BACKGROUND: Deep Brain Stimulation (DBS), applying chronic electrical stimulation of subcortical structures, is a clinical intervention applied in major neurologic disorders. In order to achieve a good clinical effect, accurate electrode placement is necessary. The primary localisation is typically based on presurgical MRI imaging, often followed by intra-operative electrophysiology recording to increase the accuracy and to compensate for brain shift, especially in cases where the surgical target is small, and there is low contrast: e.g., in Parkinson's disease (PD) and in its common target, the subthalamic nucleus (STN). METHODS: We propose a novel, fully automatic method for intra-operative surgical navigation. First, the surgical target is segmented in presurgical MRI images using a statistical shape-intensity model. Next, automated alignment with intra-operatively recorded microelectrode recordings is performed using a probabilistic model of STN electrophysiology. We apply the method to a dataset of 120 PD patients with clinical T2 1.5T images, of which 48 also had available microelectrode recordings (MER). RESULTS: The proposed segmentation method achieved STN segmentation accuracy around dice = 0.60 compared to manual segmentation. This is comparable to the state-of-the-art on low-resolution clinical MRI data. When combined with electrophysiology-based alignment, we achieved an accuracy of 0.85 for correctly including recording sites of STN-labelled MERs in the final STN volume. CONCLUSION: The proposed method combines image-based segmentation of the subthalamic nucleus with microelectrode recordings to estimate their mutual location during the surgery in a fully automated process. Apart from its potential use in clinical targeting, the method can be used to map electrophysiological properties to specific parts of the basal ganglia structures and their vicinity.
- MeSH
- elektrofyziologie MeSH
- hluboká mozková stimulace * metody MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mikroelektrody MeSH
- Parkinsonova nemoc * terapie chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Antarctica provides a unique environment for studying human adaptability, characterized by controlled conditions, limited sensory stimulation, and significant challenges in logistics and communication. This longitudinal study investigates the relationship between stress indicators, with a specific focus on mean sleep heart rate, during a COVID-19 quarantine and subsequent 83 days long summer Antarctic expedition at the J. G. Mendel Czech Antarctic Station. Our novel approach includes daily recordings of sleep heart rate and weekly assessments of emotions, stress, and sleep quality. Associations between variables were analyzed using the generalized least squares method, providing unique insights into nuances of adaptation. The results support previous findings by providing empirical evidence on the stress reducing effect of Antarctic summer expedition and highlight the importance of previous experience and positive emotions, with the novel contribution of utilizing physiological data in addition to psychological measures. High-frequency sampling and combination of psychological and physiological data addresses a crucial gap in the research of stress. This study contributes valuable knowledge to the field of psychophysiology and has implications for expedition planners, research organizations, teams in action settings, pandemic prevention protocols, global crises, and long-duration spaceflight missions. Comprehensive insights promote the well-being and success of individuals in extreme conditions.
- MeSH
- expedice * MeSH
- lidé MeSH
- longitudinální studie MeSH
- psychofyziologie MeSH
- spánek MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Antarktida MeSH
Current advances in epilepsy treatment aim to personalize and responsively adjust treatment parameters to overcome patient heterogeneity in treatment efficiency. For tailoring treatment to the individual and the current brain state, tools are required that help to identify the patient- and time-point-specific parameters of epilepsy. Computational modeling has long proven its utility in gaining mechanistic insight. Recently, the technique has been introduced as a diagnostic tool to predict individual treatment outcomes. In this article, the Wendling model, an established computational model of epilepsy dynamics, is used to automatically classify epileptic brain states in intracranial EEG from patients (n = 4) and local field potential recordings from in vitro rat data (high-potassium model of epilepsy, n = 3). Five-second signal segments are classified to four types of brain state in epilepsy (interictal, preonset, onset, ictal) by comparing a vector of signal features for each data segment to four prototypical feature vectors obtained by Wendling model simulations. The classification result is validated against expert visual assessment. Model-driven brain state classification achieved a classification performance significantly above chance level (mean sensitivity 0.99 on model data, 0.77 on rat data, 0.56 on human data in a four-way classification task). Model-driven prototypes showed similarity with data-driven prototypes, which we obtained from real data for rats and humans. Our results indicate similar electrophysiological patterns of epileptic states in the human brain and the animal model that are well-reproduced by the computational model, and captured by a key set of signal features, enabling fully automated and unsupervised brain state classification in epilepsy.
