Cerebral Blood Circulation Research Articles

Variability of the circle of Willis in North American Caucasian and middle East Arabic Cohorts

The cerebral arterial circle (circle of Willis) plays an important role in the redistribution of the blood flow between the anterior and posterior territories and maintains the plasticity of the cerebral blood circulation. The heritability and prevalence of certain variants of the circle of Willis in different ethnic and racial groups are frequently disputed by authors.

Dynamics of recovery of cognitive and neurological functions in patients with primary and recurrent ischemic stroke in Ulyanovsk region

According to WHO statistics repeated strokes develop during the1st year in 35% of patients and are significantly more likely to lead to disability and death. Aim: To compare degree of impairment and dynamics of cognitive and neurological functions in patients with primary ischemic stroke (IS) in VBB and patients with IS in VBB, having acute cerebral blood circulation disorders.

HEMORHEOLOGIC PROFILE AND MICROCIRCULATORY HEMOSTASIS IN PATIENTS WITH CEREBROVASCULAR DISEASE IN DIABETES MELLITUS

Diabetes mellitus is one of the most serious issues faced nowadays both by medicine and society in general, which is due to the wide spread of endocrine issues affecting nearly every country globally, the growing incidence rate, as well as the severity of complications that are hard to treat. Type 2 diabetes mellitus increases significantly the risk of developing acute cerebral blood circulation disorders, which urges further comprehensive studies focusing on the role played by the vascular-platelet relation and coagulation hemostasis in the development and progression of diabetic vascular complications. The results of our study, which involved 74 patients with acute cerebral circulation disorders against type 2 diabetes mellitus revealed alterations affecting the hemostasis system. This could be seen from activated vascular-platelet and coagulation links, decreased anticoagulant activity, and a slowdown in fibrinolysis. The severity of disorders induced by the alterations in the hemorheological profile and the microcirculatory hemostasis are associated with the duration of type 2 diabetes mellitus and the carbohydrate metabolism indicators (hyperglycemia, increased HbA1c levels and glycation end products).

Neuroprotective and cerebrovascular effects of endogenous N-Arachidonoyl-GABA and its putative Cox-2 metabolite – GABA conjugate with Prostaglandin E2

Introduction: The aim of the study was to compare the neuroprotective and cerebrovascular effects of bioactive, endogenous lipid – N-arachidonoyl-GABA (AA-GABA) and GABA conjugate with prostaglandin E2 (PGE2-GABA) by evaluation of a morphological state of rat brain tissue and lipofuscin levels under the condition of permanent focal brain ischemia, as well as cerebral circulation under the condition of global transient ischemia.
 Materials and methods: The study has been implemented using the models of the left middle cerebral artery occlusion (MCAO) and global transient ischemia of the brain. A morphological examination of the brain tissue, a registration of local blood flow by laser flowmeter, and quantitative measurement of lipofuscin by fluorescence spectroscopy were used.
 Results and discussion: AA-GABA and the putative COX-2 metabolite PGE2-GABA showed significant neuroprotective and cerebrovascular effects in rat models of global and focal cerebral ischemia. In the MCAOmodel, AA-GABA and PGE2-GABA at a dose of 2 mg/kg/day administered i.p. for 6 or 12 days led to: 1) significant restoration of neurons and glial cells with intracellular regeneration of cytoplasmic and nuclear structures, 2) decrease in brain tissue edema; 3) attenuated thrombosis and stasis, and 4) absence of large necrotic foci in rat brain tissue. AA-GABA and PGE2-GABA at the same dose prevented excessive accumulation of lipofuscin in both brain hemispheres in rats with MCAO. All the studied compounds increase cerebral blood circulation in rats subjected to global transient ischemia. However, the cerebrovascular effect of PGE2-GABA was superior to the activity of AA-GABA and all other tested compounds. AA-GABA and PGE2-GABA, unlike PGE2 and nimodipine, increase the cerebral blood flow in rats with global transient brain ischemia and have no influence on the intact animals. Apparently, the GABAergic vascular system of the brain is involved in the mechanisms of the neuroprotective action of AA-GABA and PGE2-GABA.
 Conclusion: For the first time, we demonstrated the ability of AA-GABAand its putative metabolite COX-2 PGE2-GABA to improve cerebral circulation, attenuate structural damage and lipofuscin accumulation during cerebral ischemia. The natural origin of AA-GABA, which possesses neuroprotective and cerebrovascular activity, as well as anti-aggregatory activity, allows considering AA-GABA as one of the endogenous protective factors in ischemic brain lesions.

