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Jo KJ, Ho S, Hong YJ, Jeong JH, Kim S, Wang MJ, Choi SH, Han S, Yang DW, Park KH. Relationship Between Amyloid Positivity and Sleep Characteristics in the Elderly With Subjective Cognitive Decline. Dement Neurocogn Disord 2024; 23:22-29. [PMID: 38362054 PMCID: PMC10864700 DOI: 10.12779/dnd.2024.23.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/17/2024] Open
Abstract
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 amyloid-positive 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.
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Affiliation(s)
- Kyung Joon Jo
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - SeongHee Ho
- Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
- Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | | | - Seong Hye Choi
- Department of Neurology, Inha University, School of Medicine, Incheon, Korea
| | | | - Dong Won Yang
- Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
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Na S, Kang DW, Kim GH, Kim KW, Kim Y, Kim HJ, Park KH, Park YH, Byeon G, Suh J, Shin JH, Shim Y, Yang Y, Um YH, Oh SI, Wang SM, Yoon B, Yoon HJ, Lee SM, Lee J, Lee JS, Rhee HY, Lim JS, Jung YH, Chin J, Hong YJ, Jang H, Choi H, Choi M, Jang JW. The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis. Dement Neurocogn Disord 2024; 23:54-66. [PMID: 38362056 PMCID: PMC10864694 DOI: 10.12779/dnd.2024.23.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
Background and Purpose Dementia subtypes, including Alzheimer's dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes. Results From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88-0.98) and specificity was 0.84 (95% CI, 0.70-0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70-0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80-0.91) and the specificity was 0.88 (95% CI, 0.80-0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University College of Medicine, Jeonju, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University Hospital, College of Medicine, Hanyang University, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Jeewon Suh
- Department of Neurology, National Medical Center, Seoul, Korea
| | | | - YongSoo Shim
- Department of Neurology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - YoungSoon Yang
- Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong-il Oh
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bora Yoon
- Department of Neurology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sun Min Lee
- Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Juyoun Lee
- Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hak Young Rhee
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myungji Hospital, Goyang, Korea
| | - Juhee Chin
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Hyemin Jang
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Miyoung Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
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Na S, Lee C, Ho S, Hong YJ, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Han S, Kang SW, Kang S, Yang DW. A Longitudinal Study on Memory Enhancement in Subjective Cognitive Decline Patients: Clinical and Neuroimaging Perspectives. J Alzheimers Dis 2024; 97:193-204. [PMID: 38108349 DOI: 10.3233/jad-230667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) refers to the self-reported persistent cognitive decline despite normal objective testing, increasing the risk of dementia compared to cognitively normal individuals. OBJECTIVE This study aims to investigate the attributes of SCD patients who demonstrated memory function improvement. METHODS In this prospective study of SCD, a total of 120 subjects were enrolled as part of a multicenter cohort study aimed at identifying predictors for the clinical progression to mild cognitive impairment or dementia (CoSCo study). All subjects underwent 18F-florbetaben PET and brain MRI scans at baseline and annual neuropsychological tests. At the 24-month follow-up, we classified SCD patients based on changes in memory function, the z-score of the Seoul verbal learning test delayed recall. RESULTS Of the 120 enrolled patients, 107 successfully completed the 24-month follow-up assessment. Among these, 80 patients (74.8%) with SCD exhibited memory function improvements. SCD patients with improved memory function had a lower prevalence of coronary artery disease at baseline and performed better in the trail-making test part B compared to those without improvement. Anatomical and biomarker analysis showed a lower frequency of amyloid PET positivity and larger volumes in the left and right superior parietal lobes in subjects with improved memory function. CONCLUSIONS Our prospective study indicates that SCD patients experiencing memory improvement over a 24-month period had a lower amyloid burden, fewer cardiovascular risk factors, and superior executive cognitive function. Identifying these key factors associated with cognitive improvement may assist clinicians in predicting future memory function improvements in SCD patients.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, South Korea
| | - Chonghwee Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - SeongHee Ho
- Department of Neurology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea
| | - Yun Jeong Hong
- Department of Neurology, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, South Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | | | - Seung Wan Kang
- Data Center for Korean EEG, College of Nursing, Seoul National University, Seoul, South Korea
- iMediSync Inc. Seoul, South Korea
| | - Sungmin Kang
- Research and Development, PeopleBio Inc., Seongnam-si, Gyeonggi-do, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
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Lim EY, Ho SH, Hong YJ, Jeong JH, Park HK, Park KH, Kim SY, Wang MJ, Choi SH, Shim YS, Cho AH, Yang DW. Clinical Significance of Physical Frailty in Subjects With Subjective Cognitive Decline: A Prospective Study With Amyloid PET Data. J Clin Neurol 2023; 19:447-453. [PMID: 37455506 PMCID: PMC10471550 DOI: 10.3988/jcn.2022.0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND PURPOSE Physical frailty is known to be closely associated with cognitive impairment and to be an early sign of Alzheimer's disease. We aimed to understand the characteristics of physical frailty and define factors associated with physical frailty in subjects with subjective cognitive decline (SCD) by analyzing amyloid data. METHODS We prospectively enrolled subjects with SCD from a cohort study to identify predictors for the clinical progression to mild cognitive impairment or dementia from SCD (CoSCo). All of the subjects underwent brain magnetic resonance imaging, and brain amyloid positron-emission tomography (PET) to detect amyloid beta plaques. Self-reported exhaustion, handgrip strength, and gait speed were used to measure physical frailty. RESULTS Of 120 subjects with SCD, 26 (21.7%) were amyloid-positive in PET. Female (odds ratio [OR]=3.79, p=0.002) and amyloid-PET-positive (OR=3.80, p=0.008) subjects with SCD were at high risks of self-reported exhaustion. Amyloid PET positivity (OR=3.22, p=0.047) and high burden from periventricular white-matter hyperintensity (OR=3.34, 95% confidence interval=1.18-9.46, p=0.023) were significantly associated with a weaker handgrip. The subjects with SCD with self-reported exhaustion and weaker handgrip presented with lower cognitive performance in neuropsychological tests, especially for information processing speed and executive function. Subjects with a slower gait performed worse in visual memory function tests. CONCLUSIONS Amyloid PET positivity was associated with a higher risk of self-reported exhaustion and weaker handgrip in subjects with SCD. The subjects with SCD and physical frailty also performed worse in neuropsychological tests.
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Affiliation(s)
- Eun Ye Lim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Hee Ho
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun Jeong Hong
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee Kyung Park
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Jeong Wang
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Yong Soo Shim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - A Hyun Cho
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Hong YJ, Ho S, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Yang DW. Impacts of baseline biomarkers on cognitive trajectories in subjective cognitive decline: the CoSCo prospective cohort study. Alzheimers Res Ther 2023; 15:132. [PMID: 37550761 PMCID: PMC10405399 DOI: 10.1186/s13195-023-01273-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is a risk factor for Alzheimer's disease (AD); however, the rates of cognitive decline are variable according to underlying pathologies and biomarker status. We conducted an observational study and aimed to investigate baseline characteristics and biomarkers related with cognitive declines in SCD. Our study also assessed whether SCD participants showed different cognitive and biomarker trajectories according to baseline amyloid deposition. METHODS This study is a part of a longitudinal cohort study conducted in multi-centers in South Korea between 2018 and 2021. Individuals (≥ 60 years old) with persistent cognitive complaint despite of normal cognitive functions were eligible for the study. All participants underwent neuropsychological tests, florbetaben PET scans, plasma amyloid markers, and brain MRI scans. Annual follow-up evaluations included neuropsychological tests and assessments for clinical progressions. Regional brain volumetry and amyloid burden represented by PET-based standardized uptake value ratio (SUVR) were measured. We compared cognitive and brain atrophic changes over 24 months between amyloid positive-SCD (Aβ + SCD) and amyloid negative-SCD (Aβ-SCD) groups. Baseline factors associated with cognitive outcomes were investigated. RESULTS A total of 120 participants with SCD were enrolled and 107 completed follow-up evaluations. Aβ + SCD participants (n = 20, 18.5%) were older and more frequently APOE4 carriers compared with Aβ-SCD participants (n = 87). Baseline cognitive scores were not different between the two groups, except the Seoul Verbal Learning Test (SVLT) scores showing lower scores in the Aβ + SCD group. After 24 months, plasma amyloid markers were higher, and regional volumes (entorhinal, hippocampal, and pallidum) were smaller in the Aβ + SCD participants compared with Aβ-SCD participants adjusted by age, sex, and baseline volumes. SVLT delayed recall and controlled oral word association test (COWAT) scores indicated more declines in Aβ + SCD participants. Baseline left entorhinal volumes were related to verbal memory decline, while baseline frontal volumes and global SUVR values were related to frontal functional decline. CONCLUSION Aβ + SCD participants showed more cognitive decline and medial temporal atrophic changes during 24 months. Baseline neurodegeneration and amyloid burden were related with future cognitive trajectories in SCD. TRIAL REGISTRATION This study was registered at CRIS (KCT0003397).
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Affiliation(s)
- Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - SeongHee Ho
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, South Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Min Jeong Wang
- Department of Neurology, Roa Neurology Clinic, Seongnam, South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
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Kim M, Lee JL, Shin SJ, Bae WK, Lee HJ, Byun JH, Choi YJ, Youk J, Ock CY, Kim S, Song H, Park KH, Keam B. Phase II study of a trastuzumab biosimilar in combination with paclitaxel for HER2-positive recurrent or metastatic urothelial carcinoma: KCSG GU18-18. ESMO Open 2023; 8:101588. [PMID: 37385153 PMCID: PMC10485395 DOI: 10.1016/j.esmoop.2023.101588] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2) is a widely explored therapeutic target in solid tumors. We evaluated the efficacy and safety of trastuzumab-pkrb, a biosimilar of trastuzumab, in combination with paclitaxel, in HER2-positive recurrent or metastatic urothelial carcinoma (UC). PATIENTS AND METHODS We enrolled 27 patients; they were administered a loading dose of 8 mg/kg trastuzumab-pkrb on day 1, followed by 6 mg/kg and 175 mg/m2 paclitaxel on day 1 every 3 weeks, intravenously. All patients received six cycles of the combination treatment and continued to receive trastuzumab-pkrb maintenance until disease progression, unacceptable toxicity, or for up to 2 years. HER2 positivity (based on immunohistochemistry analysis) was determined according to the 2013 American Society of Clinical Oncology /College of American Pathologists HER2 testing guidelines. The primary endpoint was objective response rate (ORR); the secondary endpoints were overall survival (OS), progression-free survival (PFS), and safety. RESULTS Twenty-six patients were evaluated via primary endpoint analysis. The ORR was 48.1% (1 complete and 12 partial responses) and the duration of response was 6.9 months [95% confidence interval (CI) 4.4-9.3 months]. With a median follow-up of 10.5 months, the median PFS and OS were 8.4 months (95% CI 6.2-8.8 months) and 13.5 months (95% CI 9.8 months-not reached), respectively. The most common treatment-related adverse event (TRAE) of any grade was peripheral neuropathy (88.9%). The most common grade 3/4 TRAEs were neutropenia (25.9%), thrombocytopenia (7.4%), and anemia (7.4%). CONCLUSIONS Trastuzumab-pkrb plus paclitaxel demonstrates promising efficacy with manageable toxicity profiles in patients with HER2-positive recurrent or metastatic UC.
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Affiliation(s)
- M Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul; Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - J L Lee
- Department of Oncology and Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - S J Shin
- Division of Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul
| | - W K Bae
- Department of Hemato-Oncology, Chonnam National University Medical School & Hwasun Hospital, Hwasun
| | - H J Lee
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon
| | - J H Byun
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon
| | - Y J Choi
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul
| | - J Youk
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul; Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - C Y Ock
- Lunit, Seoul, Republic of Korea
| | - S Kim
- Lunit, Seoul, Republic of Korea
| | - H Song
- Lunit, Seoul, Republic of Korea
| | - K H Park
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul
| | - B Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul; Cancer Research Institute, Seoul National University College of Medicine, Seoul.
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Kim HJ, Shim Y, Han HJ, Kim BC, Park KH, Moon SY, Choi SH, Yang DW, Yoon B, Kim EJ, Jeong JH, Han SH. A Multicentre, Randomised, Open-Label, Prospective Study to Estimate the Add-On Effects Of Memantine as Ebixa ® Oral Pump (Solution) on Language in Patients with Moderate to Severe Alzheimer's Disease Already Receiving Donepezil (ROMEO-AD). Neurol Ther 2023; 12:1221-1233. [PMID: 37245175 PMCID: PMC10310610 DOI: 10.1007/s40120-023-00494-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/09/2023] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION This multicentre, randomised, open-label, and prospective study aimed to evaluate the effectiveness of memantine (memantine solution) on speech function in patients with moderate to severe Alzheimer's disease (AD) who were already on donepezil therapy. METHODS Participants were divided into two groups: the drug trial group was administered donepezil + memantine (memantine solution), while the control group was administered only donepezil. Patients in the test group were required to increase the dose of memantine by 5 mg/day per week for the first 4 weeks and were maintained at 20 mg/day until the end of the trial. RESULTS Of the 188 participants, 24 dropped out, and 164 completed the final research process. As the primary outcome, K-WAB showed an increase in scores in both groups compared to baseline scores; however, the difference was not statistically significant (P = 0.678). After 12 weeks, the donepezil treatment group had higher K-MMSE and lower CDR-SB scores than the donepezil and memantine combination group, indicating better cognitive and functional status. However, this effect was not sustained for 24 weeks. Patients who were assigned to receive only donepezil had Relevant Outcome Scale for AD (ROSA) scores that were higher by an average of 4.6 points compared to the donepezil and memantine combination group. The NPI-Q index improved compared to baseline values in both groups. CONCLUSIONS Although several clinical studies have reported significant improvements in speech function after the administration of memantine, clinical studies on speech function improvement in patients with Alzheimer's disease are still insignificant. There are no studies on the effect of donepezil and memantine in combination treatment on language function in the moderate and severe stages of AD. Therefore, we investigated the effect of memantine (memantine solution) on speech function in patients with moderate to severe AD who were administered donepezil at a stable dose. Although the efficacy of the combination therapy was not superior to that of donepezil monotherapy alone, memantine was effective in improving behavioural symptoms in patients with moderate or severe AD.
