교육 경험에 따른 노인의 언어기억 기능과 회백질 부피 간 상관 차이

곽세열,최진영 한국인지및생물심리학회 2017 한국심리학회지 인지 및 생물 Vol.29 No.4

According to the cognitive reserve hypothesis, more educated older adults are less susceptible to age-related or pathological cognitive changes due to accumulated resources necessary for various cognitive tasks. Although previous studies have validated the concept of cognitive reserve, it remains elusive how the early experience of education alters the relationship between regional gray matter volume and episodic memory performance. The present work examined Elderly Verbal Learning Test (EVLT) and structural Magnetic Resonance Imaging within 54 healthy older women. Education groups were divided into low (n = 27, mean education = 2.44) and middle (n = 27, mean education = 8.48) groups. We tested each group’s correlations between regional gray matter volume and memory performances using the voxel-based morphometry (VBM) method and compared whether the correlations between the two groups differ. We found that regional volumes of the medial temporal lobe and orbitofrontal cortex highly correlated with EVLT performance among low education group, whereas the precuneus and inferior parietal lobule volumes were specifically associated with better memory performance among the middle education group. These results indicate that the neuroanatomical substrates contributing to better memory performance differ depending on the years of education, in concert with the protective effect of cognitive reserve. 인지 예비능 이론에 따르면, 개인은 정규 교육 과정과 같은 지적 경험을 통해 인지적 과제의 해결을 돕는 자원을 축적하며, 이를 통해 노년기 뇌 병리적 변화에 효과적으로 대처할 수 있다. 본 연구에서는 노인의 언어기억 기능의 뇌 구조적 기반에서 교육 경험에 따른 차이가 있는지 탐색하고자 하였다. 총 54명의 여성 노인을 대상으로 언어학습검사(EVLT)와 구조적 자기공명영상 촬영 자료가 수집되었으며, 초등교육과정 이수를 기준으로 저교육 집단(n = 27, 평균 교육연한 = 2.44)과 중등교육 집단(n = 27, 평균 교육연한 = 8.48)이 구분되었다. 각 교육 집단에서 국소적 회백질 부피와 EVLT 수행 간의 상관관계를 탐색하고, 집단 간의 상관관계 차이를 검증하였다. 분석 결과, 두 교육 집단의 EVLT 수행은 유사한 수준을 보였으나, 초등교육 미만의 교육을 받은 노인들의 기억기능은 내측두엽과 안와전두피질의 부피와 정적 상관이 높았던 반면, 초등교육 이상의 교육을 받은 노인들은 하두정피질, 쐐기앞소엽, 전전두피질의 부피와 정적 상관관계가 관찰되었다. 연구 결과는 노인들의 교육 수준에 따라 회백질 구조가 기억과제 수행에 기여하는 역할이 다를 수 있으며, 저교육 노인들의 노년기 기억 감퇴와 치매 병리에 대한 취약성을 설명하는 신경학적 기제일 가능성을 시사한다.

A Comparison Between the Performances of Verbal and Nonverbal Fluency Tests in Discriminating Between Mild Cognitive Impairments and Alzheimer’s Disease Patients and Their Brain Morphological Correlates

곽세열,Shin Seong A,Ko Hyunwoong,Kim Hairin,Oh Dae Jong,Youn Jung Hae,이준영,김유경 대한치매학회 2022 Dementia and Neurocognitive Disorders Vol.21 No.1

Background and Purpose: Verbal and nonverbal fluency tests are the conventional methods for examining executive function in the elderly population. However, differences in impairments result in fluency tests in patients with mild cognitive impairments (MCIs) and Alzheimer’s disease (AD) and in neural correlates underlying the tests still necessitate concrete evidence. Methods: We compared the test performances in 27 normal controls, 28 patients with MCI, and 20 with AD, and investigated morphological changes in association with the test performances using structural magnetic imaging. Results: Patients with AD performed poorly across all the fluency tests, and a receiver operating characteristics curve analysis revealed that only category fluency test discriminated all the 3 groups. Association, category, and design fluency tests involved temporal and frontal regions, while letter fluency involved the cerebellum and caudate. Conclusions: Category fluency is a reliable measure for screening patients with AD and MCI, and this efficacy might be related to morphological correlates that underlie semantic and executive processing.

