[Dual-tasks is an indicator of cognitive deficit specificity in patients after traumatic brain injury]. / Dvoinye zadachi - indikator osobennostei kognitivnogo defitsita u patsientov posle cherepno-mozgovoi travmy.

AIM: To investigate the brain activity impairment in patients after traumatic brain injury (TBI) during dual-tasks in comparison with the normal ranges. MATERIAL AND METHODS: Electroencephalographic (EEG), stabilographic and clinical study was performed in 9 patients (mean age 25±1.2 years) for up to 3 months after a mild traumatic brain injury (TBI) in comparison with 18 healthy subjects (mean age 26.6±0.07 years). All participants of the study performed two motor tasks and two cognitive tasks that were carried out in isolation, and simultaneously (dual-tasks). RESULTS: Clinical examination revealed cognitive deficit in TBI patients with safety of postural control. The EEG data demonstrated a pronounced decrease in the coherence for slow rhythms in the left hemisphere and frontal areas during cognitive tasks performance. In healthy subjects, an increase in EEG coherence for slow spectral bands was observed in these brain areas. CONCLUSION: Dual-tasks are an informative method for estimation of predominant cognitive deficit after mild TBI and the use of this approach for rehabilitation contributes to positive clinical dynamics.

[FMRI study of visual task switching in healthy individuals].

The present study was aimed, first, at developing a visual switching task for fMRI research and, second, at identification of the brain regions involved in task switching. Forty eight healthy individuals (from 21 to 56 years of age) participated in the study. The designed visual switching task was relatively short, it consisted of an easy stimulus set and involved a simple condition, in which participants had to shift their attention between two task conditions (classifying figures according to their form or number). Thus, this developed testing procedure can further be used to assess special populations, including patients with brain damage who cannot do monotonous tasks for a long period of time and have language impairments. The results of this testing technique revealed that task switching is carried out by an interconnected neuronal network, consisting of dorsolateral prefrontal cortex, inferior parietal area, secondary visual area, supplementary motor area and cerebellum cortex of both hemispheres.

[The analysis of fMRT answer's individual variability at healthy examinees when opening eyes, motor and speech tests].

This paper analyzes the variation of the functional anatomy of the brain in healthy people performing identical activities on the basis of functional magneticresonance imaging (fMRI). According to the authors, this approach allows you to showcase a variety of individual strategies to achieve the same external (behavioral) result intracerebral different means, and to identify the factors that determine this diversity. Investigated hemodynamic (fMRT) brain reactions at activization of attention to opening of eyes, motor (search of the right and left hand fingers) and speech tests (mental transfer of months or days of the week upside-down) at 21 healthy subjects (21-30 years): 14 men, 7 women. Certain variety of fMRT answers is revealed: 3-4 jet types of hemodynamic changes were allocated for test in group, and the percent of supervision of each type fluctuated from 40 to 10%. Shown marked gender differences responses which specificity is determined by the nature of the functional load. In motor and speech tests, performed with his eyes closed, fMRI response in women is characterized by greater specificity and locality than in men. At motor tests fMRT answers of men are accompanied big, than at women, inclusion in reaction of frontal areas of the cortex, providing realization of regulatory functions. When opening of eyes the women's fMRT responses, on the contrary, become more diffusion, and men's--more local.

[Sex Differences in Visual Task Switching (an fMRI Study)].

Executive functions are an important ability of human brain to program, regulate and control various cognitive processes; one of these processes is the voluntary task switching. However, the sex differences in this process are poorly studied. In our study, these differences were investigated in 70 healthy subjects (36 men and 34 women) aged 21-48 years by means of functional magnetic resonance imaging (fMRI) and neuropsychological examination. During the fM RI study, the subjects had to shift their attention between two tasks (classifying figures according to their form or number). During neuropsychological examination, the subjects completed a series of visual attention, task switching and memory tests. The results of fMRI study showed that visual task switching in women is carried out by a neuronal network, consisting of dorsolateral prefrontal cortex, inferior parietal areas, secondary visual areas of both hemispheres and cerebellum cortex. Task switching in men involved the same areas and, in addition, right supplementary motor area, right insula and left thalamus. As compared with women, the rate of activation of prefrontal cortex, left parietal lobe and right insula in men was significantly higher. The results of neuropsychological tests showed that men completed the tasks with attention switching, searching and arranging of stimuli significantly slower than women. The data demonstrate the differences in the organization of task switching processes in men and women.

