A. Poydasheva, I. Bakulin, D. Sinitsyn, Alfiya H. Zabirova, D. Lagoda, N. Suponeva, M. Piradov
Studying rhythmic neural synchronization (cross-frequency coupling in various ranges) is an emerging topic in present-day neurophysiology. One of the best-studied cross-frequency couplings is theta-gamma phase-amplitude coupling that contributes to the cognitive function and may vary in patients with several conditions associated with cognitive impairment. Changes in theta-gamma coupling can be registered in a wide range of diseases associated with cognitive decline. The review covers the physiological basics of theta-gamma coupling, its registration and calculation, correlation with cognitive test results in healthy volunteers, and changes in patients. We have discussed the results of the preliminary studies of frequency-dependent non-invasive brain stimulation based on theta-gamma coupling.
{"title":"Theta-gamma phase-amplitude coupling: physiological basics, analysis methods, and perspectives of translation into clinical practice","authors":"A. Poydasheva, I. Bakulin, D. Sinitsyn, Alfiya H. Zabirova, D. Lagoda, N. Suponeva, M. Piradov","doi":"10.54101/acen.2022.4.9","DOIUrl":"https://doi.org/10.54101/acen.2022.4.9","url":null,"abstract":"Studying rhythmic neural synchronization (cross-frequency coupling in various ranges) is an emerging topic in present-day neurophysiology. One of the best-studied cross-frequency couplings is theta-gamma phase-amplitude coupling that contributes to the cognitive function and may vary in patients with several conditions associated with cognitive impairment. Changes in theta-gamma coupling can be registered in a wide range of diseases associated with cognitive decline. \u0000The review covers the physiological basics of theta-gamma coupling, its registration and calculation, correlation with cognitive test results in healthy volunteers, and changes in patients. We have discussed the results of the preliminary studies of frequency-dependent non-invasive brain stimulation based on theta-gamma coupling.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84519461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Dobrynina, Z. S. Gadzhieva, E. Kremneva, K. Shamtieva, M. M. Tsypushtanova, A. G. Makarova, V. V. Trubitsyna, E. T. Bitsieva, Aleksey S. Filatov, A. A. Byrochkina, M. Krotenkova
Introduction. Contributing to high disability and mortality, cerebral small vessel disease (cSVD) is a common condition in senior and elderly individuals. Objective: to assess the 5-year survival as well as cognitive and MRI changes in patients with cSVD and cognitive impairment (CI). Materials and methods. A prospective 5-year study included 54 patients (of them 37 women; mean age: 60.51 6.76 years) with cSVD, CIs, and white matter hyperintensities (WMHs; Fazekas 23). Twenty-two subjects were followed up to assess cognitive functions and a type of CI, cSVD MRI features, WMH, white and grey matter, and cerebrospinal fluid (CSF) volume as well as microstructural brain changes and correlate cognitive and MRI parameters at 5 years timepoint after the baseline. Results. Dementia developed in 14% of the subjects and 14% of the subjects died over a 5-year period. The subjects assessed twice had controlled hypertension (HTN). CIs worsened in the domain of executive functions and memory with mixed-type CI worsening. The follow-up showed that the WMH and CSF volume increased while the white matter volume decreased and axial diffusivity increased in the corpus callosum. The CSF volume correlated with the Stroop Test results and delayed memory (r = 0.803 and r = 0.701, respectively) and with white matter atrophy (r = 0.256) while the latter correlated with the axial diffusivity increased in the corpus callosum (r = 0.560). Conclusion. cSVD with advanced WMHs is associated with high mortality and dementia progression. General cognition assessment and MRI scan are not enough sensitive to assess disorder progression over a 5-year period. Stroop Test and Delayed 10-Word Recall Test results and transition to mixed-type CI indicate CI worsening and, therefore, can be used for the follow-up assessment. Cognitive decline in extensive cSVD is mediated by the brain matter atrophy and altered CSF circulation.
