Background: and Purpose: This study aimed to evaluate the brain magnetic resonance imaging (MRI) of patients with acute transient global amnesia (TGA) using volumetric analysis to verify whether the brains of TGA patients have pre-existing structural abnormalities. Methods: We evaluated the brain MRI data from 87 TGA patients and 20 age- and sexmatched control subjects. We included brain MRIs obtained from TGA patients within 72 hours of symptom onset to verify the pre-existence of structural change. For voxel-based morphometric analyses, statistical parametric mapping was employed to analyze the structural differences between patients with TGA and control subjects. Results: TGA patients exhibited significant volume reductions in the bilateral ventral anterior cingulate cortices (corrected p<0.05). Conclusions TGA patients might have pre-existing structural changes in bilateral ventral anterior cingulate cortices prior to TGA attacks.

Background: and Purpose: Voice, reflecting cerebral functions, holds potential for analyzing and understanding brain function, especially in the context of cognitive impairment (CI) and Alzheimer’s disease (AD). This study used voice data to distinguish between normal cognition and CI or Alzheimer’s disease dementia (ADD). Methods: This study enrolled 3 groups of subjects: 1) 52 subjects with subjective cognitive decline; 2) 110 subjects with mild CI; and 3) 59 subjects with ADD. Voice features were extracted using Mel-frequency cepstral coefficients and Chroma. Results: A deep neural network (DNN) model showed promising performance, with an accuracy of roughly 81% in 10 trials in predicting ADD, which increased to an average value of about 82.0%±1.6% when evaluated against unseen test dataset. Conclusions Although results did not demonstrate the level of accuracy necessary for a definitive clinical tool, they provided a compelling proof-of-concept for the potential use of voice data in cognitive status assessment. DNN algorithms using voice offer a promising approach to early detection of AD. They could improve the accuracy and accessibility of diagnosis, ultimately leading to better outcomes for patients.

Background: and Purpose: Alzheimer’s disease (AD) is a neurodegenerative disease characterized by a progressive decline in cognition and performance of daily activities. Recent studies have attempted to establish the relationship between AD and sleep. It is believed that patients with AD pathology show altered sleep characteristics years before clinical symptoms appear. This study evaluated the differences in sleep characteristics between cognitively asymptomatic patients with and without some amyloid burden. Methods: Sleep characteristics of 76 subjects aged 60 years or older who were diagnosed with subjective cognitive decline (SCD) but not mild cognitive impairment (MCI) or AD were measured using Fitbit ® Alta HR, a wristwatch-shaped wearable device. Amyloid deposition was evaluated using brain amyloid plaque load (BAPL) and global standardized uptake value ratio (SUVR) from fluorine-18 florbetaben positron emission tomography. Each component of measured sleep characteristics was analyzed for statistically significant differences between the amyloid-positive group and the amyloid-negative group. Results: Of the 76 subjects included in this study, 49 (64.5%) were female. The average age of the subjects was 70.72±6.09 years when the study started. 15 subjects were classified as amyloid-positive based on BAPL. The average global SUVR was 1.598±0.263 in the amyloidpositive group and 1.187±0.100 in the amyloid-negative group. Time spent in slow-wave sleep (SWS) was significantly lower in the amyloid-positive group (39.4±13.1 minutes) than in the amyloid-negative group (49.5±13.1 minutes) (p=0.009). Conclusions This study showed that SWS is different between the elderly SCD population with and without amyloid positivity. How SWS affects AD pathology requires further research.

