Disturbances Of Cerebral Blood Circulation Research Articles

Progesterone Protects Prefrontal Cortex in Rat Model of Permanent Bilateral Common Carotid Occlusion via Progesterone Receptors and Akt/Erk/eNOS.

Sustained activation of pro-apoptotic signaling due to a sudden and prolonged disturbance of cerebral blood circulation governs the neurodegenerative processes in prefrontal cortex (PFC) of rats whose common carotid arteries are permanently occluded. The adequate neuroprotective therapy should minimize the activation of toxicity pathways and increase the activity of endogenous protective mechanisms. Several neuroprotectants have been proposed, including progesterone (P4). However, the underlying mechanism of its action in PFC following permanent bilateral occlusion of common carotid arteries is not completely investigated. We, thus herein, tested the impact of post-ischemic P4 treatment (1.7mg/kg for seven consecutive days) on previously reported aberrant neuronal morphology and amount of DNA fragmentation, as well as the expression of progesterone receptors along with the key elements of Akt/Erk/eNOS signal transduction pathway (Bax, Bcl-2, cytochromeC, caspase3, PARP, and the level of nitric oxide). The obtained results indicate that potential amelioration of histological changes in PFC might be associated with the absence of activation of Bax/caspase3 signaling cascade and the decline of DNA fragmentation. The study also provides the evidence that P4 treatment in repeated regiment of administration might be effective in neuronal protection against ischemic insult due to re-establishment of the compromised action of Akt/Erk/eNOS-mediated signaling pathway and the upregulation of progesterone receptors.

A role of the autonomic nervous system in cerebro-cardiac disorders

The authors consider anatomical/physiological characteristics and a role of different autonomic CNS regions, including insula cortex, amygdala complex, anterior cingulate cortex, ventral medial prefrontal cortex, hypothalamus and epiphysis, involved in the regulation of cardiovascular activity. The damage of these structures, e.g., due to the acute disturbance of cerebral blood circulation, led to arrhythmia, including fatal arrhythmia, in previously intact myocardium; systolic and diastolic dysfunction, ischemic changes considered in the frames of cerebro-cardial syndrome. On the cellular level, the disturbance of autonomic regulation resulted in catechol amine excitotoxicity, oxidative stress and free radical myocardium injury.

Sex differences in acute disturbances of cerebral blood circulation

It is shown that in the development of stroke observed sex differences, which manifest themselves both clinically and by laboratory parameters. While men have a higher incidence of stroke for most of his life, a woman in a more advanced age have a higher risk for stroke. Sex differences in the development of stroke depend on several factors, including genetic and hormonal changes throughout life. Studies sex differences in the risk of stroke is only in the initial stage, but the first results show that there are differences in neuronal cell death in males and females after experimental ischemic stroke. A better understanding of the mechanisms underlying the development of stroke in men and women will lead to more appropriate treatment strategies for patients of both sexes.

The influence of non-invasive electrical stimulation of the spinal cord on the locomotor function of patients presenting with movement disorders of central genesis

The objective of the present study was to evaluate the influence of non-invasive (transcutaneous) electrical spinal cord stimulation on the locomotor function of the patients suffering from movement disorders. The study involved 10 patients of both sexes at the age from 32 to 70 years (including 40% of men and 60% of women) presenting with the compromised locomotor function of varying severity associated with the disturbances of cerebral blood circulation caused either by an injury to the brain and spinal cord or by stroke. The transcutaneous electrical spinal cord stimulation was applied using different frequency regimes with the placement of the electrodes in the projection onto the region of TXI-TXII vertebrae. The active factors were bipolar electrical stimuli 0.5 ms in duration; the current strength was chosen for each patient on an individual basis taking into consideration its threshold level. Electromyograms and evoked motor responses of selected muscles, viz. m. rectus femoris, m.biceps femoris, m. tibialis anterior, and m.gastrocnemius were recorded with the use of the 'Neuro-MVP-8 eight-channel electromyography' ('Neurosoft', Russia). The data obtained give evidence that the stimulation of the spinal cord with a frequency of 1 Hz induces reflectory responses with monosynaptic and polysynaptic components in the muscles of the lower extremities, with the thresholds of these responses being significantly higher in the patients presenting with serious neurological problems. Stimulation with the frequencies of 5 and 30 Hz caused in the patients with paresis the involuntary movement of the legs the characteristics of which were similar to those of the locomotor movements. It has been demonstrated that the application of transcutaneous electrical spinal cord stimulation leads to increased excitability of the lumbar spinal neural structures of the patients. The study has shown the possibility of regulation of the locomotor functions in the patients presenting with movement disorders of central genesis by means of non-invasive electrical stimulation of the spinal cord.

