BACKGROUND: Spatial navigation deficits are early symptoms of Alzheimer's disease (AD). The apolipoprotein E (APOE) ε4 allele is the most important genetic risk factor for AD. This study investigated effects of APOE genotype on spatial navigation in biomarker-defined individuals with amnestic mild cognitive impairment (aMCI) and associations of AD biomarkers and atrophy of AD-related brain regions with spatial navigation. METHODS: 107 participants, cognitively normal older adults (CN, n = 48) and aMCI individuals stratified into AD aMCI (n = 28) and non-AD aMCI (n = 31) groups, underwent cognitive assessment, brain MRI, and spatial navigation assessment using the Virtual Supermarket Test with egocentric and allocentric tasks and a self-report questionnaire. Cerebrospinal fluid (CSF) biomarkers (amyloid-β1-42, phosphorylated tau181 and total tau) and amyloid PET imaging were assessed in aMCI participants. RESULTS: AD aMCI participants had the highest prevalence of APOE ε4 carriers and worst allocentric navigation. CSF levels of AD biomarkers and atrophy in AD-related brain regions were associated with worse allocentric navigation. Between-group differences in spatial navigation and associations with AD biomarkers and regional brain atrophy were not influenced by APOE genotype. Self-reported navigation ability was similar across groups and unrelated to spatial navigation performance. CONCLUSIONS: These findings suggest that allocentric navigation deficits in aMCI individuals are predominantly driven by AD pathology, independent of APOE genotype. This highlights the role of AD pathology as measured by biomarkers, rather than genetic status, as a major factor in navigational impairment in aMCI, and emphasizes the assessment of spatial navigation as a valuable tool for early detection of AD.
- MeSH
- Alzheimer Disease * genetics cerebrospinal fluid diagnostic imaging complications physiopathology pathology MeSH
- Amyloid beta-Peptides cerebrospinal fluid MeSH
- Apolipoprotein E4 * genetics MeSH
- Apolipoproteins E * genetics MeSH
- Atrophy MeSH
- Biomarkers cerebrospinal fluid MeSH
- Genotype MeSH
- Cognitive Dysfunction * genetics cerebrospinal fluid diagnostic imaging physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Brain pathology diagnostic imaging MeSH
- Neuropsychological Tests MeSH
- Peptide Fragments cerebrospinal fluid MeSH
- Positron-Emission Tomography MeSH
- Spatial Navigation * physiology MeSH
- tau Proteins cerebrospinal fluid MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Cíl: Montrealský kognitivní test (MoCA) je jednou z nejpoužívanějších screeningových zkoušek kognice u dospělých osob, pro něž existují normy pro českou populaci. Varianta MoCA-22, která je určena pro osoby s poruchami zraku či imobilitou horních končetin, se dá administrovat i po telefonu. Tato studie přináší české normy MoCA-22. Materiál a metodika: Soubor (n = 1 049) se skládá z účastníků čtyř studií provedených v ČR. Zařazeny byly osoby ve věku 19–98 let, bez neurodegenerativního, psychiatrického či jiného závažného onemocnění. Data pro MoCA-22 byla odvozena z dat získaných vyšetřením standardní verzí MoCA. V souladu se zavedenou klinickou praxí i statistickou analýzou jsou soubor a odvozené normy rozděleny na tři věkové kategorie: 19–50 let, 51–74 let, 75 a více let. Výsledky: Pro výše uvedené věkové kategorie dále rozdělené dle dosaženého vzdělání (nižší, vyšší) předkládáme průměrné skóry i odhadované percentilové hranice. Výkon v MoCA-22 je ovlivněn dosaženým vzděláním a věkem, ale nikoli pohlavím. Pro úpravu výsledků dle demografických faktorů proto poskytujeme i regresní rovnici. Závěr: Normativní údaje pro MoCA-22 rozšíří klinické instrumentárium v Česku a umožní adekvátní screening kognice u osob, jež jsou zdravotním stavem limitovány při využití standardních metod.
