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Papillary Meningioma Presenting as Rapidly Progressive Dementia and Parkinsonism.

In Seok PARK ; Seung Hee NA ; Young Do KIM ; In Uk SONG ; Lee So MAENG ; Youngsoon YANG

Dementia and Neurocognitive Disorders.2013;12(3):81-85. doi:10.12779/dnd.2013.12.3.81

There are a variety of different causes of parkinsonism including PD, secondary parkinsonism, and the parkinsonism plus syndromes. Secondary parkinsonism is caused by structural, toxic, metabolic, or infectious mechanisms. Among structural causes, intracranial neoplasms are a rare cause of secondary parkinsonism. Moreover, there are almost never case reports with intracranial space-occupying lesions resulting in parkinsonism associated with rapid cognitive impairment. Therefore, we report herein a 37-year-old woman diagnosed with papillary meningioma who presented with parkinsonism associated with rapidly progressive cognitive impairment mimicking diffuse Lewy body disease.
Adult ; Brain Neoplasms ; Dementia ; Female ; Humans ; Lewy Body Disease ; Meningioma ; Parkinson Disease, Secondary ; Parkinsonian Disorders

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Dementia Pugilistica with Clinical Features of Frontotemporal Dementia and Parkinsonism: Case Report.

Youngsoon YANG ; Jaejeong JOO ; Jinho KANG ; Sangwo HAN ; Sangwon HA ; Jungho HAN ; Eunkyung CHO ; Dooeung KIM

Dementia and Neurocognitive Disorders.2013;12(3):78-80. doi:10.12779/dnd.2013.12.3.78

Dementia pugilistica (DP) or chronic traumatic encephalopathy (CTE) is a neurodegenerative disease or dementia that may affect amateur or professional boxers as well as athletes in other sports who suffer concussions. The condition is thought to affect around 15% to 20% of professional boxers and caused by repeated concussive or subconcussive blows. CTE was in the past referred to as dementia pugilistica, which reflected the prevailing notion that this condition was restricted to boxers. Recent research, however, has demonstrated neuropathological evidence of CTE in retired American football players, a professional wrestler, a professional hockey player and a soccer player, as well as in nonathletes. It is probable that many individuals are susceptible to CTE, including those who experience falls, motor vehicle accidents, assaults, epileptic seizures, or military combat, and that repeated mild closed head trauma of diverse origin is capable of instigating the neurodegenerative cascade leading to CTE. We report a 62-year old man suspicious of dementia pugilistica with clinical features of frontotemporal dementia and parkinsonism.
Athletes ; Brain Injury, Chronic ; Dementia ; Epilepsy ; Football ; Frontotemporal Dementia ; Head Injuries, Closed ; Hockey ; Humans ; Military Personnel ; Motor Vehicles ; Neurodegenerative Diseases ; Parkinsonian Disorders ; Soccer ; Sports

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Unusual FDG-PET Findings in Traumatic Brain Injury; Did Traumatic Brain Injury Provoke Rapid Progression of Alzheimer's Disease?.

Inha HWANG ; Sang Won HA ; Jeong Ho HAN

Dementia and Neurocognitive Disorders.2017;16(2):54-55. doi:10.12779/dnd.2017.16.2.54

No abstract available.
Alzheimer Disease* ; Brain Injuries*

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Comparison of Behavioral and Psychological Symptoms between Early and Late Onset Alzheimer's Disease According to the Progression of Dementia.

