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Multi-tensor imaging of spinal cord detail from high anglular resolution dMRI data
Zimolka, Jakub ; Starčuk, Zenon (referee) ; Labounek, René (advisor)
The aim of this work was to establish a comprehensive processing pipeline of cervical spinal cord HARDI dMRI data and T2-weighted anatomical MRI images in high-resolution. In the research part we provide description of anatomical data processing, theoretical background of dMRI, description of current approaches to 3D anisotropic diffusion estimation as well as current imaging methods of spinal cord axonal bundles. As one of the first in the world, we are investigating multiple-direction diffusion models for human in-vivo spinal cord white matter minority bundles imaging. We designed our own processing pipeline utilizing Spinal Cord Toolbox (SCT), FSL, in-house developer scripts and TORQUE-based batch system for grid computation, tested on real data from cervical spinal cord area between segments C4-C6 from 26 healthy volunteers. Designed processing pipeline with one non-automatic step, works from pre-processing to parcelation of selected spinal cord structures based on co-registration with anatomical spinal cord template for 25 subjects. One person data includes motion artifacts for which the proces failed. There are visible waves in sagittal images of some subjects caused probably by blood-vessel pulsing. Local quantification metrics of spinal cord anatomy (fractional anisotropy – FA, fractional volumes of first – f1 and second – f2 direction of anisotropic diffusion) from different parts (white matter, gray matter, cortico-spinal tract) and from different population groups (men vs. women), were extracted from dMRI data. As we expected, FA maps show visible decreases in areas of gray matter. We also detected second diffusion dirrection in slices, where the spinal roots come out. In some areas, fractional volume of second diffusion direction reaches up to 40% of the total component of the dMRI signal. All mentioned parameters probability density functions for all mentioned groups are non-normal distributions. Between male and female groups there were no significant distribution differences for f1 and f2 volumes. The distribution of FA values between men and women is statistically different. Unfortunatelly, there is a significant inter-subject variability in results, which has much higher dispersion than differences between different group distributions. Despite the inter-subject variability, this work significantly extends the knowledge about data acquisiton capabilities and MRI and dMRI data from cervical spinal cord image processing. This work also lays down foundations for utilization of the imaging method in future and planned clinical research, where it will be possible to test the alteration of the spinal cord anatomy on the minor secondary bundles separately.
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Neurotraining in tennis
Gavendová, Karolína ; Kočíb, Tomáš (advisor) ; Hráský, Pavel (referee)
Title: Neuro-athletic training in tennis Objectives: The bachelor thesis is divided into two parts. The first part is theoretical and its aim is to inform about neuro-athletic training and the possibilities of including this training in the tennis preparation of players of different age categories. At the same time, the theoretical part also provides a basic overview of the central nervous system and sensory systems on which neuro-athletic training is built. The goal of the second part is to create a stack of exercises that neuro-athletic training uses for tennis players of different age categories. The set of exercises will be divided into four sections - evaluation of training results, general exercises for visual, vestibular and proprioceptive training, neuro-athletic exercises for speed development, neuro-athletic exercises for strength development. Methods: In the theoretical part, we analyzed literature, internet resources and videos dealing with the topic of neuro-athletic training. Based on the analysis, we synthesized the individual findings in order to create a clear information base on the physiological aspects of tennis, the central nervous system and sensory senses, neuro-athletic training. Based on this information, we selected suitable neuro- athletic exercises and created a stack of...
