뇌 기능 자기공명영상을 통해 확인한 경도인지장애 환자의 뇌 활성화와 임상 지표와의 연관성 분석

다국어 초록 (Multilingual Abstract)

Analysis of the Relationship between Brain Activation Determined Using Functional MRI and Clinical Indicators in Amnestic Mild Cognitive Impairment by Hye Min Heo Department of Clinical Korean Medicine Graduate School of Kyung Hee University (Directed by Professor Jung Mi Park, K.M.D., Ph D.) Objectives: The study aimed to identify clinical symptoms and indicators that can affect the brain activity of amnestic mild cognitive impairment (MCI) patients by comparative analysis of brain function images and clinical indicators of amnestic MCI patients. Methods: Amnestic MCI patients were recruited from March 2022 to June 2023. Brain functional magnetic resonance imaging (fMRI)—with the stimuli of the face-name association memory and working memory N-back tasks—, neuropsychological tests, and blood test were performed on 31 participants. Furthermore, the Sasang constitution survey was performed on 16 participants. Subsequently, the brain activation of the subjects was analyzed using voxel- and region-of-interest(ROI)-based methods. The correlation between the fMRI results with acquired clinical indicators was determined with Pearson correlation analysis. Results: With the face-name association memory task, the activity of the hippocampus and parahippocampal gyrus negatively correlated with the Short form of Geriatric Depression Scale(SGDS) score. Furthermore, precentral gyrus and precuneus activity were positively correlated with the percentage of correct answers in the one-back task. With the working memory N-back task, the activity of the superior parietal lobule was positively correlated with the percentage of correct answers in the zero-back task that required attention. Furthermore, negative correlations were noted between the activity of the hippocampus and hippocampus volume and between the activity of parahippocampal gyrus and attention score, respectively. Meanwhile, age and the activity of both the hippocampus and parahippocampal gyrus were positively correlated. There was no difference between the Sasang constitutional type. Conclusion: Depression in amnestic MCI patients may significantly affect brain function, but the Sasang constitution does not significantly affect clinical symptoms in amnestic MCI. This study is the first attempt to analyze not only neuropsychological test scores but also the correlation between brain function of amnestic MCI patients and clinical indicators such as amyloid β ratio and Sasang constitution. Key words: Amnestic mild cognitive impairment, Functional magnetic resonance imaging, Brain activation, Sasang constitution

목차 (Table of Contents)

• List of Tables ⅳ
• List of Figures ⅵ
• List of Abbreviations ⅷ
• Abstract ⅸ
• I. 서론 1
• 1. 경도인지장애(Mild cognitive impairment, MCI) 1
• 2. aMCI 환자에서의 뇌 기능 자기공명영상 2
• 3. 연구 목적 3
• Ⅱ. 연구 대상 및 방법 4
• 1. 연구 설계 4
• 2. 연구 대상 4
• 3. 연구 과정 5
• 3.1. Pre-screening 7
• 3.2. Screening 7
• 3.3. Amyloid-β 비율 확인 7
• 3.4. Brain MRI 촬영 8
• 3.5. 영상 processing 11
• 3.6. 사상체질 조사 13
• 3.7. 통계 분석 13
• Ⅲ. 결과 15
• 1. 1st level analysis of fMRI data 18
• 1.1. Face-name association memory task 에서의 뇌 활성화 18
• 1.2. Working memory N-back task 에서의 뇌 활성화 18
• 2. 2nd level analysis (group analysis) 21
• 2.1. Face-name association memory task 에서의 뇌 활성화 21
• 2.2. Working memory N-back task 에서의 뇌 활성화 26
• 2.3. 뇌 활성화와 임상 지표와의 상관관계 분석 31
• 2.4. 성별에 따른 뇌 활성화 비교 분석 39
• 2.5. 사상체질별 비교 분석 43
• Ⅳ. 고찰 46
• 1. fMRI task 시 aMCI 환자의 뇌 활성화 47
• 2. aMCI 환자의 뇌 활성화와 임상 지표와의 상관관계 51
• 3. aMCI 환자의 뇌 활성화와 성별과의 관계 53
• 4. aMCI 환자의 뇌 활성화와 사상체질과의 관계 54
• 5. 추후 연구 방향 제시 54
• 6. 본 연구의 의의 55
• V. 요약 및 결론 56
• Ⅵ. 참고문헌 58
• Ⅶ. 부록 62