Jinsick Park

Development and Verification of an Alcohol Craving–Induction Tool Using Virtual Reality: Craving Characteristics in Social Pressure Situation

Alcoholism is a disease that affects parts of the brain that control emotion, decisions, and behavior. Therapy for people with alcoholism must address coping skills for facing high-risk situations. Therefore, it is important to develop tools to mimic such conditions. Cue exposure therapy (CET) provides high-risk situations during treatment, which raises the individuals ability to recognize that alcohol craving is being induced. Using CET, it is hard to simulate situations that induce alcohol craving. By contrast, virtual reality (VR) approaches can present realistic situations that cannot be experienced directly in CET. Therefore, we hypothesized that is possible to model social pressure situations using VR. We developed a VR system for inducing alcohol craving under social pressure situations and measured both the induced alcohol craving and head gaze of participants. A 2 x 2 experimental model (alcohol-related locality vs. social pressure) was designed. In situations without an avatar (no social pressure), more alcohol craving was induced if alcohol was present than if it was not. And more alcohol craving was induced in situations with an avatar (social pressure) than in situations without an avatar (no social pressure). The difference of angle between the direction of head gazing and the direction of alcohol or avatar was smaller in situations with an avatar alone (social pressure) than in situations with alcohol alone. In situations with both alcohol and an avatar, the angle between the direction of head gaze and the direction of the avatar was smaller than between the direction of head gaze and the direction of the alcohol. Considering the results, this VR system induces alcohol craving using an avatar that can express various social pressure situations.

Association of homocysteine with hippocampal volume independent of cerebral amyloid and vascular burden

This study aimed to clarify whether homocysteine has independent association, not mediated by cerebral beta amyloid protein deposition and vascular burden, with whole brain or hippocampal volume in elderly individuals with normal cognition, mild cognitive impairment, and Alzheimers disease. Nineteen mild cognitive impairment and 24 Alzheimers disease patients were recruited from the Dementia Clinic of the Seoul National University Hospital. Fourteen cognitively normal elderly subjects were also selected from a pool of elderly volunteers. Multiple linear regression analyses showed that plasma total homocysteine level was significantly associated with hippocampal volume even after controlling the degree of global cerebral beta amyloid deposition and vascular burden as well as other potential confounders including age, gender, education, and apolipoprotein E ε4 genotype. On the contrary, plasma total homocysteine level did not show any significant association with whole brain volume. Our finding of the independent negative association between homocysteine and hippocampal volume suggests that homocysteine has a direct adverse effect, not mediated by cerebral beta amyloid deposition and vascular burden, on the hippocampus.

Heterogeneity of Regional Brain Atrophy Patterns Associated with Distinct Progression Rates in Alzheimer's Disease.

We aimed to identify and characterize subtypes of Alzheimer’s disease (AD) exhibiting different patterns of regional brain atrophy on MRI using age- and gender-specific norms of regional brain volumes. AD subjects included in the Alzheimers Disease Neuroimaging Initiative study were classified into subtypes based on standardized values (Z-scores) of hippocampal and regional cortical volumes on MRI with reference to age- and gender-specific norms obtained from 222 cognitively normal (CN) subjects. Baseline and longitudinal changes of clinical characteristics over 2 years were compared across subtypes. Whole-brain-level gray matter (GM) atrophy pattern using voxel-based morphometry (VBM) and cerebrospinal fluid (CSF) biomarkers of the subtypes were also investigated. Of 163 AD subjects, 58.9% were classified as the “both impaired” subtype with the typical hippocampal and cortical atrophy pattern, whereas 41.1% were classified as the subtypes with atypical atrophy patterns: “hippocampal atrophy only” (19.0%), “cortical atrophy only” (11.7%), and “both spared” (10.4%). Voxel-based morphometric analysis demonstrated whole-brain-level differences in overall GM atrophy across the subtypes. These subtypes showed different progression rates over 2 years; and all subtypes had significantly lower CSF amyloid-β1–42 levels compared to CN. In conclusion, we identified four AD subtypes exhibiting heterogeneous atrophy patterns on MRI with different progression rates after controlling the effects of aging and gender on atrophy with normative information. CSF biomarker analysis suggests the presence of Aβ neuropathology irrespective of subtypes. Such heterogeneity of MRI-based neuronal injury biomarker and related heterogeneous progression patterns should be considered in clinical trials and practice with AD patients.

