Russian Neurological Journal最新文献

{"title":"The condition of the erector spinae muscle in patients with chronic nonspecific low back pain","authors":"D. O. Rozhkov, O. E. Zinovyeva, N. Penkov, A. Ulanova, S. Popova, G. Mikhailova, I. Vikhlyantsev","doi":"10.30629/2658-7947-2022-27-5-45-50","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-5-45-50","url":null,"abstract":"Myofascial pain syndrome caused by damage to the paravertebral muscles is considered as one of the causes of chronic back pain. At the same time, there is not enough information about the condition of the paravertebral muscles, and it is contradictory.The aim of the work is to elucidate the presence and severity of structural and functional changes in the paravertebral muscles and their role in the development of chronic nonspecific pain in the lower back in women.Material and methods. Morphological, immunohistochemical examination of a muscle tissue biopsy was performed in 17 patients aged 24 to 59 years (average age — 41.5 ± 12.1 years) with CNS (average duration of pain syndrome 10.0 ± 6.9 months) caused by myofascial pain syndrome, as well as determination by gel electrophoresis of the isoform composition of giant sarcomeric proteins titin and nebulin.Results. Morphological examination revealed no signs of necrosis, proliferation of connective and adipose tissue, inflammatory infiltration. The transformation of the myosin phenotype in the direction of an increase in the proportion of “fast” type II muscle fibers was revealed in the biopsies of the patients’ muscles. A decrease in the content of giant titin and nebulin proteins associated with myosin and actin in the sarcomere was also found.Conclusion. The data obtained indicate a violation of the contractile function of the paravertebral muscle in CNS.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45987832","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}

{"title":"Predictors of thrombosis development in the acute period of stroke","authors":"S. A. Chazov, S. Mekhryakov, A. V. Pavlova, A. Kulesh, L. Syromyatnikova, J. Karakulova, V. Shestakov, P. Astanin","doi":"10.30629/2658-7947-2022-27-5-36-44","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-5-36-44","url":null,"abstract":"Introduction. According to foreign studies, the frequency of asymptomatic deep vein thrombosis (DVT) in the acute period of stroke varies from 10 to 75%, clinically obvious — from 2 to 10%. DVT is a life-threatening complication as it can lead to the development of pulmonary embolism (PE).Purpose of the study: to identify predictors of DVT development in the lower extremities in patients with stroke according to the registry of the Regional Vascular Center (RVC).Materials and methods. 100 patients with stroke who were admitted to the wards/intensive care unit of the RVC from November to December 2021 were examined. In addition to the standard examination, all patients underwent duplex scanning of the veins of the lower extremities upon admission and on the 7th day of inpatient treatment.Results. The incidence of DVT was 13%. Compared with patients without DVT, patients with thrombosis were characterized by higher median values of age (77 vs 67 years, p = 0.015), time from stroke to hospital admission (24 vs 5 hours, p = 0.026), stroke severity by NIHSS score at admission (16 vs 5 points, p = 0.006) and completion of the first stage of treatment (10 vs 3 points, p = 0.010), movement disorders in the leg according to the Medical Research Council scale (4 vs 1 points, p = 0.011) and IMPROVE-VTE scales (4 vs 2 points, p < 0.001). In half of patients with DVT, thrombosis occurred already at admission to the hospital, in the rest it occurred during treatment. In a quarter of patients, thrombosis involved the proximal veins and was complicated by the development of PE in one patient, the rest had distal DVT. In all cases, DVT developed in the paretic limb. In all patients, thrombosis was initially regarded as asymptomatic and was diagnosed only by duplex scanning of the veins. The most significant risk factors for developing DVT in the acute period of stroke were age 64 years and over (OR = 8.1), stroke severity on the NIHSS scale at admission of 6 points and above (OR = 5.6), time to admission from 10 hours or more (OR = 3.8), leg strength not more than 3 points (OR = 4.5) and an IMPROVE-VTE score of 3 points or more (OR = 9.5). When building a logistic regression model using the identified risk factors, accuracy values were obtained equal to 83% and 85% for the training and test samples, respectively.Conclusion. DVT is observed in 13% of patients in the acute period of stroke and is associated with the age of patients, the severity of stroke and movement disorders, the time from the development of symptoms to hospital admission, and the risk of venous thromboembolic complications according to the IMPROVE-VTE scale.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42807214","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}