{"title":"Survival, cognitive functions, and brain MRI in patients with cSVD: 5-year observation","authors":"L. Dobrynina, Z. S. Gadzhieva, E. Kremneva, K. Shamtieva, M. M. Tsypushtanova, A. G. Makarova, V. V. Trubitsyna, E. T. Bitsieva, Aleksey S. Filatov, A. A. Byrochkina, M. Krotenkova","doi":"10.54101/acen.2022.4.3","DOIUrl":"https://doi.org/10.54101/acen.2022.4.3","url":null,"abstract":"Introduction. Contributing to high disability and mortality, cerebral small vessel disease (cSVD) is a common condition in senior and elderly individuals. \u0000Objective: to assess the 5-year survival as well as cognitive and MRI changes in patients with cSVD and cognitive impairment (CI). \u0000Materials and methods. A prospective 5-year study included 54 patients (of them 37 women; mean age: 60.51 6.76 years) with cSVD, CIs, and white matter hyperintensities (WMHs; Fazekas 23). Twenty-two subjects were followed up to assess cognitive functions and a type of CI, cSVD MRI features, WMH, white and grey matter, and cerebrospinal fluid (CSF) volume as well as microstructural brain changes and correlate cognitive and MRI parameters at 5 years timepoint after the baseline. \u0000Results. Dementia developed in 14% of the subjects and 14% of the subjects died over a 5-year period. The subjects assessed twice had controlled hypertension (HTN). CIs worsened in the domain of executive functions and memory with mixed-type CI worsening. The follow-up showed that the WMH and CSF volume increased while the white matter volume decreased and axial diffusivity increased in the corpus callosum. The CSF volume correlated with the Stroop Test results and delayed memory (r = 0.803 and r = 0.701, respectively) and with white matter atrophy (r = 0.256) while the latter correlated with the axial diffusivity increased in the corpus callosum (r = 0.560). \u0000Conclusion. cSVD with advanced WMHs is associated with high mortality and dementia progression. General cognition assessment and MRI scan are not enough sensitive to assess disorder progression over a 5-year period. Stroop Test and Delayed 10-Word Recall Test results and transition to mixed-type CI indicate CI worsening and, therefore, can be used for the follow-up assessment. Cognitive decline in extensive cSVD is mediated by the brain matter atrophy and altered CSF circulation.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90890537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sleep disorder, especially insomnia, is one of the most common panic disorder (PanD) comorbidities, with PanD and insomnia being closely related. PanD severity is definitely associated with sleep disorder while sleep disorder is caused by abnormal anxiety. Insomnia management in PanD patients is based on a multidisciplinary approach to achieve emotional balance and includes both medicinal treatment and a wide range of psychotherapy methods. Successful insomnia management contributes to the effectiveness of PanD therapy, reduces relapse probability, and improves susceptibility to many anxiolytics.
{"title":"Insomnia and its management in patients with panic disorder","authors":"E. Korabelnikova, E. Yakovleva","doi":"10.54101/acen.2022.4.8","DOIUrl":"https://doi.org/10.54101/acen.2022.4.8","url":null,"abstract":"Sleep disorder, especially insomnia, is one of the most common panic disorder (PanD) comorbidities, with PanD and insomnia being closely related. PanD severity is definitely associated with sleep disorder while sleep disorder is caused by abnormal anxiety. Insomnia management in PanD patients is based on a multidisciplinary approach to achieve emotional balance and includes both medicinal treatment and a wide range of psychotherapy methods. Successful insomnia management contributes to the effectiveness of PanD therapy, reduces relapse probability, and improves susceptibility to many anxiolytics.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75887727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anion-conducting cys-loop receptors activated by -aminobutyric acid (GABAАRs) and glycine (GlyRs) have inhibitory activity in the brain and spinal cord. GABAАRs and GlyRs are targets for various substances that potentiate or inhibit the receptor functions. Many of these substances are clinically significant agents to treat neurological and psychiatric conditions. The review covers both our results and literature data on electrophysiology, mutations, and biochemistry of non-competitive antagonists, general anesthetics, barbiturates, and fenamates modulating GABAАRs and GlyRs. We focused on our own molecular modeling to determine the sites and the characteristics of binding of these substances to the GABAАR and GlyR transmembrane domain. With the structural patterns of the binding, we have identified possible molecular mechanisms of action for these substances.
