주요우울장애 환자에서 자살사고 동반 여부에 따른 부적격 짝맞추기 음성파의 비교

이민지,이연정,황재욱,우성일,김민재,강병주,김영근,한상우,Lee, Minji,Lee, Yeon Jung,Hwang, Jaeuk,Woo, Sung-il,Kim, Min Jae,Kang, Byungjoo,Kim, Younggeun,Hahn, Sang-Woo 대한불안의학회 2021 대한불안의학회지 Vol.17 No.2

Objective : Mismatch negativity (MMN) is known to reflect several abnormalities of cognitive functioning. This study is aimed to investigate the differences in MMN among major depressive disorder (MDD) patients with or without suicidal ideation. Methods : Sixty-seven patients with MDD were recruited into this study. MMN was measured by a 64-channel electroencephalography (EEG) using oddball paradigm over the front-central area. Clinical characteristics were assessed using the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II), and the Beck Scale for Suicide ideation (SSI-BECK). Patients were divided into two groups, no suicidal ideation (N=12) and suicidal ideation (N=55), depending on the presence of suicide ideation in SSI-BECK questionnaires. Results : The MMN latencies were significantly longer in the MDD patients with suicidal ideation than in the MDD patents without suicidal ideation (p<0.05). The MMN amplitudes were not significantly different between the two groups. Conclusion : Suicidal ideation may be associated with longer MMN latencies, and it suggests that MMN may play a potential role in assessing the suicidal risk among MDD patients.

뇌연령, 새로운 신경병리 지표

김명주 ( Myung Ju Kim ),황재욱 ( Jaeuk Hwang ),우성일 ( Sung-il Woo ) 한국정신병리진단분류학회 2020 精神病理學 Vol.24 No.2

The human brain undergoes aging throughout one’s lifetime after its maturation period. However, the patterns of brain aging vary from person to person. Recently, the brain age prediction brings our attention increasingly since it may be useful as a biological marker of the level of brain aging. Estimation of brain age is of great clinical significances, since it can suggest the severity of neurological diseases as well as psychiatric disorders. It has been reported that regional volumes of cerebral structures and cortical thickness would be decreased with aging. Yet, these changes vary depending on numerous factors such as tissue and area of the brain aging and accelerate after a certain period of time. In order to establish brain age prediction algorithms with high accuracy, it is necessary to select relevant input data and algorithms. Majority of the previous studies trained the models through volume-based data and in particular, the study applying the latest prediction algorithms, such as convolutional neural networks, has shown reasonably high accuracy with a mean absolute error of around 4 years. Growing body of literatures regarding the brain age prediction has been available since 2015. In the future, more accurate model will be developed with more advanced machine learning and larger number of brain imaging data. If the model would be developed for younger population, its clinical significance will be increased.

치매 환자에서 뇌 자기공명영상의 특징과 비정형 항정신병 약제 사용여부의 상관 관계

최종택,김지원,노양호,류석환,우성일,한상우,황재욱,Choi, Jongtaek,Kim, Jiwon,Roh, Yangho,Rhu, Sukhwan,Woo, Sungil,Hahn, Sangwoo,Hwang, Jaeuk 대한생물정신의학회 2013 생물정신의학 Vol.20 No.3

Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

Now and Future of Data Sharing

Eun Namgung(남궁은),Seunghee Kim(김승희),Jaeuk Hwang(황재욱) 대한생물치료정신의학회 2019 생물치료정신의학 Vol.25 No.1

