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Veverka T, Hok P, Trnečková M, Otruba P, Zapletalová J, Tüdös Z, Lotze M, Kaňovský P, Hluštík P. Interhemispheric parietal cortex connectivity reflects improvement in post-stroke spasticity due to treatment with botulinum toxin-A. J Neurol Sci 2023; 446:120588. [PMID: 36827809 DOI: 10.1016/j.jns.2023.120588] [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] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023]
Abstract
In post-stroke spasticity (PSS), effective treatment with botulinum neurotoxin (BoNT) is associated with transient decrease in activation of the ipsilesional superior parietal lobule (SPL) and intraparietal sulcus (IPS). We hypothesized that this would be reflected in changes in resting-state functional connectivity (rsFC) of the SPL/IPS. Our aim was therefore to assess rsFC of the ipsilesional SPL/IPS in chronic stroke patients with hemiparesis both with and without PSS and to explore the relationship between SPL/IPS rsFC and PSS severity. To this end, fourteen chronic stroke patients with upper limb weakness and PSS (the PSS group) and 8 patients with comparable weakness but no PSS (the control group) underwent clinical evaluation and 3 fMRI examinations, at baseline (W0) and 4 and 11 weeks after BoNT (W4 and W11, respectively). Seed-based rsFC of the atlas-based SPL and IPS was evaluated using a group×time interaction analysis and a correlation analysis with PSS severity (modified Ashworth scale), integrity of the ipsilesional somatosensory afferent pathway (evoked potential N20 latency), and age. In the PSS group, transient improvement in PSS was associated with increase in rsFC between the ipsilesional IPS and the contralesional SPL at W4. The interhemispheric connectivity was negatively correlated with PSS severity at baseline and with PSS improvement at W4. We propose adaptation of the internal forward model as the putative underlying mechanism and discuss its possible association with increased limb use, diminished spastic dystonia, or improved motor performance, as well as its potential contribution to the clinical effects of BoNT.
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Affiliation(s)
- Tomáš Veverka
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia.
| | - Pavel Hok
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia; Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Str. 46, 17475 Greifswald, Germany.
| | - Markéta Trnečková
- Department of Computer Science, Faculty of Science, Palacký University Olomouc, 17. listopadu 1192/12 779 00 Olomouc, Olomouc, Czechia
| | - Pavel Otruba
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia.
| | - Jana Zapletalová
- Department of Biophysics, Biometry and Statistics, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia.
| | - Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia.
| | - Martin Lotze
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Walther-Rathenau-Str. 46, 17475 Greifswald, Germany.
| | - Petr Kaňovský
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia.
| | - Petr Hluštík
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc and University Hospital Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czechia.
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Hok P, Hvizdošová L, Otruba P, Kaiserová M, Trnečková M, Tüdös Z, Hluštík P, Kaňovský P, Nevrlý M. Botulinum toxin injection changes resting state cerebellar connectivity in cervical dystonia. Sci Rep 2021; 11:8322. [PMID: 33859210 PMCID: PMC8050264 DOI: 10.1038/s41598-021-87088-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 03/19/2021] [Indexed: 11/30/2022] Open
Abstract
In cervical dystonia, functional MRI (fMRI) evidence indicates changes in several resting state networks, which revert in part following the botulinum neurotoxin A (BoNT) therapy. Recently, the involvement of the cerebellum in dystonia has gained attention. The aim of our study was to compare connectivity between cerebellar subdivisions and the rest of the brain before and after BoNT treatment. Seventeen patients with cervical dystonia indicated for treatment with BoNT were enrolled (14 female, aged 50.2 ± 8.5 years, range 38-63 years). Clinical and fMRI examinations were carried out before and 4 weeks after BoNT injection. Clinical severity was evaluated using TWSTRS. Functional MRI data were acquired on a 1.5 T scanner during 8 min rest. Seed-based functional connectivity analysis was performed using data extracted from atlas-defined cerebellar areas in both datasets. Clinical scores demonstrated satisfactory BoNT effect. After treatment, connectivity decreased between the vermis lobule VIIIa and the left dorsal mesial frontal cortex. Positive correlations between the connectivity differences and the clinical improvement were detected for the right lobule VI, right crus II, vermis VIIIb and the right lobule IX. Our data provide evidence for modulation of cerebello-cortical connectivity resulting from successful treatment by botulinum neurotoxin.
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Affiliation(s)
- Pavel Hok
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
- Department of Neurology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Hvizdošová
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
- Department of Neurology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
- Department of Neurology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic
| | - Michaela Kaiserová
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
| | - Markéta Trnečková
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
- Department of Computer Science, Faculty of Science of Palacký University Olomouc, Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, University Hospital Olomouc, Olomouc, Czech Republic
- Department of Radiology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic
| | - Petr Hluštík
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
- Department of Neurology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic
| | - Petr Kaňovský
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
- Department of Neurology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic
| | - Martin Nevrlý
- Department of Neurology, University Hospital Olomouc, I. P. Pavlova 6, 77900, Olomouc, Czech Republic.
- Department of Neurology, Faculty of Medicine and Dentistry of Palacký University Olomouc, Olomouc, Czech Republic.
