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Modulation of consequences of ischemia and hypoxia
Nohejlová, Kateryna ; Mareš, Jan (advisor) ; Šonka, Karel (referee) ; Vožeh, František (referee)
Modulation of consequences of ischemia and hypoxia Kateryna Nohejlová (maiden Deykun), MD Abstract It is known from literature that that many types of insults are accompanied by the increase of free radicals level. The models of three pathological states, which are known to be related to the changes in free radicals production, were used for the purposes of the work. These models were also chosen because the intensity of action of pathogenic factor borderlines the threshold of mainly functional CNS disturbances. It was need for the animals to survive the interventions in order use behavioral methods of assessment. For the estimation of the degree of disturbances were used tests of postural motor function and motor learning and spatial orientation. The action of free radicals was evaluated indirectly by application of their scavengers and antioxidants: tempol and melatonin, which act extracellularly as well as intracellularly. Scavengers were administered as prevention, before an insult, and as therapy, after an insult. The results were divided into three sets of experiments: 1. Focal photothrombotic ischemia of sensorimotor cortex: The performance of animals that received tempol treatment did not significantly differ from the animals subjected to plain ischemia in either of tests. Melatonin application...
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Ischemic strokes in vertebrobasilar region, caused by lesions of magistral arteries
Škoda, Ondřej ; Kalvach, Pavel (advisor) ; Šonka, Karel (referee) ; Kemlink, David (referee)
Vertebrobasilar ischemic strokes, caused by lesions of magistral arteries. Background and Purpose Progress in modern non-invasive or minimally invasive diagnostic methods has improved detection and evaluation of pathological changes in the vertebral arterial system. Ischemia in vertebrobasilar circulation, often caused by stenotic processes of vertebral arteries, is considered a severe form of stroke, with a mortality of 20 - 30%. Stenoses of these arteries may be responsible for up to one half of ischemic events in their nutritive region. Although there is no general consensus on treatment of the VA stenoses so far, recent recommendations consider interventions in secondary stroke prevention, when optimal conservative treatment did not prevent recurrent clinical symptoms. With the increasing number of centers providing diagnostics and possible interventional treatment, the objective assessment of these lesions should be available. However, due to a relatively small part of patients, who are indicated to vertebral angioplasty, the diagnostic procedures should be as noninvasive and safe, as possible. The aim of this study was to create the accurate, noninvasive an safe diagnostic algorithm for the detection and evaluation of the VA stenoses and to test its reliability on our own patients group....
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Alternative methods in the surgical treatment of mesial temporal lobe epilepsy
Vojtěch, Zdeněk ; Nevšímalová, Soňa (advisor) ; Šonka, Karel (referee) ; Komárek, Vladimír (referee)
Purpose: The aim of the study was to evaluate effectiveness and complications of alternative methods of stereotactic treatment (gamma knife radiosurgery and radiofrequency amygdalohippocampectomy) in mesial temporal lobe epilepsy due to mesial temporal sclerosis. Methods: Both patient groups underwent a standard preoperative epilepsy evaluation. Both procedures were planned according to the individual anatomy of each patient. Between November 1995 and May 1999, 14 patients underwent Leksell Gamma Knife radiosurgical amygdalohippocampectomy with a marginal dose of 18, 20, or 25 Gy to the 50% isodose following. Between April 2004 and October 2009 a group of 51 patients was treated using stereotactic thermo-lesion of the same mesiotemporal structures. Lesions were performed using a string electrode inserted through the occipital approach with a single trajectory. Results: In the radiosurgical group, one patient was classified as Engel Class Ib, three were Engel Class IIc, four were Engel Class IIIa, five were Engel Class IVb and one was Engel class IVc 39 months after treatment. One patient was classified as Engel Class Ib, three were Engel Class IIc, one was Engel Class IIIa, and two were Engel Class IVb in a subgroup of seven patients who were unoperated 2 years prior to the last visit and at least 8...
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Objective and subjective characteristics of sleep in chronic insomnia
Janků, Karolina ; Kopřivová, Jana (advisor) ; Papežová, Hana (referee) ; Šonka, Karel (referee)
Background: Insomnia is one of the most prevalent sleep disorders, negatively impacting the quality of life and increasing the risk of other health problems. Many patients with insomnia underestimate their sleep quantity compared to objective sleep measures. This objective and subjective sleep discrepancy (sleep misperception) occurs in different insomnia subtypes as well as in insomnia with a comorbid psychiatric disorder. Although previous research suggests that the sleep discrepancy reflects specific objective sleep alterations, the results of studies are inconsistent. Moreover, its relation to psychiatric comorbidities is not clear, as well as its role in the insomnia treatment. Aims: The theoretical part of the present thesis aimed to provide an overview of the recent research on sleep discrepancy in insomnia. The experimental part consists of four studies with the following goals: (1) to explore sleep electroencephalographic (EEG) correlates of sleep discrepancy in insomnia patients (Study 1); (2) to assess the association between sleep discrepancy and psychopathology (Study 2); (3) to examine changes of sleep discrepancy during and after the cognitive behavioural therapy for insomnia (CBT-I; Study 3); (4) to assess whether the additional chronotherapeutic tool can enhance the effect of CBT-I...