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Affiliation(s)
- Hee-Jin Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, South Korea.
| | - YongSoo Shim
- Department of Neurology, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gil Medical Center, Gachon University, Incheon, Republic of Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Eun-Joo Kim
- Department of Neurology, School of Medicine and Medical Research Institute, Pusan National University Hospital, Pusan National University, Busan, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Seol-Heui Han
- Department of Neurology, KonKuk University Seoul Hospital, Seoul, South Korea.
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Kang JM, Shin JH, Kim WR, Seo S, Seo H, Lee SY, Park KH, Na DL, Okamura N, Seong JK, Noh Y. Effects of the APOEɛ4 Allele on the Relationship Between Tau and Amyloid-β in Early- and Late-Onset Alzheimer's Disease. J Alzheimers Dis 2023; 94:1233-1246. [PMID: 37393505 DOI: 10.3233/jad-230339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023]
Abstract
BACKGROUND Little is known regarding the differential effects of the apolipoprotein E (APOE) ɛ4 on the regional topography of amyloid and tau in patients with both early-onset (EOAD) and late-onset Alzheimer's disease (LOAD). OBJECTIVE To compare the distribution and association of tau, amyloid, and cortical thickness among groups classified by the presence of APOEɛ4 allele and onset age. METHODS A total of 165 participants including 54 EOAD patients (29 ɛ4-; 25 ɛ4+), 45 LOAD patients (21 ɛ4-; 24 ɛ4+), and 66 age-matched controls underwent 3T MRI, 18F-THK5351 (THK) and 18F-flutemetamol (FLUTE) PET scans, APOE genotyping, and neuropsychological tests. Data for voxel-wise and standardized uptake values from PET scans were analyzed in the context of APOE and age at onset. RESULTS EOAD ɛ4- patients showed greater THK retention in the association cortices, whereas their EOAD ɛ4+ counterparts had more retention in medial temporal areas. THK topography of LOAD ɛ4+ was similar to EOAD ɛ4 + . THK correlated positively with FLUTE and conversely with mean cortical thickness, being lowest in EOAD ɛ4-, highest in LOAD ɛ4-, and modest in ɛ4+ groups. Even in the APOEɛ4+ groups, THK tended to correlate with FLUTE and mean cortical thickness in the inferior parietal region in EOAD and in the medial temporal region in LOAD. LOAD ɛ4- manifested with prevalent small vessel disease markers and the lowest correlation between THK retention and cognition. CONCLUSION Our observations suggest the differential effects of the APOEɛ4 on the relationship between tau and amyloid in EOAD and LOAD.
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Affiliation(s)
- Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jeong-Hyeon Shin
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea
- Bio Medical Research Center, Bio Medical & Health Division, Korea Testing Laboratory, Daegu, Republic of Korea
| | - Woo-Ram Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Seongho Seo
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Haeun Seo
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Sang-Yoon Lee
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul, Republic of Korea; Happymind Clinic, Seoul, Republic of Korea
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Joon-Kyoung Seong
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- Department of Health Science and Technology, GAIHST, Gachon University, Incheon, Republic of Korea
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Park KH, Yang DW, Hong YJ, Kim A, Ho S, Jeong JH, Kim S, Choi SH, Han S. Deep Sleep Time Measured by Wearable Device Associated with Amyloid Burden in the Elderly with Subjective Cognitive Decline. Alzheimers Dement 2022. [DOI: 10.1002/alz.060755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kee Hyung Park
- Gachon University Gil Medical Center Incheon Republic of South Korea
| | - Dong Won Yang
- Department of Neurology, St.Mary’s Hospital, School of Medicine, The Catholic University of Korea Seoul Republic of South Korea
| | - Yun Jeong Hong
- Catholic University of Korea, Uijeongbu ST. Mary’s Hospital Uijeongbu Republic of South Korea
| | - Ahro Kim
- The Catholic University of Korea, College of Medicine, Seoul St. Mary’s Hospital Seoul Republic of South Korea
| | - SeongHee Ho
- Department of Neurology, St.Mary’s Hospital, School of Medicine, The Catholic University of Korea Seoul Republic of South Korea
| | - Jee Hyang Jeong
- Ewha Womans University Mokdong Hospital Seoul Republic of South Korea
| | - SangYun Kim
- Seoul National University Bundang Hospital, Seoul National University College of Medicine Seongnam Republic of South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine Incheon Republic of South Korea
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Park SY, Ho SH, Hong YJ, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Kim REY, Yang DW, Park SN. The Effect of Hearing Loss on Cognitive Function in Subjective Cognitive Decline. Dement Geriatr Cogn Disord 2022; 51:348-356. [PMID: 36215961 DOI: 10.1159/000526230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/25/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Subjective cognitive decline (SCD) is a self-reported cognitive decline without objective cognitive impairment. The relationship between audiometric hearing loss (HL) and cognitive function has not been reported in SCD. The purpose of this study was to investigate whether HL affects cognition-related indexes in SCD individuals. METHODS This is a cross-sectional study that used the baseline data of a multicenter cohort study that monitors clinical progression from SCD to dementia. Individuals aged ≥60 years who reported cognitive decline but had no objective cognitive impairment on comprehensive neuropsychological tests were recruited. Participants were grouped into the normal-hearing (NH) and bilateral HL groups. The demographics, clinical characteristics, dementia biomarkers, global cognition, questionnaire scores, neuropsychological test scores, and segmental brain volumes from MRI were compared between the groups. RESULTS Of a total of 120 participants, one hundred and two had NH (n = 57) or bilateral HL (n = 45). There were no group differences in the demographic and clinical data except the age. The biomarkers, global cognition, and questionnaire scores were not different between the groups. The HL group performed worse (the z-score of -0.06) in the Stroop Color Word Test than the NH group (0.27) (p = 0.025). Brain volumetric analysis revealed that the HL group had reduced gray matter volumes in four brain subregions: left temporal pole, left caudal middle frontal gyrus, left hippocampus, and right isthmus of the cingulate gyrus. CONCLUSION In SCD, HL exerted an adverse effect on cognitive function, primarily frontal executive function tested in the Stroop task. HL was also related to gray matter volume reductions in brain subregions, although causality needs further investigation. This study may provide evidence for a potential link between hearing and cognition in SCD, an emerging clinical entity.
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Affiliation(s)
- So Young Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong Hee Ho
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yun Jeong Hong
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | | | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Regina E Y Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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11
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Kim EJ, Na DL, Kim HJ, Park KW, Lee JH, Roh JH, Kwon JC, Yoon SJ, Jung NY, Jeong JH, Jang JW, Kim HJ, Park KH, Choi SH, Kim S, Park YH, Kim BC, Youn YC, Ki CS, Kim SH, Seo SW, Kim YE. Genetic Screening in Korean Patients with Frontotemporal Dementia Syndrome. J Alzheimers Dis Rep 2022; 6:651-662. [DOI: 10.3233/adr-220030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Frontotemporal dementia (FTD) syndrome is a genetically heterogeneous group of diseases. However, pathogenic variants in the chromosome 9 open reading frame 72 (C9orf72), microtubule-associated protein tau (MAPT), and progranulin (GRN) genes are mainly associated with genetic FTD in Caucasian populations. Objective: To understand the genetic background of Korean patients with FTD syndrome. Methods: We searched for pathogenic variants of 52 genes related to FTD, amyotrophic lateral sclerosis, familial Alzheimer’s disease, and other dementias, and hexanucleotide repeats of the C9orf72 gene in 72 Korean patients with FTD using whole exome sequencing and the repeat-primed polymerase chain reaction, respectively. Results: One likely pathogenic variant, p.G706R of MAPT, in a patient with behavioral variant FTD (bvFTD) and 13 variants of uncertain significance (VUSs) in nine patients with FTD were identified. Of these VUSs, M232R of the PRNP gene, whose role in pathogenicity is controversial, was also found in two patients with bvFTD. Conclusions: These results indicate that known pathogenic variants of the three main FTD genes (MAPT, GRN, and C9orf72) in Western countries are rare in Korean FTD patients.
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Affiliation(s)
- Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee-Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jee Hoon Roh
- Department of Biomedical Sciences and Department of Physiology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jay C. Kwon
- Department of Neurology, Changwon Fatima Hospital, Changwon, Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Daejeon
| | - Na-Yeon Jung
- Department of Neurology, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Busan, Korea
| | - Jee H. Jeong
- Department of Neurology, Ewha Womans University Hospital, Seoul
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine and Clinical Neuroscience Center, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University College of Medicine and Clinical Neuroscience Center, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Byeong C. Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | | | - Seung-Hyun Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Young-Eun Kim
- Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, Korea
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
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Han HJ, Park MY, Park KW, Park KH, Choi SH, Kim HJ, Yang DW, Ebenezer EGAM, Yang YH, Kewalram GM, Han SH. A Multinational, Multicenter, Randomized, Double-Blind, Active Comparator, Phase III Clinical Trial to Evaluate the Efficacy and Safety of Donepezil Transdermal Patch in Patients With Alzheimer's Disease. J Clin Neurol 2022; 18:428-436. [PMID: 35796268 PMCID: PMC9262446 DOI: 10.3988/jcn.2022.18.4.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Oral administration of cholinesterase inhibitors is often associated with adverse gastrointestinal effects, and so developing an alternative administration route, such as transdermal, is urgently needed. The primary objective of this study was to determine the efficacy and safety of the IPI-301 donepezil transdermal patch compared with donepezil tablets (control) in mild-to-moderate probable Alzheimer’s disease (AD). Methods This prospective, randomized, double-blind, double-dummy, two-arm parallel, multicenter trial included 399 patients, among whom 303 completed the trial. For randomization, the patients were stratified based on previous treatment and donepezil dose; patients in each stratum were randomized to the test and control groups at a 1:1 ratio. Results The difference between the control group and the IPI-301 group, quantified as the Hodges–Lehmann estimate of location shift, was 0.00 (95% confidence interval: -1.00 to 1.33), with an upper limit of less than 2.02. The change in Alzheimer’s Disease Cooperative Study–Activities of Daily Living (ADCS-ADL) score differed significantly between the IPI-301 and control groups (p=0.02). However, the changes in the full-itemized ADCS-ADL scores at week 24 did not differ significantly between the two groups. There were no differences between the two groups regarding the scores for the Clinician Interview-Based Impression of Change (p=0.9097), Mini-Mental State Examination (p=0.7018), Neuropsychiatric Inventory (p=0.7656), or Clinical Dementia Rating (p=0.9990). Adverse events, vital signs, and laboratory test results were comparable between the two groups. Conclusions IPI-301 was safe and efficacious in improving cognitive function in patients with mild-to-moderate AD.
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Affiliation(s)
- Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Dong Won Yang
- Department of Neurology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | | | - Yuan-Han Yang
- Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | | | - Seol-Heui Han
- Department of Neurology, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
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13
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Ryu SY, Hong YJ, Ho S, Jeong JH, Park KH, Kim S, Wang MJ, Choi SH, Yang DW. Subtle Cognitive Deficits Are Associated with Amyloid-β Positivity, but Not Severity of Self-Reported Decline: Results from the CoSCo Study. Dement Geriatr Cogn Disord 2022; 51:159-167. [PMID: 35381591 DOI: 10.1159/000523971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/07/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Subjective cognitive decline (SCD) can be considered as the preclinical manifestation of Alzheimer's disease (AD). The National Institute on Aging and the Alzheimer's Association criteria for preclinical AD proposed that subtle cognitive changes appear along with AD biomarkers in the late stage of preclinical AD. The objective of this study was to explore whether subtle cognitive impairment (SCI) in individuals with SCD is associated with brain amyloid-β (Aβ) status and SCD severity. METHODS One hundred twenty individuals with SCD (mean age: 70.87 ± 6.10 years) were included in this study. SCI was defined as performance ≤ -1.0 SD on at least two neuropsychological tests. Participants underwent an amyloid positron emission tomography, which was assessed visually and quantitatively using standardized uptake value ratio (SUVR). The severity of SCD was assessed using two self-reported questionnaires: the SCD questionnaire based on the SCD-plus features and the Korean-Everyday Cognition (K-ECog) scale. RESULTS SCD individuals with SCI (n = 25) had more Aβ positivity than the SCD only group (n = 95) (44% vs. 15.79%; p = 0.002). In addition, the SCI group had a higher global SUVR than the SCD only group (p = 0.048). For self-reported questionnaires, there were no differences in SCD questionnaire total scores and K-ECog global and cognitive domain-specific scores between two groups. CONCLUSIONS In SCD individuals, SCI was associated with higher Aβ positivity, but not with the severity of self-reported cognitive decline, compared to the SCD only group. These results suggest that the recognition of objectively defined subtle cognitive deficits may contribute to the early identification of AD in SCD.
