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Kalisova L, Michalec J, Dechterenko F, Silhan P, Hyza M, Chlebovcova M, Brenova M, Bezdicek O. Impact of cognitive performance and negative symptoms on psychosocial functioning in Czech schizophrenia patients. Schizophrenia (Heidelb) 2023; 9:43. [PMID: 37460587 DOI: 10.1038/s41537-023-00374-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/05/2023] [Indexed: 07/20/2023]
Abstract
Schizophrenia has a profound influence on the real-life functioning of patients. There are several factors inherent to the disease course affecting the level of psychosocial functioning. Our study focused on the impact of cognitive deficit and severity of negative symptoms (i.e., the experiential domain (avolition, asociality, and anhedonia) and the expressive domain (blunted affect and alogia)) to explore psychosocial functioning in schizophrenia. Schizophrenia patients (n = 211) were tested for the presence of cognitive impairment using the NIMH-MATRICS: Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Cattery (MCCB; MATRICS Consensus Cognitive Battery) and the extent of negative symptoms using the PANSS (PANSS; Positive and Negative Syndrome Scale-selected items). The level of psychosocial functioning was measured with the Personal and Social Performance Scale (PSP). The path analysis using three regression models was used to analyse variables influencing psychosocial functioning (PSP). One of these models analyzed influence of cognitive functioning (MCCB) and negative schizophrenia symptoms (PANSS selected items reflecting expressive and experiential deficits) as predictors and NART/CRT and disease length as confounders. R2 was 0.54. The direct effect of the MCCB (β = 0.09) on the PSP was suppressed by the strong effect of the negative symptoms (β = -0.64). The presence of cognitive deficits and negative symptoms in our sample of schizophrenia patients significantly influences the level of their psychosocial functioning, a key factor in remission and recovery.
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Affiliation(s)
- L Kalisova
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - J Michalec
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic.
| | - F Dechterenko
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - P Silhan
- Department of Psychiatry, Faculty Hospital, Ostrava, Czech Republic
| | - M Hyza
- Department of Psychiatry, Faculty Hospital, Ostrava, Czech Republic
| | - M Chlebovcova
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - M Brenova
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - O Bezdicek
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
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Abstract
BACKGROUND Electroconvulsive therapy (ECT) is an effective treatment method for severe mental illnesses. ECT has gone through significant modernization. Side effects of ECT have largely decreased. Temporary disturbance of cognitive performance can be still present as a side effect of electroconvulsive treatment. METHODS Cognitive functioning in the sample of patients with severe and acute mental illness treated with electroconvulsive therapy (ECT) was assessed. Basic assessment of cognitive functions was applied in the beginning, in the middle, and at the end of ECT course treatment with the Montreal Cognitive Assessment (MoCA). Complex and detailed testing of cognitive functions using the MATRICS Consensus Cognitive Battery (MCCB) was done at two points in time - within the first week of and then 6 weeks after the end of ECT. RESULTS Participants had cognitive deficits at baseline, which were most likely influenced markedly by the psychopathology of the illness itself. The improvement in cognition came together with the reduction in psychopathology; psychopathology scores were significantly reduced during ECT treatment. Compared to the baseline, all scores for cognitive testing were significantly improved but remained low in comparison with the controls. After 6 weeks, there was further significant improvement. CONCLUSION Our results confirm the safety and efficacy of ECT in the treatment of severe mental disorders.
