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E Růzicka

Publications and source records attributed to E Růzicka.

At least 19 recordsLinked to original sources
PubMed2005

[Organ changes induced by ergot derivative dopamine agonist drugs: time to change treatment guidelines in Parkinson's disease?].

Ergot derivative dopamine agonists, e.g. pergolide, bromocriptine, dihydroergocriptine used in treatment of Parkinson's disease can cause pleural, pericardial, retroperitoneal and valvular fibrotic changes. Case No 1: A 56-year-old woman with PD was treated with pergolide 3mg/24h since July 2002. In June 2003, edema of lower extremities was first noticed and echocardiography found a minor mitral regurgitation without any morphological changes of the valve. In January 2004, left- sided cardiac failure rapidly developed and echocardiography revealed multivalvular insufficiency with predominating severe mitral regurgitation. Mitral valve replacement was performed and pergolide was changed to ropinirole. Until now, neither cardiac functions nor motor status are sufficiently compensated. Case No 2: A 66-year-old-man with PD since 1996 was treated with pergolide 3 mg/day since 1999. In the beginning of 2004, leg edema appeared. On examination, bilateral hydronephrosis with ureteric strictures and incipient renal insufficiency was found. Bilateral ureteroplasty was performed and the histology showed periureteric fibrosis. Treatment with steroids was initiated and pergolide was changed to pramipexole. Despite the treatment, the fibrosis progressed, requiring ureteral stenting. Based on the literature review and on our own experience, we propose following guidelines to minimize the risk of complications: A. Not to use EAD as the first-line dopamine agonists. B. Regularly follow all patients treated with EAD, especially monitor the majorsymptoms: dyspnea, cough, fatigue, leg edema (also asymmetric), symptoms of urinary outflow obstruction, cardiac insufficiency, chest pain, heart murmur. An elevated ESR, C-reactive protein or anemia support the diagnosis. C. All symptomatic patients should undergo workup for serosal fibrosis (according to type of complication): chest X-ray or CT scan, spirometry, renal functions, renal ultrasound, CT of retroperitoneum. D. Before the introduction of EAD therapy, examine the renal functions, perform chest X-ray and echocardiography. Screening echocardiography should be performed in 3-6 months and subsequently in every 6-12 months.

Aged↗
PubMed2002

Rat spatial memory tasks adapted for humans: characterization in subjects with intact brain and subjects with selective medial temporal lobe thermal lesions.

In the present paper we describe five tests, 3 of which were designed to be similar to tasks used with rodents. Results obtained from control subjects, patients with selective thermo-coagulation lesions to the medial temporal lobe and results from non-human primates and rodents are discussed. The tests involve memory for spatial locations acquired by moving around in a room, memory for objects subjects interacted with, or memory for objects and their locations. Two of the spatial memory tasks were designed specifically as analogs of the Morris water task and the 8-arm radial-maze tasks used with rats. The Morris water task was modeled by hiding a sensor under the carpet of a room (Invisible Sensor Task). Subjects had to learn its location by using an array of visual cues available in the room. A path integration task was developed in order to study the non-visual acquisition of a cognitive representation of the spatial location of objects. In the non-visual spatial memory task, we blindfolded subjects and led them to a room where they had to find 3 objects and remember their locations. We designed an object location task by placing 4 objects in a room that subjects observed for later recall of their locations. A recognition task, and a novelty detection task were given subsequent to the recall task. An 8-arm radial-maze was recreated by placing stands at equal distance from each other around the room, and asking subjects to visit each stand once, from a central point. A non-spatial working memory task was designed to be the non-spatial equivalent of the radial maze. Search paths recorded on the first trial of the Invisible Sensor Task, when subjects search for the target by trial and error are reported. An analysis of the search paths revealed that patients with lesions to the right or left hippocampus or parahippocampal cortex employed the same type of search strategies as normal controls did, showing similarities and differences to the search behavior recorded in rats. Interestingly, patients with lesions that included the right parahippocampal cortex were impaired relative to patients with lesions to the right hippocampus that spared the parahippocampal cortex, when recall of the sensor was tested after a 30 min delay (Bohbot et al. 1998). No differences were obtained between control subjects and patients with selective thermal lesions to the medial temporal lobe, when tested on the radial-maze, the non-spatial analogue to the radial-maze and the path integration tasks. Differences in methodological procedures, learning strategies and lesion location could account for some of the discrepant results between humans and non-human species. Patients with lesions to the right hippocampus, irrespective of whether the right parahippocampal cortex was spared or damaged, had difficulties remembering the particular configuration and identity of objects in the novelty detection of the object location task. This supports the role of the human right hippocampus for spatial memory, in this case, involving memory for the location of elements in the room; learning known to require the hippocampus in the rat.

