The initial phase of multiple sclerosis (MS), often known as clinically isolated syndrome (CIS), is a critical period for identifying individuals at high risk of progressing to full-blown MS and initiating timely treatment. In this study, we aimed to evaluate the prognostic value of C-X-C motif chemokine ligand 13 (CXCL13) and interleukin-8 (IL-8) as potential markers for CIS patients' conversion to MS. Our study encompassed patients with CIS, those with relapsing-remitting MS (RRMS), and control subjects, with sample analysis conducted on both cerebrospinal fluid (CSF) and serum. Patients were categorized into four groups: CIS-CIS (no MS development within 2 years), CIS-RRMS (conversion to RRMS within 2 years), RRMS (already diagnosed), and a control group (CG) with noninflammatory central nervous system disorders. Results showed significantly elevated levels of CXCL13 in CSF across all patient groups compared with the CG (p < 0.0001, Kruskal-Wallis test). Although CXCL13 concentrations were slightly higher in the CIS-RRMS group, statistical significance was not reached. Similarly, significantly higher levels of IL-8 were detected in CSF samples from all patient groups compared with the CG (p < 0.0001, Kruskal-Wallis test). Receiver operating characteristic analysis in the CIS-RRMS group identified both CXCL13 (area under receiver operating characteristic curve = .959) and IL-8 (area under receiver operating characteristic curve = .939) in CSF as significant predictors of CIS to RRMS conversion. In conclusion, our study suggests a trend towards elevated CSF IL-8 and CSF CXCL13 levels in CIS patients progressing to RRMS. These findings emphasize the importance of identifying prognostic markers to guide appropriate treatment strategies for individuals in the early stages of MS.

• Klíčová slova
• CXCL13, IL‐8, biomarkers, clinically isolated syndrome, multiple sclerosis,
• MeSH
• biologické markery mozkomíšní mok   krev   MeSH
• chemokin CXCL13 * mozkomíšní mok   krev   MeSH
• demyelinizační nemoci mozkomíšní mok   MeSH
• dospělí MeSH
• interleukin-8 * mozkomíšní mok   krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• prognóza MeSH
• progrese nemoci * MeSH
• relabující-remitující roztroušená skleróza * mozkomíšní mok   krev   diagnóza   MeSH
• roztroušená skleróza mozkomíšní mok   krev   diagnóza   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
• Názvy látek
• biologické markery MeSH
• chemokin CXCL13 * MeSH
• CXCL13 protein, human MeSH Prohlížeč
• CXCL8 protein, human MeSH Prohlížeč
• interleukin-8 * MeSH

BACKGROUND: The pathophysiology of abnormal temperature sensation in Parkinson's disease (PD) remains unclear. Abnormal thermal detection does not seem to depend on the dopaminergic deficit, suggesting that other systems play a role in these changes, probably both central and peripheral. METHODS: We measured thermal detection thresholds (TDT) using quantitative sensory testing (QST) in 28 patients with PD and compared them with 15 healthy controls. RESULTS: Of 28 patients, 21% had increased TDT according to the normative data. TDT were higher on the dominant side. No correlation between TDT and disease duration, severity of motor impairment, and dopaminergic therapy was observed. 50% of the patients had difficulty differentiating between warm and cold stimuli, as TDT were within the normal range in most of these patients. CONCLUSIONS: Twenty-one percent of the patients in our study had increased TDT according to the normative data. Abnormal thermal detection was more pronounced on the dominant side. Abnormal differentiation between the thermal stimuli suggest impaired central processing of thermal information.

• Klíčová slova
• Parkinson’s disease, cold detection threshold, quantitative sensory testing, warm detection threshold,
• MeSH
• čití, cítění fyziologie   MeSH
• lidé MeSH
• nízká teplota MeSH
• Parkinsonova nemoc * diagnóza   MeSH
• studie případů a kontrol MeSH
• teplota MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Parkinson's disease (PD) is characterized by typical motor symptoms. However, recent studies show several non-motor features that may precede the development of the motor symptoms of PD. The best known premotor symptoms include hyposmia, REM sleep behavior disorder (RBD), constipation, and depression; other symptoms are excessive daytime somnolence, orthostatic hypotension and symptomatic hypotension, erectile or urinary dysfunction, musculoskeletal symptoms, pain, and global cognitive deficit. In this review, we summarize currently available diagnostic methods for these symptoms. We also briefly summarize neuroimaging, polyneuropathy, peripheral markers, and cerebrospinal fluid biomarkers that may be used in the early diagnosis of PD.

