Vol 4, No 4 (2010)

Original articles

Results of surgical treatment of atherosclerotic stenosis of carotid arteries in patients after ischemic stroke

Kazanchyan P.O., Popov V.A., Larkov R.N., Esayan A.V., Kotov S.V., Kozlova I.A.

Abstract

Dynamics of neurological recovery was assessed in 121 patients with atherosclerotic stenosis of the internal carotid arteries suffered from stroke. Patients underwent carotid endarterectomy that was carried out from 1 month to 5 years after stroke. Somatic, neurologic and neuropsychological state, as well as functional characteristics and quality of life were assessed, and utrasound testing of the brachiocephalic arteries and neuroimaging studies were carried out. After carotid endarterectomy, significant decrease in the severity of focal neurological symptoms and cognitive impairment, increase in quality of life and functional improvement was registered. Post-operatively, ischemic events occurred in 2.5% of patients.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):4-9
pages 4-9 views

Regional pattern of beta-amyloid accumulation in the preclinical and clinical states of Alzheimer’s disease

Vlassenko A.G., Morris J.C., Minton M.A.

Abstract

Amyloid- (A ) plaque accumulation in the brain is a hallmark of Alzheimer’s disease (AD). The concept of preclinical AD implies that A deposits may accumulate in the brain years prior to the clinical manifestations of AD. In this study, we measured binding potentials (BP) of different brain regions using positron emission tomography (PET) study with A radiotracer N-methyl-[11C]2-(4ґ-methylaminophenyl)-6-hydroxybenzothiazole ([11C]PIB) in 16 patients with mild to moderate dementia of Alzheimer’s type (DAT) and 223 cognitively normal individuals aged 50 to 86 years old. Mean cortical BP was calculated from binding potentials of brain regions prone to A accumulation and was used as a measure to define threshold value for abnormal elevation of [11C]PIB uptake in cognitively normal individuals. In both groups, with low (n=181) or high (n = 42) A accumulation, the highest [11C]PIB BP was demonstrated in the precuneus. In DAT patients, A accumulation was substantially increased in all regions, with the precuneus and prefrontal cortex having the highest [11C] PIB BP. We suggest that the precuneus may be brain region with the earliest involvement in the A plaque accumulation.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):10-14
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Mechanisms of the development of skeletal muscle atrophy in chronic alcohol intoxication

Kazantseva Y.V., Maslova G.V., Lysenko E.A., Zinovyeva O.E., Shenkman B.S., Yakhno N.N.

Abstract

Chronic alcohol myopathy (CAM) is one of frequent manifestations of the alcoholic disease, but its pathogenesis remains to be elucidated. Main mechanism of the CAM development is suggested to be abnormalities of protein synthesis in muscle fibers. A complex clinical, morphological and biochemical investigation of 38 patients with chronic alcohol intoxication was performed. Clinical manifestations of skeletal muscle damage corresponded to severity of the atrophic process assessed by histological studies of muscle biopsies. Disturbances of main stages of protein synthesis both on intracellular and on systemic regulatory level was revealed.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):15-19
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Method and possibilities of the in vivo CSF assessment of a cerebral endothelial destruction in patients with enteroviral meningitis

Pilipenko V.V., Voznyuk I.A., Klur M.V., Karev V.E., Semenov A.V.

Abstract

With the use of expert immunohysto/cytochemical methods in 30 patients with enteroviral serous meningitis and cyclic noncomplicated disease course, the presence of circulating endothelial cells (CEC) in the cerebrospinal fluid (CSF) was shown. The CSF CEC quantity was determined in the acute period of illness. It was confirmed the possibility for quantitative CEC detection in smears stained with hematoxylin. CEC in the CSF of hernioplastic patients operated under epidural anesthesia were not detected.

 
 
Annals of Clinical and Experimental Neurology. 2010;4(4):20-24
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Clinical-electroencephalographic analysis of early stages of Parkinson’s disease

Titova N.V., Katunina Е.A., Oleinikova O.M., Lagutin Y.V., Bezdolny Y.N., Avakyan G.N.

