Zbigniew Stelmasiak

Publications of Zbigniew Stelmasiak

• Neurofilament heavy chain and heat shock protein 70 as markers of seizure-related brain injury.

  Authors: Konrad Rejdak, Jens Kuhle, Stephan Rüegg, Raija L P Lindberg, Axel Petzold, Dorota Sulejczak, Ewa Papuc, Robert Rejdak, Zbigniew Stelmasiak, Paweł Grieb

  Epilepsia. 04/2012;

  Purpose:  Status epilepticus (SE) has deleterious effects on brain tissue, but whether brief recurrent seizures may also damage neurons represents a matter of controversy. Therefore, it remains aPurpose:  Status epilepticus (SE) has deleterious effects on brain tissue, but whether brief recurrent seizures may also damage neurons represents a matter of controversy. Therefore, it remains a central area of epilepsy research to identify individuals at risk where disease progression can be potentially prevented. Biomarkers may serve as tools for such identification. Thus the present study aimed at analyzing the levels of heat shock protein 70 (HSP-70, also designated as HSPA1A) and neurofilament heavy chain protein (NfH(SMI35) ) in cerebrospinal fluid (CSF) of patients with seizures of different severity. Methods:  Forty-one patients were included, of whom 20 patients had a single generalized tonic-clonic seizure (GTCS) episode (SS), 11 had repetitive GTCS (RS), and 10 experienced convulsive SE. The control group consisted of 18 subjects. HSP-70 levels were measured using a conventional enzyme-linked immunosorbent assay (ELISA), whereas the NfH(SMI35) protein levels were detected by an electrochemiluminescence (ECL) immunoassay. Key Findings:  Patients with SE (p < 0.001) and RS (p < 0.05) had significantly higher NfH(SMI35) levels than controls, and SE was associated with increased concentrations when compared with SS (p < 0.001). NfH(SMI35) levels in SS did not differ from controls. Patients with SE had significantly raised HSP-70 levels compared to RS (p < 0.05), SS (p < 0.05), and controls (p < 0.001). SS and RS did not differ from each or from controls. Levels of NfH(SMI35) and HSP-70 showed a significant correlation (r = 0.34; p = 0.007) in the group of all study subjects, which was not apparent when controls and patients with seizures were considered separately. The correlation between NfH(SMI35) and HSP-70 tended to be inverse in patients with SE, but it did not reach statistical significance (r = -0.3; p > 0.05). Significance:  Studying biochemical markers as additional quantitative tools for the measurement of neuronal damage (especially subclinical), complementary to available techniques of imaging, and clinical assessment might prove useful for identifying patients at risk of accumulating neuronal injury resulting from uncontrolled seizures. NfH(SMI35) and HSP-70 are of potential value as sensitive and specific biomarkers of seizure-related pathologic events. Future longitudinal studies are needed to monitor such patients by correlating biochemical, neuroimaging, and clinical methods of assessment.

• Factors predicting quality of life in a group of Polish subjects with multiple sclerosis: Accounting for functional state, socio-demographic and clinical factors.

  Authors: Ewa Papuć, Zbigniew Stelmasiak

  Clinical neurology and neurosurgery. 11/2011;

  OBJECTIVES: Quality of life (QoL) has presently a firmly established position as an important endpoint in medical care. Multiple sclerosis (MS) is a chronic neurological disease with considerableOBJECTIVES: Quality of life (QoL) has presently a firmly established position as an important endpoint in medical care. Multiple sclerosis (MS) is a chronic neurological disease with considerable effect on patients' QoL. QoL of MS patients from many European countries has already been assessed but little is known on health-related QoL of Polish subjects with MS. Few studies have taken into consideration multiple predictors of QoL. The aim of this study was to elicit the most relevant factors that determine QoL of Polish group of MS patients. Socio-demographic and clinical factors as well as the influence of disability level were analyzed in this study. PATIENTS AND METHODS: 173 MS patients and 86 healthy controls underwent assessment using the Mini Mental Status Examination, WHOQOL-100, Beck Depression Inventory and Fatigue Severity Scale. Data were analyzed by a stepwise linear regression analysis. RESULTS: MS patients had significantly worse global QoL and worse QoL in physical and psychological health domains, lower level of independence, worse social relations and were less satisfied with the surrounding environment they lived in compared with healthy controls (p<0.05). MS subjects had also higher level of depression and fatigue compared to healthy controls (p<0.05). CONCLUSIONS: The study determined that the strongest predictors of global QoL of Polish MS patients were depression, disability level and fatigue.

