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Pavelekova P, Necpal J, Jech R, Havrankova P, Svantnerova J, Jurkova V, Gdovinova Z, Lackova A, Han V, Winkelmann J, Zech M, Skorvanek M. Predictors of whole exome sequencing in dystonic cerebral palsy and cerebral palsy-like disorders. Parkinsonism Relat Disord 2023:105352. [PMID: 36997436 DOI: 10.1016/j.parkreldis.2023.105352] [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] [Received: 11/20/2022] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Cerebral palsy (CP) is a group of permanent disorders attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. Cerebral palsy-like (CP-like) disorders may clinically resemble CP but do not fulfill CP criteria and have often a progressive course and/or neurodevelopmental regression. To assess which patients with dystonic CP and dystonic CP-like disorder should undergo Whole Exome Sequencing (WES), we compared the rate of likely causative variants in individuals regarding their clinical picture, co-morbidities, and environmental risk factors. METHOD Individuals with early onset neurodevelopmental disorder (ND) manifesting with dystonia as a core feature were divided into CP or CP-like cohorts based on their clinical picture and disease course. Detailed clinical picture, co-morbidities, and environmental risk factors including prematurity, asphyxia, SIRS, IRDS, and cerebral bleeding were evaluated. RESULTS A total of 122 patients were included and divided into the CP group with 70 subjects (30 males; mean age 18y5m±16y6m, mean GMFCS score 3.3 ± 1.4), and the CP-like group with 52 subjects (29 males; mean age 17y7m±1y,6 m, mean GMFCS score 2,6 ± 1,5). The WES-based diagnosis was present in 19 (27.1%) CP patients and 30 CP-like patients (57.7%) with genetic conditions overlap in both groups. We found significant differences in diagnostic rate in CP individuals with vs. without risk factors (13.9% vs. 43.3%); Fisher's exact p = 0.0065. We did not observe the same tendency in CP-like (45.5% vs 58.5%); Fisher's exact p = 0.5. CONCLUSION WES is a useful diagnostic method for patients with dystonic ND, regardless of their presentation as a CP or CP-like phenotype.
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Pavelekova P, Jech R, Zech M, Krepelova A, Han V, Mosejova A, Liba Z, Urgosik D, Gdovinova Z, Havrankova P, Fecikova A, Winkelmann J, Skorvanek M. Atypical presentations of DYT1 dystonia with acute craniocervical onset. Parkinsonism Relat Disord 2021; 83:54-55. [PMID: 33476878 DOI: 10.1016/j.parkreldis.2020.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/14/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
DYT1 gene mutations lead to early-onset dystonia that begins with focal limb onset and spreads to other body regions within 5 years, with typical sparing of the oromandibular muscles. In the present study, we describe two patients with an unusual presentation of the disease.
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Affiliation(s)
- P Pavelekova
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia.
| | - R Jech
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - M Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute for Human Genetics, Technische Universität München, Munich, Germany
| | - A Krepelova
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - V Han
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia; Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
| | - A Mosejova
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia; Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
| | - Z Liba
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - D Urgosik
- Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
| | - Z Gdovinova
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia; Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
| | - P Havrankova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - A Fecikova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - J Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany; Institute for Human Genetics, Technische Universität München, Munich, Germany; Lehrstuhl für Neurogenetik, Technische Universität München, Munich, Germany; Munich Cluster for Systems Neurology, SyNergy, Munich, Germany
| | - M Skorvanek
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia; Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
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Vaclavik D, Vilionskis A, Jatuzis D, Karlinski MA, Gdovinova Z, Kõrv J, Tsivgoulis G, Mikulik R. Clinical outcome of cardioembolic stroke treated by intravenous thrombolysis. Acta Neurol Scand 2018; 137:347-355. [PMID: 29218699 DOI: 10.1111/ane.12880] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Cardioembolic stroke (CS) in patients without thrombolytic treatment is associated with a worse clinical outcome and higher mortality compared to other types of stroke. The aim of this study was to determine the clinical outcome of CS in patients treated by intravenous thrombolysis (IVT). MATERIAL AND METHODOLOGY Data of patients from the SITS-EAST register (Safe Implementation of Treatments in Stroke) were analyzed in patients who received IVT treatment from 2000 to April 2014. The effect of the stroke etiology according to ICD-10 classification on outcome was analyzed using a univariate and multivariate analysis. The outcomes were assessed as follows: excellent clinical outcome (modified Rankin scale (mRS) 0-1) at 3 months, the rate of symptomatic intracranial hemorrhage (sICH), mortality, and improvement at 24 hours after IVT. RESULTS Data of 13 772 patients were analyzed. CS represented 30% of all strokes. The mean age of patients with CS, atherothrombotic stroke, lacunar stroke, and other stroke was 70.8, 66.7, 66.2, and 63.3 years, respectively (P < .001). Severity of stroke on admission by median NIHSS score was 13 points in patients with CS, 12 points - in atherothrombotic stroke, 7 points - in lacunar stroke, and 10 points-in other stroke types (P < .001). No difference in mortality was detected among atherothrombotic and CS; however, atherothrombotic strokes had higher odds of sICH [OR = 1.63 (95% CI: 1.07-2.47), P = .023], lower odds of early improvement [OR = 0.79 (95% CI: 0.72-0.86), P < .001], and excellent clinical outcome [OR = 0.77 (95% CI: 0.67-0.87), P < .001] compared with CS. CONCLUSIONS Cardioembolic strokes are not associated with increased mortality. Patients with CS are less likely to have sICH and have better outcome after IVT.
