• 대한의생명과학회지
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• 제24권4호
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• pp.418-425
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• 2018

Amyloid brain positron emission tomography (PET) images are visually and subjectively analyzed by the physician with a lot of time and effort to determine the ${\beta}$-Amyloid ($A{\beta}$) deposition. We designed a convolutional neural network (CNN) model that predicts the $A{\beta}$-positive and $A{\beta}$-negative status. We performed 18F-florbetaben (FBB) brain PET on controls and patients (n=176) with mild cognitive impairment and Alzheimer's Disease (AD). We classified brain PET images visually as per the on the brain amyloid plaque load score. We designed the visual geometry group (VGG16) model for the visual assessment of slice-based samples. To evaluate only the gray matter and not the white matter, gray matter masking (GMM) was applied to the slice-based standard samples. All the performance metrics were higher with GMM than without GMM (accuracy 92.39 vs. 89.60, sensitivity 87.93 vs. 85.76, and specificity 98.94 vs. 95.32). For the patient-based standard, all the performance metrics were almost the same (accuracy 89.78 vs. 89.21), lower (sensitivity 93.97 vs. 99.14), and higher (specificity 81.67 vs. 70.00). The area under curve with the VGG16 model that observed the gray matter region only was slightly higher than the model that observed the whole brain for both slice-based and patient-based decision processes. Amyloid brain PET images can be appropriately analyzed using the CNN model for predicting the $A{\beta}$-positive and $A{\beta}$-negative status.

• 근관절건강학회지
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• 제27권3호
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• pp.219-228
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• 2020

Purpose: This study was a comparative analysis of stroke-related factors between recurrent patients and non-recurrent patients. Methods: A retrospective cohort study design was used, and data were collected from March 2020 to April 2020 using electronic medical records. 244 patients (221 first-timers and 23 recurrent) were included in this study. Results: The stroke recurrence rate in 5 years was 9.4%, the readmission rate was 39.3%, and the mortality rate was 2.0%. The number of patients hospitalized for stroke was greater among men than among women. Of the patients, 60.7% had an underlying disease. With regard to daily life abilities, over 70% of participants needed more than moderate dependence and about 40% of participants had more than mild cognitive impairment. More than 50% were moved to wheelchairs or stretcher cars. The difference in the stroke readmission rate between recurrent and non-recurrent patients was statistically significant. Conclusions: Based on our findings, a program to prevent recurrence of stroke should be developed to considering age, ability of daily living, place of discharge, gait ability at discharge, and place of discharge.

• 대한통합의학회지
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• 제10권2호
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• pp.187-202
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• 2022

Purpose : This study is a descriptive research study to establish basic data for stable operation of dementia relief center as a part of national responsibility system for dementia and to establish the role of the professional workforce. Methods : This study is a survey study involving 126 nurses working at 19 dementia relief centers. The collected data were analyzed using the SPSS/WIN 23.0. Results : The importance tasks that nurses think of were Dementia Diagnosis, Counseling, Register and Classification and Dementia Preventive Projects. In addition, tasks that showed high performance were in the order of Dementia Diagnosis, Counseling, Register and Classification, Management of Dementia subjects. As a result, the final items of work areas and contents included 45 subcategories of work content for eight work areas. Conclusion : Through this study, it was possible to investigate the overall work area and content of nurses at the Dementia relief Center. It is necessary to develop a work description suitable for nurses who are medical personnel specializing in dementia safety centers. It is necessary to develop a work description suitable for nurses who are medical personnel specializing in dementia safety centers. In connection with the purpose of establishing the centers for disease control and prevention, it is necessary to operate a systematic and continuous program to manage dementia patients and those with mild cognitive impairment in the community.

• 노인정신의학
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• 제16권1호
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• pp.17-23
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• 2012

The diagnosis of Alzheimer's disease (AD) is still obscure even to specialists. To improve the diagnostic accuracy, to find at-risk people as early as possible, to predict the efficacy or adverse reactions of pharmacotherapy on an individual basis, to attain more reliable results of clinical trials by recruiting better defined participants, to prove the disease-modifying ability of new candidate drugs, to establish prognosis-based therapeutic plans, and to do more, is now increasing the need for biomarkers for AD. Among AD-related biochemical markers, cerebrospinal beta-amyloid and tau have been paid the most attention since they are materials directly interfacing the brain interstitium and can be obtained through the lumbar puncture. Level of beta-amyloid is reduced whereas tau is increased in cerebrospinal fluid of AD patients relative to cognitively normal elderly people. Remarkably, such information has been found to help predict AD conversion of mild cognitive impairment. Despite inconsistent findings from previous studies, plasma beta-amyloid is thought to be increased before the disease onset, but show decreasing change as the disease progress. Regarding other peripheral biochemical markers, omics tools are being widely used not only to find useful biomarkers but also to generate novel hypotheses for AD pathogenesis and to lead new personalized future medicine.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제17권11호
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• pp.2924-2944
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• 2023

