• 대한치매학회지
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• 제22권1호
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• pp.1-15
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• 2023

The Seoul Neuropsychological Screening Battery (SNSB) is known as a representative comprehensive neuropsychological evaluation tool in Korea since its first standardization in 2003. It was the main neuropsychological evaluation tool in the Clinical Research Center for Dementia of South Korea, a large-scale multi-center cohort study in Korea that was started in 2005. Since then, it has been widely used by dementia clinicians, and further solidified its status as a representative dementia evaluation tool in Korea. Many research results related to the SNSB have been used as a basis for the diagnosis and evaluation of patients in various clinical settings, especially, in many areas of cognitive assessment, including dementia evaluation. The SNSB version that was updated in 2012 provides psychometrically improved norms and indicators through a model-based standardization procedure based on a theoretical probability distribution in the norm's development. By providing a score for each cognitive domain, it is easier to compare cognitive abilities between domains and to identify changes in cognitive domain functions over time. Through the development of the SNSB-Core, a short form composed of core tests, which also give a composite score was provided. The SNSB is a useful test battery that provides key information on the evaluation of early cognitive decline, analysis of cognitive decline patterns, judging the severity of dementia, and differential diagnosis of dementia. This review will provide a broad understanding of the SNSB by describing the test composition, contents of individual subtests, characteristics of standardization, analysis of the changed standard score, and related studies.

• 정신신체의학
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• 제8권1호
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• pp.122-140
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• 2000

신체화 장애란 명백한 기질적 병리가 없이 다양한 신체 증상을 호소하는 만성 장애를 말한다. 그런데 신체화 장애는 역사적으로 기질적인 이상이 없이 신체적인 증상이 나타나는 히스테리와 연관이 있다고 알려져 왔다. 따라서 신체화와 관련된 대부분의 이론들은 주로 정신역동이나 사회적인 관점에 초점이 맞추어져 왔다. 그러나 감정적인 문제나 정신질환이 신체화로 나타나는 기전에서 신경생물학적인 관점에 대한 관심 또한 적지 않았었다. 이런 신경생물학적인 관점에서 히스테리아의 원형으로 알려져 있는 Anna O 증례조차도 신경심리학적인 관점에서 재조명되기도 하였다. 몇몇 신경생리학적 및 신경심리학적 연구결과들, 히스테리 환자에서 신체화증상 표현의 좌우 반구차이에 대한 연구결과들이 신체화의 생물학적 근거를 뒷받침해 주고 있다. 최근 들어 신체화 장애의 신경영상검사는 신체화 장애에서 뇌의 기능 이상이 존재함을 보여 주고 있다. 이에 저자는 생물학적 관점에서 신체화의 과정을 설명해 줄 수 있는 몇몇 가설들을 고찰하고 이를 바탕으로 신체화에 대한 새로운 신경심리학적 가설을 제시하고자 한다. 이와 함께 이 가설을 신체화 장애의 치료에 어떻게 적용시킬 수 있을까도 논의하고 이 가설의 제한정과 이 영역에 있어 앞으로의 발전 방향에 대해서도 논의하려고 한다.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.125-135
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• 2021

Objective : This study aimed to validate the Korean version of the Repeatable Battery for the Assessment of Neuropsychological Status Update (K-RBANS). Methods : We performed a retrospective analysis of 283 psychiatric and neurosurgery patients. To investigate the convergent validity of the K-RBANS, correlation analyses were performed for other intelligence and neuropsychological test results. Confirmatory factor analysis was used to test a series of alternative plausible models of the K-RBANS. To analyze the various capabilities of the K-RBANS, we compared the area under the receiver operating characteristic (ROC) curves (AUC). Results : Significant correlations were observed, confirming the convergent validity of the K-RBANS among the Total Scale Index (TSI) and indices of the K-RBANS and indices of intelligence (r=0.47-0.81; p<0.001) and other neuropsychological tests at moderate and above significance (r=0.41-0.63; p<0.001). Additionally, the results testing the construct validity of the K-RBANS showed that the second-order factor structure model (model 2, similar to an original factor structure of RBANS), which includes a first-order factor comprising five index scores (immediate memory, visuospatial capacity, language, attention, delayed memory) and one higher-order factor (TSI), was statistically acceptable. The comparative fit index (CFI) (CFI, 0.949) values and the goodness of fit index (GFI) (GFI, 0.942) values higher than 0.90 indicated an excellent fit. The root mean squared error of approximation (RMSEA) (RMSEA, 0.082) was considered an acceptable fit. Additionally, the factor structure of model 2 was found to be better and more valid than the other model in χ2 values (Δχ2=7.69, p<0.05). In the ROC analysis, the AUCs of the TSI and five indices were 0.716-0.837, and the AUC of TSI (AUC, 0.837; 95% confidence interval, 0.760-0.896) was higher than the AUCs of the other indices. The sensitivity and specificity of TSI were 77.66% and 78.12%, respectively. Conclusion : The overall results of this study suggest that the K-RBANS may be used as a valid tool for the brief screening of neuropsychological patients in Korea.

