[Selection criteria for parameters of electric current in trans-CSF brain stimulation in patients with posttraumatic vegetative state].

Trans-CSF brain stimulation is on of applied methods of stimulation in posttraumatic vegetative state. The paper analyzes application of this technique under the control by different methods of electrophysiological monitoring. Authors suggest principles of selection of stimulation parameters and detectable criteria of its effectiveness.

[Treatment outcome of chemotherapy with superselective cerebral artery catheterization in vegetative state patients].

The purpose of the study is to assess the impact of superselective neurotransmitter metabolic therapy in patients in a vegetative state. Superselective intraarterial infusion was conducted on 26 patients with relevant international criteria for the diagnosis of vegetative state. Comprehensive assessment of neurologic symptoms and severity of low metabolism on PET scan allowed to select the vascular pool, for the catheter installation. The catheter was placed either in the carotid or the vertebrobasilar pool. Infusion of neurotransmitter agents was conducted for 7 days continuously. Control of the level of metabolism of labeled glucose in the brain (PET) was performed within 2 weeks after arterial infusion. 14 out of 26 patients showed a positive trend of changes in energy metabolism of the brain. However, only 7 out of 14 patients showed further recovery of consciousness. The data confirms that the delivery path and a combination of medications play a definite role in the effectiveness of vegetative state therapy.

[Peculiarities of disorders of brain bioelectrical activity spatial-time organization in patients with different consciousness depression after severe head injury].

Specific changes of bioelectrical brain activity was found in 27 patients with different level of posttraumatic consciousness depression by the methods of crosscorrelation, coherence and factor analysis of EEG. The changes of activity of morphofunctional systems of intracerebral integrations were revealed partially by decreasing of unspecific activity from brainstem structures reflected with increasing of slow wave activity and decreasing of EEG coherence in alpha- and beta-range. Depression of system organization of interconnections of bioelectrical brain activity in frontal and occipital regions of both hemispheres was also detected, and testified about decreasing of intercortical and thalamocortical brain system action under brain dislocation. The changes of integrative brain system activity, provides interhemispheric interaction, had the specific characted. Our results propose a "facilitation" of activity of system, providing "direct" interhemispheric connections through corpus callosum and other commissural tracts of telencephalon as a sequel of mesodiencephalon structures depression with steady reciprocal, antiphase relations of slow weve activity in symmetrical areas of hemispheres in coma II patients. The data of our research had shown no complete disintegration of system brain activity in coma II patients in spite of consciousness and brainstem reflexes depression.

[The role of rivastigmine (exelon) in the treatment of consequences of cranial-brain trauma].

The use of rivastigmine in the rehabilitation of patients with cognitive disturbances after cranial-brain trauma (CBT) is reviewed. Replacement of cholinergic deficit exerts a positive effect on sanogenetic process in the brain, facilitate consolidation and learning of afferent information in the restoring brain. The authors emphasize that the administration of neuromediator preparations needs the level of organization of integrative brain activity which is sufficient for the formation of awakening reaction (opening of eyes - awakening from coma). It is suggested that neuromediator preparations, in particular cholinesterase inhibitor rivastigmine, should be used after the acutest CBT period, i.e. at least 2-3 weeks after CBT, when the main acute processes have been stabilized.

[Possibilities of measurement of impedance by the use of long-range intracerebral electrodes]. / O vozmozhnostiakh impedansometrii v praktike dolgosrochnykh vnutrimozgovykh elektrodov

An investigation of constituents in the complex (overall) resistance of deep-lying brain structures of patients with hyperkinesis treated by employing implanted electrodes helped disclose some specific features common to the impedance of conduction pathways, ventricles and some basal ganglia. The actual value of the impedance depends upon the technical peculiarities of the method. The latter does not permit it to identify the position of the electrodes amidsts various cellular structures, but is of a definite value in defining more accurately the localization of electrodes and in identifying them.