• 대한한의학회지
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• 제28권3호통권71호
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• pp.289-298
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• 2007

Objectives : Electrical acupoint stimulation (EAS) has been used to treat motor dysfunction of stroke patients with reportedly effective results. The purpose of this study was to evaluate the efficacy of EAS with different frequencies in treating motor dysfunction of ischemic stroke patients. Methods : The subjects of this study were sixty-two ischemic stroke patients with motor dysfunction at 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, we measured latency, central motor conduction time (CMCT) and amplitude of MEP before and after EAS treatment. Results : After two weeks of treatment, we compared MEP data of the affected side between the 2Hz group and the 120Hz group. The 2Hz group showed more significant improvement than the 120Hz group in latency, CMCT and amplitude (P=0.008, 0.002, 0.002). In case of the affected side MEP data divided by normal side MEP data, the 2Hz group also showed improvement on latency, CMCT and amplitude with significant differences (P=0.003, 0.000, 0.008). Conclusions : These results suggest that low frequency EAS activates the central motor conduction system better than high frequency EAS, and it means that EAS with low frequency is more helpful for motor recovery after ischemic stroke than that with high frequency.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.78-87
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• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• Annals of Clinical Neurophysiology
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• 제1권2호
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• pp.126-146
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• 1999

In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.

• Annals of Clinical Neurophysiology
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• 제6권2호
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• pp.85-91
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• 2004

Background: Needle electromyography (EMG) and motor evoked potential (MEP) of the genioglossus (tongue) are difficult to perform in evaluations of the craniobulbar region in amyotrophic lateral sclerosis (ALS). Therefore, we investigated the yields of needle EMG and MEP recorded from the upper trapezius, since it receives innervation from the lower medulla and upper cervical cord. Methods: Needle EMG and MEP of the upper trapezius were obtained in 17 consecutive ALS patients. The needle EMG parameters recorded included abnormal spontaneous activity and motor unit action potential (MUAP) morphology. An upper motor neuron (UMN) lesion was presumed when either response to cortical stimulation was absent, or the central conduction time was delayed (>mean+2SD). Results: Of the five patients with bulbar-onset ALS, four had abnormalities in the upper trapezius and four in the tongue by needle EMG. In contrast, of the 12 patients with limb-onset ALS, 11 had abnormalities in the upper trapezius, and only five in the tongue. When MEP was performed, it was found that three of the five patients with bulbar symptoms and three of the six patients with isolated limb involvement had abnormal MEP findings. Conclusions: Electrophysiological studies of the upper trapezius are more sensitive those of the tongue in patients without bulbar symptoms. Thus, needle EMG and MEP of the upper trapezius are alternative tools for assessing bulbar and rostral neuraxial involvement in the diagnosis of ALS.

• 정신신체의학
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• 제18권1호
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• pp.3-10
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• 2010

뚜렛 증후군은 주로 아동기에 발생하는 만성적인 운동 및 음성 틱을 주소로 하는 질환이다. 기저핵-시상-피질 회로에서의 이상이 비자발성 틱의 병태생리에 중요한 역할을 하는 것으로 생각된다. 뚜렛 증후군은 흔히 주의력 결핍 과잉행동장애나 강박장애와 병존한다. 경두개 자기자극술은 연구용으로 많이 사용되는 신경생리학적 기법이다. 이 기법이 피질의 활성을 변화시킬 수 있다는 증거들이 많아서, 반복적 경두개 자기자극술은 피질의 활성도를 바꾸어서 결과적으로 내재한 서로 연결된 피질-피질하 회로에 영향을 주기 위하여 치료적 목적으로도 사용된다. 우리는 본 논문에서 경두개자극술의 여러 신경생리학적 변인들과 임상적 응용에 관하여 기존의 연구보고들을 고찰하여 보고자 한다.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.156-159
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• 2001

Miller Fisher syndrome(MFS) has been the focus of conflicting opinions regarding the peripheral versus the central nature of the site of major neural injury. We present our electrophysiological findings in one case of MFS to help clarify the pattern of peripheral nerve injury in this syndrome. A 45-year-old man visited our hospital due to sudden diplopia. Initial examination revealed internuclear opthalmoplegia. The next day, his symptoms rapidly aggravated to complete external ophthalmoplegia, ataxia, and areflexia with hand and foot numbness. Serial electrophysiological studies were performed. The results of brainstem evoked potential(BAEP) and blink reflex were normal in the serial studies. Motor and sensory nerve conduction study(NCS) were normal findings in second hospital day, but ulnar sensory nerve shows no sensory nerve action potential(SNAP) and sural sensory conduction velocity was delayed in 7th hospital day. Our patient's clinical presentation began to improve on 15th hospital day, and his electrophysiologic study showed improvement on 29th hospital day. We believe that all the manifestations of MFS can be explained by the involvement of peripheral nerves without brainstem or cerebellar lesion with the serial electrophysiological studies.

