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Spatial Navigation Impairment as An EarlyMarker of Neurodegenerative Disease
Mokrišová, Ivana ; Hort, Jakub (advisor) ; Stuchlík, Aleš (referee) ; Vymazal, Josef (referee)
Aging of population with related increase of incidence of neurodegenerative diseases mostly Alzheimer disease (AD), poses a serious socioeconomic problem. In the recent years, research has been focused on specific early disease markers and identifications of patient's populations at increased risk of AD, which comprise mild cognitive impairment (MCI) and subjective cognitive decline (SCD) which may represent prodromal and preclinical stage of AD, while still preserving functional capacity. This thesis summarizes and further extends current knowledge in the field of AD with a specific focus on early disease markers. The main topic of the thesis is spatial navigation, especially its allocentric component and path integration. Examination of spatial navigation might serve as the valuable diagnostic tool which could be used in wider clinical practice for timely diagnostics, disease monitoring and also for evaluation of the treatment effect. We also present here experimental tests (questionnaires of subjective spatial navigation complaints and tests of visual perception) that have enough sensitivity and specificity for identification of subjects at risk for AD.
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Complex Preoperative Brain Tumor Imaging
Tupý, Radek ; Ferda, Jiří (advisor) ; Vymazal, Josef (referee) ; Tüdös, Zbyněk (referee)
Title Complex preoperative brain tumor imaging Abstract The differentiation of glioblastoma, metastases and brain lymphoma using modern diagnostic imaging methods has a major impact on the strategy of further diagnostic examinations and treatment. In a group of 67 patients with glioblastoma and 31 with cerebral metastasis, the ability to differentiate them according to the evaluation of perfusion parameters changes in peritumoral white matter by T1 dynamic post-contrast magnetic resonance imaging was verified, with the positive predictive value in glioblastoma detection up to 91%. In a group of 36 brain lymphoma patients the importance of imaging submodalities and contribution of a complex magnetic resonance imaging protocol to detect lymphoma up to 80% were evaluated. Key words brain, glioblastoma, lymphoma, magnetic resonance imaging, neoplasm metastasis
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MR imaging and MR spectroscopy of human during physical stress (MR spectroscopy imaging, MR diffusometry, MR relaxometry etc.)
Šedivý, Petr ; Hájek, Milan (advisor) ; Haberlová, Jana (referee) ; Vymazal, Josef (referee)
The dissertation is concerned to in vivo phosphorus MR spectroscopy (31 P MRS) and 1 H MR imaging (MRI) of muscle in combination with physical workload. The theoretical part of the thesis describes methodology of 31 P MRS measurement and its clinical use in research of metabolic changes in diabetes, heart failure and peripheral artery disease (PAD). The results of the thesis are divided into methodical and clinical parts. Methodical results deal with the construction of experimental equipment, software modification and development, and show of the reproducibility of the dynamic 31 P MRS. The MRI after exercise was used to the describe involvement of the individual calf muscles to muscle contraction during pedal movement in MR compatible ergometer. The first part of the clinical results of the thesis describes changes in muscle metabolism during diabetes and critical ischemia. In patients with critical ischemia the effect of treatment by angioplasty or transplantation of mesenchymal stem cells was evaluated. In the second part of the clinical results the metabolism of patients with heart failure complicated by sideropenia was studied. In these patients the effect of experimental treatment by iron carboxymaltose was described.
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Immunosuppression in active multiple sclerosis: combination treatment with interferon beta and azathioprine and fingolimod monotherapy
Tichá, Veronika ; Kubala Havrdová, Eva (advisor) ; Vymazal, Josef (referee) ; Laczó, Jan (referee)
Introduction: Addition of a second drug used to be a strategy to achieve clinical stabilization of multiple sclerosis in many patients with on-going activity despite monotherapy. Modern immunosuppressive drugs used in monotherapy exert more specific mode of action. Methods: This retrospective observational study evaluated 5-year data from 85 patients with active multiple sclerosis despite monotherapy with either interferon beta or azathioprine, who received add-on azathioprine or interferon beta, respectively. In a subgroup of 23 patients 10- year data were analysed. In a second part of the study, a group of 126 patients switched either from interferon beta or glatiramer acetate to fingolimod was followed-up for one after the change of their treatment and a in a subgroup of 53 patients the 2-year data were assessed. Clinical (relapse frequency, disability) parameters were compared preceding and following the addition of second drug or the switch of treatment. Laboratory results and potential serious adverse events were evaluated in a group of patients with combination therapy. Results: The add-on treatment triggered a drop in annualised relapse rate by approximately 1.5 points sustained over 5 and 10 years. No effect on disability was observed. Simultaneously, white blood cell and lymphocyte counts...
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Influence of corticosteroids and movement disorder on development of osteoporosis in patients with multiple sclerosis (MS)
Týblová, Michaela ; Kubala Havrdová, Eva (advisor) ; Vymazal, Josef (referee) ; Taláb, Radomír (referee)
Introduction: Multiple sclerosis (MS) is associated with impaired bone health in comparison to an equally healthy population, even already in patients at the onset of this disease. The main risk factors for development of osteoporosis in MS patients are known. The aim of the study was to find the relationship of the decrease in bone mineral density (BMD) to the administered cumulative dose of steroids and to other risk factors in MS, mainly to the degree of motor deficit. Further goal was to evaluate the occurence of the risk of low-trauma fractures in multiple sclerosis patients.. The BMD and muscle mass was compared in MS patients (women and men) and control subjects, to examine the effect of main ones - physical disability and long-term glucocorticoid (GC) therapy on BMD. Clinical values of bone remodeling markers were evaluated in assessment of rate of bone loss in patients with multiple sclerosis long term treated with low dose of GC. Patients and methods: We used dual -energy X-ray absorptiometry for a measurement of BMD in 591 MS patients (455 females and 136 males) in 2004 and in cross-sectional longitudinal study published in 2014 with 474 patients (353 women and 121 men). Out of the whole study group body composition was evaluated in 250 MS females, 104 males and 247 healthy controls (193...