• Analysis of ventricular late potentials in signal-averaged ECG of people with epilepsy.

  Authors: Konrad Rejdak, Andrzej Rubaj, Andrzej Głowniak, Kamila Furmanek, Andrzej Kutarski, Andrzej Wysokiński, Zbigniew Stelmasiak

  Epilepsia. 09/2011; 52(11):2118-24.

  There has been growing interest in cardiac disturbances in epilepsy patients and their etiologic role in the context of sudden death. Ventricular late potentials (VLPs) recorded on signal-averagedThere has been growing interest in cardiac disturbances in epilepsy patients and their etiologic role in the context of sudden death. Ventricular late potentials (VLPs) recorded on signal-averaged electrocardiography (SAECG) reflects delayed ventricular depolarization and identifies the structural or functional substrate for the ventricular tachycardia in the reentry mechanism. Therefore, abnormal SAECG poses the potential of identifying patients at increased risk of malignant ventricular arrhythmias and sudden cardiac death. The aim of this exploratory study was to screen epilepsy patients who were treated with established doses of antiepileptic drugs (AEDs) on the presence of VLPs. Forty-five consecutive patients with the diagnosis of epilepsy and 19 healthy volunteers, aged younger than 46 years, participated in the study. Exclusion criteria included symptoms or signs of diseases other than epilepsy, in particular relating to heart disease or medication influencing the cardiovascular system, as well as seizure reported by patients that occurred <3 days before the ECG examination. The electrocardiogram was recorded according to the standard protocol. The seizure frequency was calculated based on the available data of epileptic events within the preceding 3 months. Disease duration was estimated by determining the time from the first reported seizure to the present. There were 22 patients (48%) in the epilepsy group and only one patient (5%) in the control group fulfilling the criteria for VLP (p = 0.0005). Subsequently, epilepsy patients were divided into two subgroups according to VLP presence. Patients with VLP had longer disease duration (p = 0.03) compared to those without VLP. Similarly, patients with VLP more frequently had refractory epilepsy (p = 0.03) and had higher monthly seizure frequency (p = 0.02). Analysis of the proportions of generalized seizures (GS) and focal seizures (FS) showed a tendency for higher number of generalized tonic-clonic seizures in the VLP group, but this did not reach statistical significance (p = 0.06). VLP patients tended to be more often on polytherapy (defined as more than one AED per patient) (p = 0.07) as compared to epilepsy patients without VLP. However, if the numbers of AEDs per patients among the subgroups were compared, patients with VLP were treated with more AEDs than patients without VLP (p = 0.01). The study was not sufficiently powered to pinpoint any particular drug or AED combination to influence the appearance of VLP in epileptic patients. In particular, there was no difference in valproate or carbamazepine exposure, considering the percentage of patients exposed or the total daily dose administered. Epilepsy patients more frequently display abnormal SAECGs with VLPs as compared to the control population, and their presence correlates with the disease duration, uncontrolled seizures, and polytherapy. Further longitudinal studies are needed in order to stratify the risk of life-threatening ventricular events in epilepsy patients with VLPs.

• Simvastatin displays an antioxidative effect by inhibiting an increase in the serum 8-isoprostane level in patients with acute ischemic stroke: brief report.

