바이오피드백을 이용하여 측정한 불면증 환자의 정신생리적 특징

허성영,이진성,김성곤,김지훈,정우영,Huh, Sung-Young,Lee, Jin-Seong,Kim, Sung-Gon,Kim, Ji-Hoon,Jung, Woo-Young 대한수면의학회 2015 수면·정신생리 Vol.22 No.2

목 적 : 불면증은 여러 가지 신체질환, 정신질환에 공이환 된 경우가 많아 일차 진료에서 가장 흔한 문제 중 하나이다. 정신생리적 과각성이 병태생리에서 중요하다고 알려져 있다. 이 연구에서는 바이오피드백 기기를 이용한 스트레스 반응 검사로 일차성 불면증과 정상인 간에 생리신호 특성을 비교하였다. 방 법 : 일차성 불면증 환자 80명(남자 35, 여자 45명, $49.71{\pm}12.91$세)과 정상인 101명(남자 64, 여자 37명, $27.65{\pm}2.77$세)에게 바이오피드백 기기를 이용하여 스트레스 반응 검사를 하였다. 스트레스 반응 검사는 기저, 스트레스 1, 회복 1, 스트레스 2, 회복 2단계의 다섯 단계로 하였다. 각 단계에서 근전도(EMG), 심장박동수(heart rate), 피부전도(skin conductance), 피부체온(skin temperature), 그리고 호흡수(respiratory rate)를 각각 2분 동안 기록하여 평균값을 산출하였다. 측정값들의 양 군 사이 비교에는 독립 t-검정, 이전 단계와 비교한 측정값의 변화는 대응표본 t-검정으로 분석하였다(양측검정, p < 0.05). 결 과 : 불면증 환자는 정상인에 비해 5단계 스트레스 반응 검사 모두에서 전두근이 더 긴장해 있었다(기저 : $7.72{\pm}3.88{\mu}V$ vs. $4.89{\pm}1.73{\mu}V$, t = -6.06, p < 0.001 ; 스트레스 1 : $10.29{\pm}5.16{\mu}V$ vs. $6.63{\pm}2.48{\mu}V$, t = -5.84, p < 0.001 ; 회복 1 : $7.87{\pm}3.86{\mu}V$ vs. $5.17{\pm}2.17{\mu}V$, t = -5.61, p < 0.001 ; 스트레스 2 : $10.22{\pm}6.07{\mu}V$ vs. $6.98{\pm}2.98{\mu}V$, t = -4.37, p < 0.001 ; 회복 2 : $7.88{\pm}4.25{\mu}V$ vs. $5.17{\pm}1.99{\mu}V$, t = -5.27, p < 0.001 ). 정상인은 불면증 환자와 비교하여 각 단계에 따른 심장박동수의 변화 정도가 더 컸다(스트레스 1-기저 : $6.48{\pm}0.59$ vs. $3.77{\pm}0.59$, t = 3.22, p = 0.002 ; 회복 1-스트레스 1 : $-5.36{\pm}0.0.59$ vs. $-3.16{\pm}0.47$, t = 2.91, p = 0.004 ; 스트레스 2-회복 1 : $8.45{\pm}0.61$ vs. $4.03{\pm}0.47$, t = 5.72, p < 0.001 ; 회복 2-스트레스 2 : $-8.56{\pm}0.65$ vs. $-4.02{\pm}0.51$, t = -5.31, p < 0.001). 결 론 : 일차성 불면증 환자는 정상인에 비해 전두근 근전도 측정값이 전반적으로 증가되었고, 심장박동수의 검사 단계별 변화 정도가 작았다. 이는 불면증 환자의 자율신경계가 정상인에 비해 과각성 상태에 있음을 시사한다. Background and Objectives: Insomnia is the most prevalent sleep disorder in the general population and is considered to be a disorder of hyperarousal. The aim of this study was to measure the psychophysiological responses in insomnia patients using a biofeedback system, and to compare them with results from normal healthy subjects. Materials and Methods: Eighty patients with primary insomnia (35 males and 45 females, average age $49.71{\pm}12.91years$) and 101 normal healthy controls (64 males and 37 females, average age $27.65{\pm}2.77$) participated in this study. Electromyography (EMG), heart rate (HR), skin conductance (SC), skin temperature (ST), and respiratory rate (RR) were recorded using a biofeedback system during 5 phases (baseline, stress 1, recovery 1, stress 2, recovery 2) of a stress reactivity test, and average values were calculated. Difference in values between the two groups in each corresponding phase was analyzed with independent t-test, and change in values across phases of the stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). Results: Compared to normal controls, insomnia patients had higher EMG in all 5 phases (baseline : $7.72{\pm}3.88{\mu}V$ vs. $4.89{\pm}1.73{\mu}V$, t = -6.06, p<0.001 ; stress 1 : $10.29{\pm}5.16{\mu}V$ vs. $6.63{\pm}2.48{\mu}V$, t = -5.84, p<0.001 ; recovery 1 : $7.87{\pm}3.86{\mu}V$ vs. $5.17{\pm}2.17{\mu}V$, t = -5.61, p<0.001 ; stress 2 : $10.22{\pm}6.07{\mu}V$ vs. $6.98{\pm}2.98{\mu}V$, t = -4.37, p<0.001 ; recovery 2 : $7.88{\pm}4.25{\mu}V$ vs. $5.17{\pm}1.99{\mu}V$, t = -5.27, p<0.001). Change in heart rate across phases of the stress reactivity test were higher in normal controls than in insomnia patients (stress 1-baseline : $6.48{\pm}0.59$ vs. $3.77{\pm}0.59$, t = 3.22, p = 0.002 ; recovery 1- stress 1 : $-5.36{\pm}0.0.59$ vs. $-3.16{\pm}0.47$, t = 2.91, p = 0.004 ; stress 2-recovery 1 : $8.45{\pm}0.61$ vs. $4.03{\pm}0.47$, t = 5.72, p<0.001 ; recovery 2-stress 2 : $-8.56{\pm}0.65$ vs. $4.02{\pm}0.51$, t = -5.31, p<0.001). Conclusion: Psychophysiological profiles of insomnia patients in a stress reactivity test were different from those of normal healthy controls. These results suggest that the sympathetic nervous system is more highly activated in insomnia patients.

