• MeSH
• epilepsie MeSH
• kongresy jako téma MeSH
• lidé MeSH
• neurofyziologie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• zprávy MeSH

Degenerative cervical myelopathy (DCM) represents the final consequence of a series of degenerative changes in the cervical spine, resulting in cervical spinal canal stenosis and mechanical stress on the cervical spinal cord. This process leads to subsequent pathophysiological processes in the spinal cord tissues. The primary mechanism of injury is degenerative compression of the cervical spinal cord, detectable by magnetic resonance imaging (MRI), serving as a hallmark for diagnosing DCM. However, the relative resilience of the cervical spinal cord to mechanical compression leads to clinical-radiological discordance, i.e., some individuals may exhibit MRI findings of DCC without the clinical signs and symptoms of myelopathy. This degenerative compression of the cervical spinal cord without clinical signs of myelopathy, potentially serving as a precursor to the development of DCM, remains a somewhat controversial topic. In this review article, we elaborate on and provide commentary on the terminology, epidemiology, natural course, diagnosis, predictive value, risks, and practical management of this condition-all of which are subjects of ongoing debate.

• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• amyotrofická laterální skleróza * etiologie   komplikace   MeSH
• lidé MeSH
• parkinsonské poruchy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH

• Publikační typ
• abstrakt z konference MeSH

The term 'endemic parkinsonism' refers to diseases that manifest with a dominant parkinsonian syndrome, which can be typical or atypical, and are present only in a particular geographically defined location or population. Ten phenotypes of endemic parkinsonism are currently known: three in the Western Pacific region; two in the Asian-Oceanic region; one in the Caribbean islands of Guadeloupe and Martinique; and four in Europe. Some of these disease entities seem to be disappearing over time and therefore are probably triggered by unique environmental factors. By contrast, other types persist because they are exclusively genetically determined. Given the geographical clustering and potential overlap in biological and clinical features of these exceptionally interesting diseases, this Review provides a historical reference text and offers current perspectives on each of the 10 phenotypes of endemic parkinsonism. Knowledge obtained from the study of these disease entities supports the hypothesis that both genetic and environmental factors contribute to the development of neurodegenerative diseases, not only in endemic parkinsonism but also in general. At the same time, this understanding suggests useful directions for further research in this area.

• MeSH
• biologie MeSH
• fenotyp MeSH
• lidé MeSH
• parkinsonské poruchy * epidemiologie   genetika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Guadeloupe MeSH

In post-stroke spasticity (PSS), effective treatment with botulinum neurotoxin (BoNT) is associated with transient decrease in activation of the ipsilesional superior parietal lobule (SPL) and intraparietal sulcus (IPS). We hypothesized that this would be reflected in changes in resting-state functional connectivity (rsFC) of the SPL/IPS. Our aim was therefore to assess rsFC of the ipsilesional SPL/IPS in chronic stroke patients with hemiparesis both with and without PSS and to explore the relationship between SPL/IPS rsFC and PSS severity. To this end, fourteen chronic stroke patients with upper limb weakness and PSS (the PSS group) and 8 patients with comparable weakness but no PSS (the control group) underwent clinical evaluation and 3 fMRI examinations, at baseline (W0) and 4 and 11 weeks after BoNT (W4 and W11, respectively). Seed-based rsFC of the atlas-based SPL and IPS was evaluated using a group×time interaction analysis and a correlation analysis with PSS severity (modified Ashworth scale), integrity of the ipsilesional somatosensory afferent pathway (evoked potential N20 latency), and age. In the PSS group, transient improvement in PSS was associated with increase in rsFC between the ipsilesional IPS and the contralesional SPL at W4. The interhemispheric connectivity was negatively correlated with PSS severity at baseline and with PSS improvement at W4. We propose adaptation of the internal forward model as the putative underlying mechanism and discuss its possible association with increased limb use, diminished spastic dystonia, or improved motor performance, as well as its potential contribution to the clinical effects of BoNT.

