|
|
Bipolar Disorder and Diabetes Mellitus
Růžičková, Martina ; Höschl, Cyril (advisor) ; Haluzík, Martin (referee) ; Papežová, Hana (referee)
Despite lots of research, the genetic and pathophysiological basis of bipolar disorder (BD) remains unclear. One of the possible reasons is that BD spectrum comprises a heterogeneous group of different subtypes of the illness sharing certain pathophysiological or genetic mechanisms. Patients with co-morbid diabetes mellitus (DM) may represent such a subgroup of BD with a distinct pathophysiology and possibly different clinical characteristics of BD. This thesis is aimed at investigating the possible link between BD and DM. Bipolar patients have about 3 times higher risk of DM (type 2 in particular). The first part of my thesis outlines the possible links between DM and BD, including medication, alterations in the hypothalamo-pituitary axis and signal transduction, and genetics. In the second part, I examined the possible differences in clinical characteristics between patients with (N=26) and without (N=196) co-morbid DM. Next, I examined the variables showing differences between groups, using logistic regression. Patients were recruited via The Maritime Bipolar Registry. The prevalence of DM was 11.7%. Diabetic patients were significantly older than non-diabetic patients (P < 0.001), had higher rates of rapid cycling (P = 0.02), more chronic course of BD (P = 0.006), more disability (P < 0.001), lower...
|
|
|
Neuronavigation of RMTS based on brain functional imaging in clinical aplication in auditory hallucinations
Klírová, Monika ; Horáček, Jiří (advisor) ; Papežová, Hana (referee) ; Rektorová, Irena (referee)
NEURONAVIGATION OF rTMS BASED ON BRAIN FUNCTIONAL IMAGING IN CLINICAL APPLICATION IN AUDITORY HALLUCINATIONS Monika Klírová Summary Transcranial magnetic stimulation (TMS) represents a noninvasive method used in diagnostics of neurological disorders and physiological research of sensoric, motor and cognitive function and intracortical relations. This method has found its leading position also in the treatment of neuropsychiatric disorders. TMS is based on the administration of short pulses of a strong magnetic field, which induces secondary electric currents in a limited volume of cerebral cortex. Therapeutic modification utilizes a repetitive TMS (rTMS) in which the magnetic coil generate a series of pulses of different frequencies. Low-frequency rTMS (LF-rTMS) of the left temporo-parietal cortex (LTPC) has been proposed as a useful therapeutic method for auditory hallucinations (AHs). Majority of rTMS studies use "standard" coil positioning, which is often not fully corresponding to cortical area(s) of maximal functional changes. Stereotactic neuronavigation enables the magnetic coil to be targeted according to the individual parameters obtained from neuroimaging. Individualized rTMS neuronavigated according to positron emission tomography (18 FDG PET) allows us to focus the coil explicitly on a given...
|
|
|
Dissociation: Phenomenology, Pathophysiology and Relation to Obsessive-Compulsive Disorder
Raszka, Michal ; Praško Pavlov, Ján (advisor) ; Papežová, Hana (referee) ; Libiger, Jan (referee)
The aim of this study was to investigate dissociative symptoms in OCD from many angles. This is the context in terms of psychopathology, prediction of therapeutic effects of cognitive-behavioral therapy (CBT), neuropsychology (with emphasis on inhibitory processes), the structure of personality, and neurobiology. The work offers a model of neurobiological correlates of blending dissociation and OCD, which has been experimentally validated parts.
|
|
|
Functional-imaging and electrophysiological correlates of obsessive-compulsive disorder and their potential use in neurofeedback intervention
Kopřivová, Jana ; Horáček, Jiří (advisor) ; Papežová, Hana (referee) ; Stuchlík, Aleš (referee)
Background: Obsessive-compulsive disorder (OCD) is a common mental disorder that may seriously affect quality of life and even the ability to work. Despite advanced medical care there are still patients who do not respond or do not respond sufficiently to treatment. Recently proposed treatment strategies such as deep brain stimulation or repetitive transcranial magnetic stimulation have targeted several levels of fronto-striatal circuits which dysfunction underlies OCD pathophysiology. Likewise, neurofeedback (NFB) could target dysfunctional fronto-striatal networks by providing almost real- time feedback about their activity. As the success of these methods critically depends on good knowledge of dysfunctional loops in OCD, a more detailed investigation of neurobiological basis of this disorder is highly needed. Aims: The aim of the first part of this dissertation was to provide an overview of the current literature related to OCD and NFB. The second section of the thesis is based on five original studies of the author that were conceived to 1) explore anatomical correlate of OCD in our patients, 2) to verify its functional relevance and specificity in electroencephalographic (EEG) studies, and 3) to test the utility of the findings in NFB treatment of OCD. Methods: In our studies we included...
