• Title/Summary/Keyword: cognitive impairments

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Herbal Medicine Treatment of Refractory Epilepsy in Tuberous Sclerosis Complex : A Case Report

  • Son, Kwanghyun;Lee, Jinsoo;Kim, Moonju
    • The Journal of Korean Medicine
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    • v.36 no.2
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    • pp.50-55
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    • 2015
  • Infants with tuberous sclerosis complex (TSC) have a higher chance of experiencing seizures before the age of 1 year; in particular, they commonly accompany infantile spasms. In cases where infantile spasms resulting from TSC are drug-resistant, more severe neuro-developmental and cognitive impairments occur. This particular case dealt with an infant with TSC who continued to experience partial seizures and infantile spasms despite using two different kinds of antiepileptic drugs (AEDs). His spasms ceased on the seventh day of taking modified Yukmijihwang-tang (YMJ), at which point he stopped the use of all AEDs. He became seizure-free after a month of the treatment and modified hypsarrythmia was found to have been resolved in the electroencephalogram test. Until now, the infant has been taking YMJ for 16 months and is maintaining the seizure-free state without side effects. Moreover, his developmental status is continually improving, with a significant progress in language and cognitive-adaptive abilities. Such results suggest that YMJ can serve as an alternative treatment option for refractory epilepsy.

The ability of orexin-A to modify pain-induced cyclooxygenase-2 and brain-derived neurotrophic factor expression is associated with its ability to inhibit capsaicin-induced pulpal nociception in rats

  • Shahsavari, Fatemeh;Abbasnejad, Mehdi;Esmaeili-Mahani, Saeed;Raoof, Maryam
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.261-270
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    • 2022
  • Background: The rostral ventromedial medulla (RVM) is a critical region for the management of nociception. The RVM is also involved in learning and memory processes due to its relationship with the hippocampus. The purpose of the present study was to investigate the molecular mechanisms behind orexin-A signaling in the RVM and hippocampus's effects on capsaicin-induced pulpal nociception and cognitive impairments in rats. Methods: Capsaicin (100 g) was applied intradentally to male Wistar rats to induce inflammatory pulpal nociception. Orexin-A and an orexin-1 receptor antagonist (SB-334867) were then microinjected into the RVM. Immunoblotting and immunofluorescence staining were used to check the levels of cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) in the RVM and hippocampus. Results: Interdental capsaicin treatment resulted in nociceptive responses as well as a reduction in spatial learning and memory. Additionally, it resulted in decreased BDNF and increased COX-2 expression levels. Orexin-A administration (50 pmol/1 µL/rat) could reverse such molecular changes. SB-334867 microinjection (80 nM/1 µL/rat) suppressed orexin's effects. Conclusions: Orexin-A signaling in the RVM and hippocampus modulates capsaicin-induced pulpal nociception in male rats by increasing BDNF expression and decreasing COX-2 expression.

Bayesian bi-level variable selection for genome-wide survival study

  • Eunjee Lee;Joseph G. Ibrahim;Hongtu Zhu
    • Genomics & Informatics
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    • v.21 no.3
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    • pp.28.1-28.13
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    • 2023
  • Mild cognitive impairment (MCI) is a clinical syndrome characterized by the onset and evolution of cognitive impairments, often considered a transitional stage to Alzheimer's disease (AD). The genetic traits of MCI patients who experience a rapid progression to AD can enhance early diagnosis capabilities and facilitate drug discovery for AD. While a genome-wide association study (GWAS) is a standard tool for identifying single nucleotide polymorphisms (SNPs) related to a disease, it fails to detect SNPs with small effect sizes due to stringent control for multiple testing. Additionally, the method does not consider the group structures of SNPs, such as genes or linkage disequilibrium blocks, which can provide valuable insights into the genetic architecture. To address the limitations, we propose a Bayesian bi-level variable selection method that detects SNPs associated with time of conversion from MCI to AD. Our approach integrates group inclusion indicators into an accelerated failure time model to identify important SNP groups. Additionally, we employ data augmentation techniques to impute censored time values using a predictive posterior. We adapt Dirichlet-Laplace shrinkage priors to incorporate the group structure for SNP-level variable selection. In the simulation study, our method outperformed other competing methods regarding variable selection. The analysis of Alzheimer's Disease Neuroimaging Initiative (ADNI) data revealed several genes directly or indirectly related to AD, whereas a classical GWAS did not identify any significant SNPs.

Incidence and Features of Cognitive Dysfunction Identified by Using Mini-mental State Examination at the Emergency Department among Carbon Monoxide-poisoned Patients with an Alert Mental Status (의식이 명료한 일산화탄소 중독환자를 대상으로 응급실에서 시행한 간이정신상태검사의 임상적 의의)

  • Youk, Hyun;Cha, Yong Sung;Kim, Hyun;Kim, Sung Hoon;Kim, Ji Hyun;Kim, Oh Hyun;Kim, Hyung Il;Cha, Kyoung Chul;Lee, Kang Hyun;Hwang, Sung Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.115-121
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    • 2016
  • Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

Iron deficiency increases blood concentrations of neurotoxic metals in children

  • Kim, Yangho;Park, Sangkyu
    • Clinical and Experimental Pediatrics
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    • v.57 no.8
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    • pp.345-350
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    • 2014
  • Iron deficiency affects approximately one-third of the world's population, occurring most frequently in children aged 6 months to 3 years. Mechanisms of iron absorption are similar to those of other divalent metals, particularly manganese, lead, and cadmium, and a diet deficient in iron can lead to excess absorption of manganese, lead, and cadmium. Iron deficiency may lead to cognitive impairments resulting from the deficiency itself or from increased metal concentrations caused by the deficiency. Iron deficiency combined with increased manganese or lead concentrations may further affect neurodevelopment. We recently showed that blood manganese and lead concentrations are elevated among iron-deficient infants. Increased blood manganese and lead levels are likely associated with prolonged breast-feeding, which is also a risk factor for iron deficiency. Thus, babies who are breast-fed for prolonged periods should be given plain, iron-fortified cereals or other good sources of dietary iron.

