• 제목/요약/키워드: Neuropsychological assessment

검색결과 53건 처리시간 0.023초

Clinical impact of cerebral microbleeds on cognition in patients with CADASIL

  • Lee, Jung Seok;Ko, Keun Hyuk;Oh, Jung-Hwan;Choi, Jay Chol;Kim, Joong-Goo
    • Journal of Medicine and Life Science
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    • 제15권2호
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    • pp.89-94
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    • 2018
  • Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds(CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

스마트 토이를 활용한 아동용 인지능력 증진 프로그램의 예비 효과 연구 (A Preliminary Study of Computerized Cognitive Ability Enhancement Program Using Smart-Toy for Children)

  • 신민섭;이정은;이지현;이진주;권은미;전혜진;이승환
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.106-114
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    • 2017
  • Objectives: This study was to examine the effectiveness of computerized cognitive ability enhancement program (CCAEP) using Smarttoy. The CCAEP using Smart-toy which can interact with children via bluetooth is a kids-friendly and convenient method for improving children's cognitive abilities by increasing their motivation for performing the program. We developed the CCAEP which designed to train auditory-verbal memory, visual-spatial memory, auditory-verbal working memory, and visual-spatial working memory. Methods: Eighteen children aged 8 to 10 participated in CCAEP individual training composed of 8 sessions of 40 minutes each for 4 weeks. The effect of the training was measured with Smart Toyweb's cognitive assessment tasks (smart device based assessment) as well as traditional neuropsychological tests before and after the training. Results: Children showed significant improvement in auditory-verbal memory, visual-spatial memory, auditory-verbal working memory and visual-spatial working memory abilities after the training. Conclusion: This study demonstrated promising results suggesting the effectiveness of CCAEP using Smart-Toy in clinical settings as well as school and home situations. Further controlled study with larger sample size including various clinical groups is needed to confirm the present results.

항정신병약물 치료 후 인지기능 변화 차이 연구 : 장기 지속형 주사제와 경구제 비교의 예비 연구 (Change in Cognitive Function after Antipsychotics Treatment : A Pilot Study of Long-Acting Injectable versus Oral Form)

  • 성기영;김서영;김의태
    • 대한조현병학회지
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    • 제21권2호
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    • pp.74-80
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    • 2018
  • Objectives : This study investigated whether long-acting injectable (LAI) paliperidone is different from its oral form in terms of the effect on cognitive function in schizophrenia spectrum and other psychotic disorders. Methods : We reviewed the medical records of patients in Seoul National University Bundang Hospital who were diagnosed as having schizophrenia and/or other psychotic disorders based on DSM-5 from 2016 to 2017. Seven patients were treated with oral paliperidone and 11 were treated with paliperidone palmitate. All patients underwent clinical and neuropsychological assessment, including the Korean version of the MATRICS Consensus Cognitive Battery (MCCB) at their first visit or within one month of their initial treatment. MCCB was repeated within three to 12 months after the initial assessment. Results : There was no significant difference between the two groups in most cognitive domains including speed of processing, attention and vigilance, working memory, verbal learning, visual learning and reasoning and problem solving domain. However, patients treated with paliperidone palmitate showed better improvement in social cognition domain than those taking oral paliperidone. The standardized values of social cognition domain scores had significantly improved over time in patients under paliperidone palmitate, demonstrating a significant time-by-group interaction. Conclusion : Our results show that long-acting injectable paliperidone could be helpful in some aspects of improving cognitive function in schizophrenia spectrum and other psychotic disorders. Further studies with other antipsychotics are necessary to generalize the results.