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Tüdös Z, Szász P, Veverková L, Hruška F, Hartmann I, Škarda J, Thomas RP. Spleno-adrenal fusion mimicking an adrenal metastasis of a renal cell carcinoma: A case report and embryological background. Open Med (Wars) 2020; 16:87-94. [PMID: 33392391 PMCID: PMC7764737 DOI: 10.1515/med-2021-0201] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/14/2020] [Accepted: 11/06/2020] [Indexed: 11/24/2022] Open
Abstract
Foci of splenic tissue separated from the spleen can occur as a congenital anomaly. Isolated nodules of splenic tissue are called accessory spleens or spleniculli. However, nodules of splenic tissue can merge with other organs during embryonic development, in which case we speak of spleno-visceral fusions: most often, they merge with the tail of the pancreas (thus forming spleno-pancreatic fusion or an intrapancreatic accessory spleen), with the reproductive gland (i.e., spleno-gonadal fusion), or with the kidney (i.e., spleno-renal fusion). Our case report describes the fusion of heterotopic splenic tissue with the right adrenal gland, which was misinterpreted as a metastasis of a renal cell carcinoma. To the best of our knowledge, this is the first reported case of spleno-adrenal fusion. Spleno-visceral fusions usually represent asymptomatic conditions; their main clinical significance lies in the confusion they cause and its misinterpretation as tumors of other organs. We believe that the cause of retroperitoneal spleno-visceral fusions is the anomalous migration of splenic cells along the dorsal mesentery to the urogenital ridge, together with primitive germ cells, at the end of the fifth week and during the sixth week of embryonic age. This theory explains the possible origin of spleno-visceral fusions, their different frequency of occurrence, and the predominance of findings on the left side.
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Affiliation(s)
- Zbyněk Tüdös
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900 Olomouc, Czech Republic
| | - Paulína Szász
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900 Olomouc, Czech Republic
| | - Lucia Veverková
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900 Olomouc, Czech Republic
| | - František Hruška
- Department of Urology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900 Olomouc, Czech Republic
| | - Igor Hartmann
- Department of Urology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900 Olomouc, Czech Republic
| | - Jozef Škarda
- Department of Clinical and Molecular Pathology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, Hněvotínská 3, 775 15 Olomouc, Czech Republic
| | - Rohit Philip Thomas
- Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Philipps University, Baldingerstrasse, 35043 Marburg, Germany
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Szász P, Kučera P, Čtvrtlík F, Langová K, Hartmann I, Tüdös Z. Diagnostic Value of Unenhanced CT Attenuation and CT Histogram Analysis in Differential Diagnosis of Adrenal Tumors. Medicina (Kaunas) 2020; 56:medicina56110597. [PMID: 33182333 PMCID: PMC7695290 DOI: 10.3390/medicina56110597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 01/13/2023]
Abstract
Background and Objectives: Our aim was to verify the optimal cut-off value for unenhanced CT attenuation and the percentage of negative voxels in the volume CT histogram analysis of adrenal masses. Materials and Methods: We retrospectively analyzed the CT data of patients who underwent an adrenalectomy in the period 2002-2019. In total, 413 adrenalectomies were performed. Out of these, 233 histologically verified masses (123 adenomas, 58 pheochromocytomas, 18 carcinomas, and 34 metastases) fulfilled the inclusion criteria and were selected for analysis. The mean unenhanced attenuation in Hounsfield units (HU) and the percentage of voxels with attenuation less than 0 HU (negative voxels) were measured in each mass. Results: The mean unenhanced attenuation with a cut-off value of 10 HU reached a sensitivity of 59.4% and a specificity of 99.1% for benign adenomas. The mean unenhanced attenuation with a cut-off value of 15 HU reached a sensitivity of 69.1% and a specificity of 98.2%. For the histogram analysis, a cut-off value of 10% of negative pixels reached a sensitivity of 82.9% and a specificity of 98.2%, whereas a cut-off value of 5% of negative pixels reached a sensitivity of 87.8% and a specificity of 75.5%. The percentage of negative voxels reached a slightly better area under the curve (0.919) than unenhanced attenuation (0.908). Conclusion: Mean unenhanced attenuation with a cut-off value of 10 HU represents a simple tool, and the most specific one, to distinguish adrenal adenomas from non-adenomas. CT histogram analysis with cut-off values of 10% of negative voxels improves sensitivity without any loss of specificity.
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Affiliation(s)
- Paulína Szász
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic; (P.S.); (P.K.); (F.Č.)
| | - Petr Kučera
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic; (P.S.); (P.K.); (F.Č.)
| | - Filip Čtvrtlík
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic; (P.S.); (P.K.); (F.Č.)
| | - Kateřina Langová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University, 775 15 Olomouc, Czech Republic;
| | - Igor Hartmann
- Department of Urology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic;
| | - Zbyněk Tüdös
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic; (P.S.); (P.K.); (F.Č.)
- Correspondence: ; Tel.: +420-588-445-995
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Affiliation(s)
- Zbyněk Tüdös
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900, Olomouc, Czech Republic.