|
|
|
Cerebellar functions in Attention DeficitHyperactivityDisorder
Goetz, Michal ; Hort, Vladimír (advisor) ; Příhodová, Iva (referee) ; Papežová, Hana (referee)
Univerzita Karlova v Praze 1. lékařská fakulta Studijní obor: Lékařská psychologie a psychopatologie MUDr. Michal Goetz Cerebelární funkce u poruchy pozornosti s hyperaktivitou Cerebellar functions in Attention Deficit Hyperactivity Disorder Abstract Školitel: Doc. MUDr. Vladimír Hort, CSc. Praha 2014 1 Prohlášení Prohlašuji, že jsem závěrečnou práci zpracoval samostatně a že jsem řádně uvedl a citoval všechny použité prameny a literaturu. Současně prohlašuji, že práce nebyla využita k získání jiného nebo stejného titulu. Souhlasím s trvalým uložením elektronické verze mé práce v databázi systému meziuniverzitního projektu Theses.cz za účelem soustavné kontroly podobnosti kvalifikačních prací. V Praze 14. 2. 2014 MUDr. Michal Goetz 2 Identifikační záznam GOETZ, Michal. Cerebelární funkce u poruchy pozornosti s hyperaktivitou [Cerebellar functions in Atention Deficit Hyperactivity Disorder]. Praha, 2014. 190 stran, Disertační práce (Ph.D.). Univerzita Karlova v Praze, 1. lékařská fakulta Práce byla ...
|
|
|
Multifamily Therapy in the Treatment of Eating Disorders
Tomanová, Jana ; Papežová, Hana (advisor) ; Miovský, Michal (referee) ; Eisler, Ivan (referee)
This paper gives the summary of the six-year operations of multi-family therapy programme in eating disorders at The Eating Disorders Centre at The Psychiatric Clinic, Prague. The research done has been the first experience with multi-family treatment of psychiatric patients in the Czech Republic. This therapy concept is often used abroad as a form of work with patients suffering from the diagnosis of eating disorders. It is a "first choice" method due to NICE Guideline(2004). The inspiration for the Prague team was the London Maudsley model. The main aims of the research were: 1/ to introduce this therapeutic approach into a complex treatment of patients suffering from eating disorders, optimize the functioning structure and programme and stabilize the therapeutic team and 2/ to evaluate the effectiveness of multi-family treatment and suggest the suitable metodology. Since 2004 twenty families which form the observed group have been involved in the project. The combination of qualitative and quantitative methodology was chosen during the primary stage of the research. The methods used were: questionnaires of Beck Depression Inventory (BDI),Schwartz scale of therapy assessment (SOS-10), the life quality questionnaire (SQUALA) and Rosenberg self-concept questionnaire (RSE). We evaluated ten...
|
|
|
Neuroanatomical aspects of nonGmotor effects of deep brain stimulation
Růžička, Filip ; Růžička, Evžen (advisor) ; Papežová, Hana (referee) ; Druga, Rastislav (referee)
Summery The underlying mechanisms of weight gain and other affective and cognitive changes after initiation of deep brain stimulation in Parkinson's disease are still unclear. Considering the functional organization within the subthalamic nucleus (STN); limbic, associative and sensorimotor regions residing in the medial, central and later STN respectively, we hypothesized that weight gain may be related to medial localization of stimulation, while motor improvement may be related to lateral localization of stimulation within the STN (study 1). We further hypothesized that stimulation close to the limbic and associative part of the STN may be associated with negative impact on limbic system leading to enhanced anxiety and changes in the hypothalamic- pituitary- adrenal axis (HPA)(study 2). Therefore, the primary aims our study were to assess changes in body weight (study 1) and the hypothalamic- pituitary- adrenal axis (HPA) (study 2) in relation to the position of the active stimulating contact within the nucleus. ...