{"title":"The structural patterns of the potentiation and the blockade of inhibitory cys-loop receptors through the transmembrane domain","authors":"A. Rossokhin","doi":"10.54101/acen.2022.4.6","DOIUrl":"https://doi.org/10.54101/acen.2022.4.6","url":null,"abstract":"Anion-conducting cys-loop receptors activated by -aminobutyric acid (GABAАRs) and glycine (GlyRs) have inhibitory activity in the brain and spinal cord. GABAАRs and GlyRs are targets for various substances that potentiate or inhibit the receptor functions. Many of these substances are clinically significant agents to treat neurological and psychiatric conditions. \u0000The review covers both our results and literature data on electrophysiology, mutations, and biochemistry of non-competitive antagonists, general anesthetics, barbiturates, and fenamates modulating GABAАRs and GlyRs. We focused on our own molecular modeling to determine the sites and the characteristics of binding of these substances to the GABAАR and GlyR transmembrane domain. With the structural patterns of the binding, we have identified possible molecular mechanisms of action for these substances.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77358128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. The differential diagnosis of vertebrobasilar stroke (VBS) and vestibular neuritis (VN) is important challenge for a neurologist when a patient presents to the emergency department with acute vertigo. Current approaches and algorithms of management need to be modified, taking into account clinical practice. The aim of the study was to identify the clinical features of acute vestibular syndrome that are the most helpful in the differential diagnosis of VBS and VN. Materials and methods. We examined 80 emergency admissions to the neurological ward with suspected stroke. A detailed otoneurological examination (including the STANDING and HINTS+ algorithms) and brain imaging (DWI MRI) were performed. Results. Out of 80 patients, 26 were diagnosed with VBS, 30 with VN, 11 with vestibular migraine and 2 with Meniere's disease, while the cause of vertigo could not be determined in 11 patients. The most powerful indicator of VBS in the differential diagnosis was gaze-evoked nystagmus, which had a 15.9-fold association with VBS. An increased likelihood of VBS was also associated with unsteadiness (6.3 times), age over 58 years (4.1 times), dysmetria in the finger-to-nose test (3.7 times), adiadochokinesia (3.1 times), and trunk ataxia (3 times). An increased likelihood of VN was associated with a positive unilateral head impulse test (6 times), nystagmus that followed Alexander's law (3.7 times), and presence of nausea (2.5 times). A model was developed for the differential diagnosis of VBS and VNin patients presenting with acute vertigo. The model accuracy was 100% in the validation sample. Conclusions. Clinical approach remains crucial when differentiating between VBS and VN. The most useful criteria for a differential diagnosis in emergency neurology were the patient's age, the type of nystagmus, head impulse test, and cerebellar dysfunction.
{"title":"Differential diagnosis of stroke and vestibular neuritis in emergency neurology","authors":"A. A. Monak, A. Kulesh, V. Parfenov, P. Astanin","doi":"10.54101/acen.2022.3.3","DOIUrl":"https://doi.org/10.54101/acen.2022.3.3","url":null,"abstract":"Introduction. The differential diagnosis of vertebrobasilar stroke (VBS) and vestibular neuritis (VN) is important challenge for a neurologist when a patient presents to the emergency department with acute vertigo. Current approaches and algorithms of management need to be modified, taking into account clinical practice. \u0000The aim of the study was to identify the clinical features of acute vestibular syndrome that are the most helpful in the differential diagnosis of VBS and VN. \u0000Materials and methods. We examined 80 emergency admissions to the neurological ward with suspected stroke. A detailed otoneurological examination (including the STANDING and