| | - Filip Čtvrtlík
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900, Olomouc, Czech Republic
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Tüdös Z, Čtvrtlík F. Letter to the Editor: "CT Characteristics of Pheochromocytoma: Relevance for the Evaluation of Adrenal Incidentaloma". J Clin Endocrinol Metab 2019; 104:5112-5113. [PMID: 31127827 DOI: 10.1210/jc.2019-00748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/17/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Filip Čtvrtlík
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
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Hok P, Opavský J, Labounek R, Kutín M, Šlachtová M, Tüdös Z, Kaňovský P, Hluštík P. Differential Effects of Sustained Manual Pressure Stimulation According to Site of Action. Front Neurosci 2019; 13:722. [PMID: 31379481 PMCID: PMC6650750 DOI: 10.3389/fnins.2019.00722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
Sustained pressure stimulation of the body surface has been used in several physiotherapeutic techniques, such as reflex locomotion therapy. Clinical observations of global motor responses and subsequent motor behavioral changes after stimulation in certain sites suggest modulation of central sensorimotor control, however, the neuroanatomical correlates remain undescribed. We hypothesized that different body sites would specifically influence the sensorimotor system during the stimulation. We tested the hypothesis using functional magnetic resonance imaging (fMRI) in thirty healthy volunteers (mean age 24.2) scanned twice during intermittent manual pressure stimulation, once at the right lateral heel according to reflex locomotion therapy, and once at the right lateral ankle (control site). A flexible modeling approach with finite impulse response basis functions was employed since non-canonical hemodynamic response was expected. Subsequently, a clustering algorithm was used to separate areas with differential timecourses. Stimulation at both sites induced responses throughout the sensorimotor system that could be mostly separated into two anti-correlated subsystems with transient positive or negative signal change and rapid adaptation, although in heel stimulation, insulo-opercular cortices and pons showed sustained activation. In direct voxel-wise comparison, heel stimulation was associated with significantly higher activation levels in the contralateral primary motor cortex and decreased activation in the posterior parietal cortex. Thus, we demonstrate that the manual pressure stimulation affects multiple brain structures involved in motor control and the choice of stimulation site impacts the shape and amplitude of the blood oxygenation level-dependent response. We further discuss the relationship between the affected structures and behavioral changes after reflex locomotion therapy.
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Affiliation(s)
- Pavel Hok
- Department of Neurology, University Hospital Olomouc, Olomouc, Czechia.,Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia
| | - Jaroslav Opavský
- Department of Physiotherapy, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - René Labounek
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.,Department of Biomedical Engineering, University Hospital Olomouc, Olomouc, Czechia
| | | | - Martina Šlachtová
- Department of Physiotherapy, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.,Department of Radiology, University Hospital Olomouc, Olomouc, Czechia
| | - Petr Kaňovský
- Department of Neurology, University Hospital Olomouc, Olomouc, Czechia.,Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia
| | - Petr Hluštík
- Department of Neurology, University Hospital Olomouc, Olomouc, Czechia.,Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia
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Veverka T, Hok P, Otruba P, Zapletalová J, Kukolová B, Tüdös Z, Krobot A, Kaňovský P, Hluštík P. Botulinum Toxin Modulates Posterior Parietal Cortex Activation in Post-stroke Spasticity of the Upper Limb. Front Neurol 2019; 10:495. [PMID: 31143157 PMCID: PMC6521800 DOI: 10.3389/fneur.2019.00495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/23/2019] [Indexed: 11/30/2022] Open
Abstract
Post-stroke spasticity (PSS) is effectively treated with intramuscular botulinum toxin type A (BoNT-A), although the clinical improvement is likely mediated by changes at the central nervous system level. Using functional magnetic resonance imaging (fMRI) of the brain, this study aims to confirm and locate BoNT-A-related changes during motor imagery with the impaired hand in severe PSS. Temporary alterations in primary and secondary sensorimotor representation of the impaired upper limb were expected. Thirty chronic stroke patients with upper limb PSS undergoing comprehensive treatment including physiotherapy and indicated for BoNT treatment were investigated. A change in PSS of the upper limb was assessed with the modified Ashworth scale (MAS). fMRI and clinical assessments were performed before (W0) and 4 weeks (W4) and 11 weeks (W11) after BoNT-A application. fMRI data were acquired using 1.5-Tesla scanners during imagery of finger-thumb opposition sequences with the impaired hand. At the group level, we separately modeled (1) average activation at each time point with the MAS score and age at W0 as covariates; and (2) within-subject effect of BoNT-A and the effect of time since W0 as independent variables. Comprehensive treatment of PSS with BoNT-A significantly decreased PSS of the upper limb with a maximal effect at W4. Task-related fMRI prior to treatment (W0) showed extensive activation of bilateral frontoparietal sensorimotor cortical areas, bilateral cerebellum, and contralesional basal ganglia and thalamus. After BoNT-A application (W4), the activation extent decreased globally, mostly in the bilateral parietal cortices and cerebellum, but returned close to baseline at W11. The intra-subject contrast revealed a significant BoNT-A effect, manifesting as a transient decrease in the activation of the ipsilesional intraparietal sulcus and superior parietal lobule. We demonstrate that BoNT-A treatment of PSS of the upper limb is associated with transient changes in the ipsilesional posterior parietal cortex, possibly resulting from temporarily altered sensorimotor upper limb representations.
