PURPOSE: The purpose of this study was to know psychological characteristics of psychogenic non-epileptic seizure (PNES) patients by analyzing profiles of Minnesota Multiphasic Personality Inventory (MMPI). In addition, we tried to investigate whether there are differences of MMPI profiles, depending on the gender and age.METHODS: We included 65 patients with non-epileptic psychogenic seizures. Their diagnosis was based on clinical features, provocative test and confirmed by video-EEG monitoring.RESULTS: The results of MMPI analysis did not show any statistically significant differences of quantitative scoring on the main clinical scales. However, additional analysis indicated that patients with PNES had some characteristics of more somatic complaints and depressive mood. According to sex difference, the MMPI profiles of female group showed an increase in the depression scale (D-Pt), whereas those of male group revealed an increased in the somatisation (Hs-Hy). According to age difference, MMPI profiles of adolescent group had the characteristics of personality pattern with a tendency toward somatisation. MMPI profiles of adult group had more depressive tendency. This study suggests that profiles of MMPI, according to the gender and age, can have different characteristics.CONCLUSIONS: Clinical consideration of those factors may be helpful for improving the care of PNES patients.
Adolescent ; Adult ; Depression ; Epilepsy ; Female ; Humans ; Male ; MMPI ; Seizures ; Sex Characteristics ; Weights and Measures

BACKGROUND AND PURPOSE: The occurrence of PWD in neurodegenerative disease is very rare, and this is the first report of it being related to early-onset AD. We describe a patient with early-onset Alzheimer's disease (AD) who presented with pure word deafness (PWD). CASE REPORT: The patient had experienced PWD for 2 years, followed by other cognitive deficits suggestive of parietotemporal dysfunction. Brain imaging including 18FDG-PET and [11C] PIB-PET supported the diagnosis of AD. CONCLUSIONS: Our case highlights the clinical variability that characterizes early-onset AD.
Alzheimer Disease ; Aphasia, Primary Progressive ; Deafness ; Humans ; Neurodegenerative Diseases ; Neuroimaging

Objectives: To investigate the relationship between subjective sleep quality and cognitive function in patients with subjective memory impairment (SMI), a self-perceived cognitive decline without objective cognitive impairment, and amnestic mild cognitive impairment (aMCI). Methods: We enrolled 246 patients with memory impairment (126 with SMI and 120 with aMCI) who fulfilled the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K), a standardized battery of neuropsychological tests, and mood questionnaires. Based on the PSQI-K cutoff point of 5, patients were classified as good sleepers (GS) or poor sleepers (PS). Results: There was no difference in the proportion of GS and PS between patients with SMI and aMCI [68 PS (54.0%) in SMI vs. 62 PS (51.7%) in aMCI, p>0.05]. Demographics did not differ between the SMI and aMCI groups. In both the SMI and aMCI groups, PS had worse sleep-wake parameters, such as sleep latency, total sleep time, and sleep efficiency, than GS and reported worse performance in all PSQI-K subcomponents. Neuropsychological data were not different between GS and PS, except for the Stroop word test in patients with aMCI. Depressive scores were worse in PS than in GS in both the SMI and aMCI groups. Conclusions We observed that cognitive function was not significantly different between GS and PS in both the SMI and aMCI groups, except in the Stroop word test in the aMCI group, while PS had more depressive mood than GS in both groups. This suggests that subjective sleep quality may depend on mood disturbances in patients with mild cognitive impairment.

