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Marchiafava Bignami Disease Potentially Complicating Normal Pressure Hydrocephalus.

Sanghak LEE ; Insub YOO ; Kyung Hoe LEE ; Hyun Duk YANG

Dementia and Neurocognitive Disorders.2014;13(1):24-26. doi:10.12779/dnd.2014.13.1.24

Marchiafava-Bignami disease (MBD) is a rare disorder of demyelination or necrosis of the corpus callosum. Mainly, MBD is associated with alcohol and malnutrition. We report a 60-year-old woman with no history of alcohol consumption or malnutrition who had MBD as a possible complication of normal pressure hydrocephalus (NPH). The patient presented with a 2-month history of progressive gait unsteadiness, urinary incontinence, and forgetfulness, for which the patient underwent ventriculoperitoneal shunt surgery with remarkable improvement. Magnetic resonance imaging (MRI) demonstrated hyperintensity in the body and splenium of corpus callosum when she was brought to the hospital again with rapid deterioration of her mental ststus. It might be postulated that cerebrospinal fluid (CSF) tumor necrosis factor-alpha (TNF-alpha) might have contributed to the development of MBD although not measured in this patient, given that TNF-alpha, as a proinflammatory cytokine mediating demyelinating process have been found in be increased in the CSF of NPH.
Alcohol Drinking ; Cerebrospinal Fluid ; Corpus Callosum ; Demyelinating Diseases ; Female ; Gait ; Humans ; Hydrocephalus, Normal Pressure* ; Magnetic Resonance Imaging ; Malnutrition ; Marchiafava-Bignami Disease* ; Middle Aged ; Necrosis ; Negotiating ; Tumor Necrosis Factor-alpha ; Urinary Incontinence ; Ventriculoperitoneal Shunt

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A Case of Progressive Multifocal Leukoencephalopathy in Acquired Immune Deficiency Syndrome Initially Presented with Early Onset Dementia.

Pyeong Kang PARK ; Jung Geun OH ; Seong Ho KOH ; Kyu Yong LEE ; Young Joo LEE ; Hojin CHOI

Dementia and Neurocognitive Disorders.2014;13(1):20-23. doi:10.12779/dnd.2014.13.1.20

Progressive multifocal leukoencephalopathy (PML) is a very rare and often fatal demyelinating disease of central nervous system (CNS), which mostly occurs in patients with immunosuppression such as acquired immunodeficiency syndrome (AIDS) patients, transplant patients and patients receiving chemotherapy. PML usually manifests with acute or subacute neurologic deficit. and its late diagnosis may lead death or significant permanent disability. We report a 33-year old man diagnosed with PML in AIDS, who initially presented with gradual onset of dementia. Most symptoms of PML were progressed rapidly for several months, and characterized by focal neurological symptoms. On the other hand, we were experienced in patients without focal neurological symptoms and ongoing overall cognitive decline slowly. Patients with immunosuppression can be presented in a variety of neurological symptoms, detailed examinations for cognitive functions were needed in early stage of the disease.
Acquired Immunodeficiency Syndrome* ; Adult ; Central Nervous System ; Delayed Diagnosis ; Dementia* ; Demyelinating Diseases ; Drug Therapy ; Hand ; Humans ; Immunosuppression ; Leukoencephalopathy, Progressive Multifocal* ; Neurologic Manifestations

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Reversible Amygdala and Parahippocampal Lesions of Brain 18Fluorodeoxy Glucose-Positron Emission Tomography in Neuropsychiatric Systemic Lupus Erythematosus.

Do Young YOON ; Doo Yong PARK ; Subin LEE ; Jee Young KIM ; Hyun Jeong HAN ; Eun Jung KIM

Dementia and Neurocognitive Disorders.2015;14(1):48-51. doi:10.12779/dnd.2015.14.1.48

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease that is a significant source of morbidity and mortality when it manifests in the central nervous system. The early detection and treatment of neuropsychiatric SLE (NPSLE) is very important, but a confirmative diagnostic tool has yet to be developed. CASE REPORT: We report here a case of neuropsychiatric manifestations in a patient that were associated with SLE, and evidence of reversal of bilateral amygdala and parahippocampal lesions in the brain revealed by 18fluorodeoxy glucose-positron emission tomography. CONCLUSIONS: We are suggestive of 18fluorodeoxy glucose-positron emission tomography appear to be more sensitive in detecting subtle brain changes in NPSLE.
Amygdala* ; Autoimmune Diseases ; Brain* ; Central Nervous System ; Humans ; Lupus Erythematosus, Systemic ; Lupus Vasculitis, Central Nervous System* ; Mortality

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The Effects of Aging and Mild Cognitive Impairment on the Tip-of-the-Tongue Phenomenon in People Naming Task.