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REM sleep behavior disorder:Characteristics of polysomnographic and behavioral manifestations.
Nepožitek, Jiří ; Šonka, Karel (advisor) ; Bušková, Jitka (referee) ; Marusič, Petr (referee)
REM sleep behavior disorder: Characteristics of polysomnographic and behavioral manifestations Abstract REM sleep behavior disorder (RBD) is a disease characterized by abnormal motor activity corresponding to the dream content. REM sleep without atonia (RWA) and behavioral manifestations are the main features registered by video-polysomnography (PSG). Because idiopathic RBD (iRBD) is considered as prodromal stage of synucleinopathies, the direction of current research is the search for markers of early conversion. The goal of this study was to observe the group of patients with iRBD with regard to the development of manifest neurodegenerative disease, to find and test a new polysomnographic marker of phenoconversion, to perform analysis of the movements registered by video and to quantify excessive fragmentary myoclonus (EFM), which is a frequent finding in neurodegenerative processes. A total of 55 patients with iRBD were observed for 2.3±0.7 years. The annual conversion rate was 5.5%. Mixed RWA, representing simultaneous occurrence of phasic and tonic RWA, was suggested as a new marker of phenoconversion. Converted patients showed a higher mixed RWA (p=0.009) and the ROC analysis confirmed that mixed RWA is the best predictive marker of conversion among other RWA types (AUC 0.778). An average of...
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Cognitive and psychosocial sequelae following hypoxic brain injury.
Dostálová, Veronika ; Bezdíček, Ondřej (advisor) ; Šonka, Karel (referee) ; Feketeová, Eva (referee)
Cognitive and psychosocial sequelae following hypoxic brain injury Abstract in English Hypoxic brain injury leads to neuronal necrosis and to other cerebral changes which may affect psychosocial functioning. Although the pathophysiology of cerebral hypoxia is multifactorial, and it is not possible to reliably describe the unified clinical picture of hypoxia patients, the most commonly described psychosocial consequences of cerebral hypoxia are cognitive impairment, increased anxiety and depressive symptoms. The aim of the present study is to characterize cognitive functioning and psychosocial changes of the patients exposing mild intermittent cerebral hypoxia (=chronic form of hypoxia, model of obstructive sleep apnea diagnosed by neurologist) and patients after severe one-time cerebral hypoxia (=acute form of hypoxia, model of cardiac arrest diagnosed by cardiologist). Regardless of the different etiology of particular hypoxia forms described in the theoretical part of the thesis, both forms may lead to neuronal death. In the experimental part we test a hypothesis comparing healthy individuals to patients with acute or chronic form of hypoxia in cognitive performance or anxiety and depressive symptoms. We document a decreased cognitive performance and higher level of state anxiety in a group of patients...
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Pineal lesions: clinical presentation, hormone secretion, sleep quality and effect of surgical treatment
Májovský, Martin ; Netuka, David (advisor) ; Šonka, Karel (referee) ; Lipina, Radim (referee)
Introduction: Pineal region is a deep-seated part of the brain surrounded by highly eloquent structures. Differential diagnosis of space-occupying lesions in this region encompasses pineal gland cysts, pineal gland tumours, metastases, germ cell tumours, meningiomas, gliomas, hemangioblastomas and neuroectodermal tumours. In this thesis, I focused mainly on patients with pineal cysts, which is a benign affection of the human pineal gland on the borderline between pathology and normality. The clinical management of patients with a pineal cyst remains controversial, especially when patients present with non-specific symptoms. A melatonin secretion in patients with a pineal cyst before and after a pineal cyst resection has not been studied yet and the effect of surgery on human metabolism is unknown. Materials and Methods: We performed a prospective study between 2000 and 2016. All patients with a pineal cyst larger than 7 mm were included. Epidemiological data, presenting symptoms, surgical results and radiographic and clinical follow-up were documented. We examined melatonin, cortisol and blood glucose secretion profiles perioperatively in a subgroup of 4 patients. The control group was represented by 3 asymptomatic patients with a pineal cyst. For each patient, 24-h circadian secretion curves of...
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