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Biomedical subjects

Young H Sohn

Publications and source records attributed to Young H Sohn.

17 recordsLinked to original sources
PubMed2006

Electromyography patterns of propriospinal myoclonus can be mimicked voluntarily.

In order to investigate the clinical impact of polymyographic evaluation on the diagnosis of propriospinal myoclonus (PSM), we performed electromyography recordings of various truncal muscles in eight healthy volunteers while they mimicked PSM symptoms. Before the experiment, each volunteer learned how to mimic PSM by watching a videotape that showed typical PSM characteristics, i.e., brief symmetric flexion of the trunk. The recorded polymyographic patterns of all volunteers were quite compatible with those found in the previous reports. The present study demonstrates that previously known polymyographic patterns of PSM can be voluntarily mimicked. Additional studies, such as jerk-locked cortical potential, are required to confirm the diagnosis of true PSM.

Adult↗
PubMed2005

Motor training as treatment in focal hand dystonia.

Focal hand dystonia may arise as a result of aberrant plasticity from excessive repetitive use. Improvement might be possible with appropriate motor training. Focusing on trying to decrease abnormal overflow of movement to fingers not involved in a task, we developed a motor training program for individualized finger movements. Ten patients with writer's cramp participated in the motor training program. Evaluation was done with the Fahn dystonia scale, kinematic analysis of handwriting, transcranial magnetic stimulation (TMS), and electroencephalography (EEG). Clinical improvement of dystonia was significant using the Fahn dystonia scale, and 6 patients reported an improvement in writing. The handwriting analysis showed a trend for improvement after training in simple exercises. There were no changes in cortical excitability measured by TMS and EEG. Whereas this method of motor training for 4 weeks led to mild subjective improvement and some improvement in handwriting, it is not sufficient to reverse motor cortex abnormalities measured by TMS and EEG.

Cerebral Cortex↗
PubMed2005

Dopaminergic influence on disturbed spatial discrimination in Parkinson's disease.

Various sensory symptoms and disturbed sensory perception are often observed in patients with idiopathic Parkinson's disease (PD). The basis of sensory disturbance in PD is unknown but possibly reflects a role for the basal ganglia in sensory processing. To investigate the relationship between the sensory dysfunction and dopaminergic deficiency in PD, we measured spatial discrimination using the Grating Orientation Task in 21 drug-naive patients with PD, before and after long-term antiparkinson therapy, and 25 age-matched healthy controls. The grating orientation threshold was significantly higher in patients (3.03 +/- 0.84) than controls (2.03 +/- 0.79). After 3 to 10 months of antiparkinson therapy, the grating orientation threshold was significantly lowered (2.66 +/- 0.84), although it was still higher than that in controls. Improvement in the patients' sensory function was significantly correlated with motor improvement (r = 0.44). These results suggest that sensory dysfunction in Parkinson's disease is related at least in part to the dopaminergic deficit.

Antiparkinson Agents↗
PubMed2004

Corticospinal disinhibition during dual action.

When attempting to perform two tasks simultaneously, the human motor as well as the cognitive system shows interference. Such interference often causes altered activation of the cortical area representing each task compared to the single task condition. We investigated changes in corticospinal inhibition during dual action by transcranial magnetic stimulation (TMS). Single-pulse TMS was applied to the left motor cortex, triggered by right leg movement (tibialis anterior muscle) while the right abductor digiti minimi (ADM) muscle was moderately activated (10-20% of the maximal voluntary contraction). The background electromyography (EMG) activity of ADM was measured before and during the leg movement. The silent period (SP) and amplitude of motor evoked potential (MEP) following magnetic stimulation in active ADM were compared for the conditions with and without leg movement. The mean area of the rectified EMG activity of ADM did not alter, while the SP was significantly shortened during leg movement compared to that without leg movement. MEP amplitude was comparable between the two conditions. These results suggest that corticospinal inhibition tested by the SP duration is reduced during the movement of another body part, presumably in order to help maintain muscle force by compensating interference-related alteration in motor cortical activation.

Adult↗
PubMed2004

Clinical implication of cerebral artery calcification on brain CT.

