[EEG Beta and Gamma Powers When Comparing Certain Psychophysiological States with Normal and Weakened Electromyogram of Facial Muscles.]

The aim of the present study was to investigate EMG contamination on high-frequency scalp electroencephalogram (EEG) during comparisons of certain cognitive tasks performance. 19 healthy women who performed similar test tasks before and after cosmetic injections of Dysport in various face regions for reduction of facial muscles activity took part in the study. The test tasks were focused on induction of emotional states with different valences, on memory storing and extraction of verbal information. Default state of rest was uncluded too. During performance of the tasks, parallel registrations of EEG from a scalp surface(19 channels) and EMG from several facial muscles (6 channels) were carried out. Changes of spectral power in ß2 and low γ frequency ranges (18-40 Hz) in EEG- and EMG-derivations after Dysport injections were analyzed. Changes of spectral power in the same derivations during comparisons of the different test tasks were analyzed before and after Dysport injections separately. It was demonstrated that Dysport injections lead to reduction of EMG power in regions of injections and to reduction of EEG power in frontal and temporal derivations. However, the EEG-correlates revealed when comparing different test tasks remain qualitatively invariable both after, and before Disports injections. These facts confirmed that EMG makes a noticeable contribution to the electric activity registered from a scalp in the frequency ranges more than 18-Hz. At the same time, it was shown that in certain experimental situations influence of EMG not necessarily interferes with identification of EEG-correlates of mental activity during EEG registration from a head surface in ß2 and low γ frequency ranges.

[A clinical case of combined treatment of a patient with breast cancer and metastases to the brain and meninges].

The article describes a clinical case of successful chemotherapeutic and radiation treatment of a patient with breast cancer and metastases to the brain and meninges and with a pronounced neurological deficit. The patient underwent combined treatment (whole brain radiation with TBD of 30 Gy and local radiation of a metastasis with TBD of 15 Gy associated with capecitabine therapy) with continued administration of capecitabine until improvement. A partial metastasis reduction by 50% and complete regression of the neurological deficit were observed. Disease-free period was 1 year and 10 months, and the overall survival amounted to 2 years.

[The role of stereotactic radiotherapy in treatment of patients with metastatic lesion of lungs].

Since February 2012, in order to increase the effectiveness of treatment and quality of life of patients with disseminated disease, there was developed and implemented a method of stereotactic radiotherapy for metastatic lesion of lungs by tumors of different histological types. 20 patients were treated by stereotactic radiotherapy ROD 7 Gy in five sessions during 5 days. There were evaluated results of treatment and prospects of this method.

[Prognostic value of hemoglobin concentration in the course of chemoradiotherapy of patients with oropharyngeal squamous cell carcinoma].

There was performed a comparative analysis of the indicators of immediate and long-term results of chemoradiotherapy in 342 patients with squamous cell oropharyngeal carcinoma depending on hemoglobin level before and after treatment. In patients with normal level of hemoglobin a rate of response to treatment was almost two times higher than that of patients with anemia (75,3% vs. 23,5%) and complete regression of tumors was detected by more than three times often (65,4% vs. 17,6%). The overall five-year survival of patients with anemia was significantly worse than that of patients who had normal hemoglobin level (50,7% vs. 67,7%). Patients who had normal hemoglobin level at the time of discharge demonstrated a five-year overall survival of 75,7%, while those with a hemoglobin level below normal, but more than 80 g/l,--only 57,8%. Hemoglobin concentration was a significant prognostic factor for survival of patients with squamous cell carcinoma of the oral cavity and oropharynx. Low baseline of hemoglobin was also a negative prognostic factor for tumor response to treatment, especially to chemotherapy.

[Complex treatment of breast cancer patients with brain metastases].

Brain metastases in breast cancer develop for 24-32 months after the detection of the primary tumor. The study included patients with brain metastases who were divided into three groups: the first group--with early chemoradiotherapy (CRT) without induction chemotherapy (IC) by capecitabine; the second group--with delayed CRT with 4 or 8 courses of IC by capecitabine; the third group (a historical control) who received only whole brain radiation therapy. The median time to progression of intracranial metastases was 15.3, 12 and 5 months, respectively. The median time to the intracranial progression significantly less in the third group (5 months) compared with the first (15.3 months) (p = 0.0007) and the second (12 months) (p = 0.027) groups. The overall survival rate was 22.1, 15.1 and 6.8 months in three groups, respectively.