{"title":"Nutrition in the prevention and treatment of pressure ulcers in stroke patients","authors":"A. V. Pogozheva","doi":"10.30629/2658-7947-2022-27-5-78-84","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-5-78-84","url":null,"abstract":"Stroke is one of the most important causes of mortality and disability of the population worldwide. In 16–20% of patients with acute stroke at admission, during hospitalization and rehabilitation, protein-energy deficiency, as well as micronutrient insufficiency is observed, which is associated with an unfavorable prognosis and the development of pressure ulcers. The widespread use of high-calorie mixtures for oral or probe enteral nutrition for such patients, containing increased amounts of protein, arginine, vitamins A, E, C and minerals (zinc and selenium) of an antioxidant orientation, can have a positive effect on the healing of pressure ulcers. The inclusion of specialized therapeutic mixtures in diet therapy can also potentially reduce the risk of developing pressure ulcers.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43645676","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}

{"title":"A modern view on the prevention and treatment of HIV-associated neurocognitive disorders","authors":"E. .. Egorova, A. Useinova, S. A. Abibulaev, S. P. Mar’yanenko, K. N. Koryanova","doi":"10.30629/2658-7947-2022-27-5-5-13","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-5-5-13","url":null,"abstract":"Acquired Immune Deficiency Syndrome (AIDS) is now considered one of the most global pandemics in human history. Despite the use of highly active antiretroviral therapy (HAART), HIV-1 infection is often accompanied by the development of CNS disorders, including neurocognitive disorders. The use of etiologic therapy has successfully prevented many of the possible terminal complications of the disease, but as patient survival time increases, the prevalence of cognitive impairment among AIDS patients is increasing. Theclinical manifestations of these disorders can rapidly progress from subtle attention deficits and behavioral disorders to the development of dementia. Diagnosing neurocognitive impairment in HIV-infected patients is usually difficult and requires consistent diagnostic procedures from the clinician, including initial screening and, if necessary, neuropsychiatric testing and neuroimaging. Early diagnosis and correction of neurocognitive impairment in HIV-infected individuals with adequate antiretroviral therapy is essential for successful treatment. The review also considers the use of drugs for the prevention and treatment of neurocognitive impairment, taking into account the peculiarities of persistence of the pathogen in the nervous system and the capabilities of modern medicine. One of the most promising methods of supporting therapy for such disorders is the delivery of antiretroviral drugs using various nanosystems (polymeric nanoparticles, lipid nanoparticles, nanogels, magnetic particles).","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45416755","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}

{"title":"High-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation in multiple sclerosis: preliminary clinical results of approbation of the method","authors":"A. Polushin, Yury R. Zalyalov, A. Gavrilenko, A. Tsynchenko, E. Lopatina, I. Skiba, M. A. Estrina, E. Babenko, A. A. Gotovchikov, L. Prakhova, A. Ilves, N. Totolyan, A. Kulagin, A. Skoromets","doi":"10.30629/2658-7947-2022-27-5-25-35","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-5-25-35","url":null,"abstract":"Introduction. In 2018–2020, a study was conducted in the Russian Federation on the efficacy and safety of highdose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT-AHSCT) in multiple sclerosis (MS).The aim of the study was to analyze preliminary data on the effectiveness and safety of the HDIT-AHSCT in patients with MS who participated in the clinical approbation of the method.Material and methods. 21 patients were included in a single-center Pavlov University (Saint Petersburg) observational study. In 10 patients (47.6%) the Expanded Disability Status Scale (EDSS) ranged from 1.0 to 4.0, in 10 — from 4.5 to 6.0 points, 1 patient with primary-progressive MS (PPMS) had 6.5 EDSS points. Cyclophosphamide conditioning regimen (200 mg/kg) in combination with rituximab (1000 mg/m2) was used. Neurological assessment (EDSS, SNRS, T25-FW, 9-HPT, PASAT, MoCA, HADS) and brain MRI were performed before and after 12 months. The early and long-term complications of HDIT-AHSCT were also analyzed.Results. One year after HDIT-AHSCT improvement and significant improvement were noted in 10 patients (47.6%), stabilization — in 8 (38.1%), relapse/progression — in 3 (14.3%). A lower effect was observed in patients with spasticity of more than 3 points by the MAS. According to MRI data 18 patients (85.7%) had stabilization of MS with no disease activity after 1 year, that met the No Evidence of Disease Activity (NEDA) criteria. Long-term complications included autoimmune thyroiditis (n = 1) and amenorrhea in two patients older than 38 years. No TRM were registered during the observation period.Conclusion. HDIT-AHSCT is an effective method of treating patients with multiple sclerosis. The results of the research demonstrate the safety and effectiveness of HDIT-AHSCT and it can be used to expanse the opportunities for providing treatment of patients with MS in the Russian Federation.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47826725","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}