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Affiliation(s)
- Seon Young Ryu
- Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea,
| | - Yun Jeong Hong
- Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - SeongHee Ho
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Min Jeong Wang
- Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Shim Y, Han HJ, Park KW, Kim BC, Park KH, Park MY, Kim HJ, Moon SY, Choi SH, Park KW, Yang DW, Yoon SJ, Kim SY, Youn YC, Choi HJ, Yoon KE, Cho HJ, Han SH. A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase IIb Clinical Study to Evaluate the Safety and Efficacy of DHP1401 in Patients with Mild to Moderate Alzheimer's Disease Treated with Donepezil: DHP1401 Randomized Trial in Mild to Moderate Alzheimer's Disease (DRAMA). J Alzheimers Dis 2022; 87:391-403. [PMID: 35275529 DOI: 10.3233/jad-215277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Preclinical studies in transgenic models of Alzheimer's disease (AD) suggest that DHP1401 has neuroprotective and memory-enhancing effects. OBJECTIVE To evaluate the efficacy and safety of DHP1401 in AD patients treated with donepezilMethods:Methods: In a double-blind study, patients with mild-to-moderate AD were randomized (1:1:1) to receive a twice daily total dose of 500 mg or 1000 mg DHP1401 or placebo for 24 weeks. Tolerability and safety were monitored at baseline and weeks 12 and 24. RESULTS total of 180 patients were randomized to Active 1 (500 mg: n = 62), Active 2 (1000 mg: n = 53), and control groups (n = 65) in 16 sites in Korea. There was no significant difference in the Alzheimer's Disease Assessment Scale (ADAS-cog) score, the primary efficacy endpoint, from baseline. However, in the subgroup with mild AD patients (MMSE, 20-26) who received the high dose of DHP1401 and the group that received donepezil 5 mg, the ADAS-cog scores improved. MMSE and K-TMT-e type B were significant in both active groups at week 24. The most frequently observed symptom was dizziness (2.78%), and the most commonly observed reactions were related to metabolism and nutrition disorders (5.00%). No remarkable adverse events were observed for 24 weeks. CONCLUSION Although the effectiveness of DHP1401 was not proved to be superior as the primary efficacy endpoint, the secondary endpoints, MMSE and K-TMT-e type B, showed significant beneficial effects. Also, the subgroups showed that ADAS-cog scores significantly were improved. DHP1401 could be proven beneficial for the AD treatment by further clinical trials.
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Affiliation(s)
- YongSoo Shim
- Department of Neurology, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine and Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan, Republic of Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Hee-Jin Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Kun Woo Park
- Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Dong Won Yang
- Department of Neurology, The Catholic University of Korea, Seoul St. Mary's hospital, Seoul, Republic of Korea
| | - Soo Jin Yoon
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University, College of Medicine, Seoul, Republic of Korea
| | - Ho Jin Choi
- Department of Neurology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Koung Eun Yoon
- Clinical Trial Team, Daehwa Pharmaceutical Co., Ltd, Seoul, Republic of Korea
| | - Hyun Ju Cho
- Clinical Trial Team, Daehwa Pharmaceutical Co., Ltd, Seoul, Republic of Korea
| | - Seol-Heui Han
- Department of Neurology, Konkuk University Medical Center, Seoul, Republic of Korea
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15
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Yang DW, Hong YJ, Ho S, Jeong JH, Park KH, Kim S, Wang M, Choi SH, Han S, Kang SW. APOE ε4 predicts amyloid PET positive in amnesic subjective cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.055976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Dong Won Yang
- The Catholic University of Korea College of Medicine Seoul St. Mary’s Hospital Seoul South Korea
| | - Yun Jeong Hong
- Catholic University of Korea Uijeongbu St. Mary’s Hospital Uijeongbu South Korea
| | - SeongHee Ho
- Catholic University of Korea St Mary's Hospital Seoul South Korea
| | | | - Kee Hyung Park
- Gachon University Gil Medical Center Incheon South Korea
| | - Sangyun Kim
- Seoul National University Bundang Hospital Seoul National University College of Medicine Seongnam South Korea
| | | | | | | | - Seung Wan Kang
- Data Center for Korean EEG College of Nursing Seoul National University Seoul South Korea
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16
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Kim BC, Youn YC, Jeong JH, Han HJ, Kim JH, Lee JH, Park KH, Park KW, Kim EJ, Oh MS, Shim Y, Lee JM, Choi YH, Park G, Kim S, Park HY, Yoon B, Yoon SJ, Cho SJ, Park KC, Na DL, Park SA, Choi SH. Cilostazol Versus Aspirin on White Matter Changes in Cerebral Small Vessel Disease: A Randomized Controlled Trial. Stroke 2021; 53:698-709. [PMID: 34781708 DOI: 10.1161/strokeaha.121.035766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral small vessel disease is characterized by progressive cerebral white matter changes (WMCs). This study aimed to compare the effects of cilostazol and aspirin on changes in WMC volume in patients with cerebral small vessel disease. METHODS In a multicenter, double-blind, randomized controlled trial, participants with moderate or severe WMCs and at least one lacunar infarction detected on brain magnetic resonance imaging were randomly assigned to the cilostazol and aspirin groups in a 1:1 ratio. Cilostazol slow release (200 mg) or aspirin (100 mg) capsules were administered once daily for 2 years. The primary outcome was the change in WMC volume on magnetic resonance images from baseline to 2 years. Secondary imaging outcomes include changes in the number of lacunes or cerebral microbleeds, fractional anisotropy, and mean diffusivity on diffusion tensor images, and brain atrophy. Secondary clinical outcomes include all ischemic strokes, all ischemic vascular events, and changes in cognition, motor function, mood, urinary symptoms, and disability. RESULTS Between July 2013 and August 2016, 256 participants were randomly assigned to the cilostazol (n=127) and aspirin (n=129) groups. Over 2 years, the percentage of WMC volume to total WM volume and the percentage of WMC volume to intracranial volume increased in both groups, but neither analysis showed significant differences between the groups. The peak height of the mean diffusivity histogram in normal-appearing WMs was significantly reduced in the aspirin group compared with the cilostazol group. Cilostazol significantly reduced the risk of ischemic vascular event compared with aspirin (0.5 versus 4.5 cases per 100 person-years; hazard ratio, 0.11 [95% CI, 0.02-0.89]). CONCLUSIONS There was no significant difference between the effects of cilostazol and aspirin on WMC progression in patients with cerebral small vessel disease. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01932203.
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Affiliation(s)
- Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea (B.C.K.)
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea (Y.C.Y.)
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea (J.H.J.)
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea (H.J.H.)
| | - Jong Hun Kim
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea (J.H.K.)
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (J.-H.L.)
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea (K.H.P.)
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine and Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan, Republic of Korea (K.W.P.)
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea (E.-J.K.)
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea. (M.S.O.)
| | - YongSoo Shim
- Department of Neurology, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea (Y.S.)
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea. (J.-M.L., Y.-H.C., G.P.)
| | - Yong-Ho Choi
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea. (J.-M.L., Y.-H.C., G.P.)
| | - Gilsoon Park
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea. (J.-M.L., Y.-H.C., G.P.)
| | - Sohui Kim
- Department of Electronic Engineering, Hanyang University, Seoul, Republic of Korea. (S.K.)
| | - Hyun Young Park
- Department of Neurology, Wonkwang University School of Medicine, Iksan, Republic of Korea (H.Y.P.)
| | - Bora Yoon
- Department of Neurology, Konyang University College of Medicine, Daejeon, Republic of Korea (B.Y.)
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea (S.J.Y.)
| | - Soo-Jin Cho
- Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea. (S.-J.C.)
| | - Key Chung Park
- Department of Neurology, Kyung Hee University School of Medicine, Seoul, Republic of Korea (K.C.P.)
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (D.L.N.)
| | - Sun Ah Park
- Department of Anatomy and Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea (S.A.P.)
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea (S.H.C.)
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17
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Kang JM, Cho SE, Lee GB, Cho SJ, Park KH, Kim ST, Kang SG. Relationship between the Spectral Power Density of Sleep Electroencephalography and Psychiatric Symptoms in Patients with Breathing-related Sleep Disorder. Clin Psychopharmacol Neurosci 2021; 19:521-529. [PMID: 34294621 PMCID: PMC8316670 DOI: 10.9758/cpn.2021.19.3.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 11/18/2022]
Abstract
Objective Patients with breathing-related sleep disorder (BRSD) often complain of psychiatric symptoms such as depression in addition to snoring, excessive sleepiness, and disturbed sleep. However, the relationship between psychiatric symptoms and severity of sleep apnea in BRSD is controversial. We conducted this study to investigate the relationship between psychiatric symptoms and sleep electroencephalography (EEG) findings in BRSD patients using spectral analysis. Methods All participants underwent polysomnography and evaluation using Symptom Checklist-90-Revised (SCL-90-R) scale. We analyzed the absolute spectral power density values of standard EEG frequency bands in the participants (n = 169) with BRSD during the non-rapid eye movement (NREM) sleep period. We performed correlation analysis between the domain scores of SCL-90-R scale and the absolute values of the EEG frequency bands. Results Significant positive correlation was observed between the absolute spectral power density values in the slow oscillation band and the degree of paranoid ideation (r = 0.226, p = 0.028) and depression (r = 0.216, p = 0.044) in SCL-90-R. The multiple linear regression model showed that higher paranoid ideation domain score (B = 0.007, p = 0.020), younger age (B = −0.011, p < 0.001), and female sex (B = 0.213, p = 0.004) were associated with higher slow oscillation power during NREM sleep. Conclusion The results of the present study suggested a relationship between sleep EEG and psychiatric symptoms in patients with BRSD. This relationship needs to be validated with further studies.
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Affiliation(s)
- Jae Myeong Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Gun Bae Lee
- Gachon Sleep Medicine Center, Gachon University Gil Medical Center, Incheon, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seon Tae Kim
- Department of Otolaryngology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seung-Gul Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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18
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Kim EJ, Koh SH, Ha J, Na DL, Seo SW, Kim HJ, Park KW, Lee JH, Roh JH, Kwon JC, Yoon SJ, Jung NY, Jeong JH, Jang JW, Kim HJ, Park KH, Choi SH, Kim S, Park YH, Kim BC, Kim YE, Kwon HS, Park HH, Jin JH. Increased telomere length in patients with frontotemporal dementia syndrome. J Neurol Sci 2021; 428:117565. [PMID: 34311139 DOI: 10.1016/j.jns.2021.117565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Telomeres are repetitive DNA sequences of TTAGGG at the ends of chromosomes. Many studies have shown that telomere shortening is associated with aging-related diseases, such as cardiovascular diseases, hypertension, diabetes, cancer, and various neurodegenerative diseases, including Alzheimer's disease, vascular dementia, Parkinson's disease, and dementia with Lewy bodies. However, changes in telomere length (TL) in patients with frontotemporal dementia (FTD) syndrome are unclear. Accordingly, in this study, we assessed TL in blood samples from patients with FTD syndrome. METHODS Absolute TL was measured in peripheral blood leukocytes from 53 patients with FTD syndromes (25 with behavioral variant FTD, 19 with semantic variant primary progressive aphasia [PPA], six with nonfluent/agrammatic variant PPA, and three with amyotrophic lateral sclerosis [ALS] plus) and 28 cognitively unimpaired (CU) controls using terminal restriction fragment analysis. RESULTS TL was significantly longer in the FTD group than in the CU group. All FTD subtypes had significantly longer TL than controls. There were no significant differences in TL among FTD syndromes. No significant correlations were found between TL and demographic factors in the FTD group. CONCLUSIONS Longer telomeres were associated with FTD syndrome, consistent with a recent report demonstrating that longer telomeres are related to ALS. Therefore, our results may support a shared biology between FTD and ALS. More studies with larger sample sizes are needed.
