Publications by authors named "Petr Krupa"

31 Publications

Understanding the Biological Basis of Glioblastoma Patient-derived Spheroids.

Anticancer Res 2021 Mar;41(3):1183-1195

Department of Neurosurgery, New York Medical College/Westchester Medical Center, Valhalla, NY, U.S.A.

Background/aim: Resistance to glioblastoma (GB) therapy is attributed to the presence of glioblastoma stem cells (GSC). Here, we defined the behavior of GSC as it pertains to proliferation, migration, and angiogenesis.

Materials And Methods: Human-derived GSC were isolated and cultured from GB patient tumors. Xenograft GSC were extracted from the xenograft tumors, and spheroids were created and compared with human GSC spheroids by flow cytometry, migration, proliferation, and angiogenesis assays. Oct3/4 and Sox2, GFAP, and Ku80 expression was assessed by immunoanalysis.

Results: The xenograft model showed the formation of two different tumors with distinct characteristics. Tumors formed at 2 weeks were less aggressive with well-defined margins, whereas tumors formed in 5 months were diffuse and aggressive. Expression of Oct3/4 and Sox2 was positive in both human and xenograft GSC. Positive Ku80 expression in xenograft GSC confirmed their human origin. Human and xenograft GSC migrated vigorously in collagen and Matrigel, respectively. Xenograft GSC displayed a higher rate of migration and invasion than human GSC.

Conclusion: Human GSC were more aggressive in growth and proliferation than xenograft GSC, while xenograft GSC had increased invasion and migration compared to human GSC. A simple in vitro spheroid system for GSC provides a superior platform for the development of precision medicine in the treatment of GB.
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http://dx.doi.org/10.21873/anticanres.14875DOI Listing
March 2021

Trends and outcomes for non-elective neurosurgical procedures in Central Europe during the COVID-19 pandemic.

Sci Rep 2021 03 17;11(1):6171. Epub 2021 Mar 17.

Department of Neurosurgery and Neuro-Oncology, 1St Medical Faculty, Charles University, Central Military Hospital, Prague, Czech Republic.

The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care. We aimed to determine the incidence and 30-day mortality rate of various non-elective neurosurgical procedures during the COVID-19 pandemic. A retrospective, multi-centre observational cohort study among neurosurgical centres within Austria, the Czech Republic, and Switzerland was performed. Incidence of neurosurgical emergencies and related 30-day mortality rates were determined for a period reflecting the peak pandemic of the first wave in all participating countries (i.e. March 16th-April 15th, 2020), and compared to the same period in prior years (2017, 2018, and 2019). A total of 4,752 emergency neurosurgical cases were reviewed over a 4-year period. In 2020, during the COVID-19 pandemic, there was a general decline in the incidence of non-elective neurosurgical cases, which was driven by a reduced number of traumatic brain injuries, spine conditions, and chronic subdural hematomas. Thirty-day mortality did not significantly increase overall or for any of the conditions examined during the peak of the pandemic. The neurosurgical community in these three European countries observed a decrease in the incidence of some neurosurgical emergencies with 30-day mortality rates comparable to previous years (2017-2019). Lower incidence of neurosurgical cases is likely related to restrictions placed on mobility within countries, but may also involve delayed patient presentation.
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http://dx.doi.org/10.1038/s41598-021-85526-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969942PMC
March 2021

New Model of Ventral Spinal Cord Lesion Induced by Balloon Compression in Rats.

Biomedicines 2020 Nov 5;8(11). Epub 2020 Nov 5.

Institute of Experimental Medicine, Czech Academy of Sciences, Vídeňská, 1083 Prague, Czech Republic.

Despite the variety of experimental models of spinal cord injury (SCI) currently used, the model of the ventral compression cord injury, which is commonly seen in humans, is very limited. Ventral balloon compression injury reflects the common anatomical mechanism of a human lesion and has the advantage of grading the injury severity by controlling the inflated volume of the balloon. In this study, ventral compression of the SCI was performed by the anterior epidural placement of the balloon of a 2F Fogarty's catheter, via laminectomy, at the level of T10. The balloon was rapidly inflated with 10 or 15 μL of saline and rested in situ for 5 min. The severity of the lesion was assessed by behavioral and immunohistochemical tests. Compression with the volume of 15 μL resulted in severe motor and sensory deficits represented by the complete inability to move across a horizontal ladder, a final Basso, Beattie and Bresnahan (BBB) score of 7.4 and a decreased withdrawal time in the plantar test (11.6 s). Histology and immunohistochemistry revealed a significant loss of white and gray matter with a loss of motoneuron, and an increased size of astrogliosis. An inflation volume of 10 μL resulted in a mild transient deficit. There are no other balloon compression models of ventral spinal cord injury. This study provided and validated a novel, easily replicable model of the ventral compression SCI, introduced by an inflated balloon of Fogarty´s catheter. For a severe incomplete deficit, an inflated volume should be maintained at 15 μL.
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http://dx.doi.org/10.3390/biomedicines8110477DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694490PMC
November 2020

Microsurgical versus endoscopic surgery for non-functioning pituitary adenomas: a retrospective study.

Croat Med J 2020 Oct;61(5):410-421

Tomáš Česák, Department of Neurosurgery, University Hospital Hradec Kralove, Sokolská 581, 500 05 Hradec Králové, Czech Republic,

Aim: To compare microsurgical technique (mTSS) and endoscopic technique (eTSS) in the treatment of non-functioning pituitary adenomas (NFPAs).

Methods: We retrospectively evaluated the charts of 50 patients who underwent either mTSS or eTSS for NFPA in the Department of Neurosurgery, University Hospital Hradec Kralove from 2013 to 2019. We enrolled all patients who were not treated by postoperative adjuvant radiotherapy and who underwent at least two regular postoperative magnetic resonance imaging (MRI) tests. We compared the groups in terms of the extent of resection, surgery duration, blood loss, complication rate, overall clinical effect on the endocrinological and ophthalmological deficit, and postoperative growth pattern of the residual tumor mass.

Results: The mTSS group had significantly shorter surgical time (75 min vs 127 min, P<0.001) and lower perioperative blood loss (156 mL vs 256 mL, P=0.027). The groups did not significantly differ in the extent of resection, overall clinical or hormonal effect, and the complication rate. The extent of resection did not correlate with tumor consistency, while the tumor growth rate did not correlate with age or Ki-67 expression.