This report presents a unique case of checkrein deformities in both halluces following isolated intramuscular sarcoidosis, a rare occurrence given the infrequent musculoskeletal involvement in sarcoidosis. Typically resulting from flexor hallucis longus tendon entrapment by scar tissue post-trauma, the checkrein deformity reported in this paper presented with unusual metatarsophalangeal joint flexion and interphalangeal joint extension during ankle dorsiflexion. A 49-year-old woman with a history of intramuscular sarcoidosis presented with a great toe deformity and discomfort while wearing shoes, leading to a diagnosis of dynamic deformity, possibly attributed to tendon tethering by sarcoidosis. Surgical treatments, including abductor hallucis muscle intratendinous tenotomy, flexor hallucis longus Zplasty lengthening, Weil osteotomy, and Kirschner wire fixation, significantly improved the functional scores and patient discomfort.This report underscores the importance of recognizing dynamic deformities and the potential for rare diseases, such as sarcoidosis, to cause such conditions, highlighting the need for careful diagnosis and tailored surgical intervention for atypical checkrein deformities.

Background: and Purpose: Subjective cognitive decline (SCD) refers to the self-perception of cognitive decline with normal performance on objective neuropsychological tests. SCD, which is the first help-seeking stage and the last stage before the clinical disease stage, can be considered to be the most appropriate time for prevention and treatment. This study aimed to compare characteristics between the amyloid positive and amyloid negative groups of SCD patients. Methods: A cohort study to identify predictors for the clinical progression to mild cognitive impairment (MCI) or dementia from subjective cognitive decline (CoSCo) study is a multicenter, prospective observational study conducted in the Republic of Korea. In total, 120 people aged 60 years or above who presented with a complaint of persistent cognitive decline were selected, and various risk factors were measured among these participants.Continuous variables were analyzed using the Wilcoxon rank-sum test, and categorical variables were analyzed using the χ2 test or Fisher’s exact test. Logistic regression models were used to assess the predictors of amyloid positivity. Results: The multivariate logistic regression model indicated that amyloid positivity on PET was related to a lack of hypertension, atrophy of the left temporal lateral and entorhinal cortex, low body mass index, low waist circumference, less body and visceral fat, fast gait speed, and the presence of the apolipoprotein E ε4 allele in amnestic SCD patients. Conclusions The CoSCo study is still in progress, and the authors aim to identify the risk factors that are related to the progression of MCI or dementia in amnestic SCD patients through a two-year follow-up longitudinal study.

Background: and Purpose: Early detection of subjective cognitive decline (SCD) due to Alzheimer’s disease (AD) is important for clinical research and effective prevention and management. This study examined if quantitative electroencephalography (qEEG) could be used for early detection of AD in SCD. Methods: Participants with SCD from 6 dementia clinics in Korea were enrolled.18 F-florbetaben brain amyloid positron emission tomography (PET) was conducted for all the participants. qEEG was performed to measure power spectrum and source cortical activity. Results: The present study included 95 participants aged over 65 years, including 26 amyloid PET (+) and 69 amyloid PET (−). In participants with amyloid PET (+), relative power at delta band was higher in frontal (p=0.025), parietal (p=0.005), and occipital (p=0.022) areas even after adjusting for age, sex, and education. Source activities of alpha 1 band were significantly decreased in the bilateral fusiform and inferior temporal areas, whereas those of delta band were increased in the bilateral cuneus, pericalcarine, lingual, lateral occipital, precuneus, posterior cingulate, and isthmus areas. There were increased connections between bilateral precuneus areas but decreased connections between left rostral middle frontal area and bilateral frontal poles at delta band in participants with amyloid PET (+) showed. At alpha 1 band, there were decreased connections between bilateral entorhinal areas after adjusting for covariates. Conclusions SCD participants with amyloid PET (+) showed increased delta and decreased alpha 1 activity. qEEG is a potential means for predicting amyloid pathology in SCD. Further longitudinal studies are needed to confirm these findings.

Background: and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. Methods: This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). Results: Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. Conclusions In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.

Background: and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. Methods: This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). Results: Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. Conclusions In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.