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Affiliation(s)
- Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Seong-Ho Koh
- Department of Neurology, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea.
| | - Jungsoon Ha
- Department of Neurology, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea; GemVax & Kael Co., Ltd, Gyeonggi-do, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee Hoon Roh
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jay C Kwon
- Department of Neurology, Changwon Fatima Hospital, Changwon, Republic of Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulgi University Hospital, Daejeon, Republic of Korea
| | - Na-Yeon Jung
- Department of Neurology, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Busan, Republic of Korea
| | - Jee H Jeong
- Department of Neurology, Ewha Womans University Hospital, Seoul, Republic of Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine and Clinical Neuroscience Center, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University College of Medicine and Clinical Neuroscience Center, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Young-Eun Kim
- Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Hyuk Sung Kwon
- Department of Neurology, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Hyun-Hee Park
- Department of Neurology, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jeong-Hwa Jin
- Department of Neurology, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
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19
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Shim YS, Park KH, Chen C, Dominguez JC, Kang K, Kim HJ, Hong Z, Lin YT, Chu LW, Jung S, Kim S. Caregiving, care burden and awareness of caregivers and patients with dementia in Asian locations: a secondary analysis. BMC Geriatr 2021; 21:230. [PMID: 33827446 PMCID: PMC8028783 DOI: 10.1186/s12877-021-02178-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background This study investigated the differences in caregiver activity, caregiver burden, and awareness of both caregivers and patients with Alzheimer’s disease (AD) across different Asian locations. Methods This was a secondary analysis of a multi-national cohort study that aimed to assess caregiver activity and caregiver burden using the Caregiver Activity Scale (CAS) and Zarit Burden Interview (ZBI), respectively. Patients’ awareness of their dementia diagnosis was assessed by asking the following yes/no question: “Do you have dementia?” Caregivers’ awareness of the patient’s dementia diagnosis was assessed by asking the following yes/no question: “Does your patient have dementia?” Results In total, 524 caregivers of patients with AD from China, Hong Kong, South Korea, the Philippines, Singapore, Thailand, and Taiwan participated. The CAS and ZBI score were significantly different across most locations (p < 0.001 and p = 0.033, respectively). Overall, 56.6% of caregivers and 37.5% of patients had awareness of the dementia diagnosis, and the proportion of patients and caregivers with awareness were also different between each location (all, p < 0.001). Conclusions Caregiving, caregiver burden, and the awareness of caregivers and patients were different across many Asian locations. With understanding of cultural differences, further public education on dementia could help increase the awareness of patients and caregivers and reduce caregiver burden. Trial registration ClinicalTrials.gov, NCT02262975. Registered 13 October 2014,
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Affiliation(s)
- Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hee-Jin Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Zhen Hong
- Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yu-Te Lin
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Leung-Wing Chu
- Queen Mary Hospital, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - San Jung
- Department of Neurology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, 582, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Seoul, Republic of Korea.
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20
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Abstract
OBJECTIVE This retrospective study investigated the nature and severity of venom-induced consumption coagulopathy (VICC) and determined the clotting factors involved in VICC in patients after envenomation by South Korea's snakes. Additionally, we studied the effectiveness of antivenom for the treatment of VICC after envenomation. METHODS Included patients were divided into three groups according to the severity of VICC (no VICC, partial VICC, and complete VICC). Data, including changes in coagulation parameters during hospitalization and clotting factors at presentation, were collected and analyzed. RESULTS One hundred nineteen patients who presented at our emergency department within 3 h after snake envenomation were included. VICC developed in 34 patients (27 patients with partial VICC and 7 patients with complete VICC). Two of 34 patients with VICC required blood transfusions. Five patients with complete VICC had an undetectable fibrinogen concentration at presentation. Three patients with complete VICC had an unmeasurable INR and aPTT within 24 h. The median times of the most extreme values were 10 h for INR, 12 h for aPTT, and 16 h for fibrinogen after presentation in the VICC group. The D-dimer concentration peaked at a median of 63.5 h after presentation. The activities of factors II and X were significantly reduced in the complete VICC group (factor II: 88 (84-99.3)% in the non-VICC group vs. 69 (49.5-83.5)% in the complete VICC group; factor X:94 (83-102) in the non-VICC group vs. 70 (66.5-79.8)% in the complete VICC group), while there was no difference in factor V activity at presentation. The time from bite to first antivenom administration did not correlate with the time course and most extreme concentrations for fibrinogen and D-dimer within the VICC groups. DISCUSSION AND CONCLUSION VICC occurs in approximately one-quarter of snakebite patients in South Korea; however, VICC itself does not appear to lead to clinical deterioration. Fibrinogen is an early diagnostic maker for complete VICC. Clotting factors II and X are involved in VICC. Future investigations should explore the mechanism of VICC from Korean snakebites and the effect of antivenom on VICC.
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Affiliation(s)
- J M Moon
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - B J Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Y S Cho
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - J C Kim
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Y J Koo
- Department of Agricultural Chemistry, Chonnam National University, Gwangju, Republic of Korea
| | - K H Park
- Department of Emergency Medical Rescue, Nambu University, Gwangju, Republic of Korea.,Department of Medical science, Chonnam National University Graduate School, Gwangju, Republic of Korea
| | - S D Lee
- Department of Emergency Medicine in Trauma Center, Wonkwang University Hospital, Iksan, Republic of Korea
| | - J S Ahn
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - D K Kim
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - S J Ryu
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
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21
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Lee HJ, Lee EC, Seo S, Ko KP, Kang JM, Kim WR, Seo HE, Lee SY, Lee YB, Park KH, Yeon BK, Okamura N, Na DL, Seong JK, Noh Y. Identification of Heterogeneous Subtypes of Mild Cognitive Impairment Using Cluster Analyses Based on PET Imaging of Tau and Astrogliosis. Front Aging Neurosci 2021; 12:615467. [PMID: 33584247 PMCID: PMC7874013 DOI: 10.3389/fnagi.2020.615467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Mild cognitive impairment (MCI) is a condition with diverse causes and clinical outcomes that can be categorized into subtypes. [18F]THK5351 has been known to detect reactive astrogliosis as well as tau which is accompanied by neurodegenerative changes. Here, we identified heterogeneous groups of MCI patients using THK retention patterns and a graph theory approach, allowing for the comparison of risk of progression to dementia in these MCI subgroups. Methods: Ninety-seven participants including 60 MCI patients and individuals with normal cognition (NC, n = 37) were included and undertook 3T MRI, [18F]THK5351 PET, and detailed neuropsychological tests. [18F]Flutemetamol PET was also performed in 62 participants. We calculated similarities between MCI patients using their regional standardized uptake value ratio of THK retention in 75 ROIs, and clustered subjects with similar retention patterns using the Louvain method based on the modularity of the graph. The clusters of patients identified were compared with an age-matched control group using a general linear model. Dementia conversion was evaluated after a median follow-up duration of 34.6 months. Results: MCI patients were categorized into four groups according to their THK retention patterns: (1) limbic type; (2) diffuse type; (3) sparse type; and (4) AD type (retention pattern as in AD). Subjects of the limbic type were characterized by older age, small hippocampal volumes, and reduced verbal memory and frontal/executive functions. Patients of the diffuse type had relatively large vascular burden, reduced memory capacity and some frontal/executive functions. Co-morbidity and mortality were more frequent in this subgroup. Subjects of the sparse type were younger and declined only in terms of visual memory and attention. No individuals in this subgroup converted to dementia. Patients in the AD type group exhibited the poorest cognitive function. They also had the smallest hippocampal volumes and the highest risk of progression to dementia (90.9%). Conclusion: Using cluster analyses with [18F]THK5351 retention patterns, it is possible to identify clinically-distinct subgroups of MCI patients and those at greater risk of progression to dementia.
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Affiliation(s)
- Hyun Jeong Lee
- Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Eun-Chong Lee
- School of Biomedical Engineering, Korea University, Seoul, South Korea
| | - Seongho Seo
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, South Korea
| | - Kwang-Pil Ko
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, South Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Woo-Ram Kim
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
| | - Ha-Eun Seo
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
| | - Sang-Yoon Lee
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, South Korea
| | - Yeong-Bae Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Byeong Kil Yeon
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul, South Korea.,Department of Artificial Intelligence, Korea University, Seoul, South Korea.,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.,Department of Health Science and Technology, GAIHST, Gachon University, Incheon, South Korea
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22
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Park J, Choi H, Jang JW, Lim JS, Yang Y, Lee CN, Park KH. Validation of a New Screening Tool for Dementia: The Simple Observation Checklist for Activities of Daily Living. J Clin Neurol 2021; 17:106-112. [PMID: 33480205 PMCID: PMC7840314 DOI: 10.3988/jcn.2021.17.1.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/25/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose Screening tests for dementia such as the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment are widely used, but there are drawbacks to their efficient use. There remains a need for a brief and easy method of assessing the activities of daily living (ADL) that can be administered to elderly individuals by healthcare workers. We have therefore developed a new scale named the Simple Observation Checklist for Activities of Daily Living (SOC-ADL). Methods We developed the SOC-ADL scale as a team of experts engaged in caring for individuals with dementia. This scale comprises eight items and was designed based on the Korean instrumental activities of daily living (K-IADL) scale and the Barthel activities of daily living scale (Barthel Index). The new scale was validated by enrolling 176 patients with cognitive dysfunction across 6 centers. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed. We assessed its concurrent validity by performing comparisons with the Korean-MMSE, Clinical Dementia Rating, Clinical Dementia Rating-Sum of Boxes, K-IADL, and Barthel Index, and its criterion validity by performing comparisons between mild cognitive impairment (MCI) and dementia. We also used Cronbach's alpha to assess the interitem reliability. The appropriate cutoff values were determined by analyzing receiver operating characteristic curves, including the areas underneath them. Results EFA extracted one factor and CFA revealed that all of the model fits exceeded the minimum acceptable criteria. The SOC-ADL scores were strongly correlated with those of the other tools for dementia and could be used to differentiate MCI from dementia. Cronbach's alpha values indicated that the results were reliable. The optimal cutoff value of the SOC-ADL for discriminating dementia from MCI was 3 points, which provided a sensitivity and specificity of 74.5% and 75.7%, respectively. Conclusions Our results demonstrate that the SOC-ADL is a valid and reliable tool for differentiating dementia from MCI based on an assessment of ADL. This new tool can be used for screening ADL in elderly subjects who have difficulty communicating, and to increase the efficiency of dementia screening at the population level.
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Affiliation(s)
- Jinse Park
- Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Hojin Choi
- Department of Neurology, Hanyang University Guri Hospital, Guri, Korea.
| | - Jea Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Jae Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym Neurological Institute, College of Medicine, Hallym University, Anyang, Korea
| | - YoungSoon Yang
- Department of Neurology, Veterans Health Service Medical Center, Seoul, Korea
| | - Chan Nyoung Lee
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Medical Center, Incheon, Korea
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23
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Kim HJ, Shim YS, Park KH, Lee CN, Jung S, Yoon SJ, Jeong SK, Jeong JH, Choi SH, Kim EJ, Jang JW, Kang K, Yang Y, Kim S. Impact of an Education Program for Caregivers of Patients with Alzheimer's Disease on Treatment Discontinuation and Compliance in Korea. J Clin Neurol 2021; 17:368-375. [PMID: 34184444 PMCID: PMC8242308 DOI: 10.3988/jcn.2021.17.3.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE Reportedly 30-50% of patients being treated for chronic illnesses do not adhere to their medication regimen. We assessed the impact of a nurse-led education program for caregivers of Korean de novo Alzheimer's disease patients who had newly been prescribed donepezil. METHODS This multicenter study analyzed 93 participants in a caregiver education group and 92 participants in a caregiver no-education group. At every visit up to the end of the study (1 year), caregivers in the education group were given educational brochures regarding Alzheimer's disease and the efficacy and adverse events of donepezil treatment. The primary endpoint was the discontinuation rate of donepezil treatment during the 1-year observation period. The secondary endpoints included the effect of education on compliance with donepezil treatment assessed at each visit using a clinician rating scale (CRS) and visual analog scale (VAS), and changes from baseline in cognitive assessment tests. RESULTS The donepezil discontinuation rates at 1 year were 5.38% (5/93) and 6.52% (6/92) in the caregiver education and no-education groups, respectively (p=0.742). No significant between-group differences in donepezil compliance rates on the CRS and VAS were observed, but significant changes were observed in some cognitive tests from baseline to the end of the study. CONCLUSIONS Caregiver education had no significant effect on treatment discontinuation, but this may have been due to the low severity of cognitive impairment among the included population at baseline. In addition, the low discontinuation rates meant that no significant difference in treatment compliance was observed.
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Affiliation(s)
- Hee Jin Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea
| | - Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Chan Nyoung Lee
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - San Jung
- Department of Neurology, Hallym University Medical Center, Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Seul Ki Jeong
- Department of Neurology, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Eun Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Jae Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - YoungSoon Yang
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea.
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Park KH, Yang Y, Chen C, Shim YS, Domingueze JC, Lee CN, Kang K, Kim HJ, Jeong SK, Jeong JH, Hong Z, Yoon SJ, Zhang ZX, Kim EJ, Jang JW, Li Y, Xu Y, Lin YT, Qu Q, Hu CJ, Chou CH, Fan D, Kandiah N, Yang YH, Lau CI, Chu LW, Wang H, Jung S, Choi SH, Kim S. Discontinuation Rate of Newly Prescribed Donepezil in Alzheimer's Disease Patients in Asia. J Clin Neurol 2021; 17:376-384. [PMID: 34184445 PMCID: PMC8242303 DOI: 10.3988/jcn.2021.17.3.376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - YoungSoon Yang
- Department of Neurology, Soonchunhyang University of College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | - Chan Nyoung Lee
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyunghun Kang
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hee Jin Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea
| | - Seul Ki Jeong
- Department of Neurology, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Zhen Hong
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Soo Jin Yoon
- Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Zhen Xin Zhang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Eun Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Jae Won Jang
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Yansheng Li
- Department of Neurology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Xu
- Nanjing Drum Tower Hospital, Nanjing, China
| | - Yu Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Qiumin Qu
- Department of Neurology, the First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Chaur Jong Hu
- Dementia Center, Department of Neurology, Taipei Medical University Shuang-Ho Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih Ho Chou
- Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute; Singapore, Duke-NUS Graduate Medical School, Singapore: Lee Kong Chian Medical School-NTU, Singapore
| | - Yuan Han Yang
- Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi Ieong Lau
- Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Leung Wing Chu
- Queen Mary Hospital, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - San Jung
- Department of Neurology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine & Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea.