Alzheimer's disease (AD) is a neurological condition that is recognized as one of the primary causes of memory loss. AD currently has no cure. Therefore, the need to develop an efficient model with high precision for timely detection of the disease is very essential. When AD is detected early, treatment would be most likely successful. The most often utilized indicators for AD identification are the Mini-mental state examination (MMSE), and the clinical dementia. However, the use of these indicators as ground truth marking could be imprecise for AD detection. Researchers have proposed several computer-aided frameworks and lately, the supervised model is mostly used. In this study, we propose a novel 3D Convolutional Neural Network Multilayer Perceptron (3D CNN-MLP) based model for AD classification. The model uses Attention Mechanism to automatically extract relevant features from Magnetic Resonance Images (MRI) to generate probability maps which serves as input for the MLP classifier. Three MRI scan categories were considered, thus AD dementia patients, Mild Cognitive Impairment patients (MCI), and Normal Control (NC) or healthy patients. The performance of the model is assessed by comparing basic CNN, VGG16, DenseNet models, and other state of the art works. The models were adjusted to fit the 3D images before the comparison was done. Our model exhibited excellent classification performance, with an accuracy of 91.27% for AD and NC, 80.85% for MCI and NC, and 87.34% for AD and MCI.

• Korean Journal of Radiology
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• 제22권3호
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• pp.405-414
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• 2021

Objective: To compare two clinically available MR volumetry software, NeuroQuant^® (NQ) and Inbrain^® (IB), and examine the inter-method reliabilities and differences between them. Materials and Methods: This study included 172 subjects (age range, 55-88 years; mean age, 71.2 years), comprising 45 normal healthy subjects, 85 patients with mild cognitive impairment, and 42 patients with Alzheimer's disease. Magnetic resonance imaging scans were analyzed with IB and NQ. Mean differences were compared with the paired t test. Inter-method reliability was evaluated with Pearson's correlation coefficients and intraclass correlation coefficients (ICCs). Effect sizes were also obtained to document the standardized mean differences. Results: The paired t test showed significant volume differences in most regions except for the amygdala between the two methods. Nevertheless, inter-method measurements between IB and NQ showed good to excellent reliability (0.72 < r < 0.96, 0.83 < ICC < 0.98) except for the pallidum, which showed poor reliability (left: r = 0.03, ICC = 0.06; right: r = -0.05, ICC = -0.09). For the measurements of effect size, volume differences were large in most regions (0.05 < r < 6.15). The effect size was the largest in the pallidum and smallest in the cerebellum. Conclusion: Comparisons between IB and NQ showed significantly different volume measurements with large effect sizes. However, they showed good to excellent inter-method reliability in volumetric measurements for all brain regions, with the exception of the pallidum. Clinicians using these commercial software should take into consideration that different volume measurements could be obtained depending on the software used.

• 대한치매학회지
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• 제21권2호
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• pp.71-78
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• 2022

Background and Purpose: The expression of the 18-kDA mitochondrial translocator protein (TSPO) in the brain is an attractive target to study neuroinflammation. However, the binding properties of TSPO ligands are reportedly dependent on genetic polymorphism of the TSPO gene (rs6971). The objective of this study is to investigate the rs6971 gene polymorphism in the Korean population. Methods: We performed genetic testing on 109 subjects including patients with mild cognitive impairment, Alzheimer's disease (AD) dementia, non-AD dementia, and cognitively unimpaired participants. Magnetic resonance imaging scans and detailed neuropsychological tests were also performed, and 29 participants underwent ¹⁸F-DPA714 PET scans. Exon 4 of the TSPO gene containing the polymorphism rs6971 (Ala or Thr at position 147) was polymerase chain reaction amplified and sequenced using the Sanger method. The identified rs6971 genotype codes (C/C, C/T, or T/T) of the TSPO protein generated high-, mixed-, or low-affinity binding phenotypes (HABs, MABs, and LABs), respectively. Results: We found that 96.3% of the study subjects were HAB (105 out of 109 subjects), and 3.7% of the subjects were MAB (4 out of 109 subjects). ¹⁸F-DPA-714 PET scans showed nonspecific binding to the thalamus and brainstem, and increased tracer uptake throughout the cortex in cognitively impaired patients. The participant with the MAB polymorphism had a higher DPA714 signal throughout the cortex. Conclusions: The majority of Koreans are HAB (aprox. 96%). Therefore, the polymorphism of the rs6971 gene would have a smaller impact on the availability of second-generation TSPO PET tracers.

