Nervous System In Patients Research Articles

Features of lipid metabolism in patients after coronary artery bypass grafting treated with physiotherapy methods in the conditions of a health resort

Rehabilitation of patients after coronary artery bypass grafting (CABG) is one of the most difficult tasks, since it includes a number of certain conditions that limit the use of hardware and physical methods. When conducting cardiac rehabilitation, special attention is paid to optimizing metabolic processes in cardiomyocytes, reducing the dose of drugs, and improving the psycho-emotional status and functional state of the cardiovascular and nervous systems in patients. Correction of lipid metabolism is crucial for effective rehabilitation after CABG, since in cardiovascular patients, it is characterized by pronounced instability and a tendency to dyslipidemic changes. The study included 117 patients after endovascular (EV) methods of treatment. The median age of the patients was 58.6±1.5 years (p <0.01). At the stage of additional treatment, all patients have been treated with drug and non-drug methods, as provided for by the clinical standard (a special complex of physical therapy for patients with CVD and non-drug methods in the form of drug electrophoresis and low-intensity infrared laser radiation). Clinical complaints and indicators of lipid metabolism in patients after CABG treated comprehensively with the use of physiotherapy methods and physical means against the background are analyzed. Clinical complaints and indicators of lipid metabolism in patients after CABG treated comprehensively with the use of physiotherapy methods and physical means against the background supportive drug therapy in the conditions of the rehabilitation department of the health resort were analyzed.

RUNX1 Upregulation Causes Mitochondrial Dysfunction via Regulating the PI3K-Akt Pathway in iPSC from Patients with Down Syndrome.

Down syndrome (DS) is the most common autosomal aneuploidy caused by trisomy of chromosome 21. Previous studies demonstrated that DS affected mitochondrial functions, which may be associated with the abnormal development of the nervous system in patients with DS. Runt-related transcription factor 1 (RUNX1) is an encoding gene located on chromosome 21. It has been reported that RUNX1 may affect cell apoptosis via the mitochondrial pathway. The present study investigated whether RUNX1 plays a critical role in mitochondrial dysfunction in DS and explored the mechanism by which RUNX1 affects mitochondrial functions. Expression of RUNX1 was detected in induced pluripotent stem cells of patients with DS (DS-iPSCs) and normal iPSCs (N-iPSCs), and the mitochondrial functions were investigated in the current study. Subsequently, RUNX1 was overexpressed in N-iPSCs and inhibited in DS-iPSCs. The mitochondrial functions were investigated thoroughly, including reactive oxygen species levels, mitochondrial membrane potential, ATP content and lysosomal activity. Finally, RNA-sequencing was used to explore the global expression pattern. It was observed that the expression levels of RUNX1 in DS-iPSCs were significantly higher than those in normal controls. Impaired mitochondrial functions were observed in DS-iPSCs. Of note, overexpression of RUNX1 in N-iPSCs resulted in mitochondrial dysfunction, while inhibition of RUNX1 expression could improve the mitochondrial function in DS-iPSCs. Global gene expression analysis indicated that overexpression of RUNX1 may promote the induction of apoptosis in DS-iPSCs by activating the PI3K/Akt signaling pathway. The present findings indicate that abnormal expression of RUNX1 may play a critical role in mitochondrial dysfunction in DS-iPSCs.

Association of hyper IgE with herpetic viral encephalitis and ecthyma gangrenosum in a male Egyptian patient

There are two forms of hyper-immunoglobulin E syndromes (HIES): a dominant form (AD-HIES) is caused by mutations in signal transducer and activator of transcription 3 (STAT3), and a recessive form (AR-HIES) is caused by mutations in dedicator of cytokinesis 8 (DOCK8). DOCK8 autosomal recessive hyper IgE syndrome (AR-HIES) patients have a more symptomatic neurologic disease than those with STAT3 deficiency. Involvement of the central nervous system in patients with HIES has been rarely reported. Being a rare primary immuno-deficiency, the disease may be underdiagnosed and under-reported. In the central nervous system abnormalities with definite neurologic manifestations, very few articles were published previously which may vary from hemiplegia to partial facial nerve paralysis in children and acute disseminated encephalomyelitis (ADEM), but viral encephalitis has not been reported. Herein, we describe a 21-year-old male with hyper-immunoglobulin E syndrome presented with fever, pneumonia, skin abscesses, and altered consciousness who proved to have herpetic viral encephalitis. The purpose of this study is to emphasize that neurologic complications with herpetic viral encephalitis may occur in patients with hyper IgE syndrome. In the case series, no cases of hyper IgE were described to have viral encephalitis, and to the best of our knowledge, this is the first description of herpes simplex encephalitis in a patient with hyper IgE syndrome.