  Authors: Anna Szczepańska-Szerej, Jacek Kurzepa, Joanna Wojczal, Zbigniew Stelmasiak

  Clinical neuropharmacology. 09/2011; 34(5):191-4.

  Oxidative stress plays an important role in ischemic stroke pathophysiology. Some drugs are known to have a substantial influence on oxidative stress. In this study, we examined the antioxidantOxidative stress plays an important role in ischemic stroke pathophysiology. Some drugs are known to have a substantial influence on oxidative stress. In this study, we examined the antioxidant effect of simvastatin through its influence on patients' serum 8-isoprostane levels. We measured serum 8-isoprostane levels in 67 patients with acute ischemic stroke treated and not treated with simvastatin within 5 days after stroke onset, in comparison with 20 normal controls. Stroke patients from both groups had significantly higher initial serum 8-isoprostane levels than the controls. The median value of serum 8-isoprostane level was significantly lower in the simvastatin-treated group after 5 days of treatment. The results confirm the contribution of oxidative stress to brain ischemia and suggest antioxidative properties of statins in the acute phase of ischemic stroke patients.

• Atypical symptomatology of myoclonus dystonia (DYT-11) with positive response to bilateral pallidal deep brain stimulation.

  Authors: Ewa Papuć, Katarzyna Obszańska, Konrad Rejdak, Zbigniew Stelmasiak, And Tomasz Trojanowski

  Movement disorders : official journal of the Movement Disorder Society. 05/2011;

• Does serum Tau protein predict the outcome of patients with ischemic stroke?

  Authors: Joanna Bielewicz, Jacek Kurzepa, Elżbieta Czekajska-Chehab, Zbigniew Stelmasiak, Halina Bartosik-Psujek

  Journal of molecular neuroscience : MN. 03/2011; 43(3):241-5.

  The prediction of outcome after ischemic stroke (IS) is currently based on indirect data from clinical and radiological evaluation. We evaluated the usefulness of serum Tau protein as possibleThe prediction of outcome after ischemic stroke (IS) is currently based on indirect data from clinical and radiological evaluation. We evaluated the usefulness of serum Tau protein as possible prognostic markers for IS. Fifty-six patients with computed tomography-confirmed IS were enrolled. Blood samples were obtained on days 1, 3, 5, and 10 after stroke onset. Tau and S100BB serum levels were measured by commercially available enzyme-linked immunosorbent assay. Neurological deficits were quantified by the National Institute of Health Stroke Scale on days 1, 3, 5, and 10 of stroke. Functional disability was rated with the Barthel Index and Rankin Scale on days 1, 3, 5, and 10 and additionally 3 months after the stroke. Computed tomography scan was performed to calculate infarct volume on admission to hospital and on day 10 from the diagnosis of IS onset. Tau protein was detected in the serum of 47.8% patients with IS. Patients in whom Tau protein was detected in serum, when compared with patients without Tau protein, developed more severe neurological deficits, had worse functional status measured in the early and late phase of IS, and were found to have larger volume of infarction. However, Tau protein concentrations measured within the early phase of IS did not correlate with degrees of neurological deficit and disability in the early phase and also after 3 months of IS. Detection of Tau protein in the serum of patients with IS but not its concentration can be considered as a bad prognostic factor for the clinical outcome in early and late phase of IS.

• [Efficacy and tolerability of dose-escalation with generic gabapentin--a multicenter, non-interventional study].

  Authors: Konrad Rejdak, Aurelia Lipa, Krzysztof Kaczyński, Zbigniew Stelmasiak

  Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(2):91-6.

