Saratov JOURNAL of Medical and Scientific Research

Original article

Clinical and epidemiological features of familial multiple sclerosis

Year: 2020, volume 16 Issue: №1 Pages: 416-419
Heading: Neurology Article type: Original article
Authors: Goncharova Z.A., Pogrebnova Yu.Yu.
Organization: Rostov State Medical University
Summary:

Objective: determination of the clinical and epidemiological features of familial multiple sclerosis (MS) in the population of Rostov-on-Don. Material and Methods. Subjects of the research were patients with idiopathic inflammatory demyelinating diseases (HDD) numbering 806 people, among them 710 people with MS according to McDonald criteria (2010, 2017), living in Rostov-on-Don. Results. In the analyzed population 78 family cases were revealed; among them was a patient with clinically isolated syndrome (CIS), one with radiologically isolated syndrome (RIS) in 44 families. The general risk of repetition in the population demyelinating account for 3.7%. The prevalence rate of the familial MS in the population was 6.9 per 100000 people. In the male-to-female correlation for cases of familial MS makes 1:3.5. In most analyzed cases of familial MS (61.2%), a woman had the disease. The onset age in the first generation was considerably higher than the one in the following generations, on average 13.1±4.8 years more. The first remission continued 2.6 years in the familial MS group. In the group of the familial MS, the average disease development speed is 0.8±0.3 points per year. An analysis of clinical features revealed a predominance of polysymptomatic debut, which was noted in 20.63% of cases. Conclusion. A burdened family history in patients with MS may bean unfavorable prognostic factor for the aggressive course of the disease, and given the predominance of women as "progenitors", it is possible to suggest the role of mitochondria in the pathogenesis of the disease.

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Factor analysis of IQ of children born to mothers with epilepsy

Year: 2020, volume 16 Issue: №1 Pages: 408-416
Heading: Neurology Article type: Original article
Authors: Yakunina A.V., Poverennova I.E., Kalinin V.A., Ananyeva S.A., Korobov G.D., Mazankina E.V.
Organization: Samara State Medical University, Vitebsk State Order of Peoples Friendship Medical University
Summary:

Objective: to investigate the intelligence quotient (IQ) in children born to mother with epilepsy; to analyse possible factors affecting childhood IQ. Material and Methods. The Wechsler test (WAIS for adults and WISC for children) examined 47 pairs of "a mother with epilepsy — her child". Twelve women did not take antiepileptic drugs, 24 had monotherapy, 11 had polytherapy Treatment with valproic acid (VK) was received during pregnancy by 23 women (48.9%). Statistical processing was carried out by the method of correlation (according to Pearson) and variance (according to Fisher) analysis, by the method of "classification trees" CART. Results. The average indicators of the general, verbal and non-verbal IQ of children amounted to 118.7 points (Cl09579.5-158.0); 106.3 (Cl 67.7-144.9) and 128.0 points (Cl 93.2-162.7). The correlation between the age of the mother, taking VC and the level of IQ of the child was revealed. Univariate analysis of variance did not reveal the effect of the treatment regimen (mono-, polytherapy, without antiepileptic drugs, using VK, without VK) on the total IQ of the child (p>0.05), but a decrease in IQ was found in children who were brought up in single-parent families. Multifactor analysis showed that a decrease in the total IQ of the child is most likely to occur with the use of VK drugs in mothers with a total IQ level below 113 and at the age of the child's birth >32 years of age. Conclusion. Children of women with epilepsy are characterized with normal IQ level. When planning pregnancy, it is necessary to consider factors that affect the IQ of the offspring.

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Stroke awareness among Saratov respondents, and risk factors for acute cerebral circulation disorders (according to a population survey)

Year: 2020, volume 16 Issue: №1 Pages: 394-402
Heading: Neurology Article type: Original article
Authors: Yakovlev D.S., Kolokolov O.V., Makarov N.S., Lipatova Т.Е., Loiko V.S., Kolokolova A.M., Lukina E.V., Sitkali I.V., Tolstykh А.О., Yudina V.V.
Organization: Saratov State Medical University
Summary:

Objective: to analyze awareness level among Saratov's population about stroke, and to identify regional characteristics of risk factors for the development of acute cerebrovascular accident (ACVA) based on the results of a survey. Material and Methods. A personal questionnaire was conducted through a personal conversation with the residents of Saratov who applied for medical care in polyclinics as part of the campaign "World Day Against Stroke" October 29, 2019. Results. The survey involved 123 people. Most respondents showed a high level of awareness of such risk factors for ACVA as arterial hypertension, obesity, high blood cholesterol, alcohol abuse, and smoking. The significance of cardiac arrhythmias, a history of transient ischemic attacks, and a hereditary predisposition to the development of stroke were underestimated by the participants of the action. The level of knowledge of the population about thrombolytic therapy and surgical intervention on the vessels of the neck and brain as the leading methods of treating stroke is insufficient. Conclusion. Public informing is necessary to increase the level of awareness about stroke, which allows motivating citizens to remain committed to a healthy lifestyle and eliminate risk factors for developing ACVA.