OBJECTIVES: The purpose of this study was to develop new meal planning tools for a nutritionally balanced diet. METHODS: Based on the food exchange list for diabetes, we adjusted the food group classification system to reflect the suggested nutritional factors for chronic disease prevention and health promotion. We developed a nutritionally balanced dietary profile for adults and compared it with the dietary reference intakes for Koreans (KDRIs) and the food pattern recommended by the Korean Diabetes Association. RESULTS: The newly developed menu planning tools are the LOHAS food exchange table and the LOHAS food pattern. Our recommended daily 1,800 kcal dietary composition for adults is as follows: The carbohydrate food group consists of 4 ‘whole grains’, 3 ‘refined grains’, 2 ‘sugars’, 9 ‘vegetables’, 3 ‘starchy vegetables’, 2 ‘fruits’ and 1 ‘high sugar fruits’. The protein food group includes 3 ‘plant protein foods’, 3 ‘animal protein foods (low-fat)’, and 1 ‘animal protein foods (high-fat)’. The fat food group consists of 2 ‘oils and nuts’ and 1 ‘solid fats’. The total number of calories is estimated at 1,840 kcal and the energy ratio is 62% carbohydrate, 18% protein, 20% fat, 6.8% saturated fat and 13.2% sugars. Using the LOHAS food exchange table, it is possible to estimate values of saturated fat, unsaturated fat, dietary fiber, and sugars besides carbohydrate, protein and fat. It is also possible to compose a dietary design considering carbohydrate, sugars, saturated fat and dietary fiber. The LOHAS food pattern provides benefits for the management of both institutional food services and individual meals, as it can help reduce the levels of saturated fat and sugar intake and help develop healthy meals rich in unsaturated fats and dietary fiber. CONCLUSIONS: The LOHAS food exchange table and LOHAS food pattern are expected to be practical tools for designing and evaluating nutritionally balanced diets.
Adult ; Carbohydrates ; Chronic Disease ; Classification ; Diet ; Dietary Fats ; Dietary Fiber ; Fats, Unsaturated ; Food Services ; Health Promotion ; Humans ; Meals ; Menu Planning ; Recommended Dietary Allowances

OBJECTIVES: The purpose of this study was to develop new meal planning tools for a nutritionally balanced diet. METHODS: Based on the food exchange list for diabetes, we adjusted the food group classification system to reflect the suggested nutritional factors for chronic disease prevention and health promotion. We developed a nutritionally balanced dietary profile for adults and compared it with the dietary reference intakes for Koreans (KDRIs) and the food pattern recommended by the Korean Diabetes Association. RESULTS: The newly developed menu planning tools are the LOHAS food exchange table and the LOHAS food pattern. Our recommended daily 1,800 kcal dietary composition for adults is as follows: The carbohydrate food group consists of 4 ‘whole grains’, 3 ‘refined grains’, 2 ‘sugars’, 9 ‘vegetables’, 3 ‘starchy vegetables’, 2 ‘fruits’ and 1 ‘high sugar fruits’. The protein food group includes 3 ‘plant protein foods’, 3 ‘animal protein foods (low-fat)’, and 1 ‘animal protein foods (high-fat)’. The fat food group consists of 2 ‘oils and nuts’ and 1 ‘solid fats’. The total number of calories is estimated at 1,840 kcal and the energy ratio is 62% carbohydrate, 18% protein, 20% fat, 6.8% saturated fat and 13.2% sugars. Using the LOHAS food exchange table, it is possible to estimate values of saturated fat, unsaturated fat, dietary fiber, and sugars besides carbohydrate, protein and fat. It is also possible to compose a dietary design considering carbohydrate, sugars, saturated fat and dietary fiber. The LOHAS food pattern provides benefits for the management of both institutional food services and individual meals, as it can help reduce the levels of saturated fat and sugar intake and help develop healthy meals rich in unsaturated fats and dietary fiber. CONCLUSIONS: The LOHAS food exchange table and LOHAS food pattern are expected to be practical tools for designing and evaluating nutritionally balanced diets.
Adult ; Carbohydrates ; Chronic Disease ; Classification ; Diet ; Dietary Fats ; Dietary Fiber ; Fats, Unsaturated ; Food Services ; Health Promotion ; Humans ; Meals ; Menu Planning ; Recommended Dietary Allowances