Interventional electrophysiology offers a great variety of treatment options to patients suffering from symptomatic cardiac arrhythmia. Catheter ablation of supraventricular and ventricular tachycardia has globally evolved a cornerstone in modern arrhythmia management. Complex interventional electrophysiological procedures engaging multiple ablation tools have been developed over the past decades. Fluoroscopy enabled interventional electrophysiologist throughout the years to gain profound knowledge on intracardiac anatomy and catheter movement inside the cardiac cavities and hence develop specific ablation approaches. However, the application of X-ray technologies imposes serious health risks to patients and operators. To reduce the use of fluoroscopy during interventional electrophysiological procedures to the possibly lowest degree and to establish an optimal protection of patients and operators in cases of fluoroscopy is the main goal of modern radiation management. The present manuscript gives an overview of possible strategies of fluoroscopy reduction and specific radiation protection strategies.
- Klíčová slova
- Radiation awareness, Radiation dosage reduction, Radiation protection, Ultra low-dose protocols,
- MeSH
- dávka záření MeSH
- elektrofyziologické techniky kardiologické MeSH
- fluoroskopie metody MeSH
- katetrizační ablace * MeSH
- lidé MeSH
- radiační expozice * škodlivé účinky MeSH
- srdeční arytmie terapie MeSH
- srdeční elektrofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- elektrofyziologické techniky kardiologické * MeSH
- lidé MeSH
- pohlavní dimorfismus * MeSH
- srdce fyziologie MeSH
- srdeční elektrofyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- komentáře MeSH
- úvodníky MeSH
A selection of the most important changes in recent ADA guidelines on diabetes screening, diagnosis, pharmacotherapy, or technologies in 2022.
- Klíčová slova
- diabetes, guidelines, heart failure, pharmacotherapy, technology,
- MeSH
- diabetes mellitus * diagnóza terapie MeSH
- endokrinologie * MeSH
- lidé MeSH
- společnosti lékařské MeSH
- standardní péče MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Pituitary incidentaloma are being accidentally found during imaging procedures in approximately 10% of normal population. Facing pituitary incidentalomas endocrinologists have to decide about further management based on the assessment of hormonal activity, aetiology, size, and possible compressive symptoms. Treatment of choice for prolactinomas is medical therapy. Surgical treatment is a treatment of choice for other hormonally active tumours and in case of complications as defects of visual field, pituitary apoplexy with compressive symptoms, ophthalmoplegia respectively. Tumour not indicated for surgical treatment are followed-up by imaging techniques and in indicated cases also by endocrinological or visual field evaluation.
- Klíčová slova
- diagnosis, follow‑up, incidentaloma, monitoring, pituitary, therapy, tumor, tumours, type 2 diabetes,
- MeSH
- adenom * diagnóza MeSH
- apoplexie hypofýzy * diagnóza etiologie terapie MeSH
- endokrinologie * MeSH
- lidé MeSH
- nádory hypofýzy * komplikace diagnóza MeSH
- prolaktinom * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
This review article introduces the basic principles of infants' neurophysiology, while summarizing the core knowledge of the anatomical structure of the auditory pathway, and presents previous findings on newborns' neural speech processing and suggests their possible applications for clinical practice. In order to tap into the functioning of the auditory pathway in newborns, recent approaches have employed electrophysiological techniques that measure electrical activity of the brain. The neural processing of an incoming auditory stimulus is objectively reflected by means of auditory event-related potentials. The newborn's nervous system processes the incoming sound, and the associated electrical activity of the brain is measured and extracted as components characterized by amplitude, latency, and polarity. Based on the parameters of event-related potentials, it is possible to assess the maturity of a child's brain, or to identify a pathology that needs to be treated or mitigated. For instance, in children with a cochlear implant, auditory event-related potentials are employed to evaluate an outcome of the implantation procedure and to monitor the development of hearing. Event-related potentials turn out to be an irreplaceable part of neurodevelopmental care for high-risk children e.g., preterm babies, children with learning disabilities, autism and many other risk factors.