지난 10년간, 인간 신경과학의 재현성과 투명성의 가치를 감안하여 뇌 자기공명영상(MRI) 데이터 공유 관행이 증대하고 있다. 인간 신경과학의 큰 변동성과 높은 위양성 비율을 고려했을 때, 보다 견고한 연구 결과를 위해서는 더욱 방대한 다차원 데이터베이스가 필요하다. 현재, 여러 조건과 다중양식을 활용한 수백여 개의 뇌영상 연구들에 걸친 수만 개의 뇌 자기공명영상 데이터세트가 뇌 자기공명영상 데이터 저장소를 통해 공유되고 있다. 본 논문에서는 뇌 자기공명영상 공유의 목적, 절차 및 현재 상태를 검토할 것이다. 비판적으로 검토할 예정이다. 본 종설은 주로 구조적 및 기능적 뇌 자기공명영상 공공 데이터베이스를 이용한 프로젝트와 과학적 발견에 중점을 두었으며, 이는 구조적 뇌영상의 경우 T1 및 확산 강조 영상으로, 기능적 뇌영상의 경우 휴지상태 및 과제기반 기능적 뇌영상으로 세분화될 것이다. 뇌자기공명영상 공유의 도전과제와 미래적 지향점은 마지막으로 논의된다. 뇌 자기공명영상 공유의 진보는 효과적인 종적 및 다방향 뇌영상 연구 환경을 조성함으로써 인간 신경과학의 더욱 빠른 진전으로 이어지리라 기대되는 바이다. Over the past decade, practice of sharing brain magnetic resonance imaging (MRI) data is increasing given significance of reproducibility and transparency in human neuroscience. Larger multimodal brain MRI databases are needed for more robust research findings considering potential possibilities of large variability in human neuroscience. There are currently more than tens of thousands of shared brain MRI datasets across multiple conditions and hundreds of neuroimaging studies using multimodality through shared brain MRI data repositories. This article critically reviews aims, procedures, and current state of brain MRI data sharing. This review focuses on projects and research findings using structural and functional MRI open databases and is further divided into T1- and diffusion-weighted images for structural MRI as well as resting-state and task-based functional MRI. The challenges and directions are finally discussed. Advances in brain MRI data sharing will lead to more rapid progression in human neuroscience by fostering effective longitudinal, multi-site, multimodal neuroimaging research.

텍스트 분류 기반 기계학습의 정신과 진단 예측 적용

백두현,황민규,이민지,우성일,한상우,이연정,황재욱,Pak, Doohyun,Hwang, Mingyu,Lee, Minji,Woo, Sung-Il,Hahn, Sang-Woo,Lee, Yeon Jung,Hwang, Jaeuk 대한생물정신의학회 2020 생물정신의학 Vol.27 No.1

Objectives The aim was to find effective vectorization and classification models to predict a psychiatric diagnosis from text-based medical records. Methods Electronic medical records (n = 494) of present illness were collected retrospectively in inpatient admission notes with three diagnoses of major depressive disorder, type 1 bipolar disorder, and schizophrenia. Data were split into 400 training data and 94 independent validation data. Data were vectorized by two different models such as term frequency-inverse document frequency (TF-IDF) and Doc2vec. Machine learning models for classification including stochastic gradient descent, logistic regression, support vector classification, and deep learning (DL) were applied to predict three psychiatric diagnoses. Five-fold cross-validation was used to find an effective model. Metrics such as accuracy, precision, recall, and F1-score were measured for comparison between the models. Results Five-fold cross-validation in training data showed DL model with Doc2vec was the most effective model to predict the diagnosis (accuracy = 0.87, F1-score = 0.87). However, these metrics have been reduced in independent test data set with final working DL models (accuracy = 0.79, F1-score = 0.79), while the model of logistic regression and support vector machine with Doc2vec showed slightly better performance (accuracy = 0.80, F1-score = 0.80) than the DL models with Doc2vec and others with TF-IDF. Conclusions The current results suggest that the vectorization may have more impact on the performance of classification than the machine learning model. However, data set had a number of limitations including small sample size, imbalance among the category, and its generalizability. With this regard, the need for research with multi-sites and large samples is suggested to improve the machine learning models.