Conclusions: There was no major difference between the approaches in surgery radicality or safeness. However, eTSS remains the method of choice due to its potentially higher postoperative preservation of hormonal functions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684532PMC
October 2020

The Translesional Spinal Network and Its Reorganization after Spinal Cord Injury.

Neuroscientist 2020 Oct 22:1073858420966276. Epub 2020 Oct 22.

Department of Neurology, Mayo Clinic, Rochester, MN, USA.

Evidence from preclinical and clinical research suggest that neuromodulation technologies can facilitate the sublesional spinal networks, isolated from supraspinal commands after spinal cord injury (SCI), by reestablishing the levels of excitability and enabling descending motor signals via residual connections. Herein, we evaluate available evidence that sublesional and supralesional spinal circuits could form a after SCI. We further discuss evidence of translesional network reorganization after SCI in the presence of sensory inputs during motor training. In this review, we evaluate potential mechanisms that underlie translesional circuitry reorganization during neuromodulation and rehabilitation in order to enable motor functions after SCI. We discuss the potential of neuromodulation technologies to engage various components that comprise the translesional network, their functional recovery after SCI, and the implications of the concept of translesional network in development of future neuromodulation, rehabilitation, and neuroprosthetics technologies.
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http://dx.doi.org/10.1177/1073858420966276DOI Listing
October 2020

Moyamoya disease associated with fibromuscular dysplasia of intrapulmonary bronchial arteries-a case report.

Cardiovasc Pathol 2020 Mar - Apr;45:107182. Epub 2019 Nov 23.

Department of Neurosurgery, Charles University Faculty of Medicine and Faculty Hospital, Hradec Králové, Czech Republic.

A case is reported of a 40-year-old woman clinically diagnosed as moyamoya disease with associated fibromuscular dysplasia of intrapulmonary bronchial arteries incidentally revealed during autoptic examination. Moyamoya disease represents an idiopathic noninflammatory and nonatherosclerotic arterio-occlusive process of intracranial arteries. Prolonged brain ischemia leads to formation of tiny and fragile collaterals. Clinically, patients with moyamoya angiopathy commonly present with severe neurological symptoms caused by brain infarction or hemorrhage. Histologically, the steno-occlusive process is based on fibrocellular thickening of intima and intimal smooth muscle cell proliferation. In the literature, extracranial arterial involvement, i.e. fibromuscular dysplasia of renal or pulmonary arteries, has been described in several cases of moyamoya disease. Our aim is to show a unique case of moyamoya disease associated with fibromuscular dysplasia affecting an uncommon site.
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http://dx.doi.org/10.1016/j.carpath.2019.107182DOI Listing
June 2020

The Evaluation of Glioblastoma Cell Dissociation and Its Influence on Its Behavior.

Int J Mol Sci 2019 Sep 18;20(18). Epub 2019 Sep 18.

Department of Medical Biology and Genetics, Faculty of Medicine, Charles University, Simkova 870, CZ-500 38 Hradec Kralove, Czech Republic.

Purpose: Primary cell lines are a valuable tool for evaluation of tumor behavior or sensitivity to anticancer treatment and appropriate dissociation of cells could preserve genomic profile of the original tissue. The main aim of our study was to compare the influence of two methods of glioblastoma multiforme (GBM) cell derivation (mechanic-MD; enzymatic-ED) on basic biological properties of thus derived cells and correlate them to the ones obtained from stabilized GBM cell line A-172.

Methods: Cell proliferation and migration (xCELLigence Real-Time Cell Analysis), expression of microRNAs and protein markers (RT-PCR and Western blotting), morphology (phase contrast and fluorescent microscopy), and accumulation of temozolomide (TMZ) and its metabolite 5-aminoimidazole-4-carboxamide (AIC) inside the cells (LC-MS analysis) were carried out in five different samples of GBM (GBM1, GBM2, GBM32, GBM33, GBM34), with each of them processed by MD and ED types of isolations. The same analyses were done in the A-172 cell line too.

Results: Primary GBM cells obtained by ED or MD approaches significantly differ in biological behavior and properties of these cells. Unlike in primary MD GBM cells, higher proliferation, as well as migration, was observed in primary ED GBM cells, which were also associated with the acquired mesenchymal phenotype and higher sensitivity to TMZ. Finally, the same analyses of stabilized GBM cell line A-172 revealed several important differences in measured parameters.

Conclusions: GBM cells obtained by MD and ED dissociation show considerable heterogeneity, but based on our results, MD approach should be the preferred method of primary GBM cell isolation.
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http://dx.doi.org/10.3390/ijms20184630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770747PMC
September 2019

Nano-formulated curcumin (Lipodisq™) modulates the local inflammatory response, reduces glial scar and preserves the white matter after spinal cord injury in rats.

Neuropharmacology 2019 09 17;155:54-64. Epub 2019 May 17.

Institute of Experimental Medicine, Czech Academy of Sciences, Vídeňská 1083, Prague, Czech Republic; Department of Neuroscience, Charles University, Second Faculty of Medicine, Prague, Czech Republic. Electronic address:

A highly water soluble, nano-formulated curcumin was used for the treatment of the experimental model of spinal cord injury (SCI) in rats. Nanocurcumin and a vehicle nanocarrier as a control, were delivered both locally, immediately after the spinal cord injury, and intraperitoneally during the 4 consecutive weeks after SCI. The efficacy of the treatment was assessed using behavioral tests, which were performed during the experiment, weekly for 9 weeks. The behavioral tests (BBB, flat beam test, rotarod, motoRater) revealed a significant improvement in the nanocurcumin treated group, compared to the nanocarrier control. An immunohistochemical analysis of the spinal cord tissue was performed at the end of the experiment and this proved a significant preservation of the white matter tissue, a reduced area of glial scaring and a higher amount of newly sprouted axons in the nanocurcumin treated group. The expression of endogenous genes (Sort1, Fgf2, Irf5, Mrc1, Olig2, Casp3, Gap43, Gfap, Vegf, Nfkβ) and interleukins (IL-1β, TNF-α, IL-6, IL-12, CCL-5, IL-11, IL-10, IL-13) was evaluated by qPCR and showed changes in the expression of the inflammatory cytokines in the first two weeks after SCI.
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http://dx.doi.org/10.1016/j.neuropharm.2019.05.018DOI Listing
September 2019

Magnetic Resonance Imaging Compatible Non-Invasive Fibre-Optic Sensors Based on the Bragg Gratings and Interferometers in the Application of Monitoring Heart and Respiration Rate of the Human Body: A Comparative Study.

