남성 알코올 의존 환자 대뇌의 휴지기 네트워크별 피질 두께

이준기,김시경,Lee, Jun-Ki,Kim, Siekyeong 대한생물정신의학회 2017 생물정신의학 Vol.24 No.2

Objectives It is well known that problem drinking is associated with alterations of brain structures and functions. Brain functions related to alcohol consumption can be determined by the resting state functional connectivity in various resting state networks (RSNs). This study aims to ascertain the alcohol effect on the structures forming predetermined RSNs by assessing their cortical thickness. Methods Twenty-six abstinent male patients with alcohol dependence and the same number of age-matched healthy control were recruited from an inpatient mental hospital and community. All participants underwent a 3T MRI scan. Averaged cortical thickness of areas constituting 7 RSNs were determined by using FreeSurfer with Yeo atlas derived from cortical parcellation estimated by intrinsic functional connectivity. Results There were significant group differences of mean cortical thicknesses (Cohen's d, corrected p) in ventral attention (1.01, < 0.01), dorsal attention (0.93, 0.01), somatomotor (0.90, 0.01), and visual (0.88, 0.02) networks. We could not find significant group differences in the default mode network. There were also significant group differences of gray matter volumes corrected by head size across the all networks. However, there were no group differences of surface area in each network. Conclusions There are differences in degree and pattern of structural recovery after abstinence across areas forming RSNs. Considering the previous observation that group differences of functional connectivity were significant only in networks related to task-positive networks such as dorsal attention and cognitive control networks, we can explain recovery pattern of cognition and emotion related to the default mode network and the mechanisms for craving and relapse associated with task-positive networks.

연령, 성별, 머리 크기가 대뇌 피질 두께에 미치는 효과

박윤영,김시경,Park, Yunyoung,Kim, Siekyeong 대한생물정신의학회 2015 생물정신의학 Vol.22 No.3

Objectives Standardization of head size is essential for the volume study. Cortical thickness analyses are increasingly being used in many fields of neuroscience. However, it is not established whether head size correction should be done for thickness study. Methods Using the Open Access Series of Imaging Studies data, we determined cortical thickness of 316 cognitively normal participants aged 18-94 with FreeSurfer. The association between head size and cortical thickness of whole cortical mantle and in each lobe among age tertile groups was assessed. Estimated total intracranial volume (eTIV) was calculated for determining head size. Results Across all participants, cortical thickness in whole brain except some areas in cingulate and insula decreased with aging. eTIV had positive correlation with the thickness of frontal, parietal, occipital and whole brain areas. However, the age effect was not shown in whole brain of the first tertile group and in cingulate areas of the third tertile group. eTIV had negative correlation with the thickness of cingulate in the third tertile group. Gender effects were shown in some areas in third tertile group, but it would be due to difference of head size. Conclusions These findings suggest that head size standardization might be done especially in older population and in studies of paralimbic areas.

자동화 프로그램을 이용한 아동의 전체두개강내용적 평가

이정환,김지은,임성진,주가원,김시경,손정우,신철진,이상익,김혜리,Lee, Jeonghwan,Kim, Ji-Eun,Im, Sungjin,Ju, Gawon,Kim, Siekyeong,Son, Jung-Woo,Shin, Chul-Jin,Lee, Sang-Ick,Ghim, Hei-Rhee 대한생물정신의학회 2014 생물정신의학 Vol.21 No.3

Objectives Total intracranial volume (TIV) is a major nuisance of neuroimaging research for interindividual differences of brain structure and function. Authors intended to prove the reliability of the atlas scaling factor (ASF) method for TIV estimation in FreeSurfer by comparing it with the results of manual tracing as reference method. Methods The TIVs of 26 normal children and 26 children with attention-deficit hyperactivity disorder (ADHD) were obtained by using FreeSurfer reconstruction and manual tracing with T1-weighted images. Manual tracing performed in every 10th slice of MRI dataset from midline of sagittal plane by one researcher who was blinded from clinical data. Another reseacher performed manual tracing independently for randomly selected 20 dataset to verify interrater reliability. Results The interrater reliability was excellent (intraclass coefficient = 0.91, p < 7.1e-07). There were no significant differences of age and gender distribution between normal and ADHD groups. No significant differences were found between TIVs from ASF method and manual tracing. Strong correlation between TIVs from 2 different methods were shown (r = 0.90, p < 2.2e-16). Conclusions The ASF method for TIV estimation by using FreeSurfer showed good agreement with the reference method. We can use the TIV from ASF method for correction in analysis of structural and functional neuroimaging studies with not only elderly subjects but also children, even with ADHD.