Cerebral blood circulation and static balance in football players after paravertebral muscle relaxation in an aquatic environment

It was found out that the stability of the body is optimized with an increase in the statistical relationship with the parameters of cerebral circulation after the use of paravertebral muscle relaxation in the aquatic environment. A decrease in the length and area of the migration of the center of body mass is accompanied by an increase in the rate of blood filling of the brain vessels in football players. It was found out that in football players who underwent a course of paravertebral muscle relaxation in an aquatic environment, the stability of the body was accompanied, to a greater extent, by an increase in the time of rapid filling of the blood vessels of the brain, the time of the rise of the rheogram, the amplitude of the differentiated rheogram at the point characterizing the filling rate. In the football players of the second group, where the course of paravertebral muscle relaxation was not used, the maintenance of static balance was accompanied, with a lower share of statistical weight from the indicators of the speed and volume of blood filling of the brain vessels.

A neuro-cardiac self-regulation therapy to improve autonomic and neural function after SCI: a randomized controlled trial protocol

BackgroundSpinal cord injury (SCI) is associated with autonomic imbalance and significant secondary conditions, including cardiac and brain dysfunction that adversely impact health and wellbeing. This study will investigate the effectiveness (intention-to-treat) of a neuro-cardiac self-regulation therapy to improve autonomic and neural/brain activity in adults with SCI living in the community.MethodsA two-arm parallel, randomised controlled trial in which adults with SCI living in the community post-rehabilitation will be randomly assigned to a treatment or control group. The treatment group (N = 60) aged 18–70 years with a chronic traumatic or non-traumatic SCI, will receive intervention sessions once per week for 10 weeks, designed to regulate autonomic activity using computer-based feedback of heart rate variability and controlled breathing (called HRV-F). Comprehensive neurophysiological and psychological assessment will occur at baseline, immediate post-treatment, and 6 and 12-months post-treatment. Primary outcome measures include electrocardiography/heart rate variability (to assess autonomic nervous system function) and transcranial doppler sonography (to assess cerebral blood circulation in basal cerebral arteries). Secondary outcomes measures include continuous blood pressure, electroencephalography, functional near-infrared spectroscopy, respiration/breath rate, electrooculography, cognitive capacity, psychological status, pain, fatigue, sleep and quality of life. Controls (N = 60) will receive usual community care, reading material and a brief telephone call once per week for 10 weeks and be similarly assessed over the same time period as the HRV-F group. Linear mixed model analysis with repeated measures will determine effectiveness of HRV-F and latent class mixture modelling used to determine trajectories for primary and selected secondary outcomes of interest.DiscussionTreatments for improving autonomic function after SCI are limited. It is therefore important to establish whether a neuro-cardiac self-regulation therapy can result in improved autonomic functioning post-SCI, as well as whether HRV-F is associated with better outcomes for secondary conditions such as cardiovascular health, cognitive capacity and mental health.Trial registrationThe study has been prospectively registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12621000870853.aspx).Date of Registration: 6th July 2021.Trial Sponsor: The University of Sydney, NSW 2006.Protocol version: 22/07/2021.

Timing is everything: Exercise therapy and remote ischemic conditioning for acute ischemic stroke patients.

Physical exercise is a promising rehabilitative strategy for acute ischemic stroke. Preclinical trials suggest that exercise restores cerebral blood circulation and re-establishes the blood–brain barrier’s integrity with neurological function and motor skill improvement. Clinical trials demonstrated that exercise improves prognosis and decreases complications after ischemic events. Due to these encouraging findings, early exercise rehabilitation has been quickly adopted into stroke rehabilitation guidelines. Unfortunately, preclinical trials have failed to warn us of an adverse effect. Trials with very early exercise rehabilitation (within 24 h of ischemic attack) found an inferior prognosis at 3 months. It was not immediately clear as to why exercise was detrimental when performed very early while it was ameliorative just a few short days later. This review aimed to explore the potential mechanisms of harm seen in very early exercise administered to acute ischemic stroke patients. To begin, the mechanisms of exercise’s benefit were transposed onto the current understanding of acute ischemic stroke’s pathogenesis, specifically during the acute and subacute phases. Then, exercise rehabilitation’s mechanisms were compared to that of remote ischemic conditioning (RIC). This comparison may reveal how RIC may be providing clinical benefit during the acute phase of ischemic stroke when exercise proved to be harmful.

