Assessing imaging biomarker in the prodromal and early phases of Parkinson's disease (PD) is of great importance to ensure an early and safe diagnosis. In the last decades, imaging modalities advanced and are now able to assess many different aspects of neurodegeneration in PD. MRI sequences can measure iron content or neuromelanin. Apart from SPECT imaging with Ioflupane, more specific PET tracers to assess degeneration of the dopaminergic system are available. Furthermore, metabolic PET patterns can be used to anticipate a phenoconversion from prodromal PD to manifest PD. In this regard, it is worth mentioning that PET imaging of inflammation will gain significance. Molecular imaging of neurotransmitters like serotonin, noradrenaline and acetylcholine shed more light on non-motor symptoms. Outside of the brain, molecular imaging of the heart and gut is used to measure PD-related degeneration of the autonomous nervous system. Moreover, optical coherence tomography can noninvasively detect degeneration of retinal fibers as a potential biomarker in PD. In this review, we describe these state-of-the-art imaging modalities in early and prodromal PD and point out in how far these techniques can and will be used in the future to pave the way towards a biomarker-based staging of PD.

• MeSH
• biologické markery * metabolismus   analýza   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• neurozobrazování metody   MeSH
• optická koherentní tomografie metody   MeSH
• Parkinsonova nemoc * diagnostické zobrazování   metabolismus   diagnóza   MeSH
• pozitronová emisní tomografie MeSH
• prodromální symptomy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• antidepresiva farmakologie   terapeutické užití   MeSH
• časná diagnóza MeSH
• glycin farmakologie   terapeutické užití   MeSH
• kognitivní remediace metody   MeSH
• lidé MeSH
• lithium farmakologie   terapeutické užití   MeSH
• magnetická rezonanční tomografie metody   MeSH
• nenasycené mastné kyseliny farmakologie   terapeutické užití   MeSH
• prodromální symptomy MeSH
• schizofrenie * diagnostické zobrazování   farmakoterapie   patofyziologie   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

INTRODUCTION: The diagnosis of mild cognitive impairment (MCI) refers to cognitive impairment not meeting dementia criteria. A survey among members of the American Association of Neurology (AAN) showed that MCI was considered a useful diagnosis. Recently, research criteria have been proposed for the diagnosis of Alzheimer's disease (AD) in MCI based on AD biomarkers (prodromal AD/MCI due to AD). The aim of this study was to investigate the attitudes of clinicians in Europe on the clinical utility of MCI and prodromal AD/MCI due to AD criteria. We also investigated whether the prodromal AD/MCI due to AD criteria impacted management of MCI patients. METHODS: An online survey was performed in 2015 among 102 members of the European Academy of Neurology (EAN) and the European Alzheimer's Disease Consortium (EADC). Questions were asked on how often criteria were used, how they were operationalized, how they changed patient management, and what were considered advantages and limitations of MCI and prodromal AD/MCI due to AD. The questionnaire consisted of 47 questions scored on a Likert scale. RESULTS: Almost all respondents (92%) used the MCI diagnosis in clinical practice. Over 80% of the EAN/EADC respondents found a MCI diagnosis useful because it helped to label the cognitive problem, involve patients in planning for the future, and start risk reduction activities. These findings were similar to those reported in the AAN survey. Research criteria for prodromal AD/MCI due to AD were used by 68% of the EAN/EADC respondents. The most common reasons to use the criteria were increased certainty of diagnosis (86%), increased possibilities to provide counseling (51%), facilitation of follow-up planning (48%), start of medical intervention (49%), and response to patients' wish for a diagnosis (41%). Over 70% of the physicians considered that a diagnosis of prodromal AD/MCI due to AD had an added value over the MCI diagnosis. CONCLUSIONS: The diagnostic criteria of MCI and prodromal AD/MCI due to AD are commonly used among EAN/EADC members. The prodromal AD/MCI due to AD were considered clinically useful and impacted patient management and communication.