• Journal of Yeungnam Medical Science
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• 제18권1호
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• pp.67-74
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• 2001

정상 성인 남녀 36명(남:여=23:13)을 대상으로 LFCN의 SSEP검사를 시행한 결과로서 다음과 같은 결론을 얻을 수 있었다. 1. MP의 진단에 있어서는 $P_0$, $N_1$의 절대잠복기 뿐만 아니라 좌 우측 잠복기의 차이값($DP_0$, $DN_1$을 비교하여 보는 것이 더욱 중요하며 그 차이는 모두 2 msec 이하였다. 2. $P_0N_1$의 진폭만으로 비정상과 정상의 기준을 정할 수는 없으나 좌 우측 평균 진폭의 차이는 1.6배 이하였다. 3. $P_0(N_1)$, $DP_0(DN_1)$, 그리고 A(DA)에 있어 남녀군 간의 차이는 없었다.

• 융합신호처리학회논문지
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• 제19권1호
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• pp.7-13
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• 2018

현재의 연구에서는 소음을 제거하기 위해 블라인드 소스 분리(BSS)접근 방식에 의해 최적화된 두뇌-컴퓨터 인터페이스(BCI)를 제안했다. 모터 이미지(MI)신호와 정상 상태 시각적 제거 전위(SSVEP)신호는 신호 대 잡음비(SNR)의 증가로 인해 쉽게 검출되었다. 또한, MI와 SSVEP사이의 조합은 일반적으로 현재 BCI에서 생성되는 명령 수를 증가시킬 수 있다. 현재 시스템은 계산 시간을 줄이고 BCI를 실제 용도에 가깝게 하기 위해 단일 채널 EEG신호를 사용했다. 또한, 복잡한 신경 네트워크(CNN)가 다중 클래스 분류 모델로 사용되었다. 우리는 비 MS/BCI와 BBS/BCI사이의 정확성 측면에서 성능을 평가했다. 결과적으로 BBS+BCI의 정확도는 비 BBS+BCI의 정확도보다 $16.15{\pm}25.12%$더 높은 수준에 도달했다. 사용하지 않을 때보다 BBS를 사용함으로써 전반적으로 제안된 BCI시스템은 비교적 정확한 다차원 제어 애플리케이션에 적용될 가능성을 입증했다.

• Journal of Ginseng Research
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• 제36권2호
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• pp.190-197
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• 2012

Ginseng has a long history of use for health enhancement, and there is some evidence from animal studies that it has a beneficial effect on cognitive performance. The purpose of this study was to investigate the effect of Korean red ginseng on cognitive performance in humans. A total of 15 healthy young males with no psychiatric or cognitive problems were selected based on an interview with a board-certified psychiatrist. The subjects were randomly assigned to receive a daily dose of 4,500 mg red ginseng or placebo for a 2-week trial. There were 8 subjects in the red ginseng group and 7 subjects in the placebo group. All of the subjects were analyzed with the Vienna test system and a P300 event-related potential (ERP) test. There were no significant differences in the Vienna test system scores between the red ginseng group and the placebo group. In the event-related potential test, the C3 latency of the red ginseng group tended to decrease during the study period (p=0.005). After 2 wk, significant decreases were observed in the P300 latencies at Cz (p=0.008), C3 (p=0.005), C4 (p=0.002), and C mean (p=0.003) in the red ginseng group. Our results suggest that the decreased latency in ERP is associated with improved cognitive function. Further studies with a higher dosage of ginseng, a larger sample size, and a longer follow-up period are necessary to confirm the clinical efficacy of Korean red ginseng.

• 전자공학회논문지
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• 제50권9호
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• pp.179-185
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• 2013

본 논문에서는 시각에 대해 반응하는 운동 행동의 효과를 분석하기 위해서 응답속도정합-유발전위(RTA-ERP: Response Time Aligned-Event Related Potential)를 모델링하고, RTA-ERP의 진폭과 응답 속도를 이용하여 사이먼 효과를 분석하였다. 건강한 성인 15명(남성 9명, 여성 6명, 평균 연령 31세)을 대상으로, 같은 숫자에 대한 다른 숫자를 찾아 반응하는 '양자극방안' 실험을 7분 동안 수행하였다. 실험결과 제안된 RTA-ERP는 기존의 ERP에 비해 뇌에서의 처리시간 차이에 따른 변이를 보상할 수 있었으며, 향상된 LRP(Lateralized Readiness Potential)와 Pe(Error Related Positivity)를 나타내었다. '일치', '불일치' 시험 패턴에 대하여 '일치'에 대한 RTA-ERP의 진폭과 응답속도는 각각 '불일치'보다 컸으며 진폭은 $0.03{\mu}V$ 크고 반응속도는 43 ms 만큼 빨랐다. 응답속도에 따른 동기 시점을 보정하여 정합함에 따라, RTA-ERP의 진폭특성은 사이먼 효과의 특징인 ERP의 P300 진폭과 대응함을 확인하였다.