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Affiliation(s)
- Tomáš Veverka
- Department of Neurology, Palacký University and University Hospital, Olomouc, Czechia
| | - Pavel Hok
- Department of Neurology, Palacký University and University Hospital, Olomouc, Czechia
| | - Pavel Otruba
- Department of Neurology, Palacký University and University Hospital, Olomouc, Czechia
| | - Jana Zapletalová
- Department of Biophysics, Biometry and Statistics, Palacký University and University Hospital, Olomouc, Czechia
| | | | - Zbyněk Tüdös
- Department of Radiology, Palacký University and University Hospital, Olomouc, Czechia
| | - Alois Krobot
- Department of Physiotherapy, Palacký University and University Hospital, Olomouc, Czechia
| | - Petr Kaňovský
- Department of Neurology, Palacký University and University Hospital, Olomouc, Czechia
| | - Petr Hluštík
- Department of Neurology, Palacký University and University Hospital, Olomouc, Czechia.,Department of Radiology, Palacký University and University Hospital, Olomouc, Czechia
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Látal J, Špaček M, Přeček J, Tüdös Z, Hutyra M, Tichý T, Táborský M. Giant-cell myocarditis - A case report and a brief review. Cor Vasa 2018. [DOI: 10.1016/j.crvasa.2017.10.010] [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: 11/17/2022]
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10
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Nevrlý M, Hluštík P, Hok P, Otruba P, Tüdös Z, Kaňovský P. Changes in sensorimotor network activation after botulinum toxin type A injections in patients with cervical dystonia: a functional MRI study. Exp Brain Res 2018; 236:2627-2637. [PMID: 29971454 PMCID: PMC6153868 DOI: 10.1007/s00221-018-5322-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 06/28/2018] [Indexed: 11/26/2022]
Abstract
Botulinum toxin type A (BoNT) is considered an effective therapeutic option in cervical dystonia (CD). The pathophysiology of CD and other focal dystonias has not yet been fully explained. Results from neurophysiological and imaging studies suggest a significant involvement of the basal ganglia and thalamus, and functional abnormalities in premotor and primary sensorimotor cortical areas are considered a crucial factor in the development of focal dystonias. Twelve BoNT-naïve patients with CD were examined with functional MRI during a skilled hand motor task; the examination was repeated 4 weeks after the first BoNT injection to the dystonic neck muscles. Twelve age- and gender-matched healthy controls were examined using the same functional MRI paradigm without BoNT injection. In BoNT-naïve patients with CD, BoNT treatment was associated with a significant increase of activation in finger movement-induced fMRI activation of several brain areas, especially in the bilateral primary and secondary somatosensory cortex, bilateral superior and inferior parietal lobule, bilateral SMA and premotor cortex, predominantly contralateral primary motor cortex, bilateral anterior cingulate cortex, ipsilateral thalamus, insula, putamen, and in the central part of cerebellum, close to the vermis. The results of the study support observations that the BoNT effect may have a correlate in the central nervous system level, and this effect may not be limited to cortical and subcortical representations of the treated muscles. The results show that abnormalities in sensorimotor activation extend beyond circuits controlling the affected body parts in CD even the first BoNT injection is associated with changes in sensorimotor activation. The differences in activation between patients with CD after treatment and healthy controls at baseline were no longer present.
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Affiliation(s)
- Martin Nevrlý
- Department of Neurology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
| | - Petr Hluštík
- Department of Neurology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, Olomouc, Czech Republic
| | - Pavel Hok
- Department of Neurology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, Olomouc, Czech Republic
| | - Petr Kaňovský
- Department of Neurology, University Hospital and Faculty of Medicine and Dentistry of Palacký University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic
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Affiliation(s)
- Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
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13
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Čtvrtlík F, Koranda P, Schovánek J, Škarda J, Hartmann I, Tüdös Z. Current diagnostic imaging of pheochromocytomas and implications for therapeutic strategy. Exp Ther Med 2018; 15:3151-3160. [PMID: 29545830 PMCID: PMC5840941 DOI: 10.3892/etm.2018.5871] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022] Open
Abstract
The topic of pheochromocytomas is becoming increasingly popular as a result of major advances in different medical fields, including laboratory diagnosis, genetics, therapy, and particularly in novel advances in imaging techniques. The present review article discusses current clinical, biochemical, genetic and histopathological aspects of the diagnosis of pheochromocytomas and planning of pre-surgical preparation and subsequent surgical treatment options. The main part of the paper is focused on the role of morphological imaging methods (primarily computed tomography and magnetic resonance imaging) and functional imaging (scintigraphy and positron emission tomography) in the diagnosis and staging of pheochromocytomas.
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Affiliation(s)
- Filip Čtvrtlík
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
| | - Pavel Koranda
- Department of Nuclear Medicine, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
| | - Jan Schovánek
- Department of Internal Medicine III-Nephrology, Rheumatology and Endocrinology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
| | - Jozef Škarda
- Department of Clinical and Molecular Pathology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
| | - Igor Hartmann
- Department of Urology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic
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Nevrlý M, Hluštík P, Hok P, Otruba P, Kaiserova M, Tüdös Z, Kaňovský P. Differences in botulinum toxin treated and non-treated cervical dystonia patients in somatosensory task-related functional imaging response. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.342] [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: 10/18/2022]
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15
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Klásková E, Zapletalová J, Kaprálová S, Šnajderová M, Lebl J, Tüdös Z, Pavlíček J, Černá J, Mihál V, Stará V, Procházka M. Increased prevalence of bicuspid aortic valve in Turner syndrome links with karyotype: the crucial importance of detailed cardiovascular screening. J Pediatr Endocrinol Metab 2017; 30:319-325. [PMID: 28236629 DOI: 10.1515/jpem-2016-0301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 01/09/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bicuspid aortic valve (BAV) represents one of the strongest risk factors for aortic dissection in Turner syndrome (TS). An exact relation between the occurrence of BAV and a particular karyotype has not been established yet. The aim of this study was to determine the association between karyotype and prevalence of BAV. METHODS Sixty-seven TS patients aged between 6.6 and 32.5 years underwent cardiac magnetic resonance imaging (MRI) study. They were divided into four cytogenetic subgroups-45,X karyotype (n=27); 45,X/46,XX mosaicism (n=17); structural abnormalities of the X chromosome (n=10); and 45,X/structural abnormality of the X chromosome mosaicism (n=13). Prevalence of BAV and odds ratio (OR) compared with the general population in the whole study group, and statistical comparison of prevalences of BAV among the individual subgroups were determined. RESULTS Prevalence of BAV in the whole study group was established as 28.4% [OR 208.3 (95% CI - 103.8-418.0); p-value<0.0001]. Individuals with 45,X karyotype had the highest prevalence of BAV - 40.7%, p-value<0.0001. Presence of any 45,X cell line in karyotype significantly predisposed to BAV (p-value=0.05). CONCLUSIONS The 45,X karyotype is associated with the highest prevalence of BAV. Also, the presence of the 45,X cell line in any mosaic karyotype increases the probability of BAV.