BACKGROUND AND PURPOSE: Arterial calcification is a process of atherosclerosis, usually taking place within advanced atheromatous plaque. In the coronary arteries, calcification seen on computed tomography (CT) often indicates severe stenosis, and is noted in almost all patients with coronary symptoms. Calcification of the cerebral arteries is also frequently observed on brain CT, but its clinical significance has yet to be clarified. To evaluate the clinical significance of cerebral arterial calcification on brain CT, we investigated the angiographic and transcranial Doppler ultrasonography (TCD) findings of calcified cerebral arteries. METHODS: The subjects were 57 patients with ischemic stroke, all of whom underwent brain CT, digital subtraction cerebral angiography and TCD. Stroke subtypes were defined according to TOAST classification. Two clinicians who were blinded in respect to the patients' clinical history and to each other's interpretation, determined the presence of cerebral arterial calcification and the degree of angiographic stenosis. RESULTS: Cerebral artery calcification was noted in 23 patients (40%) out of a total of 46 arteries, consisting of 23 internal carotid, 15 vertebral, 5 basilar, 2 middle cerebral and 1 anterior cerebral artery. The patients with calcification were significantly older and more hypertensive than those without calcification. All the patients with calcification showed either large artery atherosclerosis or lacunar stroke. Hemodynamic alterations measured by TCD were rarely observed in calcified arteries. The severity and extent of the atherosclerotic changes were significantly greater in the patients with calcification than those without calcification. CONCLUSION: These results suggest that cerebral arterial calcification does not directly indicate hemodynamically significant atherosclerotic stenosis involving calcified segments, but indicates the underlying etiology of either large artery atherosclerosis or lacunar stroke, and raises the possibility of a diffuse atherosclerotic process being present in the cerebral circulation.

Adult↗
PubMed2004

Surround inhibition in human motor system.

In sensory systems, a neural mechanism called surround inhibition (SI) sharpens sensation by creating an inhibitory zone around the central core of activation. In the motor system, the functional operation of SI remains to be demonstrated, although it has been hypothesized to contribute to the selection of voluntary movements. Here we test this hypothesis by using transcranial magnetic stimulation of the human motor cortex. The motor evoked potential of the little finger muscle is suppressed or unchanged during self-paced, voluntary movements of the index finger, mouth or leg, despite an increase in spinal excitability. This result indicates that motor excitability related to little finger movement is suppressed at the supraspinal level during these movements, and supports the idea that SI is an organizational principle of the motor system.

Adult↗
PubMed2004

Disturbed surround inhibition in focal hand dystonia.

Disturbances in surround inhibition could account for various movement disorders. Here we test the functional operation of surround inhibition in focal hand dystonia. Transcranial magnetic stimulation was set to be triggered by self-initiated voluntary flexion of the index finger. During this movement, motor-evoked potential amplitudes from the little finger muscle were significantly suppressed in healthy subjects but enhanced in dystonia patients. This result supports the idea that disturbed surround inhibition is a principal pathophysiological mechanism of dystonia.

Aged↗
PubMed2004

Unilateral periodic limb movement in sleep after supratentorial cerebral infarction.

We report a patient with involuntary right leg movements during sleep, which developed after acute ischemic stroke in the corona radiata. Nocturnal polysomnography confirmed the diagnosis of periodic limb movement in sleep (PLMS). Although the pathogenesis of PLMS is still controversial, it has been proposed that the loss of cortical or subcortical inhibition resulting from the pyramidal tract lesion might cause PLMS. The present case provides evidence to support this hypothesis.

Adult↗
PubMed2004

Levodopa-responsive parkinsonism in hereditary spastic paraplegia with thin corpus callosum.

Hereditary spastic paraplegia with thin corpus callosum is a rare degenerative disease, which is characterized by a progressive weakness of the lower limbs with a hypoplastic corpus callosum, and is often associated with other symptoms such as mental impairment, amyotrophy, sensory disturbances, dysuria, nystagmus and cataract. We describe two siblings (brother and sister) who showed a thin corpus callosum on MRI, one of whom showed the pure form of progressive spastic paraplegia, while the other showed predominant levodopa-responsive parkinsonism. The present cases are illustrative of a phenotypic heterogeneity in the same family of spastic paraplegia with a thin corpus callosum, despite the identical neuroimaging findings, and also presented another form of autosomal recessive juvenile levodopa-responsive parkinsonism.

Adolescent↗
PubMed2004

Motor evoked potentials.

Noninvasive electrical stimulation of the human brain first was attempted in the 1950s. In the early 1980s, the first clinical application method of transcranial electrical stimulation was developed. Investigators in the mid-1980s showed that it was possible to stimulate the nerve and the brain using external magnetic stimulation (transcranial magnetic stimulation [TMS]), with little or no pain. TMS now is used commonly in clinical neurology to study central motor conduction time. Depending on the stimulation techniques and parameters, TMS can excite or inhibit brain activity, allowing functional mapping of cortical regions and creation of transient functional lesions. It now is used widely as a research tool to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders.