Sensors (Basel) 2018 Oct 31;18(11). Epub 2018 Oct 31.

Department of Imaging Method, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic.

The publication presents a comparative study of two fibre-optic sensors in the application of heart rate (HR) and respiratory rate (RR) monitoring of the human body. After consultation with clinical practitioners, two types of non-invasive measuring and analysis systems based on fibre Bragg grating (FBG) and fibre-optic interferometer (FOI) have been designed and assembled. These systems use probes (both patent pending) that have been encapsulated in the bio-compatible polydimethylsiloxane (PMDS). The main advantage of PDMS is that it is electrically non-conductive and, as well as optical fibres, has low permeability. The initial verification measurement of the system designed was performed on four subjects in a harsh magnetic resonance (MR) environment under the supervision of a senior radiology assistant. A follow-up comparative study was conducted, upon a consent of twenty volunteers, in a laboratory environment with a minimum motion load and discussed with a head doctor of the Radiodiagnostic Institute. The goal of the laboratory study was to perform measurements that would simulate as closely as possible the environment of harsh MR or the environment of long-term health care facilities, hospitals and clinics. Conventional HR and RR measurement systems based on ECG measurements and changes in the thoracic circumference were used as references. The data acquired was compared by the objective Bland⁻Altman (B⁻A) method and discussed with practitioners. The results obtained confirmed the functionality of the designed probes, both in the case of RR and HR measurements (for both types of B⁻A, more than 95% of the values lie within the ±1.96 SD range), while demonstrating higher accuracy of the interferometric probe (in case of the RR determination, 95.66% for the FOI probe and 95.53% for the FBG probe, in case of the HR determination, 96.22% for the FOI probe and 95.23% for the FBG probe).
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http://dx.doi.org/10.3390/s18113713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263944PMC
October 2018

The Current State of Advanced Therapy Medicinal Products in the Czech Republic.

Hum Gene Ther Clin Dev 2018 09 13;29(3):132-147. Epub 2018 Jul 13.

1 Department of Biomaterials and Biophysical Methods, Institute of Experimental Medicine, the Czech Academy of Sciences, Prague, the Czech Republic.

Advanced therapy medicinal products (ATMPs) represent a new generation of biopharmaceuticals that comprise gene therapy medicinal products (GTMPs), somatic cell therapy products (CTMPs), tissue engineered products (TEPs), and combined advanced therapy medicinal products (cATMPs). The joint effort of the academia-industry-regulatory triangle translated scientific progress into ten authorized ATMPs in the European Community. This notion holds promise for the whole field of ATMP therapies that have been increasingly evaluated in a number of clinical studies, also in the Czech Republic (CR). Here, we prepared an overview of regulatory framework, past and present clinical studies, and already authorized ATMPs in the CR. Clinical studies on ATMPs in the CR were mapped using public databases, particularly ClinicalTrials.gov, the European Union Clinical Trials Register, and the State Institute for Drug Control database. We found 50 registered clinical studies using ATMPs in the CR that mostly involve CTMPs (n = 36), followed by GTMPs (n = 4) and TEPs (n = 4). The majority of the studies use autologous ATMPs (76%) and are aimed at the treatment of oncologic conditions (58%) and musculoskeletal disorders (24%). The most frequent autologous cell type was dendritic cells (42%), bone marrow mononuclear cells (16%) and bone marrow mesenchymal stromal cells (13%). Allogeneic ATMPs (12%) are mostly aimed at the treatment of venous ulcers (33%) and utilize keratinocytes and fibroblasts (33%). In summary, ATMPs are increasingly tested in clinical trials in the CR, which will most likely lead to their translation into broader clinical use. However, to stimulate market viability of registered ATMPs, implementation of the sophisticated reimbursement system will be required.
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http://dx.doi.org/10.1089/humc.2018.035DOI Listing
September 2018

The Effect of Human Mesenchymal Stem Cells Derived from Wharton's Jelly in Spinal Cord Injury Treatment Is Dose-Dependent and Can Be Facilitated by Repeated Application.

Int J Mol Sci 2018 May 17;19(5). Epub 2018 May 17.

Institute of Experimental Medicine, Czech Academy of Sciences, Vídeňská 1083, 14220 Prague 4, Czech Republic.

Human mesenchymal stem cells derived from Wharton's jelly (WJ-MSCs) were used for the treatment of the ischemic-compression model of spinal cord injury in rats. To assess the effectivity of the treatment, different dosages (0.5 or 1.5 million cells) and repeated applications were compared. Cells or saline were applied intrathecally by lumbar puncture for one week only, or in three consecutive weeks after injury. Rats were assessed for locomotor skills (BBB, rotarod, flat beam) for 9 weeks. Spinal cord tissue was morphometrically analyzed for axonal sprouting, sparing of gray and white matter and astrogliosis. Endogenous gene expression (, , , , , ) was studied with quantitative Real-time polymerase chain reaction (qRT PCR). Significant recovery of functional outcome was observed in all of the treated groups except for the single application of the lowest number of cells. Histochemical analyses revealed a gradually increasing effect of grafted cells, resulting in a significant increase in the number of GAP43+ fibers, a higher amount of spared gray matter and reduced astrogliosis. mRNA expression of macrophage markers and apoptosis was downregulated after the repeated application of 1.5 million cells. We conclude that the effect of hWJ-MSCs on spinal cord regeneration is dose-dependent and potentiated by repeated application.
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http://dx.doi.org/10.3390/ijms19051503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983761PMC
May 2018

Aggressive Extraocular Sebaceous Carcinoma of the Scalp Involving the Brain in a Patient With Muir-Torre Syndrome.

Am J Dermatopathol 2016 Aug;38(8):618-22

*Sikl's Department of Pathology, Charles University in Prague, Medical Faculty in Pilsen, Pilsen, Czech Republic; †Bioptical Laboratory, Pilsen, Czech Republic; ‡Department of Radiology, University of Ostrava, Medical Faculty Hospital, Ostrava, Czech Republic; and §Department of Oncology and Radiotherapy, Charles University in Prague, Medical Faculty in Pilsen, Pilsen, Czech Republic.

