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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Sleep Medicine and Psychophysiology
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KOREAN ACADEMY OF SLEEP MEDICINE
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Volume & Issues
Volume 4, Issue 2 - Dec 1997
Volume 4, Issue 1 - Jun 1997
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Neuropsychology of Memory
Rhee, Min-Kyu ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 1~14
This paper reviewed models to explain memory and neuropsychological tests to assess memory. Memory was explained in cognitive and neuroanatomical perspectives, Cognitive model describes memory as structure and process. In structure model, memory is divided into three systems: sensory memory, short-term memory(working memory), and long-term memory. In process model, there are broadly three categories of memory process: encoding, storage, and retrieval. Memory process work in memory structure. There are two prominent models of the neuroanatomy of memory, derived from the work of Mishkin and Appenzeller and that of Squire and Zola-Morgan. These two models are the most useful for the clinician in part because they take into account the connections between the limbic and frontal cortical regions. The major difference between the two models concerns the role of the amygdala in memory processess. Mishkin and his colleagues believe that the amygdala plays a significant role while Squire and his colleagues do not. The most popular and widely used tests of memory ability such as WMS-R, AVLT, CVLT, HVLT. RBMT, CFT, and BVRT-R, were reviewed.
Functional Neuroanatomy of Memory
Lee, Sung-Hoon ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 15~28
Longterm memory is encoded in the neuronal connectivities of the brain. The most successful models of human memory in their operations are models of distributed and self-organized associative memory, which are founded in the principle of simulaneous convergence in network formation. Memory is not perceived as the qualities inherent in physical objects or events, but as a set of relations previously established in a neural net by simultaneousy occuring experiences. When it is easy to find correlations with existing neural networks through analysis of network structures, memory is automatically encoded in cerebral cortex. However, in the emergence of informations which are complicated to classify and correlated with existing networks, and conflictual with other networks, those informations are sent to the subcortex including hippocampus. Memory is stored in the form of templates distributed across several different cortical regions. The hippocampus provides detailed maps for the conjoint binding and calling up of widely distributed informations. Knowledge about the distribution of correlated networks can transform the existing networks into new one. Then, hippocampus consolidats new formed network. Amygdala may enable the emotions to influence the information processing and memory as well as providing the visceral informations to them. Cortico-striatal-pallido-thalamo-cortical loop also play an important role in memory function with analysis of language and concept. In case of difficulty in processing in spite of parallel process of informations, frontal lobe organizes theses complicated informations of network analysis through temporal processing. With understanding of brain mechanism of memory and information processing, the brain mechanism of mental phenomena including psychopathology can be better explained in terms of neurobiology and meuropsychology.
Memory Impairment in Dementing Patients
Han, Il-Woo ; Seo, Sang-Hun ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 29~38
Dementia is defined as a syndrome which is characterized by various impairments in cognitive functions, especially memory function. Most of the diagnostic criteria for dementia include memory impairment as on essential feature. Memory decline can be present as a consequence of the aging process. But it does not cause significant distress or impairment in social and occupational functionings while dementiadoes. Depression may also be associated with memory impairment. However, unlike dementia, depression dose not cause decrease in delayed verbal learning and recognition memory. In dementia, different features of memory impairment may be present depending on the involved area. Memory impairment in cortical dementia is affected by the disturbance of encoding of information and memory consolidation, while memory imparnene in subcortical denentiy is affected by the disturbance of retrieval in subcortical dementia.
Memory Disorder in Schizophrenia
Jon, Duk-In ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 39~48
Memory disorder is the most consistent neuropsychological finding in schizophrenia and seems to be a stable trait in it. It is suggested that memory dysfunction found in patients with schizophrenia is primary to biological abnormalities, not secondary to attention deficits they have. Although temporal lobe structures including hippocampus and thalamus have traditionally been thought to be implicated regions for memory disorder in schizophrenia, recent studies indicate the possibility of abnormalities in the frontal lobe and the neural circuits between brain regions. Advanced research methods such as functional imaging technique are expected to produce more detailed informations about memory function in schizophrenia.
Sleep and Panic
Kim, Young-Chul ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 49~56
Nocturnal panic involves sudden awakening from sleep in a state of panic characterized by various somatic sensation of sympathetic arousal and intense fear. Many(18-71%) of the spontaneous panic attacks tend to occur from a sleeping state unrelated to the situational and cognitive context. Nocturnal panickers experienced daytime panics and general somatic sensation more frequently than other panickers. Despite frequent distressing symptoms, these patients tend to exhibit little social or occupational impairment and minimal agoraphobia and have a high lifetime incidence of major depression and a good response to tricyclic antidepressants. Sleep panic attacks arise from non-REM sleep, late stage 2 or early stage 3. The pathophysiology and the similarity of nocturnal panic to sleep apnea, dream-induced anxiety attacks, night terrors, sleep paralysis, and temporal lobe epilepsy are discussed.
