpose: Thyroid dysfunction is common in preterm infants. Congenital hypothyroidism causes neurodevelopmental impairment, which is preventable if properly treated. This study was conducted to describe the characteristics of thyroid dysfunction in very low birth weight infants (VLBWIs), evaluate risk factors of hypothyroidism, and suggest the reassessment of thyroid function with an initially normal thyroid-stimulating hormone (TSH) as part of a newborn screening test. Methods: VLBWIs (January 2010 to December 2012) were divided into two groups according to dysfunction-specific thyroid hormone replacement therapy, and associated factors were evaluated. Results: Of VLBWIs, 246 survivors were enrolled. Only 12.2% (30/246) of enrolled subjects exhibited thyroid dysfunction requiring thyroid hormone replacement. Moreover, only one out of 30 subjects who required thyroid hormone treatment had abnormal thyroid function in the newborn screening test with measured TSH. Most of the subjects in the treatment group (22/30) exhibited delayed TSH elevation. Gestational age, Apgar score, antenatal steroids therapy, respiratory distress syndrome, patent ductus arteriosus, sepsis, intraventricular hemorrhage, postnatal steroids therapy, and duration of mechanical ventilation did not differ between the two groups. Birth weight was smaller and infants with small for gestational age were more frequent in the treatment group. Conclusion: Physicians should not rule out suggested hypothyroidism, even when thyroid function of a newborn screening test is normal. We suggest retesting TSH and free thyroxine in high risk preterm infants with an initially normal TSH level using a newborn screening test.

• Korean Journal of Biological Psychiatry
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• v.26 no.1
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• pp.14-21
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• 2019

Objectives Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. Methods Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. Results The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. Conclusions The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.209-215
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• 2014

Purpose: The purpose of this study is to examine the effects of postural control training using a horseback riding simulation on the spinal alignment of children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), and they were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week for ten weeks, while the experimental group also received hippotherapy 15 minutes per session, four times per week for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators (JOBA, EU7805, Panasonic) used in this study simulated actual horse movements. Trunk imbalance, pelvic torsion, and pelvic tilt were measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a spinal structure analysis system (ABW Mapper). Results: The Intra-group effects on trunk imbalance, pelvic torsion, and pelvic tilt according to the exercise periods after the hippotherapy were tested, and the results showed significant interaction effects between the groups and the periods (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the spinal alignment of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided by type.

• Molecules and Cells
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• v.38 no.6
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• pp.540-547
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• 2015

Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, affecting approximately 5% of children. However, the neural mechanisms underlying its development and treatment are yet to be elucidated. In this study, we report that an ADHD mouse model, which harbors a deletion in the Git1 locus, exhibits severe astrocytosis in the globus pallidus (GP) and thalamic reticular nucleus (TRN), which send modulatory GABAergic inputs to the thalamus. A moderate level of astrocytosis was displayed in other regions of the basal ganglia pathway, including the ventrobasal thalamus and cortex, but not in other brain regions, such as the caudate putamen, basolateral amygdala, and hippocampal CA1. This basal ganglia circuit-selective astrocytosis was detected in both in adult (2-3 months old) and juvenile (4 weeks old) $Git1^{\check{s}/\check{s}}$ mice, suggesting a developmental origin. Astrocytes play an active role in the developing synaptic circuit; therefore, we performed an immunohistochemical analysis of synaptic markers. We detected increased and decreased levels of GABA and parvalbumin (PV), respectively, in the GP. This suggests that astrocytosis may alter synaptic transmission in the basal ganglia. Intriguingly, increased GABA expression colocalized with the astrocyte marker, GFAP, indicative of an astrocytic origin. Collectively, these results suggest that defects in basal ganglia circuitry, leading to impaired inhibitory modulation of the thalamus, are neural correlates for the ADHD-associated behavioral manifestations in $Git1^{\check{s}/\check{s}}$ mice.

