BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease that is a significant source of morbidity and mortality when it manifests in the central nervous system. The early detection and treatment of neuropsychiatric SLE (NPSLE) is very important, but a confirmative diagnostic tool has yet to be developed. CASE REPORT: We report here a case of neuropsychiatric manifestations in a patient that were associated with SLE, and evidence of reversal of bilateral amygdala and parahippocampal lesions in the brain revealed by 18fluorodeoxy glucose-positron emission tomography. CONCLUSIONS: We are suggestive of 18fluorodeoxy glucose-positron emission tomography appear to be more sensitive in detecting subtle brain changes in NPSLE.
Amygdala* ; Autoimmune Diseases ; Brain* ; Central Nervous System ; Humans ; Lupus Erythematosus, Systemic ; Lupus Vasculitis, Central Nervous System* ; Mortality

BACKGROUND AND PURPOSE: The tip-of-the-tongue (TOT) phenomenon refers to knowing the meaning of the desired information but being unable to produce the phonological information. This study induced the TOT phenomenon through a task involving naming famous people, compared and analyzed results by age, and examined the differences with effects from pathological aging [mild cognitive impairment (MCI)]. METHODS: Young (n=10), middle-aged (n=10), older (n=10), oldest (n=10), and MCI (n=10) subjects participated in this study. To examine TOT rate, rate of TOT response, voluntary TOT solution rate, and TOT solution rate after presenting syllabic cue, each group participated in the experiment through a task of naming famous people. RESULTS: First, as subject age increased, TOT rate (the number of TOTs divided by total trials) increased. There was no significant difference with pathological aging. Second, normal aging and pathological aging had no significant effect on the rate of TOT response (the number of each response type divided by total response types). Third, the voluntary TOT solution rate (the number of voluntary TOT solutions divided by total TOTs) on occurrence of the TOT phenomenon was very low. Fourth, the TOT solution rate (the number of TOT solutions after presenting syllabic cue divided by total TOTs) had a negative correlation to normal aging. In examining pathological aging, the TOT solution rate of the MCI group was significantly lower than normal oldest people. CONCLUSION: Normal aging and pathological aging showed differences regarding TOT rate and TOT solution rate when naming famous individuals. The results of this study could be helpful as a differential tool between normal and pathological aging.
Aging* ; Cues ; Mild Cognitive Impairment*

BACKGROUND AND PURPOSE: The one-day rivastigmine patch is reportedly well tolerated and has minimal side effects. However, Asian patients show more side effects than those in Western countries. We evaluated tolerability of the rivastigmine patch in South Korean patients with Alzheimer's disease (AD) and the specific factors affecting adverse events of the skin. METHODS: A 6-month, open labeled, multi-centered, observational study was carried out in 440 patients with probable AD from July 2009 to September 2010 (NCT01312363). RESULTS: A total of 25.9% of the patients experienced adverse skin events at the rivastigmine patch application site and 17.0% discontinued treatment due to adverse events at the skin application site. The most common adverse events were itching and erythema. Patients with an allergic history and users of electric heating appliances reported skin discomfort. Older age was associated with discontinuing treatment. CONCLUSION: These results suggest that the rivastigmine patch induced some adverse skin events and may contribute to understanding and improving skin tolerability to the rivastigmine patch.
Alzheimer Disease* ; Asian Continental Ancestry Group ; Erythema ; Heating ; Hot Temperature ; Humans ; Observational Study ; Pruritus ; Skin* ; Rivastigmine

BACKGROUND AND PURPOSE: Although the 15-item Geriatric Depression Scale (GDS15) is a widely used depression screening questionnaire, the implications of the GDS15 in patients with Alzheimer's disease (AD) are questionable. We designed this study to explore the GDS15 factor structure and the relationships between these factors and cognitive-behavioral aspects. METHODS: The GDS15, cognitive function tests, and the Korean-Neuropsychiatry Inventory were administered to 310 patients with probable AD, who were not medicated before visiting the hospital. Three factors were identified by principal components analysis. A bivariate correlation analysis was conducted to determine the relationships between factors and neurocognitive and behavior symptoms. RESULTS: Factor 2 was correlated with the Korean Boston Naming Test, calculating ability, the go-no-go test, the Controlled Oral Word Association Test (COWAT), the Color Word Stroop Test (CWST; words and color), aggression, depression, and apathy. Factor 3 was correlated with calculating ability, the Seoul Verbal Learning Test, immediate recall, copy, and delayed recall on the Rey-Osterieth Complex Figure Test, contrasting on the COWAT, and words and delusion on the CWST. We identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale. CONCLUSIONS: These results suggest that the GDS15 may be comprised of a heterogeneous scale and suggest multi-dimensional properties of the GDS15 in patients with AD.
Aggression ; Alzheimer Disease* ; Apathy ; Delusions ; Depression* ; Factor Analysis, Statistical ; Humans ; Mass Screening ; Memory, Short-Term ; Seoul ; Stroop Test ; Verbal Learning ; Word Association Tests ; Surveys and Questionnaires

Central nervous system involvement by relapsing polychondritis is rare. Despite the fact that several reports described its cognitive presentations, the detailed neuropsychological characteristics have not been provided. Severe cognitive impairment was noted in our patient with meningoencephalitis due to polychondiritis. With immunosuppressant therapy, his deficits recovered markedly, but not completely in some severely affected cognitive domains from the earlier time. Neuropsychological complications of polychondritis are very responsive to immunosuppressants although it does not seem to be perfect.
Central Nervous System ; Cognition ; Humans ; Immunosuppressive Agents ; Meningoencephalitis ; Neuropsychological Tests ; Polychondritis, Relapsing