This article reports an unusual case of aggressive extraocular sebaceous carcinoma located on the scalp with subsequent usurpation of the bone and penetrating through the bone and meninges to the brain in a 56-year-old man affected by Muir-Torre syndrome. Microscopically, the sebaceous neoplasm was located in the middle to deep dermis without any connection to the epidermis and showed a multinodular growth with neoplastic nodules with a central comedo-type necrosis separated from each other by fibrovascular stroma. The nodules were composed of varying proportions of mature sebaceous cells and atypical basaloid cells with high degree of atypia, including high nuclear/cytoplasmic ratio, nuclear pleomorphism, macronucleoli, atypical mitoses, and necrosis. The neoplasm was totally removed. Histopathological examinations of the recurrent lesion showed identical morphological features and, in addition, signs of the tumors growing through the periosteum were noted. In the final excision specimen, both the dura mater and the brain tissue were infiltrated by the sebaceous carcinoma. The diagnosis of Muir-Torre syndrome was confirmed by molecular genetic investigation that revealed an identical germline mutation in MSH2 gene in several family members, some of whom had colorectal tumors.
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http://dx.doi.org/10.1097/DAD.0000000000000524DOI Listing
August 2016

Claustrum damage and refractory status epilepticus following febrile illness.

Neurology 2015 Oct 4;85(14):1224-32. Epub 2015 Sep 4.

From the Department of Biomedical, Metabolic, and Neural Science (S.M., G.M., G.G.), University of Modena and Reggio Emilia, Modena; NOCSAE Hospital (S.M., G.M., G.G., A.C.), ASL Modena, Italy; Clinic of Neurology (J.S., P.H., V.M., D.B., M.B.) and Radiodiagnostic Institute (P.K.), University Hospital Ostrava; the Neurological Department of Na Homolce Hospital (I.M.), Prague, Czech Republic; and the Division of Neurology (N.S., N.P.), Bambino Gesù Children's Hospital, IRCCS, Rome Italy.

Objective: To characterize the clinical, EEG, and brain imaging findings in an adult case series of patients with de novo refractory status epilepticus (SE) occurring after a febrile illness.

Methods: A retrospective study (2010-2013) was undertaken with the following inclusion criteria: (1) previously healthy adults with refractory SE; (2) seizure onset 0-21 days after a febrile illness; (3) lacking evidence of infectious agents in CSF; (4) no history of seizures (febrile or afebrile) or previous or concomitant neurologic disorder.

Results: Among 155 refractory SE cases observed in the study period, 6 patients (17-35 years old) fulfilled the inclusion criteria. Confusion and stupor were the most common symptoms at disease onset, followed after a few days by acute repeated seizures that were uncountable in all but one. Seizures consisted of focal motor/myoclonic phenomena with subsequent generalization. Antiepileptic drugs failed in every patient to control seizures, with all participants requiring intensive care unit admission. Barbiturate coma with burst-suppression pattern was applied in 4 out of 6 patients for 5-14 days. One participant died in the acute phase. In each patient, we observed a reversible bilateral claustrum MRI hyperintensity on T2-weighted sequences, without restricted diffusion, time-related with SE. All patients had negative multiple neural antibodies testing. Four out of 5 surviving patients developed chronic epilepsy.

Conclusions: This is a hypothesis-generating study of a preliminary nature supporting the role of the claustrum in postfebrile de novo SE; future prospective studies are needed to delineate the specificity of this condition, its pathogenesis, and the etiology.
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http://dx.doi.org/10.1212/WNL.0000000000001996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607596PMC
October 2015

NANOTECHNOLOGY - NEW TRENDS IN THE TREATMENT OF BRAIN TUMOURS.

Acta Medica (Hradec Kralove) 2014 ;57(4):142-50

Charles University in Prague, Department of Oncology and Radiotherapy, Faculty of Medicine in Hradec Králové, and University Hospital Hradec Králové, Czech Republic.

High grade gliomas are some of the deadliest human tumours. Conventional treatments such as surgery, radiotherapy and chemotherapy have only a limited effect. Nowadays, resection is the common treatment of choice and although new approaches, such as perioperative magnetic resonance imaging or fluorescent microscopy have been developed, the survival rate of diagnosed patients is still very low. The inefficacy of conventional methods has led to the development of new strategies and the significant progress of nanotechnology in recent years. These platforms can be used either as novel imaging tools or to improve anticancer drug delivery into tumours while minimizing its distribution and toxicity in healthy tissues. Amongst the new nanotechnology platforms used for delivery into the brain tissue are: polymeric nanoparticles, liposomes, dendrimers, nanoshells, carbon nanotubes, superparamagnetic nanoparticles and nucleic acid based nanoparticles (DNA, RNA interference [RNAi] and antisense oligonucleotides [ASO]). These nanoparticles have been applied in the delivery of small molecular weight drugs as well as macromolecules - proteins, peptides and genes. The unique properties of these nanoparticles, such as surface charge, particle size, composition and ability to modify their surface with tissue recognition ligands and antibodies, improve their biodistribution and pharmacokinetics. All of the above mentioned characteristics make of nanoplatforms a very suitable tool for its use in targeted, personalized medicine, where they could possibly carry large doses of therapeutic agents specifically into malignant cells while avoiding healthy cells. This review poses new possibilities in the large field of nanotechnology with special interest in the treatment of high grade brain tumours.
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http://dx.doi.org/10.14712/18059694.2015.79DOI Listing
August 2015

Vocal tract and glottal function during and after vocal exercising with resonance tube and straw.

J Voice 2013 Jul 15;27(4):523.e19-34. Epub 2013 May 15.

School of Communication Science and Disorders, University of Chile, Santiago, Chile.

Objective: The present study aimed to investigate the vocal tract and glottal function during and after phonation into a tube and a stirring straw.

Methods: A male classically trained singer was assessed. Computerized tomography (CT) was performed when the subject produced [a:] at comfortable speaking pitch, phonated into the resonance tube and when repeating [a:] after the exercise. Similar procedure was performed with a narrow straw after 15 minutes silence. Anatomic distances and area measures were obtained from CT midsagittal and transversal images. Acoustic, perceptual, electroglottographic (EGG), and subglottic pressure measures were also obtained.

Results: During and after phonation into the tube or straw, the velum closed the nasal passage better, the larynx position lowered, and hypopharynx area widened. Moreover, the ratio between the inlet of the lower pharynx and the outlet of the epilaryngeal tube became larger during and after tube/straw phonation. Acoustic results revealed a stronger spectral prominence in the singer/speaker's formant cluster region after exercising. Listening test demonstrated better voice quality after straw/tube than before. Contact quotient derived from EGG decreased during both tube and straw and remained lower after exercising. Subglottic pressure increased during straw and remained somewhat higher after it.