Aim: The Montreal Cognitive Assessment (MoCA) is one of the most widely used cognitive screening tests in adults with reference standards for the Czech population. The MoCA-22 variant is designed for individuals with visual impairment or upper limb immobility and can be administered over the telephone. This study presents the Czech MoCA-22 normative standards. Materials and methods: The sample (N = 1,049) consists of participants from four studies conducted in the Czech Republic. The subjects included were aged 19–98 years, and were without neurodegenerative, psychiatric, or other serious illness. Data for the MoCA-22 were derived from data obtained by the standard version of MoCA. Following established clinical practice and statistical analysis, the population and derived norms are divided into three age categories: 19–50 years, 51–74 years, and 75 years and older. Results: For these age categories above, which were further subdivided by educational status (lower, higher), we present mean scores and estimated percentile thresholds. Performance in the MoCA-22 is affected by demoraphic factors, such as educational status and age but not sex, as reflected by the regression equation. Conclusions: Normative data for MoCA-22 will complement the clinical armamentarium in Czechia and allow adequate cognitive screening in people whose health status limits them when using standard methods.
- Keywords
- Montrealský kognitivní test (MoCA),
- MeSH
- Clinical Studies as Topic MeSH
- Cognition Disorders diagnosis MeSH
- Humans MeSH
- Neuropsychological Tests * standards MeSH
- Bedridden Persons MeSH
- Telephone MeSH
- Telemedicine MeSH
- Persons with Visual Disabilities MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
INTRODUCTION: This study explores the emotional impact of virtual forest therapy delivered through audio-visual recordings shown to patients in the oncology waiting rooms, focusing on whether simulated forest walks can positively influence patients' emotional states compared to traditional waiting room stimuli. METHODS: The study involved 117 participants from a diverse group of oncology patients in the outpatient clinic waiting room at the Masaryk Memorial Cancer Institute. Using a partially randomized controlled trial design, the study assessed basic emotional dimensions-valence and arousal-as well as specific psychological states such as thought control, sadness, anxiety, and pain. This assessment used the Self-Assessment Manikin and the modified Emotional Thermometer before and after participants watched three video types (forest, sea, news). Baseline stress levels were measured using the Kessler Psychological Distress Scale (K6). RESULTS: Participants exposed to forest and sea videos reported significant improvements in emotional valence and reduced arousal, suggesting a calming and uplifting effect. No significant changes were observed in the control and news groups. Secondary outcomes related to anxiety, sadness, and pain showed no significant interaction effects, though small but significant main effects of time on these variables were noted. DISCUSSION: The findings suggest that videos of forest and sea can be a beneficial intervention in the oncology waiting rooms by enhancing patients' emotional well-being. This pilot study underscores the potential for integrating virtual mental health support elements into healthcare settings to improve patient care experience.
- Publication type
- Journal Article MeSH
Understanding the immune response to Leishmania infection and identifying biomarkers that correlate with protection are crucial for developing effective vaccines. One intriguing aspect of Leishmania infection is the persistence of parasites, even after apparent lesion healing. Various host cells, including dendritic cells, fibroblasts, and Langerhans cells, may serve as safe sites for latent infection. Memory T cells, especially tissue-resident memory T cells (TRM), play a crucial role in concomitant immunity against cutaneous Leishmania infections. These TRM cells are long-lasting and can protect against reinfection in the absence of persistent parasites. CD4+ TRM cells, in particular, have been implicated in protection against Leishmania infections. These cells are characterized by their ability to reside in the skin and rapidly respond to secondary infections by producing cytokines such as IFN-γ, which activates macrophages to kill parasites. The induction of CD4+ TRM cells has shown promise in experimental immunization, leading to protection against Leishmania challenge infections. Identifying biomarkers of protection is a critical step in vaccine development and CD4+ TRM cells hold potential as biomarkers, as their presence and functions may correlate with protection. While recent studies have shown that Leishmania-specific memory CD4+ T-cell subsets are present in individuals with a history of cutaneous leishmaniasis, further studies are needed to characterize CD4+ TRM cell populations. Overall, this review highlights the importance of memory T cells, particularly skin-resident CD4+ TRM cells, as promising targets for developing effective vaccines against leishmaniasis and as biomarkers of immune protection to assess the efficacy of candidate vaccines against human leishmaniasis.