|
|
|
The detection of cognitive dysfunction in multiple sclerosis
Blahová-Dušánková, Jana ; Kubala Havrdová, Eva (advisor) ; Papežová, Hana (referee) ; Rektorová, Irena (referee)
Evaluation of cognitive impairment is often omitted in multiple sclerosis (MS), as the available instruments usually require considerable time and resources, and are not readily available in all countries. The aims of this study were to examine validity of the Czech translation of the MACFIMS (Minimal Assessment of Cognitive Function in MS), to validate the BICAMS (Brief International Cognitive Assessment for MS) and to compare outcomes of the MACFIMS and the BICAMS. We evaluated 367 MS patients and 134 healthy controls with the MACFIMS battery, which also comprises the 3 tests of the BICAMS (Symbol Digit Modalities Test, Brief Visuospatial Memory Test- Revised, California Verbal Learning Test, second edition). The most accurate BICAMS criterion of cognitive deficit was that of at least 1 of the overall 3 tests outside the normal range (sensitivity = 94%, specificity = 86%, p=10-28). Outcomes of the Czech translation of the MACFIMS were comparable to its original. The MACFIMS and the BICAMS identified cognitive deficit in 55% and 58% of the MS patients, respectively. Both the BICAMS and MACFIMS predicted patient vocational status. The BICAMS is highly sensitive and specific to cognitive impairment in MS as defined by the MACFIMS. This impairment is significantly associated with vocational status. Our work...
|
|
|
Cognitive Impairment in Parkinson's Disease
Bezdíček, Ondřej ; Růžička, Evžen (advisor) ; Papežová, Hana (referee) ; Hort, Jakub (referee)
Cognitive impairment is considered as essential feature of non-motor symptoms in Parkinson's disease (PD). It is a result of underlying pathological processes in the brain of PD patients and it leads to decreased quality of life. In this thesis an analysis of the structure and profile of cognitive impairment is presented with special emphasis on executive functions and memory. We take diagnostic entities developed for the description of PD cognitive spectrum such as mild cognitive impairment (PD-MCI) and dementia (PD-D) as examples of heterogeneity and different severity of cognitive impairment in PD. However, neuropsychological methods in Czech version that would measure these diagnotic units were not adequatly validated. In the experimental part we test a hypothesis, if gait disorder with falls in PD is interconnected with cognitive impairment, and if PD-fallers have more severe cognitive deficit than PD-non-fallers. On the basis of nine validity or normative data studies we show psychometric properties and clinical utility of several basic neuropsychological methods in the Czech population for memory (Rey Auditory Verbal Learning Test, California Verbal Learning Test, Second Edition, Memory For Intentions Screening Test and Enhanced Cued Recall Test), sustained attention and executive functions...
|
|
|
Psychosocial Effect Of Bariatric Surgery and the Patient's Satisfaction with the Surgery
Kravarová, Eva ; Papežová, Hana (advisor) ; Dragomirecká, Eva (referee) ; Stárková, Libuše (referee)
The doctoral dissertation is focused on the evaluation of the effect of bariatric surgery and on identifying the parameters that are related to the patients' satisfaction with the surgery. Telephone survey was used to collect data. 122 bariatric candidates were inquired, 86 of them were operated. The average time after the surgery was 20,2 months. The average weight loss was 26.6 kgs. There was a significant improvement in the monitored domains - physical appearance, general health, self-esteem, marital satisfaction, occupational functioning and social functioning. The negative effects of the surgery (post-surgery vomiting, difficulties in dietary adherence, other complications) were also experienced by significant number of patients. In total, 87% respondents were satisfied with the surgery and 13% were dissatisfied. The chi-square test was used to identify factors influencing subjective satisfaction with the surgery and the results were recorded at 95% and 99% significance levels. The satisfaction is associated with the improvement of general health and self-esteem (p<0.01), physical appearance, marital satisfaction, occupational functioning and social functioning (p<0.05). Less satisfied were patients who had troubles with postoperative dietary adherence and those with an insufficient weight...
|
guest ::
RSS feed.