  The aim of this study was to determine the efficacy and tolerability of 1800-2400 mg/day of generic gabapentin (Gabapentin Teva) as add-on treatment for refractory partial - onset epilepsy. This wasThe aim of this study was to determine the efficacy and tolerability of 1800-2400 mg/day of generic gabapentin (Gabapentin Teva) as add-on treatment for refractory partial - onset epilepsy. This was a multicenter, open-label, dose-escalation study of patients with refractory epilepsy (median age of 45.5 years [41-50; 25-75% percentile range], male 45.6%, female 47.8%). The inclusion criteria were insufficient partial-onset epilepsy control, defined as at least 1 seizure per month, while on adjunctive therapy with gabapentin used on daily doses below 1200 mg. The baseline seizure number was assessed over 3 months of observation in patients being on stable doses of their AED therapy and those subjects who met the inclusion criteria were enrolled into the study by their neurologist (Visit 0). Subsequently, patients were seen, and their data were evaluated at Visit I i.e. after the target dose of 1800 mg per day was achieved (mean duration of 3.6 [0.1-28.3] weeks) and 4 weeks later at Visit II, after the target dose up to 2400 mg per day. Primary efficacy was assessed by seizure frequency (number/month). Tolerability was assessed by adverse events and clinical evaluations. All the study periods were completed by 916 patients. A substantially lower median seizure frequency was observed at all gabapentin dosing periods (visit I - 2.0 [0-40] seizures per month and visit II - 1.0 [0-13] seizures per month; median and range) compared with the baseline period (3.0 [1-20] seizures per month) (Wilcoxon test p<0.001). In addition, the gradual increase of GBP dose led to raising proportion of patients rendered seizure free (Visit I - 1.1% and Visit II - 28.5%) compared with the baseline period 0.0% (McNemar test p<0.001). The dose escalation with GBP was well tolerated by the majority of patients. The most common adverse events during visit II were somnolence (2.8%) and dizziness (1.8%). In conclusion, gabapentin dose escalation to a dose range of 1800-2400 mg/d over 8 [1-32] week period proved to be an effective and well tolerated in patients with insufficient seizure control on lower doses with partial-onset epilepsy.

• [Processes of free radical lipid peroxidation with a particular regard to the role of paraoxonase-1 in the pathogenesis of multiple sclerosis].

  Authors: Jerzy Berbecki, Krystyna Mitosek-Szewczyk, Jacek Kurzepa, Marcin Nastaj, Katarzyna Łobejko, Zbigniew Stelmasiak

  Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(1):31-6.

  Oxidative stress is an imbalance between free radicals production and antioxidant defences. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) can attact and demage a variety ofOxidative stress is an imbalance between free radicals production and antioxidant defences. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) can attact and demage a variety of critical biological molecules, including lipids, essential cellular proteins and DNA and may be exert in pathogenesis of many disorders. Products of lipid peroxidation can be easily reliably detected in biological fluids and tissues, yielding sensitive and specific signals of lipid peroxidation occurred in vivo. Those products are: isoprostanes (isoP) dimalonealdehyde (MDA), 4-hydroxynonenal (4-HNE). Paraoxonase-1 (PON-1) play a key role in defence of lipid peroxidation. PON-1 is an serum enzyme bound up with high density lipoproteins (HDL). The aim of this work is to discuss the role of oxidative stress in the pathogenesis of multiple sclerosis.

• Validation analysis of the Polish version of the Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL).

  Authors: Anna Jamroz-Wiśniewska, Zbigniew Stelmasiak, Halina Bartosik-Psujek

  Neurologia i neurochirurgia polska. 01/2011; 45(3):235-44.