소아청소년기 발병 양극성 장애와 성인기 발병 양극성 장애의 인지 및 임상적 특성에 대한 비교 연구

김현미(Hyeonmi Kim),허성영(Sung-Young Huh),김성곤(Sung-Gon Kim),김지훈(Ji-Hoon Kim),정우영(Woo-Young Jung),유은라(Eun-ra Yu),최범성(Bum-Sung Choi),김대욱(Dae-Wook Kim),윤동욱(Dong-Uk Yoon) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.2

Objectives:Childhood/adolescent-onset of bipolar disorder presents functional impairments on emotional, academic, and social aspects. These impairments could continue into adulthood. However, there are few studies comparing cognitive function between childhood/adolescent- and adult-onset using psychological test. This study aims to improve understanding of childhood/adolescent-onset of bipolar disorder by comparing differences in cognitive function, clinical and demographic features between the two groups. Methods:This study was conducted on 145 patients diagnosed with bipolar disorder type I, II, and other specified bipolar disorder by DSM 5 at the time of discharge from 2016 to 2019 at the Department of Psychiatry, Pusan National University Yangsan Hospital. Demographic information, clinical data, and results of psychological tests (K-WISC-IV, K-WAIS-IV) were collected and reviewed. Results:Childhood/adolescent-onset group was significantly low in total potential IQ and in language understanding than adult-onset group (p=0.008 and p=0.013). The childhood/adolescent group had significantly more psychiatric comorbidities than the adult group (p<0.001). The average number of prescribed antipsychotic agents was 1.18 (SD=±0.64) in the childhood/adolescent group, and 1.78 (SD=±0.82) in the adult group. The difference was statistically significant (p<0.001). Conclusion:Patients with childhood/adolescent-onset bipolar disorder have lower total potential IQ and language understanding comparing patients with adult-onset bipolar disorder. This highlights the importance of conducting a well-designed prospective study to find out more about the characteristics of childhood/adolescent-onset bipolar disorder.