ВЕГЕТАТИВНАЯ ДИСФУНКЦИЯ ПРИ ХРОНИЧЕСКОМ ОПИСТОРХОЗЕ

Introduction. Altai Krai is one of the most significant natural foci of opisthorchiasis not only in Western Siberia, but also on the territory of the Russian Federation as a whole, where the incidence of opisthorchiasis ranges from 44 to 34 per 100,000 people. The primary habitat of opisthorchiasis is the hepatobiliary system; the polymorphism of long-term invasion polymorphism is characterized by a violation of the functions of many organs and systems: liver, immune and cardiovascular systems, digestive organs, etc. The control center responsible for these vital functions of the body is the autonomic nervous system, which regulates them in the body. Analysis of heart rate variability can give an idea of sympathetic-parasympathetic vegetative balance. The purpose of the study. A comprehensive study of the state of autonomic regulation by analyzing heart rate variability in patients with chronic opisthorchiasis. Materials and methods. During the course of the study, 31 patients with chronic opisthorchiasis (CO) were observed, a comparison was made with 30 healthy individuals of similar age and gender. When studying the function of the autonomic nervous system, the method of mathematical analysis of the heart rate according to R.M. Baevsky was used with the help of the original program "CORVEG". The level of critical significance of the null statistical hypothesis was assumed to be 0.05. Results and Discussion. In the study of the nature of vegetative changes, methods of frequency and spectral analysis of heart rate were used. Changes in heart rate regulation indicators were statistically significantly (p<0.05) indicated an increase in sympathetic regulation at rest and orthostasis in patients with SC, their autonomic homeostasis was shifted toward the sympathetic nervous system both at rest and under load, and in some patients (31%) dysregulation of the central type was detected. Conclusions. Dysregulation of autonomic nervous system in patients with chronic opisthorchiasis was revealed at all levels of its regulation and was characterized by increased sympathetic tone and a decrease in parasympathetic and humoral regulation, as well as vasoreflective and baroreflective mechanisms.

Optimizing Management of the Central Nervous System in Patients with Acute Lymphoblastic Leukemia Undergoing Allogeneic Stem Cell Transplantation

PurposeTo evaluate clinical outcomes and patterns of failure, specifically in regards to the central nervous system (CNS), in patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT) using total body irradiation (TBI)-based conditioning regimens. Methods and MaterialsAll adult patients (aged ≥18 years) with ALL undergoing allogeneic HSCT using TBI-based conditioning regimens treated from 1995 to 2020 at Duke University Medical Center were evaluated. Various patient, disease, and treatment-related factors were collected, including CNS prophylaxis and treatment interventions. Clinical outcomes, including freedom from CNS relapse, were calculated using the Kaplan-Meier method for patients with and without CNS disease at presentation. ResultsOne hundred and fifteen patients with ALL were included the analysis (myeloablative, 110; nonmyeloablative, 5). Of the 110 patients undergoing a myeloablative regimen, most (n = 100) did not have CNS disease before transplant. For this subgroup, peritransplant intrathecal chemotherapy was administered in 76% (median of 4 cycles) and 10 received a radiation boost to the CNS (cranial irradiation, 5; craniospinal, 5). Only 4 failed in the CNS after transplant, none of whom received a CNS boost, with freedom from CNS relapse at 5 years of 95% (95% confidence interval (CI), 84-98%). Freedom from CNS relapse was not improved with a radiation therapy boost to the CNS (100% vs 94%, P = .59). Overall survival, leukemia-free survival, and nonrelapse mortality at 5 years were 50%, 42%, and 36%, respectively. Among the 10 patients with CNS disease before transplant, 10 of 10 received intrathecal chemotherapy and 7 received a radiation boost to the CNS (cranial irradiation, 1; craniospinal, 6) and none subsequently failed in the CNS. A nonmyeloablative HSCT was pursued for 5 patients because of advanced age or comorbidities. None of these patients had prior CNS disease or received a CNS or testicular boost, and none failed in the CNS after transplant. ConclusionsA CNS boost may not be necessary in patients with high-risk ALL without CNS disease undergoing a myeloablative HSCT using a TBI-based regimen. Favorable outcomes were observed with a low-dose craniospinal boost in patients with CNS disease.

