• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.184-196
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• 2024

Purpose We investigated potentially promising imaging findings and their combinations in the evaluation of cognitive decline. Materials and Methods This retrospective study included 138 patients with subjective cognitive impairments, who underwent brain MRI. We classified the same group of patients into Alzheimer's disease (AD) and non-AD groups, based on the neuropsychiatric evaluation. We analyzed imaging findings, including white matter hyperintensity (WMH) and cerebral microbleeds (CMBs), using the Kruskal-Wallis test for group comparison, and receiver operating characteristic (ROC) curve analysis for assessing the diagnostic performance of imaging findings. Results CMBs in the lobar or deep locations demonstrated higher prevalence in the patients with AD compared to those in the non-AD group. The presence of lobar CMBs combined with periventricular WMH (area under the ROC curve [AUC] = 0.702 [95% confidence interval: 0.599-0.806], p < 0.001) showed the highest performance in differentiation of AD from non-AD group. Conclusion Combinations of imaging findings can serve as useful additive diagnostic tools in the assessment of cognitive decline.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.486-507
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• 2022

Cerebral small vessel disease (CSVD) includes vascular lesions detected on brain MRI, such as white matter hyperintensities, lacunar infarctions, microbleeds, or enlarged perivascular spaces. There is accumulating evidence that vascular changes may play an important role in development of Alzheimer's disease (AD), and CSVD lesions detected on brain MRI were reported to be associated with β-amyloid and tau proteins accumulation. As the vascular contribution has therapeutic potential, it is important to understand the association of CSVD with AD and AD biomarkers. This review begins with a brief introduction of AD and AD biomarkers, explains the association between AD and vascular changes, and then details the pathogenesis and MR imaging findings of CSVD. Afterwards, we discuss the association of CSVD with AD and AD biomarkers.

• The KIPS Transactions:PartA
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• v.13A no.5 s.102
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• pp.465-472
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• 2006

Recently, many suggestions have been made in image segmentation methods for extracting human organs or disease affected area from huge amounts of medical image datasets. However, images from some areas, such as brain, which have multiple structures with ambiruous structural borders, have limitations in their structural segmentation. To address this problem, clustering technique which classifies voxels into finite number of clusters is often employed. This, however, has its drawback, the influence from noise, which is caused from voxel by voxel operations. Therefore, applying image enhancing method to minimize the influence from noise and to make clearer image borders would allow more robust structural segmentation. This research proposes an efficient structural segmentation method by filtering based clustering to extract detail structures such as white matter, gray matter and cerebrospinal fluid from brain MR. First, coherence enhancing diffusion filtering is adopted to make clearer borders between structures and to reduce the noises in them. To the enhanced images from this process, fuzzy c-means clustering method was applied, conducting structural segmentation by assigning corresponding cluster index to the structure containing each voxel. The suggested structural segmentation method, in comparison with existing ones with clustering using Gaussian or general anisotropic diffusion filtering, showed enhanced accuracy which was determined by how much it agreed with the manual segmentation results. Moreover, by suggesting fine segmentation method on the border area with reproducible results and minimized manual task, it provides efficient diagnostic support for morphological abnormalities in brain.

• Korean Journal of Biological Psychiatry
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• v.22 no.2
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• pp.47-54
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• 2015

In the past decade, structural, molecular, and functional changes in glial cells have become a major focus in the search for the neurobiological foundations of schizophrenia. Glial cells, consisting of oligodendrocytes, astrocytes, microglia, and nerve/glial antigen 2-positive cells, constitute a major cell population in the central nervous system. There is accumulating evidence of reduced numbers of oligodendrocytes and altered expression of myelin/oligodendrocyte-related genes that might explain the white matter abnormalities and altered inter- and intra-hemispheric connectivities that are characteristic signs of schizophrenia. Astrocytes play a key role in the synaptic metabolism of neurotransmitters ; thus, astrocyte dysfunction may contribute to certain aspects of altered neurotransmission in schizophrenia. Increased densities of microglial cells and aberrant expression of microglia-related surface markers in schizophrenia suggest that immunological/inflammatory factors are of considerable relevance to the pathophysiology of psychosis. This review describes current evidence for the multifaceted role of glial cells in schizophrenia and discusses efforts to develop glia-directed therapies for the treatment of the disease.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.213-221
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• 2005

