• Anxiety and mood
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• v.10 no.1
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• pp.44-51
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• 2014

Objective : The amygdala has been considered to be a critical region in the pathophysiology of social anxiety disorder, but subregional connectivity pattern has not been examined yet despite lots of previous functional neuroimaging studies. Methods : Resting-state functional magnetic resonance imaging data was obtained in 19 patients with social anxiety disorder and 20 normal controls, and default mode functional connectivity with each of basolateral, centromedial and superficial areas of the amygdala was measured and compared between the two groups. Results : Differential amygdala-based networks between the two groups were distributed to all over the brain. In particular, however, a bias on the amygdala-cingulate pathway was observed in the superficial amygdala only. Connectivity strengths between the superficial amygdala and perigenual anterior cingulate cortex were correlated with scores of social interaction and avoidance. Conclusion : Our findings provide new insights into understanding of the intrinsic cognitive bias model of social anxiety disorder. An abnormality in superficial amygdala-anterior cingulate connectivity may influence on cognitive processing of socially-relevant information in social anxiety disorder.

• Safety and Health at Work
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• v.3 no.4
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• pp.257-267
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• 2012

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.

• Annals of Clinical Neurophysiology
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• v.22 no.2
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• pp.92-103
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• 2020

Background: The purpose of this study was to identify the top-100 cited articles on genetic generalized epilepsy (GGE) published in journals that have made key contributions to the field of epilepsy. Methods: We searched the Web of Science website produced by Clarivate Analytics for articles on GGE, and sorted them according to the number of citations to identify the top-100 cited articles. We then manually reviewed the contents of the top-100 cited articles, which were designated as "citation classics". Results: The top-100 cited articles were published in 27 journals, with the largest proportion appearing in Epilepsia (19 articles). The articles originated from institutions in 17 countries, with 31 articles from the USA. The institution associated with the largest numbers of articles in the field of GGE was the University of Melbourne, Australia (9 articles). Panayiotopoulos C. P. was the first author of three articles, and was listed most frequently in the GGE citation classics. The publication years were concentrated in the 2000s, when 56 articles were published. The most-common study topics were genetics (35 articles) and neuroimaging (17 articles). Conclusions: This study has identified the top-100 cited articles on GGE. These citation classics represent the landmark articles on GGE, and they provide useful insights into international research leaders and the research trends in the field.

• Sleep Medicine and Psychophysiology
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• v.6 no.2
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• pp.133-142
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• 1999

Recently, with increasing the number of patients with head injury and cerebrovascular accident, there has been an increasing need for the useful assessment tools of brain dysfunction and it's localization. With the advances in the neuroscience since the mid-1970s, particularly in the areas of neuroanatomical tracing, neuroimaging, and improved behavioraltest design, it has been possible to develop a more precise understanding and localization of brain dysfunction. However, these equipments are not readily available in the private clinics and too expensive to use as a screening tool to all suspected patients with brain dysfunction. Although several screening tests such as Mini-Mental States Examination(MMSE) or Brief Cognitive Rating Scale(BCRS) are simple in use and useful for the brief assessment of brain dysfunction, these are also limited in using for localization of brain dysfunction because of their simplicity. With increasing need of the assessment tool which is able to localize the dysfunction more precisely in the clinical practice, we planned to develop the new assessment tool, the Bedside Neurocognitive Function Localization Test(BNLT) which is suitable for this purpose. The BNLT was designed to be utilized for localizing brain dysfunction effectively and readily in the clinical practice. We introduced the whole process of designing the BNLT in this manuscript.

• Annals of Clinical Neurophysiology
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• v.2 no.1
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• pp.13-20
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• 2000

Background and Objective : Visual evoked potentials(VEPs) is considered to be a reliable diagnostic procedure for examining patients with anterior visual pathways. Some abnormalities in the recordings on monocular stimulation have been said to indicate retrochiasmal lesion, but less consistent results have been reported. This study is to evaluate the positive predictability of VEP for the detection of retrochiasmal lesion. Methods : We reviewed VEPs that could be interpreted as indicative of a retrochiasmal lesions, based on amplitude or latency asymmetry recorded on the left(O1) and right(O2) occipital regions. Bilateral absent VEPs on both recording(O1 and O2) without evidence of prechiasmal lesion were included. During 5 years, we identified 31 patients who met the above criteria and who had undergone magnetic resonance imaging(MRI) of brain(one patient underwent computerized tomography). Twenty three patients underwent pattern reversal VEPs and others underwent flash goggle VEPs. Results : Brain imagings were abnormal in 29 and were normal in 2. Of the 29 abnormal scans, lesions in posterior visual pathway were detected in 21 scans(predictive value=68%). The predictive value was not significantly different between flash goggle VEP(75%) and pattern reversal VEP(68%). The predictive value was higher in patient with visual field defect(100%) than those without visual field defect(25%). The pathologic nature of lesion also showed close relations to the predictive value. VEPs is usually paradoxically lateralized(78%), but not in all patients. Conclusion : VEPs abnormalities suggesting retrochiasmal lesion were usually corresponded with brain MRI findings. Diagnostic reliability could be increased when considering the visual field defect and nature of lesion. Therefore, the authors suggest that VEPs studies could be useful in evaluating the patients with the retrochismal lesion.