FEATURES OF THE IMMUNOLOGICAL STATUS IN PATIENTS WITH DIFFERENT FORMS OF TRANSIENT DISTURBANCES OF CEREBRAL BLOOD CIRCULATION

Objective : to determine special features of the immunological status as a result of immunophenotyping of peripheral blood leukocytes in patients with different transient disturbances of cerebral blood circulation in comparison with patients with stroke. Material and methods . We examined 14 patients with transient ischemic attack (TIA), 7 patients with cerebral hypertensive crisis (CHC), 9 patients with lacunar stroke, and 9 volunteers. All the patients underwent immunophenotyping of peripheral blood leukocytes and their immunoglobulin level was determined by immunoturbodimetrical method on the first day after admission. Results . We have defined the specific features of the inflammatory process presented by activation of the classical way of inflammation in CHC patients on the first day of the illness in the form of increased level of proteins of the complement system, activity of T- and B-cellular links of immunity in a combination with low expression of adhesion molecules. We have revealed depression of T-cellular immunity without activation of B-cellular immunity in TIA group, which distinguishes transient disturbances of cerebral blood circulation from stroke. Conclusion. Absence of the activation of B-cellular immunity in patients with CHC and TIA and low level of the expression of adhesion molecules make the sanogenic potential of transient disturbances of cerebral blood circulation in comparison with stroke.

NEUROPROTECTION INFLUENCE ON COURSE OF CEREBRAL STROKE

Objective. To evaluate clinical efficacy and tolerability of cellex in the treatment of patients with cerebral stroke. Material and methods. In 2 multi-center researches of Russian clinical sites were involved 178 and 480 patients with acute disturbance of cerebral blood circulation (ADCBC), respectively. The first research was comparative with open inclusion of 146 (82%) patients with ischemic stroke and 32 (18%) – with hemorrhagic stroke at the age of 35-80. In the second research, which was doubleblind, placebo controlled, randomized, patients with ischemic stroke got Cellex or placebo during the standard base therapy. Results and conclusion. Thus, a statistically significant (р < 0,05) advance of paresis regression (by NIHSS scale) was noted in the Cellex group by the 6th day of observation as compared to the control group. Evaluation of therapy results in patients with total aphasia showed that the value of the mean Questionnaire speech values after Cellex administration (р < 0,05) exceeded the respective control group level by 3 times. In patients who administered Cellex the IPC test result increased by 24%, whereas in the control group – only by 14.8% (p < 0,01). The research showed that in group of the patients under prescription of Cellex marked authentically better result with regress of movement, visual, speech and cognitive disorders.

Dynamics of cognitive disturbances in rats with acute cerebral ischemia on the background of introduction of 0.9 % solution NaCl

For today there are no clear recommendations on infusion therapy at the disease and injuries of brain, and infusion preparations are commonly used empirically. Within the framework of the complex study of an influence of the different infusion remedies on brain at an experimental ischemia of brain, an aim of this work is to investigate how the 0,9 % solution of NaCl influences on the dynamics of cognitive functions and neurological status of the rats with an acute cerebral ischemia at the course medical introduction into an animal organism. Methods . Experiments were carried out on 60 white rats-males. An acute disturbance of cerebral blood circulation (ADCBC) was modeled by means of the two-sided dressing of internal carotid arteries. The 0,9 % solution of NаСІ was injected intravenously in catheterized thigh vein 2,5 ml/kg 2 times/day (5 ml/kg for a day). The first introduction was carried out in 30 minutes after ADCBC and then every day in 12 hours during 7 days. The control groups consist of intact rats that received 0,9 % NаСІ and animals with a model ischemia without treatment. Neurological deficiency in animals was defined on the scale stroke-index McGrow C. P. The dynamics of position-finding activity was assessed in experiment “an open field”. An assessment of animal capacity to training and memorization of an aversive stimulus was studied in the test of conditioned response of passive avoidance. The results were processed using the program StatPlus 2009. Results . The study showed that bilateral carotid occlusion in rats without treatment is followed not only by the high animal lethality but also by the development of a hard neurological symptomatology and then by essential disturbance of mnestic functions in animals that survived during the recovery period of model insult (р<0,01). The study of lethality dynamics, neurological status, behavioral responses in rats with ADCBC on the model of bilateral carotid occlusion showed that the course therapeutic infusion of 0,9 % solution of NaCl had some advantages relative to the group of the control pathology on indicators of neurological deficiency, orientating and searching activity, capacity to training and memorization. Conclusions. Infusion therapy with 0,9 % solution of NaCl in rats with the model cerebral ischemia in some degree promotes the renewal of its cognitive functions (р<0,05) relative to the untreated animals. Therapeutic effect of infusion therapy obtained in experiment with isoosmolar 0,9 % solution of NaCl is a reason to study protective actions of infusion preparations of the other groups at an acute disturbance of cerebral blood circulation

