Clinical manifestations and issues of diagnosis of chronic cerebrovascular disease (chronic cerebral ischemia) at an early (pre-dementia) stage

The paper presents experts' opinion on the clinical manifestations and diagnosis of chronic cerebrovascular disease (CVD) (chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP)) at the pre-dementia stage. It is noted that DEP/CCI is a common diagnosis in Russian neurological practice, the criteria for which have not been updated for a long time. DEP/CCI most often develops in the presence of cerebral small artery (CSA) disease (cerebral microangiopathy (CMA)), the severity of which can be quantified by magnetic resonance imaging. The main clinical manifestation of DEP/CCI is cognitive impairment that may be subjective or moderate at the pre-dementia stage. Emotional disorders (apathy, depression, anxiety) and instability are considered as possible manifestations of CSA disease. It is noted that headache and vestibular vertigo are not caused by chronic CVD; while in patients with CMA, they are usually associated with other diseases (primary headache, peripheral vestibular vertigo, and vestibular migraine). The diagnosis of DEP/CCI should be based on the presence of cognitive impairment, reliable neuroimaging signs of CVD, and the exclusion of another cause of cognitive impairment.

Changes in EEG patterns in the α-frequency band following BCI-based therapy in children with cerebral palsy

It was demonstrated previously that neurorehabilitation with the BCI-controlled robotic device Exohand-2 combined with conventional therapeutic modalities resulted in significant motor improvement in children with cerebral palsy. However, EEG records were not analyzed in the previous study. The aim of this paper was to describe the reactivity patterns of the EEG α-rhythm during a series of 10 BCI-based neurorehabilitation sessions. The study was carried out in 32 boys and girls aged 10 to 18 years with right- or left-side hemiparesis. EEG was recorded from 21 electrodes at rest and during kinesthetic imagery of finger extension. During the first session, patterns of α-rhythm reactivity during motor imagery differed between patients with left- and right-side hemiparesis. The differences were statistically significant at Р2 during left hand movement rehearsal (F1, 30 = 5.10; p < 0.05). During the final session, the pattern of α-rhythm reactivity was different: synchronization was taken over by desynchronization at some electrode sites, suggesting increased activity of the neocortex. The most conspicuous EEG changes were observed in children with left-side hemiparesis (F20, 300 = 1.84; p < 0.05). By the end of the rehabilitation course, the differences between patients with left-and right-side hemiparesis became much less pronounced. Rearrangements in the EEG patterns in the α-frequency band can be regarded as signs of beneficial reorganization of neural circuits responsible for planning and executing complex hand movements.

[Cervical myelopathy in the hyperkinetic form of cerebral palsy: combination of botulinum therapy with surgical treatment]

The article describes the case of cervical myelopathy with tetraparesis and sphincter disorders, as a complication of cervical dystonia in a patient with hyperkinetic form of cerebral palsy. Left-side laterocollis in combination with the same side laterocaput was noted. Myelopathy symptoms progressed gradually over one year. The main clinical problems were: the inability to conduct a qualitative MRI study due to hyperkinesis, which required anesthesia, and the high risk of perioperative complications and relapses of cervical myelopathy. Before the surgery, botulinum therapy of cervical dystonia with abobotulotoxin in the total dose 1000ED was administered that led to regression of hyperkinesis. Microsurgical decompression of the spinal canal with the installation of fixation system at the level of C7-Th1 vertebrae was performed. After surgery, the neck was fixed with a Philadelphia collar. There were no complications after surgery or displacement of the stabilizing structure. This case report indicates the possibility of development of cervical myelopathy in cervical dystonia and demonstrates the need of pre - and post-operative botulinum therapy of cervical dystonia to prevent possible complications and relapses in the postoperative period.

[S100B protein in the blood of children with autism spectrum disorders]

AIM

To evaluate the plasma content of S100B protein in children with autism spectrum disorders (ASD).

MATERIAL AND METHODS

Forty-five children with autism (item F84 of ICD-10), aged from 6 to 15 years, were examined. The control group (KG) consisted of 25 healthy children. The study included examination by specialists, an assessment of the severity of the disease using the Children's Rating Scale of Autism scale (CARS), evaluation of S100B in blood serum.

RESULTS

The content of S100B in children with autism was significantly higher in comparison with KG. The level of S100B in children with ASD with abnormal development of brain structures (MRI) was significantly higher compared with KG and a group of children without signs of disturbance of brain structures. S100B levels were higher in children with severe ASD, and differed from controls in children with moderate ASD.

CONCLUSION

The majority of children with ASD show signs of stress of neuroprotective mechanisms, and children with anomalies of brain structures have signs of hypoxia of the brain and damage of the blood-brain barrier.

[The effect of cellex on regenerative processes in cerebral parenchymal hemorrhage under experimental condition]

AIM

To study an effect of the protein-peptide preparation cellex on the cerebral tissue processes in case of parenchymal hemorrhage breed under experimental conditions.

MATERIAL AND METHODS

The research involved the morphological examination of fragments of cerebral tissues of 57 rabbits of Chinchilla breed in artificially-provoked hemorrhagic stroke. Animals were divided into 2 groups: the first group received cellex once a day during 10 days, the second group received physiological solution in the same doses. The cerebral tissue was examined macroscopically and with histological, immunocytochemical and morphometric methods with subsequent data analysis.

RESULTS AND CONCLUSION

A much more pronounced regression of the neurological deficit was observed in the group of animals which were administered cellex. There was a significant increase in volume of active movements in the limbs. No connective tissue changes were observed macroscopically in rabbits of the first group. Besides, the area of destruction decreased in size in comparison with initially diagnosed one. A decline in the rate of the formation of connective tissue was observed in damaged parts of the brain. The microscopic study of the first group showed that the degree of inflammatory and hemodynamic disturbances was much lower and necrosis foci were not detected, however small foci of neoangiogenesis were found.

[Growth factors and neurotrophic control in the 'motoneuron - muscular fiber' system in children with cerebral palsy]

The article deals with the role of neurotrophic and growth factors in the development and functioning of the nervous system. The authors present general information on neurotrophic control and its role in the interaction of motor neurons and innervated muscle fibers.