- MeSH
- Biomarkers MeSH
- CD4-Positive T-Lymphocytes MeSH
- Leishmaniasis, Cutaneous * MeSH
- Humans MeSH
- Memory T Cells MeSH
- Vaccine Efficacy MeSH
- Vaccines * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
AIMS: To examine the effects of virtual reality-based cognitive interventions on cognitive function and activities of daily living among stroke patients, and to identify the optimal design for such intervention. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, EMBASE, Cochrane, CINANL, JBI-EBP and Web of Science from inception to October 2023. METHODS: Methodological quality was assessed by Risk of Bias Tool. Meta-analyses were assessed by Review Manager 5.4. Subgroup analyses were conducted to explore the influence of study design. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to assess the certainty of evidence. RESULTS: Twenty-five randomized controlled trials (1178 participants) were included. Virtual reality-based cognitive interventions demonstrated moderate-to-large effects in improving global cognitive function (SMD = 0.43; 95% CI [0.01, 0.85]), executive function (SMD = 0.84; 95% CI [0.25, 1.43]) and memory (SMD = 0.65; 95% CI [0.15, 1.16]) compared to control treatments. No significant effects were found on language, visuospatial ability and activities of daily living. Subgroup analyses indicated one-on-one coaching, individualized design and dynamic difficulty adjustment, and interventions lasting ≥ 6 weeks had particularly enhanced effects, especially for executive function. CONCLUSIONS: Virtual reality-based cognitive interventions improve global cognitive function, executive function and memory among stroke patients. IMPLICATIONS FOR THE PATIENT CARE: This review underscores the broad cognitive advantages offered by virtual technology, suggesting its potential integration into standard stroke rehabilitation protocols for enhanced cognitive recovery. IMPACT: The study identifies key factors in virtual technology interventions that effectively improve cognitive function among stroke patients, offering healthcare providers a framework for leveraging such technology to optimize cognitive outcomes in stroke rehabilitation. REPORTING METHOD: PRISMA 2020 statement. PROSPERO REGISTRATION NUMBER: CRD42022342668.
- MeSH
- Stroke * psychology MeSH
- Activities of Daily Living MeSH
- Cognition MeSH
- Humans MeSH
- Stroke Rehabilitation * methods MeSH
- Virtual Reality * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Review MeSH
- Systematic Review MeSH
Východiska: Mobilní aplikace MOÚ MindCare má za sebou první rok fungování na Masarykově onkologickém ústavu (MOÚ) v rámci randomizované kontrolované studie hodnotící její efektivitu. Cílem příspěvku je shrnout první výsledky vyplývající z procesu náboru pacientů a poukázat na úskalí implementace eHealth programu na podporu duševního zdraví do běžné praxe. Metody: Nábor pacientů do studie MOÚ MindCare probíhá na MOÚ od června roku 2022. Cesty náboru jsou tvořeny z několika úrovní. V rámci mediální propagace byly zvoleny následující komunikační kanály: reklamní bannery v čekárnách, podcasty a rozhlasové vysílaní, webové stránky, sociální sítě a cca 5 000 ks letáků. Druhou úrovní komunikace je aktivní oslovování pacientů studiovými koordinátory přímo na MOÚ. K 30. červnu 2023 bylo do studie zaregistrováno celkem 408 pacientů. Součástí sběru dat je zaznamenávání základních údajů o pacientech (demografické údaje, klinické stadium onemocnění, záměr léčby atp.), ale i důvody odmítnutí vstupu do studie. Stejně tak je sledováno předčasné ukončení v jednotlivých fázích studie. Výsledky: Výsledky naznačují, že pacientky s diagnózou karcinom prsu vykazují vyšší adherenci k účasti ve studii. Nejčastějšími důvody odmítnutí vstupu do studie je: nezájem o psychologickou intervenci, nedostatek času, absence chytrého telefonu nebo nedostatečná technická zdatnost. Z rozhovorů s oslovenými pacienty je zřejmé, že duševní zdraví, a zejména pak vlastní péče o něj, není stále dostatečně srozumitelným tématem, a to i přesto, že velké množství osob léčící se s onkologickou diagnózou zažívá v některé fázi onemocnění distres. Závěr: Z naších prvních zkušeností vyplývá, že způsob náboru, kontext a průběh studie, pohlaví respondentů a také jejich diagnóza mají zásadní vliv na adherenci k programu a drop out ze studie.
