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Relationship of olfactory functions and psychopathology in patients with autism spectrum disorders
Dudová, Iva ; Hrdlička, Michal (advisor) ; Drtílková, Ivana (referee) ; Jirák, Roman (referee)
The aim of our study was to examine olfactory functions (odor detection thresholds, odor identification and odor preference) and to explore their relationship with psychopathology in children with autism spectrum disorders (ASD). Thirty-five patients with Asperger's syndrome and high functioning autism (mean age 10,8 ± 3,6 years; 31 boys) were compared with 35 healthy control subjects (mean age 10,4 ± 2,4 years; 28 boys). There were no significant differences between groups with regard to mean age (p = 0,598) and gender proportion (p = 0,324). Olfactory testing (threshold and identification) used the Sniffin' Sticks test. Odor pleasantness was assessed on a 5-point scale using the Identification part of the Sniffin' Sticks test. The severity of autistic psychopathology was measured by the Childhood Autism Rating Scale (CARS). Participants with ASD, in comparison with healthy controls, were significantly impaired relative to odor detection thresholds (6,3 ± 3,1 vs. 7,9 ± 2,0; p = 0,025). Autistic participants were significantly better in correctly identifying the odor of an orange (94 vs. 63%; p < 0,05) and significantly worse at correctly identifying the odor of cloves (40 vs. 74%; p < 0,05). With regard to identification of fourteen other substances, there were no significant differences. There...
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Anti-platelet effects of citalopram
Richter, Tomáš ; Alušík, Štefan (advisor) ; Jirák, Roman (referee) ; Matějovská Kubešová, Hana (referee)
Introduction Citalopram is a preferred medication used for the treatment of depression and belongs to a group known as selective serotonin reuptake inhibitors (SSRI). When used on a long-term basis, it leads to a significant decrease of serotonin in thrombocytes. Citalopram-treated patients often display haemorrhagia that is explained by its anti-platelet effect, which is also - more or less - the case for other medications from the SSRI group. Aim of the Thesis The aim of the thesis was to find out: a) Whether citalopram treatment (2 weeks) has influence on the plasma concentration of thromboxane B2; b) Whether there is a relation between the expected decrease of thromboxane B2 levels and the plasma concentration of citalopram. Methods and Patient Population We carried out clinical and laboratory tests on a study population consisting of elderly and polymorbid patients who underwent a 14-day citalopram treatment with daily doses of 20mg. Among other tests, we observed the plasma concentration of thromboxane and citalopram. Out of 160 patients examined, 78 patients were assessed. Results Our study has proved that even a short-term citalopram treatment results to a significant increase in the plasma concentration of thromboxane B2 and the suppression rate of thromboxane B2 correlates with the higher...
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Early stages of neurodegenerative diseases and their diagnostics using methods of clinical and experimental neuropsychology
Marková, Hana ; Hort, Jakub (advisor) ; Rusina, Robert (referee) ; Jirák, Roman (referee)
The diagnosis of neurodegenerative diseases leading to dementia is increasingly moving to the earlier stages in an effort to find the disease-modifying treatment for these diseases. Prodromal and preclinical stages of the diseases have become the primary research interests. Neuropsychology is specifically focused on early cognitive markers and development of methods that would be able to reliably assess these markers and to evaluate the risk of progression of cognitive decline in individual cases. The theoretical part of the thesis presents the current knowledge in the field of neurodegenerative diseases, it is specifically focused on Alzheimer's disease (AD) as the most common cause of dementia. We also present the current trends in neuropsychological diagnostics of early AD and the approach to subjective and objective evaluation of cognitive functioning. Building on that, we present the rationale for the empirical part of the thesis. The empirical part of the thesis extends the existing knowledge in the field of AD. We present and discuss seven original publications that follow three basic objectives: first, to characterize subjective cognitive complaints of individuals at risk of AD, second, to evaluate the potential of selected standard and experimental neuropsychological methods to detect...
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Profiles of cognitive deficit and the use of a short neuropsychological battery in different types of dementia
Bolceková, Eva ; Kulišťák, Petr (advisor) ; Krámská, Lenka (referee) ; Jirák, Roman (referee)
Pro les of cognitive de cit and the use of a short neuropsychological battery in di erent types of dementia Eva Bolceková Abstract This work focuses on cognitive de cit pro les and the use of a short neuropsychological battery in patients with di erent types of dementia. Increasing prevalence of dementia syndromes highlights the need of their e cient diagnostics in clinical-psychological practice. Theoretical part of this work presents an overview of neurodegenerative diseases with em- phasis on their neuropsychological presentation. We describe the cogni- tive domains and their neuropsychological examination. We address in detail the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and its experimental Czech version. Research part of the work is based on neuropsychological examinations of 311 patients with cognitive de cit and 118 healthy controls. Patients' group is comprised of subjects with Alzheimer's disease, mild cognitive impairment, vascular cognitive impairment, Lewy Body disease, frontotemporal lobar degene- ration and patients with depression. We assess their cognitive pro les, present sensitivity, speci city, positive and negativne predictive values of RBANS scores for the groups and compare the results of control subjects with the original normative sample. We...
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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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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 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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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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Anti-platelet effects of citalopram
Richter, Tomáš ; Alušík, Štefan (advisor) ; Jirák, Roman (referee) ; Matějovská Kubešová, Hana (referee)
Introduction Citalopram is a preferred medication used for the treatment of depression and belongs to a group known as selective serotonin reuptake inhibitors (SSRI). When used on a long-term basis, it leads to a significant decrease of serotonin in thrombocytes. Citalopram-treated patients often display haemorrhagia that is explained by its anti-platelet effect, which is also - more or less - the case for other medications from the SSRI group. Aim of the Thesis The aim of the thesis was to find out: a) Whether citalopram treatment (2 weeks) has influence on the plasma concentration of thromboxane B2; b) Whether there is a relation between the expected decrease of thromboxane B2 levels and the plasma concentration of citalopram. Methods and Patient Population We carried out clinical and laboratory tests on a study population consisting of elderly and polymorbid patients who underwent a 14-day citalopram treatment with daily doses of 20mg. Among other tests, we observed the plasma concentration of thromboxane and citalopram. Out of 160 patients examined, 78 patients were assessed. Results Our study has proved that even a short-term citalopram treatment results to a significant increase in the plasma concentration of thromboxane B2 and the suppression rate of thromboxane B2 correlates with the higher...
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Alzheimer's Disease and Family Caregiver Burden. Impact of Alzheimer's Disease on Family Caregiver Psychosocial Health.
Zvěřová, Martina ; Jirák, Roman (advisor) ; Holmerová, Iva (referee) ; Zvolský, Petr (referee)
Alzheimer's Disease is a progressive, irreversible neurodegenerative illness and the most common of the dementing disorders. Only few diseases disrupt patients and their relatives so completely or for so long a period of time as Alzheimer 's. Caring is held to be very demanding and emotionally involving. Caregiver burden has been defined as a multidimensional response to emotional, social, physical, psychological, and financial stressors associated with the caregiving experience. The objective of the 1st study was to assess the degree of burden and its possible change in family caregivers of the long-term sick family member with progressive Alzheimer's disease during eight-month monitoring. In addition to the common psychiatric examination the Mini- Mental State Examination (MMSE) was administered in patients to indicate the severity of the dementia and the Zarit Burden Interview was administered in caregivers to assessed degree of burden. The total of 60 people have been examined - 30 patients with AD and 30 their caregivers (24 females, 6 males) were recruited from the Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague. At the beginning of the study there were 18 patients with mild stage of AD (60%), 11 patients suffered...
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