피질기저핵변성 환자에서 경두개 직류전류 자극 후 실행증 및 손기능 호전

고명환,Eric M. Wassermann,서정환,김연희 대한재활의학회 2007 Annals of Rehabilitation Medicine Vol.31 No.3

치매의 운동치료

고명환 대한뇌신경재활학회 2015 뇌신경재활 Vol.8 No.1

Dementia is one of major problem worldwide, and leading to great social and economic expense for medical and family care. Many of medical treatments have been introduced and performed to deal with this devastating disease but none could be publicized as clear evidence related with cure of dementia. Recently, it was reported that physical exercise could be useful approach to delay or prevent dementia. According to the recent Cochrane review of 16 previous literatures, exercise programs showed positive effect on the ability of performing daily activities and cognition in people with dementia. To help understanding of exercise therapy for dementia, in this review, the effect of exercise on recognition ability according to aging was investigated through the previous published papers and the proper exercise program was introduced for patients with dementia.

수처리장의 세정식 집진장치 개발 적용

고명환,Go, Myeong-Hwan 한국유체기계학회 2005 한국유체기계학회 논문집 Vol.8 No.6

Safety of Transcranial Direct Current Stimulation in Neurorehabilitation

고명환 대한뇌신경재활학회 2021 뇌신경재활 Vol.14 No.1

Transcranial direct current stimulation (tDCS) has considerable potential as a useful method in the field of neurorehabilitation. However, the safety of tDCS for the human is primarily based on theoretical evidence related to electricity, and the safety information of applying tDCS to the human is only available from researcher's reporting. Based on tDCS studies with human and animal subjects and simulation-based studies of the safety of current stimulation in the past 20 years, this review investigated the safety of tDCS application to the human body. No severe complications have been reported in either adults or children for tDCS at an intensity of 4 mA or less, within a period of 60 minutes per day, using commonly applied 25 or 35 cm2 electrodes. According to animal studies, the amount of electricity used for tDCS is less than 5% of the amount that permanently changes brain tissue, thereby ensuring safety to a certain extent. In order to increase the efficacy of tDCS for neurorehabilitation and to minimize even trivial complications in the human screening of exclusion criteria should be conducted with detailed observations of complications.

수처리장의 세정식 집진장치 개발적용

고명환 한국유체기계학회 2005 유체기계 연구개발 발표회 논문집 Vol.- No.-

반복 경두개자기자극을 이용한 작업기억 및 시공간 주의력 뇌 신경망 연구

고명환,서정환,장성호,유우경,김연희 대한재활의학회 2004 Annals of Rehabilitation Medicine Vol.28 No.4

Objective: We evaluated a role of prefrontal and parietal cortex in verbal working memory and visuospatial attention using repetitive transcranial magnetic stimulation (rTMS). Method: In six healthy volunteers, bilateral prefrontal and parietal cortex was stimulated with rTMS (90% of motor threshold, 10 trains of 1 Hz rTMS) during performed cognitive tasks (two-back verbal working memory task and endogenous visuospatial attention task). rTMS was applied to 4 different sites over left prefrontal, right prefrontal, left parietal and right parietal areas at F3, F4, P3 and P4 location on the scalp, according to the 10/20 EEG system. The sham stimulation was applied with the coil placed perpendicular to the scalp. Results: Reaction time (RT) was significantly prolonged by left prefrontal TMS in verbal working memory. In addition, performance deterioration was also observed during rTMS over the right prefrontal and left parietal areas. In visuospatial attention task, RT was significantly prolonged by right parietal TMS. Conclusion: These results show that left prefrontal cortex play a major role in the network of working memory, and right parietal cortex is important area in the visuospatial attention. We suggest that an rTMS could be a useful method for evaluation of neural network in human brain.

