Objective: Little is known about factors influencing of hippocampal metabolism (HM) in mild cognitive impairment (MCI). Our objective was to determine whether HM in patients with amnestic MCI (aMCI) is decreased than non-amnestic MCI (naMCI). Methods: Overall, 32 MCI patients underwent 18F-fluorodeoxyglucose-positron emission tomography. They were characterized as aMCI (n=18) or naMCI (n=14) according to comprehensive neuropsychological criteria. Analysis of variances were used to assess differences on HM between aMCI and naMCI after controlling age, sex, education and Korean version of Mini Mental Status Examination. Results: We found that HM was more decreased in aMCI than naMCI. This result was not changed after controlling hippocampal volume. Conclusion Our findings suggest that aMCI is associated with decreased HM in MCI.

OBJECTIVES: Most studies of hippocampal metabolism(HM) in amnestic mild cognitive impairment(aMCI) gave inconsistent results. Our objective was to evaluate the effect of amyloid-beta(Aβ) status on hippocampal metabolism in aMCI.METHODS: Overall, 23 aMCI underwent three-dimensional magnetic resonance imaging(MRI), ¹⁸F-fluorodeoxyglucose-positron emission tomography(¹⁸FDG-PET) and ¹⁸F-Fluorbetaben amyloid positron emission tomography (amyloid-PET). According to Aβ status on amyloid PET, 23 aMCI were classified as either Aβ+aMCI(N=13) or Aβ−aMCI(N=10). The primary outcome was HM using ¹⁸FDG-PET and we investigate the difference on HM between Aβ+aMCI and Aβ−aMCI using analysis of variance(ANOVA) model, after controlling hippocampal volume.RESULTS: We found that HM was more decreased in Aβ+aMCI than Aβ−aMCI. This result was not changed after controlling hippocampal volume.CONCLUSION: Our findings suggest that Aβ+ is associated with decreased HM, regardless of hippocampal volume, in aMCI.
Amyloid ; Cognition Disorders ; Metabolism ; Pilot Projects ; Plaque, Amyloid ; Positron-Emission Tomography

OBJECTIVE: The aims of this study was to present an association between the presence of psychotic symptoms and cortical thicknesses/subcortical volumes in patients with Alzheimer's disease (AD). METHODS: Fourteen AD patients with psychotic symptoms and 41 without psychotic symptoms underwent 3T MRI scanning. After adjusting the effects of confounding variables, the cortical thicknesses were compared between the AD patients with and without psychotic symptoms in multiple regions, across the continuous cortical surface. In addition, the subcortical volumes were compared with a structure-by-structure manner. RESULTS: AD patients with psychotic symptoms were characterized by significant smaller cortical thickness of left pars opercularis (F=4.67, p=0.02) and left lateral occipital gyrus (F=6.05, p=0.04) rather than those without psychotic symptoms, after adjusting the effects of age and scores on the Stroop test, non-psychotic items of Neuropsychiatry Inventory and Clinical Dementia Rating, triglyceride level and total intracranial volume. However, there were no significant differences in the subcortical volume between the two groups. CONCLUSION: These results suggest that AD psychosis may reflect more severe deterioration of neuropathologic change in specific brain region.
Alzheimer Disease* ; Brain ; Broca Area* ; Confounding Factors (Epidemiology) ; Dementia ; Humans ; Magnetic Resonance Imaging ; Neuropsychiatry ; Occipital Lobe* ; Psychotic Disorders ; Stroop Test ; Triglycerides

PURPOSE: To evaluate the changes and characteristics of the anterior segment of the eye after laser peripheral iridotomy (LPI) conducted on patients with acute angle closure crisis (AACC) for both therapeutic purposes and prophylactic purposes in the fellow eye. METHODS: Anterior segments were examined by topography, laser interferometry, anterior segment optical coherence tomography, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), angle opening distance (AOD), central corneal thickness (CCT), and axial length as compared to prior procedures in 20 eyes with glaucoma (treatment group) and 20 contralateral eyes (prophylactic group) in 20 patients diagnosed with AACC. RESULTS: Before laser treatment, there were no significant differences in pre-LPI ACV, ACA, AOD and axial length, although differences in the CCT and ACD existed between the groups. Compared to prior laser treatment at 1 and 3 months after laser treatment, the ACV, ACA, AOD 500, and AOD 750 increased in both groups. When both groups were compared 1 month after their laser treatments, the AOD 750 was increased in the treatment group. There were no significant differences between two groups 3 months post LPI. CONCLUSIONS: Other than changes in the ACD and CCT, no significant differences were observed in the anterior segment characteristics in AACC affected and contralateral eyes prior to LPI. After LPI, the treatment group showed greater changes in their anterior segments; however, the open angle was maintained at 1 month post treatment.
Anterior Chamber ; Glaucoma ; Glaucoma, Angle-Closure* ; Humans ; Interferometry ; Tomography, Optical Coherence

