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Original Article
Dementia and Neurocognitive Disorders 2014: 13: 4: 139-145

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일산화탄소 중독 환자에서의 인지중재 효과
오지향*·김고운*·최성혜† 정지향‡·나해리§·김정은‡ 나덕렬¶·홍창희**·김은주*
부산대학교 의학전문대학원 신경과학교실*, 인하대학교 의과대학 신경과학교실†, 이화여자대학교 의학전문대학원 신경과학교실‡, 보바스기념병원 신경과§, 성균관대학교 의과대학 삼성서울병원 신경과¶, 부산대학교 심리학과**
Cognitive Intervention in a Patient with Carbon Monoxide Intoxication
Ji-Hyang Oh, M.A.*, Go-Woon Kim, M.A.*, Seong H. Choi, M.D.†, Jee H. Jeong, M.D.‡, Hae R. Na, M.D.§, Jung E. Kim, M.D.‡, Duk L. Na, M.D.¶, Chang Hee Hong, Ph.D.**, Eun-Joo Kim, M.D.*
Department of Neurology*, Pusan National University School of Medicine and Medical Research Institute, Busan; Department of Neurology†, Inha University School of Medicine, Incheon; Department of Neurology‡, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul; Department of Neurology§, Bobath Memorial Hospital, Seongnam; Department of Neurology¶, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Psychology**, Pusan National University, Busan, Korea
Background: Cognitive intervention (CI) is a nonpharmacological approach used to compensate for cognitive impairment. It is categorized into cognitive training, cognitive stimulation and cognitive rehabilitation. Several studies showed that CI could induce cognitive enhancement and reduction of risk for future cognitive decline in patients with brain injury. We investigated effects of CI on cognitive functions and brain glucose metabolism based on serial cognitive assessments and [18F]-Fluorodexoxyglucose positron emission tomography (FDG-PET) in a patient with carbon monoxide (CO) intoxication. Methods: A 40-year-old man presented with memory impairment and abnormal behaviors such as apathy, indifference, and perseveration 2-month after CO intoxication. Brain magnetic resonance image (MRI) demonstrated high signal changes in the bilateral basal ganglia, hippocampus and the subcortical white matter on T2 weighted images. FDG-PET also showed glucose hypometabolism in the bilateral hippocampus, basal ganglia, and the subcortical white matter. A detailed neuropsychological evaluation revealed multiple cognitive impairments in memory, language and frontal functions. He received twice a week sessions of 60-minute group-based cognitive intervention for 12 weeks. Several neuropsychological examinations and FDG-PETs were conducted at baseline and after CI. Results: After CI, he showed improvements in memory and frontal functions compared with baseline performances. These cognitive improvements persisted by the 7-month follow-up. The extent of glucose hypometabolism was decreased 1-month after CI, however increased 8-month after CI. Conclusions: This case study suggested that CI could enhance cognitive functions and improve glucose metabolism in a patient with CO intoxication. Also, the effects of CI on cognitive functions seem to be last at least 7-month after training.
Key Words: Neuroplasticity, Neuropsychology, Cognitive intervention, Carbon monoxide intoxication, FDG-PET