A modern concept of mixed dementia

Cognitive impairment is currently one of the most urgent problems. A number of newly registered cases of dementia in the world approaches to 7,7 millions that means that a new case of dementia arises every four seconds. According to WHO data, Western Europe is in the first place (appr. 7,0 millions of patients). In 2010, Russia was among 9 countries with the highest number of patients with dementia. Mixed dementia is characterized by the presence of one or several pathogenetic mechanisms of cognitive impairment. Its prevalence is about 45%. Neurodegenerative and vascular processes underlying dementia are mutually potentiated. An analysis of the majority of characteristics demonstrates that mixed dementia has characteristics of both Alzheimer's disease and vascular dementia. Disturbances of neurotransmitter systems are caused by cholinergic deficit. Galantamine (reminil) is the drug that has demonstrated its efficacy in the treatment of dementia of Alzheimer's type including dementia with chronic disturbances of cerebral blood circulation.

Hypoglycaemia as predictor of cardiovascular accidents

Diabetes mellitus type 2 is not only a chronic disease, but also refers to a group of constantly progressing pathologies. Regardless of the level of development of medicine and used therapeutic approaches, mortality from cardio-vascular complications of diabetes exceeds the figures of the General population. According to the results of Veterans Affairs Diabetes Trial it was revealed that severe hypoglycemia are predictors for the development of myocardial infarction and acute disturbance of cerebral blood circulation. Pledge of successful treatment of patients with type 2 diabetes is the adequate choice of target values of glycemia and maintaining it by means of a combination of curative (observance of dietary recommendations, reception of hypoglycemic drugs, etc.) and not drug-induced (by which primarily active self-monitoring of blood glucose) activities.

Логико-статистический анализ связи клинико-лабораторных показателей с возникновением нарушения мозгового кровообращения у пациентов пожилого возраста с хронической ишемией головного мозга

Логико-статистический анализ связи клинико-лабораторных показателей с возникновением нарушения мозгового кровообращения у пациентов пожилого возраста с хронической ишемией головного мозга

ACUTE CEREBROVASCULAR EVENTS IN PATIENTS WITH ARTERIAL HYPERTENSION: MOLECULAR GENETIC ASPECTS

Aim. To study association between stroke and gene polymorphism of angeotensin converting enzyme (ACE), angeotensin II type 1 receptor (ATR1), apolipoprotein СIII (APO CIII), apoproteine Е (APO E), methylentetrahydrofolate reductase (MTHFR), fibrinogen (Fb), endothelial NO-synthase (NOS3) in arterial hypertension (HT). Material and methods . Molecular genetic analysis by polymerase chain reaction was done in 41 patients with HT, who experienced first episode of acute disturbances of cerebral blood circulation (ADCBC). Results. Stroke rate in patients with HT is associated with A1166C of ATR1 gene polymorphism, G-455A of Fb gene polymorphism and C677T of MTHFR gene polymorphism. The high risk markers are C-allele of ATR1 gene, -455А allele and AA genotype of Fb gene, 677T allele of MTHFR. The A-allele and genotype AA of ATR1 gene, G-445 allele of Fb gene, С677-allele and CC genotype of MTHFR gene play protective role against ADCBC in HT. Conclusion. It is established an association between gene polymorphism of some molecules and ADCBC in HT.

Hypertension disturbances of cerebral blood circulation

Hypertension is the main cause and the most important risk factor of various forms of temporary as well constant acute disturbances of cerebral blood circulation. Patients with more than 25 years hypertension and frequent increases of blood pressure have damages of brain vessels with plasmorrhage and fibrinoid necrosis of capillaries walls. This damage in their turn being “hypertonic stenosis or occlusion” of brain vessels can lead to a disturbance of blood flow in the supplied regions and result in forming small lacunar brain infarctions, the most typical for arterial hypertension. From the other hand, necrosis of media vessels myocytes can lead to their sharp thinning, forming microaneurysm, that breaks and causes intracerebral hemorrhage. The presented clinical observation states different types of hypertension angiopathy in one patient and as a result different types of disturbances of cerebral blood circulation: cerebral hypertension stroke, repeated intracerebral hemorrhage and small lacunar brain infarctions.