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Hok P, Opavský J, Kutín M, Tüdös Z, Kaňovský P, Hluštík P. Modulation of the sensorimotor system by sustained manual pressure stimulation. Neuroscience 2017; 348:11-22. [PMID: 28229931 DOI: 10.1016/j.neuroscience.2017.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/05/2017] [Accepted: 02/05/2017] [Indexed: 11/15/2022]
Abstract
In Vojta physiotherapy, also known as reflex locomotion therapy, prolonged peripheral pressure stimulation induces complex generalized involuntary motor responses and modifies subsequent behavior, but its neurobiological basis remains unknown. We hypothesized that the stimulation would induce sensorimotor activation changes in functional magnetic resonance imaging (fMRI) during sequential finger opposition. Thirty healthy volunteers (mean age 24.2) underwent two randomized fMRI sessions involving manual pressure stimulation applied either at the right lateral heel according to Vojta, or at the right lateral ankle (control site). Participants were scanned before and after the stimulation when performing auditory-paced sequential finger opposition with their right hand. Despite an extensive activation decrease following both stimulation paradigms, the stimulation of the heel specifically led to an increase in task-related activation in the predominantly contralateral pontomedullary reticular formation and bilateral posterior cerebellar hemisphere and vermis. Our findings suggest that sustained pressure stimulation of the foot is associated with differential short-term changes in hand motor task-related activation depending on the stimulation. This is the first evidence for brainstem modulation after peripheral pressure stimulation, suggesting that the after-effects of reflex locomotion physiotherapy involve a modulation of the pontomedullary reticular formation.
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Affiliation(s)
- Pavel Hok
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic; Department of Neurology, University Hospital Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic.
| | - Jaroslav Opavský
- Department of Physiotherapy, Faculty of Physical Culture, Palacky University Olomouc, tř. Míru 671/117, Olomouc CZ-77111, Czech Republic.
| | - Miroslav Kutín
- KM KINEPRO PLUS s.r.o., Horní lán 1328/6, Olomouc CZ-77900, Czech Republic; Department of Physiotherapy, Faculty of Health Sciences, Palacky University Olomouc, Hněvotínská 976/3, Olomouc CZ-77515, Czech Republic.
| | - Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic; Department of Radiology, University Hospital Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic.
| | - Petr Kaňovský
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic; Department of Neurology, University Hospital Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic.
| | - Petr Hluštík
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic; Department of Neurology, University Hospital Olomouc, I. P. Pavlova 185/6, Olomouc CZ-77520, Czech Republic.
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Přeček J, Tüdös Z, Hutyra M, Kováčik F, Vindiš D, Prouzová Z, Táborský M. Primary cardiac angiosarcoma in multimodality imaging - Case report and review of literature. Cor Vasa 2016. [DOI: 10.1016/j.crvasa.2016.04.001] [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: 10/21/2022]
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Tüdös Z, Čtvrtlík F, Kratochvíl P, Král M. Wooden Foreign Body in the Renal Pelvis. Urology 2016; 94:e7-8. [PMID: 27181245 DOI: 10.1016/j.urology.2016.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/29/2016] [Accepted: 05/03/2016] [Indexed: 11/25/2022]
Abstract
Migration of foreign bodies into the renal collecting system is very rare and usually concerns iatrogenically implanted objects. Migration of a foreign body from the gastrointestinal tract to the kidneys is even more rare. We present a case of migration of a wooden toothpick from the duodenum into the pelvis of the right kidney. The patient was not aware that he swallowed a toothpick; the foreign body resulted in hematuria and flank pain. The toothpick was missed during the initial computed tomography urography. Correct diagnosis was revealed by follow-up computed tomography. The toothpick was extracted endoscopically.
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Affiliation(s)
- Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Filip Čtvrtlík
- Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic.
| | - Pavel Kratochvíl
- Department of Urology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Milan Král
- Department of Urology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
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Žurková M, Otruba P, Lošťáková V, Tüdös Z, Kolek V, Kriegová E. Neurosarcoidosis in a Middle-aged Man – a Case Report. Cesk Slov Neurol N 2016. [DOI: 10.14735/amcsnn2016225] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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20
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Tüdös Z, Köcher M, Černá M, Odstrčil F, Prouzová Z, Formánek R, Přeček J. "Sun Ray" Appearance in a Case of Cardiac Angiosarcoma: A Comparison of MRI and PET/CT. Magn Reson Med Sci 2016; 16:176-180. [PMID: 27001389 PMCID: PMC5600078 DOI: 10.2463/mrms.cr.2015-0082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Our article reports a case of a 35-year-old man with cardiac mass, who underwent a wide range of imaging methods, including cardiac magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT). Contrast-enhanced MRI images revealed “sun ray” pattern in the mass. Final histopathological diagnosis of angiosarcoma was confirmed during autopsy. To our knowledge, our case is the second direct observation of this MRI diagnostic pattern and the first one that allows a comparison with PET/CT findings.
