억제적 반응통제 기능의 신경해부학 연구
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억제적 반응통제 기능의 신경해부학 연구 : 활성화 및 신경화학적 두뇌 기능 영상 PET 연구 - PowerPoint PPT Presentation


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억제적 반응통제 기능의 신경해부학 연구 : 활성화 및 신경화학적 두뇌 기능 영상 PET 연구. Functional Neuroanatomical Study of Inhibitory Response-Control: Activation and Neurochemical PET Brain Imaging. 연구책임자 : 김상은 ( 성균관대학교 의과대학 ). 억제적 반응 통제 기능. 정상 비정상 (ADHD, OCD, 약물중독 , 치매 ). Neuroanatomical mapping

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억제적 반응통제 기능의 신경해부학 연구:

활성화 및 신경화학적 두뇌 기능 영상 PET 연구

Functional Neuroanatomical Study of Inhibitory Response-Control: Activation and Neurochemical PET Brain Imaging

연구책임자: 김상은 (성균관대학교 의과대학)


억제적 반응 통제 기능

정상

비정상(ADHD, OCD, 약물중독, 치매)

Neuroanatomical mapping

15O-Water PET, FDG PET

Tasks

Neuropsychological tests

Behavioral study

Neurochemical mapping

Dopamine

Acetylcholine

GABA

처치효과(methylphenidate, SSRI, detoxification)

  • 억제적 반응 통제의 신경해부학적 회로 규명

  • 억제적 반응 통제의 신경화학적 기전 규명

  • 인지신경기전의 신경화학적 해석

  • 신개념의 억제적 반응 통제 인지모델 개발

  • (신경해부학적-신경화학적 통합 인지모델)

  • 고차기능 응용시스템 개발을 위한 과학적 기반 구축


Frontotemporal lobar degeneration (FTLD)

Prototypic neurobehavioral syndromes

  • Frontotemporal dementia (FTD)

  • Frontotemporal dementia with motor neuron disease (MND)

  • Semantic dementia (SD)

  • Progressive nonfluent aphasia (PA)


Core clinical diagnostic features

  • FTD: Impairment in social interpersonal conduct

  • MND: Upper or lower motor neuron involvement

  • SD: Fluent speech with impaired naming and comprehension

  • PA: Nonfluent speech with agrammatism, anomia


Patients and Subjects

MND

SD

PA

AD

FTD

Controls

No.

19

6

6

3

9

7

Age (yr)

5812

568

588

5614

704

576

Sex (M/F)

7/12

1/5

1/5

1/2

5/4

6/1

MMSE

189

136

167

86

178

All subjects were right-handed.

Neuropsychological screening battery

  • Behavioral observation

  • MMSE

  • Frontal function: attention, frontal executive function, language

  • Temporal function: language, learning and memory

  • Parietal function: visuospatial function


FTD

MND

Frequency (%)

100

100

100

100

100

50

50

50

50

50

0

0

0

0

0

F

S

C

V

P

Motor neuron

involvment

Frontal

excutive

Personality

change

Visuospatial

Spontaenous

speech

Comprehension

AD

PA

SD

Frequency (%)

F

S

C

V

P

F

S

C

V

P

F

S

C

V

P

Neuropsycological test


FTD < Healthy controls

Z=-28

Z=-2

Z=16

Z=34

T value

6

4

2

o

p < .001, k = 100 voxel


100

50

0

Neuropsycological test

FTD

Frequency (%)

Frontal

excutive

Personality

change

Visuospatial

Spontaenous

speech

Comprehension


Correlation analysis in FTD

Attention

Executive Function

Korean Boston Naming Test

p < .05, k = 100 voxel


MND < Healthy controls

Z=-22

Z=-2

Z=14

Z=48

T value

6

4

2

o

p < .001, k = 100 voxel


100

50

0

Neuropsycological test

MND

Frequency (%)

Frontal

excutive

Personality

change

Visuospatial

Spontaenous

speech

Motor neuron

involvement

Comprehension


SD < Healthy controls

Z=-16

Z=-8

Z=2

Z=14

T value

10

8

6

4

2

o

p < .001, k = 100 voxel


100

50

0

Neuropsycological test

SD

Frequency (%)

Frontal

excutive

Personality

change

Visuospatial

Spontaenous

speech

Comprehension


PA < Healthy controls

Z=-22

Z=-4

Z=6

Z=16

T value

10

8

6

4

2

o

p < .001, k = 100 voxel


100

50

Frequency (%)

0

Frontal

excutive

Personality

change

Visuospatial

Spontaenous

speech

Comprehension

Neuropsycological test

PA


AD > FTD

FTD > AD

p < .001, k = 100 voxel


100

100

50

50

0

0

Frequency (%)

Frontal

excutive

Frontal

excutive

Personality

change

Personality

change

Spontaenous

speech

Spontaenous

speech

Visuospatial

Visuospatial

Comprehension

Comprehension

Neuropsycological test

FTD

AD


Summary and Conclusion

  • Different metabolic patterns between FTLD and AD

  • Distinct metabolic patterns between clinical syndromes of FTLD

  • Good correlation between metabolic patterns and clinical

  • symptoms of FTLD

  • Biochemical basis of clinical classification of FTLD

  • Evaluation and classification of patients with FTLD

  • at neurochemical levels


Clinico-Metabolic Correlation in FTLD

(as revealed in this study)

FTD Metabolic deficit in bilateral anterior cingulate gyrus and left inferior frontal cortex - Personality change and frontal dysfunction

MND Metabolic deficit in bilateral premotor areas - Frontal dysfunction with motor neuron involvement symptoms

SD Metabolic deficit in left posterior temporal cortex including Wernicke’s area - Impaired naming and comprehension

PA Metabolic deficit in bilateral prefrontal cortex and Broca’s area -Nonfluent aphasia


Go/NoGo task

Go/NoGo task


(%)

(%)

100

10

90

8

80

6

70

4

60

2

50

0

정상 대조군에서 각 조건별 오류율

정상 대조군에서 각 조건별 정반응률

98%

*

*

92%

8%

2%

Go_Hit

NoGo_Hit

Go_miss

NoGo_commission

error

* p < 0.05


(sec)

520

500

480

460

440

420

400

정상 대조군에서 각 조건별 반응 시간

*

501 sec

442 sec

Go_Hit_RT

NoGo_commission

error_RT

*p < 0.001


오류 분포율

7%

Other errors

20%

Miss error

73%

Commission error


(%)

100

90

80

70

60

50

(%)

(%)

98%

*

*

100

10

92%

8%

2%

0

50

Go_miss

Go_Hit

NoGo_Hit

NoGo_commission

error

OCD 환자에서 조건별 오류율

OCD 환자에서 조건별 정반응률

(%)

10

92%

92%

8%

8%

8

6

4

2

0

Go_miss

Go_Hit

NoGo_Hit

NoGo_commission

error

정상 대조군


OCD 환자에서 각 조건별 반응 시간

(sec)

(sec)

600

520

504 sec

500

500

360 sec

400

480

300

460

440

200

420

100

400

0

Go_Hit_RT

NoGo_commission

error_RT

정상 대조군에서 각 조건별 반응 시간

*

501 sec

442 sec

Go_Hit_RT

NoGo_commission

error_RT


향후 연구계획

  • 억제적 반응 통제의 신경해부학적/신경화학적 회로 구성

  • 억제적 반응 통제 기능 이상 환자(OCD, ADHD, 약물중독)

  • 에서 치료 전후의 신경회로 변화 탐색

  • 억제적 반응 통제 과제(task) 개발


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