Selaginella tamariscina Extract Improves Scopolamine-induced Learning and Memory Dificits in Rats (부처손 추출물의 치매개선 효과 및 기전탐색)

  • Chu, Soon-Ju;Heo, Jin-Sun;Sohn, Kie-ho
    • Korean Journal of Pharmacognosy
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    • v.47 no.4
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    • pp.319-326
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    • 2016
  • We investigated the effect of Selaginella tamariscina extract on the learning and memory impairments in scopolamine-induced (5 mg/kg, i.p.) dementia rats. Rats treated with oral tacrin (20 mg/kg, p.o.) as positive control group and S. tamariscina extract 100, 200mg/kg, p. o. (SME 100, SME 200) as experimental group had significantly reduced scopolamine-induced memory deficits in the passive avoidance test. The acetylcholine content were paralleled the results of the behavior experiment. The acetylcholine contents of the experimental groups (SME 200 group) was higher than that of control group. We also evaluated expression of VAchT, vesicular acetylcholine transporter. SME was significantly increased VAchT expression on hippocampus of scopolamine-induced dementia rats. We suggest that S. tamariscina might exert a significantly neuro-protective effect on cognitive impairment.

Practice Guideline of Use of Benzodiazepines in Psychiatric Field (정신과 영역에서 벤조다이아제핀계 약물의 사용과 문제점)

  • Oh Kang-Seob
    • Anxiety and mood
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    • v.1 no.1
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    • pp.37-42
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    • 2005
  • Benzodiazepines are widely used for a variety of conditions in psychiatric field. In this article, the author reviewed the indications, the effects on anxiety and sleep disorders, the side effects, the drug-drug interactions, and the tapering strategies. Benzodiazepines were relatively safe and useful for the treatment of anxiety and sleep disorders. However, used clinically, benzodiazepines can induce many adverse effects (e. g. over-sedation, cognitive impairments, paradoxical effects, dependence and withdrawal symptoms, and so on). Currently available informations about their effects on the developing fetus is controversial. For this reason, pregnant women and nursing mother should be cautioned against the use of benzodiazepines. Drug-drug interactions have to be considered in combination treatments. For the tapering issues, gradual tapering was important to prevent the withdrawal symptoms. Especially, the tapering schedules have to be individualized for the each long-term benzodiapzepine users.

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Considerations for the Dental Management of Older Adults (임상가를 위한 특집3 - 노인 환자의 치과 치료시 고려 사항)

  • Kho, Hong-Seop
    • The Journal of the Korean dental association
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    • v.49 no.10
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    • pp.609-617
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    • 2011
  • The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.

Prevalence Rate of Cognitive Impairment and Dementia Among the Elderly in Busan (부산지역 거주 노인의 인지기능장애 및 치매 유병률)

  • Kim, Jung-Soon;Lee, Su-Ill;Chung, Young-In;Hwang, In-Kyung;Yih, Bong-Sook;Kim, Min-Jeong;Cho, Eu-Soo;Chun, Jin-Ho;Jeong, Ihn-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.1
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    • pp.63-70
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    • 2003
  • Objectives : To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. Methods : Total of 1,101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. Results : With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. Conclusions : The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.

Studies on the Nootropic and Anti-amnestic and Anxiolytic-like Effects of G.J.D-P.P.A. in Mice (공진단(拱辰丹)과 영신초(靈神草), 원지(遠志), 석창포(石菖蒲) 혼합제제의 기억력과 인지기능 개선 및 항불안에 관한 연구)

  • Choi, Cheol-Hong;Kim, Soo-Hyun;Chung, Dae-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.2
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    • pp.85-105
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    • 2011
  • Objectives : The purpose of this study was to characterize the neuroprotective effects and anxiolytic-like effects of Gongjin-dan and Polygala japonica, Polygala tenuifolia, Acorus gramineus mixed pills(G.J.D-P.P.A.). Methods : The neuroprotective effects of G.J.D-P.P.A. determined by the passive avoidance and Y-maze tasks and Morris water maze task, and the anxiolytic-like effects of the G.J.D-P.P.A. using an elevated plus-maze(EPM) in mice. Results : Drug-induced amnesia was induced by treating animals with scopolamine(1 mg/kg, i.p.). A single G.J.D-P.P.A.(400 and 800 mg/kg) administration significantly enhanced cognitive function and attenuated scopolamine-induced cognitive impairments as determined by the passive avoidance and Y-maze tasks(P < 0.05) and also reduced escape-latency on the Morris water maze task(P < 0.05). The administration of GJD-PPA(400 and 800 mg/kg) significantly increased the percentage of time spent in open arms and entries into the open arms of the EPM compared with saline-treated control group(P < 0.05). Moreover, there were no changes in the locomotor activity and myorelaxant effects in any group compared with saline-treated control group. Conclusions : These results suggest that GJD-PPA dramatically possesses the anti-amnestic and cognitive-enhancing activities related to the memory processes, and promotes the anxiolytic-like activity in mice.