Adolescent↗
PubMed2001

Functional magnetic resonance imaging during deep brain stimulation: a pilot study in four patients with Parkinson's disease.

Functional magnetic resonance imaging (fMRI) was performed in patients with Parkinson's disease during deep brain stimulation of the subthalamic nucleus (three patients) and during deep brain stimulation of the ventral intermedius nucleus of the thalamus (one patient). All showed an increase in blood oxygenation level-dependent signal in the subcortical regions ipsilateral to the stimulated nucleus. This effect cannot be simply explained by a mechanism of depolarization blockade; rather, it is caused by overstimulation of the target nucleus, resulting in the suppression of its spontaneous activity. We confirm that fMRI during deep brain stimulation is a safe method with considerable potential for elucidating the functional connectivity of the stimulated nuclei.

Brain↗
PubMed2001

Colour discrimination impairment is not a reliable early marker of Parkinson's disease.

Disturbances of colour visual discrimination have been shown to occur frequently in Parkinson's disease (PD). To verify the potential utility of reduced colour sensitivity as a diagnostic marker of early PD, we examined 14 PD patients, mean age 55.4 years, disease duration 2.3 years, in Hoehn and Yahr stages 1, 1.5, or 2, previously untreated with levodopa. Colour discrimination was measured with the Farnsworth-Munsell 100-hue test in patients who were compared with age-matched controls. The examinations were performed under standard conditions in a room illuminated by a daylight lamp Biolux Osram 6500 K. The mean total error score (MTES) and partial error scores (green-yellow and red-green axis) were calculated for every person examined. No significant differences were found between PD patients (MTES 49.1 +/- SD 37) and controls (MTES 37.9 +/- SD 25). Similarly, the mean partial scores were not significantly elevated in PD patients. We found an elevation of error scores exceeding the upper limit of normality (control mean + 2SD) only in three patients. We conclude that colour visual discrimination is not consistently impaired in early stages of PD and does not appear as a reliable early marker of Parkinson's disease.

Adult↗
PubMed2001

Investigation of non-linear properties of multichannel EEG in the early stages of Parkinson's disease.

OBJECTIVES: Modifications of brain activity in the early stages of Parkinson's disease (PD) are difficult to detect using electroencephalography (EEG) signals and are often biased by L-DOPA treatment. We compare here the performances of both linear and non-linear methods in differentiating EEG of L-DOPA naive PD patients from that of control subjects. METHODS: Resting multichannel EEG (20 electrodes, 30 s epochs) of 9 patients with PD in Hoehn and Yahr stages 1-2 (4 women, 5 men, mean age 54.3 years, range 48-63 years) were compared with those of 9 control subjects (7 women, two men, mean age 51.3 years, range 43-61 years). The following measurements were computed: theta-, alpha- and beta-band relative powers constituted the linear indices; localized entropy, slope asymmetry and number of non-linear EEG segments constituted the non-linear indices. RESULTS: In the case of linear quantification, only a decrease in the beta-band was observed for patients. Significant non-linear structures were observed in our EEG data. Non-linear quantifiers demonstrate an increase in entropy and in the number of non-linear EEG segments for the patients. CONCLUSIONS: Changes in EEG dynamics observed here in L-DOPA naive PD patients may represent early signs of cortical dysfunction produced by subcortical dopamine depletion.

Algorithms↗
PubMed2001

Electromagnetic field of mobile phones affects visual event related potential in patients with narcolepsy.

The effects of the mobile phone (MP) electromagnetic fields on electroencephalography (EEG) and event-related potentials (ERP) were examined. With regard to the reported effects of MP on sleep, 22 patients with narcolepsy-cataplexy were exposed or sham exposed for 45 min to the MP (900 MHz, specific absorption rate 0.06 W/kg) placed close to the right ear in a double blind study. There were no changes of the EEG recorded after the MP exposure. A subgroup of 17 patients was studied on visual ERP recorded during the MP exposure. Using an adapted "odd-ball" paradigm, each patient was instructed to strike a key whenever rare target stimuli were presented. There were three variants of target stimuli (horizontal stripes in (i) left, (ii) right hemifields or (iii) whole field of the screen). The exposure enhanced the positivity of the ERP endogenous complex solely in response to target stimuli in the right hemifield of the screen (P < 0.01). The reaction time was shortened by 20 ms in response to all target stimuli (P < 0.05). In conclusion, the electromagnetic field of MP may suppress the excessive sleepiness and improve performance while solving a monotonous cognitive task requiring sustained attention and vigilance.