PURPOSE: To evaluate the clinical characteristics and risk factors of severe manifestation of herpes zoster ophthalmicus. METHODS: We conducted a retrospective analysis using medical records from 106 patients diagnosed with herpes zoster ophthalmicus from January 2012 to June 2015. Patients were classified according to the type and frequency of ophthalmologic manifestations. Patients with conjunctivitis, punctate keratitis, and pseudodendritic keratitis were classified into the mild group, whereas patients with deep stromal keratitis, endothelitis, scleritis, glaucoma, and extraocular muscle paralysis were classified into the severe group. The age, sex, severity, location of skin lesions, delayed time to treatment, the presence of Hutchinson's sign, and associated systemic diseases were compared between the groups. In addition, we investigated changes in vision, intraocular pressure, treatment duration, recurrence and the prevalence of postherpetic neuralgia. RESULTS: The incidence of conjunctivitis (47.2%), punctate keratitis (42.5%), pseudodendritic keratitis (12.2%), deep stromal keratitis (12.2%), endothelitis (15.1%), scleritis (18.9%), glaucoma (14.2%), and extraocular muscle (EOM) paralysis (4.7%) were observed in these patients. The group with mild disease included 70 cases with conjunctivitis, punctate keratitis and pseudodendritic keratitis. The severe group included 36 cases with deep stromal keratitis, endothelitis, scleritis, glaucoma and EOM palsy. Disease most often occurred in the distribution of the first branch of the trigeminal nerve, with no differences in the age or sex of patients in both groups. Severe manifestations were more common when a greater extent of the skin was involved, when Hutchinson's sign was present, or when treatment was significantly delayed. There were no significant differences between the two groups in recurrence or the presence of postherpetic neuralgia. CONCLUSION: Long-term treatment for herpes zoster opthalmicus is more likely to be required if severe manifestation of disease exists, such as widespread skin involvement, Hutchinson's sign, or a delay to the initiation of antiviral treatment. More active observation and treatment are required in such cases.
Conjunctivitis ; Glaucoma ; Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Incidence ; Intraocular Pressure ; Keratitis ; Medical Records ; Neuralgia, Postherpetic ; Paralysis ; Prevalence ; Recurrence ; Retrospective Studies ; Risk Factors* ; Scleritis ; Skin ; Time-to-Treatment ; Trigeminal Nerve

OBJECTIVE: The aim of this study is to determine whether there is any difference in white matter (WM) integrity between Alzheimer's disease (AD) with metabolic syndrome (MetS) and without MetS. METHODS: Altogether, 30 subjects were finally recruited from the Memory Impairment Clinics of Pusan National University Hospital in Korea. All subjects (AD with MetS : n=15, matched AD without MetS for age, gender and year of education : n=15) were underwent 3-tesla magnetic resonance imaging scans of diffusion tensor imaging. RESULTS: The mean fractional anisotropy of the AD with MetS was lower (p<0.05) in right posterior corona radiate, right corticospinal tract and right superior longitudinal fasciculus than that of the AD without MetS. CONCLUSION: Our findings suggest that WM integrity damage.
Alzheimer Disease* ; Anisotropy ; Busan ; Diffusion Tensor Imaging ; Education ; Humans ; Korea ; Magnetic Resonance Imaging* ; Memory ; Pyramidal Tracts ; White Matter*