Acute Transverse Myelitis is a syndrome, not a disease, in which acute inflammation affects gray and white matter in one or more adjacent thoracic segments. Almost all patients will develope ascending weakness and numbness of feet and leg, difficulty voiding, urinary retention, and loss of bowel control. We concluded this case to MAMOK( 마목) due to Qi ascent, Qi deficiency, Qi stoppage(상기, 기허, 기체). So we used herbal medication, acupuncture, and homeopuncture according to oriental medical theory. Weakness and numbness of feet and leg, difficulty voiding, urinary retention, and loss of bowel control are reduced. Herbal medication, acupuncture, and homeopuncture helped the care of this syndrome and further study will be investigated in oriental medicine for this syndrome.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.380-383
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• 2005

Glutaric aciduria type 1 is an inborn error of lysine, hydroxylysine, and tryptophan metabolism caused by deficiency of glutaryl-coenzyme A dehydrogenase. The disease often appears in infancy with encephalopathy episode that results in acute basal ganglia and white matter degeneration. The majority of patients develop a dystonic-dyskinetic syndrome. This reports 6year-old boy who had been done previous gastrostomy due to swallowing difficulty underwent bilateral pallidotomy with intraoperative electromyography[EMG] monitoring for disabling dystonia. Intraoperative EMG was used to assess stimulation thresholds required for capsular responses and muscle tone. Surface EMG electrodes were placed on the face and cricopharyngeal muscles. Exact target were directly modified according to MRI-visualized anatomy. EMG response was consistently seen prior to visual observation of muscle activity. The surgery improved dystonic symptoms without swallowing difficulty.

• Journal of Genetic Medicine
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• v.19 no.1
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• pp.38-41
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• 2022

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a single-gene disease caused by mutations in the neurogenic locus notch homolog protein 3 (NOTCH3) gene. The spectrum of clinical manifestations is broad, ranging from asymptomatic to typical ischemic stroke, and mainly depends on the location of the mutations. We describe the case of a 76-year-old female without apparent neurological deficits. However, brain magnetic resonance imaging revealed confluent lesions in the white matter. Direct sequencing of the NOTCH3 gene revealed a novel pathogenic mutation, c.811T>A, which results in a mild phenotype. Therefore, this report will expand the current knowledge in regards to the mutations that can cause CADASIL.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.225-232
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• 2023

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

• Journal of the Korea Convergence Society
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• v.7 no.4
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• pp.1-7
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• 2016

Structural MRI(sMRI) imaging is used to extract morphometric features after Grey Matter (GM), White Matter (WM) for several univariate and multivariate method, and Cerebro-spinal Fluid (CSF) segmentation. A new approach is applied for the diagnosis of very mild to mild AD. We propose the classification method of Alzheimer disease patients from normal controls by combining morphometric features and Gaussian Mixture Models parameters along with MMSE (Mini Mental State Examination) score. The combined features are fed into Multi-kernel SVM classifier after getting rid of curse of dimensionality using principal component analysis. The experimenral results of the proposed diagnosis method yield up to 96% stratification accuracy with Multi-kernel SVM along with high sensitivity and specificity above 90%.

• Biomolecules & Therapeutics
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• v.27 no.2
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• pp.152-159
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• 2019

Multiple sclerosis (MS) is an autoimmune disease characterized by progressive neuronal loss, neuroinflammation, axonal degeneration, and demyelination. Previous studies have reported that 6-shogaol, a major constituent of ginger (Zingiber officinale rhizome), and its biological metabolite, 6-paradol, have anti-inflammatory and anti-oxidative properties in the central nervous system (CNS). In the present study, we investigated whether 6-shogaol and 6-paradol could ameliorate against experimental autoimmune encephalomyelitis (EAE), a mouse model of MS elicited by myelin oligodendrocyte glycoprotein ($MOG_{35-55}$) peptide immunization with injection of pertussis toxin. Once-daily administration of 6-shogaol and 6-paradol (5 mg/kg/day, p.o.) to symptomatic EAE mice significantly alleviated clinical signs of the disease along with remyelination and reduced cell accumulation in the white matter of spinal cord. Administration of 6-shogaol and 6-paradol into EAE mice markedly reduced astrogliosis and microglial activation as key features of immune responses inside the CNS. Furthermore, administration of these two molecules significantly suppressed expression level of tumor necrosis $factor-{\alpha}$, a major proinflammatory cytokine, in EAE spinal cord. Collectively, these results demonstrate therapeutic efficacy of 6-shogaol or 6-paradol for EAE by reducing neuroinflammatory responses, further indicating the therapeutic potential of these two active ingredients of ginger for MS.