Brain↗
PubMed2003

Current status of Parkinson's disease treatment in Korea.

The health insurance system in Korea has been under governmental control, and has covered whole population since 1989. About 97% of Korean people have benefits from this system, while 3% are covered by a Medical Aid system for poor people. According to the statistical yearbook of Health Insurance Review in Korea, the number of claims under Parkinson's Disease, in whole country increased steeply from 44619 in 1995 to 96229 in 2000. If each patient were to take medication for the full duration of their insurance coverage, the average number of visits per year would be 11 in 2000. Thus the number of PD patients calculated using these statistics is about 8600. The prevalence is 19/100000, which is much lower than that in Japan. Considering the significant increase in the number of claims in last few years, however, there are still many PD patients who do not receive an accurate diagnosis and appropriate treatment. The other factor influencing these statistics is the fact that patients were able to buy their medications in drug stores without prescription, i.e. without visiting a hospital (since 2001 this has no longer been allowed). Almost all PD medications are available in Korea. There are several forms of levodopa drugs. Dopamine agonists include bromocriptine, pergolide, dihydroergocriptine, ropinirol, and pramipexole. Other parkinsonian medications are amantadine, benztropin, trihexyphenydil, deprenyl, and entacapone. Recently multicentre clinical trials were performed using ropinirol and entacapone, which showed reliable results. Currently deep brain stimulation is available in a number of medical institutes.

Alzheimer Disease↗
PubMed2003

Suppression of corticospinal excitability during negative motor imagery.

To investigate the effect of negative motor imagery on corticospinal excitability, we performed transcranial magnetic stimulation (TMS) studies in seven healthy subjects during imagination of suppressing movements. Subjects were asked to imagine suppression of TMS-induced twitching movement of their nondominant left hands by attempting to increase the amount of relaxation after receiving an auditory NoGo cue (negative motor imagery), but to imagine squeezing hands after a Go cue (positive motor imagery). Single- and paired-pulse TMS were triggered at 2 s after Go or NoGo cues. Motor-evoked potentials (MEPs) were recorded in the first dorsal interosseus (FDI), abductor pollicis brevis (APB), and abductor digiti minimi (ADM) muscles of the left hand. Paired-pulse TMS with subthreshold conditioning stimuli at interstimulus intervals of 2 (short intracortical inhibition) and 15 ms (intracortical facilitation) and that with suprathreshold conditioning stimuli at interstimulus interval of 80 ms (long intracortical inhibition) were performed in both negative motor imagery and control conditions. Compared with the control state (no imagination), MEP amplitudes of FDI (but not APB and ADM) were significantly suppressed in negative motor imagery, but those from all three muscles were unchanged during positive motor imagery. F-wave responses (amplitudes and persistence) were unchanged during both negative and positive motor imagery. During negative motor imagery, resting motor threshold was significantly increased, but short and long intracortical inhibition and intracortical facilitation were unchanged. The present results demonstrate that excitatory corticospinal drive is suppressed during imagination of suppressing movements.

Adult↗
PubMed2002

Excitability of the ipsilateral motor cortex during phasic voluntary hand movement.

We investigated the influence of self-paced, phasic voluntary hand movement on the excitability of the ipsilateral motor cortex. Single- and paired-pulse transcranial magnetic stimulation (TMS) was applied to the right motor cortex triggered by EMG onset of self-paced movements of individual right hand fingers at intervals ranging from 13 to 2,000 ms. Motor evoked potentials (MEPs) were evaluated in several left arm muscles. Significant suppression of MEP amplitudes was observed when TMS was applied between 35 and 70 ms after EMG onset. This inhibition was diffuse, affecting "adjacent" muscles (those near the homologous muscle in the same extremity) as well as homologous muscles, but more inhibition was observed in adjacent and distal muscles than homologous and proximal muscles. Significant inhibition of ipsilateral motor cortex was produced by index finger movements (both the extensor indicis proprius and the first dorsal interosseus), but not by little finger movement (the abductor digiti minimi). Paired-pulse TMS (at 2- and 10-ms interstimulus intervals) showed a significant increase in intracortical facilitation (ICF) selectively in the homologous muscle when triggered by self-paced movement of the opposite hand, but no change was observed in intracortical inhibition. When stimulation was triggered by self-paced movements, the silent period of the homologous muscle was significantly shortened, but the F-wave and compound muscle action potential were unchanged. Our findings demonstrate that voluntary hand movement exerts an inhibitory influence on a diffuse area of the ipsilateral motor cortex. This inhibitory influence is both time and movement dependent. The inhibitory influence is nonselective, while the facilitatory influence (enhancing ICF) appears to act selectively on the homologous muscles. These effects are most likely mediated by a transcallosal pathway.