Yeo Ju YOON ; Eun Joo KIM ; Chang Hee HONG

Dementia and Neurocognitive Disorders.2014;13(4):89-93. doi:10.12779/dnd.2014.13.4.89

The aim of this study was to investigate behavioral and psychological symptoms of dementia (BPSD) measured by caregiver-administered neuropsychiatric inventory (CGA-NPI) as a function of dementia severity in early onset (EOAD) versus late onset Alzheimer's disease (LOAD). A total of 113 patients with AD consisting of 49 patients with EOAD and 64 patients with LOAD were enrolled consecutively. General cognitive function and severity of dementia were assessed by the Korean version of mini-mental status examination and clinical dementia rating (CDR), respectively. In the mild stage (CDR 0.5-1), LOAD patients had a significantly higher total CGA-NPI score than EOAD patients. Subgroup analysis demonstrated that disinhibition and night-time behavior were more common and severe in the LOAD group than the EOAD group. However, in the moderate to severe stage (CDR 2-3), EOAD patients had a significantly higher total CGA-NPI score with higher subscores in hallucination, agitation/aggression, irritability/lability, aberrant motor behavior, and appetite/eating change. This study suggested that the heterogeneity of BPSD in AD might be accounted for by dementia severity as well as age at symptoms onset.
Alzheimer Disease* ; Dementia* ; Hallucinations ; Humans ; Population Characteristics

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Driving in Patients with Dementia: A CREDOS (Clinical Research Center for Dementia of South Korea) Study.

Seong Hye CHOI ; Jiwook LEE ; Soo Jeong KIM ; Jun Yong CHOI ; Ji Won KWON ; Byung Nam YOON ; Jong Hun KIM ; Bora YOON ; Youngsoon YANG ; Sangyun KIM ; Jee Hyang JEONG

Dementia and Neurocognitive Disorders.2014;13(4):83-88. doi:10.12779/dnd.2014.13.4.83

BACKGROUND: There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia. METHODS: A total of 4,377 patients including 3,792 with Alzheimer's disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year. RESULTS: There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5+/-4.3 vs 19.8+/-5.1 vs 17.4+/-5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08+/-2.15 vs 5.80+/-3.41 vs 5.83+/-3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2+/-3.6 vs 20.8+/-4.5, p=0.003) and lower CDR-SB scores (3.30+/-1.47 vs 4.40+/-1.85, p=0.001) at baseline compared with those who quitted driving after baseline. CONCLUSIONS: Male patients who were relatively young and had high educational level and mild dementia had a tendency to drive an automobile at that time of diagnosis of dementia. About half of them continued to drive after diagnosis of dementia.
Alzheimer Disease ; Automobile Driving ; Automobiles ; Caregivers ; Dementia* ; Dementia, Vascular ; Diagnosis ; Humans ; Korea ; Male ; Neuropsychological Tests

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The Clinical Characteristics according to the Educational Level in the Elderly Patients with Mild Alzheimer's Disease Dementia.

Dae Seob SHIN ; Ho Sik SHIN ; Seung Keun LEE ; Dong Hyun LEE ; Jeong Ho PARK ; Tae Kyeong LEE ; Ki Bum SUNG ; Kwang Ik YANG ; Sun Ah PARK

Dementia and Neurocognitive Disorders.2015;14(4):158-162. doi:10.12779/dnd.2015.14.4.158

BACKGROUND AND PURPOSE: Cognitive reserve is important for the individual susceptibility to dementia. Among the various determinants of cognitive reserve, the number of years of formal education would be of prime importance. We performed this study to explore its contribution to the clinical characteristics of dementia. METHODS: We included consecutive mild Alzheimer's disease (AD) dementia patients (clinical dementia rating, CDR=0.5 or 1) who visited our memory clinic and were older than 70 years at the evaluation from October 2013 to September 2015. According to the number of years of education, the corresponding subjects was grouped into two extreme educational groups, low education (illiterate or partially illiterate, LE, n=43) vs. high education (more than 9 years of education, HE, n=34). Among these patients, we compared various demographic, neuropsychological and neuroimaging characteristics. RESULTS: The groups were comparable in terms of age, frequency of hypertension and diabetes, and CDR and its sum of box. However, female gender was more frequent in the LE group (p=0.000). Also this group showed a more depressive mood on the geriatric depression scale (p=0.007). The raw scores on Korean Version of Mini-Mental State Examination and well-validated neuropsychological tests were lower in the LE group. However, the cognitive performance was found to be more preserved in the LE group than in the HE group when assessed using the z-score in certain specified tests on univariate and multivariate analyses (p<0.05). The Schelten's grade of medial temporal atrophy was similar between the two educational groups. Also, the degree of combined ischemic burden did not differ between the two groups. CONCLUSIONS: We identified that the prevalence of depressive mood and the extent of decline from the corresponding norm in a particular neuropsychological performance differ according to the educational level of mild AD patients.
Aged* ; Alzheimer Disease* ; Atrophy ; Cognitive Reserve ; Dementia* ; Depression ; Education ; Literacy ; Female ; Humans ; Hypertension ; Memory ; Multivariate Analysis ; Neuroimaging ; Neuropsychological Tests ; Prevalence

