I. Stetkarova

I. Stetkarova
Charles University in Prague, Third School of Medicine · Neurology (3.LF)

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122
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Publications

Publications (122)
Article
Full-text available
Objectives Intrathecal baclofen (ITB) is commonly used for reduction of spasticity in chronic spinal cord injury (SCI). Its clinical effect is well-known; however, exact mechanisms of long-term effect of continuous ITB administration (cITBa) on modulation of cortical processes have not been elucidated. The aim of this study was to evaluate changes...
Article
Full-text available
Background: Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is known to be associated with poor prognosis after cardiovascular events. We aimed to assess the dynamic changes in TRAIL levels and the relation of TRAIL level to stroke severity, its impact on the short-term outcomes, and its association with markers of cardiac injury i...
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Objectives Elevated blood glucose and CRP (C-reactive protein) are usually related to a worsened clinical outcome in neurological diseases. This association in Guillain-Barré syndrome (GBS) has been studied rarely. We tried to analyse if hyperglycaemia and CRP at admission may influence the outcome of GBS, including mechanically ventilated (MV) pat...
Article
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Background Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) leading to the loss of myelin and axons. Diagnosis is based on clinical findings, MRI, and analysis of cerebrospinal fluid (CSF). CSF is an ultrafiltrate of plasma and reflects inflammatory processes in the CNS. The aim of this study was to perfor...
Article
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Importance Multiple sclerosis can also affect children. Approximately 3–10% of patients develop multiple sclerosis before the age of 16. Objective The aim of this analysis is to describe the characteristics of pediatric patients with multiple sclerosis who started their treatment with disease-modifying drugs in 2013–2020, with data obtained from t...
Article
Background: Time is brain! This paradigm is forcing the development of strategies with potential to shorten the time from symptom onset to recanalization. One of these strategies is to transport select patients with acute ischaemic stroke directly to an angio-suite equipped with flat-detector computed tomography (FD-CT) to exclude intracranial haem...
Article
The recanalization effect of large-vessel occlusion (LVO) in anterior circulation is well documented but only some patients benefit from endovascular treatment. We analysed clinical and radiological factors determining clinical outcome after successful mechanical intervention. We included 146 patients from the Prague 16 study enrolled from Septembe...
Article
Aim of the study: Spontaneous spinal epidural haematomas (SSEH) are rare nosological units wherein acute collections of blood develop in the spinal canal. SSEH are usually manifested by sudden severe back pain accompanied by the development of neurological symptoms. In this study, we retrospectively describe management and the main risk factors of...
Article
Background: When the novel coronavirus disease 2019 (COVID-19) appeared, concerns about its course in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) arose. This study aimed to evaluate the incidence, severity and risk factors of the more severe COVID-19 course among MS and NMOSD patients. Methods: From M...
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Objectives This study analyzed the learning curve effect when a new stroke thrombectomy program was initiated in a cardiac cath lab in close cooperation with neurologists and radiologists. Background Mechanical thrombectomy has proven to be the best treatment option for ischemic stroke patients, but this method is not widely available. Methods An...
Article
Background: Intrathecal baclofen (ITB) pump delivery systems are safe and effective in the treatment of generalized spasticity in chronic spinal cord injury (SCI). Despite its widespread use, few and discrepant data are available in animal studies on the effects of ITB on cognitive functions, such as memory. The effects of chronic administration of...
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Background: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system. Well-established drugs used for MS patients after the first demyelinating event in the Czech Republic include glatiramer acetate (GA), interferon beta-1a (IFNβ-1a), IFN beta-1b (IFNβ-1b), peginterferon beta-1a (peg-IFNβ-1a), an...
Article
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Background: Changes of white matter integrity in people with multiple sclerosis (MS) were documented following mainly motor/skill acquisitions physical therapy, while following neuroproprioceptive "facilitation, inhibition" (neurofacilitation) only by two pilot studies. Neurofacilitation has potential to induce white matter changes due to possibil...