• Physical Therapy Korea
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• v.18 no.2
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• pp.18-26
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• 2011

The purpose of this study was to investigate the effects of a task-oriented approach on weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement in 18 chronic stroke patients. Both groups were received neurodevelopmental treatment for 30 min/day and then the experimental group ($n_1$=9) followed additional a task-oriented approach (sit-to stand training with controlled environment) and the control group ($n_2$=9) followed a passive range of motion exercise for 15 min/day, five days/week, for four weeks. Weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement were measured before and after four weeks of training. There was significantly improved weight-bearing distribution of the paretic leg during sit-to-stand movement in the experimental group compared with that of the control group after four weeks of training (p<.05). But electromyographic activities of the quadriceps and the tibialis anterior of the paretic leg were not significantly different (p>.05). Thus, it is necessary to apply a task-oriented approach to improve the weight-bearing distribution of the paretic leg during sit-to-stand movement in chronic stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.75-82
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• 2014

PURPOSE: PURPOSE: The purpose of this study was to analyze the effect and examine the feasibility of an intervention of ankle strategy exercise on balance of patients with hemiplegia. METHODS: The subject were randomly allocated to three groups: ankle strategy exercise (group A), balance exercise (group B) and control (group C). Group A was received the conventional physical therapy plus ankle strategy exercises for 20 minutes in one session. Group B was received the same conventional physical therapy plus balance exercises for 20 minutes in one session. Two active groups were performed in the session 3 times a week, for a total of 6 weeks. and Group C was only received the same conventional physical therapy. Balance test was assessed using center of pressure (COP) in the anteroposterior (A-P), mediolateral (M-L) direction, Berg balance scale (BBS) and Timed Up and Go Test (TUG). RESULTS: All groups showed improvements in balance parameters. In especial, the Group A was statistically significant differences in almost part evaluation items and showed more improvements in BBS and TUG parameters than Group B and Group C. and moving distance of M-L COP was more improvements than Group B. CONCLUSION: Ankle strategy exercises had more influence on balance than balance exercises and neurodevelopmental treatment.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.117-122
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• 2015

Global developmental delay (GDD) is a relatively common early-onset chronic neurological condition, which may have prenatal, perinatal, postnatal, or undetermined causes. Family history, physical and neurological examinations, and detailed history of environmental risk factors might suggest a specific disease. However, diagnostic laboratory tests, brain imaging, and other evidence-based evaluations are necessary in most cases to elucidate the causes. Diagnosis of GDD has recently improved because of remarkable advances in genetic technology, but this is an exhaustive and expensive evaluation that may not lead to therapeutic benefits in the majority of GDD patients. Inborn metabolic errors are one of the main targets for the treatment of GDD, although only a small proportion of GDD patients have this type of error. Nevertheless, diagnosis is often challenging because the phenotypes of many genetic or metabolic diseases often overlap, and their clinical spectra are much broader than currently known. Appropriate and cost-effective strategies including up-to-date information for the early identification of the "treatable" causes of GDD are needed for the development of well-timed therapeutic applications with the potential to improve neurodevelopmental outcomes.

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.427-437
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• 2000

편마비 환자의 물리치료는 장애 결과를 완화시키는 것에 초점을 두고 있다. 본 연구는 신경생리학적 개념을 기초로 한 중재 접근 방법 중 편마비 환자에게 신경 발달 치료와 신경근 균형 접근 기법의 중재 효과를 비교 하였다. 연구 대상은 서울특별시와 전라북도에 소재한 종합병원 및 정형외과 의원에 입원 및 통원하고 있는 47-71세의 연령 범위에 있는 편마비 환자 30명 이다. 중재 집단의 기능적 능력 향상을 평가하기 위해 편마비 환자를 위한 운동 평가 척도와 수정된 바델 척도를 평가도구로 사용하였다. 편마비 환자의 기능적 능력 향성을 평가도구에 의해 측정된 결과를 분석한 바 운동평가 척도 항목중 바로누운 자세에서 옆으로 눕기와 앉아서 균형 취하기 영역에서, 수정된 바델 척도 항목 중 식사하기 영역에서 통계적으로 유의한 차이를 보였다(P<.05). 편마비 환자의 손상 부위, 손상 형태, 마비 부위 등의 손상의 본질에 따른 대상의 선정과 운동 조절 형태에 관한 지식 그리고 신경학적 결함 정도를 심도있게 다루어 기능적 능력 향상의 임상적 효과를 검증하는 것이 중요하다.