Background: and PurposeMild cognitive impairment (MCI) is a condition with diverse clinical outcomes and subgroups. Here we investigated the topographic distribution of tau in vivo using the positron emission tomography (PET) tracer [18F]THK5351 in MCI subgroups. Methods: This study included 96 participants comprising 38 with amnestic MCI (aMCI), 21 with nonamnestic MCI (naMCI), and 37 with normal cognition (NC) who underwent 3.0-T MRI, [18F]THK5351 PET, and detailed neuropsychological tests. [18F]flutemetamol PET was also performed in 62 participants. The aMCI patients were further divided into three groups: 1) verbal-aMCI, only verbal memory impairment; 2) visual-aMCI, only visual memory impairment; and 3) both-aMCI, both visual and verbal memory impairment. Voxel-wise statistical analysis and region-of-interest -based analyses were performed to evaluate the retention of [18F]THK5351 in the MCI subgroups. Subgroup analysis of amyloid-positive and -negative MCI patients was also performed. Correlations between [18F]THK5351 retention and different neuropsychological tests were evaluated using statistical parametric mapping analyses. Results: [18F]THK5351 retention in the lateral temporal, mesial temporal, parietal, frontal, posterior cingulate cortices and precuneus was significantly greater in aMCI patients than in NC subjects, whereas it did not differ significantly between naMCI and NC participants. [18F] THK5351 retention was greater in the both-aMCI group than in the verbal-aMCI and visualaMCI groups, and greater in amyloid-positive than amyloid-negative MCI patients. The cognitive function scores were significantly correlated with cortical [18F]THK5351 retention. Conclusions [18F]THK5351 PET might be useful for identifying distinct topographic patterns of [18F]THK5351 retention in subgroups of MCI patients who are at greater risk of the progression to Alzheimer's dementia.

OBJECTIVES: Rapid eye movement (REM) sleep behavior disorder (RBD) is well known as a prodromal symptom of neurodegenerative disease, especially α-synucleinopathy. In the previous literature, it has been reported the incidence rate of RBD in Alzheimer's disease (AD) is about 10%. This incidence rate is relatively low, if we consider that nearly half of AD patients also have Lewy body pathology. The objective of this study is to determine the incidence rate of RBD among patients with AD, confirmed by amyloid positron emission tomography (PET) image. METHODS: We enrolled 57 patients with clinically probable AD patients who identified AD pathology in amyloid PET scan. RBD was evaluated with REM sleep behavior disorder questionnaire-Korean vesion (RBDQ-KR), which validated the RBD screening questionnaire as Korean version to confirm RBD. Detailed neuropsychological tests were measured using the Seoul Neuropsychological Screening Battery (SNSB). RESULTS: We analyzed RBDQ-KR data collected from 57 AD patients. Dementia due to AD was 36 patients (63.2%) and mild cognitive impairment (MCI) due to AD was 21 (36.8%). AD with RBD was 14 (24.6%). Among these, AD dementia with RBD was 13 (36.1%), and MCI due to AD with RBD was 1 (4.8%). There were no significant differences in cognitive function between the patients with or without RBD, evaluated by detailed neuropsychological test. CONCLUSIONS In this study, the incidence of RBD in AD was not rare; therefore, if the patient shows symptoms of RBD, we should not rule out AD.

Acute peripheral facial palsy usually manifests Bell's palsy of unknown cause, and rarely lacunar infarct which located in facial nucleus can mimic peripheral facial palsy. A 73 year-old man with isolated facial asymmetry diagnosed with lacunar infarction which selectively involve the facial fascicles which lie in inferolateral aspect of pons. Clinicians should take into account the possibility of central lesion and brain stem infarction, even when patients present with isolated peripheral type facial palsy.
Bell Palsy ; Brain Stem Infarctions ; Facial Asymmetry ; Facial Nucleus ; Facial Paralysis* ; Humans ; Pons ; Stroke, Lacunar

No abstract available.
Hypoparathyroidism*

We present the case of a 28-year-old pregnant woman with subarachnoid hemorrhage who was initially unable to undergo a CT scan and exhibited interestingly high signal intensities only on T2-weighted MRI without any signal change on fluid attenuated inversion recovery and gradient-echo imaging. These findings could be explained by a combination of factors that increase the signal intensity with elevations in the concentrations of protein and oxyhemoglobin due to massive bleeding and with the decreased fluid void signal inferred by the presence of hydrocephalus.
Adult ; Female ; Hemorrhage ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Oxyhemoglobins ; Pregnant Women ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