Brain Mapping↗
PubMed2000

[Effect of normalization of an isolated increase in TSH on the neuropsychological profile of patients].

BACKGROUND: Isolated TSH increase--"subclinical hypothyreosis" (SH) appears to be comparatively common. Its incidence among women over sixty has been estimated up to 17%. Though SH was assumed to be entirely asymptomatic, recent findings revealed various fine subjective and objective symptoms of the disease. METHODS AND RESULTS: Twenty otherwise healthy female patients with SH diagnosis were examined. Using personality questionnaire MMPI/100 eight different clinical scales and two control scales were evaluated, using Wechsler's memory scale WM-R 5 memory quotients were tested. The group was randomised into a subgroup treated for six month with placebo and a subgroup where thyroxin was administrated and thyroidal test normalised. Psychological testing repeated before and after the treatment, results evaluated using paired t-test. Results indicate that: 1. Patients with SH did not differ in personality features, they only had a higher tendency to the depressive mood, which could be positively influenced by thyroxin (significance at 5% level). 2. Thyroxin treatment brought about improvement of some cognitive parameters of the verbal (p < 0.01), visual (p < 0.05), and general memory (p < 0.01). 3. Results of psychological and cognitive tests correlate better with FT4 than TSH level. CONCLUSIONS: Though SH cannot be associated with changes in personality features, TSH normalisation results in statistically significant improvement of cognitive function--verbal, visual and general memory.

Cognition↗
PubMed2000

Amantadine infusion in treatment of motor fluctuations and dyskinesias in Parkinson's disease.

Efficiency and safety of amantadine sulfate (AMS) infusions were investigated in late stage complications of Parkinson's disease (PD). In an open-label study, 21 PD patients suffering from motor fluctuations and/or dyskinesias were administered AMS infusions (PK-Merz, 400 mg per day) during seven days. Oral AMS treatment followed. Significant improvement of UPDRS motor scores was observed between day 0 and day 7, remaining improved until day 21. Based on patients' diary notes, both severity and occurrence of hypokinetic "off" state significantly decreased (from 6.6 to 3.1 hours, p < 0.001, average "off" time per day) as well as dopaminergic-induced dyskinesias (from 2.5 to 1.3 hours, p < 0.05, average duration of dyskinesias per day). AMS infusions followed by oral administration appeared as a safe method for improvement of both motor fluctuations and dyskinesias in advanced PD. In advantage to simple oral therapy, AMS infusions allowed fast introduction of a profound and durable treatment effect.

Administration, Oral↗
PubMed1999

[Various manifestations of the A8344G mtDNA heteroplasmic mutation in 4 families with the MERRF syndrome].

BACKGROUND: The most frequent manifestation of mitochondrial DNA (mtDNA) mutation 8344 A-->G is MERRF syndrome (Myoclonic Epilepsy and Myopathy with Ragged Red Fibres). Less frequent symptoms include ataxia, perceptive type of deafness, cardiomyopathy or external ophthalmoplegia and mental and motor retardation in children. We describe heterogeneity of clinical symptoms and results of biochemical and molecular investigations in four families with the heteroplasmic mutation 8344 A-->G in mtDNA. METHODS AND RESULTS: In co-operation with paediatric, neurological and genetic specialists from the Czech and Slovak Republic we found in 1993-1998 at the enzymatic or molecular level more than 90 children and adults with impaired mitochondrial energy metabolism. Heteroplasmic mutation 8344 A-->G in mtDNA was found in four families. Ataxia and progressive muscle weakness appeared in the first proband with 50% of mutated copies of mtDNA in muscle at the age of 30 years. The second proband with 95% of mutated mtDNA had his first clinical symptoms--muscle hypotonia, cardiomyopathy and mental and motor retardation--in infancy while his four relatives with 25-50% mutated mtDNA lack so far clinical symptoms. In a female from the third family with 50% mutated mtDNA in muscle the disease manifested at the age of 42 years with progressive external ophthalmoplegia (PEO) and muscle weakness. In the fourth proband with 50% of mutated mtDNA in blood the disease started in infancy with spastic quadruparesis and arrested mental and motor development. Enzymatic and histochemical investigation in muscle biopsy in two probands revealed lower cytochrom c oxidase activity. Ragged-red fibres were found only in one adult patient. CONCLUSIONS: MtDNA mutation 8344 A-->G can manifest by heterogeneous symptoms. A higher percentage of mutated mtDNA is usually associated with more serious forms of the disease, but there is not always a correlation between the degree of heteroplasmy and severity of the disease or the age of the first clinical symptoms.

