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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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Brain Activation Sequences
Šusta, Marek ; Šonka, Karel (advisor) ; Krajča, Vladimír (referee) ; Zach, Petr (referee)
Brain Activation Sequences Abstract INTRODUCTION: This research goes beyond the EEG source localization up to the field of brain connectivity in an attempt to create software tool that eases diagnostic procedures in selected nosologic units by discriminating between patients and healthy controls. METHODS: Experiment 1 - a group of 26 adult patients (14 male, 12 female) suffering from NC and 10 adult controls (5 male, 5 female) participated in the experiment. The experiment contained audio recordings designed to trigger laughter in participants during the EEG recording. Experiment 2 - twenty eight female inpatients diagnosed with ED and ten healthy controls were selected and presented with various stimuli while the EEG was recorded. The Brain Activation Sequences method, applied to all recordings, utilizes nonlinear differential model structure to calculate final output sequence of the brain locations involved substantially in the stimulus processing. RESULTS: Experiment 1 - the BAS results show statistically significant differences in activity between patients and controls namely in gyrus orbitalis, rectus, occipitalis inferior (right), occipitalis medius (right), paracentralis, cinguli, cuneus (right) and parahippocampalis (left). Experiment 2 - the results confirm significant differences in processing the...
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Sleep variability and sleep behavior of two selected homogeneous groups of aduls
Tomašovská, Jana ; Brůžek, Jaroslav (advisor) ; Šonka, Karel (referee)
Nowadays, frequency of so called civilization diseases is raising and current life style of an industrial society brings increased number of sleep disorders. Various non-physiological and pathological phenomena, for which humans do not have and cannot have any adaptation mechanisms created, can be seen in our culture and society. The purpose of this thesis is to examine sleep habits of two groups of healthy adult persons (young adults and seniors) and determine factors having an influence on sleep quality. Three hypotheses were stated (Hypothesis No. 1: Sleep length and quality are changing throughout the life. Hypothesis No. 2: Sleep length has an influence on BMI. Hypothesis No. 3: Sleep length is dependent on a life style). Validity of these hypotheses was verified. The sample consisted of a group of young adults (76 women, 51 men) and of a group of active seniors (50 women, 40 men). Sleep behavior was investigated by a questionnaire form. Every person answered to 50 questions. Their answers were statistically processed. Basic somatic characteristics as body height, body weight and Body Mass Index were measured during the contact with respondents. Statistically significant difference (p < 0,05) in sleep behavior of young adults and seniors in weekdays and weekend was found out. Young adults were...
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