Saratov JOURNAL of Medical and Scientific Research

Poverennova I.E.

Samara State Medical University, Head of Department of Neurology and Neurosurgery, Professor, Doctor of Medical Science

Preliminary results of study on efficacy of a virtual reality technique for restoration of lower extremity motor function in patients in acute stage of stroke

Year: 2019, volume 15 Issue: №1 Pages: 172-176
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.M., Pyatin V.F., Kolsanov A.V., Chaplygin S.S., Osminina E.A., Lahov A.S.
Organization: Samara State Medical University
Summary:

Objective: to study efficacy of using immersive virtual reality with proprioceptive sensory effects in the rehabilitation of static locomotor function in patients in acute stage of ischemic stroke. Material and Methods. The study included 33 patients in the acute stage of ischemic stroke in the carotid system. Patients were randomized into two groups, the main group additionally took exercises in immersive virtual reality with sensory stimulation. The course includes 10 sessions 15 minutes each. The comparison group received standard rehabilitation assistance. Results. According to Berg balance scale an improvement in static locomotor function was noted in the main group on the 6th day of exercises (p=0.03). The differences between both groups on the last day of rehabilitation course showed an

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Autonomic dysfunction in patients with chronic cerebral ischemia

Year: 2019, volume 15 Issue: №1 Pages: 167-172
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Khivintseva E.V., Zakharov A.V., Vasemazova E.N., Ananyeva S.A.
Organization: Samara State Medical University
Summary:

Various autonomic nervous system (ANS) disorders exist in 25-80% of the general population. Seniors affected by chronic cerebral ischemia (CCI) are subject to the development of autonomic disorders. Purpose: to carry out the analysis of autonomic dysfunction in subjects with CCI. Material and Methods. Autonomic status was evaluated using autonomic function tests. All patients underwent cardiointervalography. Heart rhythm variability was estimated by mode, amplitude, variation range, power of waves of various frequency, coefficient of vagosympathetic balance etc. as measured by "Rhythm-MET" system. One hundred fifty one patients aged 48-93 years were examined and distributed to three groups depending on the degree of severity of CCI. Results were statistically processed using Statistica 6 software. Results. Patients with CCI had differences in autonomic function parameters which had multidirectional character and were dependent on sympathetic-parasympathetic balance and CCI stage. The obtained data demonstrate that prevalence of sympathetic influence was observed in 52.8% patients with I grade CCI, in 64.8% patients with II grade CCI and prevalence of parasympathetic

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Migraine and epilepsy: comorbidity and problems in diagnostics

Year: 2019, volume 15 Issue: №1 Pages: 154-158
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Myakinina A.E.
Organization: Samara State Medical University
Summary:

The purpose of this review is to carry out the analysis of published data on comorbidity of migraine and epilepsy. The review is based on results of epidemiological and genetic studies. Clinical manifestations of two diseases are in many respects similar, which sometimes leads to considerable difficulties in diagnostics. Differential diagnosis is based on careful analysis of clinical manifestations, electroencephalography and neuroimaging data. Genetic forms of epilepsy are often accompanied by migrainous headaches. The unity of some pathophysiological mechanisms of epilepsy and migraine predefines comorbidity and directions of diagnostics and treatment for both diseases. Nevertheless, there is a number of questions which demand more precise answers to improve diagnostics and treatment.

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Dynamics of acetylcholine receptors antibody titer in myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E., Zakharov A.V.
Organization: Samara State Medical University
Summary:

The aim was to examine the longitudinal association between myasthenia gravis clinical severity and concentration of acetylcholine receptor (AChR) antibodies to evaluate if AChR-antibody variations correlate to disease severity. Material and Methods. Antibodies were determined by enzyme immunoassay. The International Clinical Classification (MGFA) was used to grade the severity of the disease. The level of antibodies was compared with the severity of the condition and the form of the disease at the stage of diagnosis in 65 patients, as well as in repeated studies in 26 patients. Results. The titer of AChR-antibodies did not correlate with the severity of the condition, however, a direct relationship between the change in the level of acetylcholine receptor antibodies and the change in the clinical state during the course of the disease was obtained. Conclusion. Repeated AChR-antibody measurements will help to predict the clinical state of the patient and can be used to correct immunosuppressive therapy.

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Use of the scale of clinical expression of the stroke for determining the rehabilitation prediction

Year: 2018, volume 14 Issue: №1 Pages: 161-164
Heading: Neurology Article type: Original article
Authors: Repina L.A., Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

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Multimodal evoked potential in monitoring activity relapsing and remitting multiple sclerosis

Year: 2018, volume 14 Issue: №1 Pages: 157-160
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine multimodal evoked potential in patients with or without relapse
multiple sclerosis during 12 month. Material and Methods. The study included 32 patients with
established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS
score was evaluated. All patients underwent a study of multimodal evoked potential. All examined
patients were divided into 2 groups depending on the relapse multiple sclerosis by the end of the year.
Results. Multimodal evoked potentials show ambiguous data on the activity of multiple sclerosis. The
greatest correlation with subsequent activity of multiple sclerosis is shown by stem evoked potentials.
Conclusion. This study is the initial stage in the search for a tool for predicting the course of the disease
in patients with multiple sclerosis. An increase in the group of subjects and inclusion in the analysis of
structural changes in the central nervous system according to magnetic resonance imaging probably will
increase the information content of predictions.