흑찰거대배아미 발아현미배아의 섭취가 C57BL/6 생쥐의 알코올 섭취에 미치는 영향

신동훈(Dong-Hun Shin ),김성곤(Sung-Gon Kim),김현경(Hyeon-Kyeong Kim),허성영(Sung-Young Huh),변원탄(Won-Tan Byun) 한국생명과학회 2020 생명과학회지 Vol.30 No.3

알코올 중독과 GABA계와의 관련성에 대한 많은 연구가 있으며, 중추신경계의 GABA계를 항진시키면 알코올 중독의 재발을 억제한다는 보고가 있다. 이에 GABA 고함유쌀과 저함유쌀의 섭취가 생쥐의 알코올 섭취 행동에 미치는 영향을 조사하고자 한다. 흑찰거대배아미(BSRGE), 조생흑찰벼(BSR)와 거대배아미(GER) 및 일반미(Rice)를 각각 현미상태에서 48시간 발아시켜 배아만을 채취하여 발아현미배아의 비율이 70%가 함유되도록 기존의 사료에 혼합하여 사료화한 후 C57BL/6 생쥐에게 16일 동안 자유 섭취시키면서 2시간 알코올 섭취량, 22시간 물섭취량, 24시간 사료섭취량 및 체중의 변화를 조사하였다. 흑찰거대배아미군과 조생흑찰군 간에 일별 2시간 알코올 섭취량의 일변화에 대해 repeated measure ANOVA를 실시하였을 때에 섭취일수(시간)에 따라서는 유의한 차이가 나타났다(df=7, F=4.812, p=0.026). 일별 2시간 알코올 섭취량의 일변화에 대해 양군을 비교하였을 때, BSR에 비하여 BSRGE에서 2시간 알코올 섭취량이 유의하게 감소하였으며, 이러한 감소효과는 섭취 10일째부터 16일째 까지 지속적으로 나타났다(10일째, df=14, t=3.18, p=0.012; 12일째, df=14, t=3.39, p=0.004; 14일째, df=14, t=5.11, p=0.001; 16일쨰, df=14, t=6.79, p<0.001). GER과 Rice 양군을 비교하였을 때 Rice에 비하여 GER에서 2시간 알코올 섭취량이 유의하게 감소하였으며, 이러한 감소효과는 섭취 12일째부터 16일째까지 지속적으로 나타났다(12일째, df=14, t=2.61, p=0.021; 14일째, df=14, t=4.24, p=0.001; 16일째, df=14, t=2.81, p=0.023). GABA 고함유쌀인 BSRGE과 GER을 첨가한 사료를 섭취한 경우 GABA 저함유쌀인 BSR과 Rice를 첨가한 사료를 섭취한 것에 비해 C57BL/6 생쥐의 알코올 섭취량이 억제되었다. 이는 GABA 고함유쌀인 흑찰거대배아미가 알코올 사용 장애 환자의 재발 방지에 시도될 수 있음을 시사하고 있다. Alcohol impacts many central nervous systems, such as dopamine, serotonin, opioids, and gammaaminobutyric acid (GABA), leading to addiction. Many studies have investigated the relationship between GABA and alcoholism. The purpose of this study was to investigate the effects of GABA high and low rice intake on the alcohol intake behavior of mice. Black sticky rice with giant embryo (BSRGE), black sticky rice (BSR), giant embryo rice (GER), and rice (Rice) were germinated for 48 hr in brown rice. The embryos were then collected and used in the study. The diets were fed to respective C57BL/6 mouse groups ad libitum for 16 days and investigated for 2 hr alcohol intake, 22 hr water intake, 24 hr feed intake, and body weight. As a result of the repeated measure of ANOVA for the daily change of alcohol intake for 2 hr daily between the BSRGE and BSR groups, there was a significant difference in the number of days of intake (DF = 7, F = 4.812, p = 0.026). A significant daily decrease in alcohol intake was observed in the BSRGE group compared to the BSR group. This reduction was consistent from Day 10 to Day 16. Alcohol consumption also significantly decreased in the GER group compared to the Rice group. This decrease was observed from Day 12 to Day 16. In conclusion, BSRGE and GER resulted in decreased alcohol intake in C57BL/6 mice compared to BSR and rice. This suggests that BSRGE may prevent relapse in patients with alcohol use disorder.