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25
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Ho S, Yang DW, Hong YJ, Jeong JH, Park KH, Kim S, Wang M, Choi SH, Han S, Kang SW, Lee H, Kim SM. QEEG: The tentative biomarker for early screening of preclinical Alzheimer’s disease or progressiveness of subjective cognitive decline. Alzheimers Dement 2020. [DOI: 10.1002/alz.042834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- SeongHee Ho
- Catholic University of Korea, St Mary's Hospital Seoul South Korea
| | - Dong Won Yang
- The Catholic University of Korea, College of Medicine, Seoul St. Mary’s Hospital Seoul South Korea
| | | | | | - Kee Hyung Park
- Gachon University Gil Medical Center Incheon South Korea
| | - SangYun Kim
- Alzheimer's Disease All Biomarker Research Group Seoul National University Bundang Hospital Seongnam South Korea
| | - Minjung Wang
- Roa Clinic Bundang South Korea
- Roa Neurology Clinic Seoungnam South Korea
| | - Seong Hye Choi
- Department of Neurology Inha University School of Medicine Incheon South Korea
| | | | - Seung Wan Kang
- Data Center for Korean EEG Seoul National University Seoul South Korea
- iMediSync Inc. Seoul South Korea
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26
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Noh Y, Cho J, Seo S, Kim W, Park KH, Kim C. Association between visceral fat amount and brain cortical thinning in the community‐dwelling elderly population. Alzheimers Dement 2020. [DOI: 10.1002/alz.045691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Young Noh
- Gachon University Gil Medical Center Incheon South Korea
| | - Jaelim Cho
- School of Medicine University of Auckland Auckland New Zealand
| | - Seongho Seo
- College of Medicine Gachon University Incheon South Korea
| | - Woo‐Ram Kim
- Neuroscience Research Institute Gachon University Incheon South Korea
| | - Kee Hyung Park
- Gachon University Gil Medical Center Incheon South Korea
| | - Changsoo Kim
- Institute of Human Complexity and Systems Science Yonsei University Incheon South Korea
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27
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Yang DW, Hong YJ, Ho SH, Jeong JH, Park KH, Kim SY, Wang M, Choi SH, Han S, Kang SW. A cohort study to identify predictors for the clinical progression to mild cognitive impairment or dementia from subjective cognitive decline. Alzheimers Dement 2020. [DOI: 10.1002/alz.043099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Dong Won Yang
- The Catholic University of Korea College of Medicine Seoul St. Mary’s Hospital Seoul South Korea
| | - Yun Jeong Hong
- Catholic University of Korea Uijeongbu St. Mary’s Hospital Uijeongbu South Korea
| | - Seong Hee Ho
- Catholic University of Korea St. Mary's Hospital Seoul South Korea
| | | | - Kee Hyung Park
- Gachon University Gil Medical Center Incheon South Korea
| | - Sang Yun Kim
- Alzheimer's Disease All Biomarker Research Group Seoul National University Bundang Hospital Seongnam South Korea
| | | | - Seong Hye Choi
- Department of Neurology Inha University School of Medicine Incheon South Korea
| | | | - Seung Wan Kang
- Data Center for Korean EEG Seoul National University Seoul South Korea
- iMediSync Inc. Seoul South Korea
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28
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Lee EC, Kang JM, Seo S, Seo HE, Lee SY, Park KH, Na DL, Noh Y, Seong JK. Association of Subcortical Structural Shapes With Tau, Amyloid, and Cortical Atrophy in Early-Onset and Late-Onset Alzheimer's Disease. Front Aging Neurosci 2020; 12:563559. [PMID: 33192457 PMCID: PMC7650820 DOI: 10.3389/fnagi.2020.563559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Abstract
The objectives of this study were to compare the topographical subcortical shape and to investigate the effects of tau or amyloid burden on atrophic patterns in early onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD). One hundred and sixty-one participants (53 EOAD, 44 LOAD, 33 young controls, and 31 older controls) underwent [18F]THK5351 positron emission tomography (PET), [18F]flutemetamol (FLUTE) PET, and 3T MRI scans. We used surface-based analysis to evaluate subcortical structural shape, permutation-based statistics for group comparisons, and Spearman's correlations to determine associations with THK, FLUTE, cortical thickness, and neuropsychological test results. When compared to their age-matched controls, EOAD patients exhibited shape reduction in the bilateral amygdala, hippocampus, caudate, and putamen, while in LOAD patients, the bilateral amygdala and hippocampus showed decreased shapes. In EOAD, widespread subcortical shrinkage, with less association of the hippocampus, correlated with THK retention and cortical thinning, while in LOAD patients, subcortical structures were limited which had significant correlation with THK or mean cortical thickness. Subcortical structural shape showed less correlation with FLUTE global retention in both EOAD and LOAD. Multiple cognitive domains, except memory function, correlated with the bilateral amygdala, caudate, and putamen in EOAD patients, while more restricted regions in the subcortical structures were correlated with neuropsychological test results in LOAD patients. Subcortical structures were associated with AD hallmarks in EOAD. However, the correlation was limited in LOAD. Moreover, relationship between subcortical structural atrophy and cognitive decline were quite different between EOAD and LOAD. These findings suggest that the effects of Alzheimer's pathologies on subcortical structural changes in EOAD and LOAD and they may have different courses of pathomechanism.
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Affiliation(s)
- Eun-Chong Lee
- School of Biomedical Engineering, Korea University, Seoul, South Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Seongho Seo
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, South Korea
| | - Ha-Eun Seo
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
| | - Sang-Yoon Lee
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.,Department of Health Science and Technology, GAIHST, Gachon University, Incheon, South Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul, South Korea.,Department of Artificial Intelligence, Korea University, Seoul, South Korea
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29
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Moon JM, Koo YJ, Chun BJ, Park KH, Cho YS, Kim JC, Lee SD, Min YR, Park HS. The effect of myocardial injury on the clinical course of snake envenomation in South Korea. Clin Toxicol (Phila) 2020; 59:286-295. [PMID: 32840397 DOI: 10.1080/15563650.2020.1802473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONTENT This study investigated the incidence, progression and clinical course of myocardial injury-related snake envenomation in South Korea. In addition, this study evaluated whether antivenom guidelines are appropriate to control envenomation in patients with myocardial injury. METHODS The study included 198 patients who received antivenom after a snakebite, and they were divided into two groups according to evidence of myocardial injury (defined as elevated troponin I or ischemic change on electrocardiogram) at presentation. Data including serial troponin I, echocardiogram/coronary angiogram findings, the clinical course, and treatment were collected and analyzed. RESULTS The incidence of myocardial injury at presentation was 15.2%. The troponin I level was 0.11 (0.07-0.56) ng/ml at presentation and tended to decrease over 24 h. Echocardiograms revealed neither regional wall motion abnormalities nor left ventricular dysfunction in 15 of 17 patients, while two patients showed signs of coronary artery stenosis on echocardiograms and coronary angiograms. However, compared with patients without myocardial injury, patients with myocardial injury had a higher frequency of systemic envenomation complications, including bleeding, respiratory failure, hypotension, acute kidney injury, thrombocytopenia and venom-induced consumption coagulopathy (VICC). The patients with myocardial injury at presentation needed significantly more frequent and larger doses of antivenom than indicated by the initial severity of envenomation. Multivariate analysis showed that myocardial injury was associated with the need for additional antivenom administration after initial administration. DISCUSSION AND CONCLUSION Myocardial injury is not uncommon after snake envenomation in Korea. Although myocardial injury itself seems to be benign, the clinical course of patients with myocardial injury is complicated, and myocardial injury is associated with the need for additional antivenom administration. The optimal use of antivenom to control envenomation in patents with myocardial injury after snake envenomation in South Korea should be established.
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Affiliation(s)
- J M Moon
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea
| | - Y J Koo
- Department of Agricultural Chemistry, Chonnam National University, Gwangju, Republic of Korea
| | - B J Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.,Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - K H Park
- Department of Emergency Medical Rescue, Nambu University, Gwangju, Republic of Korea.,Department of Medical science, Chonnam National University Graduate School, Gwangju, Republic of Korea
| | - Y S Cho
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - J C Kim
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - S D Lee
- Department of Emergency Medicine in Trauma Center, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Y R Min
- Department of Medical science, Chonnam National University Graduate School, Gwangju, Republic of Korea
| | - H S Park
- Department of Agricultural Chemistry, Chonnam National University, Gwangju, Republic of Korea
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30
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Choi M, Byun SJ, Lee DH, Kim KH, Park KH, Park SJ. The Association with rhegmatogenous retinal detachment and paediatric atopic dermatitis: a 12-year Nationwide Cohort Study. Eye (Lond) 2020; 34:1909-1915. [PMID: 32080352 PMCID: PMC7608199 DOI: 10.1038/s41433-020-0816-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/23/2019] [Accepted: 12/17/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Historically, atopic dermatitis (AD) is associated with an increased risk of rhegmatogenous retinal detachment (RRD). However, uncertainty remained regarding the effect of AD itself and comorbidities (e.g., allergic diseases, cataract surgery) on RRD occurrence in a large, population-based paediatric population. PATIENTS AND METHODS We analysed the 12-year National Health Insurance Service database (2002-2013) covering the entire Korean population to estimate the association between AD and RRD in people aged under 20 years. RESULTS We identified 3142 RRD patients, and matched 18,852 controls (six controls to each RRD patient); therefore, we included 21,994 peoples under aged 20 years in the analyses. AD was more prevalent in the RRD group (329 patients, 10.47%) than the control group (1043 patients, 5.53%; P < 0.001), and so were severe AD (153 patients [4.87%] and 223 patients [1.18%], respectively; P < 0.001). In conditional logistic regression analysis, AD was associated with RRD (OR, 1.61; 95% CI, 1.93-1.87) even after adjusting for allergic conditions, connective tissue disease, uveitis, and cataract surgery. In addition, severity of AD was associated with an increased risk of RRD (OR for non-severe AD and severe AD, 1.26 [95% CI, 1.05-1.51] and 2.88 [95% CI, 2.25-3.68]). CONCLUSION This study suggests that AD itself is a risk factor of RRD in children by showing the association between AD and RRD occurrence and the biologic gradient even after adjustment for known confounders including allergic conditions, uveitis, and cataract surgery.
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Affiliation(s)
- M Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - S J Byun
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - D H Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - K H Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - K H Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - S J Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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31
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Kim A, Kim S, Park KW, Park KH, Youn YC, Lee DW, Lee JY, Lee JH, Jeong JH, Choi SH, Han HJ, Kim S, Na S, Park M, Yim HW, Yang DW. Reliability and Validity of a Short Form of the Korean Dementia Screening Questionnaire-Cognition. J Clin Neurol 2020; 16:145-153. [PMID: 31942771 PMCID: PMC6974816 DOI: 10.3988/jcn.2020.16.1.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE We aimed to determine the reliability and validity of a short form of the Korean Dementia Screening Questionnaire-Cognition (KDSQ-C) as a screening tool for cognitive dysfunction. METHODS This study recruited 420 patients older than 65 years and their informants from 11 hospitals, and categorized the patients into normal cognition, mild cognitive impairment, and dementia subgroups. The KDSQ-C was completed separately by the patients and their informants. We abstracted three components of the KDSQ-C and combined these components into the following four subscales: KDSQ-C-I (items 1-5, memory domain), KDSQ-C-II (items 1-5 & 11-15, memory domain+activities of daily living), KDSQ-C-III (items 1-5 & 6-10, memory domain+other cognitive domains), and KDSQ-C-IV (items 6-10 & 11-15, other cognitive domains+activities of daily living). The reliability and validity were compared between these four subscales. RESULTS A receiver operating characteristic (ROC) analysis of questionnaire scores provided by the patients showed that the areas under the ROC curves (AUCs) for the KDSQ-C, KDSQC-I, and KDSQ-C-II for diagnosing dementia were 0.75, 0.72, and 0.76, respectively; the corresponding AUCs for informant-completed questionnaires were 0.92, 0.89, and 0.92, indicating good discriminability for dementia. CONCLUSIONS A short form of the patient- and informant-rated versions of the KDSQ-C (KDSQ-C-II) is as capable as the 15-item KDSQ-C in screening for dementia.
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Affiliation(s)
- Ahro Kim
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyung Won Park
- Department of Neurology, Cognitive Disorders and Dementia Center, Dong-A University College of Medicine and Institute of Convergence Bio-Health, Busan, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, Seoul, Korea
| | - Dong Woo Lee
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Jun Young Lee
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Jun Hong Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Goyang, Korea
| | - Semi Kim
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Seunghee Na
- Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Misun Park
- Clinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Clinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea.,Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
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32
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Jeong HJ, Lee H, Lee SY, Seo S, Park KH, Lee YB, Shin DJ, Kang JM, Yeon BK, Kang SG, Cho J, Seong JK, Okamura N, Villemagne VL, Na DL, Noh Y. [¹⁸F]THK5351 PET Imaging in Patients with Mild Cognitive Impairment. J Clin Neurol 2020; 16:202-214. [PMID: 32319236 PMCID: PMC7174126 DOI: 10.3988/jcn.2020.16.2.202] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background and Purpose Mild 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.