HINTS+ algorithms) and brain imaging (DWI MRI) were performed. \u0000Results. Out of 80 patients, 26 were diagnosed with VBS, 30 with VN, 11 with vestibular migraine and 2 with Meniere's disease, while the cause of vertigo could not be determined in 11 patients. The most powerful indicator of VBS in the differential diagnosis was gaze-evoked nystagmus, which had a 15.9-fold association with VBS. An increased likelihood of VBS was also associated with unsteadiness (6.3 times), age over 58 years (4.1 times), dysmetria in the finger-to-nose test (3.7 times), adiadochokinesia (3.1 times), and trunk ataxia (3 times). An increased likelihood of VN was associated with a positive unilateral head impulse test (6 times), nystagmus that followed Alexander's law (3.7 times), and presence of nausea (2.5 times). A model was developed for the differential diagnosis of VBS and VNin patients presenting with acute vertigo. The model accuracy was 100% in the validation sample. \u0000Conclusions. Clinical approach remains crucial when differentiating between VBS and VN. The most useful criteria for a differential diagnosis in emergency neurology were the patient's age, the type of nystagmus, head impulse test, and cerebellar dysfunction.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72917548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. V. Gavrichenko, N. A. Pasatetckaia, Maria G. Sokolova, E. Lopatina
Introduction. Chronic inflammatory demyelinating polyneuropathy (CIDP) is one of the most common primary polyneuropathies. A degenerative process is the underlying cause of muscular atrophy in CIDP, while muscle strength may not fully recover in patients after pathogenesis-based treatment, thus extending the period of disability. Information about factors affecting the trophic function of muscles can be used to treat neuromuscular disorders. Study aim to examine the trophotropic properties of the study participants' blood plasma and the myoprotective effect of acetylcholine concentration equivalent to non-quantal release, using an in vitro model of the myopathy component of CIDP. Materials and methods. The study included 25 patients diagnosed with typical CIDP in accordance with the EFNS/PNS 2010 criteria. The control group consisted of 25 healthy individuals. Serum antibody levels to the nicotinic acetylcholine receptor were measured in all study participants. A method for organotypic cultivation of skeletal muscle tissue and an in vitro model of the myopathy component of CIPD were developed. The effect of the study participants' blood plasma on the growth of skeletal muscle explants in organotypic culture was assessed. Results. Patients with CIPD were found to have symmetrical sensorimotor polyneuropathy of varying severity (100%); muscle atrophy (88%), and sensory ataxia (84%). The median INCAT Overall Disability Sum Score was 2 [1; 3] for the arms and 3 [2; 5] for the legs. The median Neurological Impairment Scale (NIS) score was 17 [10; 34]. The nicotinic acetylcholine receptor antibody levels were higher in patients with CIDP (0.47 [0.31; 0.54] nmol/l) than in the control group (0.02 [0.01; 0.03] nmol/l). For the first time, a myotoxic effect of the blood plasma from patients with CIDP was observed in organotypic skeletal muscle culture. Using 1:70 and 1:100 dilutions, patient blood plasma inhibited the growth of explants by 27% (n = 120; p 0.001) and 21% (n = 120; p 0.001), respectively. This myotoxic effect removed acetylcholine at a concentration equivalent to non-quantal release (108 М). Conclusion. These results expand our understanding of skeletal muscle damage in CIPD and the role of non-quantal acetylcholine in regulating skeletal muscle growth.