[Electroencephalograpic Parameters of Healthy Persons with Different Successfulness of Dual-Task Performance (Postural Control and Calculation)].

Complex electroencephalographic (EEG), stabilographic and psychological study was executed during the number dual tasks performance--postural control and calculation in 25 healthy volunteers (age 25 ± 0.7). Successful performances of dual tasks required a high usage of cognitive resources, such as memory and attention as well as good motor command and low level of anxiety. Two EEG-markers of successful dual tasks performance were revealed. An increase of EEG coherence for long diagonal pairs of leads between frontal and parieto-occipital areas was observed. Additionally a decrease of EEG coherence for short pairs of leads was revealed. The poor performance of dual tasks was accompanied by an increase of EEG coherence between local pairs of leads for different spectral bands.

[EEG markers of spontaneous recovery of vertical posture in patients with consequences of severe traumatic brain injury].

9 patients (mean age 23.6 +/- 3.15 y.o.) with severe traumatic brain injury (TBI) and impairment of vertical posture were included in complex clinical and EEG study during spontaneous recovery of vertical posture (VP). Patients were included in three different groups according to severity of deficit according to MPAI, FIM and MMSE scales. EEG data have been compared to those of 10 healthy volunteers (mean age 22.8 +/- 0.67 yo.). In patients with moderate brain impairment and fast recovery of VP (over 2 weeks) change of posture from sitting to standup has been accompanied by EEG-signs similar to those of healthy people. These included predominant increase of coherence in right hemisphere for majority of frequency bands, although in more complex conditions EEG of these patients showed pathological signs. In patients with more severe deficit spontaneous recovery of VP has been accompanied by "hyper-reactive" change of EEG for all frequency bands without local specificity. This finding didn't depend on side ofbrain impairment and could be considered as marker of positive dynamics of VP restoration. In patients with most severe brain impairment and deficit of functions VP didn't recover after 3 month of observation. EEG-investigation has revealed absence of reactive change of EEG during passive verticalisation. This finding can be used as marker of negative prognosis.

[EEG and fMRI reactions of a healthy brain at active and passive movements by a leading hand].

Bioelectrical (EEG) and hemodynamic (fMRI) responses of cerebral reactions to active and passive movements by the right hand were analyzed in 17 right-handed healthy persons. Individual and averaged fMRI and EEG data was analyzed. The main cortex fMRI responses (sensorimotor cortex of the contralateral, left hemisphere) were topographically similar during both active and passive movements. This fact allows us to recommend the usage of the passive movement paradigm for the mapping of the motor areas in patients with movement disorders. Including in reactive process of cerebellum and subcortical structures at passive movements was more variability than active ones. FMRI-reactions at passive movements were characterized more individual variability than during active ones at the expense of diversity of cerebellum and subcortical structures answers. The EEG analysis revealed that at both passive and active movements there is a coherence increase in the high-frequency alpha-ban in left central-frontal area of the left, activated hemisphere. The power-frequency changes of the EEG parameters during active and passive movements were primarily shown in a frequency increase and the desynchronization of the beta-band. Consistency with the topography of the fMRI response was not found.

[Complex pathogenetic treatment schemes of vascular dyscirculatory disorders in the remote period after exposure to low dose radiation].