한국인 조현병 환자에서CNR1 유전자의 (AAT)n 삼핵산 반복 다형성과 안구추적운동 이상에 대한 연합 연구

김민재,김채리,박진완,백두현,신형두,최인근,한상우,황재욱,이연정,우성일,Kim, Min Jae,Kim, Chae-Ri,Park, Jin Wan,Pak, Doo Hyun,Shin, Hyoung Doo,Choi, Ihn-Geun,Hahn, Sang Woo,Hwang, Jaeuk,Lee, Yeon Jung,Woo, Sung-Il 대한생물정신의학회 2016 생물정신의학 Vol.23 No.4

Objectives According to previous studies, the cannabinoid receptor 1 (CNR1) gene could be an important candidate gene for schizophrenia. Some studies have linked the (AAT)n trinucleotide repeat polymorphism in CNR1 gene with the risk of schizophrenia. Meanwhile, smooth pursuit eye movement (SPEM) has been regarded as one of the most consistent endophenotypes of schizophrenia. In this study, we investigated the association between the (AAT)n trinucleotide repeats in CNR1 gene and SPEM abnormality in Korean patients with schizophrenia. Methods We measured SPEM function in 167 Korean patients with schizophrenia (84 male, 83 female) and they were divided according to SPEM function into two groups, good and poor SPEM function groups. We also investigated allele frequencies of (AAT)n repeat polymorphisms on CNR1 gene in each group. A logistic regression analysis was performed to find the association between SPEM abnormality and the number of (AAT)n trinucleotide repeats. Results The natural logarithm value of signal/noise ratio (Ln S/N ratio) of the good SPEM function group was $4.34{\pm}0.29$ and that of the poor SPEM function group was $3.21{\pm}0.70$. In total, 7 types of trinucleotide repeats were identified, each containing 7, 10, 11, 12, 13, 14, and 15 repeats, respectively. In the patients with $(AAT)7$ allele, the distributions of the good and poor SPEM function groups were 18 (11.1%) and 19 (11.0%) respectively. In the patients with $(AAT)_{10}$ allele, $(AAT)_{11}$ allele, $(AAT)_{12}$ allele, $(AAT)_{13}$ allele, $(AAT)_{14}$ allele and $(AAT)_{15}$ allele, the distributions of good and poor SPEM function groups were 13 (8.0%) and 12 (7.0%), 4 (2.5%) and 6 (3.5%), 31 (19.8%) and 35 (20.3%), 51 (31.5%) and 51 (29.7%), 36 (22.2%) and 45 (26.2%), 9 (5.6%) and 4 (2.3%) respectively. As the number of (AAT) n repeat increased, there was no aggravation of abnormality of SPEM function. Conclusions There was no significant aggravation of SPEM abnormality along with the increase of number of (AAT)n trinucleotide repeats in the CNR1 gene in Korean patients with schizophrenia.

한국인 조현병 환자에서 Chromogranin B 유전자와 안구운동 이상의 연합에 대한 연구

박진완,백두현,황민규,이민지,신형두,신태민,한상우,황재욱,이연정,우성일,Park, Jin Wan,Pak, Doo Hyun,Hwang, Min Gyu,Lee, Min Ji,Shin, Hyoung Doo,Shin, Tae-Min,Hahn, Sang Woo,Hwang, Jaeuk,Lee, Yeon Jung,Woo, Sung-Il 대한생물정신의학회 2018 생물정신의학 Vol.25 No.4