{"title":"The myoprotective effect of non-quantal acetylcholine: in vitro model of the myopathy component of chronic inflammatory demyelinating polyneuropathy","authors":"A. V. Gavrichenko, N. A. Pasatetckaia, Maria G. Sokolova, E. Lopatina","doi":"10.54101/acen.2022.3.5","DOIUrl":"https://doi.org/10.54101/acen.2022.3.5","url":null,"abstract":"Introduction. Chronic inflammatory demyelinating polyneuropathy (CIDP) is one of the most common primary polyneuropathies. A degenerative process is the underlying cause of muscular atrophy in CIDP, while muscle strength may not fully recover in patients after pathogenesis-based treatment, thus extending the period of disability. Information about factors affecting the trophic function of muscles can be used to treat neuromuscular disorders. \u0000Study aim to examine the trophotropic properties of the study participants' blood plasma and the myoprotective effect of acetylcholine concentration equivalent to non-quantal release, using an in vitro model of the myopathy component of CIDP. \u0000Materials and methods. The study included 25 patients diagnosed with typical CIDP in accordance with the EFNS/PNS 2010 criteria. The control group consisted of 25 healthy individuals. Serum antibody levels to the nicotinic acetylcholine receptor were measured in all study participants. A method for organotypic cultivation of skeletal muscle tissue and an in vitro model of the myopathy component of CIPD were developed. The effect of the study participants' blood plasma on the growth of skeletal muscle explants in organotypic culture was assessed. \u0000Results. Patients with CIPD were found to have symmetrical sensorimotor polyneuropathy of varying severity (100%); muscle atrophy (88%), and sensory ataxia (84%). The median INCAT Overall Disability Sum Score was 2 [1; 3] for the arms and 3 [2; 5] for the legs. The median Neurological Impairment Scale (NIS) score was 17 [10; 34]. The nicotinic acetylcholine receptor antibody levels were higher in patients with CIDP (0.47 [0.31; 0.54] nmol/l) than in the control group (0.02 [0.01; 0.03] nmol/l). For the first time, a myotoxic effect of the blood plasma from patients with CIDP was observed in organotypic skeletal muscle culture. Using 1:70 and 1:100 dilutions, patient blood plasma inhibited the growth of explants by 27% (n = 120; p 0.001) and 21% (n = 120; p 0.001), respectively. This myotoxic effect removed acetylcholine at a concentration equivalent to non-quantal release (108 М). \u0000Conclusion. These results expand our understanding of skeletal muscle damage in CIPD and the role of non-quantal acetylcholine in regulating skeletal muscle growth.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87981275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Mirzoyan, Marine G. Balasanyan, Hakop V. Topchyan, V. Hakobyan, T. S. Gan'shina, Nikita A. Khaylov, I. N. Kurdyumov, A. I. Turilova, Тatyana A. Antipova, Valentina A. Kraineva, S. Seredenin
Aim. To examine the cerebrovascular, neuroprotective and antiarrhythmic properties of fabomotizole (brand name Afobazole). Materials and methods. A comprehensive study of fabomotizole's effects on the blood supply, morphology and neuropsychology of the rat brain in various experimental disorders. We recorded cerebral blood flow and studied brain morphology in models of local permanent and global transient ischaemia, haemorrhagic brain damage, combined cerebrovascular and cardiovascular pathology, cardiac arrhythmias, and assessed the neuropsychological status. We measured the levels of GABA, glutamic acid, nerve growth factor, and heat shock protein (HSP70). Results. Fabomotizole improves blood supply, limits the area of injury, normalizes pathological brain changes in localized cerebral ischaemia, and eliminates neuropsychological damage in models of ischaemic and haemorrhagic stroke. The drug increases cerebral blood flow in ischaemic and haemorrhagic stroke, myocardial infarction and, to a greater extent, in combined cerebrovascular and coronary disease. Fabomotizole acts through the cerebrovascular GABAAergic system, as well as having significant antiarrhythmic properties. Conclusions. Fabomotizole should be considered not only as an anxiolytic, but also as a drug with potential clinical efficacy in cerebrovascular disease, with concomitant coronary disease and cardiac arrhythmias.