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The effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke on the clinical course and prognosis of the disease

Year: 2020, volume 16 Issue: №1 Pages: 384-388
Heading: Neurology Article type: Original article
Authors: Khakhanova O.N., Skorokhodov А.Р., Kutashov V.A., Ulyanova O.V.
Organization: Federal State Institution "416 Military Hospital", Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to assess the effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke (CEI) on the clinical course and prognosis of the disease. Material and Methods. 90 patients were treated and examined in the acute period of CEI: 60 patients were discharged (main group) and 30 died (control group). A detailed study was made: general blood count, hemostasis, and biochemical changes in the blood. Neurological deficit was evaluated according to the NIHSS, Rivermead, and Rankin scales. Results. All homeostatic blood constants are higher than normal in patients who died compared to survivors (p <0.05). In patients with mortality on the first day, changes in blood biochemical parameters are more pronounced than in patients who died at a later date. The most pronounced changes in the biochemical analysis of blood (glucose, urea, creatinine, AsAT, AIAT), acid-base imbalance are associated with severe clinical manifestations of CEI and a high probability of death. The diabetes mellitus in patients with CEI is a kind of pathognomonic sign, marker and predictor of adverse outcome. Metabolic acidosis prevailed in the group of deceased patients, and respiratory acidosis prevailed in the group of survivors. Conclusion. Marked changes in homeostatic blood constants and pronounced neurological deficit at the time of the development of the disease are associated with severe clinical manifestations of CEI and a high probability of death.

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Hand dysfunction and its recovery in the acute period of lacunar ischemic stroke

Year: 2020, volume 16 Issue: №1 Pages: 380-383
Heading: Neurology Article type: Original article
Authors: Semenova T.N., Grigoryeva V.N., Novosadova O.A.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to establish the frequency of occurrence of impaired hand function and evaluate the dynamics of its recovery in patients with lacunar ischemic stroke (LS). Material and Methods. 137 patients with acute LS were examined. All patients underwent clinical and neurological examination with a quantitative assessment of strength, sensitivity, coordination, praxis and hand function according to the use of Action Research Arm Test and 9-Hole Peg Test. Results. Hand dysfunction was revealed in 79% of patients with LS. The most pronounced disorders were observed with purely motor and sensorimotor variants of LS. In the first two weeks after the development of LS, a significant improvement, including complete restoration of upper limb function, was observed in 79% of patients and was associated with the initial severity of disorders. «Dysarthria — clumsy hand» syndrome more often than other variants of LS was characterized by a complete recovery of manual capacity. Conclusion. Hand function is impaired in most patients with acute lacunar stroke. The rate of its recovery depends on the initial severity of hand dysfunction and the lacunar stroke clinical variant. The obtained data can be used in the development of individual rehabilitation programs for this category of patients

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Cerebroprotective effects of xanthohumol on experimental stroke model: study design and preliminary results

Year: 2020, volume 16 Issue: №1 Pages: 377-379
Heading: Neurology Article type: Original article
Authors: Saitgareeva A.R., Akhmadeeva L.R.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

The aim of the study is to evaluate the neuroprotective effect of xanthohumol (XN) on experimental models of acute ischemic stroke in vivo and in vitro. Material and Methods. Middle cerebral artery occlusion (MCAO) and oxygen-glucose deprivation (OGD) are used as an in vivo and in vitro model. The object of the study is Sprag-Dawley rats, which are randomly divided into three groups: a control group; two groups operated by MCAO with and without XN. Primary culture of cortical neurons was obtained from newborn rats. We use the Bederson test and the angle test to evaluate neurological disorders. Results. Preliminary results indicate a possible cerebroprotective effect of XN in an ischemic stroke model. Conclusion. Prophylactic administration of xanthohumol before cerebral ischemia in an experiment can effectively reduce the volume of cerebral infarction and improve neurological deficiency 24 hours after MCAO

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Rehabilitation potential of patients with myasthenia gravis

Year: 2020, volume 16 Issue: №1 Pages: 371-377
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Kalashnikova V.V., Romanov D.V.
Organization: Samara State Medical University
Summary:

Objective: to identify individual psychological characteristics that determine the rehabilitation potential of patients with myasthenia gravis. Material and Methods. A homogeneous group of patients was included in the examination in order to level the effect of the severity of the condition on the results obtained. We examined 25 patients with a generalized form of myasthenia gravis who were in a stable compensated state. The methodology "Rehabilitation Potential of Personality" was used. Quality of life was investigated using the SF-36 questionnaire. Results. Patients were divided into two subgroups according to their subjective assessment of quality of life. First subgroup consisted of patients with low values of the psychological component of quality of life (15 people); second subgroup consisted of patients with indicators on this scale similar to control group (10 people). Main indicators of "Rehabilitation Potential of Personality" questionnaire were compared in two subgroups and a correlation analysis of parameters of SF-36 questionnaire and indicators of rehabilitation potential was carried out. Conclusion. The psychological component of quality of life of patients with myasthenia is most dependent on internal picture of disease and emotional state. By providing targeted psychocorrectional effects, it is possible to increase patient's rehabilitation potential.