• 한국과학교육학회지
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• 제41권5호
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• pp.371-390
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• 2021

이 연구의 목적은 공간능력 구성요소에 대한 신경과학적 모델을 개발하고, 빛과 그림자 관련 과학 과제를 해결하는 과정에서의 두뇌 활성 영역을 신경과학적 모델에 기반하여 영역 일반적 능력과 영역특수적 능력으로 구분하여 설명하는 것이다. 이를 위해 남자 대학생 24명이 공간능력 검사지 문항과 빛과 그림자 과제를 해결하는 동안의 시선이동과 EEG를 동기화하여 측정하였으며, 과제 해결 전략에 대한 사후면담과 RVP를 실시하였다. 시선 이동, 두뇌 활성 영역, 참여자의 사고 과정과 전략을 통합하여 공간능력 구성요소에 대한 신경과학적 모델을 개발하고, 빛과 그림자 관련 과제 해결 과정을 분석하였다. 연구의 결과는 다음과 같다. 첫째, 공간 시각화와 심적 회전 요소는 주로 두정엽의 활성을 필요로 했으며, 공간 방향화 요소는 전두엽의 활성을 필요로 했다. 구체적으로, 공간 시각화 요소는 문제를 탐색하는 과정에서 전두엽이 활성화되었고, 문제와 답지를 비교하는 과정에서 측두엽과 두정엽이 활성화되었다. 심적 회전 요소는 회전된 정보를 탐색하는 구간에서는 전두엽이, 심적 회전을 할 때에는 두정엽이, 문제와 답지를 비교하는 구간에서는 측두엽이 활성화되었다. 공간 방향화 요소는 문제를 탐색하는 과정과 문제와 답지를 비교하는 과정 모두 전두엽이 활성화되었다. 둘째, 빛과 그림자 과제를 해결 할 때에는 영역 일반적 기능인 공간 능력과 과학적 원리를 적용하는 영역 특수적 사고가 함께 필요하였다. 평행광의 그림자 모양 추론과 빛의 방향이 바뀔 때의 그림자 모양을 추론에서의 두뇌 활성 패턴은 공간 시각화 요소에 대한 신경과학적 모델과 유사하였다. 여러 방향에서의 그림자를 통해 원래 물체를 추론할 때에는 공간 방향화 요소, 점광원의 그림자 모양을 추론할 때에는 공간 시각화 요소에 대한 신경과학적 모델과 두뇌 활성 패턴이 유사하였다. 빛과 그림자 과제를 해결할 때 추가적으로 활성화 된 부위는 주로 연역적 추론, 작업 기억, 행동에 대한 계획 기능을 담당하는 중측두이랑, 중심앞이랑, 하전두이랑, 중전두이랑이었다. 따라서 빛과 그림자 과제를 해결하는 과정에서는 공간능력 외에도 그림자 생성 원리를 기반으로 한 연역적 추론, 빛의 진행 방향을 작업 기억에 유지시키는 것, 광원의 특징에 따른 과제 해결 과정 계획, 빛-물체-스크린의 공간적 관계 인지 등이 추가적으로 필요하다.

• 수면정신생리
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• 제4권1호
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• pp.1-14
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• 1997

This paper reviewed models to explain memory and neuropsychological tests to assess memory. Memory was explained in cognitive and neuroanatomical perspectives, Cognitive model describes memory as structure and process. In structure model, memory is divided into three systems: sensory memory, short-term memory(working memory), and long-term memory. In process model, there are broadly three categories of memory process: encoding, storage, and retrieval. Memory process work in memory structure. There are two prominent models of the neuroanatomy of memory, derived from the work of Mishkin and Appenzeller and that of Squire and Zola-Morgan. These two models are the most useful for the clinician in part because they take into account the connections between the limbic and frontal cortical regions. The major difference between the two models concerns the role of the amygdala in memory processess. Mishkin and his colleagues believe that the amygdala plays a significant role while Squire and his colleagues do not. The most popular and widely used tests of memory ability such as WMS-R, AVLT, CVLT, HVLT. RBMT, CFT, and BVRT-R, were reviewed.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.506-517
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• 2010