• MeSH
• Alzheimerova nemoc diagnóza   MeSH
• kognitivní dysfunkce diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurologie MeSH
• postoj zdravotnického personálu * MeSH
• prodromální symptomy MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Schizofrenie je závažným duševním onemocněním, které nejčastěji postihuje osoby v mladém a produktivním věku. Tato nemoc narušuje každodenní fungování nemocných, jejich sociální vztahy, a může vést až k trvalé invaliditě. Ve většině případů se již několik let před nástupem onemocnění rozvíjí prodromální fáze charakteristická prohlubováním neurobiologických změn. Ty se na behaviorální úrovni projevují v myšlení, prožívání, emotivitě či komunikaci. Jedním z přístupů, jak včas zachytit rozvíjející se onemocnění, je vyšetření přítomnosti tzv. bazálních symptomů u osob, které vyhledaly psychiatrickou pomoc. Osoby, u nichž se tyto symptomy vyskytují, vyka-zují vyšší riziko pro rozvoj psychotického onemocnění. Díky včasné detekci těchto symptomů je možné pozitivně ovlivnit další průběh nemoci. Cílem tohoto textu je představit české odborné veřejnosti koncept bazálních symptomů a přispět tak k současné diagnostice psychotických stavů. Dílčím cílem je také představení českého překladu semistrukturovaného rozhovoru Škála tendence ke schizofrenii (Schizophrenia Proneness Instrument), který slouží k vyšetření přítomnosti bazálních symptomů. Detailněji budou popsány dvě jeho části: škála kognitivních a škála percepčních bazálních symptomů.

Schizophrenia is a severe mental disorder that often affects young people of productive age. The illness disrupts daily functioning of patients, their social relationships, and can lead to permanent disability. In most cases, several years before the onset of the disease, a prodromal phase develops, which is characterized by proliferation of neurobiological changes. On a behavioral level these changes manifests themselves in cognition, perception, affect, or communication. One approach to early detection of a developing psychotic disease is examination of “basic symptoms” in people who seek psychiatric help. Individuals with basic symptoms are at higher risk for the development of a psychotic illness. Through early detection of basic symptoms, there is a possibility to influence positively the course of the illness. The aim of our paper is to present to the Czech mental health professionals the concept of basic symptoms and to contribute to diagnosis of psychotic disorders. In addition, we also introduce a Czech translation of a semistructured interview called Schizophrenia Proneness Instrument, which is used to examine the presence of basic symptoms. Two scales of this interview are descri-bed in detail: scale of cognitive and scale of perceptual basic symptoms.

• Klíčová slova
• bazální symptomy, Škála tendence ke schizofrenii,
• MeSH
• behaviorální symptomy diagnostické zobrazování   diagnóza   klasifikace   MeSH
• časná diagnóza MeSH
• kognitivní poruchy MeSH
• lidé MeSH
• percepční poruchy MeSH
• prodromální symptomy * MeSH
• psychiatrické posuzovací škály MeSH
• psychotické poruchy diagnóza   MeSH
• schizofrenie * diagnóza   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Video-polysomnography (v-PSG) is essential for diagnosing rapid eye movement (REM) sleep behavior disorder (RBD). Although there are current American Academy of Sleep Medicine standards to diagnose RBD, several aspects need to be addressed to achieve harmonization across sleep centers. Prodromal RBD is a stage in which symptoms and signs of evolving RBD are present, but do not yet meet established diagnostic criteria for RBD. However, the boundary between prodromal and definite RBD is still unclear. As a common effort of the Neurophysiology Working Group of the International RBD Study Group, this manuscript addresses the need for comprehensive and unambiguous v-PSG recommendations to diagnose RBD and identify prodromal RBD. These include: (1) standardized v-PSG technical settings; (2) specific considerations for REM sleep scoring; (3) harmonized methods for scoring REM sleep without atonia; (4) consistent methods to analyze video and audio recorded during v-PSGs and to classify movements and vocalizations; (5) clear v-PSG guidelines to diagnose RBD and identify prodromal RBD. Each section follows a common template: The current recommendations and methods are presented, their limitations are outlined, and new recommendations are described. Finally, future directions are presented. These v-PSG recommendations are intended for both practicing clinicians and researchers. Classification and quantification of motor events, RBD episodes, and vocalizations are however intended for research purposes only. These v-PSG guidelines will allow collection of homogeneous data, providing objective v-PSG measures and making future harmonized multicentric studies and clinical trials possible.