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Affiliation(s)
- Lucie Kalisova
- Department of Psychiatry, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic,
| | - Marketa Kubinova
- Department of Psychiatry, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic,
| | - Jiri Michalec
- Department of Psychiatry, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic,
| | - Jakub Albrecht
- Department of Psychiatry, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic,
| | - Katerina Madlova
- Department of Psychiatry, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic,
| | - Jiri Raboch
- Department of Psychiatry, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic,
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Kalisova L, Pav M, Winkler P, Michalec J, Killaspy H. Quality of care in long-term care departments in mental health facilities across the Czech Republic. Eur J Public Health 2018; 28:885-890. [DOI: 10.1093/eurpub/cky151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lucie Kalisova
- Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marek Pav
- Psychiatric Hospital Bohnice, Prague, Czech Republic
| | - Petr Winkler
- Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic
- Health Service & Population Research Department, IoPPN, King’s College London, London, UK
| | - Jiri Michalec
- Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Helen Killaspy
- Division of Psychiatry, University College London, London, UK
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Abstract
AIM The aim of this study was to assess sociodemographic factors and factors connected with treatment of mental illness and to decide whether they can influence the level of self-stigma. METHOD Sociodemographic characteristics (age, gender, family status, level of employment, level of education) and characteristics related to illness and treatment (diagnosis, length of treatment, adherence to treatment) were gathered in a group of patients in stable mental condition, without acute symptoms of mental illness. Self-stigma was measured using the Self-stigma of Mental Illness Scale - short form (SSMIS-SF). RESULTS The sample included 197 patients: 99 patients in group 1 (G1) with psychosis and 98 in group 2 (G2) with anxious and affective disorders. The average age was 44.15 ± 12.91 years, the length of illness was 11.67 ± 9.21 years and 48% of patients were men. The total average SSMIS-SF score was 61.54 ± 23.34. We found no statistically significant difference in the total level of self-stigmatisation between these groups ( t(197) = 0.77; p = .441). The level of self-stigmatisation (total score of SSMIS-SF) in patients in G1 (psychosis) increased with the length of illness r(99) = .253; p = .011. Employment status seems to correlate with the level of self-stigmatisation ( F(3, 184) = 5.27; p = .002). Patients unemployed and on disability pension had higher levels of self-stigmatisation than patients working full-time. Patients who took medication regularly (full medical adherence) had lower scores of SSMIS-SF total scores in comparison with patients with lower compliance ( t(195) = 3.476; p = .001; Cohen's d = .25). CONCLUSION According to our results, with regard to the factors that were followed, self-stigmatisation correlates with the presence of employment (social inclusion), duration of illness in patients with psychosis and treatment adherence. We did not find a statistically significant influence of age, gender, marital status or clinical diagnosis on the level of self-stigma.
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Affiliation(s)
- Lucie Kalisova
- General University Hospital and Department of Psychiatry, First Faculty of Medicine, Charles University, Prague 2, Czech Republic
| | - Jiri Michalec
- General University Hospital and Department of Psychiatry, First Faculty of Medicine, Charles University, Prague 2, Czech Republic
| | - Demetra Hadjipapanicolaou
- General University Hospital and Department of Psychiatry, First Faculty of Medicine, Charles University, Prague 2, Czech Republic
| | - Jiri Raboch
- General University Hospital and Department of Psychiatry, First Faculty of Medicine, Charles University, Prague 2, Czech Republic
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Michalec J, Bezdicek O, Nikolai T, Harsa P, Jech R, Silhan P, Hyza M, Ruzicka E, Shallice T. A Comparative Study of Tower of London Scoring Systems and Normative Data. Arch Clin Neuropsychol 2018; 32:328-338. [PMID: 28096070 DOI: 10.1093/arclin/acw111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/12/2016] [Indexed: 11/14/2022] Open
Abstract
Objective Tower of London (ToL) is a planning ability task that includes multiple versions. The original ToL was developed by Shallice together with two scoring systems (ToL-SS). Another two ToL-SS were proposed by Anderson et al. and Krikorian et al. The purpose of this study is to provide normative data for four ToL-SS and explore the effects of demographic variables on ToL performance. Furthermore, we aimed to determine the discriminative validity of these ToL-SS in clinical samples. Method Four groups were included in the study: a normative sample of healthy adults (HC; n = 298); patients with Parkinson's disease with mild cognitive impairment (PD-MCI; n = 52) and without cognitive impairment (PD-ND; n = 57); and patients with schizophrenia (SCH; n = 28). The effects of demographic variables on ToL-SS were examined in the HC group. Between-groups comparisons of ToL-SS were conducted using regression analysis with dummy codes. Results All four ToL-SS were not significantly affected by age, whereas the effect of gender and education is not consistent. ToL-SS significantly (p < .05) differentiate HC from PD-MCI and SCH. Cohen's effect size coefficients d range from 0.68 to 1.29. Internal consistency coefficients (Cronbach's α) of ToL-SS range from 0.33 to 0.60. Conclusions Despite poor to questionable internal consistency of ToL-SS, the discriminative validity and clinical utility for assessing planning deficits in PD-MCI and SCH are high. This study provides normative standards for all four ToL-SS on an adult population for use in clinical practice.