• Klíčová slova
• Parkinson's disease, diagnostic methods, premotor symptoms,
• MeSH
• časná diagnóza MeSH
• kognitivní poruchy * MeSH
• lidé MeSH
• Parkinsonova nemoc * diagnóza   MeSH
• porucha chování v REM spánku * diagnóza   etiologie   MeSH
• zácpa MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Apart from the known efficacy of Botulinum Neurotoxin Type A (BoNT/A) in hyperactive striated and smooth muscles, different pain states have become potential targets of toxin effects. This present study determined the comparative toxin effectiveness in pain reduction among those patients injected with BoNT/A in muscle-based and in non-muscle-based conditions. Randomized controlled trials (RCTs) on the effect of BoNT/A on selected pain conditions were included. The conditions were spasticity and dystonia for muscle-based pain. For non-muscle-based pain, conditions included were painful diabetic neuropathy (PDN), post-herpetic neuralgia (PHN), trigeminal neuralgia (TN), complex regional pain syndrome (CRPS), and spinal cord injury (SCI). In view of possibly differing pathophysiology, myofascial pain, temporomandibular joint (TMJ), other joint or tendon pains, cervicogenic and lumbar pains, migraine and visceral pain syndromes were excluded. Standardized mean difference was used as the effect measure and computed with STATA. 25 RCTs were analyzed. Pooled estimates showed significantly lower pain score in the Treatment group (z = 5.23, p < 0.01, 95% CI = - 0.75, - 0.34). Subgroup analyses showed that BoNT/A significantly reduced both muscle-based (z = 3.78, p < 0.01, 95% CI = - 0.72, - 0.23) and non-muscle-based (z = 3.37, p = 0.001, 95% CI = - 1.00, - 0.27) pain. Meta-regression using four covariates namely dosage, route, frequency and duration was done which revealed that dosage significantly affects standardized mean differences, while the other three covariates were insignificant. The joint F-test was found to be insignificant (p value = 0.1182). The application of the model with these covariates does not significantly explain the derived heterogeneity of standardized mean differences. In conclusion, BoNT/A can be effectively used in muscle-based and non-muscle-based pain disorders. We detected no difference between the presence and magnitude of pain relief favoring muscle-based compared to non-muscle-based pain. Thus, we cannot say whether or not there might be independent mechanisms of toxin-induced pain relief for pain generated from either muscle or nerve hyperactivity.

• Klíčová slova
• BoNT/A, Botulinum neurotoxin, Muscle-based pain, Non-muscle-based pain, Pain,
• MeSH
• botulotoxiny typ A * terapeutické užití   MeSH
• dystonie * MeSH
• lidé MeSH
• nervosvalové látky * terapeutické užití   MeSH
• neuralgie * farmakoterapie   MeSH
• neurotoxiny MeSH
• svaly MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• Názvy látek
• botulotoxiny typ A * MeSH
• nervosvalové látky * MeSH
• neurotoxiny MeSH

INTRODUCTION: Neurogenic pulmonary oedema (NPE) is avery rare complication of epileptic seizures, which could potentially increase mortality. MATERIAL AND METHODS: The case of a66-year-old male patient with NPE caused by repeated epileptic seizures is reported. Rapid resolution of pulmonary oedema is well documented by X-ray and computed tomography images. CONCLUSIONS: Neurogenic pulmonary oedema could potentially increase mortality, and thus, it is important to perform achest X-ray in all patients presenting with seizures and dyspnoea.

• Klíčová slova
• epilepsy, neurogenic pulmonary oedema, seizure,
• MeSH
• centrální nervový systém patofyziologie   MeSH
• hemodynamika fyziologie   MeSH
• lidé MeSH
• nemoci centrálního nervového systému patologie   patofyziologie   MeSH
• plicní edém patologie   patofyziologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: Various cerebrospinal fluid (CSF) biomarkers are being studied to improve the sensitivity and specificity of the diagnostic methods for amyotrophic lateral sclerosis (ALS). AIMS OF THE STUDY: The aim of our study was to establish the CSF levels of chromogranin A (CgA) and phosphorylated neurofilament heavy chain (pNF-H) in patients with ALS in order to assess these proteins as possible biomarkers of ALS. METHODS: Cerebrospinal fluid levels of CgA and pNF-H were examined and mutually compared in 15 patients with sporadic ALS and 16 gender- and age-matched controls. RESULTS: Lumbar CSF CgA levels were increased in the patients with ALS compared to the controls (median 235 vs 138, P=.031). Lumbar CSF pNF-H levels were significantly increased in the patients with ALS compared to the control group (median 3091 vs 213, P<.0001). CONCLUSIONS: Identifying CSF biomarkers in ALS is important in order to establish the diagnosis in the early stages of the disease. pNF-H seems to be a good biomarker for the diagnosis of ALS. If confirmed on a larger group of patients, CgA may also become useful in the diagnosis of sporadic ALS.