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Early detection of cognitive impairment in patients with multiple sclerosis

Year: 2017, volume 13 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Romanova T.V., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine cognitive impairment in patients with multiple sclerosis with an emphasis on the speed and efficiency of information processing. It was supposed to reveal the patterns of these disorders depending on the duration and severity of the disease. Material and methods. The study included 50 patients with established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS score was evaluated. Cognitive functions were assessed using SDMT and PASAT-3 tests. All patients underwent a study of cognitive evoked potential. All examined patients were divided into 2 groups depending on the duration of the disease. Results. Cognitive screening tests PASSAT and SDMT showed no correlation with the duration of the disease severity and cannot serve as a tool for screening early signs of cognitive impairment in young patients with multiple sclerosis. A significant increase in latency of the P300 potential was obtained with increasing duration and severity of the disease, which correlates with the severity of cognitive dysfunction. Conclusion. This study is the initial step in the search for a tool for screening early manifestations of cognitive impairment in patients with multiple sclerosis. In the future it is planned to expand the research with the modernization of its design.

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The analysis of the clinical and tool parameters characterizing a cardiomyopathyat various forms of the progressing muscular dystrophies

Year: 2017, volume 13 Issue: №1 Pages: 160-164
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Chernikova V.V.
Organization: Samara State Medical University, Samara Regional Clinical Hospital n.a. V. D. Seredavin
Summary:

Purpose: studying of clinical and tool characteristics of cardiomyopathies at various forms of the progressing muscular dystrophies. Material and methods. There had been 103 patients with hereditary forms of the progressing muscular dystrophies examined, among which 35 persons were with Duchenne muscular dystrophy, 28 with an atrophic myo-tonia, and 40 with a limb girdle dystrophy is conducted. Assessment of clinical and tool features of cardiomyopathies at these types of the hereditary progressing muscular dystrophies had been carried out. Results. In the group of patients with diffusion damage of a myocardium in the form of dystrophic violations had been revealed. Existence of a negative tooth of T in some assignments and lengthenings of an interval of QT is noted. With a dystrophic myotonia violation of a warm rhythm occurred at patients by 87 times more often than in the group of comparison. Violation of a rhythm of heart in group of patients with a limb girdle dystrophy came to light 91 times more often in reference to the group of comparison. Conclusion. Violations in a cardiovascular system at Duchenne muscular dystrophy are preferentially diffusion changes in a myocardium. At a dystrophic myotonia and a limb girdle dystrophy cardial violations concern mainly excitability and the conductivity of heart which are the main reason of developing of this disease at these patients.

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Innovation in diagnostics and treatment of epilepsy

Year: 2017, volume 13 Issue: №1 Pages: 143-147
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Beketova E.M.
Organization: Samara State Medical University, Municipal Hospital No. 1 n.a. N. I. Pirogov, Samara
Summary:

The aim of the review is try to systematize the innovative achievements of modern epileptology and indicate the levels of diagnosis and treatment of epilepsy that are not sufficiently developed, from our point of view. Applied to epileptology, the innovation process is realized at all levels. In principle, you can divide the entire process into a diagnostic and treatment level. Promising in the diagnosis of epilepsy should be considered the analysis of age characteristics, new methods of EEG analysis and evoked potentials, innovative methods of functional neuroimaging, genetic testing. New anticonvulsants with the original mechanism of action allow to overcome pharmaco-resistance of epilepsy in a number of observations. In rare cases it is necessary to use minimally invasive surgical methods of treatment.

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Clinical and instrumental risk factors for epileptic seizures in patients after traumatic brain injury

Year: 2016, volume 12 Issue: №3 Pages: 366-370
Heading: Neurology Article type: Original article
Authors: Zakharov A.V., Poverennova I.E., Kurov M.V., Khivintseva E.M.
Organization: Samara State Medical University
Summary:

The aim: analysis of factors influencing the risks of posttraumatic epilepsy (РТЕ). Materials and Methods. The study involved 71 patients with traumatic brain injury of moderate and severe with emerging after her epileptic seizures. Among the subjects was 56 (78.9%) males and 15 (21.1%) females. The average age of the subjects was 65.6±10,3 years. The control group was 25 (71.4%) male patients and 10 (28.6%) females. The average age of the patients was 54.4.±9.3 years. Analysis of factors influencing the risks of РТЕ use nonparametric Spearman correlation and multivari-ate analysis of variance. Results. Among the many factors to be statistically significant risk factors for РТЕ was alcohol intoxication at the time of trauma 27 (38,0%), relative to the control group 2 (5.7%) p

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