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Affiliation(s)
- Jiri Michalec
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Tomas Nikolai
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Pavel Harsa
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Robert Jech
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Petr Silhan
- Department of Psychiatry, General University Hospital in Ostrava, Ostrava, Czech Republic
| | - Martin Hyza
- Department of Psychiatry, General University Hospital in Ostrava, Ostrava, Czech Republic
| | - Evzen Ruzicka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague, Prague, Czech Republic
| | - Tim Shallice
- Institute of Cognitive Neuroscience, University College London, London, UK
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Nikolai T, Bezdicek O, Markova H, Stepankova H, Michalec J, Kopecek M, Dokoupilova M, Hort J, Vyhnalek M. Semantic verbal fluency impairment is detectable in patients with subjective cognitive decline. Appl Neuropsychol Adult 2017; 25:448-457. [PMID: 28548549 DOI: 10.1080/23279095.2017.1326047] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Patients with subjective cognitive decline (SCD) are at higher risk for conversion to dementia due to Alzheimer's disease (AD). Semantic verbal fluency (SVF) seems to be impaired in the early stages of AD. The goal of the present study was to identify the discriminative potential of verbal fluency (VF) in patients with SCD to show if very early signs of cognitive decline may be detected in SCD. We examined 93 normal controls (NC) and 61 participants with SCD. Each participant was administered a comprehensive neuropsychological battery. All participants underwent tests of VF: phonemic verbal fluency (PVF), letters K and P and SVF (animals and vegetables categories). In addition to the total score, two 30-second intervals, and clustering and switching indices in SVF were evaluated. SCD generated fewer words in the total score and 30- to 60-second interval in vegetables category and they performed more switches in animals category. There was no significant difference between the SCD and the NC groups in all other VF measures. Quantitative measures of SVF (a decreased number of vegetables) as well as qualitative measures were detected in SCD group and could be considered as an early neuropsychological marker of subtle cognitive impairment.
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Affiliation(s)
- Tomas Nikolai
- a Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague , Charles University , Prague , Czech Republic.,b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Ondrej Bezdicek
- a Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague , Charles University , Prague , Czech Republic.,c National Institute of Mental Health , Klecany , Czech Republic
| | - Hana Markova
- b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Hana Stepankova
- c National Institute of Mental Health , Klecany , Czech Republic
| | - Jiri Michalec
- e Department of Psychiatry, First Faculty of Medicine , Charles University, and General University Hospital , Prague , Czech Republic
| | - Miloslav Kopecek
- c National Institute of Mental Health , Klecany , Czech Republic
| | - Monika Dokoupilova
- a Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague , Charles University , Prague , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Jakub Hort
- b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
| | - Martin Vyhnalek
- b International Clinical Research Center , St. Anne's University Hospital Brno , Brno , Czech Republic.,d Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine , Charles University and Motol University Hospital , Prague , Czech Republic
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Bezdicek O, Michalec J, Vaneckova M, Klempir J, Liskova I, Seidl Z, Janikova B, Miovsky M, Hubacek J, Diblik P, Kuthan P, Pilin A, Kurcova I, Fenclova Z, Petrik V, Navratil T, Pelclova D, Zakharov S, Ruzicka E. Cognitive sequelae of methanol poisoning involve executive dysfunction and memory impairment in cross-sectional and long-term perspective. Alcohol 2017; 59:27-35. [PMID: 28262185 DOI: 10.1016/j.alcohol.2016.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 11/25/2016] [Accepted: 12/09/2016] [Indexed: 11/24/2022]
Abstract
Methanol poisoning leads to lesions in the basal ganglia and subcortical white matter, as well as to demyelination and atrophy of the optic nerve. However, information regarding cognitive deficits in a large methanol sample is lacking. The principal aim of the present study was to identify the cognitive sequelae of methanol poisoning and their morphological correlates. A sample of 50 patients (METH; age 48 ± 13 years), 3-8 months after methanol poisoning, and 57 control subjects (CS; age 49 ± 13 years) were administered a neuropsychological battery. Forty-six patients were followed in 2 years' perspective. Patients additionally underwent 1.5T magnetic resonance imaging (MRI). Three biochemical and toxicological metabolic markers and a questionnaire regarding alcohol abuse facilitated the classification of 24 patients with methanol poisoning without alcohol abuse (METHna) and 22 patients with methanol poisoning and alcohol abuse (METHa). All groups were compared to a control group of similar size, and matched for age, education, premorbid intelligence level, global cognitive performance, and level of depressive symptoms. Using hierarchical multiple regression we found significant differences between METH and CS, especially in executive and memory domains. METHa showed a similar pattern of cognitive impairment with generally more severe executive dysfunction. Moreover, all METH patients with extensive involvement on brain MRI (lesions in ≥2 anatomical regions) had a more severe cognitive impairment. From a longitudinal perspective, we did not find any changes in their cognitive functioning after 2 years' follow-up. Our findings suggest that methanol poisoning is associated with executive dysfunction and explicit memory impairment, supposedly due to basal ganglia dysfunction and disruption of frontostriatal circuitry proportional to the number of brain lesions, and that these changes are persistent after 2 years' follow-up.