Article
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Background: The aim of this study was to assess the effect of anticoagulation treatment on platelet aggregation. Methods: The study group consisted of 24 patients on long-term warfarin therapy without any antiaggregation therapy. Platelet aggregation was measured using VerifyNow with arachidonic acid (AA) as an inducer in 23 patients and with li...
Article
A number of neurological complications have been reported after the administration of flu vaccine, including Guillain-Barré syndrome (GBS), especially after vaccination against swine flu. Only facial nerve neuropathy has thus far been reported after vaccination against COVID-19. More recently, there was a case of an elderly woman with GBS. In our r...
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Background Catheter-based thrombectomy (CBT) is the most effective treatment for acute ischemic stroke. Endovascular treatment program - Prague 16 was established in tertiary university hospital in 2012 as result of close cooperation among cardiologists, neurologists and radiologists. The aim of this substudy is to analyze relationship between stro...
Article
Introduction: Diabetic striatopathy is a rare condition characterized by unilateral hemichorea and/or hemiballismus in the settings of uncontrolled nonketotic diabetes mellitus. Imaging studies usually reveal striatal abnormality - subtle hyperdensity on CT and T1 hyperintensity on MRI. The resolution of clinical symptoms is prompt when optimal gl...
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Background: Individuals with acquired brain injuries (ABI) are in need of neurorehabilitation and neurorepair. Virtual anatomical interactivity (VAI) presents a digital game-like format in which ABI survivors with upper limb paresis use an unaffected limb to control a standard input device and a commonplace computer mouse to control virtual limb m...
Article
Cardiac myxoma is a rare cause of cardioembolic stroke, especially in young patients. Acute treatment includes intravenous thrombolysis or acute thrombectomy via mechanical recanalisation. We present a case of a young 21-year-old woman with no symptoms of dyspnoea who suddenly developed expressive aphasia and right-sided hemiparesis due to a thromb...
Article
Background: The pathogenesis of adolescent idiopathic scoliosis (AIS), including the role of brain and spinal inhibitory circuits, is still poorly elucidated. The aim of this study was to identify which central inhibitory mechanisms are involved in the pathogenesis of AIS. Design: A prospective neurophysiological study, using a battery of neurophys...
Article
Catheter-based (endovascular) thrombectomy is class I.A indication for the treatment of acute ischemic stroke. However, its availability in most countries is extremely low due to the lack of trained staff. Even the countries with best stroke services (e.g. Czech Republic) currently treat only one third of patients, who would be indicated to such th...
Article
Background: Proper management of multiple sclerosis (MS) requires feedback from clinical practice via registries. Objective: To introduce the Czech national multiple sclerosis registry, ReMuS, and explore the availability and use of disease-modifying drugs (DMD). Methods: The analysis focused on patients who started their first DMD, either wit...
Article
Objective: To determine a minimum number of trials that preserve input-output (I-O) properties of duration and magnitude of exteroceptive EMG suppression (eEMGs). Patients and methods: eEMGs was recorded in 16 healthy subjects from thenar muscles following index finger stimulation at 2.5, 5, 10, and 20 times sensory threshold (xST). Individual t...
Article
Objectives: Cerebral venous thrombosis is a serious cerebrovascular disease. Due to the variability of clinical symptoms and the scarcity of occurrence, this diagnosis is often delayed. The aim of the study was to describe the risk factors, the initial findings and the imaging methods that lead to the diagnosis. Methods: We included 34 patients...
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Abstract Clinical benefits of pallidal deep brain stimulation (GPi DBS) in dystonia increase relatively slowly suggesting slow plastic processes in the motor network. Twenty-two patients with dystonia of various distribution and etiology treated by chronic GPi DBS and 22 healthy subjects were examined for short-latency intracortical inhibition of t...
Article
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of increased prevalence with age. The main findings are loss of peripheral and central motoneurons and their pathways with extraocular and sphincter muscle sparing. These are classical forms of ALS with loss of central and peripheral motoneurons, as well as progressive b...
Article
Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progr...
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Background Direct catheter-based thrombectomy (d-CBT) was proven to be an effective treatment for proximal occlusions of the major intracranial arteries in acute stroke patients. The aim of this study was to compare clinical outcomes of patients treated by d-CBT depending on their baseline characteristics. Methods A single center, prospective, obs...