Do Psychological Factors Influence the Elastic Properties of Soft Tissue in Subjects with Fibromyalgia? A Cross-Sectional Observational Study.

Nowadays, there is evidence related to the impact that psychological factors have on symptoms, specifically vegetative ones, and on the autonomic nervous system in patients with fibromyalgia (FM). However, there are no studies to correlate the level of association between psychological factors and the elastic properties of tissue in the FM population. Elastic properties of soft tissue reflect age- and disease-related changes in the mechanical functions of soft tissue, and mechanical failure has a profound impact on morbidity and mortality. The study has a cross-sectional observational design with 42 participants recruited from a private clinic and rehabilitation service. The Pain Catastrophizing Scale, Tampa Kinesiophobia Scale and Self-Efficacy Scale were used to assess psychological factors. The elastic properties of the tissue in the characteristic painful points, which patients suffering from FM described, were assessed by strain elastography. A low and significant level of association was found between pain catastrophising scale (PCS) and the non-dominant lateral epicondyle (r = -0.318; p = 0.045). Kinesiophobia was found to be related to the dominant lateral epicondyle (r = 0.403; p = 0.010), the non-dominant knee (r = -0.34; p = 0.027) and the dominant forearm (r = 0.360; p = 0.010). Self-Efficacy showed a low level of association with the non-dominant supraspinatus (r = -0.338; p = 0.033) and the non-dominant medial epicondyle (r = -0.326; p = 0.040). Psychological factors and the elastic properties of tissue seem to be associated in patients suffering from FM. The most profound association between psychological factors and non-dominant parts of the body could be related to neglect and non-use of those parts of the body.

Impact of Immunosuppressive Therapy on Vascular and Vasogenic Alterations of the Central Nervous System in Patients With ANCAAssociated Vasculitis With Renal Involvement

Impact of Immunosuppressive Therapy on Vascular and Vasogenic Alterations of the Central Nervous System in Patients With ANCAAssociated Vasculitis With Renal Involvement

Involvement of the central nervous system in patient with chronic inflammatory demyelinating polyneuropathy: a case report

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an uncommon disease characterized by heterogeneous clinical findings, absence of specific laboratory markers and good response to treatment. Typically CIDP manifests as weakness of varying severity, from minimal paresis to plegia, as well as symmetrical loss of sensitivity in all limbs, a distinctive clinical feature of CDL is the involvement of both proximal and distal parts of extremities. At the same time, there is a large number of atypical CIDP variants, clinically similar to other chronic disimmune neuropathies. Neuroimaging findings typically include involvement of the cauda equina, brachial, and lumbar plexus. The patient sought medical help complaining of weakness and loss of sensation in the extremities. This clinical case illustrates a combined involvement of cranial and spinal nerves, as well as spinal cord and brain in a patient with chronic inflammatory demyelinating polyneuropathy.

O100 / #804 THE LINK BETWEEN SPINAL CORD STIMULATION FOR PAIN AND THE PARASYMPATHETIC NERVOUS SYSTEM: IS THERE AN INFLUENCE ON THE AUTONOMIC NERVOUS SYSTEM?: TRACK 1: MECHANISMS OF ACTION, MAPPING AND SPINAL CORD STIMULATION

Despite the well-known clinical effects of spinal cord stimulation (SCS), the mechanisms of action have not yet been fully unraveled. It is hypothesized that SCS is able to influence the autonomic nervous system. In patients with chronic pain, a relative lower parasympathetic activity is already suggested based on heart rate variability measurements. The aim of this study is to further explore the influence of SCS on the autonomic nervous system in patients with Persistent Spinal Pain Syndrome Type 2 (PSPS T2) by evaluating whether SCS is able to influence (electrochemical) skin conductance, blood volume pulse, heart rate, and respiration rate.