Objectives: To investigate the relationship between subjective sleep quality and cognitive function in patients with subjective memory impairment (SMI), a self-perceived cognitive decline without objective cognitive impairment, and amnestic mild cognitive impairment (aMCI). Methods: We enrolled 246 patients with memory impairment (126 with SMI and 120 with aMCI) who fulfilled the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K), a standardized battery of neuropsychological tests, and mood questionnaires. Based on the PSQI-K cutoff point of 5, patients were classified as good sleepers (GS) or poor sleepers (PS). Results: There was no difference in the proportion of GS and PS between patients with SMI and aMCI [68 PS (54.0%) in SMI vs. 62 PS (51.7%) in aMCI, p>0.05]. Demographics did not differ between the SMI and aMCI groups. In both the SMI and aMCI groups, PS had worse sleep-wake parameters, such as sleep latency, total sleep time, and sleep efficiency, than GS and reported worse performance in all PSQI-K subcomponents. Neuropsychological data were not different between GS and PS, except for the Stroop word test in patients with aMCI. Depressive scores were worse in PS than in GS in both the SMI and aMCI groups. Conclusions We observed that cognitive function was not significantly different between GS and PS in both the SMI and aMCI groups, except in the Stroop word test in the aMCI group, while PS had more depressive mood than GS in both groups. This suggests that subjective sleep quality may depend on mood disturbances in patients with mild cognitive impairment.

The Seoul Neuropsychological Screening Battery (SNSB) is one of the standardized neuropsychological test batteries widely used in Korea. However, it may be a bit too lengthy for patients with decreased attention span; and it does not provide the score of global cognitive function (GCF), which is useful for monitoring patients longitudinally. We sought to validate a dementia version of SNSB (SNSB-D) that was shorter than the original SNSB and contained only scorable tests with a GCF score of 300. We administered SNSB-D to patients with mild cognitive impairment (MCI) (n=43) and Alzheimer's disease (AD) (n=93), and normal controls (NC) (n=77). MCI and AD groups had GCF scores significantly different from NC group, and GCF scores were able to distinguish patients with Clinical Dementia Rating of 0.5 and 1. Test-retest reliability was high, with a correlation coefficient of 0.918 for AD, 0.999 for MCI, and 0.960 for NC. The GCF score significantly correlated with the Mini-Mental State Examination (MMSE). Through ROC-curve analysis, GCF scores were found to yield more accurate diagnoses than the MMSE. The SNSB-D is a valid, reliable tool for assessing the overall cognitive function, and can be used to monitor cognitive changes in patients with dementia.
Alzheimer Disease/diagnosis/physiopathology ; Cognition Disorders/*diagnosis/etiology/physiopathology ; Dementia/complications/*diagnosis/physiopathology ; Humans ; Korea ; *Neuropsychological Tests/standards ; ROC Curve ; Reproducibility of Results ; Severity of Illness Index

Gerstmann's syndrome, assigned to a lesion of the dominant parietal lobe, is a neurological disorder characterized by acalculia, agraphia, right-left disorientation and finger agnosia. Some studies report that these symptoms are also shown in other brain lesions. We report two patients who presented with this tetrad of symptoms in initial assessment. Their Brain MRI images both showed lesion of left frontal lobe. Over time, these symptoms became better but some still remained in last assessment. Accordingly, we suggest that a left frontal lesion cause Gerstmann's syndrome.
Agnosia ; Agraphia ; Brain ; Dyscalculia ; Frontal Lobe* ; Gerstmann Syndrome* ; Humans ; Magnetic Resonance Imaging ; Nervous System Diseases ; Parietal Lobe

It is not uncommon for idiopathic parkinson's disease (IPD) to occur concurrently with other degenerative dementing disorders such as Alzheimer's disease. However, there has been no report about the comorbidity of IPD and frontotemporal lobar degeneration. We report a 70-year-old man diagnosed with IPD accompanied by progressive non-fluent aphasia (PA). Brain MRI showed left frontal opercular atrophy, and an 18F-FDG PET scan revealed predominant left frontotemporal hypometabolism. It remains unknown whether or not the co-occurrence of IPD and PA was coincidental.
Aged ; Alzheimer Disease ; Aphasia ; Atrophy ; Brain ; Comorbidity ; Dementia ; Fluorodeoxyglucose F18 ; Frontotemporal Lobar Degeneration ; Humans ; Magnetic Resonance Imaging ; Parkinson Disease* ; Positron-Emission Tomography ; Primary Progressive Nonfluent Aphasia*