Abstract

The article is devoted to the detection of neurophysiologic features of early stages of Parkinson’s disease (PD) by using computerized electroencephalography (EEG). The obtained data illustrated that even early stages of PD were characterized by changes in the brain bioelectric activity. Patients with a trembling form demonstrated the increase of relative power in the delta and theta frequency range, the decrease of alpha-rhythm peak frequency and the increase of the ratio alpha-1/alpha-3. An akinetic-rigid form was characterized by the reduction of spectral (absolute and relative) power in the beta1-and beta2-bands. Right-side onset of the disease was associated with more severe disturbances of the EEG (particularly in an akinetic-rigid form), with the lack of differences between groups in duration of the disease, age at onset and severity of symptoms, which may be of prognostic importance in early stages of PD. The dynamics of EEG parameters included the increase of slow wave activity power and the reduction of spectral power in the beta frequency range regardless of ongoing treatment and particular group of dications.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):25-30
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Functional characteristics of the brain and cognitive functions in patients with autonomic dysfunction combined with clinically apparent asthenia

Gordeev S.A., Shvarkov S.B., Kovrov G.V., Posokhov S.I., Dyakonova N.A.

Abstract

Twenty six patients with autonomic dysfunction combined with clinically apparent asthenia and 22 healthy control subjects were examined with the use of clinico-neurologic, psychometric, neuropsychological and neurophysiological methods of investigation. Electrophysiologically, compression spectral analysis of EEG and auditory event-related potentials Р300 were used. The patients differed significantly from controls by the reduced attention selectivity, stability and switching, as well as by depression of short-term memory on words and digits. The patients group was also characterized by significantly lower Р300 wave amplitude and spectral power of EEG alpha band in the occipital areas of both hemispheres, in the posterior frontal, the central and the parietal areas of the right hemisphere, as well as by significantly higher spectral power of EEG theta band in the right frontal, the left parietal and the central areas of both hemispheres. One may conclude hat changes of spontaneous and evoked electrical activity of the brain in patients with an asthenia reflect the decrease in general level of brain functional activity owing to abnormal adjusting influences of the limbic-reticular structures. In this case a sufficient flow of cortical activation, necessary for the optimal information processing and maintenance of an adequate level of the directed attention and short-term memory, can not be generated.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):31-36
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Modulators of endogenous cannabinoid system аs neuroprotectors

Genrikhs E.E., Bobrov M.Y., Andrianova E.L., Gretskaya N.M., Lyzhin A.A., Blazhenova A.V., Frumkina L.E., Bezuglov V.V., Khaspekov L.G.

Abstract

The neuroprotective action of endocannabinoid N-arachidonoyldopamine (AA-DA) in the model of apoptosis induced in cultured rat cerebellar granule neurons by K+ deprivation was investigated. The efficacy of simultaneous application of AA-DA with fatty acid amide hydrolase inhibitor N-eicosapentaenoyldopamine (EPA-5HT) was also evaluated. It was shown that AA-DA dose-dependently protects neurons, with maximal effect of 65% survived cells observed at concentration 10 μM. The use of submaximal concentration (5 μM) of AA-DA in combination with EPA-5HT (10 μM) led to significant enhancement of neuroprotection. The value of cell survival for the combination exceeded such values for AA-DA alone in concentration of 5 and 10 μM, increasing the neuronal survival up to 78%. It may be concluded that such combination allows to reduce efficient concentration of neuroprotector and to diminish its possible side effects. Thus, the simultaneous application of endocannabinoid system modulators such as cannabinoid receptor agonists and inhibitors of endocannabinoid hydrolysis appears to be effective approach for neural cells protection.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):37-42
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Technologies

Possibilities of transcranial sonography in extrapyramidal disorders

Fedotova E.Y., Chechetkin A.O., Illarioshkin S.N.

Abstract

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Annals of Clinical and Experimental Neurology. 2010;4(4):43-50
pages 43-50 views

Clinical analysis

Cerebral radio-necrosis in a patient with pseudo-tumoral multiple sclerosis

Guryanova O.E., Stoida N.I., Konovalov R.N., Zavalishin I.A.

Abstract

A pseudo-tumoral course of multiple sclerosis is very rare. In the paper, a morphologically confirmed case of multiple sclerosis with a pseudo-tumoral course is described. A radiation treatment (because of a misdiagnosis of cerebral tumor) resulted in radio-necrosis of the cerebral tissue. Presented are the experience of treatment of this patient, differential diagnosis and efficacy of the long-term hormone therapy.

 
Annals of Clinical and Experimental Neurology. 2010;4(4):51-55
pages 51-55 views


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