[The role of stereotactic radiotherapy in the treatment of patients with liver metastases].

Application of modern linear electron accelerators, equipped with precise navigation systems, maximum conformal dose delivery as well as imaging of irradiated focus significantly increased possibilities of escalating of doses of ionizing radiation in a selected volume with the necessary protection of the surrounding critical structures. These technological solutions and modern ideas about possibilities of remote beam radiation therapy resulted in a significant increase of the role of radiation therapy and, in particular, stereotactic radiotherapy in the treatment of patients with liver metastases. This technique allows creating locally in metastatic tumor site a high dose of ionizing radiation causing by that the destruction of the tumor. This promising direction in treatment of liver metastases significantly expanded possibilities of complex treatment and enabled us to provide specific assistance to those patients who have been rejected from other methods of treatment.

[Possibilities of stereotactic radiotherapy in the palliative treatment of patients with pancreatic cancer].

Morbidity and mortality from pancreatic cancer is steadily increasing. Resectable cases are not more than 20%. Conventional schemes of chemoradiation and radiation therapy are durable over the time, have toxicity and low treatment outcomes. Many foreign authors consider as promising the technique of stereotactic radiotherapy, which is often used in pancreatic cancer and permit achieving high local control. At our institution there has been developed and introduced into clinical practice a method of stereotactic radiotherapy for the palliative treatment of patients with pancreatic cancer, which improved not only the duration but also the quality of life of patients.

[Functional interactions between caudate nuclei and inferior frontal gyrus in deliberate deception processing].

The present paper dedicated to the research of the functional interactions between brain structures while executing deliberate deceptive actions. Based on our own and literature data, we formulated the hypothesis that the functional interaction between brain areas responsible for the executive control, localized in the prefrontal cortex (inferior frontal gyrus), and the elements of error detection brain system, underlies deception. To test this hypothesis, we applied an analysis of the psychophysiological interaction (PPI), which revealed that the false actions (in comparison with true honestones) associated with increased functional connectivity between the left caudate nucleus and the left inferior frontal gyrus. Obtained experimental data support our hypothesis that the interaction of neural brain systems, which are responsible for executive control and error detection, underpins the brain maintenance of the execution of deceptive actions.

[Event-related brain potentials when Russian verbs being conjugated: to the problem of language processing modularity].

In the light of alternative conceptions of "two-system" and "single-system" models of language processing the efforts have been undertaken to study brain mechanisnis for generation of regular and irregular forms of Russian verbs. The 19 EEG channels of evoked activity were registered along with casual alternations of speech morphology operations to be compared. Verbs of imperfective aspect in the form of an infinitive, belonging either to a group of productive verbs (default, conventionally regular class), or toan unproductive group of verbs (conventionally irregular class) were presented to healthy subjects. The subjects were requested to produce first person present time forms of these verbs. Results of analysis of event related potentials (ERP) for a group of 22 persons are presented. Statistically reliable ERP amplitude distinctions between the verb groups are found onlyin the latencies 600-850 ms in central and parietal zones of the cortex. In these latencies ERP values associated with a presentation of irregular verbs are negative in relation to ERP values associated with the presentation of regular verbs. The received results are interpreted as a consequence of various complexity of mental work with verbs of these different groups and presumably don't support a hypothesis of universality of the "two-system" brain mechanism for processing of the regular and irregular language forms.

[Factor structure of regional CBF and CMRglu values as a tool for the study of default mode of the brain].

In the present article it was shown that the functional connectivity of brain structures, revealed by factor analysis of resting PET CBF and rCMRglu data, is an adequate tool to study the default mode of the human brain. The identification of neuroanatomic systems of default mode (default mode network) during routine clinical PET investigations is important for further studying the functional organization of the normal brain and its reorganizations in pathological conditions.

[Polyfunctionality of neurons: blocking of the extreme pathological afferentation leads to an improvement of the higher functions of the brain (on the example of patients in a vegetative state)].

In this paper possible mechanism of improvement of the functional state of the brain areas, maintaining movement, visual, auditory, and higher functions of the brain during correction of generalized spastic syndrome (botulinotherapy with Xeomin) in patients in a vegetative state (VS) is discussed. If to consider the vegetative state as stable pathological condition (SPC) of the brain, then from the perspective of the theory of structural and functional organization of the brain with systems with rigid and flexible elements (N.P. Behtereva), the therapy led to an unbalance of SPC, "functional release" of neurons and redistribution of their functions to provide other activities, the formation of new interneuronal connections. Taking into account the functional variability of neurons (S.V. Medvedev), blocking neuromuscular transmission in spastic muscles leads to a reduction of abnormal afferent and efferent hyperactivity of motor and sensory neuronal circuits, which releases the brain for other activities. This allows to consider botulinotherapy of pharmacoresistant muscle spasticity in patients in VS and minimal consciousness, not only as a symptomatic treatment, but also as a "indirect neuroprotection".