Background: The MOÚ MindCare mobile application has completed its first year of operation at the Masaryk Memorial Cancer Institute (MMCI) as part of a randomized controlled trial evaluating its effectiveness. The aim of this contribution is to summarize the first results stemming from the patient recruitment process and to highlight the challenges of implementing an eHealth program to support mental health in routine practice. Methods: Patient recruitment for the MOÚ MindCare study has been conducted at the MMCI since June 2022. The recruitment strategies involve several levels. For media promotion, the following communication channels were chosen: advertising banners in waiting rooms, podcasts, radio broadcasts, websites, social media, and approx. 5,000 leaflets. The second level of communication involves active engagement with patients by study coordinators directly at the MMCI. As of June 30, 2023, a total of 408 patients have been registered in the study. Data collection includes recording basic patient information (demographics, clinical stage of illness, treatment intentions, etc.), as well as reasons for study refusal and premature termination in various study phases. Results: The results show that patients diagnosed with breast cancer show higher adherence to study participation. The most common reasons for study refusal include disinterest in psychological intervention, lack of time, absence of a smartphone, or insufficient technical ability. From conversations with approached patients, it is evident that mental health, particularly self-care, remains an insufficiently comprehensible topic, even though we know that a considerable number of individuals undergoing cancer treatment experience distress at some stage of the illness. Conclusion: Based on our first experiences, recruitment methods, study context, respondents’ gender, and their diagnosis have a significant impact on program adherence and study drop-out rates.
- MeSH
- Adult MeSH
- Mental Health MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Mobile Applications MeSH
- Neoplasms * psychology MeSH
- Randomized Controlled Trials as Topic MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Telemedicine * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
The aim of this study was to investigate the impact of thymic dysplasia on the phenotypic and functional characteristics of T cells in patients with 22q11.2 deletion syndrome, including T-cell phenotype, transcriptional profile, cytokine production, as well as the possibility of utilizing IL-7 to recover their numbers and function. We found a strong bias towards Th1 response in pediatric and young adult 22q11.2DS patients, expansion of CXCR5+ follicular helper cells and CXCR3+CCR6- Th1 cells, increased production of cytokines IFN-γ, IL-10, IL-2, IL-21 and TNF-α. This Th1 skew was primarily driven by expanded terminally differentiated T cells. IL-7 further reduced naive T cells, increased cytokine production and caused an upregulation of exhaustion markers. Thus, Th1 bias in T cell populations persists from infancy into adolescence and is accompanied by accelerated maturation of T cells into memory stages. This phenotype is exacerbated by IL-7 which causes further decrease in naïve T cells in vitro.
- MeSH
- Cytokines MeSH
- DiGeorge Syndrome * MeSH
- Child MeSH
- Interferon-gamma * MeSH
- Interleukin-7 MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Memory T Cells MeSH
- Th1 Cells MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
nestr.
Alzheimerova choroba (AD) představuje jedno z nejčastějších neurodegenerativních onemocnění vedoucí k rozpadu kognitivních funkcí, a které má negativní dopad na kvalitu života pacientů i jejich pečovatelů. Kromě poruch paměti je narušená také zraková pozornost, a to již ve stadiu mírné kognitivní poruchy (MCI-AD). V dnešní době pro MCI-AD není dostupná žádná efektivní léčba. Pozornost se začíná obracet k neinvazivním stimulačním technikám mozku, jako je transkraniální stimulace stejnosměrným proudem (tDCS), ve snaze ovlivnit mozkovou plasticitu a zlepšit tak kognitivní funkce. V předkládaném návrhu projektu je naším cílem: 1. určit optimální tDCS protokol ke zlepšení zrakové pozornosti u MCI-AD pacientů; 2. zkoumat dlouhodobé vlivy optimalizovaného několikanásobného tDCS protokolu na zrakovou pozornost včetně přenosu do ekologicky validního virtuálního prostředí a určit neuronální podklad behaviorálních změn vyvolaných pomocí tDCS za použití kombinovaného tDCS/MRI přístupu.; Alzheimer’s disease (AD) is the most common neurodegenerative disease. It progressively causes the breakdown of cognitive functions and impairs quality of life for patients and their caregivers. In addition to memory impairment, visual attention is also compromised, even at the stage of mild cognitive impairment due to AD (MCI-AD). No treatment has been found for MCI-AD; therefore, attention has been drawn to non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), in order to enhance cognitive functions by modifying brain plasticity. In the current research, we aim to: 1. identify an optimal tDCS protocol for enhancing visual attention in MCI-AD ; 2. examine the long-term effects of the optimal multiple-session tDCS protocol in MCI-AD on visual attention including the transfer to an ecologically valid virtual environment and identify the neural underpinnings of tDCS-induced behavioral aftereffects using a combined tDCS/ MRI network-based approach.