Objective : We investigated whether Disability Evaluation (DE) situations influence patients' neuropsychological test performances and psychopathological characteristics and which variable play a role to establish an explanation model using statistical analysis. Methods : Patients were 536 (56.6%) brain-injured persons who met inclusion and exclusion criteria, classified into the DE group (DE; n = 300, 56.0%) and the non-DE group (NDE; n = 236, 44.0%) according to the neuropsychological testing's purpose. Next, we classified DE subjects into DE cluster 1 (DEC1; 91, 17.0%), DE cluster 2 (DEC2; 125; 23.3%), and DE cluster 3 (DEC3; 84, 15.7%) via two-step cluster analysis, to specify DE characteristics. All patients completed the K-WAIS, K-MAS, K-BNT, SCL-90-R, and MMPI. Results : In comparisons between DE and NDE, the DE group showed lower intelligence quotients and more severe psychopathologic symptoms, as evaluated by the SCL-90-R and MMPI, than the NDE group did. When comparing the intelligence among the DE groups and NDE group, DEC1 group performed worst on intelligence and memory and had most severe psychopathologic symptoms than the NDE group did. The DEC2 group showed modest performance increase over the DEC1 and DEC3, similar to the NDE group. Paradoxically, the DEC3 group performed better than the NDE group did on all variables. Conclusion : The DE group showed minimal "faking bad" patterns. When we divided the DE group into three groups, the DEC1 group showed typical malingering patterns, the DEC2 group showed passive malingering patterns, and the DEC3 group suggested denial of symptoms and resistance to treatment.

• 대한불안의학회지
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• 제7권1호
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• pp.3-8
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• 2011

Cognitive models of panic disorder have emphasized cognitive distortions' roles in the maintenance and treatment of panic disorder (PD). However, the patient's difficulty with identifying and managing emotional experiences might contribute to an enduring vulnerability to panic attacks. Numerous researchers, employing emotion processing paradigms and neuroimaging techniques, have investigated the empirical evidence for poor emotion processing in PD. For years, researchers considered that abnormal emotion processing in PD might reflect a dysfunction of the frontal-temporal-limbic circuits. Although neuropsychological studies have not provided consistent results regarding this model, a few studies have tried to find the biological basis of dysfunctional emotion processing in PD. In this article, we examine the possibility of dysregulation of emotion processing in PD. Specifically we discuss the neural basis of emotion processing and the manner in which such neurocognitive impairments may help clarify PD's core symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.226-235
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• 2015

Objectives : The purpose of this study was to examine the factor structure of the Adolescent Personality Assessment Inventory (PAI-A) in a standardized adolescent sample using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Methods : For this purpose, three models about factor structure of the PAI-A were explored with EFA in 490 adolescents and then were evaluated with CFA in 268 young offenders. Results : The results showed that the five factor model was considered to be most appropriate for factor structures of the PAI-A in EFA. However, none of the factor models were appropriate for the factor structures of the PAI-A in CFA. Conclusion : These findings suggest that the "five factor model" is thought to explain the PAI-A the best, but further studies are needed.

• 동의신경정신과학회지
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• 제24권3호
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• pp.211-228
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• 2013

Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.

• Korean Journal of Radiology
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• 제22권1호
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• pp.118-130
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• 2021

Objective: This study aimed to investigate the blood-brain barrier (BBB) disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and automatic whole brain segmentation. Materials and Methods: Forty-two consecutive mTBI patients with PCS who had undergone post-traumatic MR imaging, including DCE MR imaging, between October 2016 and April 2018, and 29 controls with DCE MR imaging were included in this retrospective study. After performing three-dimensional T1-based brain segmentation with FreeSurfer software (Laboratory for Computational Neuroimaging), the mean K^trans and v_p from DCE MR imaging (derived using the Patlak model and extended Tofts and Kermode model) were analyzed in the bilateral cerebral/cerebellar cortex, bilateral cerebral/cerebellar white matter (WM), and brainstem. K^trans values of the mTBI patients and controls were calculated using both models to identify the model that better reflected the increased permeability owing to mTBI (tendency toward higher K^trans values in mTBI patients than in controls). The Mann-Whitney U test and Spearman rank correlation test were performed to compare the mean K^trans and v_p between the two groups and correlate K^trans and v_p with neuropsychological tests for mTBI patients. Results: Increased permeability owing to mTBI was observed in the Patlak model but not in the extended Tofts and Kermode model. In the Patlak model, the mean K^trans in the bilateral cerebral cortex was significantly higher in mTBI patients than in controls (p = 0.042). The mean v_p values in the bilateral cerebellar WM and brainstem were significantly lower in mTBI patients than in controls (p = 0.009 and p = 0.011, respectively). The mean K^trans of the bilateral cerebral cortex was significantly higher in patients with atypical performance in the auditory continuous performance test (commission errors) than in average or good performers (p = 0.041). Conclusion: BBB disruption, as reflected by the increased K^trans and decreased v_p values from the Patlak model, was observed throughout the bilateral cerebral cortex, bilateral cerebellar WM, and brainstem in mTBI patients with PCS.