Wilson's disease shows considerably various symptoms that sometimes timely diagnosis is delayed when patient shows vague clinical presentation. We present a female patient whose initial symptom was hypersomnia and severe fatigue. She was initially diagnosed as depression. Because initial hepatic function test was unremarkable, it was not easy to come to think about relationship between hepatic function and hypersomnia. Her final diagnosis was Wilson's disease. This case suggested that hypersomnia otherwise unexplained could be the presenting symptom of Wilson's disease.
Depression ; Disorders of Excessive Somnolence ; Fatigue ; Female ; Hepatolenticular Degeneration ; Humans

BACKGROUND: Disability of Activities of daily living (ADL) is the most important factor for care of dementia patients. So Korean Dementia Association has prepared the survey for current state and cognition of active daily living in Korean dementia patients. METHODS: A total of 100 subjects were interviewed. Structured open and closed questions about ADL for dementia were asked. They are main caregivers of dementia patients who working over 5hours per day. Assessments included age, sex, education level, economic status, severity of dementia patients, pattern of the care-giving, current state and cognition of ADL, and needs of the caregivers. RESULTS: The cognition of ADL was very low (51%) and this is correlated with economic status. Increasing of care-giving time is the most stressful for caregivers, they frequently suffered from disability of outgoing and personal hygiene. Dementia patient's ADL disability causes serious economic losses, need of the caregivers about guide lines or education program was very high. CONCLUSION: Considering these results, we should design more detailed study about dementia patient's ADL disability and prepare guide line or program for it.
Activities of Daily Living ; Caregivers ; Cognition ; Dementia ; Humans ; Hygiene

BACKGROUND: The concept of Mild Cognitive Impairment (MCI) refers to a transitional period between normal aging and clinically demented state such as Alzheimer's disease. Detection of individuals with MCI is critical for prognosis of the disease progression and treatment of patients at risk. The current study manipulated linguistic complexity in naming nouns and verbs to examine whether the linguistically different entities contribute to differentiating individuals with MCI from normal elderly adults. Specific aims of the study are 1) to investigate the noun-verb dissociation in naming between the MCI and normal control groups and 2) to examine the differential effects between the groups depending on the linguistic subtypes of nouns (animate vs. inanimate) and verbs (the argument structure). METHODS: Twenty normal elderly individuals and 19 individuals with MCI participated in this study. A confrontation naming task was employed. Nouns were divided into the two subtypes (animate vs. inanimate), and verbs were classified into the three subtypes depending on the number of argument (1-place, 2-place, and 3-place). RESULTS: Results revealed that there were significant differences between the groups, indicating that individuals with MCI showed worse performance on naming in general than the control group. Furthermore, the MCI group presented differentially impaired performance on verbs than nouns compared to the control group. CONCLUSIONS: The results from the current study suggested that performance on a verb confrontation naming task could serve as a sensitive index to differentiate the MCI group from normal aging group.
Adult ; Aged ; Aging ; Alzheimer Disease ; Disease Progression ; Dissociative Disorders ; Humans ; Linguistics ; Mild Cognitive Impairment ; Prognosis

BACKGROUND: To elucidate the earliest changes of language function in patients with dementia of Alzheimer's type (DAT), performance on the various semantic language tasks were compared between patients with amnestic mild cognitive impairment (aMCI) (n=20), mild DAT (n=20) and normal cognition elderly individuals (NC, n=20). METHODS: Language tasks included levels of word, sentence and discourse. In the word level, confrontation naming test (Korean version-Boston Naming Test, K-BNT) and the verbal fluency (semantic and phonemic fluency) tasks were used. In the sentence level, the verbal definition tasks including 24 nouns four categories were used. In the discourse level, the Boston Cookie-Theft picture description task was used. The picture description task was analyzed for both productive aspect (total number of sentences, total number of phrases and phrases per sentence) and semantic aspect (ratio of CIU: Correct Information Unit). RESULTS: The results from this study are as follow: 1) In the confrontation naming test, mild DAT group showing worse performances than the NC and aMCI group. However, no differences were observed between the NC and aMCI group. 2) The performances of verbal fluency task showed significantly differences between the all groups. 3) In the verbal definition task, performances of NC group showing better performances than aMCI and mild DAT group. However, no differences were observed between the aMCI and mild DAT group. 4) In the picture description task, performances of the aMCI and mild DAT group were non-informative and inefficient in semantic aspect compared to the NC group. However, no differences were observed between the three groups on productive aspect. CONCLUSIONS: These results demonstrated that the deficit of semantic language is readily identified in the aMCI stage, and it can be revealed by tasks of sentence and discourse level.
Aged ; Boston ; Cognition ; Dementia ; Humans ; Mild Cognitive Impairment ; Semantics

Transient memory impairment can be occurred by many causes. One of them is acute focal brain lesion in strategic site. Caudate nucleus and medial basal ganglia (globus pallidus) are lesion of strategic site. They play its role in cognitive processing. But lateral basal ganglia (putamen) is known as a structure involving movement, not cognitive function. We report a interesting case of transient memory dysfunction with acute focal putamen ICH with old caudate nucleus infarction.
Basal Ganglia ; Brain ; Caudate Nucleus ; Infarction ; Intracranial Hemorrhages ; Memory ; Putamen