Earticle

이 연구는 첫째, 경도인지장애(MCI)가 언어 기억 및 시공간 기억 등 특정 기억의 저하와 관련이 있는지를 파악하 고, 둘째, 정상 노인으로부터 MCI를 감별하는 데 예측력이 우수한 지표를 탐색하였다. 표준화 된 기억검사를 수행한 189명(정상 노인 103 명, MCI 86 명)을 분석하였다. 언어 기억은 Seoul Verbal Learning Test를 이용하였고. 시공간 기억은 Rey Complex Figure Test를 이용해서 측정하였다. 다항 로지스틱 회귀모형을 이용하여 기억 검사의 예측력을 분석한 결과, 언어 기억과 시공간 기억은 정상 노인으로부터 MCI를 감별하는 데 예측 성능이 유의미하였다. 반면, 각 기억 검사의 수행결과를 포함하여 모든 혼란변수를 보정했을 때, 언어 기억의 즉시 회상만 정상 노인으로부터 MCI를 감별하는 데 예측력이 유의미하였으며, 시공간 기억의 즉시 회상은 예측력이 유의미하지 않았다. 이 결과는 MCI를 선별 할 때 언어 기억과 시공간 기억의 지연 회상, 언어 기억의 즉시 회상이 MCI의 기억능력을 감별할 수 있는 최상의 조합임을 시사한다.

This study examined whether Mild Cognitive Impairment (MCI) is related to the reduction of specific memory among linguistic memory and visuospatial memory, and to identify the most predictive index for discriminating MCI from normal elderly. The subjects were analyzed for 189 elderly (103 healthy elderly, 86 MCI). The verbal memory was used by the Seoul Verbal Learning Test. visuospatial memory was measured using the Rey Complex Figure Test. As a result of multiple logistic regression, verbal memory and visuospatial memory showed significant predictive performance in discriminating MCI from normal elderly. On the other hand, when all the confounding variables were corrected, including the results of each memory test, the predictive power was significant in distinguishing MCI from normal aging only in the immediate recall of verbal memory, and the predictive power was not significant in the immediate recall of visuospatial memory. This result suggests that delayed recall of visuospatial memory and immediate recall of verbal memory are the best combinations to discriminate memory ability of MCI.

본 연구는 Brief Visuospatial Memory Test-Revised(BVMT-R)의 한국 개정판 검사인 “한국판 간편 시공간 기억 검사(K-BVMT)”에 대한 표준화 연구의 일환으로서 노인 평가, 특히 치매 평가에 유용하게 사용될 수 있도록 노인집단을 대상으로 표준화하기 위해서 수행되었다. 한국 노인들에게 적합하고 Seoul Verbal Learning Test(SVLT)와 대응이 되도록 BVMT-R의 실시 및 채점방법을 변경하여 K-BVMT를 새로 제작하였고, 55세부터 90세 사이의 건강한 장노년 258명(남자 86명, 여자 172명)에게 K-BVMT와 함께 SVLT, Rey Complex Figure Test(RCFT) 및 Judgment of Line Orientation(JOLO) 검사를 실시하였다. 피검자들의 평균 연령은 68.18세(SD= 7.54)였고, 평균 교육년수는 5.54년(SD=4.78)이었다. 전체 피검자들 중 132명을 무작위로 선정하여 자극 그림들 사이에 경계선이 없는 검사 자극(NG조건)을 제시하였고, 나머지 126명에게는 경계선이 그려져 있는 검사 자극(G조건)을 제시하였으며 각 조건에서 15명씩 선발하여 30명의 피검자에게 1개월 간격으로 K-BVMT를 반복 실시하였다. K-BVMT의 검사-재검사 신뢰도는 높은 수준에 속하였다. 상관분석 결과 K-BVMT는 시각 기억 검사뿐만 아니라 언어 기억 검사와도 유의한 상관이 있음이 밝혀졌으나 K-BVMT는 G조건에서는 언어 기억 검사보다 시각 기억 검사와 더 높은 상관을 나타내었다. 또한 요인분석결과 NG 조건에서는 K-BVMT 변인들이 언어 기억 검사의 변인들과 같은 요인에 포함되었으나 G조건에서는 언어 기억 검사 요인과 독립적으로 K-BVMT의 변인들로만 구성된 K-BVMT 요인이 추출되었다. 이 결과는 G조건의 K-BVMT가 시각 기억 검사로서 타당하게 기능함을 시사한다. 따라서 이 결과들에 근거하여 K-BVMT의 노인 규준을 G조건에서 산출하였다. 끝으로, 노인집단에서 관찰된 NG조건과 G조건의 차이가 의미하는 바를 노화에 따른 시공간 기억 처리의 변화와 관련지어 논의하였다.