Differences in functional brain connectivity alterations associated with cerebral amyloid deposition in amnestic mild cognitive impairment

Despite potential implications for the early detection of impending Alzheimer’s disease (AD), very little is known about the differences of large-scale brain networks between amnestic mild cognitive impairment (aMCI) with high cerebral amyloid-beta protein (Aβ) deposition (i.e., aMCI+) and aMCI with no or very little Aβ deposition (i.e., aMCI−). We first aimed to extend the current literature on altering intrinsic functional connectivity (FC) of the default mode network (DMN) and salience network (SN) from cognitively normal (CN) to AD dementia. Second, we further examined the differences of the DMN and the SN between aMCI−, aMCI+, and CN. Forty-three older adult (12 CN, 10 aMCI+, 10 aMCI−, and 11 AD dementia) subjects were included. All participants received comprehensive clinical and neuropsychological assessment, resting-state functional magnetic resonance imaging, structural MRI, and Pittsburgh compound-B-PET scans. FC data were preprocessed using multivariate exploratory linear optimized decomposition into independent components of FMRIB’s Software Library. Group comparisons were carried out using the “dual-regression” approach. In addition, to verify presence of gray matter volume changes with intrinsic functional network alterations, voxel-based morphometry was performed on the acquired T1-weighted data. As expected, AD dementia participants exhibited decreased FC in the DMN compared to CN (particularly in the precuneus and cingulate gyrus). The degree of alteration in the DMN in aMCI+ compared to CN was intermediate to that of AD. In contrast, aMCI− exhibited increased FC in the DMN compared to CN (primarily in the precuneus) as well as aMCI+. In terms of the SN, aMCI− exhibited decreased FC compared to both CN and aMCI+ particularly in the inferior frontal gyrus. FC within the SN in aMCI+ and AD did not differ from CN. Compared to CN, aMCI− showed atrophy in bilateral superior temporal gyri whereas aMCI+ showed atrophy in right precuneus. The results indicate that despite the similarity in cross-sectional cognitive features, aMCI− has quite different functional brain connectivity compared to aMCI+.

Role of low- and high-frequency oscillations in the human hippocampus for encoding environmental novelty during a spatial navigation task

The hippocampus plays a key role in the encoding and retrieval of information related to novel environments during spatial navigation. However, the neural basis for these processes in the human hippocampus remains unknown because it is difficult to directly measure neural signals in the human hippocampus. This study investigated hippocampal neural oscillations involved in encoding novel environments during spatial navigation in a virtual environment. Seven epileptic patients with implanted intracranial hippocampal depth electrodes performed three sessions of virtual environment navigation. Each session consisted of a navigation task and a location‐recall task. The navigation task consisted of eight blocks, and in each block, the participant navigated to the location of four different objects and was instructed to remember the location of the objects. After the eight blocks were completed, a location‐recall task was performed for each of the four objects. Intracranial electroencephalography data were monitored during the navigation tasks. Theta (5–8 Hz) and delta (1–4 Hz) oscillations were lower in the first block (novel environment) than in the eighth block (familiar environment) of the navigation task, and significantly increased from block one to block eight. By contrast, low‐gamma (31–50 Hz) oscillations were higher in the first block than in the eighth block of the navigation task, and significantly decreased from block one to block eight. Comparison of sessions with high recall performance (low error between identified and actual object location) and low recall performance revealed that high‐gamma (51–100 Hz) oscillations significantly decreased from block one to block eight only in sessions with high recall performance. These findings suggest that delta, theta, and low‐gamma oscillations were associated with encoding of environmental novelty and high‐gamma oscillations were important for the successful encoding of environmental novelty.

Correlation between Inter-Blink Interval and Episodic Encoding during Movie Watching.

Human eye blinking is cognitively suppressed to minimize loss of visual information for important real-world events. Despite the relationship between eye blinking and cognitive state, the effect of eye blinks on cognition in real-world environments has received limited research attention. In this study, we focused on the temporal pattern of inter-eye blink interval (IEBI) during movie watching and investigated its relationship with episodic memory. As a control condition, 24 healthy subjects watched a nature documentary that lacked a specific story line while electroencephalography was performed. Immediately after viewing the movie, the subjects were asked to report its most memorable scene. Four weeks later, subjects were asked to score 32 randomly selected scenes from the movie, based on how much they were able to remember and describe. The results showed that the average IEBI was significantly longer during the movie than in the control condition. In addition, the significant increase in IEBI when watching a movie coincided with the most memorable scenes of the movie. The results suggested that the interesting episodic narrative of the movie attracted the subjects’ visual attention relative to the documentary clip that did not have a story line. In the episodic memory test executed four weeks later, memory performance was significantly positively correlated with IEBI (p<0.001). In summary, IEBI may be a reliable bio-marker of the degree of concentration on naturalistic content that requires visual attention, such as a movie.

