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약물에 노출되지 않은 공황장애 환자들에서 인지행동치료 후 뇌혈류 변화에 대한 예비연구
김정범,신영아,채정호,장은진,류설영,원경숙,전석길,정용안,Kim, Jung-Bum,Shin, Young-Ah,Chae, Jeong-Ho,Chang, Eun-Jin,Ryu, Seol-Young,Won, Kyoung-Sook,Zeon, Seok-Kil,Chung, Yong-An 대한불안의학회 2008 대한불안의학회지 Vol.4 No.2
Objective : Although cognitive-behavior therapy (CBT) is effective in patients with panic disorder, its the-rapeutic mechanism of action in the brain remains unclear. This study was performed to investigate regional blood flow changes associated with successful completion of CBT in drug-naive patients with panic disorder. Method : The regional blood flow in 4 patients with panic disorder was compared to that in 11 healthy controls before and after a 12-week group CBT using $^{99m}Tc$-ECD SPECT imaging. Psychopathology was assessed using Panic Disorder Severity Scale. Data were analyzed using software for statistical parametric mapping (SPM2). Results : Before CBT, significantly decreased blood flow was found in the parietal and occipital area in panic patients than normal volunteers. In all the patients who showed remission after CBT, increased blood flow was detected in the right cingulate gyrus, left lingual gyrus, and left superior parietal lobule, whereas decreased blood flow was seen in the left inferior temporal gyrus. Conclusion : These results suggested that CBT is effective for panic disorder and change the activity of cingulate gyrus and left temporal gyrus, a part of the brain areas associated with fear in panic disorder.
양동원,김범생,손영민,박정욱,정용안,손형선,김상윤 대한치매학회 2002 Dementia and Neurocognitive Disorders Vol.1 No.2
Background and Objectives . Alzheimer's disease (AD) is the most common cause of the dementia Pathologic and functional changes of AD are known to be unevenly distributed in the brain. This study investigates changes of cerebral blood flow (CBF) in patients with AD to determine brain regions with hypoperfusion that reflects progression of disease. Methods. Tc-99m-ECD single photon emission computed tomography (SPECT) was performed to measure regional CBF and statistical parametric mapping (SPM) 99 soft ware was used for the automated and objective approach to analyze SPECT image data. Twenty-five patients with mild to moderate dementia who met NINCDS-ADRDA critena for AD (male 11 female 14) and 17 age-matched normal control subjects were studied. The severity of AD was measured by clinical dementia rating (CDR) scale Results. SPM analysis of SPECT images revealed that CBF in the anterior cingulate gyrus left superior panetal cortex left medial frontal cortex left infenor temporal cortex. right thalamus and left hippocampus was significantly decreased in AD patients compared with normal controls (corrected p<0.05). The reduction of CBF according to CDR was localized in the left hippocampus and infenor temporal cortex right antenor and postenor ciagulate cortex and right superior panetal cortex (uncorrected p<0.01). Conclusions : Our data suggest that the cognitive dysfunction of AD is strongly related with functional abnormality in discrete brain areas 99m-Tc ECD SPECT with SPM analysis could be used as a useful functional imaging tool in AD study.