• Klíčová slova
• amyotrophic lateral sclerosis, biomarkers, cerebrospinal fluid,
• MeSH
• amyotrofická laterální skleróza mozkomíšní mok   diagnóza   MeSH
• biologické markery mozkomíšní mok   MeSH
• chromogranin A mozkomíšní mok   MeSH
• fosforylace MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurofilamentové proteiny mozkomíšní mok   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• chromogranin A MeSH
• neurofilamentové proteiny MeSH

INTRODUCTION: In post-stroke spasticity, functional imaging may uncover modulation in the central sensorimotor networks associated with botulinum toxin type A (BoNT) therapy. Investigations were performed to localize brain activation changes in stroke patients treated with BoNT for upper limb spasticity using functional magnetic resonance imaging (fMRI). METHODS: Seven ischemic stroke patients (4 females; mean age 58.86) with severe hand paralysis and notable spasticity were studied. Spasticity was scored according to the modified Ashworth scale (MAS). fMRI examination was performed 3 times: before (W0) and 4 (W4) and 11weeks (W11) after BoNT. The whole-brain fMRI data were acquired during paced repetitive passive movements of the plegic hand (flexion/extension at the wrist) alternating with rest. Voxel-by-voxel statistical analysis using the General Linear Model (GLM) implemented in FSL (v6.00)/FEAT yielded group session-wise statistical maps and paired between-session contrasts, thresholded at the corrected cluster-wise significance level of p<0.05. RESULTS: As expected, BoNT transiently lowered MAS scores at W4. Across all the sessions, fMRI activation of the ipsilesional sensorimotor cortex (M1, S1, and SMA) dominated. At W4, additional clusters transiently emerged bilaterally in the cerebellum, in the contralesional sensorimotor cortex, and in the contralesional occipital cortex. Paired contrasts demonstrated significant differences W4>W0 (bilateral cerebellum and contralesional occipital cortex) and W4>W11 (ipsilesional cerebellum and SMA). The remaining paired contrast (W0>W11) showed activation decreases mainly in the ipsilesional sensorimotor cortex (M1, S1, and SMA). CONCLUSIONS: The present study confirms the feasibility of using passive hand movements to map the cerebral sensorimotor networks in patients with post-stroke arm spasticity and demonstrates that BoNT-induced spasticity relief is associated with changes in task-induced central sensorimotor activation, likely mediated by an altered afferent drive from the spasticity-affected muscles.

• Klíčová slova
• Botulinum toxin, Functional magnetic resonance imaging, Hand weakness, Neuronal plasticity, Spasticity, Stroke,
• MeSH
• botulotoxiny typ A terapeutické užití   MeSH
• cévní mozková příhoda komplikace   MeSH
• elektromyografie MeSH
• kinestezie MeSH
• kvadruplegie diagnostické zobrazování   farmakoterapie   etiologie   MeSH
• kyslík krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozková kůra diagnostické zobrazování   MeSH
• následné studie MeSH
• neparametrická statistika MeSH
• neurologické vyšetření MeSH
• neurotoxiny terapeutické užití   MeSH
• počítačové zpracování obrazu MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• botulotoxiny typ A MeSH
• kyslík MeSH
• neurotoxiny MeSH

INTRODUCTION: Clusterin, a heterodimeric glycoprotein, is thought to be involved in many cellular functions, including cell-cell interaction, cell survival and apoptosis. In the brain, post-mortem analysis has found increased clusterin associated with the pathology of many other neurodegenerative diseases (ND) such as Parkinson's disease (PD), dementia with Lewy bodies (DLB), Alzheimer's disease (AD) and multiple system atrophy (MSA). In vivo cerebrospinal fluid (CSF) levels of clusterin in ND diseases may reflect differences in the pathology and thus aid in the differential diagnosis. METHODS: CSF levels of clusterin were assessed in 102 patients with clinical manifestations of neurodegenerative diseases (23 patients with PD, 18 with PDD, 15 with DLB, 18 with AD, 16 with PSP, 12 with MSA) and 21 subjects as a control group (CG). RESULTS: Significantly higher CSF clusterin levels were found in PD compared to CG (median 6884 vs. 4484; p=0.012), DLB (median 6884 vs. 4192; p=0.023), MSA (median 6884 vs. 3606; p=0.001) and PSP (median 6884 vs. 4193; p=0.014). Significantly higher CSF clusterin levels were found in PDD compared to CG (median 8617 vs. 4484; p=0.045), DLB (median 8617 vs. 4192; p=0.025) and MSA (median 8617 vs. 3606; p=0.004). CONCLUSION: The results of the presented "feasibility" study support the role of clusterin in PD/PDD pathogenesis. Clusterin CSF levels could serve as a potential marker for PDD and DLB differentiation.