경도인지장애를 동반한 파킨슨병 환자의 서울신경심리검사와 뇌 자기공명영상에서 뇌실 체적 변화에 대한 상관관계 (Correlation between the Seoul Neuropsychological Screening Battery of the Parkinson's Disease Patient with Mild Cognitive Impairment and Change of the Cerebral Ventricle Volume in the Brain MRI)

  • 이현용;김현진;임인철;이재승
    • 한국방사선학회논문지
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    • 제8권5호
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    • pp.231-240
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    • 2014
  • 본 연구는 경도인지장애가 동반된 파킨슨병 환자에 대하여 인지 기능 평가를 위한 서울신경심리검사와 뇌 자기공명 영상에서 영역별 뇌실에 대한 체적 변화를 분석하여 경도인지장애가 동반된 파킨슨병에 대한 진단적 기준을 판단할 수 있는 가이드라인을 제시하고자 하였다. 이를 위하여 파킨슨병으로 진단 받은 환자(경도인지장애군: 34명, 비인지장애군: 34명)를 대상으로 주의력, 언어, 기억력, 시공간, 그리고 전두엽 집행 기능에 대한 서울신경심리검사와 뇌 자기공명영상 검사를 시행하였다. 또한 영역별 뇌실에 대한 체적 변화를 비교하기 위하여 정상인 32명(정상 대조군)을 추가 선정하여 추가적으로 뇌 자기공명영상 검사를 시행하였으며 영역별 뇌실에 대한 체적 분석은 프리서퍼(Freesurfer Ver. 5.1, Boston MA, USA)를 통해 수행되었다. 결과적으로 경도인지장애군은 시공간 및 기억력에 대한 수행 능력이 비인지장애군과 비교하여 통계적으로 유의하게 감소되었다(p<0.05). 영역별 뇌실에 대한 체적 변화는 좌 우측뇌실, 좌 우하측뇌실, 제3뇌실에서 통계적으로 유의한 체적 변화를 나타내었으며 객관화된 비교를 위하여 정규화한 백분율을 적용한 체적의 변화는 비인지장애군보다 경도인도장애군에서 확장되어 나타났다. 특히 경도인지장애를 동반한 파킨슨병 환자의 좌 우측뇌실의 확장은 서울신경심리검사에서 시공간 및 기억력 영역에 대하여 뚜렷한 양적 선형관계를 보였다(r>0.5, p<0.05). 따라서 뇌 자기공명영상에서 프리서퍼를 이용하여 영역별 뇌실의 체적 변화를 관찰하고 서울 신경심리검사와 상관관계를 분석함으로써 경도인지장애를 동반한 파킨슨병 환자의 진단적 기준을 마련할 수 있을 것으로 판단되었다.

뇌졸중 환자의 인지손상을 위한 몬트리올인지평가의 신뢰도 (A Reliability the Montreal Cognitive Assessment on Cognitive impairment Following Stroke)

  • 송창순
    • 한국산학기술학회논문지
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    • 제14권3호
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    • pp.1228-1233
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    • 2013
  • 본 연구는 한국판 만성 뇌졸중 환자의 신경심리학적 평가도구를 결정하기 위하여 한국판 몬트리올인지평가 및 한국판 간이정신상태검사의 신뢰도를 알아보고, 두 평가도구의 상관관계를 알아보았다. 연구대상자는 만성뇌졸중환자 52명을 대상으로 하였으며, 인지손상 진단 여부에 따라서 정상인지 뇌졸중군(20명)과 인지손상 뇌졸중군(32명)으로 구분하였다. 연구대상자는 한국판 몬트리올인지평가 및 한국판 간이정신상태검사를 평가받았으며, 연구기간은 2012년 10월 2일부터 2012년 11월 30일까지 이었다. 연구결과 정상인지 뇌졸중군은 한국판 몬트리올인지평가에서 중등도 이상의 신뢰도를 보여주었으며, 한국판 간이정신상태검사에서 중등도의 신뢰도를 보여주었다. 인지손상 뇌졸중군은 한국판 몬트리올인지평가 및 한국판 간이정신상태검사에서 모두 중등도 이상의 신뢰도를 보여주었다. 또한 정상인지 뇌졸중군과 인지손상 뇌졸중군은 한국판 몬트리올인지평가의 점수가 높을수록 한국판 간이정신상태검사의 점수도 높은 양의 상관관계를 보여주었다. 본 연구의 결과는 한국판 몬트리올인지평가 및 한국판 간이정신상태검사 모두 뇌졸중으로 인한 인지손상을 진단하는데 적합하다고 사료되어, 연구 및 임상환경에서 신경심리학적 평가도구로 사용할 것을 제언한다.