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Organization of the auditory cortex and changes in the auditory system in presbycusis.
Profant, Oliver ; Syka, Josef (advisor) ; Vymazal, Josef (referee) ; Chrobok, Viktor (referee)
2. Abstract The aim of my study was to identify specific features of the structure and function of neurons in the auditory cortex of rat and to analyze age-related changes in the inhibitory system (GAD 65 and 67) in the central auditory structures of the same species. Based on the findings in the animal model we focused on changes in the central part of the auditory pathway and auditory cortex in aging human population that were examined by various MRI techniques (spectroscopy, morphometry, diffusion tensor imaging and functional MRI). We found that the most significant feature of neurons in the auditory cortex is the presence of the hyperpolarization-activated cation current that influences functional properties of neurons. The differences among neurons in different fields of the AC were based on their specific functional characteristics, with the tonotopy being the key factor of the AC structural organization. Aging of the auditory system has a negative influence on the speech understanding in which the processing of temporal parameters of the sound plays a significant role. In animal experiments we observed decreases of the enzymes GAD65 and 67 (that catalyze synthesis of the main inhibitory neurotransmitter GABA) in central parts of the auditory system. Inhibition is the key factor in coding and...
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Application of Diffusion Tensor Imaging to Brain Gray and White Marker
Rulseh, Aaron Michael ; Vymazal, Josef (advisor) ; Hluštík, Petr (referee) ; Hájek, Milan (referee)
Application of Diffusion Tensor Imaging to Brain Gray and White Ma er A In the present work we explore the gray and white ma er applicability of diffusion tensor imaging (DTI). To evaluate effect of ferritin-bound iron on gray ma er contrast in DTI, we created an in vitro model consisting of agarose gel phantoms doped with ferritin, and validated our results in vivo on healthy volunteer subjects - years of age in the basal ganglia. We further explored the application of DTI to amyotrophic lateral sclerosis (ALS) and multiple system atrophy (MSA); neurodegenerative diseases with gray and white ma er pathophysiological components. In the ALS study, patients and age- and sex-matched controls were recruited, while the MSA study included probable MSA subjects ( MSA-P, MSA-C) and age- and sex-matched controls. We found that ferritin-bound iron may make a signi cant contribution to DTI scalars in gray ma er regions of the brain, mediated by eigenvalue repulsion. is has important implications for DTI studies targeting gray ma er regions, especially in adolescence and in diseases associated with altered brain-iron load. In ALS, we found altered diffusion in the corona radiata and callosal body, and changes in R in the caudate nucleus and frontal white ma er. In MSA, we observed widespread white ma er changes associated...
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Early diagnosis of memory disorders in neurodegenerative disease
Kadlecová, Alexandra ; Hort, Jakub (advisor) ; Stuchlík, Aleš (referee) ; Vymazal, Josef (referee)
lncreased incidence and prevalence of dementi a syndrome is related to ageing of the population. The most common cause of dementia is Alzheimer disease (AD), which represents serious health, social and economical burden to the society. Current diagnostic criteria and research of AD tend to make a diagnosis of AD at the earliest stages or the disease, when the likelihood to influence the course ofthe disease is the highest and extension of the period with high quality of life can be expected. AD begins by impairment or mediotemporal structures - amygdala and hippocampus. Atrophy in these critical brain structures is well detectable before the onset of dementia syndrome and can be manifested by Hrst clinical symptoms. Presented PhD thesis deals with detection of these early signs of AD - spatial disorientation, emotional agnosia and behavioural disturbances or patients with mild cognitive impairrnent, the condition understood as prodromal stage of AD. Powered by TCPDF (www.tcpdf.org)
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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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Contrast-enhanced MR angiography utilizing parallel acquisition techniques in renal artery stenosis detection
Slanina, Martin ; Žižka, Jan (advisor) ; Vymazal, Josef (referee) ; Ferda, Jiří (referee)
Contrast-enhanced MR angiography utilizing parallel acquisition techniques in renal artery stenosis detection Objective: The aim of our study was to assess the diagnostic value of contrast- enhanced MR angiography (MRA) utilizing parallel acquisition techniques in the detection of renal artery stenosis (RAS). Material and Methods: 81 hypertensive subjects with suspected RAS were examined on a 1.5 T MR system with body array coil. Bolus tracking was used to monitor the arrival of contrast agent to the abdominal aorta. The MRA sequence parameters were as follows: TR 3.7 ms; TE 1.2 ms; flip angle 25ř; acquisition time 18 s; voxel size 1.1 mm × 1.0 mm × 1.1 mm; centric k-space sampling; parallel acquisition techniques with acceleration factor of 2 (GRAPPA). Renal artery stenosis of 60% and more was considered hemodynamically significant. The results of MRA were compared to digital subtraction angiography serving as a standard of reference. Results: Sensitivity, specificity, positive predictive value and negative predictive value of MRA in the detection of hemodynamically significant RAS were 91%, 96%, 94% and 94%, respectively. Prevalence of RAS was 41% in our study population. Conclusion: Contrast-enhanced MRA with high spatial resolution offers sufficient sensitivity and specificity for screening of...
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