{"title":"The cerebrovascular, neuroprotective and antiarrhythmic properties of the anxiolytic fabomotizole","authors":"R. Mirzoyan, Marine G. Balasanyan, Hakop V. Topchyan, V. Hakobyan, T. S. Gan'shina, Nikita A. Khaylov, I. N. Kurdyumov, A. I. Turilova, Тatyana A. Antipova, Valentina A. Kraineva, S. Seredenin","doi":"10.54101/acen.2022.3.8","DOIUrl":"https://doi.org/10.54101/acen.2022.3.8","url":null,"abstract":"Aim. To examine the cerebrovascular, neuroprotective and antiarrhythmic properties of fabomotizole (brand name Afobazole). \u0000Materials and methods. A comprehensive study of fabomotizole's effects on the blood supply, morphology and neuropsychology of the rat brain in various experimental disorders. We recorded cerebral blood flow and studied brain morphology in models of local permanent and global transient ischaemia, haemorrhagic brain damage, combined cerebrovascular and cardiovascular pathology, cardiac arrhythmias, and assessed the neuropsychological status. We measured the levels of GABA, glutamic acid, nerve growth factor, and heat shock protein (HSP70). \u0000Results. Fabomotizole improves blood supply, limits the area of injury, normalizes pathological brain changes in localized cerebral ischaemia, and eliminates neuropsychological damage in models of ischaemic and haemorrhagic stroke. The drug increases cerebral blood flow in ischaemic and haemorrhagic stroke, myocardial infarction and, to a greater extent, in combined cerebrovascular and coronary disease. Fabomotizole acts through the cerebrovascular GABAAergic system, as well as having significant antiarrhythmic properties. \u0000Conclusions. Fabomotizole should be considered not only as an anxiolytic, but also as a drug with potential clinical efficacy in cerebrovascular disease, with concomitant coronary disease and cardiac arrhythmias.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77788727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. V. Prokhorova, A. Yakovlev, I. Voznyuk, E. M. Morozova, E. A. Gogoleva, L. Pivovarova
Introduction. There are inconsistent data on the incidence of stroke in patients with COVID-19, including acute cerebrovascular accidents in younger people without obligate risk factors, as well as the risk of SARS-CoV-2 infection in patients with acute stroke. The aim of the study was to evaluate the features of concomitant stroke and COVID-19, and the role of inflammation and endothelial toxicity in cerebral damage. Materials and methods. The study included 1,524 patients admitted to vascular clinics across St. Petersburg in 20202021, including 1,068 people with confirmed COVID-19 infection and 551 death cases. The patients were divided into four groups depending on disease severity, for clinical and laboratory data analysis. Results. There were marked changes in the laboratory markers of inflammation, haemostasis, fibrinolysis, cytolysis, iron metabolism, cerebral ischaemia, proteolysis, immunodeficiency (lymphocytopenia, monocytopenia, elevated white blood cell count, elevated levels of C-reactive protein, fibrinogen, D-dimer, creatine kinase, ferritin and neutrophil elastase), with statistically significant differences when compared with patients without COVID-19. Changes in inflammatory markers in the first 2472 hours provided the most information. A multifold increase (escalation) in the marker values was always correlated with an imminent adverse outcome and was usually accompanied by subsequent laboratory confirmation of COVID-19 infection or specific signs of viral pneumonia. Conclusion. COVID-19 should be considered an independent risk factor for acute stroke, while the virus-induced thrombosis, manifesting in an escalation in inflammatory factors and products of endothelial damage, should be considered a pathogenetic link leading to cerebral tissue damage.
{"title":"Inflammation and endothelial toxicity: pathogenetic aspects of central nervous system damage due to novel coronavirus disease","authors":"M. V. Prokhorova, A. Yakovlev, I. Voznyuk, E. M. Morozova, E. A. Gogoleva, L. Pivovarova","doi":"10.54101/acen.2022.3.2","DOIUrl":"https://doi.org/10.54101/acen.2022.3.2","url":null,"abstract":"Introduction. There are inconsistent data on the incidence of stroke in patients with COVID-19, including acute cerebrovascular accidents in younger people without obligate risk factors, as well as the risk of SARS-CoV-2 infection in patients with acute stroke. \u0000The aim of the study was to evaluate the features of concomitant stroke and COVID-19, and the role of inflammation and endothelial toxicity in cerebral damage. \u0000Materials and methods. The study included 1,524 patients admitted to vascular clinics across St. Petersburg in 20202021, including 1,068 people with confirmed COVID-19 infection and 551 death cases. The patients were divided into four groups depending on disease severity, for clinical and laboratory data analysis. \u0000Results. There were marked changes in the laboratory markers of inflammation, haemostasis, fibrinolysis, cytolysis, iron metabolism, cerebral ischaemia, proteolysis, immunodeficiency (lymphocytopenia, monocytopenia, elevated white blood cell count, elevated levels of C-reactive protein, fibrinogen, D-dimer, creatine kinase, ferritin and neutrophil elastase), with statistically significant differences when compared with patients without COVID-19. Changes in inflammatory markers in the first 2472 hours provided the most information. A multifold increase (escalation) in the marker values was always correlated with an imminent adverse outcome and was usually accompanied by subsequent laboratory confirmation of COVID-19 infection or specific signs of viral pneumonia. \u0000Conclusion. COVID-19 should be considered an independent risk factor for acute stroke, while the virus-induced thrombosis, manifesting in an escalation in inflammatory factors and products of endothelial damage, should be considered a pathogenetic link leading to cerebral tissue damage.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88414499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lyudmila A. Geraskina, Amina A. Galaeva, Rabiyat D. Sheikhova, A. Fonyakin, M. Maksimova
Introduction. Cognitive impairment, gait and balance disorders are the most important risk factors for falls in older persons. These neurological impairments are the main clinical manifestations of chronic cerebral ischaemia (CCI), and can develop at a younger age. Aim: to evaluate the risk factors for falls in patients with CCI in different age groups and to identify the most significant predictors of falls. Materials and methods. We examined 104 patients with CCI. Patients were divided into three age groups: middle age (4059 years old; n = 13), older age (6074 years old; n = 62), and the elderly (75 years and older; n = 29). We assessed the frequency of falls and the presence of risk factors. Results. Thirty-seven (36%) patients had a history of falls, with its incidence increasing from 8% in the middle-aged group to 37% in the older persons and 45% in the elderly. Some patients had multiple risk factors for falls, while the presence of 5 risk factors increased the risk of falling fourfold. The most common factors in middle age were pain due to degenerative spine conditions (85%), anxiety (54%), and visual impairment (31%); in older age back pain (77%), cognitive impairment (45%), visual impairment (39%), and decreased walking speed (23%); in the elderly visual impairment (76%), cognitive impairment (69%), back pain (69%), decreased walking speed (38%), and orthostatic hypotension (28%). Discriminant analysis revealed that the best predictors of falls in CCI were female sex, age over 69 years, depression, cognitive impairment, and a walking speed below 1 m/sec. Conclusion. Falls were observed in all age groups of people with CCI. Not only the presence of a specific risk factor for falls, but the presence of multiple risk factors, has predictive value. The presence of five or more risk factors, as well as a walking speed below 1 m/sec, can indicate a high risk of falls.
{"title":"Risk factors for falls in different age groups of patients with chronic cerebral ischaemia","authors":"Lyudmila A. Geraskina, Amina A. Galaeva, Rabiyat D. Sheikhova, A. Fonyakin, M. Maksimova","doi":"10.54101/acen.2022.3.1","DOIUrl":"https://doi.org/10.54101/acen.2022.3.1","url":null,"abstract":"Introduction. Cognitive impairment, gait and balance disorders are the most important risk factors for falls in older persons. These neurological impairments are the main clinical manifestations of chronic cerebral ischaemia (CCI), and can develop at a younger age. \u0000Aim: to evaluate the risk factors for falls in patients with CCI in different age groups and to identify the most significant predictors of falls. \u0000Materials and methods. We examined 104 patients with CCI. Patients were divided into three age groups: middle age (4059 years old; n = 13), older age (6074 years old; n = 62), and the elderly (75 years and older; n = 29). We assessed the frequency of falls and the presence of risk factors. \u0000Results. Thirty-seven (36%) patients had a history of falls, with its incidence increasing from 8% in the middle-aged group to 37% in the older persons and 45% in the elderly. Some patients had multiple risk factors for falls, while the presence of 5 risk factors increased the risk of falling fourfold. The most common factors in middle age were pain due to degenerative spine conditions (85%), anxiety (54%), and visual impairment (31%); in older age back pain (77%), cognitive impairment (45%), visual impairment (39%), and decreased walking speed (23%); in the elderly visual impairment (76%), cognitive impairment (69%), back pain (69%), decreased walking speed (38%), and orthostatic hypotension (28%). Discriminant analysis revealed that the best predictors of falls in CCI were female sex, age over 69 years, depression, cognitive impairment, and a walking speed below 1 m/sec. \u0000Conclusion. Falls were observed in all age groups of people with CCI. Not only the presence of a specific risk factor for falls, but the presence of multiple risk factors, has predictive value. The presence of five or more risk factors, as well as a walking speed below 1 m/sec, can indicate a high risk of falls.","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87595059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vitaliy F. Fokin, Аlla А. Shabalina, N. Ponomareva, R. Konovalov, R. Medvedev, O. Lagoda, M. Krotenkova, M. Tanashyan