• MeSH
• botulotoxiny typu A * terapeutické užití   MeSH
• cévní mozková příhoda * komplikace   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nervosvalové látky * terapeutické užití   MeSH
• svalová spasticita MeSH
• temenní lalok MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: In this study we evaluated the impact of location of deep brain stimulation electrode active contact in different parts of the subthalamic nucleus on improvement of non-motor symptoms in patients with Parkinson's disease. METHODS: The subthalamic nucleus was divided into two (dorsolateral/ventromedial) and three (dorsolateral, medial, ventromedial) parts. 37 deep brain stimulation electrodes were divided according to their active contact location. Correlation between change in non-motor symptoms before and one and four months after deep brain stimulation electrode implantation and the location of active contact was made. RESULTS: In dividing the subthalamic nucleus into three parts, no electrode active contact was placed ventromedially, 28 active contacts were located in the medial part and 9 contacts were placed dorsolaterally. After one and four months, no significant difference was found between medial and dorsolateral positions. In the division of the subthalamic nucleus into two parts, 13 contacts were located in the ventromedial part and 24 contacts were placed in the dorsolateral part. After one month, significantly greater improvement in the Non-motor Symptoms Scale for Parkinson's disease (P=0.045) was found on dorsolateral left-sided stimulation, but no significant differences between the ventromedial and dorsolateral positions were found on the right side. CONCLUSION: This study demonstrated the relationship between improvement of non-motor symptoms and the side (hemisphere, left/right) of the deep brain stimulation electrode active contact, rather than its precise location within specific parts of the subthalamic nucleus in patients treated for advanced Parkinson's disease.

• MeSH
• elektrody MeSH
• hluboká mozková stimulace * MeSH
• lidé MeSH
• nucleus subthalamicus * fyziologie   MeSH
• Parkinsonova nemoc * terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The GAITFAST study (gait recovery in patients after acute ischemic stroke) aims to compare the effects of treadmill-based robot-assisted gait training (RTGT) and therapist-assisted treadmill gait training (TTGT) added to conventional physical therapy in first-ever ischemic stroke patients. GAITFAST (Clinicaltrials.gov identifier: NCT04824482) was designed as a single-blind single-center prospective randomized clinical trial with two parallel groups and a primary endpoint of gait speed recovery up to 6 months after ischemic stroke. A total of 120 eligible and enrolled participants will be randomly allocated (1:1) in TTGT or RTGT. All enrolled patients will undergo a 2-week intensive inpatient rehabilitation including TTGT or RTGT followed by four clinical assessments (at the beginning of inpatient rehabilitation 8-15 days after stroke onset, after 2 weeks, and 3 and 6 months after the first assessment). Every clinical assessment will include the assessment of gait speed and walking dependency, fMRI activation measures, neurological and sensorimotor impairments, and gait biomechanics. In a random selection (1:2) of the 120 enrolled patients, multimodal magnetic resonance imaging (MRI) data will be acquired and analyzed. This study will provide insight into the mechanisms behind poststroke gait behavioral changes resulting from intensive rehabilitation including assisted gait training (RTGT or TTGT) in early subacute IS patients.