Article
Objective: Lithium has been long used in psychiatry as an adjuvant treatment for bipolar disorder. Chronic lithium intoxication is very rare. Design: We present the case of a 72-year-old female, treated with lithium for more than 10 years for bipolar disorder, who was admitted for gait impairment with weakness of limbs, myoclonus, speech impairm...
Article
Introduction: Antibodies against N-methyl D-aspartate receptor (anti-NMDAR) are directly pathogenic autoantibodies associated with encephalitis. Cases reporting the presence of anti-NMDAR antibodies associated with a demyelinating disease have been published, some without symptoms of NMDAR encephalitis. The aim of our study was to describe characte...
Conference Paper
Introduction Pallidal stimulation (GPi DBS) is an effective treatment of dystonic syndromes with a relatively high variability of clinical benefit. As patients with dystonia typically have a lower ability to suppress unwanted movements, we expected a decreased intracortical inhibition of motor cortex, which can be potentially reversed by GPi DBS....
Article
Aims: The aim of this study was to evaluate the role of direct catheter-based thrombectomy (d-CBT, without thrombolysis) and the feasibility and safety of d-CBT performed in an interventional cardiology center. Methods and patients: Single center, prospective observational registry based on the prespecified protocol included 3 months follow-up....
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Full-text available
The pathogenesis of adolescent idiopathic scoliosis (AIS), including the associated local changes in deep paravertebral muscles, is poorly understood. The asymmetric expression of several molecules involved in the melatonin signaling pathway, including melatonin receptors 1A/1B (MTNR1A/MTNR1B), estrogen receptor 2 (ESR2) and calmodulin (CALM1), has...
Article
Full-text available
Purpose The pathogenesis of adolescent idiopathic scoliosis (AIS) remains poorly understood. To date, potentially involved local changes in the deep paraspinal muscles still remain unknown. Methods Needle electromyography (EMG) and muscle biopsy of paraspinal muscles at convexity and concavity of the AIS main thoracic curve were performed in 25 sub...
Conference Paper
Introduction Deep brain stimulation (DBS) of the globus pallidus interna (GPi) is widely used in treatment of pharmacoresistant dystonic syndromes. In our study, we analyzed functional connectivity change derived from resting state fMRI in two conditions: with the DBS chronically switched on (ON condition) and two hours after switching the DBS off...
Article
Background: Deep brain stimulation (DBS) of the globus pallidus interna is an effective tool for the treatment of dystonia with possible distant effects reaching beyond the basal ganglia network. Aim: We analyzed the cortical silent period (CoSP) to test inhibitory circuits at the cortical level, and the cutaneous silent period (CuSP) and the H-...
Article
This review summarizes the modern early diagnosis and acute phase treatment of acute stroke. The guidelines for treatment of acute ischemic stroke underwent major changes in 2015 and endovascular therapy (catheter-based mechanical thrombectomy with a stent retriever) became the class IA indication for patients presenting within less than 6h from sy...
Article
Objective The pathogenesis of idiopathic scoliosis (IS) remains poorly understood. Local changes in deep paraspinal muscles and/or dysfunction of spinal inhibitory circuits are not fully elucidated. We compared the morphological and functional changes of paraspinal muscles on both sides of the scoliosis curve. Methods Before corrective surgery we...
Article
Objective Stiff-person syndrome (SPS) is an autoimmune disease characterized by progressive rigidity and generalized muscle stiffness caused by loss of GABA-ergic inhibition. Diffuse impairment of the GABA-system can be observed by neurophysiological methods. We investigated intracortical and spinal inhibition and correlate these findings with clin...
Article
Objectives: Traumatic lesions of brachial plexus are serious periferal nerve injuries. Neurological examination and CT myelography or MRI are the basic examination methods that can confirm spinal root avulsion. To specify severity of the injury - electromyography and evoked potentials are used. The objective of this study was to determine whether i...
