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Early diagnostic of cognitive disorders in neurodegenerative diseases, especially Alzheimer's disease
Magerová, Hana ; Bojar, Martin (advisor) ; Jirák, Roman (referee) ; Mareš, Jan (referee)
The ageing of population leads to increase prevalence of dementias that are becoming a serious socio economic problem. Early initiation of treatment resulting from early diagnosis may delay the loss of self- sufficiency. These cause a growing effort for finding an early marker of these diseases that allows making diagnosis before developing dementia. The attention is focused mainly to Alzheimer's disease (AD) that represents the most common type of dementia and is the most affected by currently available drugs. The aim is to enable to diagnose AD already at the stage of Mild Cognitive Impairment (MCI) that represents a transitional stage between normal aging and dementia. The olfactory impairment was considered to be a possible marker of AD as there is evidence that it occurs in very early stages of AD and its severity correlates with the disease progression. On the other hand, very poor data are available on olfactory functioning in other types of dementias. The neurodegenerative process starting in mesial temporal structures also suggests that AD patients may have an early spatial navigation impairment (especially in allocentric navigation) as well as facial emotion recognition impairment as the mesial temporal structures are crucial for these functions. These topics are presented in the submitted thesis....
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Evolutionary aspects of Alzheimer's disease. Major role of the Apolipoprotein E
Škubica, Patrik ; Daňková, Pavlína (advisor) ; Jirák, Roman (referee)
Alzheimer's disease is one of the most discussed conditions, due to its huge social and economic consequences. Whereas molecular and genetic aspects causing early onset of the disease are relatively well known, it still remains to be clearly shown how genetic risks and environmental factors interact to ultimately cause the late onset form. Major molecular-genetic factors affecting risk of developing Alzheimer's disease are APOE gene and its product apolipoprotein E. This gene occurs in humans in three common variants that differ among each other in exon sequence by one single nucleotide polymorphism. Similar difference exists between human and mammal APOE gene that served as an origin for human forms. This thesis discusses possible evolutionary scenarios of APOE gene and links acquired information to molecular and environmental ascpects of Alzheimer's disease.
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Early diagnostic of mnestic disorders in neurodegenerative diseases
Laczó, Jan ; Bojar, Martin (advisor) ; Jirák, Roman (referee) ; Mareš, Jan (referee) ; Rektorová, Irena (referee)
The ageing of the world's population means that the number of people with dementia, especially Alzheimer's disease (AD), will dramatically increase. That's why there is now a great effort to detect the presence of AD in its earliest predementia stages, in the stage of mild cognitive impairment (MCI), and particularly to identify individuals with amnestic syndrome of the hippocampal type (Ha-MCI - preclinical AD). The aim of our studies was to reveal whether spatial navigation testing could serve as an early biomarker of AD - whether spatial navigation is impaired early in patients with MCI, especially in Ha-MCI patients. We used the human analogue of the Morris water maze, the Hidden Goal Task (HGT), which is designed t! o separate two different modes of navigation, egocentric (body- centred, hippocampus independent) and allocentric (world-centred, hippocampus dependent), using a real space navigation setting called the Blue Velvet Arena (BVA), fully enclosed cylindrical arena, as well as a computer version of the BVA. Our results suggest that spatial navigation is impaired already in patients with amnestic MCI, who are more likely to progress to AD, especially in those with amnestic syndrome of the hippocampal type. The Ha-MCI patients presented severe spatial navigation impairment similar to that seen in...
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Diabetes mellitus type 1 and depression. Psychopathology by somatic deseases
Komorousová, Jana ; Beran, Jiří (advisor) ; Lacigová, Silvie (referee) ; Jirák, Roman (referee)
Diabetes mellitus is a severe chronic life-long disease. The condition itself introduces a need for patient's lifestyle adjustment to the disease and a number of everyday therapeutic and diagnostic restrictions. Therefore, mental disorders are more common in diabetic patients than in the rest of the population. Biochemical and hormonal connections between mental disorders and diabetes mellitus represent another reason for their higher incidence in diabetic patients. Comorbid mental diseases can further negatively influence the course of diabetes. They are especially depression, anxiety disorders, eating disorders and cognitive disorders including dementia. Type 2 diabetes is also more common in patients with primary mental disease, as is e.g. schizophrenia and bipolar affective disorder. Regarding therapy, psychoactive drugs are used in diabetic patients. It is important to respect the specifics of the underlining disease during drug selection. The main factor for the selection of the medication is, apart of mental problems, the influence on body weight and blood glucose. Mental disorders can be also treated by psychotherapy and psychoeducation. Studies performed in diabetic patients with mental problems suggest the need for intervention in this area. The practical part of the work introduces a...