  The aim of this study was to perform a validation analysis of the Polish adaptation of the Multiple Sclerosis International Quality of Life Questionnaire, MusiQoL. Validation analysis included theThe aim of this study was to perform a validation analysis of the Polish adaptation of the Multiple Sclerosis International Quality of Life Questionnaire, MusiQoL. Validation analysis included the translation of the original English version into Polish according to translation principles and the analysis of convergent validity, internal reliability and reproducibility of the Polish version of MusiQoL. The study included 150 randomly chosen patients (109 women and 41 men) with definite multiple sclerosis (MS) diagnosed according to McDonald criteria. Mean age of patients was 41 ± 10 years and mean disease duration was 11.7 ± 7.2 years. The patients completed the examined MusiQoL, the Functional Assessment of Multiple Sclerosis (FAMS) and the Multiple Sclerosis Impact Scale (MSIS-29). Data regarding sociodemographic status and MS history were collected. The disability of the patients was assessed according to the Expanded Disability Status Scale (EDSS). The examination was repeated after 28 ± 4 days. The internal reliability, convergent validity and reproducibility of MusiQoL were satisfactory. The dimensions of the scale exhibited high internal consistency (Cronbach's alpha from 0.67 to 0.90). The MusiQoL correlated with FAMS (positive correlations), EDSS and MSIS-29 (negatively). Psychometric-statistical analysis showed that the Polish version of MusiQoL is a valuable measure to examine the health-related quality of life of Polish MS patients.

• Some markers of neuronal damage in cerebrospinal fluid of multiple sclerosis patients in relapse.

  Authors: Krystyna Mitosek-Szewczyk, Wanda Gordon-Krajcer, Dorota Flis, Zbigniew Stelmasiak

  Folia neuropathologica / Association of Polish Neuropathologists and Medical Research Centre, Polish Academy of Sciences. 01/2011; 49(3):191-6.

  In this paper the performance of cerebrospinal fluid (CSF) protein biomarkers important for monitoring damage of brain astrocytes and neurons for MS is reviewed. We estimated neurofilament, tau andIn this paper the performance of cerebrospinal fluid (CSF) protein biomarkers important for monitoring damage of brain astrocytes and neurons for MS is reviewed. We estimated neurofilament, tau and phospho-tau proteins, β-APP, Aβ, S-100B and neuron-specific enolase in CSF of MS patients during relapse. We noted elevation of neurofilament, tau and phospho-tau proteins, S-100B, neuron-specific enolase and c-terminal epitopes of β-APP; concomitantly decrease of Aβ was observed. These CSF biomarkers for MS relapse should reflect the central pathogenic processes in the brain, i.e., axonal and neuronal degeneration.

• Immunomodulatory effects of vitamin D on monocyte-derived dendritic cells in multiple sclerosis.

  Authors: Halina Bartosik-Psujek, Jacek Tabarkiewicz, Krystyna Pocinska, Zbigniew Stelmasiak, Jacek Rolinski

  Multiple sclerosis (Houndmills, Basingstoke, England). 12/2010; 16(12):1513-6.

  In order to evaluate the effects of vitamin D3 on monocyte-derived dendritic cells (DCs) of relapsing-remitting multiple sclerosis patients, DCs differentiation and maturation were evaluated in vitroIn order to evaluate the effects of vitamin D3 on monocyte-derived dendritic cells (DCs) of relapsing-remitting multiple sclerosis patients, DCs differentiation and maturation were evaluated in vitro based on surface phenotypic changes. The expression of CD14, CD83, CD1a, CD80, CD86, CD206 and C209 was analysed by fluorescence-activated cell sorting. The results reveal that vitamin D3 inhibits both the differentiation and maturation of DCs. Moreover, inhibits the secretion of IL 23/12p40 and increases the secretion of CCL2. The data suggest that one of the mechanisms of the beneficial action of vitamin D3 in multiple sclerosis may be associated with its influence on DCs.

• Monocyte chemoattractant protein (MCP-1) A-2518G gene polymorphism in stroke patients with different comorbidities.

  Authors: Kinga Buraczynska, Piotr Luchowski, Joanna Wojczal, Andrzej Ksiazek, Zbigniew Stelmasiak

  Clinical biochemistry. 09/2010; 43(18):1421-6.