- Klíčová slova
- auditory pathway, cortical auditory evoked potentials, learning disabilities, maturation of the central nervous system, newborns,
- MeSH
- dítě MeSH
- kochleární implantáty * MeSH
- kognice MeSH
- kojenec MeSH
- lidé MeSH
- mozek MeSH
- neurofyziologie * MeSH
- novorozenec MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Cardiac arrhythmias are a major cause of death and disability. A large number of experimental cell and animal models have been developed to study arrhythmogenic diseases. These models have provided important insights into the underlying arrhythmia mechanisms and translational options for their therapeutic management. This position paper from the ESC Working Group on Cardiac Cellular Electrophysiology provides an overview of (i) currently available in vitro, ex vivo, and in vivo electrophysiological research methodologies, (ii) the most commonly used experimental (cellular and animal) models for cardiac arrhythmias including relevant species differences, (iii) the use of human cardiac tissue, induced pluripotent stem cell (hiPSC)-derived and in silico models to study cardiac arrhythmias, and (iv) the availability, relevance, limitations, and opportunities of these cellular and animal models to recapitulate specific acquired and inherited arrhythmogenic diseases, including atrial fibrillation, heart failure, cardiomyopathy, myocarditis, sinus node, and conduction disorders and channelopathies. By promoting a better understanding of these models and their limitations, this position paper aims to improve the quality of basic research in cardiac electrophysiology, with the ultimate goal to facilitate the clinical translation and application of basic electrophysiological research findings on arrhythmia mechanisms and therapies.
- Klíčová slova
- Animal models, Arrhythmias, Atrial fibrillation, Cardiac electrophysiology, Cellular electrophysiology, Experimental models, Ion channels, Mechanisms, Position paper,
- MeSH
- elektrofyziologické jevy MeSH
- elektrofyziologické techniky kardiologické * MeSH
- fibrilace síní * MeSH
- lidé MeSH
- srdeční elektrofyziologie MeSH
- teoretické modely MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.
- Klíčová slova
- Ambulatory ECG monitoring, Antiarrhythmic drug therapy, Antitachycardia pacing, Arrhythmogenic cardiomyopathy, Arrhythmogenic right ventricular cardiomyopathy, Asystole, Atrioventricular block, Bradycardia, Brugada syndrome, Cardiac channelopathies, Cardiac transplantation, Cardiomyopathy, Cardiovascular implantable electronic devices, Catecholaminergic polymorphic ventricular tachycardia, Children, Congenital heart disease, Coronary artery compression, ECG, Echocardiography, Endocardial lead, Epicardial lead, Expert consensus statement, Genetic arrhythmias, Heart block, Heart failure, Hypertrophic cardiomyopathy, Implantable cardioverter defibrillator, Insertable cardiac monitor, Lead extraction, Lead removal, Long QT syndrome, Low- and middle-income countries, MR imaging, Neuromuscular disease, PACES, Pacemaker, Pediatrics, Postoperative, Remote monitoring, Shared decision-making, Sick sinus syndrome, Sports and physical activity, Sudden cardiac arrest, Sudden cardiac death, Syncope, Transvenous, Ventricular fibrillation, Ventricular tachycardia,
- MeSH
- defibrilátory implantabilní * MeSH
- diagnostické techniky kardiovaskulární * MeSH
- diagnostické zobrazování MeSH
- dítě MeSH
- konsensus MeSH
- lidé MeSH
- odstranění implantátu MeSH
- srdeční elektrofyziologie normy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- směrnice pro lékařskou praxi MeSH
- Geografické názvy
- Spojené státy americké MeSH