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The influence of sertraline treatment on the metabolic and antropometric parameters in people with depression
Podlipný, Jiří ; Beran, Jiří (advisor) ; Filipovský, Jan (referee) ; Jirák, Roman (referee)
Introduction: Pharmacotherapy with antidepressants can cause a metabolic risk, can be neutral in terms of metabolism or can perform a metabolic benefit for the treated patients. Objective: The aim of the presented study is to assess the effects of long-term use of sertraline on the particular laboratory and anthropometric parameters in somaticaly healthy or compensated outpatients treated for unipolar depression. Methods: The study was performed in cooperation of Centre of Preventive Cardiology (CPC) of 2nd Department of Internal Medicine and Department of Psychiatry of Charles University in Prague, Faculty of Medicine in Plzeň (Pilsen) and University Hospital Plzeň, Czech Republic. A screening of risk factors in relation to the development of cardiovascular (CV) diseases and metabolic syndrom was carried out in 350 people from the cohort Pilsen Longitudinal Study III (PILS III) at CPC. The participants filled in a Czech version of the Zung Self-Rating Depression Scale (SDS) simultaneously with the screening. Those of them scoring up the threshold set for the suspicion of depression in SDS were invited to the department of psychiatry outpatient's office in order to undertake a psychiatric examination. There were 31 persons in total fulfilling the following criteria: (1) aduld patients diagnosed with...
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Cognitive Predictors of Healthy Ageing
Červenková, Markéta ; Nikolai, Tomáš (advisor) ; Jirák, Roman (referee) ; Holmerová, Iva (referee)
Worldwide we are becoming witnesses to trend leading to rising number of people living to an older age. Focus of the research changes compared to previous studies in last few decades which studied the pathological aging and shifts to identification of factors leading to healthy (also "successful" aging). The focus is thus on finding the definition of successful and unsuccessful aging, so we would be able to timely identify the risks connected with aging and their influence on health or the level of quality of life. In connection with this, new concepts are becoming known, meaning "SuperAging" and "SuperAger" (SA). SuperAging is a phenomenon presenting successful (also as healthy) aging. SuperAger is the given individual, who is successfully (also as healthy) ages. In the theoretical part of the submitted thesis is presented the summary of findings in the field of neuropsychological changes connected with aging. The concept of successful (or healthy) aging is presented and the methodology of cognitive deficit detection in old age is described. The research part presents the summary of four studies following two main objectives. In the first part, we focused on improvement of conditions of neuropsychological clinical diagnostics by expanding the available diagnostic tools usable in the environment of...
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Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age
Vaňková, Hana ; Čelko, Alexander (advisor) ; Dohnal, Karel (referee) ; Jirák, Roman (referee)
Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age Hana Vaňková, MD Abstract Background: Given the population ageing in Europe and in the Czech Republic, strategies aiming to prevent functional decline in older age are of great importance. Depression in old age increases functional decline and is also associated with increased morbidity, mortality and deterioration of quality of life (Anstey et al., 2007; Karakaya et al., 2009). Therefore, there is a need for a comprehensive intervention addressing both functional status and depressive symptoms. Methods: Using comprehensive geriatric assessment, the relationship between functional status and depressive symptoms was examined in 308 residents of long-term care facilities (RCFs) in the Czech Republic. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. An additional randomized control trial (RCT) evaluated the effect of a dance-based therapy on depressive symptoms in 162 institutionalized older adults with average age over 80 years. Results: A multiple regression analyses adjusted for sociodemographic factors and for taking antidepressants found that cognitive function and functional limitation by pain were most strongly associated with depressive symptoms. The ability to...
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Neuropsychological aspects of preclinical stages of neurodegenerative diseases
Nikolai, Tomáš ; Roth, Jan (advisor) ; Holmerová, Iva (referee) ; Jirák, Roman (referee)
Neuropsychological aspects of preclinical stages of neurodegenerative diseases are an extensively studied topic in neuropsychological research. Neuropsychological assessment can be helpful for the estimation of conversion risk in individual cases. The focus of neuropsychological research shifted from the evaluation of dementia to mild cognitive impairment (MCI) or even to the detection of cognitive change before significant cognitive decline. In the theoretical part is presented a contemporary outline of preclinical stages of neurodegenerative diseases. The construct of MCI is the most studied topic in the prodromal stage of neurodegeneration and this part is dedicated to comprehensive analysis of MCI. The empirical research includes five studies on screening methods of cognitive abilities, memory and verbal fluency tests. We present normative and validity data in older adults and show their detection potential in MCI or preclinical stages of neurodegenerative diseases. Furthermore, we tried to show the detection potential of different memory measures in patients with MCI and estimate the relations between hippocampal atrophy and memory performance. Key words mild cognitive impairment, dementia syndrome, Alzheimer's Disease, neuropsychological assessment, diagnostic procedures
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The picture of mental illness in the print media in three central European countries
Nawková, Lucie ; Jirák, Roman (advisor) ; Bražinová, Alexandra (referee) ; Vevera, Jan (referee)
Media are considered to be the public's primary source of information regarding mental illness. Evidence suggests that media representations of people with psychiatric disorders are frequently negative and contribute to their stigmatization. On the other hand, media can play an important role in reducing this stigmatisation by providing adequate information about this topic and engaging in antistigma campaigns. Up to now there was no standardised measurement of the stigma of mental illness in print media using clearly operationalized definitions. The objectives of this project were twofold; to develop a standardised and objective instrument to measure stigma of mental illness in print media; and to conduct an analysis of the current coverage on mental health/illness issues in Czech, Croatian, and Slovak print media. The development of the Picture of Mental Illness in Newspapers (PICMIN) instrument was based on the principles of content analysis, a research technique for making replicable and valid inferences from text to the kontext in their use. The instrument consists of eleven descriptive and five analytical categories. The most interesting findings based on the analysis of media representations of mental illness were; a similarly high level of stigmatizing articles across countries, clearly...
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