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Bezdicek O, Nikolai T, Michalec J, Růžička F, Havránková P, Roth J, Jech R, Růžička E. The Diagnostic Accuracy of Parkinson's Disease Mild Cognitive Impairment Battery Using the Movement Disorder Society Task Force Criteria. Mov Disord Clin Pract 2016; 4:237-244. [PMID: 30363396 DOI: 10.1002/mdc3.12391] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 04/27/2016] [Accepted: 05/10/2016] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the present study was to provide empirical evidence regarding the classification accuracy of the International Parkinson and Movement Disorder Society (MDS) neuropsychological battery (NB) in the determination of Parkinson's disease mild cognitive impairment (PD-MCI). Methods The present cross-sectional study included 106 PD patients subjected to PD-MCI classification at Level I and 120 healthy controls (HCs). All HC and PD subjects were then assessed with MDS-NB at Level II and matched according to age and education using different thresholds (1.5 and 2.0 standard deviations [SDs] below average). Results We found that Level I and II resulted in different classifications of PD-MCI status. Detection thresholds of -1.5 SD and -2.0 SDs at Level II had also a significant impact on the discriminative validity of all measures in the MDS neuropsychological battery, based on area under the curve analyses. Overall, semantic fluency showed the highest potential in all comparisons not only between PD-MCI and HC, but also between PD-MCI and PD with no deficit (PD-ND). Conclusions Our results show that the battery at Level II is applicable and that some measures, such as semantic fluency, have high discriminative validity in the detection of PD-MCI versus PD-ND and HCs.
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Affiliation(s)
- Ondrej Bezdicek
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Tomas Nikolai
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Jiri Michalec
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Psychiatry Prague Czech Republic
| | - Filip Růžička
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Petra Havránková
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Jan Roth
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Robert Jech
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
| | - Evžen Růžička
- Charles University in Prague, First Faculty of Medicine and General University Hospital Department of Neurology and Center of Clinical Neuroscience Prague Czech Republic
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Bezdicek O, Lukavsky J, Stepankova H, Nikolai T, Axelrod BN, Michalec J, Růžička E, Kopecek M. The Prague Stroop Test: Normative standards in older Czech adults and discriminative validity for mild cognitive impairment in Parkinson's disease. J Clin Exp Neuropsychol 2016; 37:794-807. [PMID: 26313510 DOI: 10.1080/13803395.2015.1057106] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to provide normative data for older and very old Czech adults on the Prague Stroop Test (PST) and to test its discriminative validity in individuals with Parkinson's disease mild cognitive impairment (PD-MCI). METHOD The construction of the PST was modeled after the Victoria Stroop Test. We examined 539 participants aged 60-96 that met strict inclusion criteria. After, we compared the PST scores for a group of 45 PD-MCI patients with a healthy adult sample (HAS) of 45 age- and education-matched individuals. RESULTS I. In the non-clinical sample, robust age- and education-related influences were observed on all PST scores. No gender effect was noted. II. For clinical cases, interference condition (PST-C) was able to discriminate between PD-MCI and HAS (all scores ps < .01). Area under the curve (AUC) was 77% when a screening cut-off of ≤ 27 s was used, showing sensitivity of 82% and specificity of 53%. A more conservative diagnostic cut-off of ≤ 33 s showed sensitivity of 60% and specificity of 80%. DISCUSSION The present study provides PST normative data for basic, interference, and error scores stratified by age (60-96 years). PST appears to be a helpful tool for the diagnostics of PD-MCI especially in research settings at Level II (Litvan et al., 2012) and for PD-MCI attention/working memory and executive function subtyping.