Adult↗
PubMed2002

Modulation of human corticomotor excitability by somatosensory input.

In humans, somatosensory stimulation results in increased corticomotoneuronal excitability to the stimulated body parts. The purpose of this study was to investigate the underlying mechanisms. We recorded motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) from abductor pollicis brevis (APB), first dorsal interosseous (FDI), and abductor digiti minimi (ADM) muscles. MEP amplitudes, recruitment curves (RC), intracortical inhibition (ICI), intracortical facilitation (ICF), resting (rMT) and active motor thresholds (aMT) were recorded before and after a 2-h period of ulnar nerve electrical stimulation at the wrist. Somatosensory input was monitored by recording somatosensory evoked potentials. To differentiate excitability changes at cortical vs. subcortical sites, we recorded supramaximal peripheral M-responses and MEPs to brainstem electrical stimulation (BES). In order to investigate the involvement of GABAergic mechanisms, we studied the influence of lorazepam (LZ) (a GABA(A) receptor agonist) relative to that of dextromethorphan (DM) (an NMDA receptor antagonist) and placebo in a double-blind design. We found that somatosensory stimulation increased MEP amplitudes to TMS only in the ADM, confirming a previous report. This effect was blocked by LZ but not by either DM or placebo and lasted between 8 and 20 min in the absence of (i) changes in MEPs elicited by BES, (ii) amplitudes of early somatosensory-evoked potentials or (iii) M-responses. We conclude that somatosensory stimulation elicited a focal increase in corticomotoneuronal excitability that outlasts the stimulation period and probably occurs at cortical sites. The antagonistic effect of LZ supports the hypothesis of GABAergic involvement as an operating mechanism.

Adolescent↗
PubMed2002

Effect of levetiracetam on rapid motor learning in humans.

BACKGROUND: The human motor cortex (M1) has a role in motor learning. Antiepileptic drugs that suppress M1 excitability may affect learning, presumably by inhibiting long-term potentiation. Levetiracetam, a new antiepileptic drug with a unique preclinical profile, also suppresses M1 excitability, but in a way that is different from other antiepileptic drugs. The effect of levetiracetam on motor learning has yet to be addressed. OBJECTIVE: To investigate whether levetiracetam alters rapid motor learning in humans. METHODS: We measured pinch force and acceleration and motor excitability before and after 30 minutes of pinch practice at 0.5 Hz in 10 healthy volunteers. Either 3000 mg of levetiracetam or placebo was administered 1 hour before the experiment. RESULTS: After practice, pinch acceleration was significantly increased with placebo, but not with levetiracetam. All other measures showed no significant change. CONCLUSION: Levetiracetam interferes with rapid motor learning; this is consistent with a negative influence on long-term potentiation.

Adult↗
PubMed2002

Effect of volitional inhibition on cortical inhibitory mechanisms.

To investigate the effect of volitional inhibition on cortical inhibitory mechanisms, we performed transcranial magnetic stimulation (TMS) studies with a Go/NoGo reaction task in seven healthy subjects. Subjects were asked to extend their right index finger only after Go, but to remain relaxed after NoGo. Single- and paired-pulse TMS were triggered at the average reaction time for the Go response in each subject after Go or NoGo cues. Motor evoked potentials were recorded in the extensor indicis proprius (EIP) and abductor digiti minimi (ADM) muscles of right hand. Paired-pulse TMS with subthreshold conditioning stimuli at interstimulus intervals (ISIs) of 2 ms [short intracortical inhibition (SICI)] and 15 ms [intracortical facilitation (ICF)] and that with suprathreshold conditioning stimuli at ISI of 80 ms [long intracortical inhibition (LICI)] were performed in both Go/NoGo and control conditions. Inhibition of SICI was enhanced in both EIP and ADM after NoGo and was reduced only in EIP after Go. Inhibition of LICI was reduced in both muscles during both conditions, while ICF was not altered. The present results demonstrate that volitional inhibition enhances SICI but reduces LICI nonselectively. These results suggest that these two inhibitory mechanisms act differently during execution and suppression of voluntary movements.

Adult↗