The role of microcirculation in the conducting structures of the nervous system in patients with vibration disease burdened by metabolic syndrome

Introduction. The study of microcirculation processes in peripheral nerve damage remains a necessary area of experimental and clinical research, because the microvascular bed is one of the most important systems in which the disease manifests itself in the early stages. The aim of the study is to identify the role of microcirculation disorders in the state of central and peripheral conductive structures in patients with vibration disease (VD) associated with combined exposure to general and local vibration, and burdened with metabolic syndrome (MS) and diabetes mellitus (DM). Materials and methods. Group 1 included patients with VD associated with combined exposure to general and local vibration, group 2 - persons diagnosed with VD, burdened with MS, group 3 - with a diagnosis of VD, burdened with DM. At the 1st stage of the study, basal blood flow was studied, at the 2 nd stage - load functional tests (respiratory and occlusive). The state of sensory and motor axons of the nervous system was determined. Results. In patients of the examined groups, there was proved a relationship between the indicators of the state of peripheral nerves and central structures with the indicators of microcirculation, the state of the myogenic level of regulation, with the index of specific oxygen consumption and the index of relative perfusion oxygen saturation in the microcirculation. In patients with VD, burdened with MS and DM, an association was found between changes in axons with an indicator of the intensity of functioning of the regulatory systems of the microvascular bed, indicators of the levels of active regulation of microcirculation (myogenic, neurogenic and endothelial) and indicators characterizing the dynamic state of the microcirculation system. Limitations. The disadvantage of the study is the fact that the parameters of the microcirculation system determined in the peripheral departments were extrapolated to the central structures, and were not determined in the capillary network of the brain. Conclusion. Changes in the microcirculatory bed were established to be a link in the pathogenesis of demyelination processes in VB associated with the combined effects of general and local vibration, and vibration disease burdened with MS and DM.

Pupillary Responses Reveal Autonomic Regulation Impairments in Patients With Central Serous Chorioretinopathy.

PurposeThis study assessed the autonomic nervous system in patients with central serous chorioretinopathy (CSC) by simultaneously measuring pupillary responses and heart rate variability (HRV).MethodsWe recruited 33 patients with CSC and 26 age- and sex-matched healthy controls. Using a pupillometry and acceleration plethysmography system, we measured the participants’ pupillary light reflex and HRV simultaneously, and compared the following parameters between the two groups: the pupil diameters, diameter changes, and time and frequency domain HRV indices (high frequency power: HF; low frequency power: LF; log LF/HF ratio). Additional data from the Profile of Mood States (POMS) and pupillary responses during mental tasks were also analyzed.ResultsThe CSC group had a significantly lower constriction amplitude and a higher re-dilation ratio compared with the control group, indicating parasympathetic inhibition and sympathetic activation. For the HRV measures, the CSC group demonstrated significantly lower HF and higher LF and log LF/HF ratio, indicative of higher sympathetic activity. The CSC group also showed significantly larger pupil dilation during tasks of moderate difficulty, and higher negative/lower positive POMS mood scores. Further analyses also revealed that the baseline pupil diameter was significantly larger in patients with active as opposed to chronic CSC.ConclusionsPupillary responses and HRV measures both revealed sympathetic activation and parasympathetic attenuation in patients with CSC. Larger pupil dilation during mental tasks in CSC could be a potential marker of psychophysiological stress.

Dynamic coupling between the central and autonomic cardiac nervous systems in patients with refractory epilepsy: A pilot study.

The heart and brain are reciprocally interconnected and engage in two-way communication for homeostatic regulation. Epilepsy is considered a network disease that also affects the autonomic nervous system (ANS). The neurovisceral integration model (NVM) proposes that cardiac vagal tone, indexed by heart rate variability (HRV), can indicate the functional integrity of cognitive neural networks. ANS activity and the pattern of oscillatory EEG activity covary during the transition of arousal states and associations between cortical and autonomic activity are reflected by HRV. Cognitive dysfunction is one of the common comorbidities that occur in epilepsy, including memory, attention, and processing difficulties. Recent studies have shown evidence for the active involvement of alpha activity in cognitive processes through its active role in the control of neural excitability in the cortex through top-down modulation of cortical networks. In the present pilot study, we evaluated the association between resting EEG oscillatory behavior and ANS function in patients with refractory epilepsy. Our results show: (1) In patients with refractory epilepsy, there is a strong positive correlation between HRV and the power of cortical oscillatory cortical activity in all studied EEG bands (delta, theta, alpha, and beta) in all regions of interest in both hemispheres, the opposite pattern found in controls which had low or negative correlation between these variables; (2) higher heartbeat evoked potential amplitudes in patients with refractory epilepsy than in controls. Taken together, these results point to a significant alteration in heart-brain interaction in patients with refractory epilepsy.

