• 제목/요약/키워드: Neuropsychiatric disorders

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정상적인 노화 과정에서 국소뇌포도당대사의 변화: FDG PET 연구 (Changes of Regional Cerebral Glucose Metabolism in Normal Aging Process : A Study With EDG PET)

  • 윤준기;김상은;이경한;최용;최연성;김병태
    • 대한핵의학회지
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    • 제35권4호
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    • pp.231-240
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    • 2001
  • Purpose: Normal aging results in detectable changes in the brain structure and function. We evaluated the changes of regional cerebral glucose metabolism in the normal aging process with FDG PET. Materials and Methods: Brain PET images were obtained in 44 healthy volunteers (age range 20-69 'y'; M:F = 29:15) who had no history of neuropsychiatric disorders. On 6 representative transaxial images, ROIs were drawn in the cortical and subcortical areas. Regional FDG uptake was normalized using whole brain uptake to adjust for the injection dose and correct for nonspecific declines of glucose metabolism affecting all brain areas equally. Results: In the prefrontal, temporoparietal and primary sensorimotor cortex, the normalized FDG uptake (NFU) reached a peak in subjects in their 30s. The NFU in the prefrontal and primary sensorimotor cortex declined with age after 30s at a rate of 3.15%/decade and 1.93%/decade, respectively. However, the NFU in the temporoparietal cortex did not change significantly with age after 30s. The anterior (prefrontal) posterior (temporoparietal) gradient peaked in subjects in their 30s and declined with age thereafter at a rate of 2.35%/decade. The NFU in the caudate nucleus was decreased with age after 20s at a rate of 2.39%/decade. On the primary visual cortex, putamen, and thalamus, the NFU values did not change significantly throughout the ages covered. These patterns were not significantly different between right and left cerebral hemispheres. Of interest was that the NFU in the left cerebellar cortex was increased with age after 20s at a rate of 2.86%/decade. Conclusion: These data demonstrate regional variation of the age-related changes in the cerebral glucose metabolism, with the most prominent age-related decline of metabolism in the prefrontal cortex. The increase in the cerebellar metabolism with age might reflect a process of neuronal plasticity associated with aging.

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주작환(朱雀丸)이 일시적 국소 뇌허혈 유발 백서(白鼠)에 대한 인지 및 운동기능 회복에 미치는 효과 (The Recovery Effects of Joojakwhan - A Traditional Korean Medical Poly-herbal Drug for the Cognitions and Motor Functions in Mild Stroke Rat Model by Using Transient Middle Cerebral Artery Occlusion)

  • 김보은;강석봉;정대규
    • 동의신경정신과학회지
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    • 제24권4호
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    • pp.419-434
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    • 2013
  • Objectives: The object of this study is to observe the cognition and motor function recovery effects of Joojakwhan (JJW), a traditional Korean poly-herbal formula for treating various neuropsychiatric diseases such as dementia, for the mildly stroke rats, with 60 minutes of reperfusion transient middle cerebral artery occlusion (tMCAO). Methods: In the present study, 125, 250 and 500 mg/kg of JJW were orally administered, once per day for 10 continuous days 2 hours after the tMCAO. The body weight changes, infarct sizes under 2% 2, 3, 5-triphenyl tetrazolium chloride (TTC) stain, sensorimotor functions and cognitive motor behavior tests were serially monitored with cerebral caspase-3 and cleaved poly (ADP-ribose) polymerase (PARP)-immunoreactivities and histopathological changes. The effects of tMCAO on sensorimotor functions were evaluated by using of limb placing and body-swing tests, and the cognitive motor behaviors were also observed with water maze tests. Results: From the results of tMCAO, with marked decreases of body weights, disorders of sensorimotor functions increases the limb placing test scores, and decrease the numbers and percentages of body swings to the ipsilateral sides. The cognitive motor behaviors increases the distances and time to reach the escape platform which included the inhibitions of the decreases with repeated trials that were observed with focal cerebral cortex infarct volumes. In addition, the marked increases of the atrophy, numbers of degeneration, caspase-3- and PARP-immunoreactive cells around peri-infarct ipsilateral cerebral cortex were also observed in tMCAO controls when compared with the sham control rats, respectively. Conclusions: The results obtained from this study suggest that oral administrations of JJW indicate obvious cognitions and motor function recoveries of the rats with tMCAO, mild strokes, which are mediated by neuro-protective effects through known antioxidant effects of components.