Objectives According to previous studies, the Chromogranin B (CHGB) gene could be an important candidate gene for schizophrenia which is located on chromosome 20p12.3. Some studies have linked the polymorphism in CHGB gene with the risk of schizophrenia. Meanwhile, smooth pursuit eye movement (SPEM) abnormality has been regarded as one of the most consistent endophenotype of schizophrenia. In this study, we investigated the association between the polymorphisms in CHGB gene and SPEM abnormality in Korean patients with schizophrenia. Methods We measured SPEM function in 24 Korean patients with schizophrenia (16 male, 8 female) and they were divided according to SPEM function into two groups, good and poor SPEM function groups. We also investigated genotypes of polymorphisms in CHGB gene in each group. A logistic regression analysis was performed to find the association between SPEM abnormality and the number of polymorphism. Results The natural logarithm value of signal/noise ratio (Ln S/N ratio) of good SPEM function group was $4.19{\pm}0.19$ and that of poor SPEM function group was $3.17{\pm}0.65$. In total, 15 single nucleotide polymorphisms of CHGB were identified and the genotypes were divided into C/C, C/R, and R/R. Statistical analysis revealed that two genetic variants (rs16991480, rs76791154) were associated with SPEM abnormality in schizophrenia (p = 0.004). Conclusions Despite the limitations including a small number of samples and lack of functional study, our results suggest that genetic variants of CHGB may be associated with SPEM abnormality and provide useful preliminary information for further study.nwhile, smooth pursuit eye movement (SPEM) abnormality has been regarded as one of the most consistent endophenotype of schizophrenia. In this study, we investigated the association between the polymorphisms in CHGB gene and SPEM abnormality in Korean patients with schizophrenia. MethodsZZWe measured SPEM function in 24 Korean patients with schizophrenia (16 male, 8 female) and they were divided according to SPEM function into two groups, good and poor SPEM function groups. We also investigated genotypes of polymorphisms in CHGB gene in each group. A logistic regression analysis was performed to find the association between SPEM abnormality and the number of polymorphism. ResultsZZThe natural logarithm value of signal/noise ratio (Ln S/N ratio) of good SPEM function group was $4.19{\pm}0.19$ and that of poor SPEM function group was $3.17{\pm}0.65$. In total, 15 single nucleotide polymorphisms of CHGB were identified and the genotypes were divided into C/C, C/R, and R/R. Statistical analysis revealed that two genetic variants (rs16991480, rs76791154) were associated with SPEM abnormality in schizophrenia (p = 0.004). ConclusionsZZDespite the limitations including a small number of samples and lack of functional study, our results suggest that genetic variants of CHGB may be associated with SPEM abnormality and provide useful preliminary information for further study.

한국인에서 조현병과 Cannabinoid Receptor 1 유전자의 삼핵산 반복서열의 연합에 대한 연구

김지원,노양호,김민재,김채리,박병래,배준설,신형두,최인근,한상우,황재욱,우성일,Kim, Ji-Won,Roh, Yang-Ho,Kim, Min-Jea,Kim, Chea-Ri,Park, Byung-Lae,Bae, Joon Seol,Shin, Hyoung Doo,Choi, Ihn-Geun,Han, Sang-Woo,Hwang, Jaeuk,Woo, Sung-Il 대한생물정신의학회 2014 생물정신의학 Vol.21 No.3

Objectives Previous studies suggest that the cannabinoid receptor 1 (CNR1) gene could be an important candidate gene for schizophrenia. According to linkage studies, this gene is located on chromosome 6q14-q15, which is known to harbor the schizophrenia susceptibility locus (locus 5, SCZ5, OMIM 803175). The pharmacological agent delta-9-tetrahydrocannabinol (${\Delta}$-9-THC) seems to elicit the symptoms of schizophrenia. The association between CNR1 polymorphisms and schizophrenia is actively being investigated, and some studies have linked the AAT-trinucleotide repeats in CNR1 to the onset of schizophrenia. In this study, we have investigated the association between the AAT-trinucleotide repeats in CNR1 and schizophrenia by studying schizophrenia patients and healthy individuals from Korea. Methods DNA was extracted from the blood samples of 394 control subjects and 337 patients diagnosed with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria). After polymerase chain reaction amplification, a logistic regression analysis, with age and gender as the covariates, was performed to study the variations in the AAT-repeat polymorphisms between the two groups. Results In total, 8 types of trinucleotide repeats were identified, each containing 7, 8, 10, 11, 12, 13, 14, and 15 repeats, respectively. $(AAT)_{13}$ allele was most frequently observed, with a frequency of 33.6% and 31.6% in the patient and control groups, respectively. The frequency of the other repeat alleles in the patient group (in the decreasing order) was as follows : $(AAT)_{13}$ 33.6%, $(AAT)_{14}$ 21.6%, $(AAT)_{12}$ 18.5%, and $(AAT)_{7}$ 11.1%. The frequency of the repeat alleles in the control group (in the decreasing order) was as follows : $(AAT)_{13}$ 31.6%, $(AAT)_{14}$ 24.5%, $(AAT)_{12}$ 17.2%, and $(AAT)_{7}$ 11.6%. However, there were no significant differences in the AAT-repeat polymorphisms of the CNR1 gene between the patient group and the control group. Conclusions Although our study revealed no significant association of the AAT-repeat polymorphism of the CNR1 gene with schizophrenia, it will serve as a good reference for future studies designed to examine the cannabinoid hypothesis of schizophrenia.

