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Neuropsychiatric symptoms in predementia stages and the degree of congruence between the close informant and patient ratings
Krejčí, Monika ; Vyhnálek, Martin (advisor) ; Šustová, Petra (referee)
This Master's thesis deals with neuropsychiatric symptoms (NPS) in the early stages of neurodegenerative diseases with an emphasis on Alzheimer's disease (AD). It aims to introduce these symptoms and their contexts and, within the framework of the research, to describe the prevalence and severity of NPS and to compare the informant- and self-rating of NPS in the Mild Behavioral Impairment-Checklist (MBI-C). Attention is focused on the total MBI-C scores but also on the individual domains of the NPS. A quantitative research is conducted on a sample of 70 dyads of patients and their informants; patients with subjective cognitive decline and mild cognitive impairment were included. The performed statistical analyses prove that patients and their informants differ from each other in the assessment of NPS in the total score of the MBI-C and in the impulse dyscontrol domain. These differences are also correlated with the degree of cognitive deficit of the patient. Evaluation of NPS by both the patient and informant and evaluation of the degree of their consistency might therefore be useful and important for predicting the progression of the neurodegenerative disease. However, this assumption will need to be verified in further research, the possibilities of which are also discussed in the thesis.
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Neuropsychiatric and cognitive aspects of early stages of Alzheimer's disease and other neurodegenerative disorders in late-life
Matušková, Veronika ; Vyhnálek, Martin (advisor) ; Kopeček, Miloslav (referee) ; Mitterová, Kristína (referee)
Neuropsychiatric and cognitive aspects of early stages of Alzheimer's disease and other neurodegenerative disorders in late-life Abstract The early diagnosis of Alzheimer's disease (AD) is currently focused on the stages preceding the dementia syndrome, i.e. the preclinical stage and the mild cognitive impairment (MCI) stage. However, the detection of AD using specific biomarkers of beta amyloid and tau protein is limited in clinical practice and often costly or invasive. Therefore, the detection of early clinical signs of AD continues to be invaluable. The aim of this dissertation is to contribute to the early diagnosis of AD by examining specific cognitive markers as well as neuropsychiatric symptoms (NPS), which have so far received little research and clinical attention. The first study introduces criteria for what is termed mild behavioral impairment (MBI), a syndrome analogous to mild cognitive impairment (MCI) describing new-onset and persistent NPS in older adults, and maps MBI symptoms across the cognitive spectrum with the Mild Behavioral Impairment Checklist (MBI-C), translated and adapted in this study. The second study shows that the severity of MBI-C symptoms, particularly impulse dyscontrol and decreased motivation in non-demented older adults, is associated with lower volume or thickness of...
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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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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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The influence of rehabilitation by electrotactile stimulation through the tongue on stability of stance and gait in patients with degenerative cerebellar ataxia
Kodríková, Kateřina ; Čakrt, Ondřej (advisor) ; Vyhnálek, Martin (referee)
INTRODUCTION This graduation theses considers with the influence of rehabilitation by electrotactile stimulation of the tongue on stability of stance and gait in patients with degenerative cerebellar ataxia. Electrotactile stimulation of the tongue is an innovative method based on biofeedback principle, which uses additive sensory information about the position of the head to train the postural stability METHOD We used this method in six patients (four men and two women) with this disease. Patients went through intensive twelve-day therapy. The duration of the lessons was 30 minutes twice a day. We examined postural stability of the patients by using clinical evaluations (Balance Evaluation Systems Test, Dynamic Gait Index), posturography (modified Clinical Test of Sensory Interaction for Balance) and questionnaires (Activities -specific Balance Confidence, Dizziness Handicap Inventory) before and after the therapy. RESULTS The patients showed significant improvement in both clinical tests after the therapy. The results of posturography measurement are not so definite - the significant improvement was achieved only in some measured parameters. Both questionnaires did not show significant improvement. CONCLUSION The results of this study show, that electrotactile stimulation tongue could have a...
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