Mild cognitive impairment (MCI) is an intermediate cognitive state between normal aging and dementia. It has disparate features in activities of daily life which is interfered notably in dementia. Recently, there have been consistent reports of MCI which is predementia, however significant controversy exist. In this review, we make out the diagnostic criteria, classification, risk factor, prevalence, diagnostic test including neuroimaging and biomarkers, management, and prognosis of MCI. This review will cover current knowledge and future directions on MCI.
Aging ; Biomarkers ; Classification ; Dementia ; Diagnostic Tests, Routine ; Mild Cognitive Impairment* ; Neuroimaging ; Prevalence ; Prognosis ; Risk Factors

BACKGROUND AND PURPOSE: Repetitive transcranial magnetic stimulation (rTMS) has been examined as a potential treatment for many neurological disorders. High-frequency rTMS in particular improves cognitive functions such as verbal fluency and memory. This study explored the effect of rTMS combined with cognitive training (rTMS-COG) on patients with Alzheimer's disease (AD). METHODS: A prospective, randomized, double-blind, placebo-controlled study was performed with 27 AD patients (18 and 8 in the treatment and sham groups, respectively, and 1 drop-out). The participants were categorized into mild [Mini-Mental State Examination (MMSE) score=21-26] and moderate (MMSE score=18-20) AD groups. The rTMS protocols were configured for six cortical areas (both dorsolateral prefrontal and parietal somatosensory associated cortices and Broca's and Wernicke's areas; 10 Hz, 90-110% intensity, and 5 days/week for 6 weeks). Neuropsychological assessments were performed using the AD Assessment Scale-cognitive subscale (ADAS-cog), Clinical Global Impression of Change (CGIC), and MMSE before, immediately after, and 6 weeks after the end of rTMS-COG treatment. RESULTS: Data from 26 AD patients were analyzed in this study. There was no significant interactive effect of time between the groups. The ADAS-cog score in the treatment group was significantly improved compared to the sham group (4.28 and 5.39 in the treatment group vs. 1.75 and 2.88 in the sham group at immediately and 6 weeks after treatment, respectively). The MMSE and CGIC scores were also improved in the treatment group. Based on subgroup analysis, the effect of rTMS-COG was superior for the mild group compared to the total patients, especially in the domains of memory and language. CONCLUSIONS: The present results suggest that rTMS-COG represents a useful adjuvant therapy with cholinesterase inhibitors, particularly during the mild stage of AD. The effect of rTMS-COG was remarkable in the memory and language domains, which are severely affected by AD.
Alzheimer Disease* ; Cholinesterase Inhibitors ; Cognitive Therapy ; Humans ; Memory ; Nervous System Diseases ; Prospective Studies* ; Rabeprazole ; Transcranial Magnetic Stimulation*

Hemichorea after cortical infarction has rarely been reported. We report a female patient in which hemichorea of the right extremities developed following a left temporo-parietal infarction. An acute infarction in the territory of the inferior division of the left middle cerebral artery was evident in diffusion-weighted imaging, but the basal ganglia, thalamus, and brainstem appeared normal. Her choreic movement gradually improved after administering haloperidol, and the hemichorea disappeared after 4 days.
Basal Ganglia ; Brain Stem ; Chorea ; Extremities ; Female ; Haloperidol ; Humans ; Infarction* ; Middle Cerebral Artery ; Thalamus

Sleep disorders are common, occurring in both healthy elderly people and in association with neurodegenerative diseases, sometimes preceding other clinical manifestations of those diseases. The sleep disorders of neurodegenerative diseases include insomnia, hypersomnia, parasomnia, excessive nocturnal motor activity, circadian sleep-wake rhythm disturbances, and sleep breathing disorders. This review addresses the neuroanatomical basis of sleep, the associated regulatory mechanisms and neurotransmitters, and the relationship between cognitive function and sleep. Furthermore, the clinical features of sleep disorders in a wide variety of neurodegenerative diseases are reviewed, including movement disorders and dementia.
Aged ; Dementia* ; Disorders of Excessive Somnolence ; Humans ; Motor Activity ; Movement Disorders* ; Neurodegenerative Diseases ; Neurotransmitter Agents ; Parasomnias ; Respiration ; Sleep Wake Disorders* ; Sleep Initiation and Maintenance Disorders