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Effect of Illiteracy on Cognition and Cerebral Morphology in Later Life.

Oh Dae KWON ; Uicheul YOON ; Duk L NA

Dementia and Neurocognitive Disorders.2015;14(4):149-157. doi:10.12779/dnd.2015.14.4.149

BACKGROUND AND PURPOSE: A better developmental environment has positive effects on brain development. The acquisition of literacy during childhood may affect brain functional organization. The present study aimed to evaluate the effects of illiteracy on neuropsychological test results and cerebral morphology in later life. METHODS: We recruited 7 illiterate elderly farmers who had never attended school and had no reading or writing knowledge. These subjects were compared with 9 literate subjects in terms of neuropsychological performance and brain volume. All subjects were over 65-years-old and had the same regional and occupational background. RESULTS: Neuropsychological tests indicated that the performance of the illiterate subjects was worse than that of literate subjects in all cognitive domains except forward digit span, tool-use and tool-free gestures, verbal word recognition, and verbal generation of animals and grocery items. The illiterate group also showed significantly decreased cortical volume and surface area in both parietal lobes. However, the illiterate group showed increased cortical thickness in the left cuneus. CONCLUSIONS: Literacy acquired in childhood may increase the volume of the parietal lobe and improve neuropsychological performance through the process of brain plasticity. The effects can be lifelong.
Aged ; Animals ; Brain ; Cognition* ; Literacy* ; Gestures ; Humans ; Learning ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Parietal Lobe ; Plastics ; Writing

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Reduced Gray Matter Volume in Subjective Cognitive Decline: A Voxel-Based Morphometric Study.

Yoonjae CHOI ; Byung Nam YOON ; Seong Hye CHOI ; Myung Kwan LIM ; Hee Jin KIM ; Dong Won YANG

Dementia and Neurocognitive Disorders.2015;14(4):143-148. doi:10.12779/dnd.2015.14.4.143

BACKGROUND AND PURPOSE: Subjective cognitive decline has been proposed as a potential indicator of the preclinical state of Alzheimer's disease (AD). The results of the studies of cortical atrophy on brain MRIs in subjects with subjective cognitive decline are inconsistent across the literatures. We investigated whether subjects with subjective cognitive decline had less gray matter volume compared to controls without subjective cognitive decline as per brain MRI. METHODS: Thirty-six subjects with subjective cognitive decline and thirty-three controls without subjective cognitive decline were recruited retrospectively from among the patients who had visited the department of neurology at Inha University Hospital between January 2008 and December 2010. All subjects had undergone a brain MRI scan including 3D T1-weighted spoiled gradient recalled echo imaging. We used voxel-based morphometry (VBM) to examine gray matter volumes between the two groups, after controlling for age, sex, education, and total intracranial volumes (TIV). RESULTS: There were no significant differences in age, gender, education, and TIV between the two groups. In comparison to controls without subjective cognitive decline, subjects with subjective cognitive decline showed gray matter atrophy in the left superior and medial frontal gyri, left superior and inferior parietal lobules, and right precuneus and insular in the VBM analysis. CONCLUSIONS: Individuals with subjective cognitive decline encountered in clinical settings have greater similarity to an AD gray matter atrophy pattern compared with cognitively normal individuals without subjective cognitive decline.
Alzheimer Disease ; Atrophy ; Brain ; Education ; Humans ; Magnetic Resonance Imaging ; Neurology ; Rabeprazole ; Retrospective Studies

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Constructing a Composite Score for the Seoul Neuropsychological Screening Battery-Core.