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Case Study of Physiotherapeutic Treatment of a Patient Diagnosed with Vascular Myelopathy
Kleanderová, Michala ; Novotná, Irena (advisor) ; Vrbický, David (referee)
Author: Michala Kleanderová Supervisor: Mgr. Irena Novotná Title: Case Study of Physiotherapeutic Treatment of a Patient Diagnosed with Vascular Myelopathy Objectives: The aim of this bachelor thesis is to present a case study of a patient diagnosed with vascular myelopathy. The next aim is to summarize the theoretical findings from published literature about this disease and the possibilities of its influence from the perspective of physiotherapy. Methods: The thesis is divided into theoretical and special parts. The theoretical part of the thesis was based on a research of Czech and foreign literature available on this topic. In the special part, a case study of a patient with this diagnosis is presented. During the treatment of the patient, examination and therapy techniques which are part of the curriculum of the Bachelor's degree in physiotherapy at Faculty of Physical Education and Sport of Charles University were used. Results: During the therapy sessions, improvement of pathologic gait patterns was achieved, which were the main goals of the therapy plan. Thus, an improvement in the patient's quality of life was achieved. Conclusion: The stated objectives of the thesis were achieved. Keywords: spinal cord, arteriovenous malformation, spastic paraparesis, physiotherapy
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Spinal trauma in terms of pre-hospital care
VAŠÍČKOVÁ, Denisa
This bachelor thesis topic is the pre-hospital care about the patient with spinal trauma. The aim of the thesis is to evaluate used algorithms of paramedics during the first contact. This thesis contains of theoretical and research part. Theoretical part is focused on anatomical and physiological relationships which are neccesary to understand because of complexity of spinal trauma. Detail view on anatomy of spine and spinal cord is introduced same as the mutual topographical relationships. Following that general pathophysiology of spinal trauma is briefly pointed out same as the most common causes of this injury. For complete overview thesis also contains basic diagnostical procedures and spinal trauma classification. For the pre-hospital care remains the most important part precise collecting of patient history and evaluation of situation on site. Imagine methods and clinical examination is the most important steps for final diagnostics in the hospital. But this thesis major focus is targeted on the pre-hospital care. Because of that it also mentions cooperation between integrated rescue system members and their imobilisation and transportation equipment. Research part has two goals. First one is to find out methods and algorithm used by paramedics. Second goal is to analyze their equipment. For this was used qualitative research study. Data were gathered by semistructured questionnaire and its outcomes were analyzed by method of coding. Representative sample was picked with method of snowball among paramedics of Rescue servis Vysočina. After data evaluation was found that participating paramedics are all well educated in the recent rescue guidelines for spinal trauma. Small surprise was that most of them prefer to use manual extraction methods to extraction equipment which seems to be too complicated for fast use in the field. The most prefered equipment was cervical collar and vacuum splint. Other equipment was used rarely according to specific situation. As the conclusion it can be said that methods and equipment of Rescue service Vysočina follows latest algorithms and guidelines. Yet crucial remains professional attitude, following evidence based medicine triads and personalized medicine.
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The role of nociceptive synaptic transmission modulation
Heleš, Mário ; Paleček, Jiří (advisor) ; Rokyta, Richard (referee) ; Krůšek, Jan (referee)
Pain represents a major symptom in a multitude of medical conditions and can often become the main negative factor in a patient's low quality of life. The complex issue of pain management is further underscored by the reduced efficacy of conventional analgesics in conditions such as neuropathic pain. Neuropathic pain, unlike acute nociceptive pain, originates from damage to the peripheral or central nervous system and often develops into chronic pain syndrome. Most analgesics available today provide only limited and unsatisfactory analgesia in chronic neuropathic pain and are often associated with severe adverse effects. Modulation of nociceptive transmission in spinal cord dorsal horn (SCDH) stands out in recent research as a pivotal mechanism, especially in chronic pain development and maintenance. The major aim of this doctoral thesis was to investigate how pain-associated processes interfere with opioid-induced analgesia, with the main focus on the interaction between chemokine (C-C motif) ligand 2 (CCL2), transient receptor potential vanilloid type 1 (TRPV1), and μ-opioid receptor (MOR). To achieve a better insight into opioid signaling in SCDH we studied the following issues: (I.) How does CCL2 modulate MOR-mediated effects on nociceptive synaptic transmission in SCDH neurons and in vivo...
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Pathological pain states, the role of synaptic modulation at spinal cord level
Nerandžič, Vladimír ; Paleček, Jiří (advisor) ; Krůšek, Jan (referee)
(English) Modulation of synaptic transmission in dorsal horn of spinal cord plays a key role in nociceptive signalling. Recent studies have indicated a great importance of presynaptic TRPV1 receptors (transient receptor potential vanilloid) in spinal cord. These receptors act as molecular integrator of nociceptive stimulation on periphery. The way of their activation and the effect on modulation of the synaptic transmission are not clarified yet. Previous studies demonstrated the influence of many inflammatory mediators and cytokins on TRPV1 receptors. The aim of our research was to show changes in activation of presynaptic TRPV1 receptors in the spinal cord following the application of endogenous agonist N-oleoyl dopamine (OLDA) in a model of peripheral neuropathy, after incubation with cytokine TNFα and to show the effect of precursor of anandamide N-acylphosphatidylethanolamine (NAPE). In our experiments, we have recorded miniature excitatory postsynaptic currents (mEPSC) from neurons of acute spinal cord slices by the patch-clamp method. The first series of experiments tested sensitivity to application of the endogenous agonist OLDA 5 days after evoking peripheral neuropathy. The frequency of mEPSC increased significantly - to 250 % of base level after applying a low concentration of OLDA (0,2...