Prevalence and heart rate variability characteristics of premature ventricular contractions detected by 24-hour Holter among outpatients with palpitations in China: a cross-sectional study

ObjectiveTo analyse the prevalence and heart rate variability (HRV) characteristics of premature ventricular contraction (PVC) detected by 24-hour Holter among Chinese outpatients with palpitations.DesignA cross-sectional study.SettingThis study was conducted in...

The State of Vegetative Regulation in Patients with Ischemic Stroke in the Acute and Peracute Periods: an Observational Cohort Study

Background. The high number of stroke cases is predetermined by risk factors, pathogenetic heterogeneity, genetic predisposition to the disease. Neurovascular changes can serve as a marker for the severity of the patient’s condition. By means of cardiointervalography, the reactions of the autonomic nervous system in patients with ischemic stroke were studied, depending on the territory of the cerebral infarction and its period. With a favorable outcome of the disease, the detected changes in regulatory mechanisms can be considered adaptive, while with fatal outcome — disadaptive. Objectives. Determination of the state of the autonomic nervous system by means of cardiointervalography in patients with stroke in various pools of blood supply.Methods. 52 patients with a verifi ed diagnosis of ischemic stroke in the acute and peracute periods were examined. All patients were divided into 3 groups. Group 1 — patients with ischemic stroke in the middle cerebral artery territory on the left. Group 2 — with ischemic stroke in the middle cerebral artery territory on the right. Group 3 — with ischemic stroke in the vertebrobasilar territory. Patients with a fatal outcome are separately described. The functional state of the autonomic nervous system was assessed by the method of mathematical analysis of heart rate variability according to R.M. Baevsky (1984). Cardiointervalography was performed in the morning on the 1st day from the onset of the stroke and on the 10th day.Results. The state of autonomic regulation in patients with ischemic stroke depends on the localization and size of the lesion. According to cardiointervalography, parasympathetic effects on the rhythm of the heart prevailed in patients with ischemic stroke in the middle cerebral artery territory on the left and in the vertebrobasilar territory in the peracute period, while the sympathetic one predominated in patients with ischemic stroke in the middle cerebral artery territory on the right. In the acute period, the general tendency for the increase in activity of the opposite part of the autonomic nervous system was observed.Conclusion. Statistically signifi cant changes in the indicators of the total power of the wave oscillation spectrum and the indicator of ultra-low-frequency waves in the peracute and acute periods of stroke in the examined patients indicate the importance of neurohumoral mechanisms of regulation in the dynamics of the pathological state

Continuous monitoring with wearables in multiple sclerosis reveals an association of cardiac autonomic dysfunction with disease severity

BackgroundDysfunction of the autonomic nervous system is common in multiple sclerosis patients, and probably present years before diagnosis, but its role in the disease is poorly understood.ObjectivesTo study the autonomic nervous system in patients with multiple sclerosis using cardiac autonomic regulation measured with a wearable.MethodsIn a two-week study, we present a method to standardize the measurement of heart rate variability using a wearable sensor that allows the investigation of circadian trends. Using this method, we investigate the relationship of cardiac autonomic dysfunction with clinical hallmarks and subjective burden of fatigue and autonomic symptoms.ResultsIn 55 patients with multiple sclerosis and 24 healthy age- and gender-matched controls, we assessed the cumulative circadian heart-rate variability trend of two weeks. The trend analysis revealed an effect of inflammation (P = 0.0490, SMD = -0.5466) and progressive neurodegeneration (P = 0.0016, SMD = 1.1491) on cardiac autonomic function. No association with subjective symptoms could be found.ConclusionsTrend-based heart rate variability measured with a wearable provides the opportunity for unobtrusive long-term assessment of autonomic functions in patients with multiple sclerosis. It revealed a general dysregulation in patients with multiple sclerosis.

