Vol 8, No 3 (2014)

Original articles

Аcute stroke and type 2 diabetes

Tanashyan M.M., Antonova K.V., Lagoda O.V., Maksimova M.Y., Glebov M.V., Shabalina A.A.

Abstract

The study is aimed at identifying various parameters of carbohydrate metabolism in acute stroke setting. We found that episodes of hyperglycemia often precede cerebrovascular events. Glycated hemoglobin levels correlate with the clinical course of stroke, including the outcome of post-stroke rehabilitation. Onset of diabetes may coincide with stroke episode.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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Ultrasound neuroimaging in chronic inflammatory demyelinating polyneuropathy

Vuytsik N.B., Suponeva N.A., Chechetkin A.O., Piradov M.A., Suslina Z.A.

Abstract

We present the results of ultrasound study of 21 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). In 100% cases were observed changes of the ultrasound structure of peripheral nerves. The ultrasound abnormalities were most prominent in the peripheral nerves of lower extremities. The changes of both tibial and ulnar nerves morphology seem to be the most valuable for the diagnostics. The cross-sectional area of nerves does not correlate with the duration of disease that hinders the performance of the ultrasound for the purpose of follow-up.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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Hemorheology and hemostasis in stroke patients with type 2 diabetes and metabolic syndrome

Tanashyan M.M., Shchepankevich L.A., Orlov S.V., Telenkova N.G., Shabalina A.A., Kostyreva M.V.

Abstract

We present results of clinical and laboratory evaluation of acute stroke patients with type 2 diabetes and metabolic syndrome (MS). Neurological deficit was assessed with NIHSS and SSS, laboratory panel included primary characteristics of hemorheology and hemostasis: platelet aggregation, beta-thromboglobulin, platelet factor 4, Von Willebrand factor, RBC aggregation and deformability. We found that disturbances of carbohydrate metabolism in patients with diabetes and MS affect all major pathways of hemorheology and hemostasis and lead to dysfunction of platelets, RBCs and endothelium. These changes along with the others metabolic abnormalities make an impact on clinical course of stroke and may significantly affect outcome due to the prolonged recovery and high rate of residual deficit.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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Infectious factors of the brain damage in the long-term unconscious states

Vaynshenker J.I., Ivchenko I.M., Zinserling V.A., Korotkov A.D., Melucheva L.A., Kataeva G.V., Lapin S.V., Nuralova I.V., Khlopunova O.V., Beresina L.A., Kulyashova L.B., Vyazovaya A.A., Kalinina O.V., Medvedev S.V.

Abstract

Serial immunological and neurologic evaluation, and testing for infections was performed in 32 patients (m – 23, f –9, 14–58 years) with chronic non-inflammatory unconscious states. The main group of patients (n=18) received treatment for subclinical infections and other infectious agents revealed. Treatment in the control group (n=14) was targeted only on community-acquired and nosocomial microbiota. Markers of inflammatory intrathecal responce of the central nervous system (CNS) were found in 88% (28/32) patients, and this was associated with Chlamydia spp. in cerebrospinal fluid (CSF) and/or blood (р<0.01). Markers of various mmunopathological vasculites/vasсulopathies were revealed in 84% patients (27/32), and the tendency of their interrelation with Chlamydia spp. in comparison with other subclinical infections was found. In some cases clinical data was confirmed by autopsy results. In the main group of patients during treatment we found the changes of structure of immunopathological syndrome and appearance in the CSF and/or blood of previously undiagnosed subclinical infections with further sanation of latent inflammatory process. It was accompanied by neurophysiological signs of “disbalance” of a stable pathological condition with improvement of brain metabolism according to PET data. In the control group the specified changes were not found, and the short-term and long-term results of treatment were worse. The obtained data showed that in patients with chronic non-inflammatory unconscious states in the substance and in the vessels of brain develops latent inflammatory process with immunopathological component associated with Chlamydia spp. and other subclinical infections. It appears to be the factor of additional brain damage that consolidates the pathological condition in CNS. It is reasonable to consider this process during elaboration of tactics of treatment for these patients.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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Clinical, epidemiological and neuro-ophthalmological features of patients with multiple sclerosis: study of Kaluga region

Maslova N.N., Andreeva E.A., Belyy Y.A., Yerokhina E.V.

Abstract

The Kaluga region is an area with high risk for multiple sclerosis (MS). We demonstrated the prognostic role of type of a MS debut and duration of the first remission for the clinical course of the disease. There was no association between the mean annual relapse rate and mean annual rate of MS progression. In patients with various MS variants were found decreased retinal nerve fibers layer thickness in all sectors, most prominent in the temporal sector, and the reduction of macular volume. We showed the role of optical coherent tomography and the visual evoked potentials for early diagnostics of multiple sclerosis and for monitoring of demyelination and neurodegeneration of optic nerve and in CNS in general.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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Modern pharmacological models of Alzheimer’s disease

Kolobov V.V., Storozheva Z.I.

Abstract

In vivo experimental models of Alzheimer’s disease are powerful tools for studying the mechanisms of pathogenesis and the search for new therapeutic agents. Pharmacological models, based on the injection of neurotoxins (beta-amyloid fragments, cholinotoxins, ibotenic acid) into the brain allow simulation the cognitive impairment typical for Alzheimer’s disease, and yield evaluation the impact of drugs on various indicators (biochemical, genetic, electrophysiological). The most validity was showed for the in vivo model of neurotoxic beta-amyloid fragments injection into basal forebrain nuclei.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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The value of various brain pathways impairment in the post-stroke rehabilitation of walking function

Kadykov A.S., Barkhatov Y.D.

Abstract

Corticospinal tract (CST) is the major brain pathway yielding motor activity; however, functional role of the CST and other pathways in the implementation of such a socially important function as walking in patients with stroke is not completely clear. Following the CST lesion the process of recovery involves not only CST on both sides but also other pathways, including the extrapyramidal tracts: corticoreticular (CRP) and corticorubrospinal (CRSP) pathways. With the help of modern neurovisualization methods we showed that Wallerian degeneration of the CST is not the only predictor of poor recovery of motor function after stroke, whereas a compensatory increase in fiber volume of CRP on the opposite side may improve recovery of affected leg. Further studies of the functional significance of brain pathways including the CRP and CRSP in the recovery of post-stroke walking function will clarify th mechanisms of neuroplasticity and predictors of recovery to optimize the personalized approach to rehabilitation.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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Navigated transcranial magnetic stimulation in rehabilitation of traumatic frontal lobes injury

Dobrushina O.R., Sidyakina I.V., Lyadov K.V., Shapovalenko T.V., Sinitsin V.E., Mershina E.A., Pechenkova E.V., Kazymaev S.A., Румшиская A.D.

Abstract

Traumatic injury of frontal lobes has severe impact on social adaptation due to alterations in cognitive function and behavior. Considering the low efficacy of conventional rehabilitation methods, the development of complementary approaches is needed. Rhythmic transcranial magnetic stimulation (rTMS) is known to improve short and long-term memory, processing speed, problem solving in dementia. However, the trials show conflicting results that might be caused by lack of individualization as the target of stimulation is defined exclusively on the base of anatomy. We used fMRI-guided rTMS of the left dorsolateral prefrontal area to ameliorate consequences of traumatic injury of the frontal lobes. Case report demonstrating the efficacy of this method is presented. Significant improvement was observedafter 15 sessions of rTMS in patient with severe traumatic brain injury who gained an increase in cognitive speed, development of ability to summarize and acquire experience, improvement in planning, control and error correction.
Annals of Clinical and Experimental Neurology. 2014;8(3):
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