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Affiliation(s)
- D. Vaclavik
- Department of Neurology; Ostrava Vitkovice Hospital; Agel Research and Training Institute; Ostrava Czech Republic
| | - A. Vilionskis
- Department of Neurology and Neurosurgery; Republican Vilnius University Hospital; Vilnius University; Vilnius Lithuania
| | - D. Jatuzis
- Department of Neurology and Neurosurgery; Center for Neurology; Vilnius University; Vilnius Lithuania
| | - M. A. Karlinski
- 2nd Department of Neurology; Institute of Psychiatry and Neurology; Warsaw Poland
| | - Z. Gdovinova
- Department of Neurology; L. Pasteur University Hospital in Kosice; Safarik University; Kosice Slovakia
| | - J. Kõrv
- Department of Neurology and Neurosurgery; University of Tartu; Tartu Estonia
| | - G. Tsivgoulis
- Department of Neurology; Democritus University of Thracr; Athens Greece
| | - R. Mikulik
- Department of Neurology; International Clinical Research Center; St. Anne's Hospital; Brno Czech Republic
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Skorvanek M, Gdovinova Z, Rosenberger J, Ghorbani Saeedian R, Nagyova I, Groothoff JW, van Dijk JP. The associations between fatigue, apathy, and depression in Parkinson's disease. Acta Neurol Scand 2015; 131:80-7. [PMID: 25288130 DOI: 10.1111/ane.12282] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Fatigue and apathy are two of the most common and most disabling non-motor symptoms of Parkinson's disease (PD). They have a high coincidence and can often be confused; moreover, their relationship is not fully understood. The aim of our study was to describe the coincidence of apathy with different fatigue domains in the presence/absence of depression and to separately describe the associations of different aspects of primary and secondary fatigue with apathy and other clinical and disease-related factors. MATERIALS AND METHODS A total of 151 non-demented patients with PD were examined using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Starkstein Apathy Scale, Multidimensional Fatigue Inventory (MFI), Beck Depression Inventory-II, and Epworth Sleepiness Scale. RESULTS The prevalence and severity of fatigue and apathy were significantly higher in depressed PD patients. However, our results show that depression, fatigue, and apathy can be clearly distinguished in PD. Apathy was associated with the MFI's-reduced motivation domain in both depressed and non-depressed patients. However, apathy was associated with mental fatigue aspects only in non-depressed patients, and it was not related to the physical aspects of fatigue in any of the studied groups. CONCLUSIONS Although the pathophysiology of fatigue and apathy in PD is clearly multifactorial, in a proportion of PD patients, these symptoms are associated with depression, dopaminergic depletion in the mesocorticolimbic structures, and disruption of the prefrontal cortex-basal ganglia axis. Therefore, in some PD patients, adequate management of depression and optimal dopaminergic medication may improve both fatigue and apathy.
