DOI QR코드

DOI QR Code

A Case Report of a Patient with Mild Cognitive Impairment Treated with Gugijihwang-tang

구기지황탕 투여 후 호전된 경도인지장애 환자 1례에 대한 증례보고

  • Park, Mi-so (Dept. of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University) ;
  • Kang, Seock-man (MyungMin Korean Medicine Clinic) ;
  • Yoo, Dai-won (MyungMin Korean Medicine Clinic) ;
  • Chae, In-cheol (Dept. of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University) ;
  • Kim, Gyeong-soon (MyungMin Korean Medicine Clinic) ;
  • Seong, Hyun-joo (MyungMin Korean Medicine Clinic) ;
  • Chung, Kwang-yeol (MyungMin Korean Medicine Clinic) ;
  • Yoo, Ho-ryong (Dept. of Cardiology and Neurology of Korean Medicine, College of Korean Medicine, Daejeon University)
  • Received : 2021.09.17
  • Accepted : 2021.11.01
  • Published : 2021.10.30

Abstract

Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

Keywords

References

  1. Mucke L. Alzheimer's disease. Nature 2009;461(7266):895-7. https://doi.org/10.1038/461895a
  2. Dubois B, Feldman HH, Jacova C, Hampel H, Molinuevo JL, Blennow K, et al. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurol 2014;13(6):614-29. https://doi.org/10.1016/S1474-4422(14)70090-0
  3. Riphagen JM, Ramakers IH, Freeze WM, Pagen LH, Hanseeuw BJ, Verbeek MM, et al. Linking APOE-ε4, blood-brain barrier dysfunction, and inflammation to Alzheimer's pathology. Neurobio Aging 2020;85:96-103. https://doi.org/10.1016/j.neurobiolaging.2019.09.020
  4. Lee JJ, Lee SB. Recent Advances in Diagnosis and Treatment of Alzheimer's Disease. Korean J Biol Psychiatry 2016;23(2):48-56.
  5. Smith GE, Petersen RC, Parisi JE, Ivnik RJ, Kokmen E, Tangalos EG, et al. Definition, course, and outcome of mild cognitive impairment. Aging Neuropsychol Cogn 1996;3(2):141-7. https://doi.org/10.1080/13825589608256619
  6. Petersen RC. Mild cognitive impairment. CONTINUUM: Lifelong Learning in Neurology 2004;10(1):9-28. https://doi.org/10.1212/01.con.0000293545.39683.cc
  7. Woo SK, Bae S, Kim JH, Kim DK. Predicting Mild Cognitive Impairment to Alzheimer's Disease Transition: Role of Instrumental Activities of Daily Living. J Korean Geriatr Psychiatry 2021;25(1):1-7. https://doi.org/10.47825/jkgp.2021.25.1.1
  8. Cooper C, Li R, Lyketsos C, Livingston G. Treatment for mild cognitive impairment: systematic review. Br J Psychiatry 2013;203(4):255-64. https://doi.org/10.1192/bjp.bp.113.127811
  9. Jung EY, Lee MS, Ahn CJ, Cho SH, Bae H, Shim I. The neuroprotective effect of gugijihwang-tang on trimethyltin-induced memory dysfunction in the rat. Evid Based Complement Alternat Med 2013;2013:542081.
  10. Seo YK, You DK, Kim H, Kim S, Kim SH, Kang HW, et al. A survey of the recognition on the practice pattern, diagnosis, and treatment of Korean medicine of dementia and mild cognitive impairment-focusing on the differences between neuropsychiatrists of Korean medicine and general physicians. J of Oriental Neuropsychiatry 2017;28(3):263-74. https://doi.org/10.7231/JON.2017.28.3.263
  11. Jhoo JH, Kim KW, Lee DY, Youn JC, Lee TJ, Choo IH, et al. Comparison of the performance in two different Korean versions of Mini-Mental State Examination: MMSE-KC and K-MMSE. J Korean Neuropsychiatr Assoc 2005;44(1):98-104.
  12. Ku HM, Kim JH, Kwon EJ, Kim SH, Lee HS, Ko HJ, et al. A study on the reliability and validity of Seoul-Instrumental Activities of Daily Living (S-IADL). J Korean Neuropsychiatr Assoc 2004;43(2):189-99.
  13. Choi SH, Na DL, Kwon HM, Yoon SJ, Jeong JH, Ha CK. The Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. J Korean Med Sci 2000;15(6):609-15. https://doi.org/10.3346/jkms.2000.15.6.609
  14. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean version of the Hamilton Depression Rating Scale (K-HDRS). J Korean Neuropsychiatr Assoc 2005;44(4):456-65.
  15. Won CW, Paik JW, Park KC, Kim SY, Park KW, Lee DW, et al. Development of global deterioration scale staging algorithm. J Korean Geriatr Soc 2011;15(2):80-9. https://doi.org/10.4235/jkgs.2011.15.2.80
  16. Choi SH, Na DL, Lee BH, Hahm DS, Jeong JH, Yoon SJ, et al. Estimating the validity of the Korean version of expanded clinical dementia rating (CDR) scale. J Korean Neurol Assoc 2001;19(6):585-91.
  17. Korean society of oriental neuropsychiatry. Korean Medicine Clinical Practice Guideline for Dementia. Seoul: Guideline center for Korean Medicine; 2017.
  18. Lee SG, Kwon YK, Kim KJ, Kim WH. Effect of Samultang and Yukmizihwangtang on Osteoporosis induced by Ovariectomy of the Rats. J of Jaehan Oriental Medical Academy 1995;1(1):31-48.