  The aim of our study was to assess the effect of A-2518G polymorphism in the monocyte chemoattractant protein-1 gene on development of stroke. A total of 194 patients with stroke and 320 healthyThe aim of our study was to assess the effect of A-2518G polymorphism in the monocyte chemoattractant protein-1 gene on development of stroke. A total of 194 patients with stroke and 320 healthy controls were genotyped for the MCP-1 gene -2518 polymorphism. There was a significant difference in genotype frequencies between ischemic stroke patients and controls (p=0.01). Stroke patients were subdivided according to gender, presence of renal disease, small-vessel disease, diabetes, atherosclerosis and hyperlipidemia. There were differences in genotype frequencies between stroke patients with atherosclerosis and controls (p=0.03), and in allele frequencies between diabetic patients and controls (p=0.04). In hyperlipidemia, the OR 2.33 for the GG genotype may be due to stroke, because it was found only vs. controls and not vs. group without hyperlipidemia. Our results demonstrate an association between the polymorphism in the regulatory region of MCP-1 gene and susceptibility to ischemic stroke.

• Matrix metalloproteinase-9 contributes to the increase of tau protein in serum during acute ischemic stroke.

  Authors: Jacek Kurzepa, Joanna Bielewicz, Aneta Grabarska, Zbigniew Stelmasiak, Marta Stryjecka-Zimmer, Halina Bartosik-Psujek

  Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 08/2010; 17(8):997-9.

  Previous studies indicate that tau protein, a marker of damage to neurons, is present in the serum of healthy patients at a concentration approximately 40 percent that of patients with ischemicPrevious studies indicate that tau protein, a marker of damage to neurons, is present in the serum of healthy patients at a concentration approximately 40 percent that of patients with ischemic stroke We assumed that increased serum activity of gelatinases (matrix metalloproteinase [MMP]-2 and MMP-9) can influence the level of tau protein in serum, probably due to disruption of the blood-brain barrier. We obtained blood sera from 31 patients admitted within the first 24 hours of ischemic stroke on days 1, 5 and 10, following the onset of stroke. Tau protein was detected in the serum of 12 patients (38.7 percent). The highest MMP-9 activity was recorded on day 5 (p < 0.05). Serum gelatinase activity did not differ between tau protein-positive or -negative individuals. However, a high degree of correlation between mean MMP-9 activity and the maximum tau protein level was observed for patients with detectable tau protein (r = 0.71, p = 0.009). Our study suggests that MMP-9 can increase the tau protein level in the sera of patients during acute ischemic stroke.

• Immunomodulatory effects of IFN-beta and lovastatin on immunophenotype of monocyte-derived dendritic cells in multiple sclerosis.

  Authors: Halina Bartosik-Psujek, Jacek Tabarkiewicz, Krystyna Pocinska, Sebastian Radej, Zbigniew Stelmasiak, Jacek Rolinski

  Archivum immunologiae et therapiae experimentalis. 08/2010; 58(4):313-9.

  Multiple sclerosis (MS) is an autoimmune disease of the central nervous system and current MS treatment is only partially effective. Recent data suggest that statins may be potent immunomodulatoryMultiple sclerosis (MS) is an autoimmune disease of the central nervous system and current MS treatment is only partially effective. Recent data suggest that statins may be potent immunomodulatory agents. In order to evaluate their role in MS, we analyzed the in vitro effects of interferon (IFN)-beta and lovastatin on the differentiation and maturation of monocyte-derived dendritic cells (DCs) of MS patients. Twenty-seven patients with relapsing-remitting MS were recruited for the study. DC differentiation and maturation were evaluated based on surface phenotypic changes and the expressions of CD14, CD83, CD1a, CD80, CD86, CD206, and C209 were analyzed by flow cytometry. The results showed that IFN-beta and lovastatin affect DC phenotype. Both agents decrease the expression of CD1a, which indicates a weakened presentation of glycolipid antigens. IFN-beta causes up-regulated and lovastatin down-regulated expression of CD86, which results in a biased Th-cell responses in MS. Furthermore, high doses of lovastatin cause a decrease in CD209 expression on the surface of DCs and can limit their migration to various tissues. One of the mechanisms of the beneficial action of IFN-beta and statins may be associated with their influence on DCs.