Conclusion: CT and acoustic results indicated that vocal exercises with increased vocal tract impedance lead to increased vocal efficiency and economy. One of the major changes was the more prominent singer's/speaker's formant cluster. Vocal tract and glottal modifications were more prominent during and after straw exercising compared with tube phonation.
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http://dx.doi.org/10.1016/j.jvoice.2013.02.007DOI Listing
July 2013

Tumors in the 18th and 19th centuries at Brno, Czech Republic.

Anthropol Anz 2013 ;70(4):385-405

Symptoms signs of benign and malignant tumors were observed during paleopathological analysis of skeletal remains from the city of Brno in the Czech Republic. Approximately 1,200 skeletons were examined from two Modern era archaeology sites: the Malá Nová ulice (Little New Street) cemetery and the cemetery of the Nemocnice Milosrdných bratrí (Merciful Brothers' Hospital). Osteomas, usually located on the flat bones of the cranial vault, were the most frequent skeletal pathology. Symptoms signs of malignant tumors were observed in three cases. In one case lytic foci caused by the metastases of a malignant tumor in the soft tissue was observed. Traces of myeloma multiplex were found in two individuals. Living conditions in that period, and possible carcinogenic environmental influences were assessed for the general population of Brno. This report contributes to a better understanding of the historical development of cancers and the clarification of possible causes for their modern increase of incidence.
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http://dx.doi.org/10.1127/0003-5548/2013/0343DOI Listing
April 2014

Functional imaging of the cerebellum and basal ganglia during predictive motor timing in early Parkinson's disease.

J Neuroimaging 2014 Jan-Feb;24(1):45-53. Epub 2011 Dec 30.

First Department of Neurology, St. Anne's Teaching Hospital, Faculty of Medicine, Masaryk University Brno, Pekarska, Brno, Czech Republic.

Background And Purpose: The basal ganglia and the cerebellum have both emerged as important structures involved in the processing of temporal information.

Methods: We examined the roles of the cerebellum and striatum in predictive motor timing during a target interception task in healthy individuals (HC group; n = 21) and in patients with early Parkinson's disease (early stage PD group; n = 20) using functional magnetic resonance imaging.

Results: Despite having similar hit ratios, the PD failed more often than the HC to postpone their actions until the right moment and to adapt their behavior from one trial to the next. We found more activation in the right cerebellar lobule VI in HC than in early stage PD during successful trials. Successful trial-by-trial adjustments were associated with higher activity in the right putamen and lobule VI of the cerebellum in HC.

Conclusions: We conclude that both the cerebellum and striatum are involved in predictive motor timing tasks. The cerebellar activity is associated exclusively with the postponement of action until the right moment, whereas both the cerebellum and striatum are needed for successful adaptation of motor actions from one trial to the next. We found a general ''hypoactivation'' of basal ganglia and cerebellum in early stage PD relative to HC, indicating that even in early stages of the PD there could be functional perturbations in the motor system beyond striatum.
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http://dx.doi.org/10.1111/j.1552-6569.2011.00663.xDOI Listing
April 2015

Root resorption associated with ectopically erupting maxillary permanent canines: a computed tomography study.

Eur J Orthod 2011 Oct 2;33(5):483-91. Epub 2010 Dec 2.

Clinic of Stomatology, Faculty of Medicine, St. Anne’s University Hospital , Brno, Czech Republic.

The aims of this retrospective computed tomography (CT) study were to determine the occurrence of severe root resorption involving the pulpal canal of adjacent permanent teeth associated with ectopically erupting canines, and to verify the existence of related factors. The sample consisted of 255 consecutive patients (159 females and 96 males, mean age 18.4 and 16.8 years, respectively). Three hundred and thirty-four ectopic maxillary canines and adjacent teeth were analysed using CT images. Statistical significance was evaluated with chi-square and Fisher's exact tests. The results showed that severe root resorption of adjacent permanent teeth occurred in 17.7 per cent of ectopic canines and was equally common in females and males. Severe root resorption affected 12.6 per cent of the lateral incisors, 4.8 per cent of the first premolars, and 2.1 per cent of the central incisors. No relationship was found between the type or side of ectopic eruption, inclination of the longitudinal axis of the ectopic canine and the occurrence of severe root resorption. A significant relationship was found between a bucco-lingual position of the ectopic canine and root resorption (P < 0.05). Root resorption mainly occurred in the apical third (57.6 per cent) and apical and middle thirds (27.1 per cent). A significant relationship existed between the occurrence of root resorption and complete loss of space for the erupting canine (P < 0.05). No association was found between alignment of the upper permanent incisor and root resorption. A widened dental follicle occurred in 15 per cent of ectopic canines but did not cause root resorption of the adjacent permanent teeth. Since root resorption is asymptomatic, early detection by radiographic examination is essential for correct diagnosis and treatment.
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http://dx.doi.org/10.1093/ejo/cjq085DOI Listing
October 2011

Outcome of patients with negative CT angiography results for arterial occlusion treated with intravenous thrombolysis.

Stroke 2009 Mar 8;40(3):868-72. Epub 2009 Jan 8.

Department of Neurology, Masaryk University, St. Anne's University Hospital, Pekarská 53, 656 91, Brno, Czech Republic.

Background And Purpose: Stroke patients without evidence of arterial occlusion may not be suitable candidates for thrombolytic therapy. In our study, we investigated the outcomes of patients with negative CT angiography results for arterial occlusion.

Methods: The study included patients treated within 3 hours after symptom onset with intravenous thrombolysis for significant neurological deficit between August 2003 and June 2007. All of the patients were documented with negative CT angiography results for arterial occlusion by independent reviews. Outcome measurements included modified Rankin score at 3 months, incidence of intracranial hemorrhage, and infarction volume on control CT. The predictors of unfavorable outcome (modified Rankin score, 2-6) were identified by multivariate logistic regression.

Results: Altogether, 173 patients received intravenous thrombolysis; of those, 138 underwent CT angiography. The CT angiography results were negative for arterial occlusion in 39 (28%) of the patients: mean age, 71+/-10 years; 16 (41%) female; median baseline NIHSS, 11. At 3 months, modified Rankin score of 0 to 1 was achieved in 18 (46%) of the patients; 6 (15%) died; and 3 (8%) had symptomatic parenchymal hemorrhage. The median infarct volume was 1.5 cm(3). The independent predictors of unfavorable clinical outcome were higher age (OR, 1.1; 95% CI, 1.01-1.27), and baseline NIHSS >12 (OR, 18.8; 95% CI, 1.4 to 261). One patient had encephalitis diagnosed.