• Klíčová slova
• Alzheimer disease, CSF, Clusterin, Neurodegeneration, Parkinson's disease,
• MeSH
• biologické markery mozkomíšní mok   MeSH
• diferenciální diagnóza MeSH
• klusterin mozkomíšní mok   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurodegenerativní nemoci mozkomíšní mok   diagnóza   MeSH
• proteiny tau mozkomíšní mok   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• klusterin MeSH
• proteiny tau MeSH

BACKGROUND: Our aim was to use functional magnetic resonance imaging (fMRI) to compare brain activation changes due to botulinum toxin A (BoNT) application between two chronic stroke patient groups with different degree of weakness treated for upper limb spasticity. METHODS: Fourteen ischemic stroke patients with hand weakness and spasticity were studied. Spasticity was scored by modified Ashworth scale (MAS). FMRI was performed 3 times: before (W0) and 4 (W4) and 11 weeks (W11) after BoNT application. Group A: 7 patients (2 males, 5 females; mean age 59.14 years) with hand plegia, who imagined moving fingers. Group B: 7 age-matched patients (6 males, 1 female; mean age 59.57 years) able to perform sequential finger movement. RESULTS: BoNT transiently lowered MAS in W4 in both groups. In group A, activation of the frontal premotor cortex dominated and persisted for all three fMRI sessions whereas the ipsilesional cerebellum and cortex bordering bilateral intraparietal sulcus activation changed over time. Between-session contrasts showed treatment-related activation decreases in the mesial occipitoparietal and lateral occipital cortex. In group B, brain activation was markedly reduced after BoNT (W4). Whereas some of these areas manifested only transient reduction and expanded again at W11, in others the reduction persisted. CONCLUSION: Study of two age-matched groups with mild and severe weakness demonstrated different effects of BoNT-lowered spasticity on sensorimotor networks. Group A performing movement imagery manifested BoNT-induced reduction of activation in structures associated with visual imagery. Group B performing movement manifested reduced activation extent and reduced activation of structures outside classical motor system, suggestive of motor network normalization.

• Klíčová slova
• Botulinum toxin, Functional magnetic resonance imaging, Hand weakness, Neuronal plasticity, Spasticity, Stroke,
• MeSH
• botulotoxiny typ A farmakologie   terapeutické užití   MeSH
• cévní mozková příhoda komplikace   patofyziologie   MeSH
• dospělí MeSH
• imaginace fyziologie   MeSH
• ischemie mozku komplikace   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozková kůra účinky léků   patofyziologie   MeSH
• nervosvalové látky farmakologie   terapeutické užití   MeSH
• paralýza farmakoterapie   etiologie   patofyziologie   MeSH
• paže patofyziologie   MeSH
• pohyb účinky léků   fyziologie   MeSH
• ruka patofyziologie   MeSH
• senioři MeSH
• svalová spasticita farmakoterapie   etiologie   patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• botulotoxiny typ A MeSH
• nervosvalové látky MeSH

BACKGROUND AND PURPOSE: Botulinum toxin (BoNT) treatment relieves focal arm spasticity after stroke, likely acting at several hierarchical levels of the motor system. The central correlate of BoNT-induced spasticity relief may be detected using repeated functional MRI (fMRI) during motor task. METHODS: Five patients (4 males, 1 female, mean age 67 years) with hemiparesis and distal arm spasticity after chronic ischemic stroke were studied. FMRI was performed while moving the paretic hand in three sessions: before and 4 and 11 weeks after BoNT treatment. RESULTS: Arm spasticity significantly decreased following BoNT treatment across the group (mean modified Ashworth scale change .6). FMRI prior to BoNT treatment showed extensive bilateral active networks, whereas post-BoNT activation was limited to midline and contralateral sensorimotor cortices, and the third examination, when the toxin effect has worn off, again showed extensive activation similar to pre-BoNT examination. Post-BoNT session 2 compared to sessions 1 and 3 demonstrated a significantly less activation in contralateral frontoparietal areas including inferior frontal, postcentral, and middle frontal gyri as well as transient crossed cerebellar activation. CONCLUSION: Relief of post-stroke arm spasticity may be associated with changes at several hierarchical levels of the cortical sensorimotor system, including the prefrontal cortex.

• Klíčová slova
• Stroke, arm spasticity, botulinum toxin, finger movement, functional magnetic resonance imaging,
• MeSH
• botulotoxiny typ A terapeutické užití   MeSH
• cévní mozková příhoda komplikace   farmakoterapie   patofyziologie   MeSH
• evokované potenciály * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nervosvalové látky terapeutické užití   MeSH
• paže MeSH
• pohyb MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzorimotorický kortex účinky léků   patofyziologie   MeSH
• svalová spasticita farmakoterapie   etiologie   patofyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• botulotoxiny typ A MeSH
• nervosvalové látky MeSH