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: 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

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: 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

OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD), the most common behavior disorder of childhood, is characterized by a pattern of diminished sustained attention and higher level of impulsivity. About 25-50% of ADHD patients were reported to have sleep problems including higher level of nocturnal activity, longer sleep latency, lower sleep efficiency, more frequent night awakenings and shorter total sleep time. However, there is a lack of consistent results of any significant sleep problems but higher number of sleep movement and night-to-night variability from objective data although the self- or parental reports have suggested higher rates of sleep problems. This study was to ascertain the nocturnal sleep disturbances in patients with ADHD by objective measure, actigraphy. METHODS: The subjects were 24 male patients with ADHD and 12 control children (6-12 years). We tested them by neurocognitive function test and applied actigraphy to get sleep variables and to compare sleep disturbances for 72 hours. RESULTS: 1) In Matching Familiar Figures Test, the patients with ADHD manifested significantly increased response error (58.71+/-28.16 percentile vs. 35.20+/-26.49 percentile, p=0.038) and response latency (69.71+/-23.57 percentile vs. 49.70+/-24.58 percentile, p=0.042) compared with control children. Also, the patients with ADHD required more time for Trail Making Test B than controls and the difference were statistically significant (164.2+/-90.88 sec. vs. 79.0+/-55.08 sec., p=0.043). 2) In sleep variables by actigraphy, the sleep latency (21.57+/-24.28 min. vs. 5.81+/-4.69 min., p=0.005), wake after sleep onset (WASO) (62.01+/-18.56 min. vs. 47.00+/-15.08 min., p=0.039) and fragmentation index (17.28+/-5.41% vs. 12.45+/-4.88%, p=0.048) were significantly increased in patients with ADHD compared with controls. There were no significant differences in total sleep time and sleep efficiency. CONCLUSION: The patients with ADHD had more sleep problems and results of this study suggested that they have significantly increased sleep latency, WASO and fragmentation index compared with controls. However, further studies improved by large sample sizes, addition of polysomnography and ADHD subtypes should repeatedly suggest consistent results about sleep problems in children with ADHD.
Actigraphy ; Child ; Humans ; Male ; Parents ; Polysomnography ; Reaction Time ; Sample Size ; Trail Making Test

OBJECTIVE: The goal of this study was to examine cognitive dysfunctions in positive and negative schizophrenic patients and investigate the effect of tardive dyskinesia on cognitive dysfunctions in them. METHODS: Thirty two schizophrenic patients with tardive dyskinesia and thirty two schizophrenic patients without tardive dyskinesia as a control group were selected some psychiatric inpatients at a lunatic asylum and the cognitive dysfunctions of these patients were assessd with some neuropsychological tests including KWIS test, Grooved Pegboard test, Trail making test A and B, Wisconsin card sorting test, and Wechsler memory scale test. From these patients, we classified eighteen schizophrenic patients as a positive syndrome group and twenty five patients as a negative syndrome group with positive and negative syndrome scale and compared the results of neuropsychological tests between these two groups. RESULTS: Patients without tardivc dyskinesia showed better performances than those with tardive dyskinesia on picture completion subtest of KWIS. Positive schizophrenic patients showed better performances than negative schizophrenic patients on comprehension subtest of KWIS and trail making test A. CONCLUSION: Negative schizophrenic patients showed frontal lobe dyfunction and more memory impairment than positive schizophrenic patients. In conclusion, negative syndrome of schizophrenia is significantly associated with cognitive dysfunctions although tardive dyskinesia is not.
Comprehension ; Dyskinesias ; Frontal Lobe ; Humans ; Inpatients ; Memory ; Movement Disorders* ; Neuropsychological Tests ; Schizophrenia ; Trail Making Test ; Wisconsin

OBJECTIVES: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. METHODS: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). RESULTS: The control group (GDS< or =9) when compared with mild (10< or =GDS< or =16) and severe (17< or =GDS) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted R2=35.6%, p<0.001) and BVRT-A score (adjusted R2=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted R2=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. CONCLUSION: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.
Adult* ; Aged ; Alzheimer Disease ; Depression* ; Education ; Humans ; Oxygen ; Polysomnography ; Sleep, REM ; Trail Making Test