The contributions of the right and left hemispheres of the brain to the polymorphism and heterogeneity of pyramidal syndrome.

This study was conducted to address the clinical and neurophysiological features of pyramidal syndrome in patients with lateralized hemispheric lesions. A total of 52 patients were studied, all with hemiparesis following acute cerebrovascular accidents of the ischemic type in the right (24 patients) or left (28 patients) hemispheres of the brain. Clinical neurological analysis was performed, along with transcranial magnetic stimulation, evoked abdominal reflexes, movement-associated motor potentials, and somatosensory evoked potentials. Lesions of the right hemisphere resulted in significant weakening of activatory influences at both the hemisphere level and on descending motor structures, with marked impairment of the afferent flow from both sides of the body and excessive disorganization of activity in the left, "presumptively healthy," side. Left-sided pathology impaired efferent control not only of the contralateral, but also of the ipsilateral side of the body. These data identify different neuroanatomical and neurophysiological features of the cerebral hemispheres not only in healthy people, but also in pathological conditions, this probably accounting for the polymorphism and heterogeneity of pyramidal syndrome in patients with lateralized cerebral lesions.

[Contribution of right and left brain hemispheres to pyramidal syndrome polymorphism and heterogeneity]. / Vklad pravogo i levogo polusharii golovnogo mozga v polimorfizm i geterogennost' piramidnogo sindroma.

The study aimed at investigation of clinical and neurophysiologic peculiarities of pyramidal syndrome in lateralized hemispheric lesion. Fifty-two patients with hemi-paresis caused by acute ischemic attack in the right (24 patients) and left (28 patients) brain hemispheres have been studied, using clinico-neurological analysis, transcranial magnetic stimulation, evoked abdominal reflexes, movement-related method of motor potential and somatosensory evoked potentials. In right hemispheric lesion, significant reduction of activating influences both on hemispheric and descending movement structures, pronounced damage of afferent flow from both body sides and excessive disorganizing activity in the left "relatively healthy" hemisphere were observed. Left hemispheric pathological process disturbs efferent control not only in the counter lateral body side, but in the ipsilateral one as well. The results obtained allow to discuss different neuroanatomical and neurophysiologic peculiarities of brain hemispheres, both in normal and pathological cases, as a factor, possibly determining polymorphism and heterogeneity of pyramidal syndrome in lateralized cerebral lesion.

[Motor asymmetry and hemisphere interactions in Parkinson's disease]. / Motornaia asimmetriia i mezhpolusharnye vzaimootnosheniia pri bolezni Parkinsona.

About 90% of the people in general population are right-handed. Such right-side motor lateralization is presumed to be, at least partially, related to higher brain functions, especially to presentation of speech areas in the left hemisphere. Although lateralization may be predetermined genetically, the investigations into this problem have not yielded the equivocal results. Motor deficit asymmetry is a constant trait of Parkinson's disease (PD). It means that a study of PD patients gives a remarkable possibility for investigation into hemisphere interactions. Using motor potential method, 62 patients with predominantly akinetico-rigid lateralized PD type and relatively preserved social adaptation have been examined. The patients differed from tho controls by all MP components and reduction of hemisphere asymmetry: while using both right and left hands counterlateral hemisphere, as well as ipsilateral one, were insufficiently activated. This indicates pathological process diffusion in PD and hemisphere interaction dysfunction. Even in hemiparkinsonian stage of PD, a rather unusual pattern of hemisphere interaction is formed.

[Motor, cognitive and affective disorders in Parkinson's disease]. / Dvigatel'nye, kognitivnye i affektivnye rasstroistva pri bolezni Parkinsona.

The study aimed at investigating the ratio of movement disorders to cognitive and affective ones. The group of patients with Parkinson's disease (PD, n = 42) compared with those with brain tumors (n = 14), neurotic depression (n = 15) and normals (n = 20). Clinical, psychological and neurophysiologic (motor evoked potentials--MP) methods were used. Location of the pathological process, lesion side, severity of movement deficit and presence of cognitive and affective disorders (depression) were shown to influence an organization of movement act. Location of the pathological process determines a disturbance of preparing and realizing the targeted movements. The more pronounced MP changes were detected in right-side parkinsonism and frontal lobes brain tumors. Affective disorders have the least influence on MP. In PD, a clear association between motor disorders and changes of cognitive and affective functions was found.

