Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle , FOV 220 mm, matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

Objective : This study was conducted to assess the changes in the functional levels of affected upper extremities after treating patients with brain injury by intensive CIMT (Constraint-Induced Movement Therapy). Method : Design was single-subject experimental reversal design (A-B-A). Subjects was 6 persons with brain injury (F: 1, M: 5), mean age (57.0±9.6). Intensive CIMT was performed over 6 hours a day for 2 weeks. Box and block test and nine hole pegboard were used for assessment of affected upper extremity function before and after intervention. Results : Compared baseline 1, functional level in both intervention and baseline 2 revealed improved functional levels. In addition, carry over effect was shown in baseline 2 period. Conclusion : Intensive CIMT based on task-oriented activity is considered to be effective because it decrease the time to use the paretic limb and thereby overcomes the “learned nonuse”.

뇌기능 장애 환자에서 자세균형 제어능력의 저하는 보행 및 일상생활동작 수행 등에 어려움을 초래하며 이에 대한 정확한 평가 및 치료를 위하여 일상의 환경변화와 유사한 상황을 제공하고 이에 따른 자세균형 조절 능력을 파악하는 것이 중요하다. 본 연구는 뇌기능 장애 환자에서 가상적 움직이는 환경에 따른 자세균형 조절 기능을 정확히 평가하고 환경의 움직임이 자세균형 조절에 미치는 영향을 분석하였다. 15명의 뇌기능 장애 환자들과 정상인 15명을 대상으로 실생활과 유사한 환경의 조성을 위하여 HMD를 이용한 가상 환경 움직임(Virtual Moving Surround)을 네 가지 다른 패턴으로 제공하였다. 자세동요의 정도는 힘판을 이용하여 신체압력중심의 변화를 전체이동거리, 동요주파수, 최대 빈도 COP 위치로 측정하였으며 가상 환경의 차이에 따른 변화를 비교 분석하였다. 연구결과 검사 재검사 신뢰도평가에서 일관된 분석결과를 나타냈고 뇌 기능장애 환자와 정상인의 분석에서는 두 그룹간의 차이를 확인할 수 있었다. 특히 전후로 빠르게 변하는 가상 환경에서 가장 큰 자세동요를 나타내었고 통계적으로 유의한 차이가 있었다. 본 연구를 통해 뇌기능 장애 환자에서 가상 환경 변화가 자세균형 조절에 미치는 영향을 확인할 수 있었으며 이러한 환자들을 위한 치료와 평가 환경 조성 등에도 유용한 자료로 쓰일 수 있을 것으로 사료된다

Stroke occurs when local thrombosis, embolic particle or the rupture of blood vessele interrupts the blood floe to the brain. -estradiol 17-valerate has been reported to exert neuroprotective effects when administered before an ischemic insult. Recently, the pathophysiology of cerebral ischemia has been studied extensively in rat with various methods. In the present study, we investigates whether -estrodiol 17-valerate can protect against brain injury. RNA sample were extracted from the hippocampus of female rat, reverse-transcription in the presence of [32p] dATP. Differential gene express-ion profiles were revealed (Bone morphogenetic protein type 1A receptor, Protein disulphide isomerase, Leukemia inhibitor factor receptor, cytochrome bc- 1 complex-x core P, thiol-specific antioxidant protein). RT-PCR was used to validate the relative expression pattern obtained by the cDNA array. The precise relationship between the early expression of recovery genes and stroke is a matter of luther investigation. This Study was supported by the Korea Science and Engineering Foundation(KOSEF) through the Biohealth Products Research Center(BPRC), Inje University, Korea.

Objectives: This study was conducted to evaluate the validity of the Korean Computerized Neuro-psychological Test in measurement of cognitive functioning in patients with brain damage. Methods: Eight tests of Korean Computerized Neuro-psychological Test, (1) Simple Reaction time, (2) Choice Reaction time, (3) Color Word Vigilance, (4) Digit Classification, (5) Digit Addition, (6) Symbol Digit Substitution, (7) Digit Span, (8)Finger Tapping Speed, were administered to the 30 patients who had impairments in cognitive function. Mini Mental State Examination-K (MMSE-K), and Purdue Pegboard Test were also administered compare with the computerized tests. Results: It was found that Choice Reaction time, Color Word Vigilance, Digit Classification, Digit Addition, Symbol digit Substitution, and Digit Span of computerized tests were acceptable in the patients who had MMSE-K score of 20 and more than 20. And Simple Reaction Time was found to be a useful test in the patients with MMSE-K score of less than 20. MMSE-K scores were highly correlated with Choice Reaction time, Color Word Vigilance, Digit Classification, Digit Span of computerized test. The scores of Purdue Pegboard were also highly correlated with the scores of Finger Tapping Speed, In computerized tests, Choice Reaction time, Color Word Vigilance, Digit Classification, and Digit Span were correlated with each other. Conclusions: The results suggested that Korean Computerized Neuro-psychological Test was found to be a useful test in measurement and rehabilitation of patients with cognitive impairments.