Conclusions: Negative baseline CT angiography is not uncommon. The risk of intracerebral hemorrhage after thrombolytic therapy for patients without evidence of arterial occlusion is similar to the risk carried in an unselected patient population. Given the prognosis, thrombolytic therapy seems justified; however, etiology other than stroke should be considered.
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http://dx.doi.org/10.1161/STROKEAHA.108.532572DOI Listing
March 2009

Allogeneic and autogenous transplantations of MSCs in treatment of the physeal bone bridge in rabbits.

BMC Biotechnol 2008 Sep 12;8:70. Epub 2008 Sep 12.

Department of Pediatric Surgery, Orthopaedics and Traumatology, the Faculty Hospital Brno, Jihlavska 20, Brno, Czech Republic.

Background: The aim of this experimental study on New Zealand's white rabbits was to find differences in the results of treating the distal physeal femoral defect by the transplantation of autologous or allogeneic mesenchymal stem cells (MSCs). After the excision of a created bone bridge in the distal physis of the right femur, modified composite scaffold with MSCs was transplanted into the defect. In animal Group A (n = 11) autogenous MSCs were implanted; in animal Group B (n = 15) allogeneic MSCs were implanted. An iatrogenic physeal defect of the left femur of each animal not treated by MSCs transplantation served as control. The rabbits were euthanized four months after the transplantation. The treatment results were evaluated morphometrically (femoral length and valgus deformity measurement) and histologically (character and quality of the new cartilage).

Results: Four months after the transplantation, the right femurs of the animals in Group A were on average longer by 0.50 +/- 0.04 cm (p = 0.018) than their left femurs, the right femurs of rabbits in Group B were on average longer by 0.43 +/- 0.01 cm (p = 0.028) than their left femurs.4 months after the therapeutic transplantation of MSCs valgus deformity of the distal part of the right femur of animals in Group A was significantly lower (by 4.45 +/- 1.86 degrees ) than that of their left femur (p = 0.028), in Group B as well (by 3.66 +/- 0.95 degrees than that of their left femur p = 0.001). However, no significant difference was found between rabbits with transplanted autogenous MSCs (Group A) and rabbits with transplanted allogeneic MSCs (Group B) either in the femur length (p = 0.495), or in its valgus deformity (p = 0.1597). After the MSCs transplantation the presence of a newly formed hyaline cartilage was demonstrated histologically in all the animals (both groups). The ability of transplanted MSCs to survive in the damaged physis was demonstrated in vivo by magnetic resonance, in vitro by Perls reaction and immunofluorescence.

Conclusion: The transplantation of both autogenous and allogeneic MSCs into a defect of the growth plate appears as an effective method of surgical treatment of physeal cartilage injury. However, the Findings point to the conclusion that there is no clear difference in the final effect of the transplantation procedure used.
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http://dx.doi.org/10.1186/1472-6750-8-70DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556323PMC
September 2008

Correlation study of optimized voxel-based morphometry and (1)H MRS in patients with mesial temporal lobe epilepsy and hippocampal sclerosis.

Hum Brain Mapp 2009 Apr;30(4):1226-35

Department of Neurology, Brno Epilepsy Centre, St. Anne's Hospital, Masaryk University Brno, Czech Republic.

Purpose: : To assess whether structural and metabolic brain abnormalities are correlated in MTLE/HS syndrome.

Methods: : Optimized voxel-based morphometry (VBM) of gray matter concentration (GMC) and gray matter volume (GMV) and proton magnetic resonance spectroscopy measurements from both-sided hippocampal and thalamic regions were performed in 20 MTLE/HS patients and 20 sex- and age-matched healthy controls. The local GMC and GMV values were calculated in both the affected and unaffected hippocampi and ipsilateral and contralateral thalami in patients and healthy subjects, and these were compared. VBM variables and NAA, NAA/Cr and NAA/(Cr+Cho) values from the investigated brain regions were correlated.

Results: : (1) Analysis revealed significantly more extensive GMV reduction than GMC reduction in patients' affected hippocampus. In addition, significant GMV reduction was observed in the ipsilateral thalamus in MTLE/HS patients. (2) Significant decreases in all VBM and MRS variables were revealed in the affected hippocampus. Whilst practically normal GMC values were revealed in patients' both-sided thalamic regions, a significant decrease in local GMV and metabolic measurements were found in the patients' ipsilateral thalamus. (3) Pearson's correlations between structural and metabolic abnormalities were significant for the ipsilateral thalamus only.

Conclusion: : Structural and metabolic abnormalities as detected by optimized voxel-based morphometry and (1)H MRS in hippocampal and thalamic regions are only partially correlated in MTLE/HS patients. It seems therefore reasonable that both methods reflect different aspects of brain pathology, which, at least to some degree, might be independently ongoing.
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http://dx.doi.org/10.1002/hbm.20589DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6870827PMC
April 2009

Magnetic resonance spectroscopy of the thalamus in patients with mesial temporal lobe epilepsy and hippocampal sclerosis.

Epileptic Disord 2007 Dec;9 Suppl 1:S59-67

Brno Epilepsy Centre, Department of Neurology, Masaryk University, St. Anne's University Hospital, Brno, Czech Republic.

Purpose: to investigate potential neuronal dysfunction within the thalamus in patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE/HS).

Methods: we examined twenty epileptic patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis (17 females, 3 males) and twenty sex- and age-matched healthy controls. H MR spectroscopic imaging (SI) was performed over the right and left thalamus in all patients and controls. In addition both hippocampi were investigated by the H MR spectroscopic single voxel (SV) technique in both groups.

Results: statistical analysis of compared data in both groups demonstrated that the total thalamic NAA level was significantly decreased in patients with MTLE/HS as compared to healthy controls. Detailed analysis revealed a statistically significant reduction of NAA, NAA/Cr and NAA/(Cr+Cho) ratios in the thalamus ipsilateral to hippocampus affected with hippocampal sclerosis in patients compared to controls, while no significant changes were observed in the thalamus contralateral to sclerotic hippocampus. A comparison of values in ipsilateral and contralateral thalami in patients showed statistically significant difference with lower values of NAA and both ratios in the ipsilateral thalamus. Previously reported reduced hippocampal concentration of NAA, NAA/Cr and NAA/(Cr+Cho) ratios on the side of hippocampal sclerosis compared with contralateral hippocampus in patients and both hippocampi in controls was confirmed.