Article
Objective: Brachial plexus injuries are usually severe and involve the entire brachial plexus, sometimes occurring with root avulsions. Imaging and electrodiagnostic studies are an essential part of the lesion evaluation; however, the results sometimes show a discrepancy. The cutaneous silent period (SP) is a spinal inhibitory reflex mediated by s...
Article
We sought to evaluate the outcomes of acute stroke patients, who did not undergo thrombolysis, and who were treated by direct catheter-based thrombectomy (CBT) in 3 interventional cardiology centers without pre-existing onsite programs for neurovascular interventions. Neurologists routinely selected
Article
Full-text available
Intrathecal baclofen (ITB) delivered by programmable pump devices represents an important modality for long-term treatment of severe spinal spasticity. One of the serious adverse events is a withdrawal syndrome after sudden interruption of ITB delivery. In this study, we analyzed the frequency and severity of this complication. Treatment recommenda...
Article
Acute ischemic stroke is a catastrophic cardiovascular disease with frequent cardiac causes and cerebral consequences, thus the close cooperation between neurologists and cardiologists is necessary for the optimal patient management. Furthermore, recent randomized trials demonstrated, that catheter-based thrombectomy (CBT) is the most effective tre...
Article
Objective Spasticity is a frequent and often disabling feature of multiple sclerosis (MS). Up to 80–85% of MS cases suffer from different levels of spasticity. Appropriate management of spasticity is therefore an important part of the patient’s care. Muscle hypertonia is generally easy to recognize clinically, quantifying it is quite a complex matt...
Article
Full-text available
Background Tremor is an involuntary rhythmic oscillatory movement of a body. It belongs to one of the most prevalent and disabling feature in multiple sclerosis (MS). Objectives The types of tremor in MS are still not unified. The aim of our work was to detect which types of oscillatory movements of upper extremities are present in MS without clin...
Article
Introduction Spasticity is a frequent disabling sign of upper motor neuron lesion in chronic spinal cord injury (SCI). In severe cases intrathecal baclofen (ITB) is recommended as a choice of effective treatment. Baclofen, being as a strong GABAB agonist, modulates cortical and spinal inhibitory circuits. The aim of this study was to assess longitu...
Article
Full-text available
Background: Intrathecal baclofen (ITB) delivered by programmable pump devices represents an important modality for long-term treatment of severe spasticity when resistance to oral drugs and/or their severe side effects may occur. Despite generally favorable outcomes and relative safety of this method, complications associated with ITB can be observ...
Article
Acute ischemic stroke is a frequent cause of death and disability. Therepautic scepticism persists both among doctors and lay people. However, modern reperfusion therapy improved outcomes of acute stroke patients - at least of those presenting early after symptom onset. This review presents multidisciplinary approach to acute stroke - cooperation o...
Article
Full-text available
There is still little scientific evidence for the efficacy of neurofacilitation approaches and their possible influence on brain plasticity and adaptability. In this study, the outcome of a new kind of neurofacilitation approach, motor programme activating therapy (MPAT), was evaluated on the basis of a set of clinical functions and with MRI. Eight...
Article
Objective The cutaneous silent period (CSP) is a spinal inhibitory reflex mediated by small-diameter afferents (A-delta fibers) and large-diameter efferents (alpha motoneurons). The effect of limb temperature on CSPs has so far not been assessed. Methods In 27 healthy volunteers (11 males; age 22 –58 years) we recorded median nerve motor and senso...
Article
Aims: To assess the feasibility of direct catheter-based thrombectomy (d-CBT) performed jointly by cardiologists, neurologists and radiologists. Methods and results: Computed tomography (CT) was completed within <6 hours from onset of acute ischaemic stroke and excluded bleeding or developed ischaemia in 23 patients who fullfilled pre-specified ent...
Article
Objective The pathogenesis of idiopathic scoliosis (IS) remains poorly understood. One of the hypothesis of the development of IS could be an abnormal sensorimotor integration. Cutaneous silent period (CSP) is a plurisegmental spinal inhibitory reflex, which occurs after painful stimulation of small diameter A-delta fibers. To date, CSPs have not b...