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Comprehensive correction of cognitive impairment in patients of older age groups with chronic heart failure

Year: 2020, volume 16 Issue: №1 Pages: 367-371
Heading: Neurology Article type: Original article
Authors: Pokachalova M.A., Silyutina M.V., Chernov A.V.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to identify the features of changes in cognitive functions (CF) and systemic hemodynamic effects in patients of older age groups with chronic heart failure (CHF) in various treatment regimens, including the use of low-intensity laser radiation (LILR) and akatinol memantine. Material and Methods. The study was conducted on the basis of the Cardiology Department of the NKZ DKB with direct consultation of neurologists: 120 patients of both sexes (average age 77.3±2.2 years) with heart failure. LILR was carried out on a Mustang-2000 low-intensity magnetic laser radiation apparatus. The following scales were used to assess CF: Montreal Cognitive Assessment (MoCA); Mini-Mental State Examination (MMSE); Frontal Assessment Batter (FAB). Results. Patients of older age groups with heart failure receiving combination therapy using LILR have an improvement in CF and quality of life, there is a positive trend in intracardiac hemodynamics, characterizing the processes of diastolic function of the left ventricular myocardium, 6 months after the start of treatment. Conclusion. The best recovery of CF occurs with complex therapy using LILR.

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Rehabilitation experience for patients with cognitive impairment

Year: 2020, volume 16 Issue: №1 Pages: 352-357
Heading: Neurology Article type: Original article
Authors: Kiparisova E.S.,Agaev M.M.
Organization: Federal Research and Clinical Center of FMBA of Russia
Summary:

Objective: to evaluate the eŸectiveness of the cognitive rehabilitation program in the treatment of patients with cognitive impairment. Material and Methods. The study included 95 patients in Federal Research and Clinical Center of FMBA of Russia, Moscow, with cognitive impairment, of which 57 were men and 38 were women, the average age was 56.8±7.5 years, and the average duration of the disease was 5.7±3.4 years. Patients were divided into 2 groups: the main one, where, along with drug treatment, the cognitive rehabilitation program developed by the authors was used, and the control one, in which only drug treatment was carried out. Results. The main group showed a statistically signi2cant improvement in cognitive functions on the SCOPA-Cog and MMSE scales, and an improvement in the qual- ity of life on the PDQ-39 scale (p<0.05). Conclusion. Against the background of the cognitive rehabilitation program, patients in the main group showed a positive dynamics compared to the control.

Keywords: rehabilitation
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Features of examination and surgical treatment of patients with trigeminal neuralgia

Year: 2020, volume 16 Issue: №1 Pages: 347-352
Heading: Neurology Article type: Original article
Authors: Kamadey О.О., Poverennova I.E., Alekseev G.N., Lazarchuk D.M., Ikromova D.R.
Organization: Samara Municipal Hospital №1, Samara Regional Hospital, Samara State Medical University
Summary:

Purpose: introduction of the examination protocol into neurosurgical practice and evaluation of the results of micro-vascular decompression of the trigeminal nerve root in patients with type I trigeminal neuralgia. Material and Methods. The results of 86 operations of microvascular decompression of the trigeminal nerve root in patients with primary trigeminal neuralgia were studied. The preoperative examination protocol for all patients included a general clinical examination, assessment of neurological status, brain MRI with contrast enhancement and a cranial nerve imaging program (CISS or FIESTA). Particular attention was paid to the criteria for the diagnosis of trigeminal neuralgia type I (classical), recommended by the International Headache Society (IHS) in the International Classification of Headache Disorder (ICHD-3, 2018). The pain syndrome was evaluated according to the Visual Analogue Scale (VAS)from 0 to 100 points before surgery, at the time of discharge of the patient from the hospital, after 6 months and after 1 year. Microvascular decompression was performed according to a standard technique using, in all cases, a retrosigmoid suboccipital access, under general anesthesia. A Russian-made fluoroplastic felt was used as a tread. In most cases (98%), the main surgical techniques for isolation of the trigeminal root were used. Results. The effectiveness of surgical treatment was 95% Conclusion. Patients with a diagnosis of trigeminal neuralgia require examination according to a specific protocol that allows you to determine the indications for surgical treatment. The expediency of surgical intervention (microvascular decompression of the trigeminal nerve root) in patients with type I trigeminal neuralgia has been shown.

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