알코올 의존 환자에서 K-MMSE를 이용한 인지 기능 연구

서승진(Suhng-Jin Suh),최성빈(Sung-Bin Choi),김한오(Han-O Kim),원성두(Sung-Doo Won),손인기(In-Ki Sohn),함 웅(Woong Hahm),신경철(Kyung Chul Shin) 한국중독정신의학회 2009 중독정신의학 Vol.13 No.2

Objectives:This study aimed to characterize the cognitive functions of chronic alcohol dependent patients in their forties as compared to normal controls, via the K-MMSE (Korean version of the Mini-Mental State Examination). Methods:Participants were 25 male volunteers from the curative program at the Keyo hospital alcohol center, recruited from June 2007 to November 2007, and 25 male social drinkers who constituted the normal controls. We compared demographic characteristics, such as age, level of education, occupation, and socioeconomic status, and also K-MMSE results between the two groups. Results:Even though the demographic characteristics showed statistically significant differences between the two groups, their K-MMSE scores were not significantly different. Also, there was no identifiable correlation between demographic variables and K-MMSE total scores and subscales. The alcohol dependent patients varied significantly from the control group with regard to visuospatial area. Conclusion:In this study the cognitive functions and demographical variables such as education, occupation and socioeconomic status were not correlated. The subjects in two groups scored similar on K-MMSE in total score ; they had different scores in the test on their visuospatial area. In conclusion, some specific items of K-MMSE are thought to be applicable to predict whether patients with alcoholic dependence will have disability in their cognitive function.

경도인지장애 선별 평가를 위한 가상현실 인지기능평가의 개발: 예비 연구

강민재,이은,석정호,노현웅,손상준,채헌주,최선우,장수아,김우정 대한신경정신의학회 2022 신경정신의학 Vol.61 No.3

Objectives Mild cognitive impairment (MCI) is known to have a high rate of progression to Alzheimer’s disease. Early detection and intervention of MCI are of great interest in psychiatric and socioeconomic aspects. There are various screening tools for MCI, but their sensitivity and specificity vary greatly. This study assessed the usefulness of virtual reality (VR) neurocognitive tests as an assessment tool for neurocognitive function deficit in MCI. Methods Both VR neurocognitive tests and conventional neurocognitive tests, including Mini- Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Seoul Neuropsychological Screening Battery (SNSB), were conducted, and 21 participants completed the tests. The test results of the MCI and normal groups were compared, and correlation coefficients between the VR neurocognitive tests and SNSB were examined. Results The mean VR neurocognitive test total score of the MCI participants was significantly lower than that of normal participants (30.0±1.0 vs. 36.9±6.4; p<0.001). There were no significant differences in the SNSB, MMSE, and MoCA scores between the two groups. The VR neurocognitive total score correlated significantly with the MMSE, MoCA, and SNSB total scores (r=0.61, r=0.54, r=0.50, respectively; p<0.05). The scores of the subdomains of VR neurocognitive tests showed significant correlations with those of MMSE, MoCA, and subdomains of SNSB, with VR executive function and visuospatial function scores showing significant correlations with the SNSB executive function (r=0.46; p<0.05) and visuospatial function (r=0.60; p<0.01) scores, respectively. Conclusion This preliminary study suggests that the VR neurocognitive test can be a feasible and realistic tool for assessing the subtle but complex cognitive deficits in MCI, emphasizing spatial reasoning and executive functions.

