Vol 6, No 2 (2012)

Original articles

MRI in the assessment of motor function restoration in patients with chronic supratentorial infarction

Dobrynina L.A., Konovalov R.N., Kremneva E.I., Kadykov A.S.

Abstract

To analyze potential of different MRI methods in the quantitative assessment of brain lesions after ischemic stroke, 19 patients (mean age 38.9±6.2 years) with hemiparesis of various severity resulted from supratentorial ischemic stroke (6–12 months prior the examination) were studied. A relationship was established between such parameters as fractional anisotropy (FA), apparent diffusion coefficient (ADC), size of the brain lesion, and severity of motor deficit. The FA and ADC values obtained in the corticospinal tract (CST) projection allow them to be considered as indicators of the degree of the CST post-ischemic damage predicting motor deficit. FA was found to be the most reproducible indicator of the CST structural integrity. FA threshold values (index, %) for unfavorable outcome of the motor function restoration were determined as follows: 50% for posterior limb of internal capsule, 42% for cerebral peduncle, and 65% for pons varolii. High sensitivity and specificity of the obtained parameters provides ground for their use in identifying patients with poor prognosis for the motor function restoration.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Neuropsychological abnormalities in early-stage Parkinson’s disease

Vereyutina I.A., Illarioshkin S.N., Zhuravleva E.Y., Shikhkerimov R.K.

Abstract

Comparative assessment of affective and cognitive abnormalities in different clinical forms of early-stage Parkinson’s disease (PD) was performed. In the majority of patients, cognitive decline of predominantly executive and neurodynamic type not reaching the dementia level was registered. The revealed cognitive disturbances prevailed in patients with an akinetic-rigid form of PD, while a trembling form turned out more benign from the viewpoint of its influence on the intellectual sphere. High prevalence of depression on early-stage PD was shown: depressive symptoms of various severities were observed in 84% examined patients. By analogy with cognitive decline, depression and anxiety at the debut of PD were significantly more frequent in patients with an akinetic-rigid form compared to a trembling phenotype. These data confirm that affective disturbances are very characteristic early (including premotor) manifestations of PD.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Diagnostics of headache in Russia and post-Soviet countries: state of the problem and ways for its solution

Osipova V.V., Azimova Y.E., Tabeeva G.R., Tarasova S.A., Amelin A.V., Kutsemelov I.V., Moldovanu I.V., Odobesku S.S., Naumova G.I.

Abstract

The article prepared by a group of authors on the initiative of the Russian Headache Research Society (RHRS) is a result of the analysis of approaches to the diagnosis of headache used by neurologists and general practitioners in Russia and some post-Soviet countries. Common diagnostic mistakes and misinterpretation of instrumental investigations results, as well as the reasons for erroneous treatment strategies in patients with headache are discussed. Practical steps focused on the improvement of headache diagnosis and treatment, as well as specialized care for headache patients are proposed.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Role of transcranial magnetic stimulation in cervical spondilotic myelopathy

Hit’ M.A., Nikitin S.S., Gushcha A.O.

Abstract

In the present paper, the significance of main parameters of transcranial magnetic stimulation (TMS) in cervical spine stenosis (CSS) confirmed by MRI was assessed. Forty two patients (26 men and 16 women, mean age 49±7.4 years) and a control group comprising 9 men and 7 women (mean age 44±2.1 years) were examined. The Japanese Orthopaedic Association (JOA) score was used for neurological assessment. It was shown that the duration and polyphasy of MEP were the most informative  parameters on the early stage of CSS, even in the absence of MRI changes and in normal values of the central motor conduction time (CMCT). Increase of CMCT was seen in extended SCS. TMS may be regarded as a valuable tool in the assessment of functional state of subclinical and clinically evident cervical spondylotic myelopathy.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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A modifying effect of the method of tempo-rhythmic correction of gait in Parkinson’s disease

Pohabov D.V., Abramov V.G., Nesterova Y.V.