The present study examined the validity of the Korean version of the Brief Visuospatial Memory Test (K-BVMT) for assessing visuospatial memory in the elderly. The K-BVMT was developed with some modifications in stimulus presentations and scoring methods of the original Brief Visual Memory Test-Revised (BVMT-R) for use with the Korean elderly. The subjects were 258 healthy elderly people (86 men, 172 women; mean age = 68.18 ± 7.54 years; mean education = 5.54 ± 4.78 years) recruited from the community. They were given the K-BVMT, with Seoul Verbal Learning Test, Rey Complex Figure Test, and Judgment of Line Orientation. The K-BVMT was re-administered to 30 subjects after a 4-week interval. The K-BVMT test-retest reliability was significantly high (r = .83 - .84, p < .001). Of 258 subjects, 132 were shown the stimulus without grid, as in the original BVMT-R (NG condition), and the rest were shown the stimulus with grid (G condition). The correlation analyses showed that the K-BVMT correlated significantly with the verbal memory test as well as the visuospatial memory test. In the G condition, however, the K-BVMT correlated more strongly with the visuospatial memory test than with the verbal memory test, in contrast to the NG condition. In the G condition, the K-BVMT factor that consisted of only K-BVMT variables was extracted from the factor analysis, whereas, in the NG condition, the K-BVMT variables were included in the same factor with the verbal memory variables. These results confirmed that the K-BVMT is a valid visuospatial memory test in the G condition. Therefore, elderly norms for the K-BVMT were produced only in the G condition. Finally, we discussed the implications of the differences between the K-BVMT's NG and G conditions in relation to age-related changes in visuospatial memory processing.

본 연구는 정상인을 대상으로 20대, 30대, 40대, 50대, 60대의 연령대별 시공간구성능력, 시각기억력, 실행능력의 차이가 있는지 알아보고자 Rey-Osterrieth Complex Figure 검사(Rey, 1941; 이하 ROCF)를 실시하였다. 그 결과, 시공간구성능력에서는 연령증가에 따른 차이가 없었고, 시각기억력에서는 회상 시 연령이 증가할수록 감퇴하는 양상이었고, 재인과제 시에는 연령에 따른 변화가 없었다. 실행기능면에서 60대가 다른 연령대보다 줄기선6의 정확성이 떨어지고 반복억제력이 높게 나타나 실행기능의 부분적 손상이 나타났다. 따라서 정상인은 60대를 기점으로 하여 기억력과 실행기능이 부분적으로 감퇴됨이 시사되었다. 추가적으로 50대이상의 고령자를 중심으로 뇌손상집단과 정상집단의 ROCF 수행을 비교하였을 때, 시공간구성능력, 시각기억력 및 실행능력에서 뇌손상집단이 정상집단보다 현저히 떨어지는 수행을 보여, 손상으로 인한 인지능력의 질적인 변화가 시사되었다. 따라서 ROCF는 시공간 구성능력과 기억력 및 실행능력을 탐지하는데 비교적 유용한 도구임을 알 수 있었다.

The purpose of this study was to consider the visuospatial ability, memory and executive function of normal adults according to their age groups by using Rey-Osterrieth Complex Figure Test(ROCF). 71 normal adults were divided into the five groups by 10-year age group: I.e, 20-29, 30-39, 40-49, 50-59, 60-69 year. As a result, 60-69 year-old group acquired significantly low scores of the executive functions and memory recall, but not visuospatial function comparing to other groups. These results reflect that mild cognitive decline starts with 60 years of the elderly. Additionally, this research was to investigate for the aged in relation of cognitive function between the normal aged and patient aged group. Subjects were compose of twenty-two normal aged group and fifteen patient aged group who had mild traumatic brain injury and they all were aged over 50 years. Patient group had a significant visuospatial disability, memory deficit and executive dysfunction relative to normal group. These results indicate that qualitatively different cognitive function due to traumatic brain injury. Finally, the suggestions, limitations and further issues for future study were discussed.