편마비 환자에서 마비측 상지의 골밀도 감소 양상

고명환,이루지,임석태,박성희,서정환 대한재활의학회 2004 Annals of Rehabilitation Medicine Vol.28 No.3

Objective: Bone mineral loss in the upper extremity of hemiplegic patients can increase the prevalence of fractures that interrupt the rehabilitation program and lower the level of activity. The aim of this study was to investigate any difference between the affected and unaffected forearm's bone mineral density (BMD) and evaluate the relationship between several clinical variables and osteoporosis of hemiplegic forearm. Method: Sixty-seven hemiplegic patients (42 males, 25 females, mean age 55.2 years) were enrolled. The BMD of radius was measured using dual energy X-ray absorptiometry in 67 hemiplegic subjects. Results: The BMD of affected forearm was significantly lower than unaffected side (p<0.05). The reduction of BMD in the hemiplegic forearm well correlated with duration of hemiplegia, self care of functional independence measure score, complex regional pain syndrome-type 1 (CRPS-1) (p<0.05). But, there was no correlation between BMD and modified Ashworth scale, muscle power of wrist extension. Conclusion: Hemiplegic forearm had high prevalence of osteoporosis like lower extremity. Therefore, increasing level of ADL and early detection of CRPS-1 was necessary for prevention of osteoporosis of forearm.

뇌기저핵 뇌졸중 환자의 임상 및 신경심리적 소견

고명환,김연희,서정환 大韓再活醫學會 1997 Annals of Rehabilitation Medicine Vol.21 No.4

말초신경의 신장에 따른 운동유발전위의 촉통

고명환,박은경,박성희,서정환,김연희 대한재활의학회 2001 Annals of Rehabilitation Medicine Vol.25 No.2

뇌졸중 환자에서 경두개 직류전류 자극에 의한 손 기능 호전

고명환,박성희,서정환,한상형 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.3

Objective: To investigate therapeutic effects of anodal direct current (DC) polarization on the primary motor cortex in subacute and chronic stroke patients by measuring changes of hand function and corticospinal excitability before and after stimulation. Method: Fourteen subacute and chronic stroke patients were included in this study. This study was designed as a sham-controlled, double-blind, and crossover experiment. The anode was positioned on the primary motor cortex of the affected hemisphere. The primary motor cortex was identified using transcranial magnetic stimulation (TMS), the motor evoked potentials (MEPs) were recorded by surface electrodes placed over the contralateral first dorsal interosseous muscle. DC was delivered for 20 minute at 2 mA with 25 cm2 saline-soaked sponge electrodes. Before and after DC polarization, we checked the box and block test, nine hole peg test, grip power, lateral prehension power, MEPs amplitude, and MEPs latency. Results: The box and block test, grip power, lateral prehension power, and MEPs amplitude increased after anodal DC to primary motor cortex (p<0.05). Positive correlation showed between improvement of box and block test and change of MEPs amplitude (r=0.808, p=0.001). Conclusion: Increased hand functions and the corticospinal tract excitability were obtained by 2 mA, 20 minute anodal DC polarization. Anodal DC polarization to primary motor cortex may play a potential role for facilitating the corticospinal tract thereby enhancing hand motor recovery in stroke patients. Objective: To investigate therapeutic effects of anodal direct current (DC) polarization on the primary motor cortex in subacute and chronic stroke patients by measuring changes of hand function and corticospinal excitability before and after stimulation. Method: Fourteen subacute and chronic stroke patients were included in this study. This study was designed as a sham-controlled, double-blind, and crossover experiment. The anode was positioned on the primary motor cortex of the affected hemisphere. The primary motor cortex was identified using transcranial magnetic stimulation (TMS), the motor evoked potentials (MEPs) were recorded by surface electrodes placed over the contralateral first dorsal interosseous muscle. DC was delivered for 20 minute at 2 mA with 25 cm2 saline-soaked sponge electrodes. Before and after DC polarization, we checked the box and block test, nine hole peg test, grip power, lateral prehension power, MEPs amplitude, and MEPs latency. Results: The box and block test, grip power, lateral prehension power, and MEPs amplitude increased after anodal DC to primary motor cortex (p<0.05). Positive correlation showed between improvement of box and block test and change of MEPs amplitude (r=0.808, p=0.001). Conclusion: Increased hand functions and the corticospinal tract excitability were obtained by 2 mA, 20 minute anodal DC polarization. Anodal DC polarization to primary motor cortex may play a potential role for facilitating the corticospinal tract thereby enhancing hand motor recovery in stroke patients.