Abstract

The study was aimed at evaluating effectiveness of the method of tempo-rhythmic correction (TRC) of gait in patients with Parkinson’s disease (PD) in terms of main motor symptoms of the disorder. The following methods were used: a step-speed performance assessment device, a method of TRC of gait elaborated by our group, and a questionnaire of quality of life for patients with PD (PDQ-39). It was shown that the TRC method could improve gait in PD patients, increase quality of their life and reduce the pharmaco-economic burden. We suggest the existence of a possible neuroprotective effect of the TRC method in view of increased intervals between consecutive stages of PD and later occurrence of new disease symptoms in patients undergoing respective courses of treatment.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Modern ethical aspects of clinical trials in patients with multiple sclerosis

Ivashkova E.V., Petrov A.M., Votintseva M.V., Shkilnyuk G.G., Stolyarov I.D.

Abstract

In this article, universal guidelines and requirements to clinical trials of new drugs in multiple sclerosis are presented. Principles of patients’ informed consent, various ethical aspects and possible problems occurring in the course of clinical trials in these patients are discussed in detail. Presented are main current documents regulating clinical trials of new drugs in the Russian Federation.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Polyamines: their role in normal condition and in disorders of the central neural systems

Berezov T.T., Makletsova M.G., Fedorova T.N.

Abstract

Along with a well-studied role of polyamines in the regulation of biosynthesis of protein, RNA and DNA, reparative regeneration and oncopathology, the ability of polyamines to act as modulators of neurotransmitter systems in the brain has been shown. There is growing evidence that metabolic abnormalities of polyamines may lead to the development of a number of the central nervous system (CNS) disorders. The study of this problem is important for understanding the molecular basis of pathogenesis and methods of diagnosis of the CNS disorders, as well as for the development of methods for their pharmacological correction on the basis of influence on the polyamine system.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Role of modern neuroimaging in the studies of focal dystonia

Timerbaeva S.L.

Abstract

Presented is a detailed analysis of different modern neuroimaging technologies used for studying pathophysiological mechanisms and morpho-physiological substrate of primary focal dystonia. Main attention is paid to functional MRI and voxel-based morphometry. Various applications of these methods for the purposes of basic neurology and neurophysiology, as well as for control of the effects of ongoing treatment, are summarized and discussed.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Myotonic dystrophy type 2

Rudenskaya G.E., Polyakov A.V.

Abstract

Myotonic dystrophy, type 2 (DM2) is an autosomal dominant disorder caused by expansion of the CCTG repeats in the zinkfinger protein-9 gene (ZNF9). It has been clinically reported in the middle 1990th. DM2 is less frequent than “classic” DM1, yet is relatively common, mostly in Europeans. Like DM1, DM2 is a multisystem disorder, and main distinctions from DM1 are: relatively late onset, proximal character of myopathy, less severe myotonia, presence of myalgia, etc. Clinical features complicate the diagnosis, and a number of cases cannot be identifiedon time. In the Research Centre for Medical Genetics the DNA diagnostics of DM2 is now available, and several cases have been confirmed molecularly.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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Clinical polymorphism of cerebrovascular disease in pathology of the brachio-cephalic arteries

Tanashyan M.M., Lagoda O.V., Chervyakov A.V.

Abstract

Cerebrovascular diseases are the most important cause of morbidity and mortality from cardiovascular disease among adults. Generalized atherosclerosis is the most frequent basis for vascular lesions of the brain, leading to the development of acute and chronic disorders of cerebral circulation. Polymorphism of clinical symptoms caused not only by lesions of the brachio-cephalic arteries, but also by simultaneous involvement in the variable-degree atherosclerotic rocess of other vessels, is often responsible for diagnostic difficulties. In the paper, a number of case reports describing patients with advanced atherosclerotic lesions of different vascular systems and marked variability of clinical manifestations are presented. Discussed are questions of rational diagnosis and general approaches to treatment of atherosclerosis, as well as questions of asymptomatic brachio-cephalic stenosis, “silent” brain infarcts and risk factors for atherosclerosis.

 
Annals of Clinical and Experimental Neurology. 2012;6(2):
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