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Prevention and therapy of spasticity in patients after cerabral apoplexy
TÁBORSKÁ, Žaneta
Spasticity is a manifestation of many neurological diseases, for example an infantile cerebral palsy, a traumatic injury of brain and spinal cord, a multiple sclerosis and a stroke. A genesis of the spasticity is not yet completely clarified and many definitions try to explain it. The spasticity can deepen a disability of patients even with a minimal paresis. The spasticity has a different clinical picture at various diseases of the central nervous system, but even at different patients with the same diagnosis, it also varies in the course of time at one and the same patient. The biggest problem in the treatment of the spasticity is the fact that the treatment, efficient at one patient, can completely fail at the other. A goal of this thesis was to give an overview of current options in a treatment of the spasticity. Therapeutic approaches to reduce the spasticity are usually a part of special kinesio-therapeutic methodologies, which are for example an anti-spastic positioning, a volitionary relaxation, passive movements, an anti-spastic placing (Bobath´s conception), relaxation techniques (PNF), an application of splints, a long-term effect of the heat, an icing and others. On the contrary, it is intensified by pain, pressure sores, a sub-luxation position most often of the shoulder joint, a psychical stress, urinary tract infections etc. In the theoretical part I focused on a control of the muscle tone, pathophysiology, clinical symptomatology, diagnostics and especially prevention and the treatment of the spasticity. In the practical part I investigated an effectiveness of an anti-spastic therapy through the qualitative research. For the data collection it was used an anamnesis, observations (kinesiological analysis), case reports and a secondary data analysis. The research was made at two probands with a brain damage on the vascular basis. I was finding out an effectiveness of selected therapies for individual probands {--} and at the same time its suitable combination. I focused on the area of the upper extremity. At the first patient there was a success, by a suitable combination of individual methods, to positively affect the spasticity and an active momentum of the upper extremity. At the second patient in a chronic stage of spasticity it was managed to influence it always only for a short term and results varied considerably in the course of time. The treatment of the spasticity must be preceded by a thorough knowledge of pathophysiological mechanisms, a neurophysiology and above all a complex kinesiological analysis. The therapeutic approach should be always individual, to respond appropriately to changes in the clinical picture and to use suitable combinations of therapeutic approaches. If the treatment of the spasticity is successful, it positively affects the motor deficit and reduces the patient's disability.
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Neurogenesis and gliogenesis after ischemic brain injury in EGFP/GFAP mice
Dlouhá, Veronika ; Anděrová, Miroslava (advisor) ; Vargová, Lýdia (referee)
Focal ischemia induces enhancement of neurogenesis/gliogenesis in the subventricular zone (SVZ) of the lateral ventricle and it also leads to glial scar formation in the vicinity of the ischemic lesion. The gliotic scar is mainly formed by reactive astrocytes that express glial fibrilarly acidic protein (GFAP), nevertheless this protein is also expressed in adult multipotent neural stem cells (NSCs). Therefore, we have used the strain of transgenic mice (GFAP/EGFP mice), in which the enhanced green fluorescent protein (EGFP) is expressed under human GFAP promoter in astrocytes as well as in NSCs, thus allowing us an immediate vizualization of these cells, and to estimate the effect of ischemic injury on their fate during proliferation and differentiation in vitro. Focal ischemia was induced by the occlusion of the middle cerebral artery (MCAO) and 3 days post injury, an immunohistochemical analysis was carried out. Furthermore, the cell isolation from SVZ and the region of gliotic scar was performed, followed by their cultivation under proliferative conditions (as neurospheres) and their differentiation for 7-10 days. The differentiation potential of these cells was studied using immunocytochemical analyses and patch clamp technique was employed to estimate their membrane properties. Based on increased...
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Neuron-glia communication by extrasynaptic transmission
Syková, Eva
Dynamic changes in ECS ionic composition, volume and geometry accompany neuronal activity, neuronal loss, glial development and proliferation, aging, CNS injury, anoxia/ischemia, spreading depression, tumors, inflammation dyemyelination and many other brain pathological states.
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The Analysis of the Effect of HBOT in Patients After Acute Ischemic Stroke
Jason, Tufikameni ; Prokešová, Michaela (advisor) ; Otáhal, Jakub (referee)
The purpose of this report is to give an analysis of the effectiveness of HBOT in patients after stroke. This can be acbieved by illustrate the main pathophysiologic reactions, including inflammatory a reparatory mechanisms that all brain cells undergo during ischemie brain attack. The fundamentals of stroke where reviewed with the aim of achieving a clear view on the subject. Hence tbe recognition of therapeutic specificity that hyperbaric oxygen therapy (HBOn offers. We also took a closer look on the basics of HBO, its history, physiological aspects, indications, the principles that accompany it. An analysis of methods, results, and conclusions of a literature review on the use ofthis therapy (HBOn to treat manifestations ofstroke in humans is assessed. Key words: Hyperoxygenation, adjuvant therapy, HBOT, therapeutic hyperbaric medicine, Acute Ischemie stroke, Neuronal cells, Non-neuronal cells. 21 Page
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The effect of analgesics and their combination with neurotropic drugs on pain and brain mediators
Soukupová, Marie ; Kršiak, Miloslav (advisor) ; Farghali, Hassan (referee) ; Rokyta, Richard (referee)
The first aim was to investigate changes in analgesic efficacy of several analgesics in combination with selected drugs affecting nervous system after systemic administration. The second aim was to ascertain changes of levels of pain mediators in vivo in supraspinal brain structures (in periaqueductal gray matter, central amygdala, striatum) in pain and under the drug influence. The analgesic efficacy of combinations of analgesics with neurotropic drugs was investigated in the writhing test in mice. Interactions between analgesics and neurotropic drugs were evaluated by the isobolographic analysis, which enables to distinguish the supra-additive (synergistic) interactions from solely additive and sub-additive ones. A possible negative effect of neurotropic drugs on motor functions was determined in the rota-rod test in mice. Changes of levels of pain mediators in the brain during pain and under the drug influence in rats were measured by microdialysis in vivo coupled with a high performance liquid chromatography. A model of inflammatory pain induced by intraplantar injection of carrageenan and a model of neuropathic pain produced by a spared sciatic nerve injury model were used in rats. We evaluated pain in plantar and von Frey filament test. Our microdialysis experiments revealed that inflammatory pain...