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Affiliation(s)
- Zbyněk Tüdös
- Department of Radiology, Palacky University and University Hospital
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Veverka T, Hluštík P, Hok P, Otruba P, Zapletalová J, Tüdös Z, Krobot A, Kaňovský P. Sensorimotor modulation by botulinum toxin A in post-stroke arm spasticity: Passive hand movement. J Neurol Sci 2016; 362:14-20. [PMID: 26944111 DOI: 10.1016/j.jns.2015.12.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 10/25/2015] [Revised: 12/08/2015] [Accepted: 12/31/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In post-stroke spasticity, functional imaging may uncover modulation in the central sensorimotor networks associated with botulinum toxin type A (BoNT) therapy. Investigations were performed to localize brain activation changes in stroke patients treated with BoNT for upper limb spasticity using functional magnetic resonance imaging (fMRI). METHODS Seven ischemic stroke patients (4 females; mean age 58.86) with severe hand paralysis and notable spasticity were studied. Spasticity was scored according to the modified Ashworth scale (MAS). fMRI examination was performed 3 times: before (W0) and 4 (W4) and 11weeks (W11) after BoNT. The whole-brain fMRI data were acquired during paced repetitive passive movements of the plegic hand (flexion/extension at the wrist) alternating with rest. Voxel-by-voxel statistical analysis using the General Linear Model (GLM) implemented in FSL (v6.00)/FEAT yielded group session-wise statistical maps and paired between-session contrasts, thresholded at the corrected cluster-wise significance level of p<0.05. RESULTS As expected, BoNT transiently lowered MAS scores at W4. Across all the sessions, fMRI activation of the ipsilesional sensorimotor cortex (M1, S1, and SMA) dominated. At W4, additional clusters transiently emerged bilaterally in the cerebellum, in the contralesional sensorimotor cortex, and in the contralesional occipital cortex. Paired contrasts demonstrated significant differences W4>W0 (bilateral cerebellum and contralesional occipital cortex) and W4>W11 (ipsilesional cerebellum and SMA). The remaining paired contrast (W0>W11) showed activation decreases mainly in the ipsilesional sensorimotor cortex (M1, S1, and SMA). CONCLUSIONS The present study confirms the feasibility of using passive hand movements to map the cerebral sensorimotor networks in patients with post-stroke arm spasticity and demonstrates that BoNT-induced spasticity relief is associated with changes in task-induced central sensorimotor activation, likely mediated by an altered afferent drive from the spasticity-affected muscles.
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Affiliation(s)
- Tomáš Veverka
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Petr Hluštík
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic; Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Pavel Hok
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Jana Zapletalová
- Department of Biophysics, Biometry and Statistics, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Alois Krobot
- Department of Physiotherapy, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Petr Kaňovský
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
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Vastik M, Hok P, Hlustik P, Otruba P, Tüdös Z, Kanovsky P. Botulinum toxin treatment of freezing of gait in Parkinson's disease patients as reflected in functional magnetic resonance imaging of leg movement. Neuro Endocrinol Lett 2016; 37:147-153. [PMID: 27179579] [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] [Received: 01/28/2016] [Accepted: 02/22/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Freezing of gait (FOG) is a common disabling symptom of (in) Parkinson's disease (PD). The mechanism of FOG is (in) not clearly understood. We investigated the clinical effect and changes of the activity of the sensorimotor system using repeated functional MRI (fMRI) before and after application of botulinum toxin in Parkinson's disease patients with FOG. METHODS We investigated 20 patients with PD, 10 with FOG and 10 without FOG. PD patients with FOG were treated with intramuscular application of botulinum toxin type A into the tensor fasciae latae muscle bilaterally. The clinical effect of treatment was assessed using FOG questionnaire, "Time up and go" test, UPDRS, Hoehn and Yahr staging, Clinical global impression scale. Activation of the sensorimotor system was studied using BOLD fMRI of the whole brain during repetitive abduction - adduction of each leg interleaved with rest. The clinical (in the FOG group) and imaging (in both groups) examination was repeated after a four-week interval. RESULTS In the FOG group, the FOG questionnaire has shown a decline of scores after application of botulinum toxin that suggests possible effect of botulinum toxin on freezing of gait. In fMRI results, both groups manifested reduction of the sensorimotor network activated with leg movement, however, the FOG group also showed increased activation in cerebellar vermis and nuclei, in dorsal pons and in medulla after treatment. CONCLUSION Alleviation of the FOG in PD patients by botulinum toxin seems to be reflected in the functional participation of the cerebellum and its projections as seen by fMRI.
