OBJECTIVE: This study was conducted to develop the computerized attention tests for Korean adults. It also aimed at evaluating the reliability and validity of these tests and providing their normative data. METHODS: Computerized versions of auditory & visual continuous performance tests (CPTs), controlled CPTs, and trail making test A & B were developed through several steps of preliminary applications and corrections. The test-retest reliabilities of each test was evaluated by the paired t-test and Pearson's correlation coefficient using the data from 27 normal persons. The validity of each test was evaluated by the Pearsons's correlation coefficient between the computerized test scores and the preexisting cognitive function tests using the data from 48 normal persons. The normative data were obtained from the 154 Korean adults, aged 20 to 50, whose educational levels were higher than high school graduate. RESULTS: There were no statistical differences between the means of the test and retest scores. High correlations were also observed between the tests and retest scores. The number of correct responses of the computerized CPTs were highly correlated with each other. They were also highly correlated with the scores of the pre-existing attentional measures. Trail making test scores were highly correlated with higher cortical functions such as IQ and hypothesis formation abilities. The CPTs scores were not affected by sex, educational level, and age. The performances for the visual CPTs were higher than those of auditory tests. Trial making test scores were influenced by educational level and age. The normative data and guidelines for interpretation were provided. CONCLUSION: Clinically applicable computerzied attention assessement tools with high reliability and validity were developed. The normative data for the Korean adults aged 20 to 50 were obtained and the guidelines for the interpretation were provided.
Adult* ; Humans ; Reproducibility of Results ; Trail Making Test

OBJECTIVES: The aim of this study is to investigate correlation between the location of white matter hyperintensities (WMH) and neurocognitive dysfunction in non-demented Korean vascular depression patients. METHODS: A total of 148 subjects diagnosed with first major depressive episode after the age of 60 were included in this study. Subjects were divided into the vascular depression group (n=83) and the non-vascular depression group (n=65) according to the degree of WMH. The degree and location of WMH on T2-weighted images were measured using the Scheltens scale. In addition, several clinical features, including cognitive functions and depression severities, were evaluated. Correlation analysis was performed for examination of the relationships between the location of WMH and neuropsychological functions. RESULTS: Capsular frontal periventricular hyperintensities showed correlation with poorer performance of the word list memory test, constructional recall test, and trail making test A and B. Lateral ventricular hyperintensities showed correlation with poorer performance of verbal fluency test, word list recognition test, and trail making test B. Deep WMH, especially parietal and occipital lesions, showed an association with poorer performance on trail making test B. In addition, deep WMH, but not periventricular WMH, showed an association with Hamilton Depression Scale score. CONCLUSION: Our results suggest that subjects with vascular depression showed significantly poorer performance on neurocognitive tests than those with non-vascular depression. In addition, WMH, depending on their locations, showed different correlations according to details of cognitive dysfunction and severity of depressive symptoms.
Depression ; Humans ; Memory ; Trail Making Test

OBJECTIVE: The purpose of this study was to compare cognitive flexibility abilities, stress, and anxiety between starters and non-starter athletes. METHODS: A total of 30 male professional-soccer and 40 professional-baseball athletes were recruited. Wisconsin Card Sorting Test (WCST) and Trail Making Test A & B (TMT A & B) were administered to assess cognitive flexibility during competition. The Korean version of the STAI form Y (STAI-KY) and Visual analogue scale for anxiety and stress were used to assess the anxiety and stress. RESULTS: The starter group had better cognitive function (fewer perseverative errors and rapid TMTB times) (Z=3.32, p<0.01; Z=2.20, p=0.03, respectively) and lower stress and anxiety (F=4.34, p=0.01; F=6.61, p<0.01, respectively) during competition than the non-starter group. CONCLUSION: The better cognitive performances were negatively correlated with stress and anxiety. Current results suggested that cognitive flexibility would enhance human performance by modulation of the anxiety and stress during competition.
Anxiety ; Athletes ; Humans ; Male ; Pliability ; Trail Making Test ; Wisconsin

