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경두개직류자극술의 인지기능 개선 작용기전에 대한 고찰 : 기능적 자기공명영상 연구를 중심으로
홍혜진(Haejin Hong),김진솔(Jinsol Kim),이향원(Hyangwon Lee),김신혜(Shinhye Kim),강일향(Ilhyang Kang),홍가혜(Gahae Hong),김정윤(Jungyoon Kim) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.2
Transcranial direct current stimulation (tDCS) is a non-invasive and effective neuromodulatory technique to modulate cortical activities by applying 1 to 2 milliamps electric current. The use of tDCS to enhance cognitive function such as executive function and memory has attracted much attention in recent years, and a lot of studies have been carried out to identify neural mechanisms underlying cognitive enhancement effects of tDCS. In this review, we discussed the previous neuroimaging studies on applications of tDCS for cognitive enhancement using functional magnetic resonance imaging (fMRI). Previous tDCS studies for neurological or psychiatric conditions and elderly individuals suggested that cognitive enhancement effects of tDCS were associated with normalizing aberrant brain networks and activities related to pathophysiology. Moreover, tDCS-induced cognitive enhancement in healthy individuals was associated with functional changes in brain activations and network connectivity. Furthermore, cognitive enhancement effects of tDCS were varied depending on the neurological structure and functional characteristics between individuals. The current review may provide critical insights into functional activity and connectivity of the brain regarding cognitive enhancement effects of tDCS, which could give direction for further studies on identifying the specific neural mechanisms and clinical strategies of tDCS.
신경항법을 이용한 반복적 경두개자기자극의 적용 위치 선정 방법과 우울증 치료 효과 고찰
김명주(Myeongju Kim),송유미(Yumi Song),서채원(Chaewon Suh),마지영(Jiyoung Ma),홍가혜(Gahae Hong),김정윤(Jungyoon Kim) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.2
Repetitive transcranial magnetic stimulation (rTMS) is widely recognized as an effective and noninvasive neuromodulation for treating depression, and has been applied in a wide range of clinical settings. However, previous studies often reported inconsistent antidepressant effects that may be due to differences in the rTMS protocols such as coil placement. The typical simulation site for rTMS depression protocol is the left dorsolateral prefrontal cortex (DLPFC). Targeting the exact site of the left DLPFC while considering individual brain structure has been challenging due to the non-invasive nature of rTMS. Several researchers have applied various targeting methods to overcome the abovementioned issue. Most of the previous studies have applied the “5-cm rule” or the “international 10-20 system,” which is easily applicable. Recently, researchers started to apply a neuronavigation system that targets the stimulation site based on neuroimaging of each individual. Pros and cons of targeting methods have been discussed in terms of validity and reliability of targeting stimulation sites, differences in treatment responses, as well as considerations of individual characteristics. Therefore, the current review focuses on the targeting methods of stimulation site and the treatment effects of depression in previous studies. For discussion, we divided neuronavigation methods into using fixed coordinates and using individualized targets. Furthermore, the limitations of each targeting method are discussed that may potentially contribute to the development of the optimal rTMS protocol for depression treatment.
주윤지(Yoonji Joo),김래영(Ryeyoung Kim),하은지(Eunji Ha),남궁은(Eun Namgung),김정윤(Jungyoon Kim),홍가혜(Gahae Hong) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.2
Hyperbaric oxygen therapy (HBOT) is a noninvasive method that supplies pure oxygen under a pressure greater than normal atmospheric pressure to increase the partial pressure of oxygen in the plasma and tissue. Based on the potential mechanisms of HBOT, including neuroprotection and neurological recovery, HBOT has been suggested as a promising therapeutic option for neurological and psychiatric disorders. This review specifically focused on the clinical trials applying HBOT for psychiatric disorders published during the recent decade. We critically reviewed the efficacy and safety of HBOT in psychiatric disorders, and cautiously suggested the future directions for further research.