Korean written language is composed of ideogram (Hanja) and phonogram (Hangul), as Japanese consists of Kanji (ideogram) and Kana (phonogram). Dissociation between ideogram and phonogram impairment after brain injury has been reported in Japanese, but few in Korean. We report a 64-yr-old right-handed man who showed alexia with agraphia in Hanja but preserved Hangul reading and writing after a left posterior inferior temporal lobe infarction. Interestingly, the patient was an expert in Hanja; he had been a Hanja calligrapher over 40 yr. However, when presented with 65 basic Chinese letters that are taught in elementary school, his responses were slow both in reading (6.3 sec/letter) and writing (8.8 sec/letter). The rate of correct response was 81.5% (53 out of 65 letters) both in reading and writing. The patient's performances were beyond mean-2SD of those of six age-, sex-, and education-matched controls who correctly read 64.7 out of 65 and wrote 62.5 out of 65 letters with a much shorter reaction time (1.3 sec/letter for reading and 4.0 sec/letter for writing). These findings support the notion that ideogram and phonogram can be mediated in different brain regions and Hanja alexia with agraphia in Korean patients can be associated with a left posterior inferior temporal lesion.
Cerebral Infarction/*complications/radiography ; Dyslexia/*etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Task Performance and Analysis ; Temporal Lobe/*injuries/radiography ; *Writing

BACKGROUND AND PURPOSE: The closing-in phenomenon is the tendency to draw near or on the target when copying figures, which has been found mostly in patients with Alzheimer's disease (AD). We attempted to quantify the degree of closing-in and to compare it between patients with AD and vascular dementia (VaD). METHODS: The subjects (55 AD, 39 VaD and 38 normal controls) were asked to copy the figure of alternating square and triangle, starting at the designated point and continuing from left to right. The patients with AD and VaD did not differ in age, education, severity of dementia or Rey Complex Figure Test copy score. The proximity (Y-axis) of the subject's drawing to the target was plotted at intervals of 2 mm along the X-axis and the degree of closing-in was computed from the slope of the regression line. RESULTS: The AD and VaD patients showed a steeper slope than the controls. There was no significant difference, however, in the magnitude of closing-in of the AD and VaD patients. When closing-in was defined as a slope that was greater than the mean+2SD of the slope observed for the controls, 32.7% of the AD and 25.6% of the VaD patients showed closing-in. CONCLUSIONS: Our study, using a new method of measuring the degree of closing-in, suggests that this phenomenon is not specific to AD.
Alzheimer Disease* ; Dementia ; Dementia, Vascular* ; Education ; Humans

BACKGROUND AND PURPOSE: Evaluating instrumental activities of daily living (IADL) is an important part of procedure to diagnose dementia. The Korean-Instrumental Activities of Daily Living (K-IADL) has been used extensively in Korea. However, its cut-off score has not been reformulated since 2002. The purpose of this study was to yield a new optimal cut-off score for the K-IADL and confirm the validity of this new cut-off score with various dementia groups. METHODS: We retrospectively collected a total of 2,347 patients' K-IADL data from 6 general hospitals in Korea. These patients had mild cognitive impairment (MCI) or dementia with various etiologies for cognitive impairment. We also recruited a normal control group (n=254) from the community. Korean-Mini Mental State Examination, Short version of the Geriatric Depression Scale, Clinical Dementia Rating, and Global Deterioration Scale were administered to all participants. Caregivers completed K-IADL and Barthel Index. RESULTS: K-IADL scores were significantly different among dementia subgroups, but not significantly different among MCI subgroups. Based on internal consistency, correlations with other scales, and factor analysis, K-IADL showed excellent reliability and validity. The new optimal cut-off score to diagnose dementia was 0.40, which gave a sensitivity of 0.901 and a specificity of 0.916. Positive predictive value for dementia using the new cut-off score was 94.2% for Alzheimer's disease, 100% for vascular dementia, and 84% for Parkinson's disease. CONCLUSIONS: Our results illustrate that the new K-IADL cut-off score of 0.40 is reliable and valid for screening impairments of daily functioning resulting from various etiologies.
Activities of Daily Living* ; Alzheimer Disease ; Caregivers ; Cognition Disorders ; Dementia ; Dementia, Vascular ; Depression ; Hospitals, General ; Humans ; Korea ; Mass Screening ; Mild Cognitive Impairment ; Parkinson Disease ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Weights and Measures