OBJECTIVE: To determine the relationship between cognitive-perceptual function and functional independence in stroke patients. METHOD: Thirty-three patients (16 male, 17 female) with first ever ischemic stroke were enrolled. Their mean age was 60.4 years and the mean post-onset duration was 8.1 months. Subjects underwent detailed cognitive assessment including digit span test, line bisection test, Albert test, Wechsler nonverbal memory scale, Korean Hopkins verbal learning Test, Rey complex figure test, and trail making test A. Their functional outcomes were assessed using Functional Independence Measure (FIM) and Modified Barthel Index (MBI). RESULTS: Among the cognitive subtests, Wechsler nonverbal memory scale, Albert test, and Rey complex figure test scores had significant correlation with both FIM and MBI scores. Patients with right hemispheric stroke showed significantly lower scores in line bisection test and Rey complex figure test than those with left hemispheric stroke patients. CONCLUSION: Visuospatial perception and nonverbal memory functions seemed to be two most important cognitive- perceptual domains for functional recovery of stroke patients.
Humans ; Male ; Memory ; Stroke* ; Trail Making Test ; Verbal Learning

OBJECTIVE: We hypothesize that the effect of aging on memory is mediated by executive function. METHODS: Two hundred and thirty healthy adults (101 male, 129 female) were recruited for the study. We used a promising, newly developed, computerized neuropsychological test for the measurement of executive function and memory. The data were analyzed using structural equation modeling and path analysis. RESULTS: The full mediation model showed a good fit to the data. However, chi-squared (chi2) tests for model comparison indicated that the partial mediation model better fits our data. Thus, the partial mediation model was used as the final model. In terms of auditory-verbal memory, the effect of aging on memory was fully mediated by executive function. However, visuo-spatial memory was significantly affected both indirectly (through executive function) and directly (by aging). Gender differences were not significant in this model. CONCLUSION: This study demonstrated the importance of executive function in the memory functioning of normal aging adults. It is noteworthy that modality differences were found between auditory-verbal and visuo-spatial memory. Aging is not the only factor that drives memory decline, and its direct, adverse effect on memory was more prominent in the visuo-spatial memory task than auditory-verbal memory task. Since performance in both modalities is fully or partially mediated by executive function, it is important to train normal aging adults in executive control skills, such as planning, strategy formation, and rapid decision making.
Adult ; Aging ; Decision Making ; Executive Function ; Humans ; Male ; Memory ; Negotiating ; Neuropsychological Tests ; Trail Making Test

OBJECTIVE: To develop an evaluation tool of cognitive perceptual function for safe driving of the brain injured patients and to check the suitability of the tool. METHOD: Cognitive Perceptual Assessment for Driving (CPAD) was constructed with 8 tasks of depth perception, sustained attention, divided attention, Stroop test, digit span test, field dependence, trail making test A, and trail making test B. The predriving assessment with CPAD and road test were applied to 101 brain injured patients. The reliability and the validity of CPAD, and the cut-off score to resume driving were determined. RESULTS: The CPAD scores of pass group (n=46) and fail group (n=55) for on-road test were 51.67+/-5.53 and 44.30+/-8.44 respectively (p=0.0001). The internal consistency of the CPAD measured by Cronbach's alpha was 0.85. The cut-off score based on 95% confidence interval was 53 or above for pass group, 42 or below for fail group, 43~52 for borderline group. The positive and negative predictive value was 90.7% and 50.3%, respectively. CONCLUSION: The CPAD could be useful for the evaluation of driving ability of persons with brain injury.
Brain Injuries* ; Brain* ; Cognition ; Depth Perception ; Humans ; Stroop Test ; Trail Making Test

OBJECTIVES : The primary purpose of this study was to investigate the effects of computerized cognitive rehabilitation training on inpatients with schizophrenia in the rehabilitation unit. METHODS : Thirty-eight patients with schizophrenia from the Yongin Mental Hospital Rehabilitation Ward were randomly assigned either to a computerized cognitive rehabilitation group or to a control group. The rehabilitation group received 12 sessions of computerized cognitive rehabilitation training (Cog-Trainer) over 3 months. This training program consisted of ten units, each of which consisted of 3 levels, practice, application, and advanced. Neurocognitive functions were assessed at the beginning and end of the training period. Cognitive measures included Span of Apprehension (SPAN), Continuous Performance Test (CPT), Digit Span, Trail Making Test, and the Stroop Test. RESULTS : Compared to controls, subjects receiving computerized cognitive rehabilitation training experienced a significant improvement in attention, concentration, and working memory. CONCLUSION : These results indicate that computerized cognitive rehabilitation training can contribute to improvement in cognitive function of patients with schizophrenia. Further study to generalize these results is required.
Hospitals, Psychiatric ; Humans ; Inpatients ; Memory, Short-Term ; Pilot Projects ; Schizophrenia ; Trail Making Test