• CSF hypocretin-1 concentrations correlate with the level of fatigue in multiple sclerosis patients.

  Authors: Ewa Papuć, Zbigniew Stelmasiak, Stelmasiak Zbigniew, Paweł Grieb, Grieb Paweł, Konrad Rejdak, Rejdak Konrad

  Neuroscience letters. 02/2010; 474(1):9-12.

  Considering the multiplicity of symptoms associated with multiple sclerosis (MS), there is possibility that hypocretin system function might be involved in the pathogenesis of the disease. TheConsidering the multiplicity of symptoms associated with multiple sclerosis (MS), there is possibility that hypocretin system function might be involved in the pathogenesis of the disease. The current study aimed to investigate the hypocretin-1 levels in cerebrospinal fluid (CSF) of MS patients in relation to different neurological deficit measures including: Ambulation Index (AI), Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), and Epworth Sleepiness Scale (ESS) in relapse-onset MS patients. 53 subjects were included into the study: 38 patients with a diagnosis of MS and 15 healthy controls. Among MS patients, 25 had relapsing-remitting and 13 secondary progressive MS. CSF hypocretin-1 levels did not differ between MS patients and healthy controls (p>0.05). A positive correlation between hypocretin-1 level and fatigue level was found in MS patients (p<0.05) and this effect was even stronger in the MS subgroup suffering from fatigue (p=0.01). Hypocretin system seems to be generally unchanged in MS but a positive correlation between hypocretin-1 level and fatigue may indicate involvement of some compensatory mechanisms stimulating the production of the neuropeptide in MS patients.

• Free radical peroxidation products in cerebrospinal fluid and serum of patients with multiple sclerosis after glucocorticoid therapy.

  Authors: Krystyna Mitosek-Szewczyk, Wanda Gordon-Krajcer, Piotr Walendzik, Zbigniew Stelmasiak

  Folia neuropathologica / Association of Polish Neuropathologists and Medical Research Centre, Polish Academy of Sciences. 01/2010; 48(2):116-22.

  Multiple sclerosis (MS) patients were found to have elevated thiobarbituric acid reactive material levels, increased soluble sulfhydryl groups and reduced protein sulfhydryl groups in cerebrospinalMultiple sclerosis (MS) patients were found to have elevated thiobarbituric acid reactive material levels, increased soluble sulfhydryl groups and reduced protein sulfhydryl groups in cerebrospinal fluid and serum, and slightly reduced superoxide dismutase in serum, which suggested disease activating free radical peroxidation. Moreover, levels of these varied across methylprednisolone (MP) therapy. We observed significant differences in the levels of peroxidation products between MS patients and controls. These changes were most evident in relapse. After MP therapy, levels of these indicators approached control values, especially in the remission period. Our findings suggest that MP protects against free radical attack.

• Neurology training around the world: asking the trainees.

  Authors: Konrad Rejdak, Axel Petzold, Karl Ng, Judit Afra, Irena Dujmovic, Zbigniew Stelmasiak, Danuta Ryglewicz, Hubert Kwiecinski, Wolfgang Grisold, Laszlo Vecsei

  Lancet neurology. 01/2010; 9(1):32-3.

• B-type natriuretic peptide as a marker of subclinical heart injury during mitoxantrone therapy in MS patients-Preliminary study.

  Authors: Piotr Luchowski, Krystyna Mitosek-Szewczyk, Halina Bartosik-Psujek, Andrzej Rubaj, Marek Jankiewicz, Joanna Wojczal, Anna Szczepańska-Szerej, Zbigniew Stelmasiak

  Clinical neurology and neurosurgery. 07/2009;