Complex studies including modern methods of investigation of structures and functions of nervous system: electroencephalograsphy (EEG), coherent analysis, neuropsychological study and methods of neuroimaging were performed in 517 participants in liquidation of consequences of the accident (LCA) at the Chernobyl NPP in 1986-1987. Dyscirculatory metabolic encephalopathy was revealed to be the main pathology with the etiological mechanism based on dyscirculatorhypoxic and metabolic disorders. Complexity of the revealed symptoms testified to an early organism aging in remote periods after exposure to low dose radiation. Pathogenetic schemes were developed for treatment of dyscirculatory encephalopathy in liquidators, which include drugs improving blood supply, antiaggregants, antioxidants and metabolites of the brains in various combinations. Taking into consideration that early appearance of vascular dyscirculatory disorders observed in liquidators is the sign of early aging of the organism, geroprotectors were added to treatment schemes.

[Structural and functional peculiarity of brain activity to performance and imaginary motor tasks in healthy persons (EEG and fMRI study)].

Bioelectrical (EEG) and hemodynamic (fMRI-response) cerebral reactions to performance and imaginary motor tasks by right or left hand were analyzed in 15 right-handed healthy persons (21-39 years old). During actual movement the main fMRI-response was registered in the area of central gyrus of the hemisphere contralateral to the working hand. Areas of activation were also revealed in the supplemental motor area and the ipsilateral hemisphere of the cerebellum. EEG data showed coherence increase in high frequency alpha- and beta-bands in the activated hemisphere. In imaginary motor tasks the intensity and topography of fMRI-response became the more variable; response was decreased in the motor area and in cerebellum, they increased in the subcortical structures and in the parietal association zones. EEG changes were very variable in this situation also; it was observe an increase of EEG coherence in the right hemisphere for higher frequency of alpha and beta spectral bands. Changes of power spectrum parameters were similar to performance and imaginary motor tasks. Spectrum power and middle frequency of beta band were increased. Topographically these changes did not correspond to activated hemisphere and it was more in the left hemisphere. These changes were reflected nonspecific component of reaction.

[Psychological and stabilographic features in healthy persons performing dual tasks with different quality].

The results of performance of 40 healthy volunteers (29.8 ± 2.47 y.o.) in four dual tasks that included postural balance task as a motor sub-task and calculation as a cognitive sub-task were compared to results of individual psychological assessment which measured working and spatial memory capacity, speed of attention switch etc. Performance of participants in dual tasks was not uniform. For each of four tasks four types of performance were observed. Those included decrease of performance in both or one task and increase of performance in both tasks. In one of the four dual tasks 30% of the group of participants performed in both components of dual task better then in separate motor and cognitive tasks. Better performance in this dual task correlated with higher speed of attention switch, higher estimates of spatial and working memory. Analysis of results of psychological and stabilografic investigations showed negative correlation between speed of sway of center of pressure (CoP) and speed of attention switch test, and also between amplitude of CoP sway along frontal axis and capacity of spatial and working memory. These correlations reflect involvement of cognitive resources in voluntary postural control and motor automatism in successful dual task performance. Selected variant of dual task could be used as an instrument of selection of individuals for activities related to high informational loads.

[Features of dual--postural and calculation--task performance in patients with consequences of traumatic brain injury].

Dual tasks with voluntary postural control and calculation have been done by 14 patients (25.7 +/- 4.7 yo.) after traumatic brain injury and 40 healthy volunteers (29.8 +/- 2.5 y.o.). Complex clinical (MMSE, FIM, MPAI-3 and Berg scales) and stabilographic evaluation has been performed. According to clinical evaluation 8 patients were included into group 1 with less severe functional deficit and 6 patients formed group 2 with more severe deficit. Parameters of motor and especially cognitive sub-tasks in patients were lower than in healthy subjects in both separate and dual tasks. In group 2 these parameters were lower than in group 1. Certain types of dual task where the quality of sub-tasks, especially of the motor-one increased in healthy subjects and patients of the first group were revealed. The complex of stabilographic parameters which could be used for estimation of quality of sub-tasks performance has been revealed. Dual tasks could be an additional method of evaluation of patients' adaptive possibilities and certain type of dual task could become a promising approach to recovery at late period of rehabilitation.

[Higher mental functions and cognitive auditory event-related potentials impairment in liquidators of Chernobyl accident].