Sang A OH ; Ji Wan HA

Dementia and Neurocognitive Disorders.2015;14(1):39-47. doi:10.12779/dnd.2015.14.1.39

BACKGROUND AND PURPOSE: The tip-of-the-tongue (TOT) phenomenon refers to knowing the meaning of the desired information but being unable to produce the phonological information. This study induced the TOT phenomenon through a task involving naming famous people, compared and analyzed results by age, and examined the differences with effects from pathological aging [mild cognitive impairment (MCI)]. METHODS: Young (n=10), middle-aged (n=10), older (n=10), oldest (n=10), and MCI (n=10) subjects participated in this study. To examine TOT rate, rate of TOT response, voluntary TOT solution rate, and TOT solution rate after presenting syllabic cue, each group participated in the experiment through a task of naming famous people. RESULTS: First, as subject age increased, TOT rate (the number of TOTs divided by total trials) increased. There was no significant difference with pathological aging. Second, normal aging and pathological aging had no significant effect on the rate of TOT response (the number of each response type divided by total response types). Third, the voluntary TOT solution rate (the number of voluntary TOT solutions divided by total TOTs) on occurrence of the TOT phenomenon was very low. Fourth, the TOT solution rate (the number of TOT solutions after presenting syllabic cue divided by total TOTs) had a negative correlation to normal aging. In examining pathological aging, the TOT solution rate of the MCI group was significantly lower than normal oldest people. CONCLUSION: Normal aging and pathological aging showed differences regarding TOT rate and TOT solution rate when naming famous individuals. The results of this study could be helpful as a differential tool between normal and pathological aging.
Aging* ; Cues ; Mild Cognitive Impairment*

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Factors Influencing Skin Tolerability to the Rivastigmine Patch in Patients with Alzheimer's Disease.

Hae Ri NA ; Moon Ho PARK ; Sangyun KIM ; Dong Won YANG ; Seong Hye CHOI ; Hyun Duk YANG ; Youngsoon YANG ; Hyun Jeong HAN ; Jung Seok LEE ; Young Chul YOON ; Seong Ho KOH ; Jung Eun KIM ; Bon D KU ; Hee Jin KIM ; Kyung Won PARK ; Eun Joo KIM ; Bora YOON ; Key Jung PARK

Dementia and Neurocognitive Disorders.2015;14(1):31-38. doi:10.12779/dnd.2015.14.1.31

BACKGROUND AND PURPOSE: The one-day rivastigmine patch is reportedly well tolerated and has minimal side effects. However, Asian patients show more side effects than those in Western countries. We evaluated tolerability of the rivastigmine patch in South Korean patients with Alzheimer's disease (AD) and the specific factors affecting adverse events of the skin. METHODS: A 6-month, open labeled, multi-centered, observational study was carried out in 440 patients with probable AD from July 2009 to September 2010 (NCT01312363). RESULTS: A total of 25.9% of the patients experienced adverse skin events at the rivastigmine patch application site and 17.0% discontinued treatment due to adverse events at the skin application site. The most common adverse events were itching and erythema. Patients with an allergic history and users of electric heating appliances reported skin discomfort. Older age was associated with discontinuing treatment. CONCLUSION: These results suggest that the rivastigmine patch induced some adverse skin events and may contribute to understanding and improving skin tolerability to the rivastigmine patch.
Alzheimer Disease* ; Asian Continental Ancestry Group ; Erythema ; Heating ; Hot Temperature ; Humans ; Observational Study ; Pruritus ; Skin* ; Rivastigmine

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The Relationship between Geriatric Depression Scale Structure and Cognitive-Behavioral Aspects in Patients with Alzheimer's Disease.

Yong Tae KWAK ; Sook Hyung SONG ; Youngsoon YANG

Dementia and Neurocognitive Disorders.2015;14(1):24-30. doi:10.12779/dnd.2015.14.1.24

BACKGROUND AND PURPOSE: Although the 15-item Geriatric Depression Scale (GDS15) is a widely used depression screening questionnaire, the implications of the GDS15 in patients with Alzheimer's disease (AD) are questionable. We designed this study to explore the GDS15 factor structure and the relationships between these factors and cognitive-behavioral aspects. METHODS: The GDS15, cognitive function tests, and the Korean-Neuropsychiatry Inventory were administered to 310 patients with probable AD, who were not medicated before visiting the hospital. Three factors were identified by principal components analysis. A bivariate correlation analysis was conducted to determine the relationships between factors and neurocognitive and behavior symptoms. RESULTS: Factor 2 was correlated with the Korean Boston Naming Test, calculating ability, the go-no-go test, the Controlled Oral Word Association Test (COWAT), the Color Word Stroop Test (CWST; words and color), aggression, depression, and apathy. Factor 3 was correlated with calculating ability, the Seoul Verbal Learning Test, immediate recall, copy, and delayed recall on the Rey-Osterieth Complex Figure Test, contrasting on the COWAT, and words and delusion on the CWST. We identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale. CONCLUSIONS: These results suggest that the GDS15 may be comprised of a heterogeneous scale and suggest multi-dimensional properties of the GDS15 in patients with AD.
Aggression ; Alzheimer Disease* ; Apathy ; Delusions ; Depression* ; Factor Analysis, Statistical ; Humans ; Mass Screening ; Memory, Short-Term ; Seoul ; Stroop Test ; Verbal Learning ; Word Association Tests ; Surveys and Questionnaires

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Splenial Corpus Callosum Infarction Presenting with Unilateral Prosopometamorphopsia: A Case Report.