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Case study of the physiotherapy treatmen of a patient after embolisation procedure of spinal arteriovenosus malformation with a nidus in the Th12-L1 segment with developed severe paraparesis of lower limbs
Zámečník, Marek ; Neuwirthová, Svatava (advisor) ; Vrhel, Otakar (referee)
Autor: Marek Zámečník Title: Case study of the physiotherapy treatment of a patient after embolisation procedure of spinal arteriovenous malformation with a nidus in the Th12-L1 segment with developed severe paraparesis of lower limbs. Objective: The aim of this work is a summary of theoretical and practical knowledge, approach the issue of spinal arteriovenous malformations. And from the perspective of a physiotherapist to manage a case report of a patient who underwent embolisation treatment of spinal arteriovenous malformation of ThL spine, after which developed severe paraparesis of lower limbs. Methods: The work is divided into two parts - general (theoretical) and special (practical). Theoretical part is based on the research of specialised literature and summarises the basic information about spinal cord lesions and in great detail about the arteriovenous malformation of spinal cord, about diagnostics and treatment of individual types of malformations and finally a physiotherapy of this kind of diagnosis. Practical part documents the process of physiotherapy of the patient after embolisation treatment of spinal arteriovenous malformation with developed severe paraparesis of lower limbs. Results: The therapy reached the best results in the area of better overall condition of the patient,...
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Possibilities of physiotherapy in whiplash injury syndrome
Šmahelová, Eva ; Molnár, Petr (advisor) ; Hamarová, Zuzana (referee)
Author: Eva Šmahelová Institution: Department of Rehabilitation Medicine in Hradec Králové Title of bachelor's thesis: Possibilities of Physiotherapy in Whiplash Injury Syndrome Supervisor: Mgr. Petr Molnár Number of pages: 68 Number of attachments: 3 Year of vindication: 2012 Key words: whiplash injury, injury of cervical spine, physiotherapy of whiplash injury, cervical spine. The Bachelor's thesis completes available knowledge about large problems of whiplash injury and about the abilities of physiotherapy within this problem. In the general part there is anatomy and kineziology of the spinal column aimed at the neck area and classification of injury of the neck spinal column. The special part summarizes the available information about whiplash injury (definition, incidention, mechanism of arise etc.) and refers to possible ways of therapy. The discussion is about the special consideration on the theme of the problems of whiplash and completes gained knowledge in the Bachelor's thesis.
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The role of synaptic modulation in pain states.
Adámek, Pavel ; Paleček, Jiří (advisor) ; Moravec, Jan (referee)
Everybody has experienced pain. Pain by definition is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. In the peripheral tissues acute painful stimuli activate specialized endings of afferent neurons called nociceptors. The information about tissue damage is then transmitted to the cell bodies of these dorsal root ganglion neurons by unmyelinated or thinly myelinated axons (C and A fibers, respectively). The central branches of these neurons form synapses with superficial dorsal horn neurons in the spinal cord. The information is conveyed at the synaptic connections by neurotransmitters such as glutamate and many others neuromodulators. Important is the subsequent activation of projection neurons that transmit the information to supraspinal brain areas. Activity of excitatory and inhibitory interneurons, glial cells and descending pathways from the CNS are also important for the modulation of nociceptive information at the spinal cord level. After peripheral tissue damage and in other pathological states, increased sensitivity to peripheral stimuli may develop. As results of this change innocuous stimuli are perceived as painful (alodynia) and increased pain is perceived after noxious stimuli (hyperalgesia). The underlying mechanisms of these changes may be...
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Behavioral testing of animals after experimental spinal cord injury.
Freislebenová, Hana ; Machová Urdzíková, Lucia (advisor) ; Kriška, Ján (referee)
Spinal cord injury is one of the most serious injury that leads to a decrease in the quality of life both physically and mentally. Although there is currently no effective treatment, great efforts are being made to develop new treatments. The effectiveness of experimental treatment is verified by behavioral tests performed on animal models, where rats are the most suitable ones for this type of injury. Behavioral tests are divided into several groups depending on what the testing is focused on. Locomotor tests examine the function of a locomotive apparatus, motor tests are used to determine the function of skeletal muscles not primarily involved in locomotion, sensory and motor tests test the functionality of sensory and motor apparatus and their interconnection, sensory tests are designed to test responses to sensory stimuli. Electrophysiological tests and functional magnetic resonance imaging are part of a series of special tests that use artificially induced electrical stimuli to measure muscle activity. This thesis is focused on detailed description of selected behavioral tests, their functionality and comparison of their advantages and disadvantages.
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