An integrated neuropsychological study and analysis of cognitive auditory event-related potentials (ERP) using the three-stimulus oddball paradigm was performed in ten subjects who participated in the liquidation of Chernobyl accident and ten healthy subjects. Impairment of higher mental functions, including aspontaneity, fatigability, a decrease in the auditory-verbal and visual memories, and higher motor function deficiency was shown in liquidators. A decrease of amplitude in all components of ERP (N1, N2 and P3) was found in liquidators for all stimuli in both experimental situations (audition of all stimuli and counting of deviant stimuli) compared to healthy subjects. The latent period (LP) of ERP in liquidators was decreased for N1 and N2 components and increased for P3. The largest between-group differences in the LP were revealed in the frontal areas for N1 and P3 in the left hemisphere and for N2 - in the right one. The correlation analysis between the ERP and a neuropsychological study had shown that changes in the LP of N1 are correlated to the impairment of short-term memory and pose praxis of the right hand while changes in the N2 were correlated to the impairment of long-term memory and pose praxis of the left hand. The changes in LP of P3 were correlated to complex cognitive processing disorders. Thus, the complex study identified the deceleration of perception, processing, and analysis of information combined with the weakened inhibition and "uneconomical" type of reactivity which led to the impairment of higher mental functions in liquidators compared to healthy subjects of the same age. The changes found in liquidators are similar to those observed in elderly people and support the hypotheses on accelerated brain ageing caused by low dose irradiation.

[Comparison of reactive EEG changes and fMRI characteristics of brain health based on multivariate statistics].

To gain a deeper insight into the relationship between the electrogenesis and oxygenation of the brain, fMRI and EEG reactions to identical functional loads (opening of the eyes and right- and left-hand fingering) were compared in 11 young right-handed healthy subjects with statistical techniques. Changes in power, frequency and coherent EEG parameters obtained by 18-channel monopolar recording were compared with values of + BOLD-fMRI response, calculated for 18 corresponding cortical areas on the basis of application of the "virtual cap" by the original algorithm. In reactive changes of both hemodynamic and bioelectrical parameters, sets of independent factors were identified, which were regarded on the basis of their topography as specific (localized in the cortical representation ofa relevant analyzer) and nonspecific (diffuse and similar under different functional loads). Specific component dominated in the fMRI response, whereas non-specific component was characteristic of the EEG reaction. The similar topography of reactive fMRI and EEG factors under normal conditions, confirmed by the correlation analysis, reflects the multilevel character of the systemic organization of the brain activity, visualized, in particular, in the sagittal projections of the individual fMRI images. Each of the reactive EEG factors included all of the EEG quantitative characteristics. EEG coherence, which dominated among other parameters (with a local increase in the cortical representation of a relevant analyzer and a diffuse decrease in the areas of the influence of the regulatory structures) displayed the highest correlation with hemodynamic responses of the brain.

[EEG-markers of vertical postural organization in healthy persons].

In 10 healthy persons (22.8 +/- 0.67 years) spectral-coherence parameters of EEG were analyzed in different steps of verticalizations--from gorizontal position to seat and stand one. Maximal changes of all EEG parameters were observed in state with absence of visual control. We observed an increase of power for fast spectral bands of EEG (beta- and gamma-bands) in all conditions and additional increase of these EEG parameters was observed at situation of complication of conditions of vertical pose supporting. Results of EEG coherent analysis in conditions of human verticalization showed specific increase of coherence for the majority of rhythm ranges in the right hemisphere especially in the central-frontal and in occipital-parietal areas and for interhemispheric pairs for these leads. This fact can reflect participation of cortical as well as subcortical structures in these processes. In conditions of complicate conditions of vertical pose supporting the additional increase of EEG coherence in fast bands (beta-rhythm) was observed at the frontal areas. This fact can testify about increasing of executive functions in this conditions.

[Integrating role of voluntary postural control recovery during rehabilitation of patients with traumatic brain injury].