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Affiliation(s)
- Miroslav Vastik
- Department of Neurology, Palacky University Medical School and University Hospital, Olomouc, Czech Republic
| | - Pavel Hok
- Department of Neurology, Palacky University Medical School and University Hospital, Olomouc, Czech Republic
| | - Petr Hlustik
- Department of Neurology, Palacky University Medical School and University Hospital, Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology, Palacky University Medical School and University Hospital, Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, Palacky University Medical School and University Hospital, Czech Republic
| | - Petr Kanovsky
- Department of Neurology, Palacky University Medical School and University Hospital, Olomouc, Czech Republic
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Hlustik P, Veverka T, Hok P, Otruba P, Tüdös Z, Krobot A, Kaňovský P. Evaluating central sensorimotor modulation due to botulinum toxin A in post-stroke arm spasticity and hand plegia: Passive hand movement. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.288] [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: 11/30/2022]
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Klásková E, Tüdös Z, Sobek A, Zapletalová J, Dostál J, Zbořilová B, Sobek A, Adamová K, Lattová V, Dostálová Z, Procházka M. Low-level 45,X/46,XX mosaicism is not associated with congenital heart disease and thoracic aorta dilatation:prospective magnetic resonance imaging and ultrasound study. Ultrasound Obstet Gynecol 2015; 45:722-727. [PMID: 25042300 DOI: 10.1002/uog.14627] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/17/2014] [Accepted: 07/04/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To establish the prevalence of risk factors for aortic dissection, such as bicuspid aortic valve, aortic coarctation and ascending aorta dilatation, in women with low-level 45,X/46,XX mosaicism undergoing an in-vitro fertilization (IVF) procedure. METHODS The study group comprised 25 women with low-level 45,X/46,XX mosaicism (ranging from 3.3% to 10.0%) who were referred to two reproductive medicine units between 2009 and 2013 because of infertility and who underwent subsequent karyotyping. In accordance with the recommendation of the Practice Committee of the American Society for Reproductive Medicine for patients with Turner syndrome (TS), prior to the IVF procedure, all women underwent careful cardiovascular screening for congenital heart disease and thoracic aorta dilatation, including standard cardiac examination, echocardiography and non-contrast cardiac magnetic resonance imaging. Aortic size index (ASI, diameter of the ascending aorta normalized to body surface area) and the prevalence of coarctation of the aorta and of bicuspid aortic valve were compared with findings previously reported in women with TS and the general population. RESULTS Bicuspid aortic valve without any stenosis or regurgitation was found in one woman in the study group with low-level 45,X/46,XX mosaicism, a statistically significantly lower prevalence of bicuspid aortic valve than that reported in women with TS. Aortic coarctation was not identified in any individual. The ASI was below the 95th percentile in all cases and the mean value was significantly lower than the mean reference values for both the general population and women with TS. CONCLUSION Compared with the general population, the prevalence of risk factors for aortic dissection was not found to be higher in women with low-level 45,X/46,XX mosaicism without any noticeable features except infertility.
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Affiliation(s)
- E Klásková
- FERTIMED, Infertility Centre, Olomouc, Czech Republic
- Department of Cardiology, Department of Paediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Z Tüdös
- Department of Radiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - A Sobek
- FERTIMED, Infertility Centre, Olomouc, Czech Republic
| | - J Zapletalová
- Department of Cardiology, Department of Paediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - J Dostál
- Infertility Centre, Department of Gynecology and Obstetrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - B Zbořilová
- FERTIMED, Infertility Centre, Olomouc, Czech Republic
| | - A Sobek
- FERTIMED, Infertility Centre, Olomouc, Czech Republic
| | - K Adamová
- Department of Medical Genetics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - V Lattová
- Infertility Centre, Department of Gynecology and Obstetrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Z Dostálová
- FERTIMED, Infertility Centre, Olomouc, Czech Republic
| | - M Procházka
- FERTIMED, Infertility Centre, Olomouc, Czech Republic
- Department of Medical Genetics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
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Hok P, Hluštík P, Kutín M, Opavský J, Tüdös Z, Kaňovský P. 22. Plasticity of sensorimotor system induced by sustained pressure stimulation. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.181] [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: 11/25/2022]
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Grambal A, Tüdös Z, Hok P, Kamarádová D, Divéky T, Hluštík P, Praško J. Predictors of poor treatment response to additional CBT in real panic disorder patients: The role of DLPF, orbitofrontal cortex, parietal lobule, frontal eye field and amygdala in PD. Neuro Endocrinol Lett 2015; 36:269-281. [PMID: 26313395] [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] [Received: 03/31/2015] [Accepted: 04/12/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Previous functional brain imaging studies have described various and contradictory activation findings in patients with panic disorder (PD). Our study focused on patients with a chronic PD, who were investigated and treated in a conventional manner, which represents the real PD patients in clinical practice. METHODS Continuing their medication, patients were included in a six-week cognitive-behavioral therapy (CBT) program in the psychiatry department. At the onset of the study, participants underwent clinical evaluation using standard scales and were examined using fMRI while listening to verbal threat-related stimuli contrasted to neutral words. According to the therapeutic outcome, they were subsequently divided into two groups, responders, and nonresponders and the two groups were mutually compared. RESULTS In non-responders compared to responders, we found increased pre-treatment activation in dorsolateral prefrontal cortex bilaterally, left orbitofrontal cortex, left frontal eye field, right parietal lobule and left amygdala. In addition, both groups showed negative fMRI BOLD correlation with BAI improvement and positive correlation with CGI improvement across the ROIs. We suggest that DLPFC over-activation may reveal a lack of cognitive control over emotional processing, which makes subsequent CBT less effective. CONCLUSION Despite several limitations, we found neuroimaging predictors of poor CBT response, under the conditions of standard clinical practice, in real PD patients.