다차원적 충동성 척도(UPPS-P)의 뇌 연결성-기반 타당화

곽세열,이다솜,조수연,최진영 한국인지및생물심리학회 2022 한국심리학회지 인지 및 생물 Vol.34 No.2

Trait impulsivity is known as a psychological construct that explains behavioral problems, including lack of attention, personality disorders, and substance use disorders in children and adolescents. While neurobiological mechanisms of adolescents’ impulsivity measured with behavioral lab tasks have been revealed using functional brain imaging techniques, little has been known whether trait impulsivity measured with self-reporting scales reflects a relevant neurobiological entity. In this study, multi-dimensional trait impulsivity scale (UPPS-P) and resting-state fMRI were acquired from 63 typically developing adolescents. We used a canonical correlation analysis (CCA) to examine whether trait impulsivity reflects the brain connectivities of impulsivity network by targeting the brain regions with the Neurosynth meta-analysis system. We found that the linear combination of UPPS-P item-level responses was associated with the linear combination of impulsivity-relevant brain connectivities in the factor items of negative urgency, sensation seeking, and positive urgency. On the contrary, the brain connectivities that were not based on the meta-analysis of impulsivity did not show a meaningful canonical correlation. These results suggest that specific questionnaires that compose the trait impulsivity scale are reflective of individual differences of adolescents’ neural circuitry of impulsiveness. 특질 충동성은 아동·청소년기의 주의력 결핍, 품행장애, 물질사용 등과 같은 문제를 설명하는 심리적 구성개념으로 알려져 있다. 뇌 영상 기법을 활용하여 청소년기 충동적 행동과 관련된 뇌 구조와 기능에 대한 신경과학적 상관물이 밝혀져 왔으나, 자기보고식 척도를 통해 측정되는 특질 충동성이 어떤 신경생물학적 기반을 반영하는지 알려진 바가 적다. 본 연구에서는 63명의 청소년을 대상으로 다차원적 충동성 척도(UPPS-P)와 휴지기 자기공명영상(resting state fMRI) 자료가 수집되었다. 정준상관분석을 사용하여 각 요인별 문항 반응이 충동성 뇌 연결망과 어떤 다변량적 관계를 맺는지 탐색했다. 분석 결과, 부정 긴급성, 감각추구, 긍정 긴급성 요인 별로 뇌 연결성과의 정준상관이 유의미했다. 특히, UPPS-P의 응답 패턴은 뉴로신스의 메타분석에 기반하여 정의된 충동성-관련 뇌 연결성과 관련이 있었던 반면, 충동성-관련 영역이 아닌 뇌 연결성에서는 이러한 정준상관이 관찰되지 않았다. 이러한 결과는 UPPS-P의 특정 문항 조합은 충동성-관련 뇌 연결성의 조합에 기반하고 있음을 나타내며, 자기보고 방법으로 측정되는 특질 충동성 척도의 일부 문항이 청소년의 뇌 기능 개인차를 반영하는 도구임을 시사한다.

Clinical Validity of Neuropsychological Assessment in Dementia: A Univariate and Multivariate Methodological Comparison

곽세열,김근유,박수미,오다영,Hairin Kim,이다솜,이준영 한국임상심리학회 2023 Korean Journal of Clinical Psychology Vol.42 No.4

Previous studies have documented validity evidence of neuropsychological measures in the assessment of dementia. However, known cognitive test measures were mostly validated as separate measurements rather than asconstituents of a whole battery. In this study, the neuropsychological battery (CERAD-K) and neuropsychiatric measures were acquired in older adults with Mild Cognitive Impairment, dementia of Alzheimer’s Disease (AD), and Vascular dementia (VD). The assessment measures and demographic information were used to predict two validity criteria: dementia severity (CDR) and dementia type (AD or VD). A correlation between a single test measure and the target criteria indicated univariate validity, whereas relative impor- tance among multiple regression models indicated the multivariate validity of a single measure as a constituent of the battery. We identified that test measures including the Boston Naming Test, Trail Making Test, and Word List Recall were predictive of the clinical outcome criteria as univariate validity; however, this strength of association did not remain consistent when evalu- ated in terms of multivariate validity. Regarding the multivariate validity, measures including Word List recognition, and neu- ropsychiatric impairment showed robust validity. This contrasting validity indices between univariate and multivariate frame- works may be owing to shared information between other measures, which can distort the conclusions of validity evidence. The findings suggest that the validity of a neuropsychological test differs as a function of the target criteria and whether ad- ministered as a whole battery. The findings suggest that the validity of a neuropsychological measure differs as a function of the criteria of clinical context and whether tested under a comprehensive battery.