정신분열병에서 연성 신경학적 징후의 가족내 전달에 관한 연구

류수정,최영락,이상익,신철진,김시경,손정우,Yoo, Sujung,Choi, Yongrak,Lee, Sangick,Shin, Chuljin,Kim, Siekyeong,Son, Jungwoo 대한생물정신의학회 2008 생물정신의학 Vol.15 No.2

목 적 연성 신경학적 징후는 정신분열병의 유전과 관계되는 생물학적 표현형으로 여겨져 왔다. 본 연구에서는 연성 신경학적 징후가 유전적 하중과 관련해서 가족 내에서 연관성을 보이는지를 알아보고자 하였다. 대상 및 방법 정신분열병 환자로서 부모 중 한 명은 정신분열병의 가족력이 있고 나머지 한 명은 가족력이 없는 환자가(N=14) 모집되었다. 이들의 부모가 가진 가족력에 따라 유전적 하중을 정하였고 이를 위해 Family Interview for Genetic Studies(FIGS)로 직접 면담을 시행하였다. 환자의 부모에서 환자를 제외한 1차 혹은 2차 친척에서 정신분열병 환자가 있는 부모를 유전적 하중이 있는 '추정 보유자'(presumed carrier)(N=9)로, 그렇지 않은 부모를 '추정 비보유자' (presumed noncarrier)(N=11)로 구분하였다. 또한 정상 대조군은 1차 혹은 2차 친척에서 정신분열병의 가족력이 없는 일반인(N=12)이었다. 이들의 연성 신경학적 징후를 한국어판 신경학적 평가 척도(Neurological Evaluation Scale-Korean version)를 사용하여 평가하였으며 가족내 연관성에 대한 분석 방법으로 급내 상관계수법(Intra-Class Coefficients[ICC]) method)을 이용하였다. 결 과 연성 신경학적 징후의 하위 영역 중 운동 조정 영역에서 환자와 추정 보유자 간에 유의한 연관성이 존재하였고(ICC=.804, p=.016) 환자와 추정 비보유자와는 연관성이 존재하지 않았다. 운동 조정 영역 이외의 다른 하위 영역에서는 유전적 하중과 상관없이 가족내 연관성이 존재하지 않았다. 그러나, 환자군과 정상 대조군의 운동 조정 영역의 점수 간에는 통계적으로 유의한 차이가 존재하지 않았다. 결 론 이번 연구에서는 연성 신경학적 징후들이 정신분열병의 유전적 하중과 같이 유전되는 생물학적 표현형일 가능성이 입증되지 못하였다. 향후 보다 많은 수를 대상으로 한 추시 연구가 필요하다. Objectives : Neurological soft signs have been regarded as endophenotypes associated with the genetic basis of schizophrenia. This study was to investigate the intra-familial correlations of the neurological soft signs according to their genetic loading. Methods : Schizophrenic patients(N=14) were included, who had one parent with a family history of schizophrenia and the other without it. Genetic loading was determined by the patient's family history of schizophrenia using the Family Interview for Genetic Studies(FIGS). These parents were subdivided into two groups. The first group was designated as 'presumed carriers'(N=9) of genetic loading, who had one or more schizophreic firstor second-degree relatives. The second group was designated as 'presumed non-carriers'(N=11) of genetic loading, who had no schizophrenic first- or second-degree relatives. Normal controls(N=12) consisted of people without schizophrenic relatives. NSS were evaluated using the Neurological Evaluation Scale-Korean Version (NES-K), and the intra-familial correlations of NSS were tested using the Intra-Class Coefficients(ICC) method. Results : The scores of Motor Coordination subdimension of NES-K were significantly correlated between the patients and their presumed carriers(ICC=.804, p=.016), but not significantly correlated between the patients and their presumed noncarriers. In other subdimensions of NES-K, no significant correlation were found between the patients and their parents regardless of the genetic loading. But, there were no statistically significant differences in the scores of Motor Coordination subdimension of NES-K between the patients and controls. Conclusion : This study did not prove that the neurological soft signs might be an endophenotype of schizophrenia that cosegregate with the genetic loading. The future study using more subjects than this would be needed.