[Pathology of the anterior cingulate cortex in obsessive compulsive disorder].

In the present article the features of the functional activity of the anterior cingulate cortex (ACC), a key element of neuroanatomical brain system of an error detection, in drug-resistant forms of obsessive-compulsive disorder (OCD) are discussed on a basis of both original and literature data. Available data indicate the presence of functional deficit in the ACC during OCD. This allows to suggest that functions of the ACC in OCD patient are partially redistributed between other brain areas. Thus in contrast to the previously accepted notion, the ACC as the target ofstereotactic surgery for OCD is pathologically altered brain region. Probably this is the reason why stereotactic destruction of ACC does not lead to significant changes in the patient's psyche. The essence of the pathological reorganisation of the functional activity of the brain in OCD remains unclear and requires further investigation.

[Mechanisms of cerebral damage in patients with HIV-infection].

Mechanisms of HIV transportation through blood-brain barrier, vascular plexus and interaction with cerebral cells having CD-4-receptors, CCR-5- and CXCR-4-coreceptors were studied. Cerebral damage developed through latent and acute periods also known as HIV-encephalopathy, HIV-associated neurocognitive dysfunction etc. Cerebral lesions are caused by a variety of chemical agents from pro-inflammatory cytokines to toxic HIV-proteins resulting in development of HIV-dementia through several years. Even early stage of this process revealed significant disturbances of glucose metabolism and evoked potentials EEG alterations which can serve as a marker of HIV-infection. Genetic differences of HIV in blood and spinal liquor with different drug resistance were revealed implying a new approach to therapy development.

Traditional Buddhist meditations reduce mismatch negativity in experienced monk- practitioners.

Thousand-year-old Buddhist traditions have developed a wide range of methods for the subjective exploration of consciousness through meditation. Combining their subjective research with the possibilities of modern neuroscience can help us better understand the physiological mechanisms of consciousness. Therefore, we have been guided by specifically Buddhist explanations when studying the physiological mechanisms of altered states of consciousness during Buddhist meditations. In Buddhism, meditations are generally divided into two large categories: (1) one-pointed concentration and (2) analytical meditation. Maintaining both one-pointed concentration and analytical meditation on 'bodhicitta' ("the thought of awakening") and 'emptiness' is a necessary condition for transitioning into tantric practices. Tantric practices involve sophisticated visualizations of Buddhist deities, the 'energy structure' of the human body, and the visualization of the stage-by-stage process of dying accompanied with the dissolution of body elements. According to Buddhism, these meditations are characterized by the gradual withdrawal from "gross levels" of consciousness associated with the five senses. From a psychophysiological perspective, this withdrawal of sensory consciousness can be considered as the decrease of sensory stimuli recognition and attentional disengagement from the external world. We concentrated on how considered meditations affect sensory and cognitive processing of external stimuli. Auditory event-related potentials (ERPs) in the passive oddball paradigm were studied both during meditations and in a controlled state of relaxed wakefulness. It was shown with a group of 115 Buddhist monks that during meditation, mismatch negativity amplitudes, amplitudes of N1 and P2 components of ERPs to deviant stimuli, and the amplitudes of the P3a component to novel stimuli all decrease. These outcomes suggest that the considered Buddhist meditations, compared to the control state of relaxed wakefulness, are accompanied by a decrease in physiological processes responsible for maintaining attention on the outside world and recognizing changes in the stream of sensory stimuli.

[Low-manifest infections with CNS damage in patients in prolonged unconscious state of non-inflammatory etiology].