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Affiliation(s)
- M. Skorvanek
- Department of Neurology; Safarik University; Kosice Slovak Republic
- Department of Neurology; L. Pasteur University Hospital; Kosice Slovak Republic
- Graduate School Kosice Institute for Society and Health; Safarik University; Kosice Slovak Republic
| | - Z. Gdovinova
- Department of Neurology; Safarik University; Kosice Slovak Republic
- Department of Neurology; L. Pasteur University Hospital; Kosice Slovak Republic
| | - J. Rosenberger
- Graduate School Kosice Institute for Society and Health; Safarik University; Kosice Slovak Republic
| | - R. Ghorbani Saeedian
- Graduate School Kosice Institute for Society and Health; Safarik University; Kosice Slovak Republic
- Department of Social Medicine; Institute of Public Health; Safarik University; Kosice Slovak Republic
| | - I. Nagyova
- Graduate School Kosice Institute for Society and Health; Safarik University; Kosice Slovak Republic
- Department of Social Medicine; Institute of Public Health; Safarik University; Kosice Slovak Republic
| | - J. W. Groothoff
- Department of Community and Occupational Health; University Medical Center Groningen; Groningen The Netherlands
| | - J. P. van Dijk
- Graduate School Kosice Institute for Society and Health; Safarik University; Kosice Slovak Republic
- Department of Community and Occupational Health; University Medical Center Groningen; Groningen The Netherlands
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Mikula P, Nagyova-Rajnicova I, Krokavcova M, Vitkova M, Rosenberger J, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP. The mediating effect of coping on the association between fatigue and quality of life in patients with multiple sclerosis. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.061] [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: 11/14/2022] Open
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Skorvanek M, Rosenberger J, Rajnicova I, van Dijk J, Groothoff J, Gdovinova Z. 1.048 FATIGUE IS NOT AN INDEPENDENT PREDICTOR OF MORTALITY IN PARKINSON'S DISEASE. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70162-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chylova M, van Dijk J, Rosenberger J, Nagyova I, Gavelova M, Gdovinova Z, Groothoff J. Depression, Anxiety and Health Status in Patients with Multiple Sclerosis. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71134-4] [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: 11/30/2022] Open
Abstract
Aims:Multiple sclerosis (MS) is the most common cause of neurological disability in young adults and is frequently accompanied by symptoms of depression and anxiety. The aim of this study was to explore the association of depression and anxiety with health status in younger and older MS patients.Method:223 MS patients (67.3% female; mean age 38.9±10.8 years; mean disease duration 5.8±5.2 years) were divided into younger and older age groups (< 45 and ≥45 years). They completed questionnaires focusing on sociodemographic data, depression and anxiety (HADS), and physical and mental health status (SF-36). Functional disability (EDSS) was assessed by a neurologist. To analyse the data, a U-test and multiple linear regression analyses were performed.Results:A model consisting of age, gender, marital status, EDSS, depression and anxiety explained 46.6% of the variance in physical health status and 60.8% of the variance in mental health status (p≤.001). Depression was a significant predictor of physical health status in older MS patients and was associated with mental health status in both age groups (p≤0.001). Anxiety was related to worse physical and mental health status in younger MS patients, but not in the older ones.Conclusion:Depression in MS patients is associated with mental health status and with physical health status only in the older group; anxiety is associated only in younger MS patients with regard to their health status. Psychiatric diagnostics focusing on depression and anxiety might be important for treatment of MS patients in order to contribute to improving a patient's health status.
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Gdovinova Z, Feketeova E, Szilasiova J, Havlikova E, Banik P. Meningeal carcinomatosis as the first manifestation of malignant carcinomatosis. BRATISL MED J 2009; 110:490-495. [PMID: 19750988] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Meningeal carcinomatosis (MC) is a malignant infiltration of the leptomeninges and subarachnoid space and can be a devastating complication of a systemic malignancy. Although often found in patients with known metastatic malignancies, MC can also be the initial manifestation of an underlying malignancy. We report four case studies where back pain, dizziness, cognitive decline, headache and headache with the cranial nerve VI palsy were the first signs of MC. In two cases, adenocarcinoma ventriculi was found, in other one, the markers of the gastrointestinal tract malignancy were highly positive but malignity was not found, and in the last one, there was a known breast carcinoma. The diagnosis of MC requires the finding of malignant cells in the cerebrospinal fluid, but sometimes several lumbar punctures are required to establish the diagnosis, and also MRI with gadolinium. Finally, we would like to highlight the fact that markedly decreased glycorrhachia in cerebrospinal fluid (CSF) can also be the first sign of MC (Fig. 6, Tab. 2, Ref. 23).
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Affiliation(s)
- Z Gdovinova
- Department of Neurology, Faculty of Medicine, Safarikiensis University and Louis Pasteur Faculty Hospital Kosice, Kosice, Slovakia.
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Krokavcova M, Nagyova I, van Dijk JP, Rosenberger J, Gavelova M, Middel B, Gdovinova Z, Groothoff JW. Mastery, functional disability and perceived health status in patients with multiple sclerosis. Eur J Neurol 2008; 15:1237-44. [DOI: 10.1111/j.1468-1331.2008.02304.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Havlikova E, Rosenberger J, Nagyova I, Middel B, Dubayova T, Gdovinova Z, van Dijk JP, Groothoff JW. Impact of fatigue on quality of life in patients with Parkinson’s disease. Eur J Neurol 2008; 15:475-80. [DOI: 10.1111/j.1468-1331.2008.02103.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Havlikova E, van Dijk J, Rosenberger J, Nagyova I, Middel B, Gdovinova Z, Groothoff J. 1.016 Excessive daytime sleepiness and fatigue are not associated features of Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70362-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Havlikova E, van Dijk J, Rosenberger J, Nagyova I, Middel B, Gdovinova Z, Groothoff J. 1.135 Excessive daytime sleepiness and fatigue are not associated features of Parkinson's disease. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70406-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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