BACKGROUND AND PURPOSE: It has been shown that sleep problems in Alzheimer's disease (AD) are associated with cognitive impairment and behavioral problems. In fact, most of studies have founded that daytime sleepiness is significantly correlated with cognitive decline in AD. However, a few studies have also shown that nighttime sleep problems are associated with cognitive function and behavioral symptoms in AD. Accordingly, the aim of this study was to evaluate the effects of nighttime sleep on cognition and behavioral and psychological symptoms of dementia (BPSD) in AD. METHODS: The study population comprised 117 subjects: 63 AD patients and 54 age- and sex-matched non-demented elderly subjects. Detailed cognitive functions and behavioral symptoms were measured using the Seoul Neuropsychological Screening Battery (SNSB) and the Korean version of the Neuropsychiatric Inventory (NPI-K). Sleep characteristics were evaluated using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). The correlations between PSQI-K and SNSB scores and between PSQI-K and NPI-K scores were analyzed. RESULTS: In AD patients, sleep latency was found to be negatively correlated with praxis (p=0.041), Rey-Osterrieth Complex Figure Test (RCFT) immediate recall (p=0.041), and RCFT recognition (p=0.008) after controlling for age and education, while sleep duration and sleep efficiency were positively correlated with praxis (p=0.034 and p=0.025, respectively). Although no significant correlation was found between PSQI-K and NPI-K scores, sleep disturbance and total PSQI-K scores were found to be significantly associated with apathy/indifference in AD. CONCLUSIONS: Sleep problems such as prolonged sleep duration, sleep latency, and poor sleep efficiency in AD patients were correlated with cognitive dysfunction, and especially frontal executive and visuospatial functions, and BPSD. These findings suggest that treatment of nighttime sleep problems might improve cognition and behavioral symptoms in AD patients.
Aged ; Alzheimer Disease* ; Behavioral Symptoms ; Cognition ; Dementia ; Education ; Humans ; Mass Screening ; Memory, Short-Term ; Seoul

BACKGROUND: Electrophysiological study has been known as a useful method to evaluate the therapeutic effect of operation in idiopathic carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the clinical and electrophysiological changes after carpal tunnel release (CTR) compared to the preoperative results. METHODS: We analyzed the changes of nerve conduction study (NCS) before and after minimal open carpal tunnel release in 18 patients (25 hands) with CTS. Follow-up study was performed over 6 months after operation. RESULTS: Clinical improvement was seen in all cases after CTR. In contrast, electrophysiological improvement was various depending on the parameters; the mean median sensory latency and nerve conduction velocity (NCV) improved significantly (p = 0.001). The mean median motor latency also improved, but NCV and compound muscle action potential (CMAP) amplitude did not change. The extent of improvement was evident in moderate CTS, but not in severe CTS. CONCLUSIONS: In this preliminary study, all subjects who underwent CTR achieved a clinical relief along with a significant improvement of electrophysiological parameters such as median sensory latency, sensory NCV and median distal motor latency. After CTR, a number of cases with mild to moderate CTS showed a prominent improvement of clinical and electrophysiological parameters, while fewer improvements were seen in severe CTS, although it did not reach the statistical significance.
Action Potentials ; Carpal Tunnel Syndrome ; Electrophysiology ; Follow-Up Studies ; Hand* ; Humans ; Median Nerve ; Neural Conduction

Brain metastasis can form large cystic lesions, and its differentiation on the basis of imaging findings alone is difficult. A 36-year-old woman with headache visited emergency room. Two years ago, she was diagnosed as neurocysticercosis and had taken anti-parasite medications. However, in the current visit, the sizes of intracranial cystic lesions increased. Brain biopsy reported metastatic neuroendocrine tumor, and chest CT showed the primary site of the tumor. Cystic brain metastasis should be considered in cases with cystic brain lesions.
Adult ; Biopsy ; Brain ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Neoplasm Metastasis* ; Neurocysticercosis* ; Neuroendocrine Tumors ; Pregnant Women* ; Tomography, X-Ray Computed

No abstract available.
Cerebral Angiography ; Headache Disorders, Primary ; Vasoconstriction*

OBJECTIVE: Increased atrial size is frequently seen in ischemic stroke patients in clinical practice. There is controversy about whether left atrial enlargement (LAE) should be regarded as a risk factor for cerebral infarction. We investigated the association between indexed left atrial volume (LAVI) and conventional stroke risk factors as well as stroke subtypes in acute ischemic stroke patients. METHODS: One hundred eighty two acute cerebral infarction patients were included in this study. Brain magnetic resonance imaging and transthoracic echocardiography were done for all patients within 30 days of diagnosis of acute cerebral infarction. Echocardiographic LAE was identified when LAVI was more than 27 mL/m2. Stroke subtypes were classified by the Trial of Org 10171 in acute stroke treatment classification. RESULTS: There were significant differences between subjects with normal and increased LAVI in prevalence of stroke risk factors including atrial fibrillation (p = 0.001), hypertension (p = 0.000), valvular heart disease (p = 0.011) and previous stroke (p = 0.031). An increased LAVI was associated with cardioembolic subtype with an adjusted odds ratio was 6.749 (p = 0.002) compared with small vessel disease. CONCLUSION: Increased LAVI was more prevalent in those who had cardiovascular risk factors, such as atrial fibrillation, hypertension, valvular heart disease and history of previous stroke. LAE influenced most patients in all subtypes of ischemic stroke but was most prevalent in the cardioembolic stroke subtype. Increased LAVI might be a risk factor of cerebral infarction, especially in patients with cardioembolic stroke subtype.
Atrial Fibrillation ; Brain ; Cerebral Infarction ; Echocardiography ; Glycosaminoglycans ; Heart Valve Diseases ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Odds Ratio ; Prevalence ; Risk Factors ; Stroke