Epilepsie postihuje asi 0,5–1,5 % populace, z čehož přibližně 30 % pacientů vykazuje farmakorezistenci. Význam MR v diagnostice spočívá zejména v odhalení strukturální etiologie onemocnění, zhodnocení prognózy pacienta a limitovaně i v plánování odpovídající léčby. Navzdory technologickému pokroku v přístrojovém a technickém vybavení zdravotnických pracovišť panuje velká nejednotnost v oblasti protokolů MR využívaných ke strukturálnímu zobrazení mozku u pacientů s epilepsií. Cílem našeho sdělení je doporučení standardizovaného MR protokolu strukturálního zobrazení mozku u pacientů s epilepsií, které vychází ze současných mezinárodních doporučení. Jeho široká implementace umožní v České republice nastavit jednotnou platformu neurozobrazení v těchto indikacích.
Epilepsy affects about 0.5-1.5% of the population, of which approximately 30% of patients are drug-resistant. The importance of MRI in diagnosis lies mainly in the detection of structural etiology of the disease, assessing the patient‘s prognosis and, to a limited extent, planning appropriate treatment. Despite technological advances and technical equipment in medical centers, there is a considerable inconsistency in the MRI protocols used for structural brain imaging in patients with epilepsy. We aim to recommend a standardized MR structural brain imaging protocol for patients with epilepsy based on current international recommendations. Its widespread implementation will enable the establishment of a unified neuroimaging platform in the Czech Republic for these indications.
- Klíčová slova
- strukturální zobrazení mozku,
- MeSH
- epilepsie * diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- neurozobrazování metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Objectives. The Social Responsiveness Scale (SRS) and the Empathizing/Systemizing Quotient (EQ/SQ) scale are both used for the assessment of individuals with autism spectrum disorder (ASD). This study aimed to investigate the use of both scales to assess another neurodevelopmental disorder, namely developmental dysphasia (DD). Additionally, we examined differences in social, empathetic, and systemizing characteristics between ASD and DD groups. Sample and settings. The authors examined 103 children with (1) ASD (n = 30, mean age 8.4 ± 2.6 years), (2) DD (n = 35, mean age 8.9 ± 2.3 years), and (3) healthy control children (HC; n = 38, mean age 9.2 ± 1.6 years) using the SRS and EQ/SQ assessments. Subjects with additional psychiatric diagnoses, e.g., intellectual disabilities and/or genetic syndromes, were excluded from the study. Statistical analysis. Descriptive statistics, one-way ANOVA, chi-square test, and Kruskal-Wallis test with the Bonferroni correction were used. Hypotheses. The null hypothesis was that there are no significant differences between the ASD, DD and HC subgroups on the Social Responsiveness Scale and on the Empathizing/Systemizing Quotients. Results. There were statistically significant differences on the SRS between the ASD, DD, and HC groups (97.0 vs. 52.0 vs. 29.0, p<0.001). Differences in EQ scores were also significant between the groups in total (17.0 vs. 30.0 vs. 35.0, p<0.001); however, post-hoc tests did not confirm a significant difference between the DD and HC groups. There were no statistically significant differences on the SQ score between the groups. Limitations. The gender imbalance of our subgroups and the relatively small sample size of our study were the main limitations of our study.
Přehledný referát prezentuje současné poznatky o vývojové dysfázii, méně známé neurovývojové poruše, jejíž prevalenci a závažnost lze srovnat s poruchou s deficitem pozornosti a hyperaktivitou. Seznamuje s důsledky v akademickém, sociálním a emocionálním vývoji, se změnami i zavádějícími chybami v terminologii. Zmiňuje silné genetické pozadí i další etiologické činitele, které vedou ke strukturálním změnám mozku. Na popis klinického obrazu navazuje výčet komorbidních poruch, se kterými se překrývá. Porucha autistického spektra je zmiňována jak v této souvislosti, tak v části o diferenciální diagnostice. Příspěvek přináší komplexnější pohled na možnosti současné diagnostiky a léčby. Část je zpracována podle aktuálního konsenzu mezinárodního fóra v anglofonních zemích.
The review article presents current knowledge of developmental dysphasia, a lesser-known neurodevelopmental disorder, which prevalence and seriousness can be compared to attention deficit / hyperactivity disorder. It acquaints the consequences of the disorder in academic, social, and emotional development, with changes and misleading errors in the terminology. It refers to a strong genetic background and the other etiological factors that lead to structural changes in the brain. The description of the clinical picture is followed by the enumeration of overlapping co-morbid disorders. Autism spectrum disorder is mentioned both in this connection and in the chapter on differential diagnosis. The contribution brings more complex view of diagnostics and treatment. The part is compiled in accordance with a recent consensus from a significant international forum in English speaking countries.
