Vol 7, No 4 (2013)

Original articles

Progressing cerebral atherosclerosis: clinical, biochemical and morphological aspects

Tanashyan M.M., Lаgoda O.V., Gulevskaya T.S., Maksyutkina L.N., Raskurazhev A.A.

Abstract

In the article, basic pathogenic mechanisms of progression of cerebral atherosclerosis leading to ischemic stroke are discussed. The ultrasound, morphological and biochemical predictors of changes of the atherosclerotic plaque structure are presented. A multifactorial nature of pathogenesis of progressing cerebral atherosclerosis as a key cause of ischemic stroke determines the need for further studies of different aspects of this problem, from vessel and brain morphology to metabolic parameters and various blood characteristics (biochemical, lipid, conformational, and hemostatic).
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Endothelial function in patients with arterial hypertension and initial clinical symptoms of shronic serebral insufficiency

Varakin Y.Y., Gnedovskaya E.V., Gornostaeva G.V., Ionova V.G., Kostyreva M.V., Kravchenko M.A., Shabalina A.A., Suslina Z.A.

Abstract

Prevention of chronic cerebral blood supply insufficiency is the leading aspect in prevention of cerebrovascular diseases. Initial stages of these changes are of special interest, with endothelial dysfunction playing the major role. The aim of the study is to assess the function of endothelium in patients with initial stages of chronic cerebral blood supply insufficiency and noncomplicated hypertension. We included 48 men and 61 women (mean age 57.4±5.8 years) to perform complex standardized assessment. Patients with history of stroke or acute coronary syndrome, head trauma or other severe disease, or stenosis of cervical arteries ≥ 30% were excluded. We performed clinical evaluation with assessment of neurological deficit and duplex ultrasound of cervical arteries, echocardiography, 24-hour blood pressure monitoring, brain MRI or CT and complex neuropsychological testing. Endothelial function was assessed with functional tests (hemoreological and vasoactive cuff test, test of cerebrovascular reactivity with nitroglycerine). We tested the level of Von Willebrand factor and homocystein as biomarkers of endothelial function. The rate of endothelial dysfunction in patients with non-complicated hypertension was 64%, and high agreement rate of both cuff tests was revealed. The hemoreological cuff test was difficult to perform, and its results were highly dependent on the initial values. Prospective studies are needed to estimate the prognostic value of endothelial dysfunction for the progression of the chronic cerebral blood supply insufficiency.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Experience of using MRI morphometry in Huntington’s disease

Yudina E.N., Konovalov R.N., Abramycheva N.Y., Klyushnikov S.A., Illarioshkin S.N.

Abstract

One of the most important inherited neurodegenerative disorders, Huntington’s disease (HD), is characterized by cerebral atrophy, the features of which need to be clarified. MRI morphometry allows assessing quantitatively the atrophy of different brain regions, and this method may be regarded as a potential biomarker of neurodegeneration. We used whole-brain voxel-based morphometry (VBM) and region-of-interest (ROI) morphometry in 24 patients with HD, 10 preclinical HD gene carriers and 9 controls. On whole-brain VBM patients had significantly lower grey matter in the caudate, the putamen, and the pre- and postcentral gyri bilaterally compared to controls, while on ROI morphometry the grey matter volume decrease in patients was seen in the caudate, the putamen and the pallidum bilaterally. In clinically unaffected gene carriers the pallidum, the putamen, and the pre-and postcentral gyri bilaterally were larger and the left pallidum was smaller compared to controls. We found more pronounced atrophy of a dominant hemisphere in patients and gene carriers, as well as negative correlation between basal ganglia and cortical structures volumes and the mutation severity, motor and cognitive impairment.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Electromyography and ultrasound studies in the diagnostics of carpal tunnel syndrome

Nikitin S.S., Maslak A.A., Kurenkov A.L., Savitskaya N.G., Pripisnova S.G.

Abstract

Carpal tunnel syndrome (CTS) is a clinical condition with sensory and motor manifestations related to median nerve (MN) compression at the wrist level. The goal of this study was tocompare two diagnostics methods, electromyography (EMG) and ultrasound (US) examination, in establishing the most reliable and precise diagnostic approach to CTS. We examined 67 patients with clinical diagnosis of CTS and a control group of 42 healthy volunteers. For EMG and US, sensitivity and specificity parameters were calculated, and grading of the severity of MN injury was assessed with these technologies. The sensitivity and specificity for EMG was 93% and 97%, and for US, 85% and 73%, respectively. The severity grades of MN injury defined by EMG and US did not correspond to each other. According to our data, EMG has higher sensitivity compared to US in the diagnosis of CTS. EMG also allows estimating quantitatively the severity of MN injury, while US method shows predominantly some qualitative estimation of MN injury in CTS.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Сlinical and biochemical assessment of dynamics of an acute period of brain injury and combined cranio-facial injury

Sadova V.A., Bel’skaya G.N., L’vovskaya E.I., Kuchin D.G., Atmansky I.A., Shkarednykh V.Y., Sumnaya D.B.