쥐오줌풀 추출물이 MIA동물모델에서의 신경발달 단백질의 발현과 행동증상에 미치는 영향 (Effect of Valeriana fauriei Extract on the Neurodevelopmental Proteins Expression and Behavioral Patterns in Maternal Immune Activation Animal Model)

  • 원한솔;김영옥;이화영;임지윤;이상현;조익현;이상원;박춘근;김형기;권준택;김학재
    • 한국약용작물학회지
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    • 제24권5호
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    • pp.341-350
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    • 2016
  • Background: Prenatal exposure to infectious and/or inflammatory insults can increase the risk of developing neuropsychiatric disorder such as bipolar disorder, autism, and schizophrenia later in life. We investigated whether Valeriana fauriei (VF) treatment alleviates prepulse inhibition (PPI) deficits and social interaction impairment induced by maternal immune activation (MIA). Methods and Results: Pregnant mice were exposed to polyriboinosinic-polyribocytidilic acid (5 mg/kg, viral infection mimic) on gestational day 9. The adolescent offspring received daily oral treatment with VF (100 mg/kg) and injections of clozapine (5 mg/kg) for 30 days starting on the postnatal day 35. The effects of VF extract treatment on behavioral activity impairment and protein expression were investigated using the PPI analysis, forced swim test (FST), open field test (OFT), social interaction test (SIT), and immunohistochemistry. The MIA-induced offspring showed deficits in the PPI, FST, OFT, and SIT compared to their non MIA-induced counterparts. Treatment with the VF extract significantly recovered the sensorimotor gating deficits and partially recovered the aggressive behavior observed in the SIT. The VF extract also reversed the downregulation of protein expression induced by MIA in the medial prefrontal cortex. Conclusions: Our results provide initial evidence of the fact that the VF extract could reverse MIA-induced behavioral impairment and prevent neurodevelopmental disorders such as schizophrenia.

자폐스펙트럼장애 환자에서 나타나는 운동 상동증 유무에 따른 임상 특성의 차이 (Clinical Characteristics of Children with Autism Spectrum Disorder According to the Presence of Motor Stereotypes)

  • 김지순;유희정;배정훈;조인희;박태원;손정우;정운선;신민섭;김붕년;김재원;양영희;강제욱;송숙형;조수철
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제26권1호
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    • pp.22-29
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    • 2015
  • Objectives : Repetitive and stereotyped behaviors are core symptoms in children with autism spectrum disorders (ASD). The purpose of our study was to investigate the frequency of motor stereotypes in ASD children and their clinical features. Methods : Among 171 ASD children (age range, 3-15), the ASD group with motor stereotypes was defined according to two items in the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R). We compared the clinical features, behavior problems and severity of other domains in the K-ADI-R and executive functions between the ASD group with motor stereotypes and the ASD group without motor stereotypes. Results : Ninety (52.6%) of 171 ASD children had motor stereotypes. The ASD group with motor stereotypes had a lower intelligence quotient score (62.23 vs. 84.94, p<.001) compared to the ASD group without motor stereotypes. The ASD group with motor stereotypes had more impairments in the social interaction domain [adjusted odds ratio (AOR) 1.11, p=.001] and communication domain (AOR 1.15, p=.008). Thought problems and lethargy were more frequent in the ASD group with motor stereotypes than the ASD group without motor stereotypes (AOR 2.059, p=.034 ; adjusted OR 1.045, p=.046). However, no significant differences in executive function were observed between the ASD group with motor stereotypes and the ASD group without motor stereotypes. Conclusion : The ASD group with motor stereotypes showed more impairment in social interaction and communication domains, which are core symptoms of autism. Motor stereotypes may indicate greater severity of ASD.

