Repeated Transcranial Magnetic Stimulation (rTMS) with Circular Coil for Patients with Treatment Resistant Depression: An Open Trial

JeongHo Chae,Won Kim,WonMyong Bahk,TaeYun Jun,KwangSoo Kim 대한신경정신의학회 2005 PSYCHIATRY INVESTIGATION Vol.2 No.1

Of the two types of typical TMS coils, namely the figure of eight and circular coils, the former has been used more commonly in recent repeated transcranial magnetic stimulation (rTMS) trials in patients with depression. However, it is unclear whether one coil is superior to the other when used for clinical trials designed to assess their effectiveness as antidepressants, since positive results have been reported with both types. The present study is a pilot study designed to assess the effectiveness and safety of high frequency rTMS using a circular coil in Korean patients with refractory depression. Fifteen patients with depressive disorder were recruited into the study. rTMS was performed using an M-Cube stimulator with an oil-cooling circular coil on the left prefrontal cortex, and the stimulus parameters were; 20Hz, 2 seconds on, 28 seconds off, intensity at 100% of the patient’s resting motor threshold. The rTMS treatment was administered for 20 minutes per day on weekdays over a 3 week period (for a total of 15 days of treatment). Thirteen subjects completed this 3 week trial. Over the course of the three weeks of rTMS treatment, all clinical variables, including the 21 item Hamilton Rating Scale for Depression, the Hamilton Anxiety Rating Scale and the Clinical Global Impression-Severity scale, were improved. The present study suggested that high frequency rTMS conducted at 20Hz with a circular coil has therapeutic potential for the treatment of refractory depression. Further evaluation of the therapeutic efficacy of rTMS should assess the importance of the various treatment parameters, and longer and medication free follow-up studies for the outcome of this treatment, along with a comparison between the different coil types, is also needed.

Longitudinal Changes of Neurological Soft Signs in Neuroleptic-Naïve Patients with Schizophrenia: A Preliminary Report

Won Kim,HoJun Seo,WonMyong Bahk,TaeYoun Jun,KwangSoo Kim,JeongHo Chae 대한신경정신의학회 2005 PSYCHIATRY INVESTIGATION Vol.2 No.2

Neurologic soft signs (NSS) have been reported to be associated with schizophrenia, but some have argued that neuroleptics may play a role in the development of NSS. The objective of the present study is to examine the relationship between NSS and antipsychotic drugs, by evaluating the changes in NSS of first onset, neuroleptic-naïve schizophrenic patients, before and after one year of neuroleptic treatment. The subjects were 11 neuroleptic-naïve patients (male = 5, female = 6, mean age = 33.3 years) with schizophrenia or schizophreniform disorder. The presence of NSS was examined using the Neurological Evaluation Scale - Korean (NES-K) Version. All subjects were evaluated before the treatment was initiated and following one year of treatment. All scores on the NES-K and the subscores of the ‘other’ area significantly decreased following one year of treatment. Even though the results were not statistically significant, the scores of the other three functional categories were lower following one year of treatment. Our findings do not support the hypothesis that NSS in patients with schizophrenia are an epiphenomenon of the neuroleptic treatment. Also, our results indicate that some components of NSS observed in patients with schizophrenia are intrinsic to this illness and independent of the neuroleptic treatment.

Relationship between Delusion of Theft and Cognitive Functions in Patients with Mild Alzheimer’s Disease

HaeRan Na,DongWoo Kang,YoungSup Woo,WonMyong Bahk,ChangUk Lee,HyunKook Lim 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.4

Although delusion of theft (DT) is the most frequent type of delusion in Alzheimer’s disease (AD), its relationship to cognitive functions remains unclear. The aim of this study was to demonstrate the relationship between DT and cognitive functions in mild AD. Two hundred eighty-nine mild AD patients were enrolled in this study. These subjects were classified into three groups: patients with no delusions (ND, n=82), patients with paranoid delusions (PD, n=114) and patients with DT (n=93). Cognitive functions and their associations with the degree of delusion were compared among the three groups. The results showed that verbal Fluency scores were significantly lower in the PD group than in the DT and ND groups. Word List Recall scores were significantly lower in the DT group than in the PD and ND groups. Interestingly, delusion severity measured with the Neuropsychiatric Inventory delusion subscale correlated negatively with the Word List Recall scores in the DT group. In this study, we demonstrated that episodic memory functions in mild AD patients were associated with DT, but not with PD. Further studies might be needed to clarify the pathophysiology of delusions associated with AD.

School Functioning of Young Male Patients with Schizophrenia at the Examination for Military Draft in Korea

JeongHo Chae,Won Kim,SaBong Roh,TaeYun Jun,KwangSoo Kim,WonMyong Bahk 대한신경정신의학회 2004 PSYCHIATRY INVESTIGATION Vol.1 No.1

It is generally accepted that patients with schizophrenia have unusual behavioral characteristics during premorbid periods. In Korea, the Record of School Life , which is a record of school students kept by the teachers who are directly in charge of them, can be used as a convenient tool for surveying and evaluating school functioning in psychiatric patients. We performed this study in order to determine whether there were any differences in the school function in the Record of School Life between patients with schizophrenia and patients with neurotic disorders. Using the Records of School Life of patients with schizophrenia and neurotic disorders, we examined the differences in the descriptions made by teachers of these two categories of subjects during their school years. Since the subjects with schizophrenia had more check marks than those with neurotic disorders in three of the eight negative items, their teachers regarded them as having more negative traits. Herein, we report that male subjects with schizophrenia with early onset show more eccentric features than subjects with neurotic disorders, using a relatively standardized and simple tool, the Record of School Life.

Prevalence of Dementia and Its Correlates among Participants in the National Early Dementia Detection Program during 2006-2009

MoonDoo Kim,JoonHyuk Park,ChangIn Lee,NaRi Kang,JaeSung Ryu,BongHee Jeon,KiWoong Kim,WonMyong Bahk,BoHyun Yoon,Seunghee Won,JunHwa Lee,DukSoo Kim,SeongChul Hong 대한신경정신의학회 2012 PSYCHIATRY INVESTIGATION Vol.9 No.2

Objective-To investigate the prevalence of dementia and its correlates among people with poor socioeconomic status, poor social support systems, and poor performance on the Korean version of the Mini-Mental Status Exam (MMSE-KC). Methods-We used 2006-2009 data of the National Early Dementia Detection Program (NEDDP) conducted on Jeju Island. This program included all residents >65 years old who were receiving financial assistance. We examined those who performed poorly (standard deviation from the norm of <-1.5) on the MMSE-KC administered as part of the NEDDP, using age-, gender-, and education-adjusted norms for Korean elders. A total of 1708 people were included in this category. Results-The prevalence of dementia in this group was 20.5%. Multivariate logistic regression analysis revealed that the following factors were statistically significantly associated with dementia: age of 80 or older, no education, nursing home residence, and depression. Conclusion-The prevalence of dementia is very high among those with lower MMSE-KC scores, and significant correlates include older age, no education, living in a nursing home, and depression. Enhancing lifetime education to improve individuals’ cognitive reserves by providing intellectually challenging activities, encouraging living at home rather than in a nursing home, and preventing and treating depression in its early phase could reduce the prevalence of dementia in this population.