MRI-related anxiety can induce slow BOLD oscillations coupled with cardiac oscillations

ObjectiveAlthough about 1–2% of MRI examinations must be aborted due to anxiety, there is little research on how MRI-related anxiety affects BOLD signals in resting states. MethodsWe re-analyzed cardiac beat-to beat interval (RRI) and BOLD signals of 23 healthy fMRI participants in four resting states by calculation of phase-coupling in the 0.07–0.13 Hz band and determination of positive time delays (pTDs; RRI leading neural BOLD oscillations) and negative time delays (nTDs; RRI lagging behind vascular BOLD oscillations). State anxiety of each subject was assigned to either a low anxiety (LA) or a high anxiety (HA, with most participants exhibiting moderate anxiety symptoms) category based on the inside scanner assessed anxiety score. ResultsAlthough anxiety strongly differed between HA and LA categories, no significant difference was found for nTDs. In contrast, pTDs indicating neural BOLD oscillations exhibited a significant cumulation in the high anxiety category. ConclusionsFindings may suggest that vascular BOLD oscillations related to slow cerebral blood circulation are of about similar intensity during low/no and elevated anxiety. In contrast, neural BOLD oscillations, which might be associated with a central rhythm generating mechanism (pacemaker-like activity), appear to be significantly intensified during elevated anxiety. SignificanceThe study provides evidence that fMRI-related anxiety can activate a central rhythm generating mechanism very likely located in the brain stem, associated with slow neural BOLD oscillation.

CELLULAR COMPOSITION STATE AND MICROFLORA OF ORAL MUCOSAL EPITHELIUM OF PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA

The cell composition and microflora of oral mucosal epithelium smearsand the hormonal composition of oral fluid in patients with chronic cerebral ischemiawere studied. We examined 54 patientsaged 45-65 years suffering from cerebral blood circulation disorders caused by atherosclerosis of cerebral vessels and under outpatient observation. In patients with chronic cerebral ischemia, a decrease in the size of the neutrophil pool and epithelial cell pool was noted in saliva smears, against the background of an increase in the number of lymphocytes (threefold) and “bare nuclei” -more than ten times, which indicates a weakening of local protection and is considered as a pathogenetically significantindicator. Smears of buccal epithelial cells revealed yeast-like fungi of the Candida genus (C.albicans), whose content reached 105CFU/ml in 61.44% of cases and averaged 82.5±6.4% of strains in CCI patients. Free progesterone increased 1.9-fold in oral fluid, whereas estradiol levels decreased 5-fold and cortisol increased 1.6-fold.Keywords: chronic cerebral ischemia, buccal cells, candidiasis, sex hormones.

Effectiveness and safety of idarucizumab in the management of perioperative complications of atrial fibrillation catheter ablation in atrial fibrillation patients under dabigatran therapy