노인 조현병 환자에서 인지기능과 호모시스테인 농도의 관계

박지용 ( Ji Yong Park ),전진숙 ( Jin Sook Cheon ) 한국정신병리진단분류학회 2015 精神病理學 Vol.23 No.1

목적 : 본 연구 목적은 노인 조현병 환자에서 나타나는 인지 장애의 빈도와 호모시스테인(Hcy) 농도 증가의 연관성을 알아보기 위함이다. 방법 : 조현병으로 입원한 65세 이상의 노인환자 108명(남자 59명, 여자 49명)을 대상으로 반구조적 면담과 인지기능(MMSE-K, MoCA-K), 정신증의 심한 정도(K-PANSS), 우울증의 심한 정도(K-GDS)를 평가하였다. 결과 : 1) 호모시스테인 증가군에서 남성이 유의하게 더 많았고, 조현병 유병기간이 유의하게 더 길었다. 2) MMSE-K와 MoCA-K로 평가한 인지 장애 빈도는 호모시스테인 정상군에서는 각각 67.86%, 96.43%, 호모시 스테인 증가군에서는 두 검사 모두에서 100%이지만, MMSE-K 검사에서만 두 군간에 통계학적으로 유의한 차이를 보였다. 3) 호모시스테인 증가군에서만 MMSE-K 및 MoCA-K의 총점수와 소검사 점수는 유의하게 더 낮았다. 4) 호모시스테인 농도 증가와 MMSE-K 총점은 유의한 역 상관관계가 있었다. 인지 기능 중에서 특히 시간/장소 지남력, 기억 회상, 언어 관련 기능과 시공간 구성 능력에 유의한 역의 연관성이 있었다. 결론 : 본 연구를 통하여 호모시스테인 농도 증가가 노인 조현병 환자에서 인지 장애의 병인에 밀접한 연관성이 있음을 시사한다. Objectives : The aims of this study were to identify the frequency of cognitive disorders and association with homocysteine levels in old age schizophrenics. Methods : The data were obtained from admitted schizophrenics with age over 65 (N=108, male 59, female 49) by semistructured interviews and measurements of cognitive function using the MMSE and the MoCA-K, severity of psychosis using the K-PANSS and depression using the K-GDS. Results : 1) The old age schizophrenics with increased homocysteine levels had significantly more males and longer duration of schizophrenia. 2) The frequency of cognitive disorder measured by the MMSE-K and the MoCA-K was 67.86% vs 96.43% in schizophrenics with normal homocysteine, and both 100% in schizophrenics with increased homocysteine. However, statistically significant difference was only found in those measured by the MMSE-K. 3) The total scores and subtests scores of the MMSE-K and the MoCA-K were significantly lower in old age scizophrenics with increased homocysteine levels. 4) The increase of homocysteine levels had significant negative correlation with total scores of the MMSE-K and subtests scores of time/place orientation, recall, languse and visuospatial function. Conclusions : These findings suggest that increased homocysteine levels may be closely associated with pathogenesis of cognitive disorder in old age schizophrenics

Normative Study of the Block Design Test for Adults Aged 55 Years and Older in Korean Aging Population

Haejung Joung,Dahyun Yi,Hyejin Ahn,Younghwa Lee,Min Soo Byun,Kiyoung Sung,Dongkyun Han,Dong Young Lee,KBASE Research Group 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.6

Objective The Block Design Test (BDT) is known to be an effective measure in diagnosing age-related cognitive decline of visuospatial function. The goal of this study is to investigate the effects of age, education years, and gender on the performance of the BDT and to provide normative data in Korean community-dwelling participants who are 55 to 90 years old.Methods The participants were 432 non-demented adults aging from 55 to 90 years old. The BDT was administered to participants according to its manual. Multiple linear regressions and analyses of variance were conducted, including age, gender, and educations were used as covariates.Results Age, educational years, and gender were found to be significantly associated with performance on the BDT. As age increased, BDT performance decreased. Educational years were associated with BDT performance. Men showed higher performance (29.9±10.3) compare to women (26.1±8.7). The BDT is influenced by age, educational years, and gender.Conclusion Unlike the previous study, the current study shows that gender has a significant influence in visuospatial ability in the old population. Present normative data will be useful for clinicians in evaluating aging participants with cognitive impairment.

Reduced P300 amplitude during a visuospatial attention task in idiopathic rapid eye movement sleep behavior disorder

Byun, Jung-Ick,Lee, Byeong Uk,Kim, Minah,Sunwoo, Jun-Sang,Lim, Jung-Ah,Moon, Jangsup,Lee, Soon-Tae,Jung, Keun-Hwa,Chu, Kon,Kim, Man-Ho,Jeong, Min Hee,Cha, Kwang Su,Choi, Jeong Woo,Kim, Kyung Hwan,Lee, Elsevier 2017 SLEEP MEDICINE Vol.38 No.-

<P><B>Abstract</B></P> <P><B>Objectives</B></P> <P>Idiopathic rapid eye movement sleep behavior disorder (IRBD) patients are prone to cognitive deficits, which include attention, executive, and visuospatial dysfunctions. Even patients with normal cognition may exhibit subclinical electrophysiological dysfunction. This study aimed to evaluate visuospatial attention processing in IRBD patients with normal cognition and to compare their findings with those of age- and sex-matched healthy controls.</P> <P><B>Methods</B></P> <P>We recorded event-related potentials (ERPs) and performance measures during a variant of the Posner task in 14 IRBD patients and 14 control subjects. Behavioral data and the mean P300 amplitude were compared between groups.</P> <P><B>Results</B></P> <P>No group difference was found for reaction time or accuracy, but a significant group effect was observed for the P300 amplitude. IRBD patients had reduced P300 amplitude (μV) than controls in both valid (IRBD: 0.53 ± 1.05 vs Controls: 1.61 ± 0.95; p = 0.008) and invalid (IRBD: 0.74 ± 0.99 vs Controls: 1.73 ± 0.86; p = 0.009) conditions. The P300 amplitude was correlated with Montreal cognitive assessment (MOCA) scores (r = 0.424, p = 0.024).</P> <P><B>Conclusion</B></P> <P>Reduced P300 amplitude during the Posner task provides electrophysiological evidence for subclinical visuospatial attention deficits in cognitively normal IRBD patients. The results of this study imply that cortical dysfunction is already present in patients with IRBD in their early disease stage.</P> <P><B>Highlights</B></P> <P> <UL> <LI> IRBD with normal cognition had reduced P300 amplitude during Posner task. </LI> <LI> Reduced P300 in IRBD was independent of age, sex, depression, and autonomic function. </LI> <LI> The P300 amplitude correlated with MOCA scores. </LI> <LI> Cortical dysfunction may be present in early stage of IRBD. </LI> </UL> </P>