  The aim of this study was to evaluate the plasma level changes of B-type natriuretic peptide (BNP), biochemical marker of heart failure, and echocardiographic parameters during mitoxantrone treatmentThe aim of this study was to evaluate the plasma level changes of B-type natriuretic peptide (BNP), biochemical marker of heart failure, and echocardiographic parameters during mitoxantrone treatment in 22 multiple sclerosis (MS) patients (8 males, 14 females, mean age 37.1+/-6.6). Mitoxantrone (after mean cumulative dose of 58.0+/-7.0mg/m(2)) did not alter left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), posterior wall thickness (PWT) and left ventricular end-diastolic volume (LVEDV). However, mean plasma level of BNP raised from 14.53+/-3.29pg/ml at the baseline to 16.79+/-3.05pg/ml and 18.83+/-4.90pg/ml (P<0.01) after mean mitoxantrone dose of 30.7+/-5.9mg/m(2) and 58.0+/-7.0mg/m(2), respectively. These results strongly suggest subclinical myocardial dysfunction in mitoxantrone-treated group. We assume, that low-cost, repeated BNP measurements may be a good alternative for detection of early subtle myocardial injury in MS patients during routine mitoxantrone therapy.

• Decreased cerebrospinal fluid hypocretin-1 (orexin A) in patients after repetitive generalized tonic-clonic seizures.

  Authors: Konrad Rejdak, Ewa Papuć, Paweł Grieb, Zbigniew Stelmasiak

  Epilepsia. 02/2009;

  Summary The effects of seizures on the hypocretin/orexin system have not yet been investigated in epileptic patients. The present study aimed to assay hypocretin-1 in the cerebrospinal fluid (CSF) ofSummary The effects of seizures on the hypocretin/orexin system have not yet been investigated in epileptic patients. The present study aimed to assay hypocretin-1 in the cerebrospinal fluid (CSF) of patients after generalized tonic-clonic (GTC) seizures. Study groups consisted of 21 patients after GTC seizures and 19 controls. Diagnostic lumbar puncture was performed in control and epileptic patients within 48 h after the GTC seizures. Hypocretin-1 levels were measured in unextracted CSF samples, using a standardized commercial radioimmunoassay. There was a significant overall difference in median CSF hypocretin-1 concentrations between controls and patients with GTC patients (p < 0.001). The lowest concentrations were noted in a subgroup of patients with repetitive GTC seizures (RS) compared to those with a single GTC seizure (SS) (p > 0.05) or controls (p < 0.001). The current results suggest that the hypocretin-1 system deficiency contributes to the complex pathophysiology of repetitive GTC seizures and status epilepticus (SE) and could be associated with typical somnolence after seizure attacks.

• Serum bilirubin and uric acid levels as the bad prognostic factors in the ischemic stroke.

  Authors: Jacek Kurzepa, Joanna Bielewicz, Zbigniew Stelmasiak, Halina Bartosik-Psujek

  The International journal of neuroscience. 01/2009; 119(12):2243-9.

  Bilirubin (Bil) and uric acid (UA) are the endogenous antioxidant compounds possibly involved in the pathogenesis of ischemic stroke (IS). Our goal was to find the relationship between serum Bil andBilirubin (Bil) and uric acid (UA) are the endogenous antioxidant compounds possibly involved in the pathogenesis of ischemic stroke (IS). Our goal was to find the relationship between serum Bil and UA levels with clinical presentation and outcomes of patients suffering from IS. Forty-three patients (mean age: 71.9 years, +/- 12.1; women: 48.8%) with confirmed IS were enrolled. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) after 1, 3, 5, and 10 days and functional disability was assessed three months after stroke onset using the Barthel Index (BI). Serum Bil and UA levels were measured 1, 3, 5, and 10 days after stroke. The difference between NIHSS scores from days 1 and 10 (improvement ratio) inversely correlated with the average UA serum level (r = -0.48, p < .01) but not with the average Bil level. Negative correlations were observed between the BI measured three months after stroke compared to the average Bil serum level (r = -0.5, p < .01). However, no relationship between BI and UA level was observed. Our results indicated that Bil and UA levels are poor prognostic factors for ischemic stroke.