Objective: To investigate the efficacy and safety of idarucizumab in the treatment of perioperative cardiac tamponade and thromboembolic events during catheter ablation in atrial fibrillation (AF) patients under dabigatran therapy. Methods: This study was a retrospective analysis enrolling patients under dabigatran therapy, who underwent catheter ablation for AF at Beijing Anzhen Hospital from January 2019 to December 2020 and developed perioperative cardiac tamponade or acute ischemic stroke (AIS) and received idarucizumab to reverse the anticoagulant effect of dabigatran. Patients' age, sex, renal function, coagulation test and safety events at 30 d after idarucizumab administration were collected and analyzed. The clinical presentation and prognosis were also analyzed. Results: A total of 7 patients were included, 2 (2/7) were male, mean age was (66.3±11.2) years, serum creatinine level was (66.3±13.6) μmol/L, estimated glomerular filtration rate was (89.4±11.2) ml·min-1·1.73 m-2, CHA2DS2-VASc and HAS-BLED scores were (3.2±1.9) and (1.3±1.3), respectively. Five patients (5/7) developed cardiac tamponade during the perioperative period and the time interval to the last dose of dabigatran was (6.3±2.6) h. Idarucizumab was given at (36.4±16.7) min after the definitive diagnosis of cardiac tamponade. A significant decrease of activated partial thromboplastin time was achieved after idarucizumab administration in all five cases. Pericardial puncture and drainage were applied to all patients (5/5) with cardiac tamponade, the drainage volume was (1 037.0±846.9) ml, the retention time of pericardial drainage catheter was (27.9±13.9) h, and the recovery time of anticoagulation was (28.4±13.2) h. One patient (1/5) underwent thoracotomy for hemostasis due to excessive blood loss with the aim of ensuring complete hemostasis. Bleeding occurred in 1 patient (1/5) after the first restart of anticoagulation. AIS occurred in 2 patients (2/7) after operation. One case (1/2) received intravenous thrombolysis after receiving 5.0 g idarucizumab, no hemorrhagic transformation was observed, and the recovery process was satisfactory. Another patient in this group experienced significantly prolonged onset time and 5.0 g idarucizumab was applied before intravascular thrombectomy, there was no bleeding complication in this patient after thrombectomy. At the time of discharge, the consciousness was not significantly improved, and the muscle strength of the right lower limb was recovered somehow compared with that before operation. No hypersensitivity reactions or thrombotic events occurred in these patients within 30 days of the administration of idarucizumab. Conclusion: In AF catheter ablation-associated cardiac tamponade and AIS, idarucizumab is safe and effective in rapidly reversing the anticoagulant effect of dabigatran, use of thrombectomy saves valuable time for timely hemostasis and improvement of cerebral blood circulation.

Features of Guillain — Barre syndrome associated with COVID-19 infection

In December 2019, an epidemic of coronavirus infection SARS-CoV-2 (Severe acute respiratory syndrome-related coronavirus 2) emerged in Wuhan (China). In February 2020, the World Health Organization assigned the official name to the infection caused by the new coronavirus SARS-CoV-2 — Coronavirus disease 2019 or COVID-19, which was accompanied by various neurological complications, including Guillain — Barre syndrome. The purpose — to study the features of Guillain — Barre syndrome (GBS) with a new COVID-19 infection. Results. Recently, various neurological complications of COVID-19 have been described: severe viral hemorrhagic encephalitis, toxic encephalopathy, acute demyelinating lesions, acute cerebral disorders blood circulation, etc. It is proposed to consider Guillain — Barre syndrome (GBS) a neurological complication of CO VID-19, since the main route of coronavirus infection is respiratory, and most patients with GBS describe a respiratory infection before the development of neurological symptoms. Typically, GBS develops 11-13 days after the onset of COVID-19. Recent studies have shown that GBS is one of the most common lesions of the peripheral nervous system in COVID-19. The clinical picture, as a rule, is represented by increasing flaccid tetraparesis, less often there is respiratory failure. In a pandemic, it is advisable to test patients with GBS for COVID-19 if there are no respiratory disorders, since laboratory signs of SARS-CoV-2 infection were detected in a number of patients with acute neuropathy. Given the higher demand for respiratory support in GBS patients infected with CoV-2, it is assumed that COVID-19 may trigger the progression of neurological symptoms. Diagnosing GBS in SARS-CoV-2 patients is particularly challenging because symptoms such as shortness of breath and fatigue can be misinterpreted as a consequence of SARS-CoV-2 lung damage, delaying the timely diagnosis of GBS. Conclusion. Successful GBS management depends on clinical vigilance and its early diagnosis in patients with COVID-19.

Variability of the Circle of Willis in North American Caucasian and Middle East Arabic Cohorts

The cerebral arterial circle (circle of Willis) plays an important role in the redistribution of the blood flow between the anterior and posterior territories and maintains the plasticity of the cerebral blood circulation. The anatomical variability of the vascular circle often alters the cerebral hemodynamics and determines the outcomes of acute and chronic cerebrovascular disease. The heritability and prevalence of certain variants of the circle of Willis in different ethnic and racial groups are frequently disputed by authors. Our cross-sectional retrospective study aims to compare the patterns of the cerebral arterial circle in 64 Caucasian cadavers with 64 Arabic living individuals, by methods of anatomic dissection and magnetic resonance angiography, respectively. The typical structure of the circle of Willis was revealed in 8.3% of the Caucasian study group, and in 22.2% of the Arabic one. The anterior part of the circle of Willis was incomplete in 6 out of 64 of the Caucasian specimens, where the anterior communicating artery was hypoplastic (6.3%) or absent (3.1%). The posterior part of the circle of Willis had hypoplastic or absent posterior communicating artery on one side in 20, and on both sides in 12 out of 64 Caucasian specimens. In the Arabic cohort, the posterior part of the circle of Willis was incomplete in 17 out of 64 specimens, with absence of the posterior communicating artery unilaterally (in 11 cases) or bilaterally (in 6 cases). The present study reveals that the configuration of the cerebral arterial circle and distribution of the blood flow between the anterior and posterior territories have certain differences in the Caucasian study group versus the Arabic one.

Morphological features of ischemic and hemorrhagic brain strokes

The article is devoted to pathomorphological features of ischemic and hemorrhagic brain strokes. The aim of the research was to establish morphological peculiarities of brain stroke development in the basins of carotid, vertebralbasilar and both arterial systems. The analysis of 50 cases of tanatological study in which acute cerebral blood circulation disorder was diagnosed was carried out. It has been established that changes in the microcirculatory channel vessels during a hemorrhagic stroke are caused by hypoxia and ischemia of the brain, its swelling, and a sharp violation of vascular permeability. Such changes are local and widespread, can be divided into acute, which occurred during a stroke, and chronic, which developed before the stroke. Pathomorphological changes cover all structural and functional levels of the arterial system of the brain, the most important of which are the vessels of the microcirculatory channel.

The influence of CYP1A1 and CYP1A2 polymorphisms on stroke risk in the Chinese population

BackgroundsStroke is a sudden disorder of cerebral blood circulation. Many studies have illustrated that dyslipidemia, hypertension, diabetes, smoking and excessive drinking are the traditional risk factors for stroke. This study aimed to observe the relationship between CYP1A1 and CYP1A2 variants and stroke risk in the Chinese population.MethodsAgena MassARRAY Assay was used to genotype four single nucleotide polymorphisms (SNPs) in 477 cases and 480 controls. The chi-square test and logistic-regression analysis were used to explore the relationship between CYP1A1 and CYP1A2 variants and stroke risk.ResultsIndividuals with CYP1A2 rs762551 C was associated with a lower risk of stroke than that of allele A. Age stratification analysis showed that rs762551 was only observed to be associated with a lower risk of stroke in ≤64ys age group. After gender stratification analysis, a significant association between rs762551 and stroke risk was found in males, but not in females. The four SNPs were found to be correlated with stroke risk in patients with hypertension, coronary heart disease, cerebral infarction and lacunar infarction.ConclusionIn this study, the results first showed that CYP1A1 and CYP1A2 variants were associated with stroke risk. Larger and well-designed studies are needed to confirm the results.

Selection of excipients for the purpose of creating an intranasal gel of interleukin-1 receptor antagonist β (IL-1ra)