관점 획득과 관련된 청소년에서의 뇌 활성화 : 성인과의 차이

박성경,손정우,이승복,김혜리,이상익,신철진,김시경,주가원,Park, Seong Kyoung,Son, Jung-Woo,Lee, Seungbok,Ghim, Hei-Rhee,Lee, Sang-Ick,Shin, Chul-Jin,Kim, Siekyeong,Ju, Gawon 대한생물정신의학회 2019 생물정신의학 Vol.26 No.2

Objectives The purpose of this study was to investigate the differences between adolescents and adults, in the perspective-taking ability, as well as the brain activation patterns during the perspective-taking situation. Methods We recruited healthy adolescents aged 13 years to 15 years (n = 20) and adults aged 19 years to 29 years (n = 20). All the subjects were scanned while performing the perspective-taking task, in which an emotional situation was presented in the form of statements comprising first person, as well as third person perspectives. Differences in brain activation between groups were assessed by contrasting neural activity during the tasks. Results In the between-group analysis, while performing the third-person perspective-taking task, the adolescent group showed greater neural activities in the middle frontal gyrus and precentral gyrus as compared to the adult group. Positive correlation was observed between the activity in the frontal areas (Brodmann area 6/9) and the score of scales related to perspective-taking and social cognition in the adolescent group. Conclusions This study suggests that several frontal brain areas of adolescents needs to be overactivated in order to compensate for low perspective-taking ability when they ought to take another person's point of view.

자가 측정 설문을 통해 평가된 한국 의과대학생들의 알코올 효과에 대한 반응 수준

박용희(Yonghee Park),이보람(Boram Lee),김시경(Siekyeong Kim) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.1

Objectives : Low level of response (LR) to alcohol is a risk factor for alcohol-use disorder (AUD). Self-Rating of Effects (SRE) scores are robust predictors of the quantity and frequency of alcohol use, alcohol-related problems, and the development of alcohol dependence. This pilot study is the first to attempt to develop and validate a Korean version of SRE. Methods : Fifty Korean medical students (22 females and 28 males) aged 18+ years were recruited. The Korean SRE was established and validated. The SRE questionnaire comprises four possible effects and three different timeframes. Demographics, first-time alcohol-use history, Korean version of the Alcohol Use Disorder Identification Test (AUDIT-KR) and gender differences were also studied. Results : The Korean SRE was in accord with earlier reports, the overall SRE scores correlated with the three individual time points and internally consistent. Fifty-five percent of the study subjects scored ≥4.5 (69% male vs 31% females), suggestive of low LR to alcohol and thus at risk of developing AUD. Males are more at risk. For 60% and 68% met cut-off for AUDIT-KR scores of ≥10 for males and ≥5 for females respectively. SRE correlated with AUDIT scores. Conclusion : The Korean SRE is valid and matched other reports. It can be implemented in large-scale nation-wide studies throughout Korea.

중증 흡연자들의 금연 성공과 관련된 흡연행태와 심리상태

곽찬용(Chan-Yong Kwak),박종혁(Jong-Hyock Park),김소영(So Young Kim),이상익(Sang Ick Lee),신철진(Chul-Jin Shin),손정우(Jung-Woo Son),주가원(Gawon Ju),김시경(Siekyeong Kim) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.2

Objectives : The purpose of this study was to determine the factors affecting smoking cessation rate of heavy smokers. Methods : Typically, 81 participants enrolled in the smoking cessation camp at Chungbuk National University Hospital from April 2016 to November 2016 were included in the present study. The psychological factors related to group classification and the factors related to the success of smoking cessation were analyzed. Results : After 24 weeks of leaving the camp, 57 out of 81 participants successfully quit smoking and 24 failed in doing so. In the successful group, depression scale, stress scale, and various smoking-related factors exhibited intercorrelation and in the failure group, no significant correlation was observed. However, a comparison of correlation coefficients showed no significant difference. In addition, smoking cessation success rate was low when exhaled CO concentration was high at the time of admission when the smoking initiation age was juvenile, and when the smoking type was A (stimulus seeking type). Conclusion : Exhaled CO concentration at the time of admission, smoking initiation age, and smoking type A (stimulus seeking type) were associated with smoking cessation success.