Results of complex clinical, stabilographic and electroencephalographic (EEG) examination of 20 patients (28 +/- 6.9 years) suffered a severe traumatic brain injury (STBI) are presented. The examination was carried out in early terms after the STBI before and after a course of stabilographic training (ST) with a visual feedback as compared to a group of 18 healthy volunteers (26 +/- 5.8 years). The 4- to 6-week course of ST consisted of 8-15 sessions. Before the course, the patients experienced problems in different kinds of activity, maximum in the motor sphere. The EEG study revealed a decrease in the power and coherence of the alpha rhythm and an increase in the power of the slow spectral bands (delta). The ST restored not only the postural control of patients, but also reduced the defects in other spheres. The EEG study showed an increase in the alpha-rhythm power maximum in the occipital-parietal areas and a tendency to normalization of its regional specificity. In all examined patients, the interhemispheric coherence increased for different EEG-rhythms, especially of the alpha-band, in the central and parietal brain areas. The described EEG changes can be a marker of the integrating role of postural control and an important stage in restoration of integrative brain activity in early terms after the STBI accompanied by improvement of damaged functions.

[Peculiarities of changes of EEG reactivity during performance of dual tasks in healthy subjects (voluntary postural control and calculation)].

Complex EEG and stabilography investigation with separate and simultaneous performance of motor (voluntary postural control) and cognitive (calculation) tasks has been performed in 20 healthy subjects (22 +/- 0.7 yo.). Specific spatial and frequency reactive changes have been revealed during motor task performance. These included increase of coherence in alpha-band for long pair of channels in right hemisphere as well as in symmetric parietal-occipital regions in both hemispheres. Cognitive task performance has been accompanied by coherence increase for low bands (delta- and theta-) with higher activation in left hemisphere and frontal regions. In dual tasks where both components were performed worse comparing to control, performance led to reactive spatial and frequency changes of both--motor and cognitive--tasks, though these changes were less than during separate task performance. Decrease of coherence in alphal-band in frontal areas appeared as a zone of "conflict of interest - interferention". In dual tasks with better performance of each component comparing to control EEG coherence increased in each specific area as well as in areas of "conflict of interest".

[FMRI-EEG estimation of cerebral reactivity to motor tasks in patients with brain tumors].

fMRI (1.5 or 3 T) and EEG studies with estimation of reactive responses on motor task (by right or left hand) were performed in 9 patients with tumors localized in frontal lobe of the brain. Results of this investigation were compared with results of the similar study in 12 healthy persons. It was shown that in cases of the brain pathology disorders of functional specialization and increase of diffuse component of reactivity was observed, fMRI-responses had been characterized the more intact reactions than reactive changes of EEG parameters. This specificity was described in cases of afferent loads in damaged hemisphere. Peculiarity of including different spectral bands in forming of EEG responses on motor tasks and changes of fMRI-answer depend on degree of cerebral decompensation, reflected in the of baseline EEG reorganization and degree of motor defect. Predominantly an increase of EEG coherence in delta-band with the predominance of reaction in the damaged hemisphere in cases of addressing any afferent load was observed in patients with severe cerebral decompensation and reflect dominant character of pathological focus forming. This data indicate on the more including of the deep brain structures in process of reactivity in patients compared with healthy persons and confirmed by fMRI-data.

[Features of cognitive audiory evoked potentials changes at participants of liquidation of chernobyl accident consequences the message II. the analysis of late component P300].

