OBJECTIVE: In multiple sclerosis (MS), deep grey matter (DGM) atrophy has been recognised as a crucial component of the disease that presents early and it has been associated with disability. Although the precise mechanism underlying grey matter atrophy is unknown, several hypotheses have been postulated. Our previous research pointed to correlations of hypothalamic metabolic alterations with clinical outcomes of MS, therefore we decided to further test the relationship of these alterations with DGM atrophy. METHODS: We used 1H-Magnetic Resonance spectroscopy (1H-MRS) of the hypothalamus to test its metabolites in 26 patients with RRMS and 22 healthy age-matched controls. DGM atrophy was evaluated by simple planimetry of third ventricular width on the hypothalamic level (3VW) in T1 weighted MRI pictures. Metabolite ratios of N-acetyl aspartate (NAA), choline (Cho), glutamate and glutamine (Glx), myo-inositol (mIns) and creatine (Cr) were correlated with Multiple Sclerosis Severity Scale (MSSS) and 3VW. RESULTS: Metabolite concentrations were compared between patients and controls using multiple regression models allowing for age, 3VW and metabolites. It revealed that the only relevant predictors of MSSS were 3VW and Glx/NAA. At a significance level of P<0.05, a unit increase of 3VW was associated with a 0.35 increase of MSSS, for a typical value of Glx/NAA; P value 0.0039. A unit increase of Glx/NAA was associated with a 0.93 increase of MSSS, for a typical value of atrophy; P value 0.090. There were significant linear correlations between Glx/Cr and MSSS, Glx/NAA and MSSS, and between mIns/NAA and 3VW. CONCLUSIONS: The results suggest that both NAA and Glx are associated with neurodegeneration of hypothalamic DGM and severe disease course. Glx related 1H-MRS parameters seem to be superior to other metabolites in determining disease burden, independently of otherwise powerful 3VW planimetry. Significantly increased mIns/NAA in MS patients compared to controls point to gliosis, which parallels the atrophy of hypothalamic DGM.
- MeSH
- atrofie MeSH
- dospělí MeSH
- kyselina asparagová analogy a deriváty metabolismus MeSH
- kyselina glutamová metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie MeSH
- mladý dospělý MeSH
- prediktivní hodnota testů MeSH
- progrese nemoci MeSH
- roztroušená skleróza diagnostické zobrazování metabolismus patofyziologie MeSH
- stupeň závažnosti nemoci MeSH
- thalamus patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cieľom práce je uviesť informácie o súčasných rádiologických zobrazovacích metódach používaných v diagnostike a te- rapii diabetickej nohy a jej komplikácií. Využívajú sa neinvazívne metódy: RTG-snímka, ultrasonografi cký záznam, CT, MRI, scintigrafi a, PET/CT. Z invazívnych metód ide o angiografi u (DSA), perkutánnu translúmenovú angioplastiku (PTA), setting laser, zavádzanie drug-eluting balónov a stentov, biodegradabilné stenty. Dôležité je minimalizovať riziko nefro- génnej systémovej fi brózy. Účinnosť endovaskulárnych výkonov je po rovnateľná s chirurgickými revaskularizačnými po- stupmi, u kriticky chorých a polymorbídnych pacientov jej dávame prednosť pre nižší počet komplikácií.
The aim of this work is to provide informations on current radiological imaging methods used in diagnosis and tre- atment of diabetic foot and its complications. Noninvasive methods are used: X-ray image, ultrasonography, CT scan, MR-imaging, scintigraphy, PET/CT scan. Invasive method s: angiography (DSA), percutaneous transluminal angio- plasty (PTA), laser setting, the introduction of drug-eluting balloons and stents, biodegradable stents. It is important to minimize the risk of nephrogenic systemic fi brosis. The eff ectiveness of endovascular in tervention is comparable to surgical revascularization procedures, in severe and polymorbid patients we prefer it because of fewer complications.
- MeSH
- balónková angioplastika metody MeSH
- diabetická noha * diagnóza etiologie radiografie terapie ultrasonografie MeSH
- digitální subtrakční angiografie metody MeSH
- endovaskulární výkony metody MeSH
- lidé MeSH
- multimodální zobrazování metody MeSH
- počítačová rentgenová tomografie metody MeSH
- radiografie metody MeSH
- ultrasonografie metody MeSH
- Check Tag
- lidé MeSH
OBJECTIVE: To evaluate the functional activation of the somatosensory cortical regions in neuropathic pain patients during therapeutic spinal cord stimulation (SCS). METHODS: In nine failed back surgery syndrome patients, the left tibial and the left sural nerves were stimulated in two sessions with intensities at motor and pain thresholds, respectively. The cortical somatosensory evoked potentials were analyzed using source dipole analysis based on 111 EEG signals. RESULTS: The short-latency components of the source located in the right primary somatosensory cortex (SI: 43, 54 and 65ms) after tibial nerve stimulation, the mid-latency SI component (87ms) after sural nerve stimulation, and the mid-latency components in the right (approximately 161ms) and left (approximately 168ms) secondary somatosensory cortices (SII) were smaller in the presence of SCS than in absence of SCS. The long-latency source component arising from the mid-cingulate cortex (approximately 313ms) was smaller for tibial and larger for sural nerve stimuli during SCS periods compared to periods without SCS. CONCLUSIONS: SCS attenuates the somatosensory processing in the SI and SII. In the mid-cingulate cortex, the effect of SCS depends on the type of stimulation and nerve fibers involved. SIGNIFICANCE: Results suggest that the effects of SCS on cortical somatosensory processing may contribute to a reduction of allodynia during SCS.
- MeSH
- dospělí MeSH
- elektroencefalografie metody MeSH
- elektrostimulační terapie metody MeSH
- financování organizované MeSH
- funkční lateralita MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- mapování mozku MeSH
- měření bolesti metody MeSH
- míšní nervy patofyziologie účinky záření MeSH
- neuralgie chirurgie patofyziologie patologie MeSH
- práh bolesti účinky záření MeSH
- reakční čas fyziologie účinky záření MeSH
- somatosenzorické evokované potenciály fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- hodnotící studie MeSH
Autori popisujú menej obvyklé zmeny skeletu pravej hornej končatiny u dieťaťa s klinickou diagnózou tuberozna skleróza. Rôntgenové vyšetrenie ukázalo periostózy metakarpov palca a druhého prsta so zhrubnutím rádia. CT potvrdilo intracerebrálne kalcifikácie.
The authors describe less usual changes on the skeleton of the right upper extremity in a child with clinical diagnosis of tuberous sclerosis. The X-ray examination revealed periostosis of metacarpi of the thumb and second finger with a thickening of radius. CT confirmed intracerebral calcifications.
- MeSH
- dítě MeSH
- lidé MeSH
- paže patologie MeSH
- počítačová rentgenová tomografie MeSH
- předškolní dítě MeSH
- prsty ruky patologie MeSH
- tuberózní skleróza diagnóza etiologie genetika MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