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Affiliation(s)
- Ondrej Bezdicek
- a Department of Neurology and Centre of Clinical Neuroscience , First Faculty of Medicine and General University Hospital in Prague, Charles University in Prague , Prague , Czech Republic
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Kalisova L, Madlova K, Albrecht J, Michalec J. The use of electroconvulsive therapy (ECT) in the Czech Republic. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AimThe aim of this study was to monitor the use of electroconvulsive therapy (ECT) in the Czech Republic for the purpose of harmonizing national practice.MethodA 13-item questionnaire was sent to all Czech inpatient psychiatric facilities. This questionnaire assessed technical background of ECT, indications for the treatment, procedure in detail, way of documentation and monitoring of side effects.ResultsECT is used 23 centers (10 psychiatric hospitals, 5 university psychiatric departments and 8 psychiatric wards) across the Czech Republic. There is no special legal act regulating the use of ECT in the CR, but there are guidelines issued by the Czech Psychiatric Society available. All centers use instruments delivering brief pulse stimuli. All patients have to be indicated for this treatment and have to sign inform consent form/excluding situation when patient's life is endangered/. Somatic state is assessed/EKG, blood tests, eye check-up regularly and other examinations in individual cases/. Thiopenthal and succinylcholine are used most often for anesthesia and myorelaxation. Bitemporal electrode placement is the preferred option in all centers. The ECT is provided 2–4 times a week in special ECT rooms in the presence of staff team/psychiatrist, anesthetist, psychiatric and anesthesiological nurses/. Continuation ECT and outpatient ECT is not used. The procedure including side effects is documented in individual patient's documentation, but summarizing documentation is conducted only in some centers.ConclusionECT is widely used in the Czech Republic. Procedures in all centers follow national guidelines. There is need to improve documentation system to harmonize national practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Bezdicek O, Michalec J, Nikolai T, Havránková P, Roth J, Jech R, Růžička E. Clinical validity of the Mattis Dementia Rating Scale in differentiating mild cognitive impairment in Parkinson's disease and normative data. Dement Geriatr Cogn Disord 2015; 39:303-11. [PMID: 25792240 DOI: 10.1159/000375365] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The aim of the present study was to provide normative data and determine the validity of the Czech version of the Mattis Dementia Rating Scale 2 (czDRS-2) in screening for mild cognitive impairment in Parkinson's disease (PD-MCI) based on the Movement Disorder Society (MDS) Level II criteria. METHODS For validation purposes, 41 healthy controls (HC), 46 patients with PD-NI (Parkinson's disease, no impairment) and 41 patients with PD-MCI (all groups assessed by the MDS Level II criteria for PD-MCI) were matched according to age and education. RESULTS With screening and diagnostic cutoff scores determined at ≤139 points, the czDRS-2 showed a sensitivity of 78% and a specificity of 88% in the detection of PD-MCI versus HC and a sensitivity of 78% and a specificity of 76% in the detection of PD-MCI versus PD-NI. The AUC (95% confidence interval) for the czDRS-2 was 84% (75-93) and 82% (73-91), respectively. We report percentile values for 286 subjects from the Czech population stratified by education level. CONCLUSION Our results show that the czDRS-2 is a valid instrument at Level I for screening PD-MCI and support its construct validity and diagnostic equivalence in a cross-cultural setting.
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Affiliation(s)
- Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Jirková J, Horák Z, Sedléček R, Tichý P, Michalec J. Experimental measurements of the lumbar spine kinematics and stiffness. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Michalec J, Jardanowski R, Pykało R. [Leydigioma--rare testicular tumor diagnosed in an adult male with undescended intraabdominal testis]. Wiad Lek 1998; 50:128-31. [PMID: 9381716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Leydig cell tumours deriving from the gonadal stroma represent one per cent of all testicular tumours. They may occur at any age. Ten per cent of cases are malignant. There is no evidence that they are prone to develop in undescended testis. We report the rare case of leydigioma in 71 year old man with unilateral cryptorchidism. Only a few cases have been reported as arising from undescended testis.
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Affiliation(s)
- J Michalec
- Katedry i Kliniki Urologii Akademii Medycznej w Warszawie
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Oshima S, Komuro T, Michalec J, Kikuno M. The localization of acetylcholinesterase in the optic lobe in the developing chick embryo. Experientia 1980; 36:120-2. [PMID: 7358116 DOI: 10.1007/bf02004011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The localization of acetylcholinesterase (AChE) in the optic lobe in the developing chick embryo was studied histochemically and biochemically. The histochemical reaction of AChE increased remarkably between stage 42 and 44 especially in the neuropile. The increase of the biochemical activity of the AChE in the synaptic membrane fraction occurred at a later stage than that in the microsomal fraction. These findings can be interpreted as the result of axonal transport of the enzyme from the synthetic to the synaptic site.
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Michalec J, Nishizawa N, Nagata F, Sekiya M, Kikuno M. The in vivo effect of chloramphenicol on acetylcholinesterase and cholinergic synaptic membrane of chick embryo brain. Pharmacol Res Commun 1977; 9:927-37. [PMID: 605152 DOI: 10.1016/s0031-6989(77)80102-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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