• Title/Summary/Keyword: Subcortical

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A Case of Subcortical Aphasic Stroke Treated with Speech-Language Therapy and Korean Medical Therapy (언어치료와 한방치료를 병행한 중풍 피질하실어증 치험 1례(例))

  • Hsing, Lichang;Yeo, Jin-Ju;Yu, Gyung;Seo, Eui-Seok;Jang, In-Soo
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.733-740
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    • 2005
  • Subcortical Aphasia is not among the typical eight types of aphasia. It is characterized as cerebral infarction or hemorrhage occurring in the region of the left basal ganglia internal capsule, accompanied with ventrical rounding and white matter. Subcortical aphasia is similar to transcortical aphasia in its symptom of repetition, and classification is difficult. Language ability can change rapidly over several months so a patient's convalescence is unpredictable. Because of the peculiarities of subcortical aphasia there are many conflicting hypotheses. Various clinical approaches and medical treatments for speech disorder(aphasia) have been presented. In Korean medicine, there are many studies about speech disorder, but few reports are related to subcortical aphasia. An aphasic stroke patient who was treated with acupuncture, herbal medicine(Jihwangumja), and speech-language therapy is here reported. Significant improvement in language abilities was seen over three months. Further clinical study of subcortical aphasia is needed.

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A Subcortical Anaplastic Meningioma

  • Kim, Chang-Hyun;Park, Seong-Hyun;Hwang, Jeong-Hyun;Hamm, In-Suk
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.235-237
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    • 2005
  • Meningioma without dural attachment usually occurs in the intraventricular region, the pineal region, and the sylvian fissure. However, subcortical meningioma located far from such locations is extremely rare. The authors report a case of subcortical anaplastic meningioma without any dural attachment in a 41-year-old woman.

A Case of Subcortical Dementia After Cerebral Malaria (말라리아 후유증으로 초래된 피질하성 치매 1례)

  • Chung, Hyo-Kyung;Lee, Young-Ho;Chung, Young-Cho;Kim, Su-Sie;Park, Byoung-Kwan
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.301-305
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    • 1995
  • Subcortical dementia may occur as a complication of cerebral malaria via deep white matter demyelination with encephalitis and diffuse small vessel vasculitis. In subcortical dementia, impairment in attention and frontal executive function are predominant. Patients are often inert, indifferent, and uninterested. They appear characteristically 'slowed up' with a marked deficit in the retrieval of information. Changes in mood, personality, and social conduct are very common. We describe a case of subcortical dementia, who has definite changes in brain MRI after cerebral malaria.

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Diversity of Subcortical Arthropod Communities in Tropical and Temperate Forests

  • Choe, Jae-Chun
    • Animal cells and systems
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    • v.1 no.4
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    • pp.577-581
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    • 1997
  • Species diversity of subcortical arthropod communities were assessed in two tropical regions and two temperate regions. In the tropics, communities of subcortical arthropods were more diverse in La Selva, Costa Rica, than on Barro Colorado Island, Panama. Costa Rican communties yielses higher values of both Shannon and Simpson diversity indices than Panamanian communities. Compared to Panamanian communities, Costa Rican ones supported higher measures of both species richness and evenness. Between the two temperate regions, communities of subcortical arthropods in Korea scored consistently higher values of both Shannon and Simpson indices than the ones in eastern Massachusetts, U.S.A. When individual diversity components were compared, however, Korean communities yielded exceptionally high evenness measures but lower species richness than the communities in the U.S.A. Unusually high evenness values of Korean subcortical arthropods were due to extremely low population densities of all component species.

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Diagnosis, Treatment and Prevention of Subcortical Vascular Dementia with a Case Report (피질하 혈관성치매의 진단, 치료 및 예방 : 1례 보고와 함께)

  • Choi, Seong-Hun;Ku, Sae-Kwang;Cheon, Woo-Hyun;Baek, Kyung-Min;Han, Chang-Hyun;Kyung, Jeon-Won;Lee, Young-Joon
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.3
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    • pp.63-75
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    • 2010
  • Vascular dementia(VaD) is currently considered to be the second most common type of dementia. VaD is not a single diagnostic entity, but a heterogeneous syndrome which encompasses several clinicopathological forms of dementia resulting from cerebrovascular diseases. A common form of VaD is subcortical VaD which is characterized by lacunar infarcts and deep white matter changes, leading to a progressive decline in memory and cognitive function. The neuropsychological and cognitive profiles of subcortical VaD have been reported relatively homogeneous. At present, subcortical vascular dementia is regarded as the most important subtype of VaD with getting the attention of vascular dementia. The aims of this study are to discuss the concept of subcortical VaD and its importance focusing on diagnosis, prevention and treatment with a case report.