Introduction. The processes of cognitive decline, which are typical for elderly and senile people, as well as for patients with chronic cerebral circulation insufficiency, involve pro-inflammatory cytokines, such as tumor necrosis factor (TNF-), interleukin-6, etc. The aim of this work was to study the association of TNF- with brain network structure and cognitive functions in patients with chronic cerebral ischemia (CCI). Materials and methods. We examined 101 patients with CCI (5085 years old, men and women) who were assessed for the saliva levels of TNF- during cognitive testing. The status of resting-state networks was analyzed in 55 patients using functional magnetic resonance therapy. Results. After cognitive tasks, the saliva level of TNF- increased by 17.6 6.2 pg/mL. Half of the CCI patients older than 60 years showed a significant increase in the level of TNF-. This cytokine correlated with delayed word recall and the ratio of delayed recall to their performance on the Luria Memory Words Test. The change in TNF- saliva levels correlated with the status of the resting-state network, mainly with the salience network. An increase in TNF- levels was associated with a higher frequency of negative correlations than at lower values of TNF- (less than 80 pg/mL). TNF--sensitive connectivities correlated with cognitive tasks, not only memory tests, but also with the Montreal Cognitive Assessment Scale, verbal fluency test scores, etc. Discussion. The study revealed two significant facts: an increase in the TNF- saliva level during cognitive performance and a lower success rate of cognitive performance associated with an increase in the levels of this cytokine. The central mechanism for the implementation of this relationship includes the restructuring of the salience network, namely the additional increase of negative correlations within the connective structure of the salience neural network of the right hemisphere. Conclusions. A change in the saliva level of TNF- affects the connectivity of resting-state networks, mainly the salience network
{"title":"Effects of tumor necrosis factor α on the structure of brain networks and cognitive functions in patients with chronic cerebral ischemia","authors":"Vitaliy F. Fokin, Аlla А. Shabalina, N. Ponomareva, R. Konovalov, R. Medvedev, O. Lagoda, M. Krotenkova, M. Tanashyan","doi":"10.54101/acen.2022.3.4","DOIUrl":"https://doi.org/10.54101/acen.2022.3.4","url":null,"abstract":"Introduction. The processes of cognitive decline, which are typical for elderly and senile people, as well as for patients with chronic cerebral circulation insufficiency, involve pro-inflammatory cytokines, such as tumor necrosis factor (TNF-), interleukin-6, etc. \u0000The aim of this work was to study the association of TNF- with brain network structure and cognitive functions in patients with chronic cerebral ischemia (CCI). \u0000Materials and methods. We examined 101 patients with CCI (5085 years old, men and women) who were assessed for the saliva levels of TNF- during cognitive testing. The status of resting-state networks was analyzed in 55 patients using functional magnetic resonance therapy. \u0000Results. After cognitive tasks, the saliva level of TNF- increased by 17.6 6.2 pg/mL. Half of the CCI patients older than 60 years showed a significant increase in the level of TNF-. This cytokine correlated with delayed word recall and the ratio of delayed recall to their performance on the Luria Memory Words Test. The change in TNF- saliva levels correlated with the status of the resting-state network, mainly with the salience network. An increase in TNF- levels was associated with a higher frequency of negative correlations than at lower values of TNF- (less than 80 pg/mL). TNF--sensitive connectivities correlated with cognitive tasks, not only memory tests, but also with the Montreal Cognitive Assessment Scale, verbal fluency test scores, etc. \u0000Discussion. The study revealed two significant facts: an increase in the TNF- saliva level during cognitive performance and a lower success rate of cognitive performance associated with an increase in the levels of this cytokine. The central mechanism for the implementation of this relationship includes the restructuring of the salience network, namely the additional increase of negative correlations within the connective structure of the salience neural network of the right hemisphere. \u0000Conclusions. A change in the saliva level of TNF- affects the connectivity of resting-state networks, mainly the salience network","PeriodicalId":36946,"journal":{"name":"Annals of Clinical and Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79343169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}