OBJECTIVE: This study proposes an automated diagnostic method to classify patients with Alzheimer's disease (AD) of degenerative etiology using magnetic resonance imaging (MRI) markers. METHODS: Twenty-seven patients with subjective memory impairment (SMI), 18 patients with mild cognitive impairment (MCI), and 27 patients with AD participated. MRI protocols included three dimensional brain structural imaging and diffusion tensor imaging to assess the cortical thickness, subcortical volume and white matter integrity. Recursive feature elimination based on support vector machine (SVM) was conducted to determine the most relevant features for classifying abnormal regions and imaging parameters, and then a factor analysis for the top-ranked factors was performed. Subjects were classified using nonlinear SVM. RESULTS: Medial temporal regions in AD patients were dominantly detected with cortical thinning and volume atrophy compared with SMI and MCI patients. Damage to white matter integrity was also accredited with decreased fractional anisotropy and increased mean diffusivity (MD) across the three groups. The microscopic damage in the subcortical gray matter was reflected in increased MD. Classification accuracy between pairs of groups (SMI vs. MCI, MCI vs. AD, SMI vs. AD) and among all three groups were 84.4% (+/-13.8), 86.9% (+/-10.5), 96.3% (+/-4.6), and 70.5% (+/-11.5), respectively. CONCLUSION: This proposed method may be a potential tool to diagnose AD pathology with the current clinical criteria.
Alzheimer Disease* ; Anisotropy ; Atrophy ; Brain ; Classification* ; Diagnosis ; Diffusion Tensor Imaging ; Humans ; Magnetic Resonance Imaging ; Memory ; Mild Cognitive Impairment ; Pathology ; Support Vector Machine

OBJECTIVES: In this study, the authors evaluated the correlation between levels of serum lipid, homocysteine, and folate with volumes of hippocampus, amygdala, corpus callosum, and in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) type. METHODS: The study recruited patients who visited the dementia clinic of Haeundae Paik Hospital in Korea between March 2010 and June 2014. Among those, patients who had taken the neurocognitive test, brain magnetic resonance imaing, tests for serum lipid, homocysteine, folate, and apolipoprotein E (APOE) genotyping and diagnosed with aMCI or AD were included for analysis. Bilateral hippocampus, entorhinal cortex, amygdala and corpus callosum were selected for region of interest (ROI). The cross-sectional relationships between serum lipid, homocysteine, folate and ROI were assessed by partial correlation analysis and multiple linear regression analysis. RESULTS: In patients with aMCI, old age (> 80) and APOE epsilon4 carrier were associated with AD [odds ration (OR) : 12.80 ; 95% confidence interval (CI) : 2.25-72.98 and OR : 4.48 ; 95% CI : 1.58-12.67, respectively]. In patients with aMCI or AD, volumes and thickness of ROI were inversely correlated with levels of serum lipid and homocysteine. In multiple linear regression analyses, higher total cholesterol level was related to lower left, right hippocampus volume and left amygdala volume ; higher low-density lipoprotein cholesterol was related to lower right entorhinal cortex thickness ; higher homocysteine level was related to lower corpus callosum volume. CONCLUSIONS: Higher serum lipid and homocysteine levels are associated with decreased volume of hippocampus, amygdala, corpus callosum and entorhinal cortex thickness in patients with aMCI or AD. These findings suggest that serum lipid and homocysteine levels are associated with AD as a modifiable risk factor.
Alzheimer Disease ; Amygdala* ; Apolipoproteins ; Apolipoproteins E ; Brain ; Cholesterol ; Corpus Callosum* ; Dementia* ; Entorhinal Cortex* ; Folic Acid* ; Hippocampus* ; Homocysteine* ; Humans ; Korea ; Linear Models ; Lipoproteins ; Mild Cognitive Impairment* ; Risk Factors

PURPOSE: In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. MATERIALS AND METHODS: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. RESULTS: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. CONCLUSION: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.
Antidepressive Agents ; Diagnosis ; Fatigue ; Fibromyalgia* ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging* ; Prostaglandins B ; Thalamus ; Pregabalin

PURPOSE: The aim of this study was to evaluate the variations of brain volumetry between the different MR scanners or the different institutes. MATERIALS AND METHODS: Ten normal subjects were scanned at four different MR scanners, two of them were the same models, to measure inter-MR scanner variations using intraclass correlation coefficient (ICC), coefficient of variation (CV) and percent volume difference (PVD) and to calculate minimal thresholds to detect the significant volumetric changes in gray matter and subcortical regions. RESULTS: Averaged statistical reliability (ICC = 0.837) and volumetric variation (CV = 4.310%) in all segmented regions were observed on overall MR scanners. Comparing the segmented volumes with PVD between two MR scanners, volumetric differences on same models were the lowest (PVD = 3.611%) and volume thresholds were calculated with 7.168%. PVD results and thresholds values on systemically different MR scanners were evaluated with 5.785% and 11.340% respectively. CONCLUSION: Authors conclude that the reliability of brain volumetry is not so high. Calibration studies of MRI system and image processing are essential to reduce the volumetric variability. Additionally, frameworks comprised of database and algorithms with high-speed image processing are also required for the efficient image data management.
Brain ; Calibration