- Klíčová slova
- vývojová dysfázie, vývojová porucha jazyka, jazykový konektom,
- MeSH
- afázie * diagnóza patofyziologie MeSH
- diagnostické techniky a postupy MeSH
- dítě MeSH
- lidé MeSH
- neurovývojové poruchy * diagnóza patofyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- hyperaktivita,
- MeSH
- autistická porucha diagnóza MeSH
- centrální nervový systém růst a vývoj MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- lidé MeSH
- nemoci centrálního nervového systému klasifikace vrozené MeSH
- nemoci mozku diagnostické zobrazování diagnóza klasifikace patologie MeSH
- neurovývojové poruchy * diagnóza klasifikace patologie MeSH
- neurulace MeSH
- poruchy autistického spektra diagnóza MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
Background: We aimed first to describe trends in cognitive performance over time in a large patient cohort (n = 203) from a single tertiary centre for paediatric epilepsy surgery over the period of 16 years divided in two (developing-pre-2011 vs. established-post-2011). Secondly, we tried to identify subgroups of epilepsy surgery candidates with distinctive epilepsy-related characteristics that associate with their pre- and post-surgical cognitive performance. Thirdly, we analysed variables affecting pre-surgical and post-surgical IQ/DQ and their change (post- vs. pre-surgical). Methods: We analysed IQ/DQ data obtained using standardized neuropsychological tests before epilepsy surgery and one year post-surgically, along with details of patient's epilepsy, epilepsy surgery and outcomes in terms of freedom from seizures. Using regression analysis, we described the trend in post-operative IQ/DQ. Cognitive outcomes and the associated epilepsy- and epilepsy surgery-related variables were compared between periods before and after 2011. Using multivariate analysis we analysed the effect of individual variables on pre- and post-operative IQ/DQ and its change. Results: Epilepsy surgery tends to improve post-surgical IQ/DQ, most significantly in patients with lower pre-surgical IQ/DQ, and post-surgical IQ/DQ strongly correlates with pre-surgical IQ/DQ (Rho = 0.888, p < 0.001). We found no significant difference in pre-, post-surgical IQ/DQ and IQ/DQ change between the periods of pre-2011 and post-2011 (p = 0.7, p = 0.469, p = 0.796, respectively). Patients with temporal or extratemporal epilepsy differed in their pre-surgical IQ/DQ (p = 0.001) and in IQ/DQ change (p = 0.002) from those with hemispheric epilepsy, with no significant difference in post-surgical IQ/DQ (p = 0.888). Groups of patients with different underlying histopathology showed significantly different pre- and post-surgical IQ/DQ (p < 0.001 and p < 0.001 respectively) but not IQ/DQ change (p = 0.345).Variables associated with severe epilepsy showed effect on cognitive performance in multivariate model. Discussion: Post-surgical IQ/DQ strongly correlates with pre-surgical IQ/DQ and greatest IQ/DQ gain occurs in patients with lower pre-surgical IQ/DQ scores. Cognitive performance was not affected by changes in paediatric epilepsy surgery practice. Pre- and post-operative cognitive performances, as well as patients' potential for cognitive recovery, are highly dependent on the underlying aetiology and epileptic syndrome.
- Publikační typ
- časopisecké články MeSH
Background: Diffusion tensor imaging (DTI) is a powerful tool for investigating brain anatomical connectivity. The aim of our study was to compare brain connectivity among children with autism spectrum disorders (ASD), developmental dysphasia (DD), and healthy controls (HC) in the following tracts: the arcuate fasciculus (AF), inferior frontal occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and uncinate fasciculus (UF). Methods: Our sample consisted of 113 children with a mean age 8.7±2.2 years (77 boys, 36 girls), divided into three subgroups: ASD (n=39), DD (n=36), and HC (n=38). The International Classification of Diseases, 10th ed. was used to make clinical diagnoses. DTI images were collected using a 1.5 T Phillips Achieva MR imaging system. Results: Detailed analyses of fractional anisotropy (FA) revealed significant differences among the ASD, DD, and HC groups in the left AF (p=0.014) and right AF (p=0.001), the left IFOF (p<0.001) and right IFOF (p<0.001), the left ILF (p<0.001) and right ILF (p<0.001), but not in the UF. Post-hoc analyses revealed three patterns of FA differences among the groups: (1) in the right AF, right IFOF, and right ILF, FA was significantly lower in the ASD group compared to the DD and HC groups; however, there was no difference in FA between DD and HC; (2) in the left AF and left IFOF, FA was significantly lower in the ASD than in the HC group, but there were no differences between DD vs HC nor DD vs ASD; and (3) in the left ILF, no difference in FA was seen between ASD and DD, but FA in both was significantly lower than in the HC. Conclusion: Microstructural white matter properties differed between ASD vs DD and HC subjects. The tract where FA impairment in ASD and DD subjects was the most similar was the left ILF.
- Publikační typ
- časopisecké články MeSH
[This corrects the article DOI: 10.3389/fneur.2018.00184.].
- Publikační typ
- časopisecké články MeSH
- tisková chyba MeSH