성 역할 정체감과 기질 성격 유형이 미용 성형 수술 의도에 미치는 영향

박혜미(Hyemi Park),이상익(Sang Ick Lee),신철진(Chul-Jin Shin),손정우(Jung-Woo Son),김시경(Siekyeong Kim),주가원(Gawon Ju) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.3

Objectives:The aim of this study was to investigate the factors that determine the intention to receive cosmetic plastic surgery, with particular attention to gender role identity and temperament character. Methods:A total of 226 university students completed the self-rating scale, including cosmetic surgery intention and experience. The Korean Sex Role Inventory(KSRI), Multidimensional Body Self Relation Questionnaires(MBSRQ), Brief Body Dysmorphic Questionnaire(BBDQ), and Temperament and Character Inventory(TCI) were also measured. To evaluate the difference of body image and cosmetic surgery intention, according to sex and gender role identity, chi-square test and one-way analysis of variance were performed. To find the influential TCI dimension for cosmetic surgery intention, multiple regression analysis was performed. The mediating effect of body image in a relationship between gender role identity score, temperament character and cosmetic surgery intention was also evaluated by multiple regression analysis. Results:Body satisfaction was different according to gender role identity. The androgyny types were more satisfied with their appearance than the undifferentiated types, in both sexes. Cosmetic surgery intention was significantly different according to sex only, but not gender role identity. High masculinity and femininity scores were significantly associated with body image satisfaction, but these were not associated with intention to receive cosmetic surgery. There was a full mediating effect of body image on the relationship between cosmetic surgery intention and increased harm avoidance(HA), decreased self-directedness(SD), and decreased cooperativeness(C). Conclusion:These results show that innate difference of sex might be more important to cosmetic surgery intention than acquired gender role identity. Moreover, individuals with high HA, low SD, and low C may have difficulty in forming positive body image due to vulnerable temperament and low self-acceptance character. Negative body image, along with these characteristics would likely lead to cosmetic surgery intention.

응급실에 내원한 자살 시도자의 추적 진료 순응도와 관련된 요인

이민제(Min-Je Lee),신철진(Chul-Jin Shin),이상익(Sang Ick Lee),손정우(Jung-Woo Son),김시경(Siekyeong Kim),주가원(Gawon Ju),이준기(Jun-Ki Lee) 대한생물치료정신의학회 2017 생물치료정신의학 Vol.23 No.3

Objectives:The purpose of this study is to research factors which affect the compliance of psychiatric outpatient follow-up treatment to the suicide attempting patients in the emergency room. Methods:We reviewed the medical records of 346 suicidal attempters who were discharged from emergency center of the Chungbuk National University Hospital from January 1, 2014 to December 31, 2015. They were divided into two groups : patients who came for outpatient department(OPD) follow up treatment and patients who did not. We gathered a data including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. After classifying the patients, we compared and analyzed the factors which could influence each group. Results:After being discharged, 233 patients did not show up for OPD follow up treatment and 113 patients came for OPD follow up treatment. There were significant differences between the two groups in the drunken status, lethality of Suicide Attempt, time of presentation to emergency room(ER), and OPD waiting time. But sociodemographic characteristics, medical condition did not influence the outpatient follow up compliance. Conclusion:There were significant differences in factors that affect the outpatient follow up compliance between the two groups. Additional research is required to increase outpatient follow up compliance.

자폐스펙트럼장애 환자에서의 인지적 공감 및 정서적 공감의 신경 상관물

정승원(Seungwon Chung),손정우(Jung-Woo Son),이승복(Seungbok Lee),김혜리(Hei-Rhee Ghim),이상익(Sang-Ick Lee),신철진(Chul-Jin Shin),김시경(Siekyeong Kim),주가원(Gawon Ju),최상철(Sang Cheol Choi),김양렬(Yang Yeol Kim),구영진(Young Jin K 대한소아청소년정신의학회 2016 소아청소년정신의학 Vol.27 No.3

Objectives: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. Methods: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. Results: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. Conclusion: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.