{"title":"Synkinesis in patients with neuropathy of the facial nerve","authors":"K. I. Chekhonatskaya, L. B. Zavaliy, G. R. Ramazanov, M. Sinkin, K. Salikhov, S. Petrikov","doi":"10.30629/2658-7947-2022-27-5-14-22","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-5-14-22","url":null,"abstract":"Facial synkinesis is involuntary contractions of unrelated groups of facial muscles that occur during voluntary movement. The article presents a review of scientific literature of the problem pathological synkinesis as a complication of facial neuropathy. The mechanism of their development and the main theories of occurrence are described. We describе the types (patterns) of synkinesis, methods for theirs detecting, description of clinical manifestations, methods of instrumental diagnostics. We reviewed approaches to treatment and rehabilitation, the main types of conservative and surgical treatment.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45436034","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}

{"title":"Cervical dissection in emergency neurology: diagnostic and treatment algorithms","authors":"A. Kulesh, D. A. Demin, O. Vinogradov","doi":"10.30629/2658-7947-2022-27-4-86-96","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-4-86-96","url":null,"abstract":"The epidemiology of cervical artery dissection (CAD), which is often not thought to be the cause of ischemic stroke and transient ischemic attack (TIA), is discussed. The pathomorphology and pathogenesis of CAD, the key feature of which is the development of intramural hematoma, as well as predisposing conditions, triggers and associated conditions, in particular migraine, are reviewed. The clinical picture of diseases — local symptoms (headache and/ or neck pain, Horner’s syndrome, caudal cranial nerve involvement, cervical radicular syndrome, pulsatile tinnitus) and ischemic events (ischemic stroke or TIA) is presented. Modern approaches to urgent neuro- and angioimaging in CAD are reflected, including the possibilities of CT angiography (direct and indirect signs) and fat sat MRI (crescent symptom). Issues of reperfusion therapy (intravenous thrombolysis, thrombectomy and stenting) are discussed. The course of disease and secondary antithrombotic prophylaxis are analyzed.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47604717","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}

{"title":"Features of neurological status in children with autism spectrum disorders","authors":"V. N. Salkov, S. Shmeleva, V. D. Levchenkova, M. Mironov, N. Logachev","doi":"10.30629/2658-7947-2022-27-4-69-74","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-4-69-74","url":null,"abstract":"Purpose of the study: to study the neurological status, anamnesis data and electroencephalography in patients with autism spectrum disorders.Material and methods. The study involved 54 children with autism spectrum disorders aged from 3 to 7 years. Anamnestic data were studied, neurological and electroencephalographic studies were performed.Results. The following were identified as the main antenatal and intranatal risk factors for the formation of neurological disorders: gestosis, the threat of termination of pregnancy, weakness of labor and an increase in the duration of the anhydrous period in mothers. A significant number of children were born prematurely and had signs of intrauterine hypoxia at birth. When examining the neurological status, the majority of patients revealed motor and coordination disorders, disorders of tactile sensitivity. Electroencephalography made it possible to register in most patients a delay in the formation of the rhythm of the bioelectrical activity of the brain. Periodic regional decelerations were detected in 9 cases, and epileptiform activity — in 5 cases.Conclusion. Disorders in the neurological status in children with autism spectrum disorders were noted in the form of mild motor symptoms, disorders of motor coordination and tactile sensitivity.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47937714","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}