• MeSH
• lidé MeSH
• pohyb MeSH
• polysomnografie MeSH
• porucha chování v REM spánku * diagnóza   MeSH
• prodromální symptomy MeSH
• spánek REM fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The neurodegenerative synucleinopathies, including Parkinson's disease and dementia with Lewy bodies, are characterized by a typically lengthy prodromal period of progressive subclinical motor and non-motor manifestations. Among these, idiopathic REM sleep behaviour disorder is a powerful early predictor of eventual phenoconversion, and therefore represents a critical opportunity to intervene with neuroprotective therapy. To inform the design of randomized trials, it is essential to study the natural progression of clinical markers during the prodromal stages of disease in order to establish optimal clinical end points. In this study, we combined prospective follow-up data from 28 centres of the International REM Sleep Behavior Disorder Study Group representing 12 countries. Polysomnogram-confirmed REM sleep behaviour disorder subjects were assessed for prodromal Parkinson's disease using the Movement Disorder Society criteria and underwent periodic structured sleep, motor, cognitive, autonomic and olfactory testing. We used linear mixed-effect modelling to estimate annual rates of clinical marker progression stratified by disease subtype, including prodromal Parkinson's disease and prodromal dementia with Lewy bodies. In addition, we calculated sample size requirements to demonstrate slowing of progression under different anticipated treatment effects. Overall, 1160 subjects were followed over an average of 3.3 ± 2.2 years. Among clinical variables assessed continuously, motor variables tended to progress faster and required the lowest sample sizes, ranging from 151 to 560 per group (at 50% drug efficacy and 2-year follow-up). By contrast, cognitive, olfactory and autonomic variables showed modest progression with higher variability, resulting in high sample sizes. The most efficient design was a time-to-event analysis using combined milestones of motor and cognitive decline, estimating 117 per group at 50% drug efficacy and 2-year trial duration. Finally, while phenoconverters showed overall greater progression than non-converters in motor, olfactory, cognitive and certain autonomic markers, the only robust difference in progression between Parkinson's disease and dementia with Lewy bodies phenoconverters was in cognitive testing. This large multicentre study demonstrates the evolution of motor and non-motor manifestations in prodromal synucleinopathy. These findings provide optimized clinical end points and sample size estimates to inform future neuroprotective trials.

• MeSH
• biologické markery MeSH
• demence s Lewyho tělísky * diagnóza   MeSH
• lidé MeSH
• Parkinsonova nemoc * komplikace   diagnóza   MeSH
• porucha chování v REM spánku * diagnóza   MeSH
• prodromální symptomy MeSH
• progrese nemoci MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

Neuromelanin (NM) is a black pigment located in the brain in substantia nigra pars compacta (SN) and locus coeruleus. Its loss is directly connected to the loss of nerve cells in this part of the brain, which plays a role in Parkinson's Disease. Magnetic resonance imaging (MRI) is an ideal tool to monitor the amount of NM in the brain in vivo. The aim of the study was the development of tools and methodology for the quantification of NM in a special neuromelanin-sensitive MRI images. The first approach was done by creating regions of interest, corresponding to the anatomical position of SN based on an anatomical atlas and determining signal intensity threshold. By linking the anatomical and signal intensity information, we were able to segment the SN. As a second approach, the neural network U-Net was used for the segmentation of SN. Subsequently, the volume characterizing the amount of NM in the SN region was calculated. To verify the method and the assumptions, data available from various patient groups were correlated. The main benefit of this approach is the observer-independency of quantification and facilitation of the image processing process and subsequent quantification compared to the manual approach. It is ideal for automatic processing many image sets in one batch.

• MeSH
• deep learning * MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• melaniny analýza   MeSH
• počítačové zpracování obrazu MeSH
• prodromální symptomy MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• substantia nigra diagnostické zobrazování   MeSH
• synukleinopatie diagnostické zobrazování   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH

OBJECTIVE: The purpose of this qualitative review is to examine prodromes, precipitants, and risk factors for repeated episodes of mania and depression in bipolar disorder. METHODS: PubMed, EMBASE, and PsychInfo were searched for "bipolar disorder" in conjunction with: "prodromes", "triggers", and "life change events". RESULTS: Phenomenology and prevalence of prodromes, precipitants, and risk factors are described, and their therapeutic implications are outlined. CONCLUSIONS: Most patients with bipolar disorder are able to recognize their prodromes. This ability depends largely on insight. Psychoeducation focused on improving various aspects of insight, including treatment adherence, reduces incidence of relapses in bipolar disorder.