At 10 participants of liquidation of consequences of Chernobyl accident (middle age 50.5 +/- 4.0 years) and at 10 healthy persons (middle age 47.0 +/- 6.0 years) are performed complex neuropsychological examination and registration acoustical cognitive evoked potentials (EP) using odd-ball paradigms. Neuropsyhological research has revealed at liquidators disorders of the higher mental functions, such as aspontanity, decrease speech and a visual memory, and also deficit of higher motor functions. According to the analysis of amplitude-time characteristics of component P300 acoustical cognitive EP a decrease in amplitude of this component at liquidators in all areas of the brain, for both experimental situations for all stimulus in comparison with healthy persons the same age was revealed. At the analysis of latent period (LP) P300 at liquidators the most distinct increase was revealed in a situation of passive listening for all kinds of stimulus. The analysis of reactivity of LP in different experimental situations has shown that at healthy persons during passive listening had similar values for all kinds of stimulus, and an account situation the maximum values--for significant stimulus. For liquidators the type of reaction in the form of increase in LP values at the majority of stimulus in both experimental situations. The analysis of regional LP changes of component P300 has found out the maximum distinctions between groups in frontal area of the left hemisphere. Along with it at liquidators the type the reactions similar for all shown stimulus without dependence from their importance in comparison with norm is revealed "uneconomical, superfluous". It can testify about decreasing of attention and memory reserves and to promote disorder of the higher mental functions. The described of amplitude-time characteristics of component P300 of acoustical EP at liquidators EP can testify to delay of perception, processing and the information analysis in a combination to easing of inhibitory processes leading to the higher mental dysfunctions. The obtained data have similarity to people of old age, supporting a hypothesis about the accelerated ageing of a brain, and also about pathological development of processes of ageing as a result of influence of low doses of radiation.

[Specificity of auditory evoked potencials changes in participants of Chernobyl accident consequences: I. Analysis of early N1 component].

Amplitude-time characteristics analysis of the N1 component of auditory cognitive evoked potentials (EP) was made in 10 persons who had participated in the cleanup of the Chenobyl Accident - liquidators (mean age 50.5 +/- 4.0 years old) and in 10 healthy subjects (mean age 47 +/- 6.0 years old). Comparison of amplitude features of the N1 auditory EP component in liquidators of the Chernobyl Accident found a decrease in all areas of the cortex with the maximum decrease in the central and frontal leads, and also an inversion in reactive changes to stimuli of different significance in comparison to healthy subjects of the same age. The most distinct differences between the healthy subjects and liquidators of the Chernobyl Accident were found for time characteristics of the N1 component. They show a significantly smaller value of latent period (LP) for all stimuli and for all experimental tasks in comparison with healthy subjects and more distinct for a significant stimulus when persons counted these stimuli. Analysis of regional changes in LP of the N1 component found that liquidators, in comparison with healthy subjects, have maximal differences in the frontal area of the left hemisphere which were accompanied with inversion asymmetry of LP in this component. Less distinct changes were observed in the central area with relatively little damage in the parietal area. Detected changes in the amplitude-time characteristics of the N1 component of the auditory cognitive EP in liquidators of Chernobyl Accident can show an abnormality in primary attention and its reserves due to weakened inhibitory processes in comparison with healthy subjects, which has similarities of old age. The obtained data supports the hypothesis about the accelerated brain aging in liquidators of Chernobyl Accident as a result of low dosage radiation effects; however, it also allows the pathological development of the brain ageing due to the effects of radiation.

[The use of stabilo-training with feedback in the rehabilitation of patients with posttraumatic Korsakov's syndrome].

The complex research, including clinical scales (FIM, Mayo-Portland) and data on stabilography and electroencephalography (EEG) studies, was conducted in 10 patients with posttraumatic Korsakov's syndrome (KS) before and after the rehabilitation course using stabilo-training (ST) with feedback (7-12 sessions). A control group consisted of 18 healthy people. In patients with KS, more severe cognitive (memory) disorders were noted before ST that was correlated with the maximal reduction of coherence in all frequency bands in frontal and parietal-occipital areas as well as in the long diagonal pairs between the left frontal and the right parietal-occipital areas which was most distinct for the alpha-band. A trend to the normalization of stabilography parameters and step-by step increasing of EEG coherence parameters, especially the alpha-band, was found after the rehabilitation ST course, which was accompanied with the KS regress. It increased initially in parietal-occipital-central areas of the right hemisphere with the following increase in central-frontal areas and then in frontal areas, mostly in the left hemisphere, that was in compliance with the tendency to the normalization of spatial-temporary EEG organization.