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Affiliation(s)
- Aleš Grambal
- Department of Psychiatry, University Hospital Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, University Hospital Olomouc, Czech Republic
| | - Pavel Hok
- Department of Neurology, University Hospital Olomouc, Czech Republic
| | - Dana Kamarádová
- Department of Psychiatry, University Hospital Olomouc, Czech Republic
| | - Tomáš Divéky
- Department of Psychiatry, University Hospital Olomouc, Czech Republic
| | - Petr Hluštík
- Department of Neurology, University Hospital Olomouc, Czech Republic
| | - Ján Praško
- Department of Psychiatry, University Hospital Olomouc, Czech Republic
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Veverka T, Hluštík P, Hok P, Otruba P, Tüdös Z, Zapletalová J, Krobot A, Kaňovský P. Cortical activity modulation by botulinum toxin type A in patients with post-stroke arm spasticity: real and imagined hand movement. J Neurol Sci 2014; 346:276-83. [PMID: 25255982 DOI: 10.1016/j.jns.2014.09.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/04/2014] [Accepted: 09/08/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Our aim was to use functional magnetic resonance imaging (fMRI) to compare brain activation changes due to botulinum toxin A (BoNT) application between two chronic stroke patient groups with different degree of weakness treated for upper limb spasticity. METHODS Fourteen ischemic stroke patients with hand weakness and spasticity were studied. Spasticity was scored by modified Ashworth scale (MAS). FMRI was performed 3 times: before (W0) and 4 (W4) and 11 weeks (W11) after BoNT application. Group A: 7 patients (2 males, 5 females; mean age 59.14 years) with hand plegia, who imagined moving fingers. Group B: 7 age-matched patients (6 males, 1 female; mean age 59.57 years) able to perform sequential finger movement. RESULTS BoNT transiently lowered MAS in W4 in both groups. In group A, activation of the frontal premotor cortex dominated and persisted for all three fMRI sessions whereas the ipsilesional cerebellum and cortex bordering bilateral intraparietal sulcus activation changed over time. Between-session contrasts showed treatment-related activation decreases in the mesial occipitoparietal and lateral occipital cortex. In group B, brain activation was markedly reduced after BoNT (W4). Whereas some of these areas manifested only transient reduction and expanded again at W11, in others the reduction persisted. CONCLUSION Study of two age-matched groups with mild and severe weakness demonstrated different effects of BoNT-lowered spasticity on sensorimotor networks. Group A performing movement imagery manifested BoNT-induced reduction of activation in structures associated with visual imagery. Group B performing movement manifested reduced activation extent and reduced activation of structures outside classical motor system, suggestive of motor network normalization.
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Affiliation(s)
- Tomáš Veverka
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic.
| | - Petr Hluštík
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic; Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Pavel Hok
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Zbyněk Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Jana Zapletalová
- Department of Biophysics, Biometry and Statistics, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Alois Krobot
- Department of Physiotherapy, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Petr Kaňovský
- Department of Neurology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
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Tüdös Z, Hok P, Hrdina L, Hluštík P. Modality effects in paced serial addition task: differential responses to auditory and visual stimuli. Neuroscience 2014; 272:10-20. [PMID: 24802163 DOI: 10.1016/j.neuroscience.2014.04.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 04/24/2014] [Accepted: 04/26/2014] [Indexed: 12/22/2022]
Abstract
Paced Auditory Serial-Addition Task (PASAT) is a complex task commonly used to examine patients with diffuse brain damage. A visual version of the neuropsychological test (Paced Visual Serial-Addition Task, PVSAT) has also been introduced to clinical practice, and both versions were adapted to be used in neuroimaging, namely functional magnetic resonance imaging (fMRI). The aim of our work was direct comparison of auditory and visual versions of the paced serial addition test (PASAT/PVSAT) in a within-subject and within-session study and description of the commonalities and differences in both activated and deactivated brain regions. Twenty young adult right-handed healthy volunteers participated in the study and underwent whole-brain fMRI examination during PASAT and PVSAT performance. Higher-level statistical analysis was performed to generate group mean activation and deactivation maps for both tasks, their conjunctions and differences across modalities. In PASAT/PVSAT activation conjunction analysis, we confirmed the existence of a modality-independent neural network similar to working memory tasks and to previous PASAT or PVSAT studies. In PASAT/PVSAT deactivation conjunction analysis, we observed a rather symmetrical extensive pattern of deactivated regions, overlapping the default mode network. Significant differences between PASAT and PVSAT were found in the right frontal eye field (FEF) and bilaterally in the striate and extrastriate cortices. Activation in one task and deactivation in the other jointly contributed to significant differences in all occipital and occipitotemporal regions. Both tasks activated right FEF, but activation during PASAT was significantly stronger than during PVSAT. Between-modality differences should be considered when preparing and interpreting neuroimaging experiments.
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Affiliation(s)
- Z Tüdös
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, I.P. Pavlova 6, Olomouc, Czech Republic.
| | - P Hok
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, I.P. Pavlova 6, Olomouc, Czech Republic.
| | - L Hrdina
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, I.P. Pavlova 6, Olomouc, Czech Republic.
| | - P Hluštík
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, I.P. Pavlova 6, Olomouc, Czech Republic; Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, I.P. Pavlova 6, Olomouc, Czech Republic.
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Hutyra M, Skála T, Kamínek M, Horák D, Köcher M, Tüdös Z, Jarkovský J, Přeček J, Táborský M. Comparison of two-dimensional longitudinal strain with rest single photon emission tomography perfusion imaging for transmural scar identification in patients with ischemic left ventricular systolic dysfunction. Int J Cardiol 2012; 156:331-2. [DOI: 10.1016/j.ijcard.2012.01.086] [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] [Received: 01/25/2012] [Accepted: 01/28/2012] [Indexed: 10/28/2022]
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