유방암 환자에서 화학요법관련 인지기능저하의 발생률과 발생양상 (Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer)

  • 박진희;배선형;정용식;정영미
    • 대한간호학회지
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    • 제45권1호
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    • pp.118-128
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    • 2015
  • Purpose: Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy. Methods: Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses. Results: At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function. Conclusion: These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

Prevalence of restless legs syndrome and sleep problems in Korean children and adolescents with attention deficit hyperactivity disorder: a single institution study

  • Kwon, Soonhak;Sohn, Youngsoo;Jeong, Seong-Hoon;Chung, Un-Sun;Seo, Hyeeun
    • Clinical and Experimental Pediatrics
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    • 제57권7호
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    • pp.317-322
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    • 2014
  • Purpose: Attention deficit hyperactivity disorder (ADHD) is a common disorder in school-aged children. Patients with restless legs syndrome (RLS) often present with ADHD symptoms and vice versa. This study was the first to attempt to identify the prevalence of RLS and sleep problems in children with ADHD in Korea. Methods: Patients diagnosed with ADHD were asked to complete a sleep questionnaire. The sleep questionnaire included items to help identify the presence of four typical symptoms that are used as diagnostic criteria for RLS. Results: A total of 56 patients, including 51 boys and 5 girls (mean age, 10.7 years old) participated. Of these, 24 complained of pain, discomfort, or an unpleasant sensation in the legs. Based on the RLS diagnostic criteria, 2 patients were diagnosed with definite RLS and 4 with probable RLS. There were no significant differences in age, medication dosage, or neuropsychological test scores between the patients with and without RLS symptoms. Conclusion: Approximately 42.9% of patients with ADHD presented with RLS symptoms and 7.1% of these were diagnosed with RLS. Patients with ADHD also experienced various other sleep disorders. Thus, appropriate assessment and treatment for sleep disorders in patients with ADHD is essential.

항암화학요법으로 인한 유방암 환자의 인지기능 측정도구 사용 실태 분석 (Analysis of a Trend of Instrument Usage to Assess Cognitive Function of Breast Cancer Patients Undergoing Chemotherapy)

  • 김경덕;정복례;김경혜;변혜선;최은희
    • 종양간호연구
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    • 제11권3호
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    • pp.179-185
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    • 2011
  • Purpose: This study analyzed recent trends of instrument usage assessing cognitive function of breast cancer patients undergoing chemotherapy. Methods: The researcher collected 64 studies outside the country that were published between January 1996 and August 2010. Results: There was no study on the instrument assessing all domains of cognitive function in breast cancer patients undergoing chemotherapy. Most instruments assessing cognitive function of breast cancer patients have been used for patients with dementia, depression, and/or organic brain damage. Also the objective neuropsychological tests such as the grooved pegboard for the psychomotor area, RCFT copy in visuospatial skill area and the WAIS-III block design have low sensitivity for measuring cognitive function in breast cancer patients, thus they are not good for applying to breast cancer patients. Conclusion: There is a need to develop an instrument which has good sensitivity and specificity for measuring the cognitive function of the breast cancer patients who experienced cognitive impairment after chemotherapy treatment. In addition, the developed instrument needs to be accessible and feasible in any nursing clinical setting for the purpose of accurate assessment and evaluation of the cognitive function among breast cancer patients.