연령대별 시공간구성능력, 기억력 및 실행능력의 차이-Rey-Osterrieth Complex Figure 검사를 중심으로-

김용희 한국건강심리학회 2008 한국심리학회지 건강 Vol.13 No.1

본 연구는 정상인을 대상으로 20대, 30대, 40대, 50대, 60대의 연령대별 시공간구성능력, 시각기억력, 실행능력의 차이가 있는지 알아보고자 Rey-Osterrieth Complex Figure 검사(Rey, 1941; 이하 ROCF)를 실시하였다. 그 결과, 시공간구성능력에서는 연령증가에 따른 차이가 없었고, 시각기억력에서는 회상 시 연령이 증가할수록 감퇴하는 양상이었고, 재인과제 시에는 연령에 따른 변화가 없었다. 실행기능면에서 60대가 다른 연령대보다 줄기선6의 정확성이 떨어지고 반복억제력이 높게 나타나 실행기능의 부분적 손상이 나타났다. 따라서 정상인은 60대를 기점으로 하여 기억력과 실행기능이 부분적으로 감퇴됨이 시사되었다. 추가적으로 50대이상의 고령자를 중심으로 뇌손상집단과 정상집단의 ROCF 수행을 비교하였을 때, 시공간구성능력, 시각기억력 및 실행능력에서 뇌손상집단이 정상집단보다 현저히 떨어지는 수행을 보여, 손상으로 인한 인지능력의 질적인 변화가 시사되었다. 따라서 ROCF는 시공간 구성능력과 기억력 및 실행능력을 탐지하는데 비교적 유용한 도구임을 알 수 있었다. The purpose of this study was to consider the visuospatial ability, memory and executive function of normal adults according to their age groups by using Rey-Osterrieth Complex Figure Test(ROCF). 71 normal adults were divided into the five groups by 10-year age group: I.e, 20-29, 30-39, 40-49, 50-59, 60-69 year. As a result, 60-69 year-old group acquired significantly low scores of the executive functions and memory recall, but not visuospatial function comparing to other groups. These results reflect that mild cognitive decline starts with 60 years of the elderly. Additionally, this research was to investigate for the aged in relation of cognitive function between the normal aged and patient aged group. Subjects were compose of twenty-two normal aged group and fifteen patient aged group who had mild traumatic brain injury and they all were aged over 50 years. Patient group had a significant visuospatial disability, memory deficit and executive dysfunction relative to normal group. These results indicate that qualitatively different cognitive function due to traumatic brain injury. Finally, the suggestions, limitations and further issues for future study were discussed.

시공간 재활훈련이 조현병 환자의 시공간 기능과 주의에 미치는 효과

김지현,김명선 한국임상심리학회 2016 Korean Journal of Clinical Psychology Vol.35 No.4

This study investigated the effect of visuospatial rehabilitation on the cognitive function in patients with schizophrenia. Fortythree patients with schizophrenia were randomly assigned into one of the three groups (rehabilitation, comparative, and control groups). The comprehensive neuropsychological tests including Rey-Osterreith Complex Figure Test (RCFT), Block Design, Puzzle, Korea-California Verbal Learning Test (K-CVLT), Stroop test, Digit Span, Spatial Span, and Wisconsin Card Sorting Test (WCST) were administered before and after rehabilitation for the three groups. In addition, schizophrenic symptoms and social function were measured by PANSS, and BASIS-32, respectively. Participants in the rehabilitation group received individual visuospatial rehabilitation three times a week for a 6 weeks durations, and the comparative group received the individual tetris game three times a week for a 6 weeks durations; the control group did not receive any treatment. The three groups did not differ on the performances of the neuropsychological tests, PANSS, and BASIS-32, which were administered before rehabilitation. However, the rehabilitation group showed significantly better performances on RCFT copy condition, Digit Span forward condition, color-word condition of the Stroop test, and PANSS negative symptom than the comparative and control groups after rehabilitation. These findings suggest that visuospatial rehabilitation is effective in improving visuospatial function, attention, and negative symptoms in patients with schizophrenia.