• Publikační typ
• časopisecké články MeSH

Degenerativní cervikální myelopatie (DCM) je způsobena kompresí krční míchy stenózou krčního míšního kanálu. Relativní odolnost míšní tkáně k mechanické kompresi však může vést k nemyelopatické degenerativní kompresi krční míchy (NMDCCC). Rutinní MR techniky jsou schopny detekovat kompresi míchy, ale nejsou schopny spolehlivě odlišit nemyelopatickou kompresi a symptomatickou myelopatii. Pokročilé MR techniky, jako magneticko-rezonanční spektroskopie (MRS) a difúzí vážená MR (dMRI), představují nový nástroj pro zhodnocení subtilních změn mikrostruktury a biochemického složení míšní tkáně. Současně jsou však tyto techniky vzhledem k velikosti míchy a jejímu uložení v míšním kanálu technicky velmi náročné. Využití pokročilého 3T MR scanneru spolu s novými MR technikami u kohorty 50 zdravých dobrovolníků, 50 NMDCCC a 50 DCM pacientů zvýší citlivost MR v časné detekci kompresivních změn míšní tkáně a pomůže najít citlivé MR markery, které odliší DCM a NMDCCC. Korelace MR nálezů s tíží míšní komprese a klinické disability pomůže určit jejich relevanci při plánování chirurgické dekomprese.; Degenerative cervical myelopathy (DCM) is caused by compression due to cervical canal stenosis. The relative resilience of the spinal cord tissue to the mechanical compression leads to non-myelopathic degenerative cervical cord compression (NMDCCC). Routine MRI techniques could detect spinal cord compression, but not to distinguish DCM and NMDCCC. Advanced MR techniques, such as diffusion MRI and magnetic resonance spectroscopy, provide unique tools for assessing subtle changes in spinal cord microstructure and biochemical composition, respectively, but are prone to technical challenges due to small size and position of the spinal cord. The utilization of advanced 3T scanner along with novel MRI/MRS techniques in a cohort of 50 NMDCC, 50 DCM and 50 healthy individuals will increase the sensitivity for detection of spinal cord changes and will establish sensitive markers of spinal cord tissue alteration with potential to distinguish NMDCC and DCM subjects. MRI outcomes will be related to severity of compression and clinical measures to establish their relevance in surgical planning.

• MeSH
• biologické markery MeSH
• difuzní magnetická rezonance metody   MeSH
• komprese míchy diagnostické zobrazování   MeSH
• magnetická rezonanční spektroskopie metody   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• neurologie
• radiologie, nukleární medicína a zobrazovací metody
• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

Spasticita je jedním z hlavních následků ischemické cévní mozkové příhody. Důsledkem ischemické léze descendentních motorických drah je syndrom horního motoneuronu, který zahrnuje jako negativní (slabost, ztráta jemné motoriky), tak pozitivní příznaky (zvláště spasticita). Těžká postiktální spasticita má za následek snížení kvality života, manuální dexterity, mobility, zhoršení chůze a pády a omezení činností denního života (ADL). Komplexní léčba postiktální spasticity obvykle zahrnuje fyzioterapeutické postupy a aplikaci botulotoxinu A, avšak mechanismy působení terapie spasticity nejsou zcela objasněny. Dostupná data, včetně námi získaných, nabízejí průkaz modulace centrálních senzorimotorických sítí během terapie postiktální spasticity, studie jsou však omezeny malou velikostí souborů, různým stupněm motorického deficitu a rozdílnou metodologií. V tomto projektu navrhujeme komplexní protokol studia centrálních senzorimotorických sítí u pacientů s postiktální spasticitou během cílené terapie. Nálezy mohou přispět k budoucí optimalizaci terapie spasticity.; Post-stroke spasticity (PSS) is one of the major sequelae following ischemic stroke. Ischemic lesions of descending motor tracts result in upper motor neuron syndrome comprising both negative signs (weakness and loss of dexterity) and positive signs (especially spasticity). Disabling PSS affects patient quality of life; causes significant reductions in manual dexterity, mobility, walking/falling, and performance of activities of daily living (ADL) have been reported among patients with PSS. Comprehensive treatment of PSS usually includes physiotherapy procedures and botulinum toxin A application, however, the therapeutic mechanisms are only incompletely understood. Available data, including our own, provide evidence of modulation in central sensorimotor networks during PSS therapy, however, the studies are limited by small samples, different degree of motor deficits and different methodology. We propose a new comprehensive protocol to study central sensorimotor networks in patients with PSS during focused therapy. The findings may inform future optimization of PSS therapy.

• MeSH
• cévní mozková příhoda komplikace   MeSH
• cílená molekulární terapie MeSH
• magnetická rezonanční tomografie MeSH
• neuroplasticita MeSH
• rehabilitace po cévní mozkové příhodě MeSH
• svalová spasticita etiologie   terapie   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• neurologie
• rehabilitační a fyzikální medicína
• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR