Vol 7, No 3 (2013)

Original articles

Changes in cognitive functions after deep-brain stimulation of the globus pallidus in patients with Parkinson disease

Mikadze Y.V., Titkova I.I., Shirshov A.V., Gushcha A.O.

Abstract

Neuropsychological investigation to 10 patients with Parkinson diseases which is carried deep brain stimulation of structurespallidum a complex was spent. For research of the cognitive functions the complex of techniques of the general neuropsychological research, the developed A.R.Lurija was used. The given inspection at the operated patients was spent to, after operation and in the remote period within 2 years. Results of inspection have shown that deep electrostimulation positively influences condition cognitive functions, especially in the remote period where it is observed about equal improvement of functioning of all departments of a brain.
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Neurophysiological features of atypical facial pain

Maksimova M.Y., Fedin P.A., Suanova E.T., Tyurnikov V.M.

Abstract

Unlike clinical research, neurophysiological testing has higher accuracy and sensitivity in revealing neurogenic defects responsible for the orofacial pain and sensory disturbance. This reseach was aimed at studying neurophysiologicl aspects of the atypical facial pain. The disorder turns out to have such specific traits as brainstem structure disfunction which occurs as higher brainstem structure sensibility, with the trigeminal system being involved during autonomic disorders. The mutimodal evoked potential potentials (auditory evoked potentials, Sympathetic Skin Response and trigeminal evoked potentials) research is recommended for differencial diagnostics for different kinds of the facial pain, verifying predominate pathogenic mechanisms, defining treatment course and treatment efficiency estimation.

 
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Predictors of massive intracerebral hemorrhages in arterial hypertension

Gulevskaya T.S., Maksimova M.Y., Romanova A.V.

Abstract

In 125 autopsies cases of massive intracerebral hemorrhages (ICH), caused by arterial hypertension (AH), retrospective clinical analysis and macro- and microscopic investigation of brain and its vascular system were conducted. There were 54 females and 71 males aged from 21 to 75 (average age is 53±11). 78% of patients suffered from essential AH, 22% – from nephrogenic AH. In 50% of cases duration of AH was over 10 years. In 62% of cases the disease was severe, with uneffective treatment, and often hypertensive cerebral crises. Over 30% of these patients suffered from strokes. In all cases brain  analysis showed large ICHs (over 40 cm3), which in 84% of cases were located in cerebral hemispheres (lateral ICHs – 49%, mixed – 38%, medial – 13%), in brainstem – 9%, and in cerebellum – 7%. In 79% of cases massive penetration of blood into ventricular system was noted. Macroscopic analysis revealed local brain changes in 63% of all cases: 35% in the form of large post-haemorrhagic cysts, 44% in the form of a single or multiple lacunar infarcts (LIs). In 38% of cases with multiple LIs lacunar condition of brain was diagnosed. In 16% of these cases both cysts and multiple LIs were revealed. Local changed were found in the same deep brain areas as ICHs: more often in basal ganglions and cerebral white matter, and less often – in thalamus, pons and cerebellum. In microscopic examination morphological changes characteristic of hypertensive angioencephalopathy were detected: LIs, incomplete necrosis foci, white matter spongiosis, perivascular encephalolysis foci, criblurs, microhemorrhages. Examination of hemorrhage foci revealed structural elements of LIs located on the edge and around hemorrhage. According to our data, we suppose, that previous local and diffuse brain tissue changes, which are typical for hypertensive angioencephalopathy and lacunar condition, are predictors of massive ICHs.

 
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Autoregulation of cerebral circulation in progressive heart failure and its relationship to seizure readiness

Mamalyga M.L.

Abstract

In the early stage of cardiac decompensation does not change the blood flow in the carotid and basilar arteries, but seizure readiness (SR) of the animals increased. Preservation of reactivity to hypercapnic and compression tests, suggests that the increase in SR is not associated with circulatory disorders in the brain. Exacerbation of heart failure (HF) leads to severe decompensation, including a decrease in blood flow in the carotid and basilar arteries. Metabolic cascade of autoregulation in these animals areaktiven and myogenic greatly reduced. In this case revealed a progressive increase in the SR. Inefficiency of the heart at different stages of HF is not the same effect on the reserves of the autoregulation of cerebral hemodynamics, which affects the formation and aggravation of SR. Moreover, its rise in various stages of decompensation is not always caused by cerebral ischemia.

 
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Visualization of dopaminergic midbrain structures in Parkinson’s disease

Bogdanov R.R., Manannikova E.I., Abramenko A.S., Maratkanova T.V., Kotov S.V.

Abstract

MRI morphometry of the substantia nigra (SN) and the red nucleus was performed in patients with Parkinson’s disease (PD) (1 and 3 stage by Hoehn and Yahr) and healthy individuals using modes T2 and T2*-WI on magnetic resonance system ”Initial Achieva 3.0T”. Nonsignificant volume decrease of SN was revealed in patients with early manifestations of PD, and vice versa, its increase in symptomatic PD, which can be regarded as an analogue of the well-known phenomenon of ultrasonography in PD. Significantly greater than in the control SN volume asymmetry was marked in PD patients, and asymmetry increased in the progression of the disease. The findings suggest the possibility of using MRI morphometry of the brainstem structures to assess the course of the neurodegenerative process in PD.

 
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Cortical cerebral atrophy in patients with Parkinson’s disease: new trends in the diagnostics in vivo

Trufanov A.G., Litvinenko I.V., Odinak M.M., Voronkov L.V., Khaimov D.A., Efimzev A.Y., Fokin V.A.

Abstract

The Parkinson’s disease (PD) pathology is not limited by degeneration of the nigrostriatal dopaminergic system, but includes also wide involvement of different regions of cerebral cortex. The aim of this study was the identification of differences in the brain cortical thickness in patients with early and advanced PD with the use of MRI morphometry. Sixty seven PD patients with Hoehn-Yahr 2 and 3 stages were examined. All patients underwent MRI with subsequent post-processing and receiving of cortical thickness parameters in different brain regions. Significant differences in the visual cortex, the cingulated and fusiform gyri and the frontopolar zone of a dominant hemisphere, and the  Brodmann’s areas 1, 2, 3 and 4 of a non-dominant hemisphere were obtained. These data allow revealing relationships between non-motor manifestations of PD and degeneration of certain cortical regions of the brain.

 
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Influence of propofol on hippocampus in developing brain: an experimental study

Lobov M.A., Dreval A.A., Ovezov A.M., Panteleeva M.V., Pashina N.R., Knyazev A.V., Borisova M.N., Lugovoy A.V.

Abstract

Anesthetic neurotoxicity and intraoperative cerebral neuroprotectioan is one of the important issues in modern anesthesiology. General anesthesia, in addition to its hypnotic effect, is considered to cause postoperative cognitive dysfunction as a manifestation of encephalopathy. Narcosis based on propofol is a “gold standard” of total intravenous anesthesia and is frequently used for surgery in patients of various ages. This experimental study investigates the effects of propofol on neuronal population in hippocampus of immature rats. In propofol-anesthezied rats within 30 min of exposition, a two-fold increase of altered hippocampal neurons was detected compared to control animals, however no neuronal cell death was observed. Intraoperative use of ethylmethylhydroxypyridine succinate ameliorates propofol-induced neuronal damagethat proves a neuroprotective effect of the drug tested.

 
Annals of Clinical and Experimental Neurology. 2013;7(3):
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State-of-the-art neuroimaging techniques in pathogenesis of multiple sclerosis

Bryukhov V.V., Kulikova S.N., Krotenkova M.V., Peresedova A.V., Zavalishin I.A.

Abstract

Magnetic resonance imaging (MRI) is one of the main methods of multiple sclerosis (MS) diagnostic, differential diagnostic and disease course monitoring. Conventional MRI techniques have low sensitivity in the assessment of diffuse damage of normal appearing white matter and focal/diffuse damage of grey matter which are of great interest in MS. Advanced MRI techniques allow to get over these limitations and to obtain more specific information about MS pathogenesis. Thus MR-spectroscopy metabolites analysis helps to assess inflammation, myelin structure, remyelination and axonal loss or dysfunction, i.e. lets us see pathochemical changes in MS. Demyelination and axonal loss differentiation is possible due to MR magnetization transfer technique and also diffusion tensor imaging, which characterize water diffusion in the brain tissue restricted by cell membranes and axonal cytoskeleton. Grey matter damage could be assessed using sequences with one or two inverted impulses and morphometric analysis of atrophy. Functional MRI performance using different paradigms characterizes cortical reorganization in response to functional injury. Vascular aspects of MS are also widely discussed nowadays. MR-perfusion and susceptibility weighted imaging allow assessing perfusion and venous flowing changes. State-of-the art neuroimaging methods let us perform detailed analysis of tissue damage in MS including the cell level, obtain more precise information about functional, metabolic and pathologic features, therapy influence on the inflammatory reactions and neuroprotection. Perspective use of high-field MR scanners (more than 1.5 T) will lead to the increase of sensitivity of different pathologic mechanisms detection.
Annals of Clinical and Experimental Neurology. 2013;7(3):
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Vascular aspects of multiple sclerosis: myth or reality?

Peresedova A.V., Kulikova S.N., Zavalishin I.A.

Abstract

The article contains recent literature data concerning vascular aspects of multiple sclerosis (MS). The review provides a summary of three vascular abnormalities described in MS which include increased risk of developing ischaemic stroke, widespread decrease in cerebral perfusion and chronic cerebral venouse insufficiency with the assessment of the endovascular interventions efficacy.
Annals of Clinical and Experimental Neurology. 2013;7(3):
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