- Keywords
- alzheimerova choroba, mírná kognitivní porucha, mild cognitive impairment, plasticita mozku, neinvazivní mozková stimulace, tDCS, fMRI, DTI, lidský mozek, funkční konektivita, Alzheimer’s disease, brain plasticity, noninvasive brain stimulation, tDCS, fMRI, DTI, human brain, functional connectivity,
- NML Publication type
- závěrečné zprávy o řešení grantu AZV MZ ČR
T-cell receptor (TR) diversity of the variable domains is generated by recombination of both the alpha (TRA) and beta (TRB) chains. The textbook process of TRB chain production starts with TRBD and TRBJ gene rearrangement, followed by the rearrangement of a TRBV gene to the partially rearranged D-J gene. Unsuccessful V-D-J TRB rearrangements lead to apoptosis of the cell. Here, we performed deep sequencing of the poorly explored pool of partial TRBD1-TRBD2 rearrangements in T-cell genomic DNA. We reconstructed full repertoires of human partial TRBD1-TRBD2 rearrangements using novel sequencing and validated them by detecting V-D-J recombination-specific byproducts: excision circles containing the recombination signal (RS) joint 5'D2-RS - 3'D1-RS. Identified rearrangements were in compliance with the classical 12/23 rule, common for humans, rats, and mice and contained typical V-D-J recombination footprints. Interestingly, we detected a bimodal distribution of D-D junctions indicating two active recombination sites producing long and short D-D rearrangements. Long TRB D-D rearrangements with two D-regions are coding joints D1-D2 remaining classically on the chromosome. The short TRB D-D rearrangements with no D-region are signal joints, the coding joint D1-D2 being excised from the chromosome. They both contribute to the TRB V-(D)-J combinatorial diversity. Indeed, short D-D rearrangements may be followed by direct V-J2 recombination. Long D-D rearrangements may recombine further with J2 and V genes forming partial D1-D2-J2 and then complete V-D1-D2-J2 rearrangement. Productive TRB V-D1-D2-J2 chains are present and expressed in thousands of clones of human antigen-experienced memory T cells proving their capacity for antigen recognition and actual participation in the immune response.
- MeSH
- Apoptosis * MeSH
- Clone Cells MeSH
- Chromosome Aberrations MeSH
- Genes, T-Cell Receptor beta * MeSH
- Rats MeSH
- Humans MeSH
- Mice MeSH
- Memory T Cells MeSH
- V(D)J Recombination * MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Humans MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
The article introduces an original VR-based experiment which explores context-dependent memory recall in humans. It specifically examines the recall of correct and falsely induced semantic memories. With the aid of VR head-mounted displays, 92 students of psychology were placed in a computer-generated indoor virtual environment and asked to memorize the presented lists of words. Afterwards, the participants were placed in the same indoor virtual environment or an alternative outdoor virtual environment and asked to recall the words. The number of correct and falsely induced words was then measured. On average, women recalled significantly more correct words from the list than men, regardless of the environmental context. Despite the assumptions, we did not observe a separate effect of exposure to different environments during learning and recall of material on memory performance. Likewise, we did not detect any effects of the learning context or biological sex in the case of the production of false memories. These results provide a novel insight into previous knowledge regarding the memory processes that occur in virtual environments. Although we failed to confirm the role of context in recalling learned material in general, we found a hint that this context might interact with specific memory processes of biological sexes. However, the design of this study only captured the effect of changing the environment during memory recall and did not address the role of specific context in remembering learning material. Further research is therefore needed to better investigate these phenomena and examine the role of biological sex in context-dependent memory processes.
- MeSH
- Cognition MeSH
- Humans MeSH
- Memory * MeSH
- Repression, Psychology MeSH
- Mental Recall MeSH
- Learning * MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH