• Korean Journal of Audiology
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• v.25 no.1
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• pp.14-21
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• 2021

Background and Objectives: There is growing interest in the use of the Level-specific (LS) CE-Chirp^® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults. Subjects and Methods: Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp^® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp^® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC). Results: The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent. Conclusions: The ABR results from both the LS CE-Chirp^® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.

• Korean Journal of Audiology
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• v.25 no.4
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• pp.199-208
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• 2021

Background and Objectives: No known studies have investigated the influence of stimulus polarity on the Auditory Brainstem Response (ABR) elicited from level-specific (LS) chirp. This study is important as it provides a better understanding of the stimulus polarity selection for ABR elicited from LS chirp stimulus. We explored the influence of stimulus polarity on the ABR from LS chirp compared to the ABR from click at 80 dBnHL in normal-hearing adults. Subjects and Methods: Nineteen adults with normal hearing participated. The ABRs were acquired using click and LS chirp stimuli using three stimulus polarities (rarefaction, condensation, and alternating) at 80 dBnHL. The ABRs were tested only on the right ear at a stimulus rate of 33.33 Hz. The ABR test was stopped when the recording reached the residual noise level of 0.04 μV. The ABRs amplitudes, absolute latencies, inter-peak latencies (IPLs), and the recorded number of averages were statistically compared among ABRs at different stimulus polarities and stimuli combinations. Results: Rarefaction polarity had the largest ABR amplitudes and SNRs compared with other stimulus polarities in both stimuli. There were marginal differences in the absolute latencies and IPLs among stimulus polarities. No significant difference in the number of averages required to reach the stopping criteria was found. Conclusions: Stimulus polarities have a significant influence on the ABR to LS chirp. Rarefaction polarity is recommended for clinical use because of its larger ABR peak I, III, and V amplitudes than those of the other stimulus polarities.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.2
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• pp.150-159
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• 2023

Objective: The aim of this study was to investigate the efficacy of intraoperative indocyanine green videoangiography (ICG-VA) and intraoperative neuromonitoring (IONM) to prevent postoperative ischemic complications during microsurgical clipping of unruptured anterior choroidal artery (AChA) aneurysms. Methods: We retrospectively reviewed the clinical and radiological records of all patients who had undergone microsurgical clipping for unruptured AChA aneurysms at our institution between April 2001 and December 2019. We compared the postoperative complication rate of the group for which intraoperative ICG-VA and IONM were utilized (group B; n=324) with that of the group for which intraoperative ICG-VA and IONM were not utilized (group A; n=72). Results: There were no statistically significant differences in demographic data between the two groups. Statistically significant differences were observed in the rate of overall complications (p=0.014) and postoperative ischemic complications related to AChA territory (p=0.039). All the cases (n=4) in group B who had postoperative infarctions related to AChA territory showed false-negative results of intraoperative ICG-VA and IONM. Conclusions: Preserving the patency of the AChA is essential to minimize postoperative complications. Intraoperative monitoring tools including ICG-VA and IONM can greatly contribute to lowering complication rates. However, their pitfalls and false-negative results should always be considered.

• The Journal of Internal Korean Medicine
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• v.27 no.1
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• pp.265-275
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• 2006

Objectives : Electrical acupoint stimulation(EAS) has been used to treat motor dysfunction of stroke patients with reportedly effective results. The purpose of this study is to evaluate the efficacy of the EAS with different frequencies in treating motor dysfunction of ischemic stroke patients. Methods : The subject of this study were forty-two ischemic stroke patients with motor dysfunction in Kyunghee oriental medicine hospital who were hospitalized for one week to one month from onset. They were treated with 2Hz or 120Hz EAS for two weeks, and motor evoked potentials(MEP) were measured before and after EAS treatment. To compare the effect of 2Hz EAS with 120Hz, the number of patients who showed MEP responses after two weeks among those who had no previous response was checked. Also measured were latency, central motor conduction time(CMCT), amplitude of MEP before and after EAS treatment. Results : After two weeks of treatment, 4 out of 15 patients(27%) in the 2Hz EAS group and lout of 19 patients(5%) in the 120Hz group showed potential responses. Yet there was no significant difference between the two groups. When MEP data of the affected side between the 2Hz group and the 120Hz group was compared, the former showed more significant improvement than the latter in latency, CMCT and amplitude(P=0.040, 0.019,0.021). When the proportion of the affected side and unaffected side in MEP data was examined, the 2Hz group showed improvement on only latency and CMCT with significant differences(P=0.040, 0.014). Conclusions : These results show that EAS with low frequency is more helpful for motor recovery after ischemic stroke than that with high frequency. This suggests that low frequency EAS activates the central motor conduction system better than high frequency EAS.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1308-1314
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• 2006

Purpose : This study aimed to evaluate the usefulness of auditory evoked potential (AEP) in clarifying neuronal development in premature small for gestational age (SGA), and appropriate for gestational age (AGA) infants. Methods : A total of 183 premature infants who were born from August 2002 to July 2005, were examined with AEP. They were divided into three groups; AGA, symmetric-SGA and asymmetric-SGA group. Results : Statistically significant differences in the head circumference were observed in three groups. Among the risk factors, prevalence of hypoglycemia and hypoalbuminemia between AGA and asymmetric SGA infants were significantly different. V absolute peak latency (APL) in the right side of AGA infants was delayed were than that of asymmetric SGA infants. III-V interpeak latency (IPL) of asymmetric SGA infants was delayed more than that of symmetric SGA infants. Moreover, I-V IPL on both sides of symmetric SGA infants was shortened more than that of AGA infants. However, all the results of AEP were within the reference range, according to gestational age. Birth weight of, only asymmetric SGA, was related to the III APL on both sides and the III-V IPL on right side. Conclusion : This study shows that the values of APL and IPL of premature SGA infants are different than that of premature AGA infants. These data could be an indicator in evaluating the neurologic functions of small for gestational age infants.

• Journal of Physiology & Pathology in Korean Medicine
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• v.33 no.6
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• pp.356-362
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• 2019

Scutellaria baicalensis (SB) has widely used in the treatment for various brain diseases in the field of Oriental medicine. Biofermantation of SB can make major chemical constituents of SB to pass blood-brain barrier easily and to have more potent anti-oxidant ability. There is a little information about the contribution of fermented SB (FSB) to the formation or maintenance of the neural plasticity in the hippocampus. The purpose of this study was to evaluate effects of FSB extract on hydrogen peroxide (H₂O₂) - induced impairments of the induction and maintenance of long-term potentiation (LTP), an electrophysiological marker for the neural plasticity in the hippocampus. From hippocampal slices of rats, the field excitatory postsynaptic potentials (fEPSPs) were evoked by the electrical stimulation to the Schaffer collaterals - commissural fibers in the CA1 areas and LTP by theta-burst stimulation by using 64 - channels in vitro multi-extracellular recording system. In order to induce oxidative stress to hippocampal slices two different concentrations (200, 400 μM) of H₂O₂ were given to the perfused aCSF before and after the LTP induction, respectively. The ethanol extract of FBS with concentration of 25 ㎍/ml, 50 ㎍/ml was diluted in perfused aCSF that had 200 μM H₂O₂, respectively. Oxidative stress by the treatment of H₂O₂ resulted in decrease of the induction rate of LTP in the CA1 area with a dose - dependent manner. However, the ethanol extract of FSB prevented the reduction of the induction rate of LTP caused by H₂O₂ - induced oxidative stress with a dose - dependent manner. These results may support a potential application of FSB to ameliorate impairments of hippocampal dependent neural plasticity or memory caused by oxidative stress.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1161-1170
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• 2000

Objective : The transverse hippocampal slice is one of the most commonly studied in vitro models of mammalian brain physiology. However, despite its broad usage, there has been no standardization of slice preparation techniques or recording condition. It is well known that variations in recording conditions can result in profound different effects to neuronal responses. Evoked field potentials, recorded extracellularly, were used to investigate the effects of variations in hippocampal slice preparation protocol on hypoxia responses of CA1 neurones. Material & Methods : Before hypoxic injury, hippocampal slices were incubated for 4 hours. During incubation period, the slices were placed in a incubation chamber($21^{\circ}C$) for recovery from preparation injury and then transferred to recording chamber($34^{\circ}C$) for more recovery and baseline electric recording with current stimulation(0.1Hz). Various time periods in incubation chamber and recording chamber were applied to each experimental group(group 1=60min : 180min, group 2=90min : 150min, group 3=180min : 60min, time in incubation chamber : time in recording chamber) before 10 min hypoxia produced by replacing 95% $O_2$+5% $CO_2$ mixed gas to 95% $N_2$+5% $CO_2$ gas. Calcium, Magnesium ions and several drugs effecting on glutamate receptor also were studied. Recoveries from hypoxic injury of hippocampal slices were estimated by percent recovery of population spike(PS). Statistic analysis of study were performed using paired t-test. Results : The percent recovery of PS after 10min hypoxia was considerably enhanced by increasing the period of current stimulation during incubation period before hypoxic injury. Temperature effect on the result of this experiment was also studied(group 4) but the result from this showed no statistic significance. Low magnesium ion concentration of artificial CSF(Mg-free aCSF) during incubation period enhanced the recovery of PS but low calcium (calcium-free) and high magnesium ion concentration(2mM) reduced it after hypoxic injury. L-glutamate($100{\mu}M$) and AP-5($50{\mu}M$) had no effect on the recovery of PS but CNQX($10{\mu}M$) in artificial CSF during incubation period markedly enhanced the recovery of PS. Co-treatment of AP-5($50{\mu}M$), CNQX($10{\mu}M$) and high magnesium concentration(2mM) enhanced recovery of PS in immediate following period of hypoxic injury but the effect of cotreatment after then decayed rapidly and lost statistic significance. Conclusions : Judging from above results, the condition of baseline recording is important in observing the recovery of population spike after hypoxia, and the time and the condition should be controled more strictly to obtain reliable results.

• The Korean Journal of Physiology
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• v.21 no.1
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• pp.1-12
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• 1987

There is evidence that the effect of extracellular $Ca^{2+}$ on heart rate is temperature-dependent: at $38^{\circ}C$ excess $Ca^{2+}$ induces positive chronotropic response, whereas at $30^{\circ}C$ there is no significant chronotropic effect of $Ca^{2+}$. The cause of this temperature-dependency, however, remains still unclear. Therefore, this study was undertaken to investigate the chronotropic effect of external $Ca^{2+}$ at different temperature in the isolated rabbit atria and in the small strips of SA node cut perpendicularly to crista terminalis. In the isolated atria, the $Ca^{2+}$ effect was temperature-dependent: at $35^{\circ}C$ excess $Ca^{2+}$ evoked positive chronotropic response, while at $30^{\circ}C$ there was no significant changes in sinus rate. On the contrary, in the small SA strips external $Ca^{2+}$ induced negative chronotropic effect. At $35^{\circ}C$ changes in $Ca^{2+}$ concentration from 2 to 4, 6, and 10 mM decreased the sinus rate by $2.7{\pm}1.6%$, $11.2{\pm}3.7%$ and $23.2{\pm}8.1%$ respectively. Lowering the temperature to $30^{\circ}C$, the negative chronotropic effect of $Ca^{2+}$ became greater. With intracellular microelectrodes transmembrane potential was recorded in the small SA strips at $30^{\circ}C$, $35^{\circ}C$ and $38^{\circ}C$. As temperature increased from 30 to $38^{\circ}C$, sinus rate was accelerated by $13/min/^{\circ}C$, $APD_{50}$(action ptential duration from peak to 50% repolarization) decreased by $5\;msec/^{\circ}C$, and amplitude of action potential was slightly decreased. With an increase in $Ca^{2+}$ concentrations from 0.5 to 6 mM, overshoot increased and MDP decreased. These $Ca^{2+}$ effects on the overshoot and MDP of action potentials were not altered by temperature. But the $Ca^{2+}$ effects on the rates of diastolic depolarization, systolic depolarization and repolarization were modified by temperature. Discrpancy of the chronotropic effects of $Ca^{2+}$ between isolated atria and small SA strips was discussed.

• Korean Journal of Biological Psychiatry
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• v.16 no.3
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• pp.181-189
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• 2009

Objectives : N100 amplitude slope(the intensity dependence of the cortical auditory evoked potentials) is widely considered as an indirect indicator of central serotonergic neurotransmission. However, there are only a few studies about N100 amplitude slopes of major psychiatric disorders. In this study, we examined N100 amplitude slope differences among major depressive disorder(MDD), bipolar disorder(BD), schizophrenia (SCZ) and normal controls(NC). Methods : We measured the N100 amplitude slopes of 35 patients with MDD, 33 patients with BD, 27 patients with SCZ and 35 NC subjects. Amplitude differences from N1 to P2 at the five different sound intensities(55, 65, 75, 85 and 95dB) were examined at Cz electrode. The N100 amplitude slope was calculated as the linear regression of five N1/P2 peak-to-peak amplitudes across stimulus intensities. Results : BD patients showed significantly reduced N100 amplitude slope compared with NC(0.54${\pm}$0.70 vs. 0.96${\pm}$0.72, p=0.035). N100 amplitude slope of SCZ patients was significantly reduced compared with NC(0.50${\pm}$0.47 vs. 0.96${\pm}$0.72, p=0.027). N100 amplitude slope of BD patients was significantly lower than that of MDD patients(0.54${\pm}$0.70 vs. 0.94${\pm}$0.60, p=0.046). SCZ patients also showed significant reduction of N100 amplitude slope compared with MDD patients(0.50${\pm}$0.47 vs. 0.94${\pm}$0.60, p=0.036). There was no significant difference of N100 amplitude slope between MDD patients and NC(0.94${\pm}$0.60 vs. 0.96${\pm}$0.72, p=1.000). Conclusion : Interestingly, the N100 amplitude slopes of BD and SCZ were reduced compared to NC and MDD patients. Our results suggest the predictive use of N100 amplitude slope in making differential diagnoses of major psychiatric disorders. Clinical implications of N100 amplitude slope in major psychiatric disorders were discussed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.352-358
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• 2017

Frontotemporal dementia, the second most common cause of early onset dementia, is a neurodegenerative clinical syndrome characterized by progressive deficits in behavior, executive function and language. Although motor symptoms in frontotemporal dementia are represented by motor neuron disease, parkinsonism and progressive supranuclear palsy syndrome, there have been no reports of motor weakness caused by the direct involvement of central motor nervous systems in frontotemporal dementia. Moreover, no association between clinical dementia groups and complex regional pain syndrome has been reported. We diagnosed a rare case with motor weakness and complex regional pain syndrome of lower limbs due to central nervous system lesion in a patient with frontotemporal dementia by magnetic resonance imaging, electrodiagnostic study and three phase bone scan. Following steroid therapy for complex regional pain syndrome, pain was improved. Functional improvement was noted after rehabilitation therapy, including functional electrical stimulation, muscle strengthening exercise and gait training during hospitalization. This case report suggests that rehabilitation therapy for motor weakness in frontotemporal dementia could be effective for improving overall function.