Vol 1, No 2 (2007)

Functional MRI (fMRI) was applied to study mechanisms of unctional reorganization of motor systems after ischemic stroke (IS) as the result of rehabilitation. Two groups of patients with IS were recruited: 16 patients on standard restorative therapy (basic group) and 16 patients on functional training – EMG biofeedback (comparison group). In addition, functional training was given to 14 healthy individuals (normal control). In controls, an increase in signal intensity from main activation zones and appearance of characteristic additional activation zones in cerebellar hemispheres, corpus callosum and premotor cortex was noted. In patients after basic rehabilitation, an increase in signal intensity from main activation zones in sensorimotor area and cerebellar hemispheres was revealed for both affected and nonaffected hand, irrespective of IS localization. In patients after functional training, the reorganization of functional motor system consisted in an increase in signal intensity of main activation zones only in the ipsilesional hemisphere; expressiveness of these changes did not depend on IS localization. The degree of motor recovery of the hand after functional training was significantly higher than after the basic course of rehabilitation therapy. So, neuroimaging (fMRI) and clinical analysis showed directional and effective influence of the functional training method on the processes of motor system reorganization.

Psychiatric abnormalities represent important, although not obligate, clinical manifestation of epilepsy. They are characterized by variability, interrelation with particular disease forms and seizure types, as well as by significant influence on patients’ quality of life. Precise assessment of these disturbances in each case is important for carrying out differential diagnosis, determining prognosis and prescribing adequate therapy. In the paper, on the basis of extensive personal experience and literature data, classification of various ictal, interictal and postictal psychiatric abnormalities is proposed, detailed phenomenology of mind disorders in epilepsy is presented, and relevant risk factors are analyzed.

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Hereditary ataxias represent a clinically and genetically heterogeneous group of disorders, modern classification of which is based on identification of a primary genetic and/or biochemical defect in examined patients and their family members. Recently, autosomal recessive ataxia with oculomotor apraxia was described; it is characterized by combination of coordination problems with specific abnormalities of voluntary eye movements and, probably, by high prevalence if a majority of populations. We presented the first description of this phenotype in Russia observed in two sibs (sisters). Biochemical screening (increased serum level of alphafetoprotein) and molecular analysis enabled to diagnose in this family ataxia-oculomotor apraxia, type 2 (AOA2) – the disorder caused by pathology of senataxin protein and mutations of the respective gene SETX on chromosome 9q34.