Conclusions: the present MRS data clearly indicate neuronal dysfunction within the thalamus ipsilateral to the sclerotic hippocampus of patients with mesial temporal lobe epilepsy. In agreement with other recent functional and structural neuroimagings our results confirm the role of the ipsilateral thalamus in the medial temporal/limbic epileptic network.
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http://dx.doi.org/10.1684/epd.2007.0148DOI Listing
December 2007

Effects of spatial smoothing on fMRI group inferences.

Magn Reson Imaging 2008 May 3;26(4):490-503. Epub 2007 Dec 3.

Department of Biomedical Engineering, FEEC, Brno University of Technology, Koleni 4, 612 00 Brno, Czech Republic.

The analysis of functional magnetic resonance imaging (fMRI) data involves multiple stages of data pre-processing before the activation can be statistically detected. Spatial smoothing is a very common pre-processing step in the analysis of functional brain imaging data. This study presents a broad perspective on the influence of spatial smoothing on fMRI group activation results. The data obtained from 20 volunteers during a visual oddball task were used for this study. Spatial smoothing using an isotropic gaussian filter kernel with full width at half maximum (FWHM) sizes 2 to 30 mm with a step of 2 mm was applied in two levels - smoothing of fMRI data and/or smoothing of single-subject contrast files prior to general linear model random-effects group analysis generating statistical parametric maps. Five regions of interest were defined, and several parameters (coordinates of nearest local maxima, t value, corrected threshold, effect size, residual values, etc.) were evaluated to examine the effects of spatial smoothing. The optimal filter size for group analysis is discussed according to various criteria. For our experiment, the optimal FWHM is about 8 mm. We can conclude that for robust experiments and an adequate number of subjects in the study, the optimal FWHM for single-subject inference is similar to that for group inference (about 8 mm, according to spatial resolution). For less robust experiments and fewer subjects in the study, a higher FWHM would be optimal for group inference than for single-subject inferences.
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http://dx.doi.org/10.1016/j.mri.2007.08.006DOI Listing
May 2008

Effective connectivity in target stimulus processing: a dynamic causal modeling study of visual oddball task.

Neuroimage 2007 Apr 23;35(2):827-35. Epub 2006 Dec 23.

1st Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic.

Purpose: To investigate the fundamental connectivity architecture of neural structures involved in the goal-directed processing of target events.

Methods: Twenty healthy volunteers underwent event-related functional magnetic resonance imaging (fMRI) while performing a standard oddball task. In the task, two types of visual stimuli - rare (target) and frequent - were randomly presented, and subjects were instructed to mentally count the target stimuli. Dynamic causal modeling (DCM), in combination with Bayes factors was used to compare competing neurophysiological models with different intrinsic connectivity structures and input regions within the network of brain regions underlying target stimulus processing.

Results: Conventional analysis of fMRI data revealed significantly greater activation in response to the target stimuli (in comparison to the frequent stimuli) in several brain regions, including the intraparietal sulci and supramarginal gyri, the anterior and posterior cingulate gyri, the inferior and middle frontal gyri, the superior temporal sulcus, the precuneus/cuneus, and the subcortical grey matter (caudate and thalamus). The most extensive cortical activations were found in the right intraparietal sulcus (IPS), the anterior cingulate cortex (ACC), and the right lateral prefrontal cortex (PFC). These three regions were entered into the DCM. A comparison on a group level revealed that the dynamic causal models in which the ACC and alternatively the IPS served as input regions were superior to a model in which the PFC was assumed to receive external inputs. No significant difference was observed between the fully connected models with ACC and IPS as input regions. Subsequent analysis of the intrinsic connectivity within two investigated models (IPS and ACC) disclosed significant parallel forward connections from the IPS to the frontal areas and from the ACC to the PFC and the IPS.

Conclusion: Our findings indicate that during target stimulus processing there is a bidirectional frontoparietal information flow, very likely reflecting parallel activation of two distinct but partially overlapping attentional or attentional/event-encoding neural systems. Additionally, a simple hierarchy within the right frontal lobe is suggested with the ACC exerting influence over the PFC.
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http://dx.doi.org/10.1016/j.neuroimage.2006.12.020DOI Listing
April 2007

fMRI evaluation of hemispheric language dominance using various methods of laterality index calculation.

Exp Brain Res 2007 May 15;179(3):365-74. Epub 2006 Dec 15.

Department of Neurology, Masaryk University, St. Anne's University Hospital, Pekarská 53, Brno, 65691, Czech Republic.

Several functional MR imaging studies evaluating the lateralisation of linguistic functions in patients who underwent Wada testing have been reported. There is extensive variance in the Laterality index (LI) calculation across the studies, and the optimal calculation method remains unclear. We attempted to calculate the LI in different ways in the same subjects, in order to find the LI calculation method with the highest correlation to the Wada test. Fifteen patients (10 females, 5 males) suffering from medically intractable temporal lobe epilepsy (TLE) (12 left, 3 right) were admitted for the study. The patients underwent a standardized bilateral intracarotid short-acting barbiturate test. Language testing included spontaneous speech, oral comprehension, reading, object and picture naming, and repetition. All the tasks were scored separately in order to increase the possibility of correlation between Wada and LI. A silent phonemic verbal fluency task (VFT) was used as a language paradigm for functional measurement. Regions of interest (ROIs), with a known association with language function (Broca's area, the lateral prefrontal cortex, etc.), were defined. First, the LIs were calculated from the ROIs using a previously reported method (simple suprathreshold count). Next, we used several new methods of LI calculation (t-weighting of voxels, methods independent of the choice of the statistical threshold, etc.) The most significant correlation with Wada was proven in the LIs that were evaluated from Broca's area (up to R = 0.94, P = 1 x 10(-7)). However, the new LI calculation methods used in the present study did not produce a statistically significant benefit in comparison to previously reported methods.
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http://dx.doi.org/10.1007/s00221-006-0794-yDOI Listing
May 2007

Prefrontal but not temporal grey matter changes in males with first-episode schizophrenia.

Prog Neuropsychopharmacol Biol Psychiatry 2007 Jan 29;31(1):151-7. Epub 2006 Sep 29.

Department of Psychiatry, Masaryk University, Faculty of Medicine and Faculty Hospital Brno-Bohunice, Jihlavska 20, 625 00, Brno, the Czech Republic.