[Gender dimorphism in Parkinson's disease]. / Polovoi dimorfizm pri bolezni Parkinsona.

The article addresses the gender differences in Parkinson's disease. Neurohumoral mechanisms of protective action of estrogen are discussed. An analysis of 159 patients with parkinsonism revealed definite differences in symptoms presentation and autonomic appearances in men and women that suggested a role of gender dimorphism in the development and course o Parkinson's disease.

[The role of clinical-electrophysiological indices in therapy for late-stage residual stroke by dynamic correction of proprioception]. / Rol' kliniko-élektrofiziologicheskikh pokazatelei v terapii pozdnei rezidual'noi stadii insul'ta metodom dinamicheskoi propriokorrektsii.

The new method dynamic proprioceptive correction using a medical loading costume was included into complex therapy in patients with late-stage residual stroke. Application of the costume promoted normalization of complex locomotor acts of walking by correcting proprioceptive pulsation resulted from the system of elastic draughts. Thus, a new motor stereotype was forced upon the patients. Clinical observation, computer analysis of the motor potential, spectrum of heart rhythm variabilities before and after therapy, and psychological testing were performed in 120 patients with motor disorders (pareses, paralyses) resulted from acute cerebral circulatory disorders. A steady-state clinical effect (p < 0.05) was found in 71.9% of the patients after 15 sessions of therapy. The patients became to walk independently, a possibility to self-attendance appeared, their speech became better. Lateralization of a damage and preservation of both the most significant homeostatic vasomotor mechanisms and the cerebral mechanisms of preparation of a movement with the minimal manifestations of emotional-affective disorders were shown to have impact on the patients' rehabilitation and on the early clinical features of pyramidal defect.

[Dynamic proprioceptive correction in the rehabilitation of patients with a late residual stage of stroke]. / Dinamicheskaia propriotseptivnaia korrektsiia v reabilitatsii patsientov s pozdnei rezidual'noi stadiei insul'ta.

Space gravity suit has been used for over 20 years in Russian space stations to prevent harmful consequences of being in zero gravity (osteoporosis, muscle atrophies, etc.). The space suit is designed in such a way that it enables to create a payload on muscles, temporarily out of function, which is adequate to the natural one. Stroke patients with motor defect of hemiparesis are quite limited in their movement. To develop walking and self-serving skills we conducted 2-hour sessions of treatment using space gravity suit. Neuro-physiological and psychological methods confirm the positive effect of treatment. The predictors of positive effect of treatment were also observed. Our experience has shown that the method is simple to use, very effective and can be applied in both clinics and home conditions.

[Efficiency of new forms of madopar in Parkinson's disease]. / Effektivnost' novykh form madopara pri bolezni Parkinsona.

The paper presents estimation of the efficiency of some new forms of madopar (madopar dispergative--Mad-Dis, Mad-HBS) in 26 patients with Parkinson's disease by methods of motor potential, autonomic tests. A good tolerance of Mad-HBS was found. Its administration neither causes changes of autonomic indices nor aggravates symptomatology of cardiovascular disease. A single dose of Mad-Dis may serve as a predictor for a positive result of DOPA-containing preparations in a certain group of patients with Parkinson's disease.

[Dreams in organic brain pathology]. / Snovideniia pri tserebral'noi organicheskoi patologii.

To specify the role of the right and left hemisphere, structural and functional involvement of the brain in dreams genesis, the authors examined 56 patients with brain tumors verified at contrast angiography, CT and intraoperatively. Specialization of the hemispheres in awake and dreaming patients, involvement of both hemispheres in dream genesis are shown. Most important specific characteristics of psychic activity in dreaming are related to reduction of cerebral afferent connection with the outer environment and intracerebral functional rearrangement concerning interhemispheric relationships.