Objective: We evaluated a role of prefrontal and parietal cortex in verbal working memory and visuospatial attention using repetitive transcranial magnetic stimulation (rTMS). Method: In six healthy volunteers, bilateral prefrontal and parietal cortex was stimulated with rTMS (90% of motor threshold, 10 trains of 1 Hz rTMS) during performed cognitive tasks (two-back verbal working memory task and endogenous visuospatial attention task). rTMS was applied to 4 different sites over left prefrontal, right prefrontal, left parietal and right parietal areas at F3, F4, P3 and P4 location on the scalp, according to the 10/20 EEG system. The sham stimulation was applied with the coil placed perpendicular to the scalp. Results: Reaction time (RT) was significantly prolonged by left prefrontal TMS in verbal working memory. In addition, performance deterioration was also observed during rTMS over the right prefrontal and left parietal areas. In visuospatial attention task, RT was significantly prolonged by right parietal TMS. Conclusion: These results show that left prefrontal cortex play a major role in the network of working memory, and right parietal cortex is important area in the visuospatial attention. We suggest that an rTMS could be a useful method for evaluation of neural network in human brain.

SNARC(Spatial-Numerical Association of Response Codes) 효과란, 보편적으로 작은 수는 왼쪽 공간에서, 큰 수는 오른쪽 공간에서 반응이 이루어질 때 수행이 더 좋아지는 현상으로서, 수와 공간의 연합을 반영하는 대표적인 현상이다. 최근 연구들은 수학 전공자와 시공간 능력이 우수한 집단에서는 SNARC 효과가 작게 관찰된다고 보고하였다. 본 연구에서는 수학적 인지 발달의 기초적 능력인 수량 변별 능력과 시공간적 작업 기억이 우수한 집단에서 SNARC 효과가 작게 나타나는지를 검증하였다. 연구 결과, 수량 변별 민감도로 측정한 기초 수 정보 처리 능력이 낮은 집단에서만 SNARC 효과가 관찰되었다. 또한, 심적 회전을 포함한 회전 폭 과제의 수행을 통해 측정한 시공간적 작업기억이 낮은 집단에서만 SNARC 효과가 관찰되었다. 반면, 언어적 작업 기억을 기준으로 집단을 나누었을 때에는 집단 간에 SNARC 효과의 차이가 없었다. 이러한 결과는 기초 수 인지 능력 및 시공간 작업 기억이 우수한 사람들은 수와 공간 간의 연합이 목표와 맥락에 따라 유동적일 가능성을 시사한다.

The SNARC(Spatial-Numerical Association of Response Codes) effect refers to the phenomenon that relatively smaller vs. larger numbers are processed more efficiently in the left vs. right side of space, respectively. The SNARC effect is a representative case of the number-space association. In relation to recent reports of a reduced SNARC effect in the mathematically skilled and high visuospatial ability groups, the present study examined whether individuals with high number acuity and visuospatial working memory capacity manifest a small SNARC effect. Number acuity refers to the sensitivity for the discrimination of numerosity which is thought to serve as one of the foundations for numerical cognition. Our results showed that a SNARC effect was observed only in the groups with low number acuity and visuospatial working memory. In contrast, there were no difference in the size of the SNARC effect between groups high and low in verbal working memory. These results suggest that individuals with high number acuity and visuospatial working memory may have a more flexible association between number and space depending on the task goal and context.