Chang Min LEE

Dementia and Neurocognitive Disorders.2015;14(2):94-97. doi:10.12779/dnd.2015.14.2.94

BACKGROUND: Prosopometamorphopsia is a disorder of face perception in which faces appear distorted to the perceiver. Cases with unilateral prosopometamorphopsia caused by splenial lesion have been very rarely reported. CASE REPORT: A 52-year-old right-handed woman complained that the left half of people's faces looked distorted. She stated that objects other than the face looked normal. Brain magnetic resonance imaging revealed an infarction of the left splenium of the corpus callosum. Electroencephalography and automated perimetry were normal. CONCLUSIONS: The mechanism of unilateral prosopometamorphopsia remains unclear. However, it could be a dominant hemisphere-specific disconnection sign.
Brain ; Corpus Callosum* ; Electroencephalography ; Female ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Visual Field Tests

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Longitudinal Clinical Changes of Non-Fluent/Agrammatic Primary Progressive Aphasia as Tau Spectrum Disorder: A Case Report.

Jin Soo KIM ; Jae Won JANG ; Seong Heon KIM ; Min Jeong WANG ; Young Ho PARK ; Sangyun KIM

Dementia and Neurocognitive Disorders.2015;14(2):87-93. doi:10.12779/dnd.2015.14.2.87

BACKGROUND: Tauopathies are a group of diseases caused by the accumulation of hyperphosphorylated tau protein in the central nervous system. Previous studies have revealed that there is considerable overlap in clinical, pathological, and genetic features among different taupathies. CASE REPORT: We report a patient with non-fluent/agrammatic primary progressive aphasia at the initial assessment. Over time, other symptoms belonging to corticobasal degeneration and progressive supranuclear palsy appeared in this patient. CONCLUSIONS: Clinical overlapping features in these disorders may represent different phenotypes of a single disease process.
Aphasia, Primary Progressive* ; Central Nervous System ; Humans ; Phenotype ; Supranuclear Palsy, Progressive ; tau Proteins ; Tauopathies

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Posterior Cortical Atrophy with Acute Onset and Rapid Progressive Visual Symptoms: A Case Report.

Jaejeong JOO ; Sul Ki LEE ; In Ha HWANG ; Kyum Il KWON ; Byoung June AHN ; Youngsoon YANG

Dementia and Neurocognitive Disorders.2015;14(2):83-86. doi:10.12779/dnd.2015.14.2.83

BACKGROUND: Posterior cortical atrophy (PCA) is characterized by slowly progressive early onset dementia with cortical visual dysfunction and disproportionate atrophy of the posterior cortex. CASE REPORT: A 55-year-old right-handed woman developed visuo-spatial impairments that progressed rapidly into cortical blindness over the following 3 months. Neuro-psychological evaluation revealed Gerstmann syndrome and severe constructional impairments with all components of Balint syndrome. However, her memory, insight, and judgment were preserved. Her brain MRI was normal. However, 18F fluorodeoxyglucose positron emission tomography revealed a marked hypometabolism in the bilateral parieto-occipital region. CONCLUSIONS: Although rapid progression of visuo-spatial dysfunction without memory impairment occurred, we considered PCA as well.
Atrophy* ; Blindness, Cortical ; Brain ; Dementia ; Female ; Fluorodeoxyglucose F18 ; Gerstmann Syndrome ; Humans ; Judgment ; Magnetic Resonance Imaging ; Memory ; Middle Aged ; Passive Cutaneous Anaphylaxis ; Positron-Emission Tomography

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Cognitive Therapy Combined with Drug Treatment in Patients with Alzheimer's Disease: A Neuropsychological and Positron Emission Tomography Investigation, a Pilot Study.

Haeri NA ; Sangyun KIM ; Yu Kyeong KIM ; Moon Ho PARK ; Sung Tae CHO ; Woo Jung KIM

Dementia and Neurocognitive Disorders.2015;14(2):76-82. doi:10.12779/dnd.2015.14.2.76

BACKGROUND: Cognitive therapy may have therapeutic benefit in patients with early Alzheimer's disease (AD). CASE REPORT: This was a 12-week, single-blind pilot study of 4 patients with AD. The cognitive therapy included exercises for orientation to time and place; memory training, including face-name association, object recall training, and spaced retrieval; visuo-motor organization using software; similarity and ruled based categorization; and behavior modification and sequencing (e.g., making change, paying bills). The regional cerebral metabolic abnormalities and the effects of treatment on cortical metabolic responses were evaluated using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography (PET). After 12 weeks, the participants showed slight improvement in some neuropsychological measures, and three of them showed increased regional cortical metabolism on brain PET studies. CONCLUSIONS: Cognitive therapy may stabilize or improve cognitive and functional performance of patients with early AD and increase regional cortical metabolism of the patients' brain.
Alzheimer Disease* ; Behavior Therapy ; Brain ; Cognitive Therapy* ; Exercise ; Humans ; Learning ; Metabolism ; Pilot Projects* ; Positron-Emission Tomography*

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