Introduction: Changes of brain morphology are now considered as a part of the pathology of schizophrenia. Voxel-based morphometry may be used to study regional changes of the grey matter in the whole brain. It is advantageous to study first-episode patients to prevent the influence of many possible biasing factors when trying to identify primary pathological processes underlying the manifestation of the illness.

Objective: To investigate regional grey matter changes in the first-episode schizophrenia patients.

Methods: Optimized voxel-based morphometry was used to detect changes in grey matter volume in 22 patients with first-episode schizophrenia compared with 18 healthy volunteers of comparable age, gender and handedness.

Results: The first-episode schizophrenia group had significantly reduced grey matter volume in the prefrontal cortex (inferior and middle prefrontal gyrus, cingulate gyrus). We identified no differences in the temporal cortex.

Conclusion: Our data support the theoretical assumption that prefrontal dysfunction underlines the primary pathology and clinical manifestation of schizophrenia. We are inclined to explain the differences in the pattern of morphological changes reported in other first-episode studies--especially the lack of changes in the temporal cortex--by heterogeneity of schizophrenia, potential progression and antipsychotic medication effect.
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http://dx.doi.org/10.1016/j.pnpbp.2006.08.011DOI Listing
January 2007

Magnetic resonance spectroscopy of the thalamus in patients with typical absence epilepsy.

Seizure 2006 Oct 31;15(7):533-40. Epub 2006 Jul 31.

Brno Epilepsy Centre, Department of Neurology, Masaryk University, St. Anne's University Hospital, Pekarská 53, 656 91 Brno, Czech Republic.

Purpose: To investigate possible neuronal dysfunction of the thalamus in patients suffering from typical absence epilepsy, using magnetic resonance spectroscopy (MRS). Special attention was paid to levels of N-acetylaspartate (NAA) and creatine (Cr), and to the NAA/Cr ratio.

Methods: MRS was performed over the right and left thalamus in nine patients suffering from typical absence epilepsy, and in nine sex- and age-matched healthy controls. All patients and controls were examined using a standard MRS-CSI (chemical shift imaging) technique.

Results: Statistical analysis of the obtained data demonstrated a significantly lower thalamic NAA/Cr ratio in patients with typical absence epilepsy when compared to the healthy controls. Our MRS data showed symmetrical distribution of NAA/Cr ratio in the right and left thalamus within both the patient group and the group of healthy controls. No significant correlation between the patients' thalamic NAA/Cr values and the duration of the epilepsy or seizure frequency was revealed.

Conclusions: The present MRS data clearly indicate neuronal dysfunction in the thalami of patients with typical absence epilepsy. In agreement with other recent MRS findings in different idiopathic generalized epilepsy syndromes, our results confirm the role of the thalamus as an important structure in the pathogenesis of typical absence epilepsy.
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http://dx.doi.org/10.1016/j.seizure.2006.06.007DOI Listing
October 2006

Combined event-related fMRI and intracerebral ERP study of an auditory oddball task.

Neuroimage 2005 May;26(1):285-93

First Department of Neurology, St. Anne's University Hospital, Brno, Czech Republic.

Event-related fMRI (efMRI) has been repeatedly used to seek the neural sources of endogenous event-related potentials (ERP). However, significant discrepancies exist between the efMRI data and the results of previously published intracranial ERP studies of oddball task. To evaluate the capacity of efMRI to define the sources of the P3 component of ERP within the human brain, both efMRI and intracerebral ERP recordings were performed in eight patients with intractable epilepsy (five males and three females) during their preoperative invasive video-EEG monitoring. An identical auditory oddball task with frequent and target stimuli was completed in two sessions. A total of 606 intracerebral sites were electrophysiologically investigated by means of depth electrodes. In accordance with the finding of multiple intracerebral generators of P3 potential, the target stimuli evoked MRI signal increase in multiple brain regions. However, regions with evident hemodynamic and electrophysiological responses overlapped only partially. P3 generators were always found within hemodynamic-active sites, if these sites were investigated by means of depth electrodes. On the other hand, unequivocal local sources of P3 potential were apparently also located outside the regions with a significant hemodynamic response (typically in mesiotemporal regions). Both methods should thus be viewed as mutually complementary in investigations of the spatial distribution of cortical and subcortical activation during oddball task.
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http://dx.doi.org/10.1016/j.neuroimage.2005.01.051DOI Listing
May 2005

Handedness shift as a consequence of motor cortex reorganization after early functional impairment in left temporal lobe epilepsy--an fMRI case report.

Neurocase 2004 Aug;10(4):326-9

1st Department of Neurology, Masaryk University, St. Anne's University Hospital, Czech Republic.

The impact of epileptiform activity on the functional organization of various cortical regions is currently a widely discussed topic. Our patient, suffering from left-sided temporal lobe epilepsy with typical mesiotemporal sclerosis, had a remarkable history of a clear-cut handedness shift in early childhood. In this study, we considered the possibility of the functional reorganization of the motor cortex using functional MRI. The results reflect epileptiform activity as an important formative factor for motor cortex development in our patient.
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http://dx.doi.org/10.1080/13554790490507669DOI Listing
August 2004

Unruptured intracranial aneurysm as a cause of focal epilepsy: an excellent postoperative outcome after intra-arterial treatment.

Epileptic Disord 2004 Mar;6(1):41-4

Department of Neurology, Brno Epilepsy Centre, Masaryk University, St Anneís Hospital, Brno, Czech Republic.

This report involves a patient suffering from focal epilepsy caused by an unruptured, intracranial aneurysm (UIA), and her treatment using intravascular embolisation, with an excellent postoperative outcome in terms of the epilepsy. A 52 year-old, right-handed woman had been suffering for three years from focal seizures, characterized by loss of consciousness, and oroalimentary and hand automatisms. The epilepsy was not controlled by carbamazepine monotherapy. Magnetic resonance imaging and digital subtraction angiography revealed a saccular aneurysm at the bifurcation of the middle cerebral artery, in contact with the cortex of the temporal opercular region. An intra-arterial embolisation, using a detachable, mechanical spiral (MDS, Bold Platinum), was performed, with no complications. The purpose of embolisation was the treatment of the aneurysm. The patient had two more, complex partial seizures (CPS) in the early postoperative period, but was seizure-free between September 1998 and September 2002. This is the first case report that presents the successful treatment of UIA-related epilepsy by means of intravascular embolisation.
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March 2004