• MeSH
• antidepresiva terapeutické užití   MeSH
• bipolární porucha farmakoterapie   epidemiologie   prevence a kontrola   MeSH
• incidence MeSH
• lidé MeSH
• prodromální symptomy * MeSH
• recidiva MeSH
• rizikové faktory MeSH
• sekundární prevence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Úvod. Identifikace jedinců ve vysokém riziku rozvoje psychotického onemocnění může pomoci v prevenci vzniku onemocnění. Cíle. Popsat základní psychometrické vlastnosti české verze dotazníku The Prodromal Questionnaire- Brief Version (PQB) a prevalenci výskytu symptomů rizika rozvoje psychózy u českých adolescentů. Soubor a metody. PQB byl předložen studentům pražských škol (gymnázia, střední odborná učiliště-SOU a střední odborné školy–SOŠ) ve věku 15–20 let. PQB se skládá s 21 otázek. Celkový skór ≥ 8 pozitivních položek byl nastaven jako prahový pro pozitivní screening (PQB+), celkový skór ≥ 8 položek, vyvolávajících signifikantní distres pro PQB distres+ a celkový skór ≥ 24 pro PQB celkový distres +. Statistická analýza. Pro testování psychometrických vlastností PQB byl použit Cronbachův koeficient α, položková analýza a explorační faktorová analýza. Rozdíly v PQB mezi skupinami (pohlaví, typ školy, věk) byly exploračně testovány pomocí Fisherova přesného testu, Mann-Whitneyho testu, Pearsonova chí-kvadrát testu a neparametrického Kruskal-Wallisova testu, dle obvyklých zvyklostí. Výsledky. Analyzována byla data 435 studentů (průměrný věk 17,2 ± 1,0 let). Mezi dotazovanými bylo 249 (54 %) chlapců a 216 (56 %) dívek. Mezi školami byl rozdíl distribuce pohlaví (dívky gymnázium 49 % vs. SOU 87 % vs. SOŠ 31 %; p < 0,001), ale ne v průměrném věku respondentů (p = 0,08). Cronbachovo α pro PQB bylo 0,85. U PQB byla nalezena třífaktorová struktura. Faktor 1 byl sycen 7 položkami (faktorová zátěž 0,444–0,729; Cronbachova α = 0,81), faktor 2 tvořilo 6 položek (faktorová zátěž 0,404–0,721; α = 0,73) a faktor 3 se skládal ze 4 položek (faktorová zátěž 0,313 – 0,618; α = 0,65). Z celkového souboru bylo 204 (44 %) studentů PQB+, 44 (9 %) PQB distres + a 174 (37 %) studentů PQB celkový distres+. Záchyt u dívek byl častější než u chlapců. Omezení studie. Ve studovaném souboru jsou pouze studenti středních škol v Praze, což limituje přenositelnost výsledků na celou Českou republiku.

Background. Identification of individuals at high risk of psychotic disorder can help to prevent onset of the disorder. Objectives. To examine both psychometric characteristics of the Czech version of The Prodromal Questionnaire Brief Version (PQB) and prevalence of risk symptoms for psychosis among Czech adolescents. Sample and methods. The PQB was administered to a sample of students in Prague (grammar and secondary vocational schools-SVS and apprentice training centers-ATC) aged 15–20 years. The PQB consists of 21 items. The cut-off score for positive screening (PQB+) was set as ≥ 8 items, the cut-off score ≥ 8 positive symptoms with significant distress was set for PQB distress + and the cut-off score ≥ 24 for total distress for PQB total distress +. Statistical analysis. Cronbach α, item analysis and exploratory factor analysis were used for reliability estimation of the PQB. Exploratory analyses using Fisher,s exact test, Mann-Whitney test, Pearson chi square test, and Kruskal- Wallis test were used as appropriate for testing between group differences in the PQB scores. Results. Data from 435 students were analyzed (mean age 17.2 ± 1.0 years). Sample consisted of 249 males (54%) and 216 females (46%). Sex distribution among schools differed (female, grammar schools 49% vs. ATC 87% vs. SVS 31%, p<0.001), but age distribution did not (p=0.08). Cronbach α of the PQB was 0.85, and three-dimensional factor structure was found. Factor 1 was made up of 7 (factor load 0.444–0.729; Cronbach α=0.73), factor 2 of 6 (factor load 0.404–0.721; α=0.73), and factor 3 of 4 items (factor load 0.313– –0.618; α=0.65). 204 subjects in the total sample were PQB+ (44%), 44 were PQB distress+ (9%) and 174 were PQB total distress + (37%). Study limitation. Generalization of study results is limited, since only students from Prague high schools were assessed.

• MeSH
• prodromální symptomy MeSH
• Publikační typ
• vysokoškolské kvalifikační práce MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• patologie