Vol 1, No 2 (2007)
Original articles
Influence of rehabilitation therapy on functional organization of motor systems after stroke
Abstract
Functional MRI (fMRI) was applied to study mechanisms of unctional reorganization of motor systems after ischemic stroke (IS) as the result of rehabilitation. Two groups of patients with IS were recruited: 16 patients on standard restorative therapy (basic group) and 16 patients on functional training – EMG biofeedback (comparison group). In addition, functional training was given to 14 healthy individuals (normal control). In controls, an increase in signal intensity from main activation zones and appearance of characteristic additional activation zones in cerebellar hemispheres, corpus callosum and premotor cortex was noted. In patients after basic rehabilitation, an increase in signal intensity from main activation zones in sensorimotor area and cerebellar hemispheres was revealed for both affected and nonaffected hand, irrespective of IS localization. In patients after functional training, the reorganization of functional motor system consisted in an increase in signal intensity of main activation zones only in the ipsilesional hemisphere; expressiveness of these changes did not depend on IS localization. The degree of motor recovery of the hand after functional training was significantly higher than after the basic course of rehabilitation therapy. So, neuroimaging (fMRI) and clinical analysis showed directional and effective influence of the functional training method on the processes of motor system reorganization.
4-8
Psychiatric disorders in epilepsy. Communication I
Abstract
Psychiatric abnormalities represent important, although not obligate, clinical manifestation of epilepsy. They are characterized by variability, interrelation with particular disease forms and seizure types, as well as by significant influence on patients’ quality of life. Precise assessment of these disturbances in each case is important for carrying out differential diagnosis, determining prognosis and prescribing adequate therapy. In the paper, on the basis of extensive personal experience and literature data, classification of various ictal, interictal and postictal psychiatric abnormalities is proposed, detailed phenomenology of mind disorders in epilepsy is presented, and relevant risk factors are analyzed.
9-16
Plastic reorganization of hippocampal synapses resulted from pharmacological blockade of type 1 cannabinoid receptors
Abstract
Endogenous cannabinoid system plays an important physiological role in brain functioning, being related to regulation of neuromediator processes and mechanisms of neuroplasticity. Cannabinoid receptors of type 1 (CB1) represent one of the key elements of this system and convenient object for various experimental effects. We showed plastic reorganization of synapses in hippocampal CA1 stratum radiatum in vitro resulted from pharmacological blockade of CB1. The ultrastructural features of this reorganization are the formation of numerous perforated contacts with elongated synaptic membranes of modified configuration, spatial synaptic rearrangement, and the appearance of atypical synaptic connections. The obtained results suggest that involvement of CB1 in modulation of synaptic transmission is one of the mechanisms which ensure the stable morphofunctional state of synapse and promote its integrity in disturbances of neurotransmission regulation.
17-21
22-28
Familial case of ataxia with oculomotor apraxia: first observation in Russian population
Abstract
Hereditary ataxias represent a clinically and genetically heterogeneous group of disorders, modern classification of which is based on identification of a primary genetic and/or biochemical defect in examined patients and their family members. Recently, autosomal recessive ataxia with oculomotor apraxia was described; it is characterized by combination of coordination problems with specific abnormalities of voluntary eye movements and, probably, by high prevalence if a majority of populations. We presented the first description of this phenotype in Russia observed in two sibs (sisters). Biochemical screening (increased serum level of alphafetoprotein) and molecular analysis enabled to diagnose in this family ataxia-oculomotor apraxia, type 2 (AOA2) – the disorder caused by pathology of senataxin protein and mutations of the respective gene SETX on chromosome 9q34.
29-33
Brain plasticity and modern rehabilitation technologies
Abstract
Discussed are basic achievements in the studies of neuronal plasticity with the use of modern neuroimaging methods and, first of all, functional MRI. The role of various afferent inputs in these processes is emphasized. Novel neurorehabilitation technologies such as constraintinduced therapy (CI therapy), “LOCOMAT” system, the robotic therapy etc., are considered as the source of intensive goaldirected afferentation. Data concerning the possibility of the use of neuromuscular electrostimulation at the first hours after ischemic stroke are presented. The unique methods of intrapharyngeal electrostimulation in the treatment of dysphagia of different etiologies are discussed. Efficiency of transcranial electrostimulation in central poststroke pain syndrome is described. Data on possibilities of the EMG feedback in training of the precision grip, one of the basic motor hand skills, are presented. The details of learning of different postural tasks using postural sway feedback in patients with poststroke hemiparesis, Parkinson’s disease and spinocerebellar ataxias are discussed. Data on efficiency of alphastimulating training in patients with central poststroke pain syndrome and with clinical prevalence of affective disturbances are presented. Finally, prospects of one of the most interesting novel rehabilitation technologies, the technology based on virtual reality, are discussed.
34-39