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E Růzicka

Publications and source records attributed to E Růzicka.

29 records · Page 2Linked to original sources
PubMed1996

[Mental dysfunction in Parkinson's disease].

In Parkinson's disease, mental disturbances frequently accompany the typical motor disorder. Subcortical dementia develops in 10 to 20% of patients. Contrary to the dementia of Alzheimer's type, the apraxia-aphasia-amnesia syndrome is uncommon. Depression and specific impairment of speech, visuospatial functions, and memory are present in an important proportion of patients. As a principal feature of cognitive disorder, deficit of executive functions can be characterised by decreased mental flexibility and inability to cope with changing external conditions. Further, psychiatric complications of pharmacological treatment of Parkinson's disease are briefly described. Finally, presumed pathophysiological mechanisms of cognitive dysfunction are characterized involving dopaminergic and non-dopaminergic changes and complex interactions on the subcortico-cortical level.

Cognition Disorders↗
PubMed1995

[Cognitive and visual functions in a sample of the aged population: analysis of evoked potentials].

BACKGROUND: There are significant changes of perception and cognition during aging. Goal of this study was to investigate these functions by means of evoked potentials, and to obtain normative data in older people for comparisons with cognitive disorders in the elderly. METHODS AND RESULTS: Twenty three healthy subjects (14 women and 9 men), aged 59 to 82 years (average 68 years), were examined for auditory event-related potentials (AERP) and somatosensory event-related potentials (SERP) using pattern reversal stimulation with large squares (1 degree 10') and small vertical bars (10'). The exogenous components N1 and P2 in both AERP and SERP exhibited significantly longer latencies and higher amplitude in response to target stimuli compared to an indifferent stimulus, a fact attributable to selective attention mechanisms (AERP: N1 delay 8 ms, p < 0.001; P2 delay 11 ms, p < 0.05; increase in amplitude N1/P2 2.2 microV, p < 0.01; SERP: N1 delay 8 ms, p < 0.05; P2 17 ms, p < 0.01; increase in amplitude N1/P2 8 microV, p < 0.001). As for the endogenous components N2 and P3, there were no latency differences between the two modalities (N2: p < 0.4; P3a: p < 02; P3b: p < 0.2). Significant correlations were found between P3 latencies AERP and SERP (r = 0.56, p < 0.01). N1, P2, N2 and P3b latencies of the AERP and P3a, P3b of the SERP correlated significantly with age. The average annual increase was 3.9 ms for P3b AERP (p < 0.01) and 3.2 ms for P3b SERP (p < 0.01). These values are markedly higher than the data reported by other authors for groups of lower average age. In the VEP, an age-related increase was seen in the N70 latency (0.6 ms/year, p < 0.05) and in the P100 latency (0.8 ms/year, p < 0.05) in response to the smaller bars stimulus and in the N140 latency (1.2 ms/year, p < 0.01) in response to the larger squares stimulus. CONCLUSIONS: We confirm an age-related increase in latencies of the AERP and SERP, which is markedly higher than the increase described in other studies with younger subjects. This finding is important to keep in mind in order to avoid false positives of cognitive deficits in older patients. The latencies of later components, compared with earlier components of the VEP, AERP and SERP are more dependent on age. This may suggest that there are universal aging influences on the neuronal conduction velocity. The latencies of the P3b SERP and N2 AERP were found to be correlated with the N140 VEP with the smaller bars stimulus. These findings suggest that parameters of some waves may be modulated by certain other factors than age.

Aged↗
PubMed1994

[The apomorphine test in the differential diagnosis of Parkinsonism. Initial experience].