This study aimed to compare the effects of computerized-assisted cognitive rehabilitation (CACR) and conventional rehabilitation (CR) on visuospatial perception, visual field and attention, and visual memory in patients with unilateral spatial neglect. Forty-eight patients with unilateral spatial neglect were randomly assigned to either the experimental group (n=23) or the control group (n=25). The experimental group received CACR intervention using RehaCom software, including saccadic eye movement, visual field, and visual-motor coordination training, whereas the control group received CR, including hemispheric activation approach, mental imagery training, and vibration therapy. Interventions for the experiemntal and control groups were performed for average 30 minutes, five times per week for four weeks. Outcome measures comprised Motor-free visual perception test (MVPT) and line bisection test (LBT) for visuospatial perception, visual span test (VST) for evaluating visual field and attention, and Visual recognition test (VRT) for evaluating visual memory. Evaluations were performed before and after the intervention. In between- group comparison, improvements on MVPT, VST, and VRT scroes after the intervention were statistically significantly different between the groups (p<.01). In within-group comparison, both groups showed statistically significant improvement in all variables after the intervention (p<.01). These findings suggest that the CACR may be beneficially used to enhance visuospatial perception, visual field and attention, and visual memory for patients with the unilateral spatial neglect caused by brain damage. Further studies will be needed to warrant our results.

목 적: 본 연구의 목적은 청소년에서 전산화 신경인지 검사를 이용하여 수면 부족과 시공간 기억력 사이의 연관성에 대해 알아보는 것이다. 방 법: 심각한 내외과적 질환이 없는 만 16세에서 만 18세 사이의 고등학생 103명(남자 26명, 여자 77명, 평균 연령 $17.11{\pm}0.50$세)이 연구에 참여하였다. 모든 대상자에게 주중 총 수면 시간과 주말 총 수면 시간에 대한 자가 보고식 설문지를 작성하도록 하였다. 주간 졸음과 우울 증상의 정도를 평가하기 위해 엡워스 졸음 척도와 벡 우울 척도를 자가 작성하도록 하였다. 시공간 기억을 평가하기 위해 캠브리지 신경정신검사 자동화 총집의 7개 하부 검사를 실시하였다. 결 과: 나이와 성별, 엡워스 졸음 척도, 벡 우울 척도를 보정한 상관 분석의 결과는 다음과 같다. 주말 총 수면 시간이 길수록 지연 표본 대응(r = -0.312, p = 0.002)와 패턴 재인 기억의 즉각 회상(r = -0.225, p = 0.025)의 정답률이 낮았다. 주말 수면 보충 시간이 길수록 지연 표본 대응(r = -0.236, p = 0.018)과 패턴 재인 기억의 즉각 회상(r = -0.220, p = 0.029), 패턴 재인 기억의 지연 회상(r = -0.211, p = 0.036)의 정답률을 낮았다. 결 론: 주중 수면 부족를 반영하는 주말 수면 보충 시간이 길수록 시각 기억의 지연 회상에서 낮은 수행도를 보였다. 본 연구의 결과는 청소년기에 수면 부족이 심할수록 청소년의 시공간 기억력이 저하될 수 있다는 것을 시사한다.

Objectives: The objective of this study was to investigate the correlation between insufficient sleep and visuospatial memory in adolescents using a computerized neurocognitive function test. Methods: A total of 103 high school students (26 males and 77 females; mean age $17.11{\pm}8.50years$) without a serious psychiatric problem was recruited. All subjects were requested to complete a self-report questionnaire about weekday total sleep time and weekend total sleep time. The epworth sleepiness scale (ESS) and the beck depression inventory (BDI) were administered to measure daytime sleepiness and symptoms of depression. Seven subsets of the Cambridge Neuropsychological test automated battery were examined to assess visuospatial memory. Results: After controlling for age, sex, ESS, and BDI, longer weekend total sleep time was correlated with poor performance on delayed matching to sample (r = -0.312, p = 0.002) and immediate recall on pattern recognition memory (r = -0.225, p = 0.025). Increased weekend catch-up sleep time was correlated with poor performance of delayed matching to sample (r = -0.236, p = 0.018), immediate recall on pattern recognition memory (r = -0.220, p = 0.029), and delayed recall on pattern recognition memory (r = -0.211, p = 0.036) after controlling for age, sex, ESS, and BDI. Conclusion: This study showed that increased weekend catch-up sleep time reflecting insufficient weekday sleep were associated with poor performance in delayed recall tasks of visual memory. This finding suggests that insufficient sleep during adolescence might produce a decline of visuospatial memory.

