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Endocrine and Metabolic Aspects of Various Sleep Disorders
Vimmerová-Lattová, Zuzana ; Anders, Martin (advisor) ; Praško, Ján (referee) ; Šonka, Karel (referee)
Endocrine and Metabolic Aspects of Various Sleep Disorders MUDr. Zuzana Vimmerová Lattová Abstract: Recent epidemiological and experimental data suggest a negative influence of shortened or disturbed night sleep on glucose tolerance. However, no comparative studies of glucose metabolism have been conducted in clinical sleep disorders. Dysfunction of the HPA axis may play a causative role in some sleep disorders and in other sleep disorders it may be secondary to the sleep disorder. Moreover, dysfunction of the HPA axis is regarded as a possible causative factor for the impaired glucose sensitivity associated with disturbed sleep. However, data on HPA system activity in sleep disorders are sparse and conflicting. We studied 25 obstructive sleep apnea (OSA) patients, 18 restless legs syndrome (RLS) patients, 21 patients with primary insomnia and compared them to 33 healthy controls. We performed oral glucose tolerance test and assessed additional parameters of glucose metabolism. The dynamic response of the HPA system was assessed by the DEX-CRH-test which combines suppression (dexamethasone) and stimulation (CRH) of the stress hormone system. Compared to controls, increased rates of impaired glucose tolerance were found in OSA (OR: 4.9) and RLS (OR: 4.7), but not in primary insomnia. In addition, HbA1c...
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The use of telemedicine in affective disorders
Doubek, Pavel ; Raboch, Jiří (advisor) ; Anders, Martin (referee) ; Masopust, Jiří (referee)
Summary: The aim of the research project was to identify options telemedicine interventions in the treatment and prevention of relapse in patients with depressive disorder and bipolar affective disorder. We observe 64 patients (28 men and 36 women) who were divided into two groups according to their diagnosis, either with depressive disorder or bipolar affective disorder. Each of these groups was divided into two subgroups, where one was used telepsychiatric adjunctive intervention (SMS or phone or web application) and the other one was the control subgroup. For assessment of patients at the beginning and the end were used scales MADRS, YMRS, CGI and BD- II, observation lasted 52 ± 1 week . We count the number of relapses in episodes of the disease in both diagnostic groups. The results were statistically analyzed and showed that for all patients with affective disorder in the group with telepsychiatric intervention came before and after intervention, significant differences for all measured parameters. For the control group of patients with affective disorder, no differences were observed . When comparing the number of relapses, a statistically significant difference between the experimental and control groups was found. The mean time to relapse , in the weeks since the beginning of follow-up was 41.7...
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Transcranial magnetic stimulation for the treatment of tinnitus
Milerová, Jana ; Anders, Martin (advisor) ; Mohr, Pavel (referee) ; Syka, Josef (referee)
Tinnitus is a common and often severely disabling symptom that is characterized by the perceived sensation of sound in the absence of an external stimulus. Traditional treatment approaches have limited efficacy. It is assumed, that tinnitus is connected with dysfunctional activation of neuronal plasticity induced by altered sensory and somatosensory input. Adaptive neuroplastic processes alter the balance between excitatory and inhibitory function of the auditory system at several levels. Functional imaging studies in tinnitus patients have revealed increased neronal activity of primary auditory cortex (PAC). Repetitive transcranial magnetic stimulation (rTMS) induces changes of neuronal activity that outlast the stimulation period. Low-frequency rTMS over the PAC region results in a decrease of cortical activity by inducing long term depression (LTD) and leads to reduced tinnitus perception. The aim of this study was to assess in prospective randomized placebo- controlled study the ability of active low-frequency rTMS guided by frameless stereotaxy to affect symptoms of chronic tinnitus compared to placebo stimulation. Treatment outcome was assessed by subjective specific questionnaires; Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ) and Visual analogue scales (VAS1, VAS2)...
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The therapeutical effect of rTMS on symptomatology in schizophrenia
Baláková, Lucie ; Horáček, Jiří (advisor) ; Rokyta, Richard (referee) ; Anders, Martin (referee)
The RTMS is a new noninvasive method has the potential to both therapeutic and experimental level. The research presented in this work was dedicated to the application of repetitive transcranial magnetic stimulation (rTMS) in psychiatry. We focused also on a deeper understanding of the mechanisms of action using methods of functional imaging methods and sensing electrical activity of the brain. The experimental part of the research include the testing of cognitive function and their potential effects by stimulating the cerebral cortex district, which is regarded as the seat of that particular modality. We discuss neurobiological factors that may explain the ineffectiveness of therapy and other options are designed to test the use of rTMS in this indication. This is the Reversible stimulation (right) or bilateral stimulation, rTMS targeting the coil at the bottom of the parietal cortex, extending the total period of stimulation and the use of individual navigation based on EEG or functional imaging.
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Borna disease virus (BDV), circulating immunocomplex (CIC) detection in the serum of psychiatric patients
Racková, Sylva ; Beran, Jiří (advisor) ; Anders, Martin (referee) ; Sedláček, Dalibor (referee)
The aim of our study was the detection of BDV CIC positivity in psychiatric patients (with affective disorders, psychosis and addiction) hospitalized in the Psychiatric department of Faculty Hospital in Pilsen. Three groups of psychiatric patients were examined (included). BDV CIC positivity was detected in 26.1% of the first group of psychiatric patients, in 48% on day 0, in 53.85% on day 28 and in 52.94% on day 56. The differences between the two groups of psychiatric patients with affective and psychotic disorders could be connected with the different period of blood sampling. We demonstrated a significantly higher BDV CIC positivity in psychiatric patients in comparison with a control group of blood donors. We demonstrated the connection between BDV infection and psychopathology. We confirmed the results of German studies. There is no difference in BDV CIC positivity in addicted patients and healthy individuals. We did not find a decrease of BDV positivity during an abstinence period. We suppose BDV infection can influence the etiology and course of psychiatric patients.
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