|
| |
|
| |
|
|
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...
|
|
|
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...
|
|
|
Pathophysiology of non-motor symptoms in basal ganglia involvement
Majerová, Veronika ; Roth, Jan (advisor) ; Rusina, Robert (referee) ; Papežová, Hana (referee)
The basal ganglia (BG) are a group of brain nuclei situated deep in the cerebral hemispheres. While BG were primarily associated with motor functions, in recent years there has been an increasing evidence that BG are also significantly involved in a wide range of non-motor functions. This work focused on some of the non-motor symptoms associated with two typical basal ganglia disorders: Parkinson's disease (PD) and Huntington's disease (HD). The first study concerned spatial navigation impairment in patients with HD. Their spatial navigation skills were tested using the Blue Velvet Arena, technique evaluating spatial navigation in real space, capable to selectively differentiate between two components of spatial navigation - allocentric (environment-oriented) and egocentric (self-oriented). Allocentric navigation is linked to hippocampal function, whereas egocentric navigation is usually associated with striatum, a structure predominantly affected in HD. We found that spatial navigation is not significantly affected in the early stages of HD and that in more advanced stages, when spatial navigation is already impaired, there is no significant difference between allocentric and egocentric navigation impairment. We speculate that the striatal involvement does not contribute to the impairment of the...
|
|
|
Anorexia nervosa - selected genetic determinants and endophenotypes
Kaminská, Deborah ; Papežová, Hana (advisor) ; Baxová, Alice (referee) ; Pacák, Karel (referee)
Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are diseases with considerable individual variation. Genetic background plays an important role in disease susceptibility and severity. To evaluate the relationship between certain genetic loci and diseases subtypes we genotyped and analysed evolution of selected clinical parameters. We investigated a group of 75 pacients with AN (1. study), 127 DSM-4 and ICD-10 diagnosed patients with AN and BN (2. study), and contributed to sample of 2907 AN patients in large GWAS study. Results from the 1st study support association of polymorphism -1438G/A in serotonine receptor 5-HT2A with AN and compare the results from other studies with metaanalyses. In next, polymorphism responsible for the serotonine neurotransmission (serotonine transporter 5-HTT, polymorphisms LPR and VNTR) the study shows different association trend of LPR with AN in Czech population compared to other studies. 5-HTT VNTR polymorphism had no observed association. The second study investigated the role of hemeoxygenase 1 (plays a pivotal role in metabolic stress protecting cells) in eating disorders, in interaction with enviromental stress. We investigated the usefulness of an aggregate measure of the risks of AN and BN that is based on genetic susceptibility loci and the added effect of...
|
|
| |
|
|
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...
|
|
|
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...
|
|
|
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...
|
guest ::
RSS feed.