• Journal of Oriental Neuropsychiatry
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• v.22 no.4
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• pp.135-142
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• 2011

Objectives : The purpose of this case was to investigate the effectiveness of electroacupuncture for ophthamoplegic migraine. Methods : We provided electroacupuncture therapy and prescribed oriental medicine, Joganiknoe-tang daily. We measured patient's pain by VAS(Visual Analogue Scale) and eye movement with a ruler every five days. Results & Conclusions : Any patient who has a headache with paresis of the extraocular muscle should be considered for ophthalmoplegic migraine. To diagnose ophthalmoplegic migraine, family history, past medical history, associated symptoms and signs, neurologic examinations and neuroimaging tests are needed. The symptoms of patient improved gradually within 26days from the first day of admission, and we can see her complete recovery.

• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.128-135
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• 2001

Background : Tremor is uncommon manifestation of stroke. Therefore a few cases have been reported until now. There is still uncertainty about the characteristics of post-stroke tremor. Furthermore the pathogenesis and responsible structures of post-stroke tremor are not precisely known. We have recently experienced 34 cases of post-stroke tremor for the past 6 years. We analysed the clinical features and electrophysiologic findings of post-stroke tremor to evaluate the general characteristics and to analogize the possible pathogenetic mechanisms of post-stroke tremor. Methods : The clinical characteristics of post-stroke tremor were summarized in according to the onset time, involved body parts, types, tremor frequencies, neuroradiologic findings, and associated symptoms. The tremor frequencies were recorded by using a gyroscope. The spectral analysis of tremor frequencies were done automatically with Motus I soft ware. Results : Tremor onset were remarkably varied. Some patients showed a tremor appearing at the onset of a stroke and other patients showed delayed-onset tremor 10 years after a stroke. Tremor frequencies were also much varied. The range of hand tremor frequencies were from 1.5 to 12 Hz. Lesions were found in 31 cases(infarction 27, hemorrhage 4) on neuroimaging. In the cases of cerebral infarctions, 7 cases showed multiple small vessel diseases and 20 cases showed cerebral vessel lesions. The most commonly involved cerebral vessel lesion was the middle cerebral artery territory Several different clinical patterns of post-stroke tremor were identified. Conclusions : There are some evidences from the data summarized here to suggest that several pathogenetic mechanisms including central oscillators could be involved for the development of tremors and that tremor generating neural circuits could be more complex than previously suggested neural circuits.

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.471-474
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• 2006

Objective : Neuroimaging data are of paramount importance in making correct diagnosis. We herein evaluate the clinical usefulness of image transfer using cellular phones to facilitate neurological diagnosis and decision-making. Methods : Selected images from CT, MRI scans, and plain films obtained from 50 neurosurgical patients were transferred by cellular phones. A cellular phone with a built-in 1,300,000-pixel digital camera was used to capture and send the images. A cellular phone with a 262,000 color thin-film transistor liquid crystal display was used to receive the images. Communication between both cellular phones was operated by the same wireless protocol and the same wireless internet service. We compared the concordance of diagnoses and treatment plans between a house staff who could review full-scale original films and a consultant who could only review transferred images. These finding were later analyzed by a third observer. Results : The mean time of complete transfer was $2{\sim}3\;minutes$. The quality of all images received was good enough to make precise diagnosis and to select treatment options. Transferred images were helpful in making correct diagnosis and decision making in 49/50 [98%] cases. Discordant result was caused in one patient by improper selection of images by the house staff. Conclusion : The cellular phone system was useful for image transfer and delivery patient's information, leading to earlier diagnosis and initiation of treatment. This usefulness was due to sufficient resolution of the built-in camera and the TFT-LCD, the user-friendly features of the devices, and their low cost.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.330-335
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• 2000

Objective : The purpose of this report is to assess the morbidity and mortality associated with clipping of intracranial unruptured aneurysms. Methods : At the authors' institution between May 1989 and December 1998, a total of 128 unruptured aneurysms in 110 patients were treated with surgical clippings. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : The main locations of the aneurysms were : middle cerebral artery 31%, internal carotid-posterior communicating artery 28%, anterior communicating artery 16%, paraclinoid 6.5%, internal carotid-anterior choroidal artery 7%, posterior circulation 7%. Forty three percent of the aneurysms were symptomatic and 57% asymptomatic. The overall outcome of the surgery was : Glasgow outcome scale(GOS) I 86%, GOS II 6%, GOS III 4.3%, GOS IV 0% and GOS V(death) 3.5%. The operative risk is higher for large to giant aneurysms, and for aneurysms in posterior circulations. Patients with non-giant aneurysm in anterior circulation showed no mortality, but morbidity of 8.2%, and in posterior circulation : 25% of mortality and 75% of morbidity. Patients with giant anterior circulation aneurysm have 22% of mortality and 22% of morbidity. For patients with giant posterior circulation aneurysm, mortality and morbidity were 25% and 25%, respectively. The postoperative deaths were related to occlusion of the major parent artery in 3 cases(75%). The postoperative morbidity was related to occlusion of artery(9/13), intraoperative rupture(3/13), and cranial nerve injury(1/13). Conclusion : This report documents 3.5% mortality and 13% of morbidity in the clipping surgery for unruptured intracranial aneurysms, and the relatively low risk of surgical clipping in non-giant and those located in anterior circulation. The natural history, especially risk of bleeding, of the unruptured intracranial aneurysms is still controversial. However, with respect to surgical results, unruptured non-giant aneurysm located in anterior circulation should be operated in patients with low risk.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.437-446
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• 2021

Background: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions: Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.