Adult↗
PubMed1999

Huntington's disease: the relationship between clinical signs, CAG repeats and the atrophy of the caudate nucleus in CT scans.

We compared clinical data from 45 patients with Huntington's Disease (HD) with CAG triplet repeats and the planimetric measurement of the caudate nucleus head area (CNHA) in CT scans. The mean age of patients was 50.4 yrs (SD +/- 10.2), the mean duration of HD 7.4 yrs (4.6), the mean age at the onset of HD 43.1 yrs (11.1). HD started with motor symptoms in 28 patients, with psychiatric symptoms in 14 patients, the history was unknown in 3 patients. The paternal transmission was observed in 29 patients, the maternal one in 12 patients, unknown in 4 patients. The mean number of CAG repeats was 46.6 (6.1). The mean CNHA was 0.4 cm2 (0.1). We found statistically significant reversed correlation between CAG repeats and the age at the onset of HD (p < 0.0001, r -0.6). The earlier onset of HD in patients with the paternal transmission compared to the maternal one was found statistically significant (p < 0.05). This phenomenon was not related to the larger number of CAG triplets in patients with the paternal transmission. No differences either of the age at the onset of HD or numbers of CAG repeats were found between subgroups of HD patients starting with motor or psychiatric symptoms. We also observed the significant reversed correlation between the duration of HD and CNHA measurement (p < 0.001, r -0.5). Even in the earliest stage of HD patients showed the marked atrophy of CNHA.

Atrophy↗
PubMed1999

The effects of apomorphine on attentional processing in Parkinson's disease.

To ascertain whether variations in central dopaminergic transmission can differentially affect motor and cognitive processing, we studied the effects of apomorphine (APO) in 9 patients with Parkinson's disease (PD). The UPDRS motor scores and auditory event-related potentials (ERPs) obtained in the 'odd-ball' (OB) and in the 'covert orientation of attention' (COA) tasks were studied in the 'off' and in the 'on' state after an injection of APO. Although APO injection improved patients' motor status, it induced a significant increase in the latencies of the P2 and P3 ERP components in the OB. In the COA task, right-hand reaction times (RTs) were markedly shortened in the 'on' state while left hand RTs remained unchanged. The contrasting effects of dopaminergic stimulation on the motor performance and on some aspects of cognitive processing suggest the existence of complex interactions within pre- and postsynaptic brain dopamine receptors, and an intervention of segregated basal ganglia-prefrontal cortex loops in motor and cognitive behaviour.

Adult↗
PubMed1998

Object location learning and non-spatial working memory of patients with Parkinson's disease may be preserved in "real life" situations.

The presence of a spatial memory deficit in Parkinson's disease (PD) is still a matter of discussion. Nineteen PD patients and 16 controls were given two spatial tests and a non-spatial task. First, the subject was led into a room containing 4 objects and had 10 s to memorize their location. After being led outside, the subject had to place icons representing the objects on a map of the room. Differences between the real and estimated locations were evaluated. Afterwards, the subject had to choose a map showing the correct arrangement of objects from 4 alternatives. Locations of some objects were changed before the second test. The subject had 10 s to detect these changes. One point was given for each change or its absence detected. In the non-spatial working memory task, 8 cards of different shapes were used. The subject had to select a different card each time while the cards were shuffled between choices. Errors consisted of selecting previously chosen cards. The means of the above measures for both groups were compared. Absence of any significant differences suggests that PD patients perform well in "real life" memory tests in contrast to similar computerized tests.

Aged↗
PubMed1997

[Tics and Tourette's syndrome].

This article is reviewing current knowledge of Tourette's syndrome (TS) including its clinical picture, pathophysiology, genetics and treatment. The semiology of TS is characterized with various types of motor and vocal tics and associated pathological behaviors as attention deficit hyperactivity disorder and obsessive-compulsive disorder. Recent pathophysiological and genetic data confirm organic character of the condition. Treatment strategies are proposed with regard to prevailing type of symptoms.

Diagnosis, Differential↗