Subcortical Ischemic Change as a Predictor of Driving Cessation in the Elderly

  • Jang, Mi;Hong, Chang Hyung;Kim, Hyun-Chung;Choi, Seong Hye;Seo, Sang Won;Kim, Seong Yoon;Na, Duk L.;Lee, Yunhwan;Chang, Ki Jung;Roh, Hyun Woong;Son, Sang Joon
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1162-1167
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    • 2018
  • Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

Clinical Correlates of Subcortical Hyperintensities on Magnetic Resonance Imaging in Patients with Bipolar Disorder : Preliminary Study (양극성장애 환자의 뇌자기공명영상에서 보이는 피질하 고신호광도의 임상적 상관변수에 관한 예비적 연구)

  • Yoon, Dae Hyun;Kwon, Jun Soo;Han, Moon Hee;Chang, Kee Hyun
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.60-66
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    • 1997
  • Objective : Accumulating evidence suggests a greater number of subcortical hyperintensities in the brain of patients with bipolar disorder. We studied the Clinical correlates of subcortical hyperintensities on magnetic resonance imaging in patients with Bipolar Disorder : Methods : Magnetic resonance images of the brain were obtained for 32 patients with bipolar disorder. The presence and location of hyperintensities were assessed. We compared clinical variables between patients with subcortical hyperintensities and patients without them. Results : Seven patients(21.8%) had subcortical hyperintensities, but among 8 patients who were 40 years or older, 5 patients(62%) had them. Age and age at onset of patients with subcortical hyperintensities were significantly older than patients without them. Psychotic symptoms were more frequent in patients with hyperintensities. Patients without hyperintensities had more familial loadings. Conclusion : Given the limitations of the study, our results should be seen as preliminary. This study, however, provides preliminary evidence supporting the notion that the onset, clinical feature and course of some bipolar disorders of late onset may be determined by underlying subcortical abnormalities, with such abnormalities being the consequence of factors related to aging or neurodegeneration(such as impaired cerebral circulation) rather than genetic factors which predispose to early-onset bipolar disorders.

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Technical Considerations of Effective Direct Cortical and Subcortical Stimulation (효과적인 대뇌 직접피질자극 검사 및 피질하자극 검사의 술기에 관한 기술적 고찰)

  • Lim, Sung Hyuk;Jang, Min Hwan
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.157-162
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    • 2022
  • The purpose of the direct cortical and subcortical stimulation technique is to prevent false positives caused by transcranial electrical motor evoked potentials (TceMEP) in surgery on patients with brain tumors that have occurred around the motor cortex and to preserve the correct mapping of motor areas during surgery and the corticospinal tract. In addition, it reduces the trial and error that occurs during the intraoperative neurophysiological monitoring (INM) process and minimizes the test time, so that accurate information is communicated to the surgeon with quick feedback on the test results. The most important factors of this technique are, first, examination at a stimulus threshold of a certain intensity, and second, maintaining anesthesia depth at an appropriate level to prevent false positives from occurring during surgery. The third is the installation of a multi-level channel recording electrode on the opposite side of the area of operation to measure the TceMEP waveform and the response to direct cortical and subcortical stimulation in as many muscles as possible. If these conditions are maintained, it is possible to predict causes that may occur in other factors, not false positives, from the INM test.

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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    • v.15 no.2
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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.

Comparison of Differences in Subcortical between Men and Women in their Seventies (70대의 성별에 따른 피질하부 차이 비교)

  • Ahn, Beyung-Ju;Park, Hye-Mi;Kim, Joo-Yeon;Lee, Jeong-hwan
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.585-595
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    • 2020
  • Magnetic resonance imaging(MRI) has become an important technique for examining changes in human brain structure with neurological disorders. Brain development is a very complex process, and is affected by neurogenesiss and genetic programs. As age increases, structures of the brain change, which can contribute to the formation of brain diseases. Among the various factors, Gender is one of the greatest influential factors that affect the development of a healthy brain. The images were analyzed through various programs found in FSL such as SIENAX, FIRST, and Vertex analysis. Our results show that significant gender-related differences in subcortical areas were observed at the particular age group. The magnitude of these differences between gender and volume varied depending on the area investigated. In this study, we used more advanced 3T MRI for the structural analysis of subcortical structures between each gender. In addition, Vertex Analysis was used to visualize the volumetric differences in subcortical structures between each gender. This study is limited to groups in their 70s, therefore, further studies are needed for wider age groups.