The Impacts of Childhood Trauma on Psychosocial Features in a Chinese Sample of Young Adults

  • Wang, Dandan;Lu, Shaojia;Gao, Weijia;Wei, Zhaoguo;Duan, Jinfeng;Hu, Shaohua;Huang, Manli;Xu, Yi;Li, Lingjiang
    • Psychiatry investigation
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    • 제15권11호
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    • pp.1046-1052
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    • 2018
  • Objective The aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features in a Chinese sample of young adults. Methods A survey was carried out in a group of 555 university students by using Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Questionnaire (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS). The moderate-severe cut-off scores for CTQ were used to calculate the prevalence of childhood trauma, and then psychosocial features were compared between individuals with and without childhood trauma. Results A proportion of 18.6% of university students had self-reported childhood trauma exposures. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and psychoticism and neuroticism dimensions of EPQ (t=4.311-5.551, p<0.001); while lower scores of SSRS and extraversion dimension of EPQ (t=-4.061- -3.039, p<0.01). Regression analyses further revealed that scores of SAS and DAS were positively (Adjusted B=0.211-0.230, p<0.05), while scores of SSRS were negatively (Adjusted B=-0.273- -0.240, p<0.05) associated with specific CTQ scores. Conclusion Childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.

호스피스 병동의 암환자에서 섬망 발생 위험 요인 (Risk Factors Related to Development of Delirium in Hospice Patients)

  • 고혜진;윤창호;정승은;김아솔;김효민
    • Journal of Hospice and Palliative Care
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    • 제17권3호
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    • pp.170-178
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    • 2014
  • 목적: 섬망은 말기암환자에서 생길 수 있는 중요한 합병증으로 임상적으로나 삶의 질 적인 측면에서 매우 중요한 문제이다. 이에 호스피스 병동에 입원한 말기암 환자에서 섬망 발생과 관계된 위험 요인들을 알고자 연구를 시행하였다. 방법: 2011년 5월부터 2012년 9월까지 일개 지역 두개의 종합병원 내 호스피스 병동에 입원한 환자 중 의식이 명료하고 다른 정신과적 질환이나 약물 중독이 없는 환자를 대상으로 전향적으로 추적하여 섬망 발생 여부를 확인하였다. DSM-IV 진단기준에 맞게 2명의 의사에 의해 진단된 경우 섬망군으로 분류하였다. 입원 시 인지기능(mini-mental status examination, MMSE), 우울 점수(Beck depression inventory, BDI), 불안 점수, 불면 척도(Insomnia Severity Index, ISI), 혈액검사 결과와 섬망 발생 여부를 로지스틱 회귀분석으로 비교하고, 유의한 항목에 대해 Cox의 비례위험모형으로 교차비를 구하였다. 결과: 선정기준에 부합하는 연구 대상자 96명 중 41명(42.7%)에서 섬망이 발생하였다. 로지스틱 회귀분석 결과 일차 암 위치, 인지기능 장애(MMSE < 24), 우울($BDI{\geq}16$), 불면($ISI{\geq}15$)의 Odds ratio (OR)이 통계적으로 유의한 결과를 보였다. 이들 4가지 인자에 대해 입력 방법을 이용해 시행한 Cox 회귀분석 결과, 우울의 OR 5.130(95% CI 2.009~13.097), 인지기능저하의 OR 5.130 (95% CI 2.009~13.097)로 나타났다. 결론: 호스피스 병동에 입원한 말기암환자에서 우울하거나 인지기능 장애가 있을 경우 섬망 발생의 위험이 유의하게 높았다. 호스피스 환자에게 우울이나 인지기능에 대한 주의 깊은 관찰이 필요할 것이다.

자폐장애 환자의 세포유전학적 분석 (CYTOGENETIC ANALYSIS OF CHILDREN WITH AUTISM)