BACKGROUND: The reactivity of postsynaptic dopamine receptors in the striatum is preserved in Parkinson's disease (PD) but not in parkinsonian syndromes of various origin (PS). Hence, the effect of dopaminergic stimulation can serve as one of the diagnostic criteria allowing to distinguish between PD and PS. The present study aimed to ascertain the clinical utility of Apomorphine (APO), a powerful short acting direct D1 and D2 receptors agonist drug, in the differential diagnosis of PD and PS. METHODS AND RESULTS: We studied 39 patients presenting parkinsonian signs. Based on clinical examination, 23 subjects (7 f, 16 m, mean age (SD) 59.2 (7.8) years were diagnosed as having probable PD, and 16 patients (5 f, 11 m, mean age 72 (7.6) yrs, p < 0.001) as having probable PS. In the PD group, mean Hoehn and Yahr degree of severity was 2.7 (1.1), mean duration of the disease 9.5 (6.2) yrs, mean duration of L-DOPA treatment (20 patients) 6.7 (5.5) yrs. In the PS group, the respective values of Hoehn and Yahr were 3.3 (0.9), mean duration of the disease 6.2 (4.1) yrs and mean duration of L-DOPA treatment (10 patients) 1.6 (1.1) yrs. After an overnight withdrawal of all other dopaminergic medication, a single subcutaneous dose of Apomorphine hydrochloride solution corresponding to 0.05 mg per kg of weight was administered. Domperidone was given 60 mg daily prior to the testing to avoid undesirable peripheral effects of APO. 20 minutes after APO administration, we noted a marked clinical improvement i.e. at least 30% decrease of pre-treatment motor score values on Columbina University Rating Scale (CURS) in 19 of 23 PD and in one of 16 PS patients. In the PD group, the difference between mean CURS values, 30.7 (19.5) before and 14.7 (10.3) after APO was highly significant (p < 0.001). In the PS group, only a slight posttreatment CURS decrease was found, 39.8 (17.5) before and 37.8 (17.5) after APO (p < 0.05). CONCLUSIONS: In individual patients, these results mostly confirm the presumed diagnosis of PD or PS. Even in the most serious cases from the PD group, the testing showed that the function of dopamine receptors in the striatum was still preserved. Thus, the Apomorphine test appears to be a helpful tool for differential diagnosis of PD and PS.

Aged↗
PubMed1994

Apomorphine induced cognitive changes in Parkinson's disease.

Auditory event related potentials (ERPs) and visual evoked potentials (VEPs) were recorded from eight patients with Parkinson's disease, before and after a single dose of apomorphine. To assess the treatment effects, the patients' motor state, Benton visual retention test (BVRT), and digit span tests were also examined. After apomorphine, although motor performance improved, the ERP latencies were delayed and the N2-P3 ERP amplitude was significantly diminished by comparison with pretreatment values. These data suggest that apomorphine induces, besides its motor effects in patients with Parkinson's disease, a slowing down of cognitive processing. Preferential stimulation of dopamine autoreceptors in mesocortical and mesolimbic systems may represent a neural mechanism for these effects. Also, the posttreatment BVRT rotation errors significantly increased, suggesting an apomorphine induced impairment of visuospatial perception.

Apomorphine↗
PubMed1992

[Botulinum toxin in the treatment of blepharospasm. Initial experience].

The clinical effects of botulinum toxin A were evaluated in eight patients with idiopathic blepharospasm and hemifacial spasm. A substantial reduction or disappearance of muscle spasms were observed after the treatment. The action of botulinum toxin became noticeable 2 days after administration with a peak effect at 2 weeks. This effect diminished with muscle spasms returning about 12 weeks after administration. No serious adverse events were noted. The treatment with botulinum toxin has become method of choice in blepharospasm, it is proposed for the management of local muscle spasms of various origin.

Adult↗
PubMedDate not supplied

Apomorphine does not influence olfactory thresholds in Parkinson's disease.

In order to verify the presumed dopaminergic basis of olfactory dysfunction in Parkinson's disease (PD), we studied olfactory functions in 12 PD patients (mean age 60.1 yrs, mean duration of PD 9.0 yrs, mean Hoehn and Yahr score 2.8) before and after apomorphine (APO) administration. Amylacetate (banana smell) in 12 sequential dilutions (in 50% steps) was used for the examination of olfactory thresholds. The testing showed no significant differences in any olfactory parameters before and after APO. Furthermore, when analysing the subgroup of 7 hyposmic PD patients, we also found no significant differences before and after APO. We therefore believe that olfactory dysfunction in PD is not dependent on dopamine deficiency.

Aged↗