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Affiliation(s)
- Hye Jin Jeong
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Hyon Lee
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Sang Yoon Lee
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea
| | - Seongho Seo
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Yeong Bae Lee
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dong Jin Shin
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Byeong Kil Yeon
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Seung Gul Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Jaelim Cho
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Joon Kyung Seong
- Department of Biomedical Engineering, Korea University, Seoul, Korea.,Department of Artificial Intelligence, Korea University, Seoul, Korea
| | | | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Centre for PET, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, Korea
| | - Young Noh
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.,Department of Health Science and Technology, GAIHST, Gachon University, Incheon, Korea.
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Ryu SY, Kim A, Kim S, Park KW, Park KH, Youn YC, Lee DW, Lee JY, Lee JH, Jeong JH, Choi SH, Han HJ, Kim S, Na S, Park M, Yim HW, Yang DW. Self- and informant-reported cognitive functioning and awareness in subjective cognitive decline, mild cognitive impairment, and very mild Alzheimer disease. Int J Geriatr Psychiatry 2020; 35:91-98. [PMID: 31650618 DOI: 10.1002/gps.5224] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/24/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The present study examined self-reports and informant reports of cognitive function and discrepancies between the two reporting methods in healthy controls (HC), subjective cognitive decline (SCD), mild cognitive impairment (MCI), and very mild Alzheimer disease (AD) using three questionnaires. METHODS The study included a total of 300 individuals (mean age: 74.4 ± 5.7 y), including 130 HC, 70 SCD, 51 MCI, and 49 very mild AD patients. Self-ratings and informant ratings of cognitive function were assessed using the Korean Dementia Screening Questionnaire-Cognition (KDSQ-C), AD8, and Subjective Memory Complaints Questionnaire (SMCQ). Awareness of cognitive functioning was measured on the basis of the discrepancy scores between self-reports and informant reports. RESULTS Group comparisons on questionnaire scores adjusting for age, education, and depressive symptoms showed that self-reports were lowest in HC than other groups, with no differences between SCD and MCI groups. Informant reports were lower in SCD than in MCI, while discrepancy scores were higher in SCD than in MCI (P < .001 for KDSQ-C and SMCQ; P = .076 for AD8). There were no differences in self-reports, informant reports, and discrepancy scores between MCI and AD groups. CONCLUSIONS These results support the usefulness of informant-reported cognitive functioning to classify MCI among elderly with subjective cognitive complaints. In addition, discrepancies between self-reports and informant reports demonstrate that overestimation and underestimation of cognitive function may serve as a clinical indicator of SCD and MCI across the cognitive continuum, respectively.
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Affiliation(s)
- Seon Young Ryu
- Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ahro Kim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung Won Park
- Department of Neurology, Cognitive Disorders and Dementia Center, Dong-A University College of Medicine and Institute of Convergence Bio-Health, Busan, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Dong Woo Lee
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Hong Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang-si, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Goyang, Republic of Korea
| | - Semi Kim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seunghee Na
- Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Misun Park
- Department of Biostatistics, Clinical Research Coordinating Center, Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kang MJ, Kim SY, Na DL, Kim BC, Yang DW, Kim EJ, Na HR, Han HJ, Lee JH, Kim JH, Park KH, Park KW, Han SH, Kim SY, Yoon SJ, Yoon B, Seo SW, Moon SY, Yang Y, Shim YS, Baek MJ, Jeong JH, Choi SH, Youn YC. Prediction of cognitive impairment via deep learning trained with multi-center neuropsychological test data. BMC Med Inform Decis Mak 2019; 19:231. [PMID: 31752864 PMCID: PMC6873409 DOI: 10.1186/s12911-019-0974-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022] Open
Abstract
Background Neuropsychological tests (NPTs) are important tools for informing diagnoses of cognitive impairment (CI). However, interpreting NPTs requires specialists and is thus time-consuming. To streamline the application of NPTs in clinical settings, we developed and evaluated the accuracy of a machine learning algorithm using multi-center NPT data. Methods Multi-center data were obtained from 14,926 formal neuropsychological assessments (Seoul Neuropsychological Screening Battery), which were classified into normal cognition (NC), mild cognitive impairment (MCI) and Alzheimer’s disease dementia (ADD). We trained a machine learning model with artificial neural network algorithm using TensorFlow (https://www.tensorflow.org) to distinguish cognitive state with the 46-variable data and measured prediction accuracies from 10 randomly selected datasets. The features of the NPT were listed in order of their contribution to the outcome using Recursive Feature Elimination. Results The ten times mean accuracies of identifying CI (MCI and ADD) achieved by 96.66 ± 0.52% of the balanced dataset and 97.23 ± 0.32% of the clinic-based dataset, and the accuracies for predicting cognitive states (NC, MCI or ADD) were 95.49 ± 0.53 and 96.34 ± 1.03%. The sensitivity to the detection CI and MCI in the balanced dataset were 96.0 and 96.0%, and the specificity were 96.8 and 97.4%, respectively. The ‘time orientation’ and ‘3-word recall’ score of MMSE were highly ranked features in predicting CI and cognitive state. The twelve features reduced from 46 variable of NPTs with age and education had contributed to more than 90% accuracy in predicting cognitive impairment. Conclusions The machine learning algorithm for NPTs has suggested potential use as a reference in differentiating cognitive impairment in the clinical setting.
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Affiliation(s)
- Min Ju Kang
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea.,Department of Neurology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Hae Ri Na
- The Brain Fitness Center, Bobath Memorial Hospital, Seongnam, South Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jong Hun Kim
- Department of Neurology, Dementia Center, Ilsan Hospital, National Health Insurance Service, Goyang, South Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, South Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine and Institute of Convergence Bio-Health, Busan, South Korea
| | - Seol-Heui Han
- Department of Neurology, Konkuk University Medical Center, Seoul, South Korea
| | - Seong Yoon Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University College of Medicine, Daejeon, South Korea
| | - Bora Yoon
- Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - YoungSoon Yang
- Department of Neurology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Min Jae Baek
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | - Young Chul Youn
- Department of Neurology, College of Medicine, Chung-Ang University, Seoul, South Korea.
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Jeon S, Kang JM, Seo S, Jeong HJ, Funck T, Lee SY, Park KH, Lee YB, Yeon BK, Ido T, Okamura N, Evans AC, Na DL, Noh Y. Topographical Heterogeneity of Alzheimer's Disease Based on MR Imaging, Tau PET, and Amyloid PET. Front Aging Neurosci 2019; 11:211. [PMID: 31481888 PMCID: PMC6710378 DOI: 10.3389/fnagi.2019.00211] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/26/2019] [Indexed: 11/13/2022] Open
Abstract
Alzheimer’s disease (AD) patients are known to have heterogeneous clinical presentation and pathologic patterns. We hypothesize that AD dementia can be categorized into subtypes based on multimodal imaging biomarkers such as magnetic resonance imaging (MRI), tau positron emission tomography (PET), and amyloid PET. We collected 3T MRI, 18F-THK5351 PET, and 18F-flutemetamol (FLUTE) PET data from 83 patients with AD dementia [Clinical Dementia Rating (CDR) ≤1] and 60 normal controls (NC), and applied surface-based analyses to measure cortical thickness, THK5351 standardized uptake value ratio (SUVR) and FLUTE SUVR for each participant. For the patient group, we performed an agglomerative hierarchical clustering analysis using the three multimodal imaging features on the vertices (n = 3 × 79,950). The identified AD subtypes were compared to NC using general linear models adjusting for age, sex, and years of education. We mapped the effect size within significant cortical regions reaching a corrected p-vertex <0.05 (random field theory). Our surface-based multimodal framework has revealed three distinct subtypes among AD patients: medial temporal-dominant subtype (MT, n = 44), parietal-dominant subtype (P, n = 19), and diffuse atrophy subtype (D, n = 20). The topography of cortical atrophy and THK5351 retention differentiates between the three subtypes. In the case of FLUTE, three subtypes did not show distinct topographical differences, although cortical composite retention was significantly higher in the P type than in the MT type. These three subtypes also differed in demographic and clinical features. In conclusion, AD patients may be clustered into three subtypes with distinct topographical features of cortical atrophy and tau deposition, although amyloid deposition may not differ across the subtypes in terms of topography.
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Affiliation(s)
- Seun Jeon
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Seongho Seo
- Department of Neuroscience, Gachon University College of Medicine, Incheon, South Korea
| | - Hye Jin Jeong
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
| | - Thomas Funck
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Sang-Yoon Lee
- Department of Neuroscience, Gachon University College of Medicine, Incheon, South Korea
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Yeong-Bae Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Byeong Kil Yeon
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Tatsuo Ido
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.,Department of Health Science and Technology, GAIHST, Gachon University, Incheon, South Korea
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Yang DW, Kim A, Lee DW, Han HJ, Jeong JH, Lee JH, Lee JY, Park KH, Park KW, Kim S, Choi SH, Youn YC. P2-290: COMPARISON OF SELF AND INFORMANT EVALUATED KOREAN DEMENTIA SCREENING QUESTIONNAIRE COGNITION (KDSQ-C) FOR THE DIAGNOSIS OF MILD COGNITIVE IMPAIRMENT AND DEMENTIA. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dong Won Yang
- The Catholic University of South Korea; College of Medicine, Seoul St. Mary's Hospital; Seoul Republic of South Korea
| | - Ahro Kim
- The Catholic University of South Korea; College of Medicine, Seoul St. Mary's Hospital; Seoul Republic of South Korea
| | - Dong Woo Lee
- Inje University; Snaggye Paik Hospital; Seoul Republic of South Korea
| | | | - Jee Hyang Jeong
- Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine; Seoul Republic of South Korea
| | - Jun Hong Lee
- National Health Insurance Service Ilsan Hospital; Goyang-si Republic of South Korea
| | - Jun-Young Lee
- Seoul National University; College of Medicine; Seoul Republic of South Korea
| | - Kee Hyung Park
- Gachon University; Gil Medical Center; Incheon Republic of South Korea
| | - Kyung Won Park
- Dong-A University; College of Medicine; Busan Republic of South Korea
| | - SangYun Kim
- Clinical Neuroscience Center; Seoul National University Bundang Hospital; Seoungnam Republic of South Korea
| | - Seong Hye Choi
- Inha University; School of Medicine; Incheon Republic of South Korea
| | - Young Chul Youn
- Chung-Ang University Hospital; Seoul Republic of South Korea
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Noh Y, Cho J, Shin JH, Park KH, Na DL, Seong JK. P3-272: HETEROGENEITY OF FACTORS ASSOCIATED WITH COGNITIVE DECLINE AND CORTICAL THINNING IN EARLY- VERSUS LATE-ONSET ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Young Noh
- Gachon University Gil Medical Center; Incheon Republic of South Korea
| | - Jaelim Cho
- School of Medicine; University of Auckland; Auckland New Zealand
| | | | - Kee Hyung Park
- Gachon University Gil Medical Center; Incheon Republic of South Korea
| | - Duk L. Na
- Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of South Korea
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38
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Park HK, Jeong JH, Park SA, Choi SH, Han SH, Kim EJ, Kim BC, Han HJ, Moon SY, Yang DW, Park KW, Park KH, Yoon B, Seo SW, Na DL, ri Na H, Lee JH. P2-308: CLINICAL CHARACTERISTICS OF EARLY-ONSET ALZHEIMER'S DISEASE: A CLINICAL RESEARCH CENTER FOR DEMENTIA OF SOUTH KOREA (CREDOS) STUDY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hee Kyung Park
- Ewha Womans Mokdong Hospital; Seoul Republic of South Korea
| | - Jee Hyang Jeong
- Ewha Womans University Mokdong Hospital; Seoul Republic of South Korea
| | - Sun A. Park
- Ajou University; School of Medicine; Suwon Republic of South Korea
| | - Seong Hye Choi
- Department of Neurology; Inha University School of Medicine; Incheon Republic of South Korea
| | - Seol-Heui Han
- Konkuk University; School of Medicine; Seoul Republic of South Korea
| | - Eun-Joo Kim
- Pusan Medical University Hospital; Pusan Republic of South Korea
| | - Byeong-Chae Kim
- Department of Neurology; Chonnam National University Medical School; Gwangju Republic of South Korea
| | - Hyun Jeoung Han
- Department of Neurology; Myongji Hospital; Goyang Republic of South Korea
| | - So Young Moon
- Ajou University; School of Medicine; Suwon Republic of South Korea
| | - Dong Won Yang
- The Catholic University of South Korea; College of Medicine, Seoul St. Mary's Hospital; Seoul Republic of South Korea
| | - Kyung Won Park
- Dong-A University; College of Medicine; Busan Republic of South Korea
| | - Kee Hyung Park
- Gachon University; Gil Medical Center; Incheon Republic of South Korea
| | - Bora Yoon
- Konyang University; College of Medicine; Daejeon Republic of South Korea
| | - Sang Won Seo
- Samsung Medical Center; Seoul Republic of South Korea
| | - Duk L. Na
- Samsung Medical Center; Seoul Republic of South Korea
| | - Hae ri Na
- Bobath Memorial Hospital; Seongnam Republic of South Korea
| | - Jae-Hong Lee
- Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of South Korea
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Kim A, Kim S, Park KW, Park KH, Youn YC, Lee DW, Lee JY, Lee JH, Jeong JH, Choi SH, Han HJ, Kim S, Na S, Park M, Yim HW, Yang DW. A Comparative Evaluation of the KDSQ-C, AD8, and SMCQ as a Cognitive Screening Test to Be Used in National Medical Check-ups in Korea. J Korean Med Sci 2019; 34:e111. [PMID: 30977313 PMCID: PMC6460109 DOI: 10.3346/jkms.2019.34.e111] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/24/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Korea has a periodic general health check-up program that uses the Korean Dementia Screening Questionnaire-Cognition (KDSQ-C) as a cognitive dysfunction screening tool. The Alzheimer Disease 8 (AD8) and Subjective Memory Complaints Questionnaire (SMCQ) are also used in clinical practice. We compared the diagnostic ability of these screening questionnaires for cognitive impairment when completed by participants and their caregivers. Hence, we aimed to evaluate whether the SMCQ or AD8 is superior to the KDSQ-C and can be used as its replacement. METHODS A total of 420 participants over 65 years and their informants were recruited from 11 hospitals for this study. The patients were grouped into normal cognition, mild cognitive impairment, and dementia subgroups. The KDSQ-C, AD8, and SMCQ were completed separately by participants and their informants. RESULTS A receiver operating characteristic analysis of questionnaire scores completed by participants showed that the areas under the curve (AUCs) for the KDSQ-C, AD8, and SMCQ for diagnosing dementia were 0.75, 0.8, and 0.73, respectively. Regarding informant-completed questionnaires, the AD8 (AUC of 0.93), KDSQ-C (AUC of 0.92), and SMCQ (AUC of 0.92) showed good discriminability for dementia, with no differences in discriminability between the questionnaires. CONCLUSION When an informant-report is possible, we recommend that the KDSQ-C continues to be used in national medical check-ups as its discriminability for dementia is not different from that of the AD8 or SMCQ. Moreover, consistent data collection using the same questionnaire is important. When an informant is not available, either the KDSQ-C or AD8 may be used. However, in the cases of patient-reports, discriminability is lower than that for informant-completed questionnaires.
