Vol 10, No 3 (2016)

Background. The article presents the results of the research on the effectiveness of the proprietary method of the locomotor function correction by activating the vestibular analyzer using the vertical oscillation procedure in patients with postapoplectic vestibular-atactic syndrome.
Methods. The study involved 47 patients, median age was 58 [51; 63] years. The patients were randomized into 2 groups. In the main (I) group (n=23), patients received complex rehabilitation treatment and the proprietary method of balance and gait correction. The originality of the method lies in activation of the vestibular analyzer and postural synergies through displacements of the center of gravity in the vertical plane. In the comparison group (II), patients (n=24) received complex rehabilitation treatment and training on biofeedback (BFB) platforms. Computer stabilometry (CS), assessment of gait function using of the proprietary method “Laser analyzer of kinematic gait parameters” (LA-1), Berg Balance scale (BBS), Dynamic Gait Index (DGI), International Cooperative Ataxia Rating Scale (ICARS), Falls Efficacy Scale (FES), and HADS were carried out before and after the course of treatment.
Results. In group I, statistically significant change in CS, LA-1, BBS, DGI, and ICARS score was observed after training course. In group II, significant changes in CS, LA-1, BBS, and DGI scores were also observed. When comparing the data of CS, BBS, and DGI, no statistically significant differences were found between groups I and II.
Conclusion. The effectiveness of the proprietary method in restoring balance and gait in postinsult patients was demonstrated to be comparable to that of training on BFB platforms.

ntroduction. Arterial hypertension (AH) is the major modified risk factor for brain injury. Clarification of the brain changes and the mechanisms of their development during the asymptomatic stage will ensure better results in the prevention of AH complications.
Objective. The study purpose was to evaluate specific changes in the brain MRI picture, associated with AH of varying severity.
Materials and methods. The study involved 82 patients with newly diagnosed asymptomatic AH, aged 45–59 years. The patients underwent MRI of the brain (T1 and T2 weighted images, FLAIR, diffusion weighted imaging with calculation of an apparent diffusion coefficient (ADC) map). We evaluated the localization and severity of white matter hyperintensity (WMH), lacunar infarcts, and dilated perivascular spaces as well as the white matter microstructure based on ADC in a visually intact white matter in areas of its potential vulnerability.
Results. The earliest and most typical change is the formation of hyperintensity lesions in the juxtacortical areas of the frontal lobes. AH worsening is associated with an increase in the number of hyperintensity lesions from the frontal to occipital areas of the white brain matter and from the surface to deep brain regions as well as microstructural changes in the intact white matter in potential vulnerability areas.
Conclusion. The observed high correlations between WMH and dilated semioval perivascular spaces and increased diffusion in the intact white matter as well as the absence of similar correlations for lacunar infarcts suggest that the pathophysiological basis of early brain changes in AH is increased vascular permeability, but not ischemia. The factors of a high risk of clinical symptoms include lesion extension to the posterior brain structures, multiple foci of hyperintensity in the periventricular white matter of the frontal lobes, and an increasing number of lacunar infarcts. These findings are significant for evaluating potential risk of clinical symptoms and for understanding the mechanisms of early brain injury in AH.

Background. Spinal cord ischemia (SCI) is accompanied by severe persistent neurological and physical disorders. The article discusses potential neuroprotective effect of L-lysine aescinat.
Objective. to assess the effect of L-lysine aescinat on the functional recovery and morphological picture of spinal cord in white rats with simulated SCI.
Methods. Spinal cord ischemia was induced by ligation of the infrarenal abdominal aorta in two experimental groups of rats. In the control group (n=8), aorta was ligated; in the experimental group (n=8), L-lysine aescinat was injected intraperitoneally at a dose of 0.14 mg/kg 30 minutes before ischemia, followed by ligation of aorta.
Results. Pronounced and statistically significant neuroprotective effect of L-lysine aescinat was demonstrated, which clinically manifested as neurological deficit reduction and morphologically manifested as increased number of normochromic neurons and decreased number of shrunken neurons and shadow-cells (p<0.01), as well as suppression of edema of the spinal cord substance.
Conclusion. L-lysine aescinat has a neuroprotective effect in rats with experimental ischemia of the spinal cord.

Tension-type headache is the most common form of headache. The article discusses prevalence, basic developmental mechanisms, and clinical aspects of tension-type headache. Tension-type headache is a multifactorial disease. Myofascial mechanisms, central sensitization, and decreased antinociceptive effect are believed to play a leading role in the pathogenesis of the disease.

Posterior cortical atrophy (PCA) is a rare disease that manifests mainly as disturbance of cortical visual function, agnosia. Bálint’s syndrome (optic ataxia) is one of the clearest clinical markers of the disease. The disease is caused by progressive atrophy of the visual cortex. Many researchers define PCA as an independent disease, while others suggest that it is a “posterior” variant of Alzheimer’s disease, corticobasal degeneration, etc. Morphological studies of brain tissues support the neurodegenerative nature of the disease.

The consequences of cerebrovascular diseases significantly reduce the quality of life of patients. Recovery of basic motor skills, such as the ability to reach the object, manipulate it, and coordinate the movements of two hands is one of the top-priority tasks in restoring patient’s living and social activity. Training in the environment as close to the real one as possible, active involvement of the patient, as well as interactive feedback, which allows patients to control the correct execution of motor tasks and adjust their own efforts are required for successful motor recovery. The development of computer technology enabled the improvement of conventional approaches to rehabilitation of stroke patients. Virtual reality (VR) is extensively used to meet these conditions and achieve successful targeted training for a specific motor task. The technical basis of VR includes computer modeling and computer simulation, as well as three-dimensional visualization, which provides realistic visualization of movements on the screen. These technologies enable reconstruction of the appropriate working space for motor skill training, and provide interactive feedback and high intensity of rehabilitation. This article provides information about the development of these technologies in the field of motor rehabilitation of upper extremity function, comparative analysis of systems that are currently used or being developed, and prospects of VR development in neurorehabilitation.

Hashimoto’s Encephalopathy is an autoimmune disease associated with significant increase in titer of autoantibodies to thyroid peroxidase and thyroglobulin and characterized by inflammatory and degenerative brain disorders. We report a clinical case of recurrent status of acute symptomatic attacks in a female patient with Hashimoto’s encephalopathy.