Jet Lag and Circadian Rhythms
Kim, Leen ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 57~65
As jet lag of modern travel continues to spread, there has been an exponential growth in popular explanations of jet lag and recommendations for curing it. Some of this attention are misdirected, and many of those suggested solutions are misinformed. The author reviewed the basic science of jet lag and its practical outcome. The jet lag symptoms stemed from several factors, including high-altitude flying, lag effect, and sleep loss before departure and on the aircraft, especially during night flight. Jet lag has three major components; including external de synchronization, internal desynchronization, and sleep loss. Although external de synchronization is the major culprit, it is not at all uncommon for travelers to experience difficulty falling asleep or remaining asleep because of gastrointestinal distress, uncooperative bladders, or nagging headaches. Such unwanted intrusions most likely to reflect the general influence of internal desynchronization. From the free-running subjects, the data has revealed that sleep tendency, sleepiness, the spontaneous duration of sleep, and REM sleep propensity, each varied markedly with the endogenous circadian phase of the temperature cycle, despite the facts that the average period of the sleep-wake cycle is different from that of the temperature cycle under these conditions. However, whereas the first ocurrence of slow wave sleep is usually associated with a fall in temperature, the amount of SWS is determined primarily by the length of prior wakefulness and not by circadian phase. Another factor to be considered for flight in either direction is the amount of prior sleep loss or time awake. An increase in sleep loss or time awake would be expected to reduce initial sleep latency and enhance the amount of SWS. By combining what we now know about the circadian characteristics of sleep and homeostatic process, many of the diverse findings about sleep after transmeridian flight can be explained. The severity of jet lag is directly related to two major variables that determine the reaction of the circadian system to any transmeridian flight, eg., the direction of flight, and the number of time zones crossed. Remaining factor is individual differences in resynchmization. After a long flight, the circadian timing system and homeostatic process can combine with each other to produce a considerable reduction in well-being. The author suggested that by being exposed to local zeit-gebers and by being awake sufficient to get sleep until the night, sleep improves rapidly with resynchronization following time zone change.
Sleep Habits and Sleep Disorders among the Elderly Between 65-84 years Who are Living in a Part of Pusan
Yang, Chang-Kook ; Yoo, Seung-Yoon ; Joo, Young-Hee ; Hahn, Hong-Moo ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 66~76
Objectives : The purpose of this study is to analyse sleep habits and sleep disorders in the elderly population ased 65-84 years. Methods : Epidemiological survey was performed at home by means of semi structured interviews in the city of Pusan, Korea. Subjects were randomly selected. The questionnaire consisted of 128 items including demographic findings, sleep habits, sleep disorders, somatic illnesses, and psychological distresses. Results : (1) The mean retiring time was 10.28 h (SD 1.30 h) and the mean wake-up time was 5.24 h (SD 1.33 h). The mean duration of sleep was 5.63 h (SD 1.80 h). The mean sleep onset time was 44.51 min. The mean frequency of daytime napping was 2.49 (SD 3.23). The subjects reported they woke up an average of 2.05 (SD 1.59) times per night. All of the above results were not related to age or gender. However, the mean frequency of difficulty in initiating/maintaining sleep was 2.2 times for men and 3.2 times for women (p<0.05). (2) The prevalence of insomnia was 57.7% and was not related to age or gender. Difficulty in initiating sleep was the most commonly reported insomnia complaint(52.4%). Early morning awakening was reported by 50.0% of patients and difficulty in maintaining sleep was reported by 45.1% of them. Worrying in bed and physical pain were strong contributing factor to insomnia. Conclusions : The results of our study showed several characteristics of sleep habits in the elderly. Sleep disorder in old age is not inevitable or trivial. Since sleep disturbance in older adults is common and distressing, it has implications for general health and well-being. Active concern and therapeutic intervention for the sleep habits and sleep disorders in the elderly are needed.
Prevalence, Cause of Insomnia and Drug Medication of Newly Admitted Patients to a University Hospital
Sohn, Jin-Wook ; Lee, Tae-Woo ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 77~88
The purpose of this study was to investigate the prevalence, primary causes, and management of insomnia newly admitted patients in a university hospital. Subjects consisted of 168 adult patients (95 men and 73 women, 88 medical and 94 surgical patients) newly admitted to Gyeongsang National University Hospital from September 7 through September 27, 1996. Sleep patterns of all subjects in the usual nights before admission(UN), the previous night to admission(PN), the night on admission(ON), and the 5th night after admission(5N) were investigated using the Korean version of the St. Mary's Hospital Sleep Questionaire. In addition, all insomnia patients and their doctors and nurses in charge were interviewed by psychiatric residents. Additionally, their medical records were reviewed. Prevalence of insomnia were 22.6% in the UN, 42.9% in PN, 51.8% in ON, and 43.5% in 5N. The prevalence of insomnia was significantly increased immediately before and after admission. There were no significant differences in the prevalence of insomnia by age and sex. The most ammon primary causes of insomnia were somatic symptoms and psychological factors in PN, somatic symptoms and noise in ON and 5n. Only 17 (10.1%) of insomnia patients took medicstions for insomnia control(analgesics in 15, hypnotics in 2). These results shorred that the prevalence of insomnia was significantly increased on hospitalization due to somatic symptoms, environmental factors, and psychological factors, but nearly none were adequately managed.