경도인지장애와 치매 환자에서 숫자 거꾸로 따라하기로 측정한 작업기억에 대한 우울증의 영향

노양호(Yang-Ho Roh),김민재(Min-Jea Kim),김채리(Chae-Ri Kim),박진완(Jin-Wan Park),이연정(Yeon-Jung Lee),우성일(Sungil Woo),한상우(Sang Woo Hahn),황재욱(Jaeuk Hwang) 대한노인정신의학회 2015 노인정신의학 Vol.19 No.2

Objective:We aimed to explore the influence of depression on working memory in patients with mild cognitive impairment (MCI) and dementia. Methods:Clinical and neuropsychological data of 43 subjects with mild cognitive impairment (MCI) (n=17) and dementia (n= 26) who had visited Department of Psychiatry at Soonchunhyang University Seoul Hospital, were collected. The subjects were di-vided into depressed (n=18) and non-depressed (n=25) groups based on the Korean version of Short Geriatric Depression Scale. Two-way analysis of variance test was conducted to evaluate the influence of diagnosis (MCI and dementia), the presence of depres-sion and their interaction on working memory which was measured by digit forward and backward span test. Results:Among the patients with MCI, test score of digit backward span test in depressed group was significantly lower than in non-depressed group. However, among the patients with dementia, there was no significant difference in digit backward span test between depressed and non-depressed groups. Conclusion:This study suggests that the depression could deteriorate working memory measured by digit backward span test in patients with MCI, relative to in patients with dementia and it also implicates the diagnostic assessment for depression has clinically importance in patients with MCI.

양극성 장애, 조증 삽화 입원 환자에서 조증 증상 경과 예측과 관련있는 임상 변인 연구

김채리(Chae-Ri Kim),박진완(Jin-Wan Park),백두현(Doo-Hyun Pak),이연정(Yeon-Jung Lee),한상우(Sang Woo Hahn),우성일(Sungil Woo),황재욱(Jaeuk Hwang) 대한생물치료정신의학회 2017 생물치료정신의학 Vol.23 No.3

Objectives:This study was aimed to investigate clinical factors associated with the prediction of symptom improvement in hospitalized patients with bipolar disorder, manic episode. Methods:We performed a retrospective observational study based on the medical records review of 53 bipolar disorder manic patients, who had been hospitalized in the psychiatric ward. During the hospitalization, Young Mania Rating Scales(YMRS) have been measured periodically. Demographic information and clinical characteristics including medications and history of prior hospitalization have been collected in each patient. Linear mixed effect model has been used to assess the effect of clinical factors on the changes of YMRS over time. Selection of clinical factors was conducted using backward elimination with the minimization of Akaike Information Criterion. Results:Mean days of hospitalization were 29.74±16.96. Mean YMRS at the admission was 33.64±7.57. Effective factors for the model included YMRS at baseline, combination of mood stabilizer, and the history of prior hospitalization. Predicted YMRS at the discharge was 10.43(95% confidence interval 7.13–13.72). Conclusion:The current findings suggest the model which may predict the clinical course of the bipolar disorder manic patients. It would be useful to establish the treatment plan for the patients.