Cognitive, emotional-affective, anxiety and autonomic disorders in patients with a new coronavirus infection (covid-19) in the acute period

The purpose of this work is to identify neuropsychiatric functions in patients at Department No. 1 responsible for medical care of patients with a new coronavirus infection at the Samara City Hospital No. 7. Appropriate scales and questionnaires were used for this purpose. Cognitive impairments were found in 86% of the cases, emotional-affective impairments of varying severity in half of the subjects, an increase in reactive and personal anxiety was revealed, and vegetative disorders were observed in 78% of the subjects. Based on these data, it can be assumed that the new coronavirus infection affects the functioning of the nervous system of patients.

筋強直性ジストロフィーの中枢神経障害の理解と対処2021

筋強直性ジストロフィーでは認知機能障害とそれに関連した日常生活援助が適切に展開されにくい問題が起こり得るが，その事実が幅広く認識されケアに有効に活用されているかどうかについては疑問であるといわざるを得ない．

Reflections of the sensory findings in the central nervous system in patients with neuropathic pain.

This study aimed to evaluate whether there was a difference in functional magnetic resonance imaging (fMRI) findings in patients who were found having hyperalgesia or hypoesthesia according to Quantitative Sensory Tests (QST). Forty participants were included in the study: 20 with neuropathic pain (NP) due to cervical disc pathology (NP group) and 20 healthy volunteers. After obtaining the socio-demographic and clinical data of the participants, the painDETECT questionnaire was administered, followed by QST analysis to show the presence of hypoesthesia and/or hyperalgesia, and fMRI examinations, which included sensory stimulation of both extremities. Sensory threshold tests were found to be higher in the NP group compared with the healthy volunteers, and the heat pain threshold was found to be lower in the tests showing pain thresholds in the intergroup analyses (p < 0.05). The changes described were found in both painful and non-painful limbs. In the hypoesthetic NP group, a lower somatosensory cortex activity was found in non-painful limbs compared with the healthy volunteers (p < 0.05). In the unilateral hyperalgesic NP group, a lower somatosensory cortex activity was found on the painful side, and if the hyperalgesia was widespread, lower blood oxygen-level-dependent activity was also found in the operculum and insular cortex (p < 0.05). The patients with different phenotypes of NP had different activities in the areas related to the processing of pain, and were more prominent in patients with widespread hyperalgesia. Studies with larger numbers of patients are required for a definite statement.

Цереброваскулярні ураження при ВІЛ-інфекції

У статті подано огляд літератури з питань патогенезу, клінічних проявів і діагностики церебральних судинних уражень нервової системи на фоні прогресування ВІЛ-інфекції. Неврологічні ускладнення ВІЛ-інфекції можуть бути викликані як самим ретровірусом, так і опортуністичними інфекціями, пухлинами, цереброваскулярною патологією, метаболічними розладами, токсичним впливом антиретровірусних препаратів. Проблема судинних уражень головного мозку у ВІЛ-інфікованих пацієнтів не настільки детально вивчена, як неврологічні порушення, що викликані безпосередньо вірусом імунодефіциту й опортуністичними інфекціями. ВІЛ-позитивні пацієнти перебувають у групі високого ризику інсульту. Описані власні спостереження ішемічних і геморагічних форм васкулярного ВІЛ-обумовленого ураження центральної нервової системи.

Quantitative Evaluation of Pupil Responses in Patients with Prolactinomas Being Treated with Dopamine Agonists

ABSTRACT The aim of this study was to determine whether the dopamine agonist (DA) drug cabergoline used in the treatment of prolactinoma causes autonomic dysfunction by measuring static and dynamic pupillary responses. The study included 25 eyes from 25 patients who were receiving DA for the treatment of prolactinoma and 25 eyes from 25 healthy individuals. Static and dynamic pupillary responses were measured by automatic quantitative pupillometry. The scotopic pupillary diameter was found to be significantly higher in patients receiving DA medication compared with the control group, while pupil contraction time and pupillary dilatation latency were significantly lower. DA drug use changes static and dynamic pupillary responses, probably by increasing sympathetic tone. Pupillometry can be used as a non-invasive method to provide information about changes in the autonomic nervous system in patients receiving such drug therapy.