Successful Treatment of Five Cases of Idiopathic Central Nervous System Hypersomnia
Yoon, In-Young ; Jeong, Do-Un ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 89~95
The authors studied 5 cases of idiopathic CNS hypersomnia who visited Division of Sleep Studies, Seoul National University Hospital in 1995. Detailed medical history was taken and nocturnal polysomnography(NPSG), multiple sleep latency test(MSLT) and human leukocyte antigen(HLA) typing were performed. Neither cataplexy nor hypnagogic hallucination was reported in all cases and in NPSGs, there were tendencies of increased sleep period time and decreased slow wave sleep time. In MSLT, all the subjects showed average sleep latencies less than 8 minutes without sleep-onset rapid eye movement period(SOREMP). In HLA typing, some correlation between idiopathic CNS hypersomnia and HLA DR4 was observed. In contrast to previous reports, overall treatment response with methylphenidate was remarkable. Therefore, the authors suggest that patients suspected of idiopathic CNS hypersomnia be actively evaluated and treated with rather optimistic perspective.
Clinical Validity of the Domestic EEG and EP Mapping System(Neuronics)
Min, Sung-Kil ; Jon, Duk-In ; Lee, Sung-Hoon ; Ahn, Chang-Beom ; Yoo, Sun-Kook ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 96~106
The clinical validity of a korean EEG and EP mapping system(Neuronics) was evaluated with schizophrenic patients(n=20), normal controls(n=19), and 10 patients with central nervous system disease(8 patients with cerebrovascular accident, 1 patient with brain mass, and 1 patient with periodic paralysis). In the normal control group, the pattern of resting computerized EEG with eyes closed showed normal parieto-occipital dominance of alpha wave. Compared with normal controls, schizophrenic patients had more delta activity in the frontal region, and less alpha activity especially in the parieto-occipital region. In most cases patients with cortical organic lesions(n=5) revealed increased delta and theta activity and decreased alpha activity on the lesion areas. These findings were compatible with their MRI and clinical findings. However in the cases of subcortical lesions(n=5) EEG showed various findings which suggest diverse influences of subcortical abnormalities on cortical activities. The P300 of schizophrenic group was smaller and more delayed than those of normal controls. These results are generally compatible with the previous studies using other EEG and EP mapping systems consequenty and suggest that the this EEG and EP mapping system(Neuronics) has clinical validity.
The Psychophysiologic Response in Korean Patients with Generalized Anxiety Disorder
Chung, Sang-Keun ; Hwang, Ik-Keun ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 107~119
Objectives: The psychophysiologic response pattern between healthy subjects and patients with generalized anxiety disorder, and the relationship among anxiety rating scales and those patterns in patients were examined. Methods: Twenty-three patients with generalized anxiety disorder(AD) and 23 healthy subjects were evaluated by Hamilton Rating Scale for Anxiety(HRSA) and State-Trait Anxiety Inventory before baseline stressful tasks. Subjective Units of Distress were evaluated just before baseline period, immediately after stressful tasks, at the end of the entire procedure, and psychophysiologic measures, i.e., skin temperature(ST), electromyographic activity(EMG), heart rate(HR), electrodermal response(EDR) during baseline & rest and during two psychologically stressful tasks (mental arithmetic, TM; talk about a stressful event, TT) were also evaluated. Results: 1) AD group showed significantly higher EMG level during rest after stressful tasks and higher HR level during all period except TM compared to control group. 2) AD group showed lower change in the startle response(SR) of ST, in the SR & the recovery response(RR) of EMG during TM, and in the RR of EDR immediately after TM than control group. AD group showed that the RR of EDR was significantly lower than the SR during stressful tasks. 3) We found that there was significantly negative correlation between state anxiety and the RR of EDR after TT in AD group. We also found that there were significantly positive correlations between HRSA score and the SRs of EDR during stressful tasks, and between state anxiety and the SR of EDR during TT. Conclusion: Our results suggest that patients with generalized anxiety disorder show higher autonomic arousal than healthy subjects and decreased physiologic flexibility or reduced autonomic flexibility.
Neuropsychological Tests in Psychiatric Outpatients
Lee, Sung-Hoon ; Park, Hee-Jung ; Park, Hye-Jung ; Lee, Hee-Sang ; Kim, Chan-Hyung ;
Sleep Medicine and Psychophysiology, volume 4, issue 1, 1997, Pages 120~128
Clinical neuropsychological tests were developed originally for the diagnosis of neurological and neuro-surgical diseases. Recently, these tests are being introduced to psychiatric patients. Authors had the experience to use these tests in pychiatric outpatient clinic. Results were as follows. There was a significantly increase in language and attentional function in residual schizophrenia compared to normal control. In chronic neurosis, as visuospatial function was reduced, language and attentional functions were enhanced. With these results, authors suggest that application of neuropsychological tests in psychiatric patients may be very helpful in classifying the subgroups of disease, in selecting the modality of treatment, and in expecting prognosis.