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Wyświetlanie 1-10 z 36
Tytuł:
Deep brain stimulation in the treatment of Holmes tremor : a long-term case observation
Autorzy:
Dec-Ćwiek, Małgorzata
Grabska, Natalia
Pietraszko, Wojciech
Rudzińska-Bar, Monika
Michalski, Michał
Szczudlik, Andrzej
Tutaj, Marcin
Opis:
We present the patient with Holmes tremor secondary to the infarction of thalamus, successfully treated with the deep brain stimulation (DBS) of the area between ventralis oralis anterior and zona incerta for a long time, in whom the severe tremor reappeared after removal of the DBS lead. This is the first presentation of the effective DBS on this location. Our case does not support the hypothesis that the DBS treatment could lead to sustained relief of symptoms after cessation of stimulation
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Opposite effects of l-dopa and DBS-STN on saccadic eye movements in advanced Parkinsons disease
Autorzy:
Gracies, Jean-Michel
Dec-Ćwiek, Małgorzata
Volkmann, Jens
Szczudlik, Andrzej
Słowik, Agnieszka
Tutaj, Marcin
Rudzińska-Bar, Monika
Opis:
Objective: To assess the effects of L-dopa and deep brain stimulation of the subthalamic nucleus (DBS-STN) on saccadic eye movements in patients with Parkinson's disease (PD). Methods: Visually and internally guided horizontal saccades were evaluated using a saccadometer in 64 patients with advanced PD and 48 healthy controls. Forty-four pharmacologically treated patients were assessed in their ‘‘med-off’’ (OFF) and ‘‘med-on’’ (ON) status, whereas 20 DBS-STN treated patients were assessed in their ‘‘med-off, stim-off’’ (OFF) and ‘‘med-off, stim-on’’ (ON) status. Results: In all PD patients the saccades in the OFF status were delayed, slower and smaller ( p < 0.01) than in controls. In pharmacologically treated patients all studied parameters showed tendency to worsen in the ON status as compared to the OFF status. In contrast, activating DBS-STN showed tendency to improve all studied parameters. Comparison of the studied saccade parameters between the ON status of DBS-STN treated patients, ON status of the pharmacologically treated patients and the controls showed that 73% of these parameters in the DBS-STN treated patients were similar as in the controls. While in the pharmacologically treated patients only 26% of these parameters were similar as in the controls. Conclusion: This prospective study comparing the influence of L-dopa and DBS-STN on saccades in advanced PD showed contrasting results between these two treatments; the majority of the studied parameters in patients on DBS-STN were similar as in the controls.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Functional magnetic resonance imaging for assessment of the autonomic dysfunction in patients with ANCA-associated vasculitides
Autorzy:
Szczeklik, Wojciech
Wawrzycka-Adamczyk, Katarzyna
Tutaj, Marcin
Domagalik, Aleksandra
Marek, Tadeusz
Włudarczyk, Anna
Łoboda, Piotr
Sznajd, Jan
Biedroń, Grzegorz
Opis:
Introduction: Nervous system involvement is common in ANCA-associated vasculitides (AAV). While peripheral and central nervous system involvement are well described, it is still unclear how and to what extent the autonomic nervous system (ANS) is involved. Functional magnetic resonance imaging (fMRI) can provide information on both – structure and potential damage of the brain as well as the function of the selected brain centers. Objectives: The aim of this study was to investigate the ANS dysfunction in AAV patients and its correlation with fMRI results during the Valsalva maneuver. Patients and methods: 31 patients with AAV and 30 healthy controls were enrolled in the study. Each participant completed the COMPASS-31 questionnaire. Magnetic resonance imaging (MRI) was performed using a 3T scanner. Participants were asked to perform the Valsalva maneuver according to the fixed protocol using the device measuring the pressure value in the subjects’ airways. During the maneuver fMRI data were collected. The generalized least squares time series analysis and the region-of-interest (ROI) analysis were performed. Results: AAV patients had higher COMPASS-31 questionnaire median score (12.86 vs. 2.99; p<0.01), as compared to the control group. Structural MRI investigation did not reveal any significant differences between the groups. The brain centers involved in ANS function were detected during fMRI, however the analysis of ROI in patients and controls showed no differences. Conclusions: Patients with AAV have symptoms related to the ANS, but no differences in the functioning of the ANS brain centers have been demonstrated in fMRI study during the Valsalva maneuver.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Cardiac responses to orthostatic stress deteriorate in Parkinson disease patients who begin to fall
Wystąpienie upadków w chorobie Parkinsona wiąże się z pogorszeniem regulacji czynności serca w czasie pionizacji
Autorzy:
Bryś, Mirosław
Szczudlik, Andrzej
Czarkowska, Hanna
Zajdel, Katarzyna
Bukowczan, Sylwia
Rudzińska-Bar, Monika
Motyl, Maciej
Kyrcz, Anna
Tutaj, Marcin
Opis:
Background and purpose It is not clear how cardiovascular autonomic nervous system dysfunction can affect falls in Parkinson disease (PD) patients. The aim of the study was to evaluate cardiovascular autonomic responses to orthostatic stress and occurrence of falls in PD patients over a period of 1-2 years. Material and methods In 53 patients, who either experienced at least one fall during 12 months preceding the study onset (fallers) or did not fall (non-fallers), we monitored RR intervals (RRI), heart rate (HR) and systolic (SBP) and diastolic (DBP) blood pressure, and calculated the coefficient of variation of RRI (RRI-CoV) and the ratio of low to high frequency spectral powers of RRI oscillations (LF/HF) at rest and upon tilting at study entry and after at least 12 months. Based on the number of falls at study closure, we identified three subgroups: non-fallers, chronic fallers, and new fallers. Results At study entry, RR-CoV, SBP, or DBP did not differ between fallers and non-fallers, while LF/HF ratios were lower in fallers than non-fallers at rest and upon tilting. After the follow-up period, HR and RRI-CoV responses to head-up tilt were reduced in new fallers as compared to study entry, whereas these variables remained unchanged during the study in non-fallers and chronic fallers. Prevalence of orthostatic hypotension did not differ between subgroups of patients. Conclusions Cardiac responses to orthostatic stress deteriorate in PD patients who begin to fall. Orthostatic blood pressure responses remain unchanged over time and are not associated with falls in PD.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Wyświetlanie 1-10 z 36

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