Abstract

The purpose of the study was to assess clinical effects and dynamics of the changes in the parameters of lipid peroxidation and antioxidant system in patients with acute traumatic brain injury and combined injuries treated with the peptide drug cortexin. As the result of this work, the ability of the drug to reduce the intensity of the of lipid peroxidation process in brain injury was revealed. Clinical effect was expressed by the reduction of asthenic symptoms, significant improvement of attention and memory, and increase of the working capacity and the tempo of mental activity, which was confirmed by psychometric tests. It was shown that cortexin use in an acute period of traumatic brain injury and combined cranio-facial injury significantly increased the patients’ quality of life, had sedative and antidepressant effect, reduced epileptic activity and decreased the frequency of epileptic seizures.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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General principles of neuron organization in the human dorsal thalamus nuclei

Berezhnaya L.A.

Abstract

In the human dorsal thalamus nuclei (VA, VL, AV, AM, AD, and MD), neurons were studied using Goldgi staining method. The method allowed identifying different species of long-axon neurons (type I): densely branched bushy neurons, bushy spine neurons, large and gigantic bushy neurons, tree-like (arborescent) neurons, brush-like neurons, double-tufted neurons, and intermediary (or combined) neurons. Species of sparsely branched neurons were also identified: short-dendritic neurons and reticular neurons. Type II neurons – short-axon neurons (interneurons) – were presented by smooth-dendritic, shaggy-dendritic and long-dendritic neurons. A classification of the nerve cells of the dorsal thalamic nuclei is proposed, and some principal features of their internal organization are established.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Resting-state fMRI: new possibilities for studying physiology and pathology of the brain

Seliverstova E.V., Seliverstov Y.A., Konovalov R.N., Illarioshkin S.N.

Abstract

A new method, resting-state fMRI, has been proposed recentl for studying basic sensory, emotional, and cognitive processes in healthy and neurologically affected subjects. It allows assessing spontaneous co-activation of different CNS regions in rest on the basis of temporal characteristics of neuronal activity of anatomically separated brain regions. On resting-state fMRI studies, the existence of stable and functionally linked restingstate brain networks was shown, that is important in the context of basic mechanisms of neurological disorders. We performed a first resting-state fMRI study in Russia in the group of 10 healthy subjects and revealed a clear default mode network pattern which was consistent with data in published papers. Examining of integrative system of functionally interacting brain regions with the use of resting-state fMRI can provide new insights into large-scale neuronal communication within the human brain.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Transcranial magnetic stimulation in treatment of central post-stroke pain

Chervyakov A.V., Belopasova A.V., Poydasheva A.G., Chernikova L.A., Kadykov A.S., Suponeva N.A., Piradov M.A.

Abstract

Transcranial magnetic stimulation (TMS) – new method based on the neurons excitation by an alternating magnetic field. According literature high-frequency TMS could be effectiveness method in the treatment of drug-resistant central post-stroke pain (CPSP). The presented cases report describes the clinical observation of two
patients with CPSP, with different localization and volume of the lesion. TMS was applied in the mode of high-frequency stimulation (10 Hz) to the primary motor cortex of the affected hemisphere. After stimulation, we record a significant reduction of pain on a visual analog scale (VAS). It is shown that after the end of TMS pain gradually returned to previous levels after 3-4 months.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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Neurodegeneration with brain iron accumulation

Rudenskaya G.E., Zakharova E.Y.

Abstract

Neurodegeneration with brain iron accumulation (NBIA) is a clinically and genetically heterogeneous group of hereditary (predominantly autosomal recessive) progressive disorders of the CNS with a common feature of iron accumulation in basal ganglia and characteristic MRI image. By now, nine genes responsible for different NBIA are known, and some of these genes cause the development of several allelic phenotypes. In the review, current data on NBIA clinical and molecular genetic aspects, particularly on recently discovered forms and atypical clinical variants, are summarized.
Annals of Clinical and Experimental Neurology. 2013;7(4):
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