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Affiliation(s)
- Ahro Kim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyung Won Park
- Department of Neurology, Cognitive Disorders and Dementia Center, Dong-A University College of Medicine and Institute of Convergence Bio-Health, Busan, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, Seoul, Korea
| | - Dong Woo Lee
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Jun Young Lee
- Department of Psychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Hong Lee
- Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Goyang, Korea
| | - Semi Kim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seunghee Na
- Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Misun Park
- Clinical Research Coordinating Center, Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Clinical Research Coordinating Center, Catholic Medical Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Choi H, Bae JH, Lim JS, Moon Y, Park KH, Kim SH, Lee CN. Survey of Current Status and Cognition of Activities of Daily Living in Dementia Patients: the 2018 "Il-sang-ye-chan" Campaign. Dement Neurocogn Disord 2019; 18:1-9. [PMID: 31097967 PMCID: PMC6494780 DOI: 10.12779/dnd.2019.18.1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND PURPOSE Disability associated with activities of daily living (ADL) is the basis of dementia diagnosis and is an important factor in the care of dementia patients. The status of awareness and burden of ADL disability in dementia patients was investigated six years ago and used as an important reference for "Il-sang-ye-chan" campaign. They were re-investigated in six years and compared with previous results. METHODS The survey included caregivers of 100 dementia patients listed at the four regional dementia centers. Structured open and closed questions about ADL were asked. Assessments included age, sex, education level, economic status, severity of dementia, caregiving pattern, current statues and cognition of ADL, and caregiver needs. RESULTS The cognition of ADL was still very low (43%). Increased stress among caregivers was the biggest burden, and they frequently suffered from outing disability (56%), recent memory loss (48%), and loss of bowel/bladder control (40%). The economic burden has been greatly reduced compared with the burden six years ago and the needs of caregivers were still highly about educational guide lines or programs. CONCLUSIONS Continued interest and further investigation into ADL disability of dementia patients are needed. Korean Dementia Association will further expand the "Il-sang-ye-chan" program: via a multi-domain cognitive intervention program under the Care for ADL in dementia and Relieve symptoms in Dementia Project.
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Affiliation(s)
- Hojin Choi
- Department of Neurology, Hanyang University Guri Hospital, Guri, Korea
| | - Jeong Hoon Bae
- Department of Neurology, Hanyang University Guri Hospital, Guri, Korea
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University, Gil Medical Center, Incheon, Korea
| | - Seung Hyun Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Chan-Nyoung Lee
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
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41
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Kim JY, Park KH, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im YH, Park YH. Abstract P1-09-11: Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Genetic alteration of Estrogen Receptor 1(ESR1) gene have been associated with acquired endocrine resistance and occurred in about 20% of endocrine resistant estrogen receptor(ER)-positive metastatic breast cancer(MBC). Mutations in ligand binding domain of ESR1 lead to constitutive activity of the ER without ligand estrogen and stimulated down stream cell growth signal. Therefore, ESR1 ligand binding domain alteration is known resistant mechanism of aromatase inhibitor. Among these ESR1 mutations, Y537S, one of the ligand binding domain mutations, caused ER antagonist, fulvestrant resistance. Therefore, assessment of ESR1 mutation in ER-positive MBC had significant benefit to further precision medicine for MBCs. In this study, we explored to identify the frequency and type of ESR1 genetic alterations of ER-positive MBC.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 990 BC tissues. Of 990 tissue samples, 341(34.5%) were MBCs. Of MBCs, 112(11.3%) were ER-positive and human epidermal growth factor receptor 2(HER2)-negative BCs. In ER-positive HER2-negative MBCs (N=112), 21 ESR1 genetic alterations were identified in 19 BCs (17.0%). Nineteen were single nucleotide variats (SNVs) and three were copy number (CN) amplification. Most commonly detected single nucleotide variant (SNV) was D538G (6 of 19, 31.6%) followed by Y537N, Y537S, V382I (4, 2 and 2 cases, respectively). Three mutations occurred in non-ligand binding domain (G415V, V392I and P79A). Two BC samples harbored two ESR1 mutations, respectively (Y537S and D538G, L536P and Y537N). In terms of treatment, 11 of 12 patients with ER-positive MBC harboring ESR1 mutation received palliative endocrine therapies. Eight patients received aromatase inhibitor and two patients received tamoxifen. One patient received letrozole plus palbociclib. In 2 MBCs with Y537S mutation, progression free survival (PFS) of endocrine therapy was 1.4 and 5.3 months. MBCs with D538G had 12.3months of PFS (range, 5.3-23.7(months)) and BCs harboring another ligand binding domain mutations (Y537N, L536H and L536P) had 15.7months of PFS of endocrine therapy (range, 8.4-17.3(months)). BC with mutation observed in non-lignand binding domain had short PFS (1.8 (V392I) and 2.7 (P79A) months, respectively). In terms of ESR1 CN amplification, patients could not receive endocrine therapy because their BCs rapidly progressed and extensive distant metastases were occurred within 3 months after curative surgery.
Conclusion: In this exploratory study, ESR1 genetic alterations were detected in about 20% of ER-positive MBC. The type of genetic alterations varied including SNVs, CNAs. Each locus of ESR1 mutation predicted endocrine resistance. In addition, we might suggest that ESR1 CN amplification is prognostic marker of ER-positive BCs.
Citation Format: Kim J-Y, Park KH, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im Y-H, Park YH. Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-09-11.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim JY, Lee EJ, Park KH, Im SA, Kim SB, Sohn SH, Lee KS, Chae YS, Lee KH, Kim JH, Im YH, Kim TY, Lee KH, Ahn JH, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH, Park YH. Abstract P3-11-07: Exploratory biomarker analysis from a phase II, multicenter, randomized trial of eribulin plus gemcitabine(EG) versus paclitaxel plus gemcitabine(PG) as first-line chemotherapy for human epidermal growth factor receptor 2 (HER2)- negative metastatic breast cancer(MBC): Korean cancer study group trial (KCSG BR13-11). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-11-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction : A phase II, multicenter, randomized clinical trial of the comparison between eribulin plus gemcitabine (EG) and paclitaxel plus gemcitabine (PG) as first-line chemotherapy for patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) found EG was less neurotoxic, but had similar efficacy of PG. In this study, we performed exploratory biomarker analysis of the impact of genetic alterations on the efficacy according to EG and PG chemotherapy.
Methods : This biomarker study was conducted using tumor samples from 40patients. When tissue collection was possible after disease progression, we performed paired sample analysis. Tumor DNA and RNA were extracted from formalin-fixed, paraffin-embedded tissues. To perform targeted deep sequencing, we used CancerScanTM, a 375 cancer gene panel. And we performed an nCounter expression assay for gene expression analysis using 730 PanCancer panel and 730 Immune panel.
Results: In total, we obtained 44 tissue samples from 40 patients. Twenty two patients were assigned in EG arm and 18 patients were in PG arm. Thirty-eight were at baseline and six after disease progression. Gene expression assay were performed in 44 tissue samples but only 31 samples were possible to be targeted deep sequencing.
We performed differently expressed gene(DEG) analysis for detecting the association between level of gene expression and disease progression. In this analysis, high expression of CCNE1, TGFB4 and BAMBI and low expression of DDB2, CD14 and SHC3 were associated with disease progression among 730 PanCancer panel genes (p<0.05, respectively). In terms of immune panel genes, most of immune related genes were highly expressed in a group without disease progression compared with that with disease progression. Only 2 genes, C8G and CD24 were highly expressed in a group with disease progression. Paired sample analysis showed that expression levels of THBS4 and CD27 decreased after disease progression while those of CCNE2 and FGFR4 increased.
In targeted deep sequencing, FAT3 (42.3%) was most frequently mutated gene followed by PKHD1, PIK3CA and TP53. Among mutated genes, EWSR1 mutation and upstream mutation of ETV1 were associated with disease progression, respectively (p<0.05, respectively). In mutation signature analysis, signature 1 (S, age related), S3(homologous recombination deficiency, HRD), S6 (mismatch repair, MMR), S20(MMR) and S21(microsatellite instability, MSI) were enriched in this population. Mutation signature 3 related to short disease free survival (p=0.0026).
Conclusion: In gene expression analysis, high expression of TGF-B signaling pathway related genes was associated with disease progression while high expression of immune related genes were related to prolonged disease free survival. In mutation analysis, EWSR1 and ETV1 mutations indicated short disease free interval and HRD mutation signature was also related to poor prognosis.
Citation Format: Kim J-Y, Lee EJ, Park KH, Im S-A, Kim S-B, Sohn SH, Lee KS, Chae YS, Lee KH, Kim JH, Im Y-H, Kim T-Y, Lee K-H, Ahn J-H, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH, Park YH. Exploratory biomarker analysis from a phase II, multicenter, randomized trial of eribulin plus gemcitabine(EG) versus paclitaxel plus gemcitabine(PG) as first-line chemotherapy for human epidermal growth factor receptor 2 (HER2)- negative metastatic breast cancer(MBC): Korean cancer study group trial (KCSG BR13-11) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-11-07.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - EJ Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - S-A Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - S-B Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SH Sohn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KS Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - YS Chae
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - JH Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - T-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - K-H Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - J-H Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - GM Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - IH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SJ Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - HS Han
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SH Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Kim HJ, Noh WC, Nam SJ, Park BW, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee SJ, Jung J, Lee MH, Cho SH, Kim SY, Kim HA, Han SH, Han W, Hur MH, Ahn SH. Abstract P4-14-04: Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-14-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND
Assessment of restoration of ovarian function after chemotherapy is critical with respect to the initiation of different types of endocrine treatment in young high risk breast cancer patients
METHODS
In total, 1289 women who remained premenopausal or resumed premenopausal status after chemotherapy were randomized to receive 5 years of tamoxifen or 5 years of tamoxifen plus 2 years of ovarian suppression. The patients who did not resume menstruation were followed up for 2 years with tamoxifen treatment after finishing chemotherapy. Prospectively collected consecutive post-chemotherapy hormone and menstruation data were available for 705 breast cancer patients who enrolled tamoxifen-only treatment group or did not resume menstruation during follow up. This analysis evaluated the proportion of patients with pre-menopausal FSH levels (<30 mIU/ml), E2 levels (340 pg/ml), and menstruation at any time point during treatment with tamoxifen.
RESULTS
During 5 years of tamoxifen treatment after chemotherapy for premenopausal breast cancer patients, 62% of patients resumed menstruation. Menstruation returned in 92% of patients under 35 years old but only in 31% of patients over 45 years old. Ovarian function, defined by serum FSH and E2 levels, resumed in 94% and 65% of patients, respectively, over 5 years. Most patients achieved ovarian function restoration during the first 2 years after chemotherapy, with 47.1% resuming menstruation and 86.2% and 50.3% achieving pre-menopausal FSH and E2 levels, respectively, in the first 2 years. Clinical factors related to menstruation restoration were younger age (HR = 6.38, 95% CI 1.33-3.47), 6 month hormone profile after chemotherapy (FSH<30: HR=1.67, 95% CI 1.28-2.17; E2 >40: HR=2.96, 95% CI 2.25-3.89), and anthracycline without taxane chemotherapy (HR=1.63, 95% CI 1.25-2.13).
CONCLUSIONS
During 5 years of tamoxifen treatment after chemotherapy, half of patients experienced menstruation restoration, including most very young patients under 35 years. The majority of patients experienced menstruation restoration in the first 2 years of tamoxifen treatment.
Citation Format: Kim HJ, Noh WC, Nam SJ, Park B-w, Lee ES, Im SA, Jung YS, Yoon JH, Kang SS, Park KH, Lee S-J, Jung J, Lee MH, Cho SH, Kim SY, Kim H-A, Han S-H, Han W, Hur MH, Ahn SH. Time course changes in serum FSH, estradiol, and menstruation restoration in premenopausal patients with breast cancer taking adjuvant tamoxifen after completing chemotherapy: A report from the ASTRRA study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-14-04.