  • 정철호;이제영;박영남;박종한;김정범;김재룡;전효진
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제5권1호
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    • pp.108-117
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    • 1994
  • 자폐장애와 fragile X증후군의 관련성과 자폐장애 환자에서 특이한 염색체 이상유무를 알고자 자폐장애 환자 29명을 대상으로 하고 질병대조군으로 정신지체 환자 30명을 대상으로 하여, 1) PHA 자극 말초혈 임파구의 G분염에 의한 상용 염색체검사를 실시하여 염색체 이상 유무를 확인하고, 2) MTX를 함유한 배지에서 fragile site 분석을 각각 실시하였다. 연구결과 G 분염에 의한 상용 염색체검사에서는 자폐장애군과 정신지체군에서 모두 46XX 혹은 46XY로서 정상 핵형을 보였으며, fragile site 분석결과에서 fra X(q27.3)은 두 군 모두에서 한 명도 발견되지 않았다. Fragile X 이외의 염색체 이상을 보인 예는 자폐장애군 11명(37.9%), 정신지체군에서 10명(33.3%) 발견되었으나 자폐장애군과 정신지체군 상호간에 유의성 있는 차이는 발견할 수 없었으며, fragile site와 gap이 A, B, C, D, E군에서 다양하게 분포되어 있어 의미있는 분절 부위는 없었다. Fragile site가 관찰된 세포의 수는 자폐장애군에서 31개로 관찰한 모든 중기 세포의 3.6%에 해당하였고 정신지체군에서 29개, 3.2%가 발견되었으며 gap이 관찰된 세포의 수는 자폐장애군에서 43개로 관찰한 모든 중기세포의 4.9%에 해당하였고 정신지체군에서 35개, 3.9%가 발견되었다. 이상의 결과에서, 본 연구에서 조사대상으로 한 자폐장애군에서는 fragile(X)(q27.3)가 한 예에서도 관찰되지 않아, fragile X 증후군에 의한 자폐장애는 매우 드물 것으로 생각되며, fragile X증후군을 자폐장애의 직접적인 원인으로는 생각하기 힘들다. 그리고 자폐장에 환자에서 관찰되는 fragile site와 gap은 정신지체군에서도 비슷한 빈도 및 양상으로 관찰되는 바 자폐장애 환자의 특이한 소견은 아니었다.

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자동합성장치를 이용한 [$^{18}F$]Fallypride의 합성 (Automated Synthesis of [$^{18}F$]Fallypride for Routine Clinical Use)

  • 박준형;문병석;이홍진;이효준;이인원;이병철;김상은
    • 핵의학기술
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    • 제14권2호
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    • pp.104-109
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    • 2010
  • $[^{18}F]$Fallypride는 뇌의 도파민(dopamine) $D_2/D_3$ 수용체 (receptor)에 특이적으로 결합하는 길항제(antagonist)로 대뇌피질의 도파민 기능을 규명하기 위하여 많이 사용되어지는 방사성의약품이다. 그동안 발표되어진 자동 합성화 장치를 이용한 [$^{18}F$]Fallypride 합성은 20~30%의 낮은 합성 수율과 33~63 GBq/mmol의 낮은 비방사능이 보고되어졌고, 또, 상대적으로 긴 표지시간과 높은 농도의 base를 사용하기 때문에 다양한 부산물이 생성되어 정제의 어려움이 있어 임상에 사용되기에 한계가 많았었다. 본 연구에서는 다목적 F-18 합성장치인 GE TracerLab $FX_{FN}$ 모듈을 사용하여 base 농도를 최소화할 수 있는 연구를 수행하였고, [$^{18}F$]fallypride 합성에 적용하여 높은 합성수율과 비방사능(specific activity) 및 방사화학적 순도(radiochemical purity)를 합성하는 최적의 조건을 찾을 수 있었다. 이를 바탕으로 $66{\pm}1.4%$ (decay-corrected, n=28)의 높은 합성수율과 HPLC 분리, SPE 정제시간을 포함하여 총 $51{\pm}1.2$분에 빠르게 합성할 수 있었다. 합성 후, 품질관리 테스를 해 본 결과, 방사 화학적 순도는 95%이상, 비방사능은 166~470 $GBq/{\mu}mol$이었다. 본 연구에서 사용된 합성법은 [$^{18}F$]Fallypride를 이용한 dopamine $D_2/D_3$ 연구의 임상적 사용에 도움이 될 것이며, 낮은 농도의 base를 사용한 이 F-18 추출방법은 base에 민감한 전구체의 자동합성 생산에 유용할 것으로 사료된다.

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PET 이용 현황 및 전망 (Current Status and Future Perspective of PET)

  • 이명철
    • 대한핵의학회지
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    • 제36권1호
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.