정신병 증상을 보이지 않는 경도 및 중등도 주요우울증 환자의 인지기능 저하 및 항우울제 치료 후 인지기능 회복 양상에 관한 전향적 연구

이강욱,조성명,박종익 대한정신약물학회 2008 대한정신약물학회지 Vol.19 No.5

본 연구에서는 정신병적 증상이 없는 경도 및 중등도 주요우울증 여성 환자 15명을 대상으로 항우울제의 영향 을 배제한 상태에서 언어적 기억력, 시공간 능력, 시각적 기억력, 갈등 조절, 실행 능력 등의 인지기능을 평가하였 다. 치료전 평가에서는 주로 언어적 기억력의 저하 소견 을 관찰할 수 있었으며 기존의 단극성 우울증에서 가장 주요한 인지기능 이상으로 알려져 있던 실행 능력의 저 하는 명확히 관찰되지 않았다. 또한 시각 정보 처리 능력 및 시공간적 기억력에서도 그 기능 저하가 확실하지 않았 다. 항우울제를 이용한 치료 후 우울증의 증상 호전이 이 루어진 12개월 후에는 WCST의 오류 반응과 보속증의 호전이 가장 뚜렷하게 관찰되었으나 우울증상의 호전도 와 직접적인 상관관계는 보이지 않았다. visual memory, visuospatial function, and executive function, and also to investigate if there is improvement of cognitive impairment after antidepressant treatment in patients with major depressive disorder (MDD). Methods: Fifteen female patients with non-psychotic MDD in mild to moderate severity and 25 age-matched female normal control subjects participated in this study. Clinical severity of depression was measured by Beck Depression Inventory (BDI), Zung’s Self-Rating Depression Scale (Zung), and Hamilton Rating Scale for Depression (HAMD). Cognitive functions were tested using Ray Complex Figure Test (RCFT) to evaluate visuospatial function and visual memory, Stroop test to evaluate conflict monitoring, Wisconsin Card Sorting Test (WCST) to evaluate executive function, and Seoul Verbal Learning Test (SVLT) to evaluate verbal memory. Both clinical depression scales and cognitive function tests were conducted at baseline and after 12 months of antidepressant treatment. Results:At baseline, there were deficits in immediate and delayed recall of SVLT in patients with MDD compared to normal control subjects, while the impairment in visuospatial function, visual memory, and executive function was not clear. After antidepressant treatment, improvement of executive function, i.e. percent of error response and perseverative response of WCST in MDD patients was greater than that in normal control subjects. Improvement of executive function, however, did not show a significant correlation with the change of clinical severity of depression. Conclusion:The verbal memory was the most prominent domain of cognitive dysfunction in non-psychotic depression with mild to moderate severity. Of further note, differential improvement in executive function was observed in MDD patients after antidepressant treatment, although the improvement in executive function was not directly associated with the improvement of clinical depression.

Lateralization of Cognitive Functions in Aphasia after Right Brain Damage

하지완,편성범,황유미,심현섭 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.3

Purpose: The lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL. Materials and Methods: The following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction). Results: All three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect. Conclusion: Based on the analysis of these three aphasic patients’ performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.

Lateralization of Cognitive Functions in Aphasia after Right Brain Damage

Ha, Ji-Wan,Pyun, Sung-Bom,Hwang, Yu Mi,Sim, Hyunsub Yonsei University College of Medicine 2012 Yonsei medical journal Vol.53 No.3

<P><B>Purpose</B></P><P>The lateralization of cognitive functions in crossed aphasia in dextrals (CAD) has been explored and compared mainly with cases of aphasia with left hemisphere damage. However, comparing the neuropsychological aspects of CAD and aphasia after right brain damage in left-handers (ARL) could potentially provide more insights into the effect of a shift in the laterality of handedness or language on other cognitive organization. Thus, this case study compared two cases of CAD and one case of ARL.</P><P><B>Materials and Methods</B></P><P>The following neuropsychological measures were obtained from three aphasic patients with right brain damage (two cases of CAD and one case of ARL); language, oral and limb praxis, and nonverbal cognitive functions (visuospatial neglect and visuospatial construction).</P><P><B>Results</B></P><P>All three patients showed impaired visuoconstructional abilities, whereas each patient showed a different level of performances for oral and limb praxis, and visuospatial neglect.</P><P><B>Conclusion</B></P><P>Based on the analysis of these three aphasic patients' performances, we highlighted the lateralization of language, handedness, oral and limb praxis, visuospatial neglect and visuospatial constructive ability in aphasic patients with right brain damage.</P>