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온석훈,박창일,이보현,김연희 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.5
Objective: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) applied over the left prefrontal cortex on the enhancement of verbal working memory in healthy persons.Method: High frequency (10 Hz) rTMS was applied over the left prefrontal cortex with the intensity of 100% resting motor threshold (RMT). A 3-back verbal working memory task was administered before, during (after applying 500 and 1,000 pulses, respectively), and 30 minutes after real or sham rTMS.Results: Real rTMS, compared with sham stimulation, significantly improved working memory performance. Accuracy of response increased significantly after applying 1,000 pulses of real rTMS (p<0.05). This effect maintained for 30 minutes after completion of stimulation (p<0.05). The error rate and reaction time did not change with rTMS. There was no noticeable side effect during or after rTMS.Conclusion: 1,000 pulses of 10 Hz rTMS administered to the left prefrontal cortex with the intensity of 100% RMT have positive impact on verbal working memory in healthy persons. Further study is necessary to address this effect of rTMS in patients with cognitive dysfunction.
온석훈 대한뇌신경재활학회 2014 뇌신경재활 Vol.7 No.2
Palatal tremor and Kernohan-Woltman notch phenomenon are rare motor symptoms that can show up in patients with lesion in brain stem or cerebellum. Patients with palatal tremor accompany ataxia, internuclear ophthalmoplegia, dysphagia, dysarthria and Kernohan-Woltman notch phenomenon causes ipsilateral motor deficits. Although its rarity, these conditions exhibit unexpected symptoms as well as considerable disability, which can raise etiologic and prognostic concerns for rehabilitation team. These two motor symptoms are discussed in this review.
만성 통증 환자에서 운동의 통증 감소 효과 및 중추성 기전
온석훈 대한임상통증학회 2023 Clinical Pain Vol.22 No.1
For the effective rehabilitation of chronic pain, it is necessary to know the changes in the pain networks of patients with chronic pain. There is a need for attention to changes in emotional pain networks and cognitive pain networks. In patients with chronic pain, post-exercise pain reduction is less pronounced than in those without chronic pain. In order to achieve the exercise effect, emotional problems must be considered in addition to the patient's physical changes. In addition, a detailed prior explanation is needed to raise the expectations for exercise effect, moreover, in order to continue exercising for a safe and long period, exercise suitable for patients should be selected and low-intensity exercise protocols should be provided.
만성 뇌졸중 후 편마비 환자에서 2주간 경두개 전기 자극 후 상지 운동기능 향상
김덕용,온석훈,박창일,정강재,박기덕,박종범,오윤택 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.1
Objective: To investigate whether transcranial direct current stimulation (tDCS) could improve the motor function of hemiparetic upper limb in chronic stroke patients through randomized double-blinded, sham-controlled study. Method: Twenty chronic post-stroke hemiparetic patients participated in this study. They were randomly assigned into either tDCS or sham group. Anodal tDCS was delivered on lesional primary motor cortex for 20 minutes in tDCS group and 30 seconds in sham group. Just after stimulation, both groups performed the shaping exercise for 30 minutes. Total 10 stimulation sessions (5 session/week for 2 weeks) were administered. Fugl-Meyer motor assessment, box and block test, grasp strength and FIM were assessed before stimulation, after 1 week of stimulation, after 2 weeks of stimulation, and 2 weeks after stimulation. Results: The upper extremity score of Fugl-Meyer motor assessment and box and block test improved significantly in tDCS group compared to sham group (p<0.05). Their improvement lasted significantly for 2 week after stimulation. However, FIM, lower extremity score of Fugl-Meyer motor assessment and grasp power did not improved significantly in tDCS group compared to sham group. Conclusion: tDCS can improve the motor function of hemiparetic upper limb in chronic post-stroke patients, and the effects lasted after stimulation. tDCS may be used as an additional tool for stroke rehabilitation. Objective: To investigate whether transcranial direct current stimulation (tDCS) could improve the motor function of hemiparetic upper limb in chronic stroke patients through randomized double-blinded, sham-controlled study. Method: Twenty chronic post-stroke hemiparetic patients participated in this study. They were randomly assigned into either tDCS or sham group. Anodal tDCS was delivered on lesional primary motor cortex for 20 minutes in tDCS group and 30 seconds in sham group. Just after stimulation, both groups performed the shaping exercise for 30 minutes. Total 10 stimulation sessions (5 session/week for 2 weeks) were administered. Fugl-Meyer motor assessment, box and block test, grasp strength and FIM were assessed before stimulation, after 1 week of stimulation, after 2 weeks of stimulation, and 2 weeks after stimulation. Results: The upper extremity score of Fugl-Meyer motor assessment and box and block test improved significantly in tDCS group compared to sham group (p<0.05). Their improvement lasted significantly for 2 week after stimulation. However, FIM, lower extremity score of Fugl-Meyer motor assessment and grasp power did not improved significantly in tDCS group compared to sham group. Conclusion: tDCS can improve the motor function of hemiparetic upper limb in chronic post-stroke patients, and the effects lasted after stimulation. tDCS may be used as an additional tool for stroke rehabilitation.
Novel Information on Anatomic Factors Causing Grasp Reflex in Frontal Lobe Infarction: A Case Report
최익준,온석훈,정광익,유우경,장소연 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.1
We report a patient with a severe limitation of function in the right hand resulting from grasp reflex following a stroke affecting the left anterior cerebral artery region. We describe, using diffusion tensor tractography (DTT), a disconnection between the bilateral frontal lobes via the corpus callosum. The patient could not control his right hand at all, even though his bilateral corticospinal tracts were intact. We noted that over the infarcted lesion on DTT, the white matter was invisible from the corpus callosum to the prefrontal cortex. These findings reflected a unique pattern of white-matter disconnection between the ipsilateral medial frontal lobe and ipsilateral and contralateral frontal cortex causing hand function deterioration in the form of severe grasp reflex.
An Exploration of the Neural Network of Lance-Adams Syndrome: a Case Report
송지민,강원일,온석훈,정광익,Bashir Shahid,유우경 대한뇌신경재활학회 2021 뇌신경재활 Vol.14 No.1
Lance-Adams syndrome (LAS) is a rare neurological disorder that may occur after cardiopulmonary resuscitation. The LAS is usually caused by hypoxic changes. Neuroimaging studies show that the brain pathology of LAS patients is not uniform, and the pathophysiology of the myoclonus can vary from patient to patient. Our case study contributes to this etiological heterogeneity by neuroimaging and transcranial magnetic stimulation (TMS). In patients with rare brain conditions such as LAS, a combination of brain stimulation methods, such as TMS, and diffusion tensor imaging can provide insights into this condition's pathophysiology. These insights can facilitate the development of more effective therapies.
Dementia due to Meningovascular Syphilis in Medial Temporal Lobe and Cognitive Rehabilitation
Seungho Ahn,온석훈,정광익,유우경,Ga Young Kang 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.3
The temporal lobe is essential in saving declarative memory and plays an important role along with the cerebral neocortex in creating and maintaining long-term memory. Damage to the temporal lobe is expected to result in cognitive impairment or dementia, which has characteristic symptoms such as cognitive and behavioral dysfunction and decreasing self-reliance in activities of daily living. We report on a patient, who suffered from dementia due to meningovascular syphilis aff ecting the medial temporal lobe, and on the outcome of cognitive rehabilitation.