AIM: Study of specter of low-manifest infections (LMI) with central nervous system (CNS) damage and their role in patients in prolonged unconscious state (PUS) of noninflammatory etiology. MATERIALS AND METHODS: 32 patients (23 male, 9 female; age 14-58) in PUS of various etiology were examined. The main group (18 patients) received therapy against all infectious diseases including LMI; control group (14 patients)--only against common and nosocomial microflora. Patients were immunologically, infectologically and neurologically examined in dynamic. The data obtained were treated by using STATISTICA for Windows (version 5.5). RESULTS: Significant differences in immune and infectologic status depending on the nature of primary CNS damage were not detected. Immunodeficiency was detected in all patients; 94% of patients had increased non-specific IgM and IgE. Among LMI agents Chlamydia spp. were predominant. Cultural and/or PCR methods detected this microorganism during the primary examination in cerebrospinal fluid samples in 56% patients and in blood samples in 56%; during the second diagnostics or autopsy--only in 13 and 25%, respectively. Detection of Bacteroides fragilis, Human Herpes Virus (HHV-6), Virus Epstein Barr (VEB), Cytomegalovirus (CMV) in cerebrospinal fluid, blood and on mucous membranes of nasopharynx and conjunctiva was grouped more frequently with the presence of Chlamydia spp. in the CNS (p < 0.05) than with other LMI agents. Sanation of CNS from LMI was significantly accompanied by regeneration of communicative activity in comparison with the control group. CONCLUSION: In patients with PUS high frequency of CNS infection by various LMI agents and primarily Chlamydia spp. should be considered. Sanation from LMI can become a "window" for effective neuro-regenerative treatment.

[Vegetative state (prolonged coma) as manifestation of stable pathological state].

Complex examination of 25 patients in vegetative state was performed before and after correction of secondary brain damage. Catamnesis over a period of at least 6 months was traced. Preliminary results showed that better recovery of consciousness and cognitive functions was observed if before treatment diffuse glucose hypometabolism was significantly more widespread than morphological changes. Minimal positive dynamics was detected in cases in which the reduction of glucose metabolism was minimal. This and other paradoxical results become explainable if to consider vegetative state as stable pathological state of the brain. This open new approaches to treatment of this group of patients.

[Effectiveness of treatment of single cerebral metastasis depending on prognostic groups (RPA RTOG)].

Our investigation was aimed at establishing a relationship between single metastases in the brain and a set of prognostic factors. It involved 278 patients treated at the Center in 1983-2003. The whole brain was irradiated in 273 while 159 of them (58.2%) received additional local irradiation of the brain. Single dosage of 2-2.5 Gy was administered to 158 (57.9%), 115--3Gy and more (42.1%). Mean total dosage was 36 Gy per metastasis for the whole brain and 46 Gy--for total plus local exposure. Among patients with favorable prognosis (RPA) were those aged up to 65, Karnofsky's index > or = 70%, with cured or controllable tumor and without extracranial metastases; poor prognosis--Karnofsky's index < or = 70%, irrespective of any other prognosticators, and intermediate prognosis--the remaining cases. The following four treatment modalities were used: 1) surgery --> radio- or radiochemotherapy (40); 2) chemotherapy > or = radiotherapy --> chemotherapy successively (56); (3) radiotherapy alone (110) and (4) simultaneous radiochemotherapy (72).

Error detection mechanisms of the brain: background and prospects.

Historical background of error detection (ED) studies is restored here from the first suggestion of such a mechanism published (Rabbit, 1966) and the first related anatomo-physiological correlates observed [Bechtereva, N.P., Gretchin, V.B., 1968. Physiological foundations of mental activity. Int. Rev. Neurobiol., vol. 11. Academic Press, N.Y., pp. 239-246; Bechtereva, N.P., 1971. Neurophysiological Aspects of Human Mental Activity. Meditzina, Moskow. 120 pp., (in Russian); Bechtereva, N.P., 1974. Neurophysiological Aspects of Human Mental Activity, second edition, revied and complete Meditzina, Moskow. 151 pp., (in Russian)]. Data from evoked potentials together with new opportunities offered by the technological revolution of the 1980s-1990s provided a large body of knowledge on the ED. The overwhelming majority of the papers stress the spatial relation of ED to Anterior Cingulate Cortex. ED was revealed in a number of other zones to whose role should be specially discussed. The other point of interest is the late appearance of ED after the brain signs of correction which seems particularly important considering the supposed functional role of ED. Data of direct observations of ECoG dynamics in left and right human ACC on correct and erroneous test performance are presented. Research on ED resulted in the development of new ways in treatment of the obsessive-compulsive syndrome. Further psychophysiological research into the ED phenomena is considered as one of the priorities of fundamental and applied investigations for the elucidation of human brain functions. Opinion that ED plays an extremely important role in mechanisms of cognition and creativity is further argumented. Investigations in the field can contribute a lot to clinical neurophysiology as well.