2.Home-Visiting Cognitive Intervention for the Community-Dwelling Elderly Living Alone
Dementia and Neurocognitive Disorders 2020;19(2):65-73
Methods:
HCI was conducted from April 2016 to November 2019. Every elder who lived alone and 2 matched partners met for 8 weeks once a week. The partners visited participants' home and did the HCI which composed of cognitive training and cognitive stimulation activities. The Mini-Mental State Examination-dementia screening (MMSE), Geriatric Depression Scale (GDS), the Korean version of instrumental activities of daily living (K-IADL), and the Social Support Scale (SSS) were evaluated before and after HCI to compare the effect of HCI.
Results:
A total of 258 participants showed significant improvements in MMSE, GDS, K-IADL, and SSS. The MMSE and GDS scores were significantly improved after HCI in both the normal cognition (NC, n=210) and cognitive impairment (CI, n=48) groups. The cognitive effect of HCI for CI was higher than for NC. Among the NC, the magnitude of cognitive improvement was greater in the higher educated group (above 7 years) than in the other groups.
Conclusions
Active cognitive interventions could provide possible benefits to improve cognition, emotion, and functional abilities. Regular cognitive-care services like HCI are necessary to reduce dementia risk for the elderly who live alone in the community.
3.Spinal MRI Abnormality in Zoster Sine Herpete.
Sungbo KIM ; Juyoun LEE ; Sangmin PARK ; Jung Geol LIM ; Ae Young LEE ; Eun Hee SOHN
Korean Journal of Clinical Neurophysiology 2013;15(2):74-76
No abstract available.
Herpes Zoster*
;
Herpesvirus 3, Human
;
Magnetic Resonance Imaging*
;
Zoster Sine Herpete*
4.Treatment of Alzheimer's Disease with Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study.
Juyoun LEE ; Byong Hee CHOI ; Eungseok OH ; Eun Hee SOHN ; Ae Young LEE
Journal of Clinical Neurology 2016;12(1):57-64
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*
5.Reversible Cerebellar Leukoencephalopathy Associated With Oral Methotrexate.
Juyoun LEE ; Eungseok OH ; Seong Hae JEONG ; Eun Hee SOHN ; Ae Young LEE
Journal of the Korean Neurological Association 2014;32(3):168-170
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
6.Characteristics of Cerebral Microbleeds.
Juyoun LEE ; Eun Hee SOHN ; Eungseok OH ; Ae Young LEE
Dementia and Neurocognitive Disorders 2018;17(3):73-82
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
7.Orthostatic Hypotension and Cognitive Function in Parkinson's Disease
Sooyoung KIM ; Juyoun LEE ; Eungseok OH ; Eun Hee SOHN ; Ae Young LEE
Journal of the Korean Neurological Association 2018;36(4):302-309
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
8.Clinical Utility of Seoul Neuropsychological Screening Battery-Core for Dementia Management Project in the Community
Ae Young LEE ; Juyoun LEE ; Eungseok OH ; Soo Jin YOON ; Bora YOON ; Seong Dong YU ;
Journal of the Korean Neurological Association 2019;37(3):277-283
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
9.The optimal preemptive dose of gabapentin following gynecologic surgery.
Hyo Seok KANG ; Hye Jin PARK ; Juyoun CHOI ; So Jin PARK ; Su kyeong LEE
Korean Journal of Anesthesiology 2009;56(3):309-312
BACKGROUND: Gabapentin decreases acute nociceptive pain in animal and human studies when given before surgical incision. Various doses of gabapentin have been used (300-1,200 mg) to measure this preemptive effect. Here, we evaluated the optimal dose of gabapentin for reducing fentanyl consumption and the adverse effects of gabapentin following gynecologic surgery. METHODS: We recruited 100 patients who underwent laparotomy for gynecologic surgery. Patients were randomly divided into 4 groups and received a placebo (control), gabapentin 300 mg (G 300), gabapentin 600 mg (G 600), or gabapentin 1,200 mg (G 1200) 2 h before surgery. Postoperatively, patients received fentanyl via an intravenous patient controlled analgesia device. The cumulative fentanyl doses were recorded 2, 6, 12, 24 h, and 48 h postoperatively, and the sedation scale was recorded in the post anesthetic care unit (PACU). RESULTS: The postoperative fentanyl requirement was lower with gabapentin treatment, but there was no significant differences for the different doses. PACU sedation scores were not different in any group. CONCLUSIONS: Gabapentin has a preemptive effect in gynecologic surgery, but there were no additional fentanyl-sparing benefits at doses above 300 mg. Thus, 300 mg is an optimal dose for decreasing fentanyl consumption following gynecologic surgery.
Amines
;
Analgesia, Patient-Controlled
;
Animals
;
Cyclohexanecarboxylic Acids
;
Female
;
Fentanyl
;
gamma-Aminobutyric Acid
;
Gynecologic Surgical Procedures
;
Humans
;
Laparotomy
;
Nociceptive Pain
10.Antiemetic effect of propofol administered at the end of surgery in laparoscopic assisted vaginal hysterectomy.
Eu Gene KIM ; Hye Jin PARK ; Hyoseok KANG ; Juyoun CHOI ; Hyun Jeong LEE
Korean Journal of Anesthesiology 2014;66(3):210-215
BACKGROUND: Postoperative nausea and vomiting (PONV) commonly occur after general anesthesia, especially in women. In this study, we evaluated the antiemetic efficacy of propofol administered at the end of surgery in highly susceptible patients undergoing a laparoscopy-assisted vaginal hysterectomy. METHODS: A total of 107 women undergoing a laparoscopy-assisted vaginal hysterectomy under general anesthesia were enrolled for this prospective, double-blind, randomized study. Fifteen minutes before the end of surgery, all patients received 50 microg fentanyl and 1 of following 3 doses; 0.5 mg/kg of propofol (propofol 0.5 group), 1 mg/kg of propofol (propofol 1.0 group), and normal saline (control group). All patients received intravenous patient-controlled analgesia (PCA). Emergence time, a visual analog scale for pain and nausea, duration of postanesthesia care unit (PACU) stay, and frequency of antiemetic use were recorded at 0-2, 2-24, and 24-48 hours postoperatively. RESULTS: The incidence of nausea significantly lower in the propofol 0.5 and propofol 1.0 groups than in the control group (12.1 vs 14.7 vs 40%). During the first postoperative 2 hours, antiemetics were less frequently administered in the propofol 0.5 and propofol 1.0 groups than in the control group (3.0 vs 5.9 vs 22.5%). Emergence time was slightly longer in the propofol 0.5 and propofol 1.0 groups than in the control group, but there was no significant difference in PACU stay time was observed between the 3 groups. CONCLUSIONS: The results of this study suggest that low-dose propofol administration at the end of surgery may effectively reduce the incidence of PONV within 2 hours postoperatively in highly susceptible women undergoing a laparoscopiy-assisted vaginal hysterectomy and receiving opioid-based PCA.
Analgesia, Patient-Controlled
;
Anesthesia, General
;
Antiemetics*
;
Female
;
Fentanyl
;
Humans
;
Hysterectomy, Vaginal*
;
Incidence
;
Laparoscopy
;
Nausea
;
Passive Cutaneous Anaphylaxis
;
Postoperative Nausea and Vomiting
;
Propofol*
;
Prospective Studies
;
Visual Analog Scale