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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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The therapeutic benefit of the repetetive transcranial magnetic stimulation on the specific symptoms of schizophrenia
Novák, Tomáš ; Horáček, Jiří (advisor) ; Vymazal, Josef (referee) ; Rektorová, Irena (referee)
The therapeutic benefit of the repetetive transcranial magnetic stimulation on the specific symptoms of schizophrenia Tomas NOVAK Prague Psychiatric Center Summary Transcranial magnetic stimulation is the modern non-invasive method based on the principle of electromagnetic induction. The TMS is widely used in research, diagnostics and treatment of neuropsychiatric disorders. Previous studies imply that repetetive TMS (rTMS) might be useful also in the treatment of some specific symptoms of schizophrenia. The thesis consists of three studies focused on the evaluation of the therapeutic effect of rTMS on specific symptoms of schizophrenia, particularly on negative symptoms and auditory hallucinations. Study 1. The double-blind sham-controlled study of high-frequency rTMS (20Hz) for negative symptoms in schizophrenia The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the prefrontal cortex is a promising method for the treatment of negative symptoms of schizophrenia. Using double-blind, sham- controlled, parallel design, we evaluated the effect of HF-rTMS over the left dorsolateral prefrontal cortex (DLPFC) on negative symptoms in patients with schizophrenia. Sixteen schizophrenia patients with predominantly negative symptoms on stable antipsychotic medication were treated with 20Hz...
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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...
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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...
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The impact of brain-derived neurotrophic factor (BDNF) gene polymorphism and BDNF levels for prediction, diagnosis and follow-up of cognitive deficit in neurodegenerative diseases
Čechová, Kateřina ; Hort, Jakub (advisor) ; Telenský, Petr (referee) ; Rektorová, Irena (referee)
Alzheimer's disease (AD) is a slowly progressing neurodegenerative disease characterized by an extracellular accumulation of senile plaques and intracellular neurofibrillary tangles. Apart from these hallmarks, AD is very heterogeneous, especially at the age of onset and the rate of progression. Genetic polymorphisms are key modulators influencing these factors. One of them is a polymorphism for the Brain-derived neurotrophic factor (BDNF), a neurotrophin involved in the synaptic plasticity in the hippocampus and medial temporal lobe structures, areas primarily affected in AD. The thesis aimed to investigate the effect of BDNF Va66Met polymorphism together with the main genetic risk factor for sporadic AD, Apolipoprotein E (APOE) polymorphism, on cognitive functions and structural brain changes. We have shown that the combination of risk alleles BDNF Met and APOE ɛ4 is associated with more severe impairment in episodic memory, egocentric orientation and smaller volumes of medial temporal lobe structures in individuals with amnestic mild cognitive impairment (aMCI), and allocentric orientation in cognitively unimpaired individuals compared to non-carriers. These findings suggest that carriers of the combination of BDNF Met and APOE ɛ4 have a higher risk of progression to more severe disease stages,...
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The impact of brain-derived neurotrophic factor (BDNF) gene polymorphism and BDNF levels for prediction, diagnosis and follow-up of cognitive deficit in neurodegenerative diseases
Čechová, Kateřina ; Hort, Jakub (advisor) ; Telenský, Petr (referee) ; Rektorová, Irena (referee)
Alzheimer's disease (AD) is a slowly progressing neurodegenerative disease characterized by an extracellular accumulation of senile plaques and intracellular neurofibrillary tangles. Apart from these hallmarks, AD is very heterogeneous, especially at the age of onset and the rate of progression. Genetic polymorphisms are key modulators influencing these factors. One of them is a polymorphism for the Brain-derived neurotrophic factor (BDNF), a neurotrophin involved in the synaptic plasticity in the hippocampus and medial temporal lobe structures, areas primarily affected in AD. The thesis aimed to investigate the effect of BDNF Va66Met polymorphism together with the main genetic risk factor for sporadic AD, Apolipoprotein E (APOE) polymorphism, on cognitive functions and structural brain changes. We have shown that the combination of risk alleles BDNF Met and APOE ɛ4 is associated with more severe impairment in episodic memory, egocentric orientation and smaller volumes of medial temporal lobe structures in individuals with amnestic mild cognitive impairment (aMCI), and allocentric orientation in cognitively unimpaired individuals compared to non-carriers. These findings suggest that carriers of the combination of BDNF Met and APOE ɛ4 have a higher risk of progression to more severe disease stages,...
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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...
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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...
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