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Sarcopenia as a marker of severity of Parkinson's disease
Vážná, Anna ; Růžička, Evžen (advisor) ; Dušek, Petr (referee)
The major focus of our study is use of the presence of sarcopenia as a marker for identification of Parkinson's disease in patients with RBD (REM sleep behaviour disorder). This intention is based on higher incidence of sarcopenia in patients with Parkinson's disease. We also evaluated connection of severity of Parkinson's disease and sarcopenia. In theoretical part of our thesis we present separately sarcopenia, Parkinson's disease and RBD for better understanding of these diseases and their connection. Our measurements of sarcopenia were based on literature review. We followed common approach of three component model of diagnosis of sarcopenia. Physical performance was evaluated based on gait characteristics. Low muscle strength was measured with handheld dynamometer. For estimation of body composition, we used two methods which were bioelectrical impedance analysis and anthropometry. In our research we measured these components in total on 72 males. This cohort was divided into three groups based on diagnosis. There were 32 patients with Parkinson's disease, 28 patients with RBD and 12 probands in control group. Based on our findings we defined suitable parameters and cut-off points for identification of sarcopenia as a marker of Parkinson's disease. In group of patients with Parkinson's disease...
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Weight changes in patients with Parkinson's disease treated with Deep Brain Stimulation.
Undus, Lucie ; Růžička, Evžen (advisor) ; Baláž, Marek (referee) ; Haninec, Pavel (referee)
1 Abstract Body weight changes have been described in the course of Parkinson's disease (PD) as well as following bilateral deep brain stimulation of the subthalamic nucleus (STN DBS) performed in advanced PD. According to the literature weight changes occur in 50-100% of patients who undergo STN DBS. In the last 15 years extensive efforts have been put in understanding the underlying mechanisms behind the weight changes following STN DBS in advanced PD patients however many sources still report conflicting evidence. Improved motor status, reduction in dyskinesias, decrease in energy expenditure, dopaminergic medication reduction, modification of food intake, hormonal factors, regional effects of stimulation were all speculated to cause this weight gain. We hypothesized that patients who underwent STN DBS procedure in our center would gain weight as reported in the literature (study 1, study 2). The etiology of post STN DBS weight gain has not been fully elucidated up to date, in our second study we further hypothesized that the weight changes are due to dysregulation of food related hormones and parameters (study 2). In the third study we hypothesized that weight gain is associated with position of active electrode contact (study 3). Aims of the study: The primary aims of our studies were to assess body...
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Eye Movement Metrics in the Differentiation of Parkinsonian Syndromes.
Bonnet, Cecilia ; Růžička, Evžen (advisor) ; Rokyta, Richard (referee) ; Jeřábek, Jaroslav (referee)
Eye Movement Metrics in the Differentiation of Parkinsonian Syndromes Cecilia Bonnet, MD Summary of thesis submitted for the degree of Ph.D., Charles University, Prague 2017 In this thesis we investigated conjugate and dis-conjugate eye movements (EM) in Parkinson's disease (PD) and other parkinsonian syndromes aiming to characterize and differentiate some aspects of their oculomotricity using infrared video-oculography. First of all we published a practical review for medical students and clinicians describing clinical examination of eye movements, and interpretation of principal findings. Then we examined principal saccadic eye movements and smooth pursuit in the horizontal and vertical directions with video-oculography in a large group of healthy subjects, aiming to help new oculomotor laboratories in the constitution of their own norms. We conclude that age influence EM metrics but not gender or education level. The latency of saccades and the error rate of antisaccaes increases, while the velocity and gain diminishes with age. Saccades should be investigated in the horizontal and vertical plane because they are influenced by the direction of the target, resulting in a right/left and up/down asymmetry. In a third project we focused on a frequent complain of PD patients, namely blurred near vision and...
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Balance and gait disorders in movement disorders
Hoskovcová, Martina ; Růžička, Evžen (advisor) ; Mareš, Jan (referee) ; Čakrt, Ondřej (referee)
Gait and balance disorders and the resulting falls are a substantial part of Parkinson's disease (PD) and other movement disorders. Especially in the late stage of PD more than 80 % of the patients fall. History of falls remains the best predictor of falls nonetheless, but it can not be used in falls prevention. Dopaminergic pharmacotherapy improves postural stability and gait in PD only in the early stage and the dopaminergic responsiveness of these symptoms decreases significantly during the disease progression. The impact of this medication on future falls risk remains still unclear. The connection between balance and gait disorders and cognitive impairment in PD is also not fully understood. The current state of knowledge about gait and balance disorders and cognitive impairment in PD is not satisfactory. Therefore the aims of the experimental part of this thesis were prospective monitoring of risk factors and predictors of falls, observation of the impact of dopaminergic medication on future falls risk and verifying the relationship between gait and balance disorders and cognitive impairment in PD. The fourth aim of the thesis was to specify the type and severity of gait and balance disorders in patients with essential tremor (ET). Although ET is one of the most common neurological disorders,...
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Olfactory impairment and other biomarkers of Alzheimer disease and other neurodegenerative diseases
Vyhnálek, Martin ; Jeřábek, Jaroslav (advisor) ; Růžička, Evžen (referee) ; Rusina, Robert (referee)
Early and differential diagnosis of Alzheimer's disease is associated mainly with the aim to depict hippocampal and mediotemporal impairment. Its massive impairment is present already in early stages. Given that mediotemporal lobe structures are anatomically and functionally closely associated with the olfactory brain, I was involved in examination of smell. In a group of patients with mild cognitive impairment (MCI) we found that olfactory identification is similarly impaired in amnestic (aMCI) which precedes commonly Alzheimer's dementia and in nonamnestic (naMCI) subtype, ), in which patients often also converted into other types of dementia. Olfactory impairment is proportional to cognitive impairment in aMCI but not in naMCI. In another study of olfactory identification with our original smell test called MHST we focused on the evaluation of patients with clinical subtypes of FTLD at the stage of mild dementia. We demonstrated impaired smell identification in all tested clinical subtypes. In another work, I tried to find a neuropsychological test reflecting selectively hippocampal impairment. I compared several standard memory tests in relation to the ability to reflect hippocampal atrophy in nondemented elderly and came to the conclusion that the Enhanced Cued recall test (ECR) with...
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