Methotrexate (MTX)-induced leukoencephalopathy is the most often reported leukoencephalopathy following intrathecal or intravenous administration. A 72-year-old woman developed leukoencephalopathy localized to the cerebellum after treatment with oral MTX at a dose of 15 mg/week for 3 years. She complained of subtle imbalance during walking and reported having fallen. Her symptoms improved after discontinuation of MTX, and the leukoencephalopathy resolved. This is therefore a case report of selective cerebellar reversible leukoencephalopathy associated with oral MTX.
Administration, Intravenous ; Aged ; Cerebellum ; Female ; Humans ; Leukoencephalopathies* ; Methotrexate* ; Walking

Cerebral microbleeds (CMBs) are increasingly recognized neuroimaging findings, occurring with cerebrovascular disease, dementia, and aging. CMBs are associated with subsequent hemorrhagic and ischemic stroke, and also with an increased risk of cognitive deterioration and dementia. They occur in the setting of impaired small vessel integrity due to hypertension or cerebral amyloid angiopathy. This review summarizes the concepts, cause or risk factors, histopathological mechanisms, and clinical consequences of CMBs.
Aging ; Cerebral Amyloid Angiopathy ; Cerebrovascular Disorders ; Dementia ; Hypertension ; Neuroimaging ; Risk Factors ; Stroke

BACKGROUND: Although orthostatic hypotension (OH) and cognitive impairment (CI) are common non-motor symptoms of Parkinson's disease (PD), the relationship between OH and CI remains to be clarified. This study was aimed to investigate the relationship between OH and CI in PD. METHODS: We recruited 192 patients who were diagnosed as PD based on the UK Brain Bank diagnostic criteria. The Hoehn & Yahr stages were ranged I to III and patients underwent extensive clinical evaluation, including brain magnetic resonance imaging (MRI) for cerebral white matter hyperintensity (WMH), tilt table test, the Korean version of Montreal Cognitive Assessments and the Korean version of Mini-Mental Status Examination in one month from the first clinic visit. The participants were divided into two groups according to the presence of OH (OH+ vs. OH−) and cognitive function (cognitive normal, CN vs. CI), respectively. RESULTS: Significant relationship between OH and cognitive function (p=0.04) was found in our patients. The patients with OH+ had higher risk of CI by 2.6 times than that of OH+ patients. Maximum heart rate change during tilt table test was correlated with cognitive function and white matter changes, whereas blood pressure change during tilt table test showed no correlation with those parameters. CONCLUSIONS: There was significant relationship between OH and CI in PD. Therefore, PD patients with either symptom may need periodic evaluation and proper management for OH and cognitive functions.
Ambulatory Care ; Autonomic Nervous System ; Blood Pressure ; Brain ; Cognition Disorders ; Cognition ; Heart Rate ; Humans ; Hypotension, Orthostatic ; Magnetic Resonance Imaging ; Parkinson Disease ; Tilt-Table Test ; White Matter

BACKGROUND: The increasing number of dementia patients is increasing the importance of identifying them and also those at a high risk of dementia. The early diagnosis and management of dementia can slow the progression of the disease and reduce the socioeconomic burden. For these purposes, the Local Dementia Centers established in all regions of Korea are working on the early detection of dementia using neuropsychological batteries. This study investigated the utility of the Seoul Neuropsychological Screening Battery-Core (SNSB-C) in a dementia management project performed in the local community. METHODS: This study was conducted in two parts. The first part used data from the Local Dementia Centers to investigate the accuracy of detecting cognitive impairment in SNSB-C compared with the Seoul Neuropsychological Screening Battery-Second Edition (SNSB-II). The second part of this study which data from hospital examined the accuracy of diagnosing dementia using SNSB-C. RESULTS: Data were collected from 508 participants at the Local Dementia Centers in Daejeon and 50 participants at a hospital. SNSB-C had a high sensitivity and specificity for detecting cognitive impairment, and also a high sensitivity, high specificity, and positive predictive value for diagnosing dementia. CONCLUSIONS: The sensitivity in diagnosing dementia was as high for SNSB-C as for SNSB-II while taking less time. SNSB-C could therefore be a good diagnostic evaluation tool for use in local dementia centers.
Cognition Disorders ; Dementia ; Diagnosis ; Early Diagnosis ; Humans ; Korea ; Mass Screening ; Neuropsychological Tests ; Sensitivity and Specificity ; Seoul