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Transcranial direct current stimulation in treatment of tinnitus and its psychiatric comorbidity
Mareš, Tadeáš ; Anders, Martin (advisor) ; Klírová, Monika (referee) ; Slovák, Matěj (referee)
The theoretical part of our work is divided into three chapters and provides a contemporary systematic literature review of tinnitus, neurostimulation, and selected neurostimulation methods in its therapy. The first chapter includes an overview of the history, epidemiology, etiopathogenesis, theoretical development models, diagnosis, treatment methods, and comorbidities of tinnitus. The second chapter summarizes the history, principles, practical application, use, and adverse effect profile of the transcranial direct current stimulation (tDCS). The third chapter describes the use of neurostimulation methods in tinnitus therapy, especially synthesizing previous works' knowledge, comparing the protocols used, and identifying the positive influence of the intervals between individual tDCS applications on the therapeutic effects. The research part evaluates the short-term and long-term effects of tDCS on the subjective perception of tinnitus, symptoms of depression and anxiety, and quality of life measured by the use of questionnaires. It is a prospective, randomized, double-blind, placebo- controlled clinical trial of 39 participants diagnosed with chronic, non-pulsatile tinnitus. The research protocol included six applications of bifrontal tDCS in two consecutive weeks, 48 to 72 hours apart, with a...
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Functional movement disorders: pathophysiological mechanisms, diagnostic neurophysiological markers, and new therapeutic approaches
Slovák, Matěj ; Serranová, Tereza (advisor) ; Vevera, Jan (referee) ; Rusina, Robert (referee)
Functional movement disorders (FMD), previously referred as psychogenic, are characterized by inconsistency and incogruence with organic neurological disorders. The original psychological models of FMD were replaced by a neurobiological model of the disease. The identification of neurophysiological correlates of FMD and their comorbidities may add to the so far limited knowledge of the pathophysiology of these disorders. This Thesis focuses on three thematic areas of FMD: 1. assessment of prevalence of comorbid restless legs syndrome (RLS) and periodic limb movements (PLM) as an objective marker of RLS using actigraphy; 2. analysis of reflexive and volitional eye movements using videooculography (VOG); 3. evaluation of emotional arousal objectively by pupillometry and subjectively using affective ratings of emotional pictures. In total, 115 FMD patients and 76 age- and matched healthy controls participated in the studies. 1. FMD patients (N=96) presented with signficantly higher prevalence of RLS (43,8 % vs. 7,9 %, p<0,001) and clinically relevant PLM (20,8 % vs. 2,6 %, p=0,0002) compared to controls. The association of RLS/PLM with FMD raises the possibility of common pathophysiological mechanisms of these conditions and has clinical implications in management of FMD. 2. VOG analyses showed normal...
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