There is a negative dynamic of the spread of cerebrovascular diseases, which often lead to disability or death in patients in the world, today. Such diseases are characterized by acute disorders of cerebral metabolism and blood circulation, against the background of other chronic pathologies. More than one hundred thousand cases of stroke are registered in Ukraine every year, with more than thirty percent of patients dying within the first month of the disease according to the Center for Medical Statistics of the Ministry of Health of Ukraine. The nasal route of administration is a promising method of transporting active substances for systemic action, various pharmacotherapeutic groups, both small and large molecules. The created nasal preparations of hormones, antibiotics, analgesics, exhibit a quick therapeutic effect due to the branched capillary system in the nasal cavity. In addition, the nasal route of administration is the most promising non-invasive method for delivering active substances to the brain for cerebroprotective drugs, due to the anatomical features of the location of the nerves. According to published data, the researchers found that the receptor antagonist of interleukin-1 (IL-1ra) exhibits neuroprotective properties in brain ischemia by blocking excess IL-1 and activating the anti-inflammatory cytokine cascade, in order to reduce local inflammation and neuronal loss. Therefore, in order to expand the range of pharmacotherapeutic drugs – neuroprotectors, the development of a new intranasal form with the active pharmaceutical ingredient - receptor antagonist interleukin-1 (IL-1ra) is an urgent problem of modern medicine and pharmacy. The aim of work was to substantiate the choice of excipients for the new intranasal gel of the receptor antagonist of interleukin-1 (IL-1ra). Materials and methods. The studies were carried out according to the plan of two-way analysis of variance with repeated observations. Factors that were investigated: factor A (type of polymer) – A1 – chitosan 3 %, A2 – sodium carboxymethyl cellulose 0.3 %, A3 – sodium hyaluronate 0.7 %, A4 – sodium alginate 0.5 %; factor B (type of alcohol): B1 – without alcohol, B2 – sorbitol, B3 – glycerin, B4 – D-panthenol. A prefabricated solution of the receptor antagonist of interleukin-1 (IL-1ra) was used as an active substance. A portion of the active substance was taken considering the calculations, to ensure a concentration of 0.5 % IL-1ra in each composition. The release of the active pharmaceutical ingredient was determined by equilibrium dialysis according to Kruvchinsky at 37.0 ± 0.5 °C through a semi-permeable membrane – “Cuprofan” for all compositions. Dialysis was performed in Franz cells at a nine-position station (PermeGear, Inc., USA). The concentration of IL-1ra, after 30 minutes, was determined by UV spectrophotometry at a wavelength of 280 nm on a UV-2600 spectrophotometer (Shimadzu Corporation, Japan). Results. We studied the effect of pharmaceutical factors (polymers and alcohols) on the intensity of the release of IL-1ra from the nasal form to justify the choice of excipients for the nasal gel of the receptor antagonist interleukin-1 β. The results of the analysis of variance of pharmaceutical factors (polymers and alcohols) showed that hydrophilic polymers and humectants had a significant effect on the release of the active substance from the experimental compositions. It is advisable to use a mucoadhesive polymer – sodium salt of carboxymethylcellulose, as well as alcohol-moisturizer D-panthenol for the new nasal form of IL-1ra, as excipients. Conclusions . Excipients were selected for a liquid intranasal gel with the receptor antagonist interleukin-1 (IL-1ra). It was found that the type of mucoadhesive polymers and alcohols, to moisten the mucous membrane, had a significant effect on the release of the active pharmaceutical ingredient from nasal dosage forms. As a result of research, it was found that the optimal release of IL-1ra from nasal compositions was provided by excipients - hydrophilic mucoadhesive component - sodium carboxymethylcellulose with the addition of humectant alcohol – D-panthenol.

Novel Insights into the Protective Properties of ACTH(4-7)PGP (Semax) Peptide at the Transcriptome Level Following Cerebral Ischaemia-Reperfusion in Rats.

Cerebral ischaemia is the most common cause of impaired brain function. Biologically active peptides represent potential drugs for reducing the damage that occurs after ischaemia. The synthetic melanocortin derivative, ACTH(4-7)PGP (Semax), has been used successfully in the treatment of patients with severe impairment of cerebral blood circulation. However, its molecular mechanisms of action within the brain are not yet fully understood. Previously, we used the transient middle cerebral artery occlusion (tMCAO) model to study the damaging effects of ischaemia–reperfusion on the brain transcriptome in rats. Here, using RNA-Seq analysis, we investigated the protective properties of the Semax peptide at the transcriptome level under tMCAO conditions. We have identified 394 differentially expressed genes (DEGs) (>1.5-fold change) in the brains of rats at 24 h after tMCAO treated with Semax relative to saline. Following tMCAO, we found that Semax suppressed the expression of genes related to inflammatory processes and activated the expression of genes related to neurotransmission. In contrast, ischaemia–reperfusion alone activated the expression of inflammation-related genes and suppressed the expression of neurotransmission-related genes. Therefore, the neuroprotective action of Semax may be associated with a compensation of mRNA expression patterns that are disrupted during ischaemia–reperfusion conditions.