Fermented Laminaria japonica improves working memory and antioxidant defense mechanism in healthy adults: a randomized, double-blind, and placebo-controlled clinical study

  • Kim, Young-Sang;Reid, Storm N.S.;Ryu, Jeh-Kwang;Lee, Bae-Jin;Jeon, Byeong Hwan
    • Fisheries and Aquatic Sciences
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    • 제25권8호
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    • pp.450-461
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    • 2022
  • A randomized, double-blind, and placebo-controlled clinical study was used to determine the cognitive functions related to working memory (WM) and antioxidant properties of fermented Laminaria japonica (FLJ) on healthy volunteers. Eighty participants were divided into a placebo group (n = 40) and FLJ group (n = 40) that received FLJ (1.5 g/day) for 6 weeks. Memory-related blood indices (brain-derived neurotrophic factor, BDNF; angiotensin-converting enzyme; human growth hormone, HGH; insulin-like growth factor-1, IGF-1) and antioxidant function-related indices (catalase, CAT; malondialdehyde, MDA; 8-oxo-2'-deoxyguanosine, 8-oxo-dG; thiobarbituric acid reactive substances, TBARS) were determined before and after the trial. In addition, standardized cognitive tests were conducted using the Cambridge Neuropsychological Test Automated Batteries. Furthermore, the Korean Wechsler Adult Intelligence Scale (K-WAIS)-IV, and the Korean version of the Montreal Cognitive Assessment (MoCA-K) were used to assess the pre and post intake changes on WM-related properties. According to the results, FLJ significantly increased the level of CAT, BDNF, HGH, and IGF-1. FLJ reduced the level of TBARS, MDA, and 8-oxo-dG in serum. Furthermore, FLJ improved physical activities related to cognitive functions such as K-WAIS-IV, MoCA-K, Paired Associates Learning, and Spatial Working Memory compared to the placebo group. Our results suggest that FLJ is a potential candidate to develop functional materials reflecting its capability to induce antioxidant mechanisms together with WM-related indices.

주의력결핍 과잉행동장애 환자의 약물치료에 따른 지적효율성의 변화 (The Comparison of Intelligence Efficacy According to Methylphenidate Administration in Attention Deficit Hyperactivity Disorder Patients)

  • 박형배;배대석;하정상;서완석;송창진
    • Journal of Yeungnam Medical Science
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    • 제18권2호
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    • pp.253-266
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    • 2001
  • ADHD 아동은 발달과정에서 학업 성취를 비롯한 많은 문제들을 야기할 수 있으며, 지적인 능력에서도 부주의성과 연관된 특정적인 검사패턴을 보여주고 있다. 저자들은 1999년 3월 1일부터 1999년 12월 31일까지 DSM-IV의 ADHD 기준을 만족시키는 환자들과 대구 시내의 모 초등학교에서 정상대조군을 선발하여, K-ABC를 이용하여 아동의 지능과 습득도를 평가하였다. ADHD 아동의 경우에는 4-6주간의 약물치료를 시행한 후 동일한 검사들을 재시행하여 약물치료 전후의 차이를 비교하였다. 약물치료전의 ADHD 집단은 정상대조군에 비해 지적인 능력아 유의하게 낮은 것으로 나타났다. 약물치료 전후에서 ADHD 집단의 전체 지능은 유의한 변화가 없었으나 약물치료후의 동시처리척도는 정상대조군과 차이가 없을 정도로 호전이 되었으며, 이는 주의집중력의 증가, 특히 분산집중력의 증가를 의미하며 산만성이 감소되는 것을 의미한다. K-ABC의 하위 영역에서는 약물치료를 받지 않은 ADHD 잡단은 전반적인 하위 영역들이 유의하게 낮은 수행을 보이고 있지만 시각적 세부단서에 대한 주의력은 약물치료에 의해 유의하게 변화되어 정상 대조군과 차이가 없을 정도로 향상되었다. 습득도 하위 영역에서는 어휘력을 제외한 영역에서 ADHD 집단이 정상 대조군에 비해 유의하게 낮은 수행을 보였으나, 결정성 지능의 경우에서 약물치료 후 정상 대조군과 차이가 없었다. methylphenidate를 이용한 약물치료는 분산 집중력, 분석과 조직화와 같은 실행능력을 향상시키며 산만성을 유의하게 감소시켜주는 것으로 나타났다. ADHD 아동에서 약물치료와 함께 다른 형태의 치료가 결합될 경우, 학업수행과 사회성 등 전반적인 영역에서의 향상이 나타날 수 있을 것으로 기대된다.

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