Neural correlates of spatial and nonspatial attention determined using intracranial electroencephalographic signals in humans.

Few studies have directly compared the neural correlates of spatial attention (i.e., attention to a particular location) and nonspatial attention (i.e., attention to a feature in the visual scene) using well‐controlled tasks. Here, we investigated the neural correlates of spatial and nonspatial attention in humans using intracranial electroencephalography. The topography and number of electrodes showing significant event‐related desynchronization (ERD) or event‐related synchronization (ERS) in different frequency bands were studied in 13 epileptic patients. Performance was not significantly different between the two conditions. In both conditions, ERD in the low‐frequency bands and ERS in the high‐frequency bands were present bilaterally in the parietal cortex (prominently on the right hemisphere) and frontal regions. In addition to these common changes, spatial attention involved right‐lateralized activity that was maximal in the right superior parietal lobule (SPL), whereas nonspatial attention involved wider brain networks including the bilateral parietal, frontal, and temporal regions, but still had maximal activity in the right parietal lobe. Within the parietal lobe, spatial attention involved ERD or ERS in the right SPL, whereas nonspatial attention involved ERD or ERS in the right inferior parietal lobule. These findings reveal that common as well as different brain networks are engaged in spatial and nonspatial attention. Hum Brain Mapp 37:3041–3054, 2016.

Effect of Proprioception Training of patient with Hemiplegia by Manipulating Visual Feedback using Virtual Reality: The Preliminary results

In this study, we confirmed proprioception training effect of patients with hemiplegia by manipulating visual feedback. Six patients with hemiplegia were participated in the experiment. Patients have trained with the reaching task with visual feedback without visual feedback for two weeks. Patients were evaluated with pre-, middle test and post-test with the task with and without visual feedback. In the results, the first-click error distance after the training of the reaching task was reduced when they got the training with the task removed visual feedback. In addition, the performance velocity profile of reaching movement formed an inverse U shape after the training. In conclusion, visual feedback manipulation using virtual reality could provide a tool for training reaching movement by enforcing to use their proprioception, which enhances reaching movement skills for patients with hemiplegia.

Development and Clinical Test of Virtual Reality Rehabilitation Training System for stiff-knee gait of stroke patients

Purposes of this paper are developing Virtual Reality rehabilitation system for hemiplegic patients who have stiff-knee gait and testing developed system. We developed rehabilitation system which is able to interact between system using PC camera and two markers. Scenario was composed simple task as crossing stepping-stone. In this paper, six males and three females with hemiplegic patients were participated. They trained seven times totally. Their performance was increasing about 30% in the last training session.

Improved prediction of bimanual movements by a two-staged (effector-then-trajectory) decoder with epidural ECoG in nonhuman primates

OBJECTIVE In arm movement BCIs (brain-computer interfaces), unimanual research has been much more extensively studied than its bimanual counterpart. However, it is well known that the bimanual brain state is different from the unimanual one. Conventional methodology used in unimanual studies does not take the brain stage into consideration, and therefore appears to be insufficient for decoding bimanual movements. In this paper, we propose the use of a two-staged (effector-then-trajectory) decoder, which combines the classification of movement conditions and uses a hand trajectory predicting algorithm for unimanual and bimanual movements, for application in real-world BCIs. APPROACH Two micro-electrode patches (32 channels) were inserted over the dura mater of the left and right hemispheres of two rhesus monkeys, covering the motor related cortex for epidural electrocorticograph (ECoG). Six motion sensors (inertial measurement unit) were used to record the movement signals. The monkeys performed three types of arm movement tasks: left unimanual, right unimanual, bimanual. To decode these movements, we used a two-staged decoder, which combines the effector classifier for four states (left unimanual, right unimanual, bimanual movements, and stationary state) and movement predictor using regression. MAIN RESULTS Using this approach, we successfully decoded both arm positions using the proposed decoder. The results showed that decoding performance for bimanual movements were improved compared to the conventional method, which does not consider the effector, and the decoding performance was significant and stable over a period of four months. In addition, we also demonstrated the feasibility of epidural ECoG signals, which provided an adequate level of decoding accuracy. SIGNIFICANCE These results provide evidence that brain signals are different depending on the movement conditions or effectors. Thus, the two-staged method could be useful if BCIs are used to generalize for both unimanual and bimanual operations in human applications and in various neuro-prosthetics fields.