本研究では、第二言語(以下、L2)としての日本語の文章聴解における空間的状況モデルの構築におい て、視空間作動記憶の働き方が学習者の言語性作動記憶容量の大小によって異なるか否かを検討する ことを目的に、母語(以下、L1)聴解を対象とした実験1とL2聴解を対象とした実験2を行った。実験で は、言語性作動記憶容量を個人差要因として扱い、二重課題として空間的タッピング課題を用い、その 種類を中央制御部の関与の大きさによって操作した。具体的には、単純タッピング条件、複雑タッピン グ条件及びタッピング無し条件を設けた。実験の結果、2つの実験ともに、言語性WM容量が大きい聴き 手のほうが、それが小さい聴き手より地図作成テストにおける正再生率が高く、言語性WMがL1とL2の 聴解における空間的状況モデルの構築において重要な役割を果たすことが示唆された。また、空間的 タッピング課題による妨害の出方が、言語性WM容量の大小によって異なった。聴き手の言語処理の自 動性、また、言語理解の効率性の高低によって、視空間WMの働き方が異なり、空間的状況モデルを構 成する意味表象のモダリティによる豊富さが異なることが明らかになった。

The purpose of the present study is to investigate how visuospatial working memory (visuospatial WM) is involved in the construction of a spatial situation model for spatial passages presented auditorily in Japanese, L2. 2 experiments were conducted to compare between L1and L2 listening comprehension. In the experiments verbal working memory (verbal WM) capacity was manipulated as an independent variable and a spatial tapping task was used as a dual task, which consisted of simple tapping conditions, complex tapping conditions as a target-tracking task, and control conditions, manipulated by the degree of involvement of central executive. As a result in both experiments the listeners with high verbal WM capacity had a higher correct recall rate in the mapping drawing test than the listeners with low verbal WMcapacity, which suggests that verbal WM plays an important role in the construction of spatial situation models in both L1 and L2 listening comprehension. In addition, the interference caused by the spatial tapping tasks differed depending on the verbal WM capacity. These results indicate that depending on the listener's automaticity of language processing and the efficiency of language comprehension the degree of the involvement of visuospatial WM differed and consequently, the richness of the representations that make up the spatial situation model differed by modality.

Objectives : Mild Alzheimer's disease(AD) is uncertain to be related to visuospatial working memory subsystem dysfunction. We used the self ordered pointing test(SOPT) to find the characteristics of visuospatial working memory in mild AD. Methods : We compared the visuospatial working memory abilities of 20 patients with mild AD and 20 normal elderly controls(NC) using SOPT, of which stimuli consisted of two stimuli types(A : abstract, C : concrete) and two stimuli numbers(8 and 12). Therefore, working memory was tested using C8, C12, A8, and A12 stimuli conditions in SOPT. Mixed-model ANOVA was conducted with the AD and NC groups as between-subjects factor, with stimuli types and stimuli numbers as the within-subjects factors and with SOPT error rates as the dependent variable. Results : The AD group showed higher error rates in SOPT than the NC group. The NC group showed low error rates in concrete stimuli than in abstract stimuli and in small stimuli numbers than in large stimuli numbers. And the AD group showed no differences between stimuli types or stimuli numbers. Conclusion : AD patients showed a poor performance in visuospatial working memory using concrete stimuli. The result suggests that there is a non-transformation from visual input to phonological working memory in AD. Patients with AD showed a poor performance although in small stimuli number condition of SOPT. It suggests that in AD, visuospatial working memory is not working well although in low central executive loads.