Justification of a New Solution in the Field of Stroke Rehabilitation

This research consists in the creation of a hardware-software complex for the rehabilitation of stroke patients. The device is designed for rehabilitation of patients after acute disorders of cerebral blood circulation with severe neurotraumas. The device is based on two existing rehabilitation technologies: the method of transcranial brain stimulation with the help of a magnetic neurostimulator, and the development of hand motility with the help of gloves. The combination of these two methods will allow patients to recover effectively, even at home, after they was suffering from neurotrauma.
 Keywords: stroke, ischemic, rehabilitation, biofeedback, paresis, brain, computer, mechanized glove, hardware, and software complex, CNS diseases, integration, TMS, magnetic neurostimulator

Изменения церебрального кровотока у детей 8-9 лет при выполнении умственной нагрузки на разных электронных устройствах

Изменения церебрального кровотока у детей 8-9 лет при выполнении умственной нагрузки на разных электронных устройствах

The role of systemic inflammation in the pathogenesis of hemorrhagic stroke in the presence or absence of effective brain blood flow

To identify the likelihood of developing systemic inflammation (SI) as a general pathological process in severe haemorrhagic intracerebral stroke with and without the phenomenon of ineffective cerebral blood flow. Three groups were examined: 1) 89 blood donors (controls), 2) 15 patients with severe haemorrhagic stroke without the phenomenon of ineffective brain blood flow; 3) 26 patients with severe haemorrhagic stroke with ineffective cerebral blood flow. Ineffective cerebral blood circulation was recorded on the basis of transcranial Doppler ultrasound data; 87% of patients had clinical signs of brain death. All patients in the groups with haemorrhagic stroke had signs of multiple organ dysfunction according to the Sepsis-related Organ Failure scale, all of them received intensive care. An integrated scale based on the determination of plasma concentrations of cytokines (IL-6, IL-8, IL-10, TNF-α), procalcitonin, cortisol, D-dimers, myoglobin, troponin I was used to verify systemic inflammation. Systemic inflammation or borderline state (pre-SI) was identified in all patients of the second group both on 1-3 days from the onset of haemorrhagic stroke, and on 5-8 days. On the contrary, in the third group, there were no signs of SI on 1-3 days. On 5-8 days, signs of SI and pre-SI were recorded only in 18.2% of patients. Apparently, the reason for these differences is the blockade of the passage of tissue decay products and other pro-inflammatory factors into the bloodstream from the damaged brain in the third group.

Clinical neurological and neuro-orthopedic characteristics of patients with vertebral artery syndrome of extravasal genesis

The article presents the results of clinical neurological and neuro-orthopedic examination of 48 patients with symptoms of vertebrobasilar insufficiency associated with complications of osteochondrosis. The main clinical syndromes that were observed in this group of patients were highlighted, the general characteristics of cardiovascular pathology, changes in brain during MRI examination and the severity of arterial sclerotic disease during ultrasound examination of the main arteries of the head and neck was given. On the basis of neuro-orthopedic examination of the cervical spine, specifically during examination of the active and passive range of movements, functional disorders in the form of restriction of movements were defined. By means of palpation, provocative and specific tests for certain motor segments, the main etiopathogenetic mechanisms of these disorders were identified. The program of clinical treatment was based on medical history, assessment of factors in the diagnosis of heart disease, analysis of cerebral blood circulation disorders in anamnesis, as well as provocative factors, which were overwhelmed by development. Surrounding the neuro-orthopedic examination of the neuro-orthopedic examination. The withers, they swallowed respect for a volume of rugs in the sheer ridge, conducted the Glison test, provocative tests on movements segments, palpation and percussion. The main types of postural disorders in patients with vertebral artery syndrome of extravasal origin have been investigated. As a result of clinical and neuro-orthopedic comparison, a higher frequency of Barre-Lieou syndromes, vestibulo-ataxic and vestibulo-cochlear disorders in patients with round posture was found, while the syndrome of ophthalmic disorders was observed with equal frequency in patients with round (70,8%) and round-incurvate (74,0%) posture and significantly more often compared to the group of patients with normal posture (49,9%). Vestibulo-ataxic syndrome was significantly more frequent at suspicion on facet syndrome or uncovertebral arthrosis (58,8%) in comparison with the group of patients with suspicion on protrusion / herniated intervertebral disc (11,8%).