음주문제를 보이는 여자 대학생들의 기질적인 특성

정재훈(Jae-hoon Chung),김성곤(Sung-Gon Kim),민은정(Eun-Jeong Min),유희정(Hee-Jung Yu),서비아(BiA Seo),나은경(Eun-Kyoung Na),허성영(Sung-Young Huh) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.2

Objectives : It is essential to determine the traits of female college students for early and effective prevention of any psychiatric or psychological disorder. Temperament is regarded as one of the important risk factors resulting in alcohol abuse. We investigated the differences in the scores of Temperament and Character Inventory (TCI) between female college students with and without alcohol abuse based on The Korean version of Alcohol Use Disorders Identification Test (AUDIT-K). Methods : The subjects included 127 female college students in Pusan, Korea. All subjects were assessed via alcohol-related questionnaires, AUDIT-K and TCI. Results : The subjects were divided into 2 groups based on the results obtained : alcohol use disorder group [N=33 (26.0%), score of AUDIT-K≥12] and control group [N=94 (74.0%)]. The mean scores of Harm-Avoidance (HA) behavior were significantly lower (t=-3.045, p=0.003), and Novelty- Seeking (NS) trait was significantly higher (t=1.883, p=0.062) in the group with alcohol use disorder than in the control group. Conclusion : It is likely that female college students with alcohol abuse manifest less HA and an increased level of NS temperament traits. In order to effectively prevent alcohol use disorder in female college students, it is imperative to determine the temperament traits using TCI.

알코올사용장애 환자의 날트렉손, 아캄프로세이트 유지기간과 관련된 사회인구학적, 임상적 요인

홍태경(Tae-Kyung Hong),정우영(Woo-Young Jung),허성영(Sung-Young Huh) 한국중독정신의학회 2018 중독정신의학 Vol.22 No.2

Objectives : The purpose of the present study was to analyze sociodemographic and clinical characteristics related to maintenance duration of naltrexone and acamprosate in patients with alcohol use disorder. Methods : The medical records including sociodemographic and clinical characteristics of 338 inpatients and outpatients with alcohol dependence and alcohol abuse were reviewed retrospectively. All patients were divided into<30 days, 30 to 179 days, and ≧180 days naltrexone or acamprosate medication maintenance groups. Results : In contrast to the <30 days maintenance group, naltrexone was used more commonly than acamprosate in the ≧180 days group (p=0.017). This group had more psychiatric comorbidities (p=0.011), less physical illness (p=0.036), increases cases of admissions to psychiatric wards (p=0.005), and additionally prescribed psychotropic medications (p<0.001) when compared with the <30 days group. Conclusion : Although it is difficult to draw assertive conclusions solely based on the results from this study, it is apparent that extensive psychiatric comorbidities, history of psychiatric ward admissions, and fewer medical diseases characterized the longterm maintenance group in this study. In future, well-controlled, and more extended prospective research is needed to identify factors related to medical treatment and maintenance for alcohol use disorder.