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Affiliation(s)
- HJ Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - WC Noh
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SJ Nam
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - B-w Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - ES Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SA Im
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - YS Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - JH Yoon
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SS Kang
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - KH Park
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-J Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - J Jung
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Lee
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Cho
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SY Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - H-A Kim
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - S-H Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - W Han
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - MH Hur
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
| | - SH Ahn
- College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea; Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Ajou University, School of Medicine, Suwon, Korea; Chonnam National University Hwasun Hospital, Gwangju, Korea; Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea; Korea University Anam Hospital, Seoul, Korea; Yeungnam University Hospital, Daegu, Korea; Gangnam Severance Hospital, Seoul, Korea; SoonChunHyang University Colleage of Medicine, Seoul, Korea; Dong-A University Hospital, Busan, Korea; Soonchunhyang University College of Medicine, Cheonan Hospital, Cheon
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Jeong HJ, Yoon CW, Seo S, Lee SY, Suh MK, Seo HE, Kim WR, Lee H, Heo JH, Lee YB, Park KH, Choi SH, Ido T, Lee KM, Noh Y. Relationships between [¹⁸F]-THK5351 Retention and Language Functions in Primary Progressive Aphasia. J Clin Neurol 2019; 15:527-536. [PMID: 31591842 PMCID: PMC6785468 DOI: 10.3988/jcn.2019.15.4.527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE There are three distinct subtypes of primary progressive aphasia (PPA): the nonfluent/agrammatic variant (nfvPPA), the semantic variant (svPPA), and the logopenic variant (lvPPA). We sought to characterize the pattern of [¹⁸F]-THK5351 retention across all three subtypes and determine the topography of [¹⁸F]-THK5351 retention correlated with each neurolinguistic score. METHODS We enrolled 50 participants, comprising 13 PPA patients (3 nfvPPA, 5 svPPA, and 5 lvPPA) and 37 subjects with normal cognition (NC) who underwent 3.0-tesla magnetic resonance imaging, [¹⁸F]-THK5351 positron-emission tomography scans, and detailed neuropsychological tests. The PPA patients additionally participated in extensive neurolinguistic tests. Voxel-wise and region-of-interest-based analyses were performed to analyze [¹⁸F]-THK5351 retention. RESULTS The nfvPPA patients exhibited higher [¹⁸F]-THK5351 retention in the the left inferior frontal and precentral gyri. In svPPA patients, [¹⁸F]-THK5351 retention was elevated in the anteroinferior and lateral temporal cortices compared to the NC group (left>right). The lvPPA patients exhibited predominant [¹⁸F]-THK5351 retention in the inferior parietal, lateral temporal, and dorsolateral prefrontal cortices, and the precuneus (left>right). [¹⁸F]-THK5351 retention in the left inferior frontal area was associated with lower fluency scores. Comprehension was correlated with [¹⁸F]-THK5351 retention in the left temporal cortices. Repetition was associated with [¹⁸F]-THK5351 retention in the left inferior parietal and posterior temporal areas, while naming difficulty was correlated with retention in the left fusiform and temporal cortices. CONCLUSIONS The pattern of [¹⁸F]-THK5351 retention was well matched with clinical and radiological findings for each PPA subtype, in agreement with the anatomical and functional location of each language domain.
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Affiliation(s)
- Hye Jin Jeong
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Cindy W Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Seongho Seo
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea
| | - Sang Yoon Lee
- Department of Neuroscience, College of Medicine, Gachon University, Incheon, Korea
| | - Mee Kyung Suh
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha Eun Seo
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Woo Ram Kim
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Hyon Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jae Hyeok Heo
- Department of Neurology, Seoul Medical Center, Seoul, Korea
| | - Yeong Bae Lee
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Kee Hyung Park
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Tatsuo Ido
- Neuroscience Research Institute, Gachon University, Incheon, Korea
| | - Kyoung Min Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Noh
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.,Department of Health Science and Technology, GAIHST, Gachon University, Incheon, Korea.
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Noh Y, Lim TS, Lee SY, Park KH, Shin DJ, Na DL, Ido T. O3‐10‐01: DIFFERENT EFFECTS OF APOE ε4 ALLELE ON THE RELATIONSHIP BETWEEN TAU AND β‐AMYLOID IN EARLY‐ONSET AND LATE‐ONSET ALZHEIMER DISEASE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Young Noh
- Gachon University Gil Medical CenterIncheonSouth Korea
| | - Tae Sung Lim
- Ajou University School of MedicineSuwonSouth Korea
| | - Sang-Yoon Lee
- College of MedicineGachon UniversityIncheonSouth Korea
| | | | - Dong Jin Shin
- Gachon University Gil Medical CenterIncheonSouth Korea
| | - Duk L. Na
- Samsung Medical CenterSeoulSouth Korea
| | - Tatsuo Ido
- Neuroscience Research InstituteGachon UniversityIncheonSouth Korea
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46
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Noh Y, Seong JK, Shin DJ, Park KH, Na DL, Ido T. IC‐P‐211: IDENTIFICATION OF HETEROGENEOUS GROUPS OF MILD COGNITIVE IMPAIRMENT BASED ON [
18
F]THK5351 RETENTION PATTERNS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Young Noh
- Gachon University Gil Medical CenterIncheonSouth Korea
| | | | - Dong Jin Shin
- Gachon University Gil Medical CenterIncheonSouth Korea
| | | | - Duk L. Na
- Samsung Medical CenterSeoulSouth Korea
| | - Tatsuo Ido
- Neuroscience Research InstituteGachon UniversityIncheonSouth Korea
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47
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Kim EJ, Kim YE, Jang JH, Cho EH, Na DL, Seo SW, Jung NY, Jeong JH, Kwon JC, Park KH, Park KW, Lee JH, Roh JH, Kim HJ, Yoon SJ, Choi SH, Jang JW, Ki CS, Kim SH. Analysis of frontotemporal dementia, amyotrophic lateral sclerosis, and other dementia-related genes in 107 Korean patients with frontotemporal dementia. Neurobiol Aging 2018; 72:186.e1-186.e7. [PMID: 30054184 DOI: 10.1016/j.neurobiolaging.2018.06.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/16/2018] [Accepted: 06/24/2018] [Indexed: 11/15/2022]
Abstract
To identify pathogenic variants in 107 Korean patients with sporadic frontotemporal dementia (FTD), 46 genes related to FTD, amyotrophic lateral sclerosis, and other dementias were screened by next-generation sequencing. Hexanucleotide repeats in C9orf72 gene were also tested by repeat-primed polymerase chain reaction. Next-generation sequencing revealed one known pathogenic variant (c.708+1G>A) in the GRN gene in a patient with behavioral variant FTD (bvFTD). In addition, a novel in-frame deletion (c.2675_2683del) in the CSF1R gene was identified in a patient with bvFTD who had severe bifrontal atrophy with frontal subcortical white matter changes. Novel compound heterozygous variants in the AARS2 gene, c.1040+1G>A and c.636G>A (p.Met212Ile), were found in a patient with bvFTD. Forty-six variants of uncertain significance were detected in other patients. None of the patients had expanded hexanucleotide repeats in C9orf72. These results show that pathogenic variants of known FTD genes are rare in Korean FTD patients but the CSF1R and AARS2 genes should be screened for a genetic diagnosis of FTD or other dementias.
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Affiliation(s)
- Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Young-Eun Kim
- Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Ja-Hyun Jang
- Green Cross Genome, Yongin, Gyeonggi-do, Republic of Korea
| | - Eun-Hae Cho
- Green Cross Genome, Yongin, Gyeonggi-do, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Na-Yeon Jung
- Department of Neurology, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Busan, Republic of Korea
| | - Jee H Jeong
- Department of Neurology, Ewha Womans University Hospital, Seoul, Republic of Korea
| | - Jay C Kwon
- Department of Neurology, Changwon Fatima Hospital, Changwon, Gyeongsangnam-do, Republic of Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jee Hoon Roh
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee-Jin Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulgi University Hospital, Daejeon, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Chang-Seok Ki
- Green Cross Genome, Yongin, Gyeonggi-do, Republic of Korea.
| | - Seung Hyun Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea.
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48
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Park DJ, Shin JH, Park KH, Ryu HC. Electrically controllable THz asymmetric split-loop resonator with an outer square loop based on VO 2. Opt Express 2018; 26:17397-17406. [PMID: 30119551 DOI: 10.1364/oe.26.017397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/18/2018] [Indexed: 06/08/2023]
Abstract
In this paper, we propose an asymmetric split-loop resonator with an outer square loop (ASLR-OSL) based on vanadium dioxide (VO2) which can actively control the transmission characteristics of a terahertz wave while maintaining a high quality factor of the asymmetric split-loop resonator (ASLR) by adding an outer square loop. The proposed ASLR-OSL demonstrated transmission characteristics similar to those of ASLR, and the transmission characteristics of ASLR-OSL were successfully controlled by directly applying a bias voltage. These results show a simple method for imposing active properties on a common metamaterial having a high quality factor by adding a loop structure.
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Park KH, Lee J, Lee JY, Lee SC, Sim DW, Shin JU, Park CO, Lee JH, Lee KH, Jeong KY, Park JW. Sensitization to various minor house dust mite allergens is greater in patients with atopic dermatitis than in those with respiratory allergic disease. Clin Exp Allergy 2018; 48:1050-1058. [PMID: 29700921 DOI: 10.1111/cea.13164] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/11/2018] [Accepted: 03/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Various allergenic proteins are produced by house dust mites (HDM). However, the allergenicity and clinical implications of these allergens are unknown. OBJECTIVE The purpose of this study was to identify allergens in Dermatophagoides farinae and elucidate the sensitization profiles to these in Korean patients suffering from respiratory (allergic rhinitis and/or asthma) and atopic dermatitis symptoms. METHODS IgE reactivities in sera from 160 HDM allergy patients were analysed by one- and two-dimensional gel electrophoresis and immunoblotting. IgE-reactive components were identified by liquid chromatography-coupled electrospray ionization-tandem mass spectrometry. Nine recombinant mite allergens (Der f 1, Der f 2, Der f 10, Der f 11, Der f 13, Der f 14, Der f 30, Der f 32 and Der f Alt a 10) were produced, and the IgE reactivity in sera to each was determined by ELISAs. RESULTS Der f 1 and Der f 2 were recognized by IgE in serum samples from 88.1% and 78.1% of all patients, respectively. Patients with respiratory allergies were mainly sensitized to these major allergens, whereas patients with atopic dermatitis symptoms showed polysensitization to major and minor allergen components (including Der f 11, Der f 13, Der f 14, Der f 32 and Der f Alt a 10). CONCLUSIONS Patients with respiratory allergic disease sensitize to major allergen components of HDM. Those with atopic dermatitis were sensitized to a broader range of minor allergen components of HDM (Der f 11, Der f 13, Der f 14, Der f 32 and Der f Alt a 10).
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Affiliation(s)
- K H Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - J Lee
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - J-Y Lee
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - S C Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - D W Sim
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - J U Shin
- Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - C O Park
- Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - J-H Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - K H Lee
- Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - K Y Jeong
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - J-W Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
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Jeong J, Kang I, Kim S, Park SJ, Park KH, Oh T, Yang S, Chae C. A modified-live porcine reproductive and respiratory syndrome virus (PRRSV)-1 vaccine protects late-term pregnancy gilts against heterologous PRRSV-1 but not PRRSV-2 challenge. Transbound Emerg Dis 2018. [PMID: 29536637 DOI: 10.1111/tbed.12862] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this study was to determine the efficacy of a commercially available porcine reproductive and respiratory syndrome virus (PRRSV)-1 modified-live virus (MLV) vaccine against PRRSV-1 and PRRSV-2 challenge in late-term pregnancy gilts. Gilts were vaccinated with the PRRSV-1 MLV vaccine at 4 weeks prior to breeding and then challenged intranasally with PRRSV-1 or PRRSV-2 at 93 days of gestation. After PRRSV-1 challenge, vaccinated pregnant gilts had a significantly longer gestation period, significantly higher numbers of live-born and weaned piglets and a significantly lower number of stillborn piglets at birth compared to unvaccinated pregnant gilts. No significant improvement in reproductive performance was observed between vaccinated and unvaccinated pregnant gilts following PRRSV-2 challenge. Vaccinated pregnant gilts also exhibited a significantly improved reproductive performance after challenge with PRRSV-1 compared to vaccinated pregnant gilts following PRRSV-2 challenge. The PRRSV-1 MLV vaccine was able to reduce PRRSV-1 but not PRRSV-2 viremia in pregnant gilts. Vaccinated gilts also showed a significantly higher number of PRRSV-1-specific IFN-γ-secreting cells (IFN-γ-SC) compared to PRRSV-2-specific IFN-γ-SC. The data presented here suggest that the vaccination of pregnant gilts with a PRRSV-1 MLV vaccine provides good protection against PRRSV-1 but only limited protection against PRRSV-2 challenge in late-term pregnancy gilts based on improvement of reproductive performance, reduction in viremia and induction of IFN-γ-SC.
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Affiliation(s)
- J Jeong
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - I Kang
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - S Kim
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - S-J Park
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - K H Park
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - T Oh
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - S Yang
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - C Chae
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul, Korea
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