BACKGROUND AND PURPOSE: This study compared the cognitive effects of 1 year of treatment with lamotrigine (LTG) and oxcarbazepine (OXC) in epilepsy patients. METHODS: This retrospective study investigated 60 epilepsy patients undergoing neuropsychological tests who were either newly diagnosed or untreated in the preceding 6 months. The cognitive function in 30 patients receiving LTG monotherapy and 30 age-matched patients receiving OXC monotherapy was compared after 1 year. The neuropsychological scores at baseline and all of the epilepsy-relevant variables except seizure type did not differ between the groups. The mean daily dosages of LTG and OXC at 1 year were 93 mg and 825 mg, respectively. RESULTS: The posttreatment list-learning performance was better in the LTG group than in the OXC group (p<0.05). The incidence of cognitive complaints did not differ between the two groups. The list-learning performance and Trail Making Test scores were better in each group after treatment. CONCLUSIONS: LTG and OXC monotherapies have similar, slightly beneficial effects on cognitive function, and are probably not harmful.
Cognition ; Epilepsy* ; Humans ; Incidence ; Neuropsychological Tests ; Retrospective Studies ; Seizures ; Trail Making Test

OBJECTIVE: This study was performed to evaluate the effect of estrogen on cognitive functions in schizophrenic patients. METHODS: Neuropsychological tests such as Paired Associate Learning Test, Complex Figure Test, Trail Making B Test, Performance IQ Test Subscales were applied to 15 normal controls, 16 estrogen treated schizophrenic patients and 15 control schizophrenic patients. The schizophrenic patients were retested with the same instruments after 4 weeks and 8 weeks of study period and psychopathology was assessed in the same patients before and at 2 weeks, 4 weeks, 6 weeks and 8 weeks of study using BPRS and PANSS. RESULTS: Cognitive impairment was found in each measure of memory, attention, executive function in schizophrenic patients as compared with the normal controls. After 8 weeks of estrogen treatment, significant improvement occurred in executive function and probable improvement occurred in memory and attention in schizophrenic patients. CONCLUSION: Short-term treatment with estrogen may possibly improve parts cognitive functions of schizophrenic patients and we expect, schizophrenic patients with long term estrogen treatment will be improved in other cognitive fuctions.
Estrogens* ; Executive Function ; Humans ; Memory ; Neuropsychological Tests ; Paired-Associate Learning ; Psychopathology ; Schizophrenia ; Trail Making Test

OBJECTIVES: To investigate the relationship of neurochemical changes of brain in SCHE patients and the level of cognitive function, the authors measured hydrogen containing neurochemicals in two brain regions using 1H MRS, and compared those changes with the level of cognitive performances such as attention, visual analysis, or fine motor function. METHODS: A total of patients with liver cirrohosis were defined as SCHE, for they performed poorly(out of 1 SD of normative data) in more than one neuropsychological tests conventionally used(digit symbol and block design tests in KWIS, trail making test A and B). They were further evaluated in attentional ability and efficacy of visual analysis using Cognitrone subtest in Vienna Neurocognitive Test battery. Fine motor coordination were also measured by Grooved Pegboard test. Patients and 20 normal controls underwent proton MRS study. Proton containing neurochemicals, such as myoinositol(mI), N-acetyl-L-aspartate(NAA), creatine(Cr), choline(Cho) were measured from 2*2*2cm3 voxel of basal ganglia and parietal white matter using 1.5 tesla clinical MRI/MRS system. The ratios of above metabolites to Cr were analyzed. RESULTS: 1) Patients with SCHE showed reductions in Cho/Cr and mI/Cr in both basal ganglia and parietal white matter compared to normal subjects. 2) Performance of Grooved Pegboard test were negatively correlated with mI level of basal ganglia and with Cho level of parietal white matter(r=-0.59, p<.05). 3) Mean time of correct responses in Cognitrone test showed negative correlation with NAA level of parietal white matter(r=-0.55, p<.05). CONCLUSION: Certain neurocognitive disturbances in SCHE patients seemed to be related with neurochemical changes in basal ganglia or parietal white matter. To further elucidate the relationship of focal biochemical changes and neurocognitive deficits in SCHE patients, however, follow-up study according to the illness stage must be performed. Studies on other disorders showing similar cognitive deficit patterns would be helpful.
Basal Ganglia ; Brain ; Hepatic Encephalopathy* ; Humans ; Hydrogen ; Liver ; Neuropsychological Tests ; Protons* ; Rabeprazole ; Trail Making Test