{"title":"Anti-MuSK myasthenia after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia","authors":"S. N. Bardakov, A. Polushin, V. A. Tsargush, P. Carlier, A. A. Emeliantsev, S. Lapin, A. Moshnikova, I. Skiba, A. Belskikh, A. Kulagin","doi":"10.30629/2658-7947-2022-27-4-44-54","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-4-44-54","url":null,"abstract":"Anti-MuSK myasthenia is a chronic autoimmune disease caused by violation of the function of the agrin-MuSK-Lrp4 complex, accompanied by the development of pathological muscle fatigue and often muscle atrophy. The disease can be a primary, as well as a complication of immunosuppressive therapy and hematopoietic stem cell transplantation. We present a case of anti-MUSK myasthenia gravis that developed after allogeneic HSCT due to acute myeloid leukemia in a 44-year-old patient (born in 1975). A distinctive feature of the case was a generalized injury, including not only extraocular, but also paravertebral muscles, dropped head syndrome in the evening. In addition, laboratory, electroneuromyographic and neuroimaging (MRI of muscles, MR-spectroscopy) data indicating the neurogenic reversible nature of changes in the involved musculature are presented.Results. This study presents MRI and EMG signs of neurogenic damage of axial musculature in a patient with weakness and swelling of the paravertebral muscles (edematous changes according to STIR, corresponding to MR signs of early functional denervation) for a period of 2–4 months, due to anti-MUSK myasthenia gravis. Clinical manifestations, as well as edematous neurogenic changes in the paravertebral muscles, regressed after pathogenetic therapy. Conclusion. The article presents up-to-date data on the clinical and instrumental characteristics of myasthenia gravis. The considered clinical example confirms the presence of neurogenic changes at an early stage of anti-MUSK myasthenia gravis and indicates the need for immediate initiation of pathogenetic therapy to avoid the development of atrophy and fatty infiltration of muscles.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43036820","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}

{"title":"Assessment of progression of Parkinson’s disease using magnetic resonance morphometry","authors":"I. A. Vlasova, A. Trufanov, A. B. Buriak, E. V. Kuznetsova, M. Odinak, I. Litvinenko","doi":"10.30629/2658-7947-2022-27-4-37-43","DOIUrl":"https://doi.org/10.30629/2658-7947-2022-27-4-37-43","url":null,"abstract":"Parkinson’s disease (PD) is the second most common neurodegenerative disease in the world, however, structural changes in the brain at different stages and the associated pathophysiological mechanisms remain unclear.Objective: to study MR-morphometric changes in the cerebral cortex in the early and advanced stages of PD in comparison with the control group.Material and methods. 88 patients with PD were examined (II stage of the disease — 42 people, III stage — 46 people according to the Hoehn–Yahr scale). The control group consisted of 35 people who did not differ in sex and age with initial manifestations of cerebrovascular insufficiency. All groups included in the study underwent a neurological examination, as well as magnetic resonance imaging of the brain on a Philips Achieva 3.0T apparatus, followed by post-processing processing of the T1 gradient echo images obtained using FreeSurfer 6.0 software.Results. In patients with stage II PD, compared with the control group, a significant decrease in the thickness of the cortex was found in the gyrus of the precuneus (p = 0.014) of the lateral part of the superior temporal gyrus, inferior frontal gyrus, postcentral sulcus, superior temporal sulcus, which progressed during the transition to the third the stage of the disease and can serve as a marker of the progression of the neurodegenerative process.Conclusion. A morphometric study of the cerebral cortex in PD makes it possible to clarify some links in the pathogenesis of the formation, including dopamine-independent symptoms of the disease.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45099811","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}