Objective: This study was conducted to develop Korean version of Modified Mini-Mental Status (3MS) Examination and to examine it’s validity and reliability in patients with brain injuries. Method: The 3MS was administered to 24 patients with brain injuries from Jan. 1 to Apr. 30 in 2001 at two university hospitals in Korea. The instruments used for evaluating validity and reliability of 3MS were Mini-Mental Status Examination (MMSE), Neurobehavioral Cognitive Status Examination (NCSE), and Modified Barthel Index (MBI). Results: Test-retest reliability of 3MS was excellent (r=0.97), and Interitem correlation coefficients ranged from 0.49 to 1.00. The score changes between the two tests were not related with the gender, level of education, and the duration after the brain injury. When items of 3MS were compared with the items of NCSE to evaluate the construct validity, correlation coefficients ranged from 0.43 to 0.73. When the NCSE was used as a gold standard to evaluate cognitive dysfunction, optimal cutoff scores analyzed by the Receiver Operating Characteristic curves for 3MS and MMSE were 68 and 22, respectively. The sensitivity and specificity of both 3MS and MMSE were the same at 80% and 89.5%, respectively. Conclusion: This study showed that the 3MS was a valid and reliable instrument to screen cognitive dysfunction in patients with brain injuries.

본 연구에서는 알코올 섭취 방법이 간과 뇌에서 산화적 스트레스 유발 정도에 미치는 영향을 알아보고자 흰쥐에 5%의 에탄올이 함유된 물을 1개월간 자유로이 섭취하게 하는 방법 또는 2.5g/㎏의 에탄올을 1일 1회 1개월간 경구 투여하는 방법 등 알코올 투여 방법을 달리하고 간, 대뇌 및 소뇌에서 지질과산화 반응과 비타민 E의 함량 변화를 비교하였다. 5%-EtOH의 간조직에서는 비타민 E의 함량이 증가하고 지질과산화물은 변화가 없었으며, 2.5g-EtOH군의 간조직에서는 비타민 E의 함량은 변화가 없으나 지질과산화물은 유의적으로 증가하였다. 뇌 조직에서는, 5%-EtOH군의 대뇌와 소뇌 모두에서 지질과산화물이 증가하고 비타민 E의 함량이 감소하였다. 또한, 2.5g-EtOH군의 대뇌와 소뇌에서도 지질과산화물이 증가하고 비타민 E의 함량이 감소하였으며 그 정도는, 5%-EtOH군에서 보다 큰 경향을 보였다. 결론적으로, 간에서의 지질과산화 반응 및 비타민 E의 함량은 알코올 투여 방법에 따라 다양하게 나타났으나 대뇌와 소뇌에서는 본 연구에서 실시한 투여 방법 모두에 의해 산화적 스트레스가 유발되었다.

Objective: The purpose of this study was to investigate the effects of cognitive function and Activities of Daily Living (ADL) improvement with Traumatic Brain Injury(TBI) and Stroke patient through Computer Assisted Cognitive Rehabilitation (CACR) program within specific approach and hierarchial approach training program. For this investigation CACR training was administered to 14 patients diagnosed of TBI and Stroke. Method: The CACR was given to the subject patient for 1months, 5times a week and each stimulation lasted 30 minutes. Cognitive function and activities of daily living were compared pre-CACR program with post-CACR program by MMSE and FIM . Results: Summarizing the results of this investigation; 1. Statistically significant improvement in 8 items of MMSE and 11 items of FIM was found after the application of CACR program training. 2. Cognitive function showed the spastically significant improvement after CACR program within specific approach and hierarchial approach training program 3. Activities of daily living showed the statistically significant improvement after CACR program within specific approach and hierarchial approach especially hierarchial approach more statistically significant increased than specific approach.

뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonu se syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환