• Journal of Korean Neurosurgical Society
• /
• v.54 no.6
• /
• pp.484-488
• /
• 2013

Objective : To examine the synergistic effects of both computer-assisted cognitive rehabilitation (CACR) and transcranial direct current stimulation (tDCS) on cognitive function in patients with stroke. Methods : The current double-blind, sham-controlled study enrolled a total of 11 patients who were newly diagnosed with stroke. The patients of the tDCS group (n=6) completed sessions of the Korean computer-assisted cognitive rehabilitation program five times a week for 30 minutes a session during a mean period of 18.5 days concomitantly with the anodal tDCS over the bilateral prefrontal cortex combined with the CACR. The patients of the control group (n=5) also completed sessions of the sham stimulation during a mean period of 17.8 days. Anodal tDCS over bilateral prefrontal cortex (F3 and F4 in 10-20 EEG system) was delivered for 30 minutes at an intensity of 2 mA. Cathode electrodes were applied to the non-dominant arm. All the patients were evaluated using the Seoul Computerized Neuropsychological Test (SCNT) and the Korean Mini-Mental State Examination. Results : Mann-Whitney U test revealed a significant difference between the two groups. The patients of the tDCS group achieved a significant improvement in the post/pre ratio of auditory continuous performance test and visual continuous performance test on the SCNT items. Conclusion : Our results indicate that the concomitant use of the tDCS with CACR to the prefrontal cortex may provide additional beneficial effects in improving the cognitive dysfunction for patients with stroke.

• Journal of Korean Neurosurgical Society
• /
• v.63 no.2
• /
• pp.261-267
• /
• 2020

Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.21 no.3
• /
• pp.147-152
• /
• 2010

Objectives : The purpose of this study was to investigate the deficits in executive function in children with ADHD and anxiety disorder, and further, to characterize executive function deficits among the two groups. Methods : Subjects consisted of 60 children between the ages of 5 and 14 (16 Normal, 24 ADHD, 20 Anxiety Disorder). Neuropsychological tests (KEDI-WISC, CCTT, STROOP, WCST, ROCF) for assessing cognitive and executive function were individually administered to all subjects. Results : There were no significant differences in FSIQ or PIQ among the three groups. However, the ADHD group tended to score lower on the VIQ and subtest of similarity, vocabulary, and digit span tests. The three groups did not significantly differ with respect to CCTT test results. On the STROOP test, the ADHD group showed poor performance on the word, color, and color-word subtests. The three groups did not exhibit significant differences in WCST test results ; however, the anxiety group performed poorly belonging to below 25 percentile rank on perseverative response. On the ROCF test, the ADHD group performed poorly with respect to their organization score and in particular, regarding copy and immediate recall. The anxiety group also performed poorly with regard to organization ; however, this was limited only to immediate recall. Conclusion : Children with ADHD displayed poor inhibition and organizational abilities compared to children with anxiety and normal controls. Further, children with anxiety disorder exhibited low cognitive flexibility and voluntary problem-solving abilities compared to ADHD children and normal controls. Based on these results, we suggest that the characteristics of executive dysfunction in ADHD and anxiety disorder in children are different.

• 한국HCI학회:학술대회논문집
• /
• 2008.02b
• /
• pp.507-512
• /
• 2008

This study investigated the navigation ability of patients with MCI in Virtual Environments(VE) and on the visual functioning. The participants consisted of elderly adults with/without MCI. Neuropsychological tests(RCFT, BVRT, TMT, and Digit Span), the Groton Maze Learning Test(12trials), and the VE navigation learning task(6 trials) were performed. As a result, there were significant group differences for the RCFT and BVRT, but not for the GMLT. For the VE task, there was a significant difference between the MCI and normal group and no interactions between the groups and trials were found. The VE task was correlated with The RCFT, the BVRT, and the GMLT and omnibus the RCFT and the BVRT accounted for 45% of VE performances. Thus, we concluded that patients with MCI are inferior to VE navigation and visual retention/memory play a role in navigation abilities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.26 no.3
• /
• pp.190-196
• /
• 2015

Objectives : The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. Methods : From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. Results : No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. Conclusion : Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.

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

• Journal of Oriental Neuropsychiatry
• /
• v.24 no.3
• /
• pp.211-228
• /
• 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 Biological Psychiatry
• /
• v.24 no.3
• /
• pp.149-154
• /
• 2017

Objectives This study investigated associations between symptom severity and neurocognitive functions in patients with major depressive disorder using comprehensive neuropsychological tests. Methods Ten patients with low depression (LD) and 22 patients with high depression (HD) participated. Symptom severity was determined by both the Beck Depression Inventory and the Hamilton Depression Rating Scale. Additionally, anxiety was measured by the Korean version of the State-Trait Anxiety Inventory (STAI-KYZ). Ten subtests of the Korean-Wechsler Adult Intelligence scale (K-WAIS), Stroop test, the word/design fluency tests were administered to assess cognition. Results The LD and HD groups did not differ in any of cognitive measures but anxiety level. Namely, the HD group obtained significantly higher scores on the state (U = 29.50, p < 0.01) and trait (U = 28.50, p < 0.001) anxiety scales than the LD group. A significant interaction effect between trait anxiety and depression severity was observed on the picture arrangement subtest of the K-WAIS [F (1, 27) = 5.09, p < 0.05]. Conclusions Cognitive deficits observed in patients with major depressive disorder may be related to other factors rather than current symptom severity. Trait anxiety possibly moderates the effect of current symptom severity on social judgment in these patients.

• Dementia and Neurocognitive Disorders
• /
• v.23 no.1
• /
• pp.11-21
• /
• 2024

Background and Purpose: Although dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia, its clinical prevalence is low. We developed a short and easy-to-complete DLB screening questionnaire (DLBSQ) to raise diagnostic sensitivity in routine clinical settings. Methods: A total of 501 participants were retrospectively enrolled, including 71 controls, 184 patients without DLB, and 246 patients with probable DLB. All patients underwent clinical evaluation, including core features of DLB, the DLBSQ, brain magnetic resonance imaging, and detailed neuropsychological assessments. The diagnostic performance of the DLBSQ for probable DLB was investigated using a receiver operating characteristic curve analysis. Results: Total DLBSQ score was associated with visuospatial and frontal/executive dysfunction and the diagnosis of probable DLB. The area under the receiver operating characteristic curve for total DLBSQ score was 0.727. Youden's method revealed an optimal cutoff value of 3. The sensitivity and specificity of the DLBSQ were 68.7% and 62.4%, respectively. Its discriminating performance improved when cognitive test profiles were additionally considered (area under the curve: 0.822, sensitivity: 80.6%, and specificity: 70.4%). Conclusions: The DLBSQ might be a useful screening tool for DLB in routine clinical practice with good sensitivity and specificity.

• The Korean Journal of Nuclear Medicine
• /
• v.36 no.4
• /
• pp.232-243
• /
• 2002

Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age $39{\pm}14$ years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were peformed $6{\sim}61$ months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.