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Attention training using EEG biofeedback in patients with brain injury
Gregorová, Iva
Celosvětové statistiky jsou pravidelně plněny varovnými čísly, která oznamují, kolik lidí každý rok podlehne následkům traumatu mozku. Díky zlepšující se lékařské péči se zvyšuje počet lidí, kteří přežívají i závažná poranění mozku. Tato poranění však sebou nesou řadu komplikací a to raných i pozdějších. Finanční prostředky vynakládané na léčbu pacientů po poranění mozku jsou značné. Přesná čísla nejsou známa, ale podle Smrčky (2001) v roce 1990 např. v USA dosáhly roční náklady na mozková traumata 25 miliard US dolarů. Tato částka zahrnuje náklady spojené jednak s přímou léčbou pacientů, ale i s následnou rehabilitací, rekvalifikačními kurzy atd. Řada pacientů je díky následkům úrazu v dlouhodobé pracovní neschopnosti nebo trvalé invaliditě. Častými následky po poranění mozku jsou mimo Jlne deficity kognitivních funkcí, zvláště pozornosti. Tato disertační práce se zaměřuje na možnost využití metody EEG biofeedback při tréninku pozornosti u pacientů po poranění mozku, Jednou z terapeutických aplikací metody EEG biofeedback jsou právě poruchy pozornosti. Metoda EEG biofeedback je mnohými opěvovaná a jinými zase zatracovaná. Využívána je při léčbě celé řady onemocnění. Původní projekt této disertační práce musel být změněn. Měla být ověřována efektivita metody EEG biofeedback u vzorku dětí s diagnózou ADHD, u...
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Psychosocial consequences of traumatic brain injury. Their impact on the patient's family.
Jira, František ; Kulišťák, Petr (advisor) ; Šivicová, Gabriela (referee)
Title: Psychosocial consequences of traumatic brain injury. Their impact on the patient's family. Author: František Jira Institution: Cathedra of psychology FF UK in Prague Supervisor: doc. PhDr. Petr Kulišťák, Ph.D. Number of pages: 116 Key words: traumatic brain injury psychosocial consequences family focus group grounded theory The submitted diploma thesis deals with the psychsocial consequences (related to the life among people) of traumatic brain injury. The main theme of the diploma thesis is the impact of these effects on the patient's family. The work consists of a theoretical and an empirical part. The theoretical part is divided into four spheres - neuroanatomy and pathology, brain injury, psychosocial consequences and rehabilitation. In the empirical part the author use a qualitative research approach to deal with the impact of psychosocial consequences after the traumatic brain injury to the patient's family. The research took place in association Cerebrum and Ústřední vojenská nemocnice Praha, it was conducted by the method of focal groups. The method of grounded theory was used for the consequent analysis. The result is an understandable processing of the extensive topic of the psychosocial consequences for people after brain injury. The work provides the detailed view of typical...
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Rehabilitation of cognitive functions in patients after brain injury
Umlaufová, Veronika ; Uhlář, Pavel (referee) ; Kulišťák, Petr (advisor)
The mm of the master thesi s "Rehabilitation of cognitive functions in patients afteľ bľain injury" was to claľify these problems fľom pľactical point of view. In the first chapter readers get acquainted with kinds of brain injury. The second chapter deals with cognitive tlmctions and the third, most extensive, lS dedicated to rehabilitation of patients after brain injury. The ľehabilitation lS conceived as a complex process involving care of patients in the biological, psychicaL social and physical sphere. The empirical part concentrates on training oť attention. Patients after brain injury. who were invol\"ed in the study. vvere divided into two groups. Within three weeks one group practiced on computer (programme RehaCom) and the other attended occupational therapy. We investigated whether there are any diťferences in the influence of training of attention by means oť computer programme or occupational therapy. In regard of a smalI sample (five patients in each group) and other conditions we came to the conclusion that the effect of training oť attention appeared in neither group after three weeks. The empirical part is completed with a questionnaire. We addressed the specialist who work with patients after brain injury and asked them what they thought about the training oť attention by means oť computer...
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