Seungmin JAHNG ; Duk L NA ; Yeonwook KANG

Dementia and Neurocognitive Disorders.2015;14(4):137-142. doi:10.12779/dnd.2015.14.4.137

BACKGROUND AND PURPOSE: The brief version of the Seoul Neuropsychological Screening Battery (SNSB), the SNSB-Core (SNSB-C), has been developed. Although each subtest score of the SNSB-C provides information on different features of broad cognitive functioning or impairment, a composite score is needed to identify the severity of global cognitive impairment. We aimed to develop and validate a composite score of the SNSB-C that would provide a normative-based summary score of global cognitive functioning, especially for differentiating patients with cognitive impairment from normal elderly. METHODS: A normative sample of 1067 elderly was used to develop a composite score of SNSB-C. The composite score was corrected for the effects of age, years of education, and sex by the regression method. Patients with Alzheimer's disease (n=41), vascular dementia (n=40), amnestic mild cognitive impairment (MCI) (n=73), vascular MCI (n=41), and Parkinson's disease with MCI (n=41) were differentiated from a normal sample (n=70) by the uncorrected and corrected composite scores using receiver operating characteristic (ROC) curve analysis. RESULTS: Confirmatory factor analysis showed that the composite score equal weight to each standardized cognitive domain of SNSB-C is appropriate for indexing overall cognitive functioning. The corrected and uncorrected composite scores yielded a satisfactory size of the area under the ROC curve comparable to the Mini Mental State Examination (MMSE). CONCLUSIONS: The composite scores of SNSB-C, especially the corrected score, provide an index of overall cognitive functioning, and they can be used as an alternative to MMSE for screening patients with cognitive impairment.
Abstracting and Indexing as Topic ; Aged ; Alzheimer Disease ; Dementia, Vascular ; Education ; Humans ; Mass Screening* ; Mild Cognitive Impairment ; Parkinson Disease ; ROC Curve ; Seoul*

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Anatomical Correlates of the "Closing-In" Phenomenon.

Se Yoon KWON ; Eek Sung LEE ; Yun Jeong HONG ; Sung Chul LIM ; Kook Jin AHN ; Bora YOON ; Yongsoo SHIM ; Dong Won YANG

Dementia and Neurocognitive Disorders.2015;14(1):17-23. doi:10.12779/dnd.2015.14.1.17

BACKGROUND AND PURPOSE: The "closing-in" phenomenon refers to the tendency to copy near or overlap a model while performing figure-copying tasks. The mechanisms underlying the closing-in phenomenon have not been fully elucidated, and previous studies only investigated the mechanisms through neuropsychological tests. We investigated the neuroanatomical correlates of the closing-in phenomenon using voxel-based morphometry (VBM). METHODS: Thirty-eight patients diagnosed with probable Alzheimer's disease (AD) and 21 normal controls were included. All subjects underwent neuropsychological testing to diagnose dementia and magnetization prepared rapid acquisition gradient echo brain magnetic resonance imaging for the voxel-based statistical analysis. The subjects were asked to copy the modified Luria's alternating squares and triangles to quantify the closing-in phenomenon. We applied SPM8 for the VBM analysis to detect gray matter loss associated with the closing-in phenomenon. RESULTS: The patients with probable AD showed a higher closing-in score than that of the normal control subjects (p<0.0001). The VBM analysis revealed more parietal and temporal atrophy in the patients with AD than that in the normal control group. Moreover, atrophy of the orbito-frontal area was associated with the closing-in phenomenon. CONCLUSIONS: The closing-in phenomenon is dysfunction while performing figure-copying tasks and is more common in patients with AD. The analysis of the orbito-frontal area, which is associated with inhibiting primitive reflexes, revealed that the closing-in phenomenon is an imitation behavior commonly observed in patients with frontal lobe damage.
Alzheimer Disease ; Atrophy ; Brain ; Dementia ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Rabeprazole ; Reflex

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