• 대한지역사회작업치료학회지
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• 제6권1호
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• pp.33-39
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• 2016

목적 : 본 연구는 일반적으로 노인에게 저하되어 있는 기억력을 회복하거나 유지하기 위한 인지재활의 필요성을 인식하고 기억전략 프로그램이 정상 노인의 기억력에 미치는 효과를 알아보고자 하였다. 연구방법 : 부산광역시에 위치한 노인복지관을 이용하는 60세 이상의 노인 20명 중 무작위로 실험군과 대조군을 나누어 대조군은 기존 노인복지관 프로그램을 이용하였고, 실험군은 기억전략 프로그램을 주 2회, 4주간, 총 8회기 동안 실시하였다. 평가 전 후의 비교는 상황기억검사(Contextural Memory Test; CMT)를 시행하였다. 결과 : 두 집단의 프로그램 전과 후를 비교한 결과 두 집단 모두 순간기억과 지연기억에서 유의한 차이를 보이지 않았다(p>.05). 그러나 프로그램 후 실험군의 순간기억과 지연기억에서 모두 유의한 차이가 나타났다(p<.05). 결론 : 연구결과 기억전략 프로그램은 정상 노인에게 기억력을 증진시킬 수 있다는 것을 보여주었다. 앞으로 정상 노인을 위한 기억 증진 목적의 프로그램이 많이 개발되고 발전된다면 이후 발생하게 될 치매 혹은 경도인지장애의 발병을 예방해 줄 수 있을 것으로 기대된다.

• 생명과학회지
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• 제30권12호
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• pp.1118-1127
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• 2020

알츠하이머병은 점진적인 신경세포의 손상과 이로 인해 인지기능 장애를 유발하는 질병이다. 이 질환은 현재로서는 치료할 수 있는 질환이 아니고 진행을 멈추게 할 수 있는 방법이 없다. 그러나 초기에 알츠하이머병을 치료하는 것이 가장 효과적이므로 초기 진단은 증상을 관리할 수 있는 가장 좋은 기회를 제공할 수 있다. 알츠하이머병을 진단하기 위한 바이오마커로는 아밀로이드 베타(Aβ), 병적인 타우, 그리고 신경퇴화가 있고, Aβ의 축적, 인산화 타우는 뇌척수액이나 양전자 방출 단층촬영술을 통해 분석할 수 있다. 그러나 뇌척수액의 채취는 매우 침습적이고 양전자 방출 단층촬영술은 전문적인 고가의 장비가 필요하다. 지난 수십년 동안 빠르고 최소한의 침습성을 가진 바이오마커 분석법을 개발하기 위하여 혈액에 기반한 바이오마커 분석 기술이 연구되어 왔다. 그 중 주목할 만 한 발견이 혈장에서 Aβ의 주요 원천으로 혈소판과의 관련성이다. 아밀로이드 베타는 혈액-뇌 장벽을 통과 할 수 있고 정상 상태에서는 뇌와 혈액 간 평형을 이루게 된다. 흥미롭게도, 여러 임상시험 결과 혈장에서 Aβ42/Aβ40 비율이 가벼운 인지장애 질환과 알츠하이머병에서 감소되어 있는 것을 증명하였다. 종합하면, 이러한 최근의 발견들은 침습성을 최소화한 알츠하이머병의 초기 진단 기술을 개발하는 데 이용될 수 있다. 본 총설에서, 저자들은 알츠하이머병의 바이오마커에 대한 최근 연구결과들, 특히 말초에서 Aβ를 생산하는 혈소판의 역할과 혈액 기반 바이오마커로서의 개발 가능성에 대해 고찰하였다.

• Korean Journal of Radiology
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• 제23권10호
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• pp.959-975
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• 2022

Objective: To investigate the agreement and reliability of estimating the volumes and normative percentiles (N%) of segmented brain regions among NeuroQuant (NQ), DeepBrain (DB), and FreeSurfer (FS) software programs, focusing on the comparison between NQ and DB. Materials and Methods: Three-dimensional T1-weighted images of 145 participants (48 healthy participants, 50 patients with mild cognitive impairment, and 47 patients with Alzheimer's disease) from a single medical center (SMC) dataset and 130 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset were included in this retrospective study. All images were analyzed with DB, NQ, and FS software to obtain volume estimates and N% of various segmented brain regions. We used Bland-Altman analysis, repeated measures ANOVA, reproducibility coefficient, effect size, and intraclass correlation coefficient (ICC) to evaluate inter-method agreement and reliability. Results: Among the three software programs, the Bland-Altman plot showed a substantial bias, the ICC showed a broad range of reliability (0.004-0.97), and repeated-measures ANOVA revealed significant mean volume differences in all brain regions. Similarly, the volume differences of the three software programs had large effect sizes in most regions (0.73-5.51). The effect size was largest in the pallidum in both datasets and smallest in the thalamus and cerebral white matter in the SMC and ADNI datasets, respectively. N% of NQ and DB showed an unacceptably broad Bland-Altman limit of agreement in all brain regions and a very wide range of ICC values (-0.142-0.844) in most brain regions. Conclusion: NQ and DB showed significant differences in the measured volume and N%, with limited agreement and reliability for most brain regions. Therefore, users should be aware of the lack of interchangeability between these software programs when they are applied in clinical practice.