배경 및 목적: 본 연구에서는 언어장애의 유무를 판단하는데 아동의 구어, 시공간적 작업기억 과제 수행이 유용한 도구가 될 수 있는지 알아보고, 이러한 조합이 표준화 언어검사에 준하는 판별력을 지니는지 살펴보고자 하였다. 방법: 만 5-6세의 언어장애아동 18명, 생활연령을 일치한 또래 일반아동 18명 총 36명을 대상으로 구어적 작업기억(nonword repetition/sentence repetition/Competing Language Processing Task), 시공간적 작업기억(Matrix) 과제 수행을 분석하였다. 결과분석은 다변량분석, Pearson의 적률상관계수 및 판별분석을 실시하였다. 결과: 분산분석 결과, 그룹 간 차이가 유의했던 과제는 ‘문장 따라말하기(SR)-단어 및 문장 점수’, ‘경쟁 언어 처리 과제(CLPT)-단어회상 점수’로 나타났으며, 본 연구의 모든 과제들을 입력하였을 때, 일반아동을 일반아동으로 판별하는 특이도(specificity)는 94.4%, 언어장애아동을 언어장애아동으로 판별하는 민감도(sensitivity)는 83.3%로 원 집단 케이스 중 총 88.9%가 올바르게 분류될 수 있는 것으로 나타났다. 논의 및 결론: 결론적으로, 본 연구를 통해 언어장애의 유무를 판단하기 위한 전제로 유용한 임상적 지표로 확인된 구어 및 시공간적 작업기억 과제들의 조합이 표준화 언어검사 결과에 준하는 높은 판별력을 지닐 수 있는 것으로 분석된다.

Objectives: In the clinical setting, it is an important issue to find more efficient measures to identify language impairment equivalent to standardized language tests can be a useful tool in identification of language impairment. This study examined whether a combination of verbal and visuospatial working memory tasks can discriminate children with language impairment from those with typical language development. Method: A total of 36 children participated?18 children with language impairment (LI) and 18 typically developing (TD) children. Participants completed verbal working memory tasks (non-word repetition [NWR], sentence repetition [SR], Competing Language Processing Task [CLPT]), visuospatial working memory task (Matrix). Multivariate analysis, Pearson’s product-moment correlation and discriminant analysis were used. Results: MANOVA results indicated that group differences for SR, CLPT scores were significant. Discriminant analysis conducted with all measures (NWR, SR, CLPT, Matrix) showed good sensitivity (83.3%) and specificity (94.4%) in distinguishing between TD and LI groups. Conclusion: Children with LI exhibited deficits in verbal tasks (SR, CLPT) rather than visuospatial task (Matrix) relatively. However, visuospatial ability was not correlated any standardized language test scores in LI group although their performance was not behind. Nevertheless, a combination of various working memory tasks can be a useful tool in discrimination of children with LI from their TD peers.

본 연구는 남녀 운전자 집단 각각에서 관찰되는 언어 및 공간 작업기억 능력에서의 개인차가 운전 중 상황인식 과제 수행에 어떠한 차이를 가져오는지 살펴보기 위해 수행되었다. 실험참가자들의 언어 작업기억 능력과 공간 작업기억 능력은 단어 재인과제와 위치 파지과제를 이용하여 각각 측정하였고, 상황인식 능력은 운전 시뮬레이션을 이용한 실시간 탐사과제를 이용하여 측정하였다. 자료의 분석 결과, 성차에 따른 상황인식 과제 수행에서의 차이는 관찰되지 않은 대신, 각각의 작업기억 능력에서 더 우수한 실험참가자일수록 상황인식 과제 수행도 더 좋았다. 특히, 두 가지 작업기억 능력에서의 상대적 우세성을 성차와 함께 고려하여 상황인식 수행을 비교하였을 때, 남성의 경우에는 공간 작업기억 능력 수준에 따라서만 상황인식 과제 수행에서 차이를 보인 반면 여성의 경우는 언어와 공간 작업기억 능력의 수준 모두가 상황인식 과제 수행에 영향을 주는 것이 관찰되었다. 이러한 결과는 운전자의 성별 자체보다는 각 성별에 따라 보이는 작업기억 하위 영역에서의 개인차가 상황인식 수행의 질을 결정할 수 있다는 것을 시사한다.

The aim of the present study was to examine whether the difference in working memory ability for both gender could be reflected differentially on the situation awareness in simulated-driving condition. The reading span task was employed to measure the participants' verbal working memory ability (VWMA), and the visuospatial span task to measure spatial working memory ability (SWMA). Situation awareness (SA) was measured by real-time probes method using driving simulation. The results indicated that although the participants of two gender groups showed similar level of performances in the SA tasks, the relative superiority in the two types of working memory abilities for the two genders appeared to have differential effects on the SA performances. That is, whereas only the difference in SWMA of the female drivers induced the difference in SA performance, both the differences in VWMA and SWMA of the male drivers made the differences in SA performance.