[Oxygen-dependent energy deficit as related to the problems of ontogenetic development disorders and human sociobiological adaptation (theoretical and applied aspects)].

The review states and argues theoretical propositions on the pathogenetic role of pre- and perinatal hypoxic-ischemic brain damage in the formation of sustained oxygen-dependent energy deficit underlying in further ontogenesis the following neurobiological abnormalities: a) a decline in the level of health and compensatory-adaptive capacities of the organism, b) disorders of the psycho-speech development and adaptive behavior in children, c) early development of neuropsychic diseases, g) addition of other types of brain energy metabolism (including glucose metabolism) disorders in chronic polyetiologic diseases young and middle-aged individuals. We highlight and theoretically substantiate the integrated physiological parameters of the oxygen-dependent energy deficit types. We address the features of abnormalities in neuroreflectory and neurohumora regulatory mechanisms of the wakefulness level and its vegetative and hemodynamic provision in different types of energy deficit in children with DSMD, ADHD and school maladjustment. The use of the state-of-the-art neuroimaging techniques significantly increased the possibility of the disintegration of regulatory processes and cognitive functions in children with psycho-speech delays and in a wide range of chronic polyetiologic diseases.

[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.

[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".

[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.

[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.

[Modern methods of functional tomographic brain imaging for brain function reseaching in norm and pathology].

For many years the modern methods of functional tomographic brain imaging (fMRI and PET) were actively used not only for the research of basic brain functions, but also in clinical practice. In present paper we described the basic characteristics of the signal registered with fMRI and PET, the principles of image reconstruction, as well as the methodological requirements, which are necessary to obtain reliable results. The advantages and limitations of modem tomographic methods of the brain functions investigation are discussed. The need of the complex approach use in brain study is emphasized and methods for the study of functional integration of the brain are suggested.

[fMRI study of deliberate deception].

The aim of the present research was to study the deliberate deception. Event related functional magnetic resonance (fMRI) imaging technique was used to assess the changes in functional brain activity by virtue of recording blood oxygen level dependant signal (BOLD-signal). 12 right-handed healthy volunteers aged 19-44 participated in the study. BOLD images were acquired in three different experimental trials. There were deliberate deception, manipulative honest and control truthful trials (catch trials). The main finding of the present study is that the deliberate deception and manipulative honest actions in comparison with instructed truthful responding was characterized by BOLD signal increase within the anterior cingulated cortex (ACC), frontal and parietal areas as well. Comparison of present fMRI data with results demonstrated in our previous research implemented with event related potentials technique points to the involvement of the brain mechanism of error detection to brain processing of deliberate deception.

[The brain mechanism of error detection: the P.E.T. study].

In present research, the brain maintenance of the error detection mechanism was studied in resting condition and while subjects consciously implemented incorrect actions (i.e. deception). Assessment of the regional cerebral blood flow revealed involvement of anterior cingulated cortex in deception. The obtained data indicate that it is impossible to consciously control the activity of the error detection mechanism. PET study of patients with obsessive compulsive disorder in resting condition revealed a decrease of brain glucose metabolism in the anterior cingulated cortex in comparison with healthy subjects. These data pointed to malfunctioning of the error detection mechanism. The findings support the formerly proposed hypothesis about the impact of the error detection mechanism in formation and support of obsessive compulsive disorder.

[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.

[Factor analysis of brain structure reorganization in patient with multiple sclerosis (based on pet data)].

The goal of present study was to investigate the functional reorganization of brain structures in patients with multiple sclerosis (MS). The patterns of distribution of relative estimations of local cerebral metabolic rate of glucose (ICMRglu) in regions of interest (ROIs), corresponding to anatomo-functional brain areas are obtained in groups of healthy volunteers (n=31 subjects) and patients with relapsing-remitting and progressive types of MS (n=59 and 39 accordingly). The analysis of factor structure of the obtained patterns allowed to make a conclusion about the existence of a common features with the factor structure of the distribution of another functional parameter--a regional cerebral blood flow (rCBF). This indicates that both factor solutions mainly reflect the functional organization of a brain. The differences revealed in factor structures of ICMRglu distribution in groups of patients with various types of MS and healthy volunteers allowed to assume that even at early stages of the disease despite the close anatomic and functional connectivity that normally exists between basal ganglia, MS patients have a functional dissociation of these structures. The bipolarity of revealed factors probably reflects the different directionality of the processes: relative decrease of functional activity in the areas which are directly responsible for performance of broken functions, caused by the deafferentation of the specified areas and its compensatory relative increase in functionally connected zones.

[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.

PET study of brain maintenance of verbal creative activity.

This paper deals with the investigation of the brain organization of verbal creativity. Psychological tasks were designed in accordance with two main strategies used by volunteers in solving creative tasks. Regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) when performing two types of creative tasks in two groups of subjects, each type of the task organizing the creativity process in its own way. Valuable brain correlates of creativity were revealed in the left parieto-temporal regions (Brodmann areas 39 and 40).

[Auditory and verbal agnosia in the left-handed patient: comparison of neuropsychological data, magnetic resonance and positron emission tomography]. / Slukhorechevaia agnoziia u levshi: sopostavlenie dannykh neiropsikhologicheskogo analiza, magnitno-resonansnoi i pozitronno- émissionnoi tomografii.

A case of the post-traumatic auditory-and-speech agnosia in a left-handed female patient is presented. The patient (a professional painter) showed satisfactory recovery in painting, speech production, reading and writing, whereas a severe deficit in auditory recognition of speech, melodies and rhythms persisted over time. She was also impaired in some aspects of visual recognition including prosopagnosia. To study this patient comprehensively, a neuropsychological assessment was combined with structural (magnetic resonance imaging-MRI) and metabolic (positron emission tomography--PET) data. Both PET and MRI revealed a large bilateral cortical damage in the medial basal cortex of the frontal, temporal and occipital lobes along with the anterior half of the lateral temporal cortex. In the left hemisphere the damaged area involved the whole temporal lobe, a large part of the occipital lobe and the opercular frontal and parietal regions. The relationship of the symptoms with the brain damage extension is discussed taking into account the left-handedness of the patient.

[Positron-emission tomography in intracranial hematomas]. / Pozitronno-émissionnaia tomografiia pri vnutricherepnykh gematomakh.

Positron emission tomography by using H2(15)O whose distribution in the brain reflects a genuine cerebral blood flow was made in 5 patients with suspected intracranial hematomas. It was shown that tunicary hematomas might be diagnosed by positron emission tomography. However, examination of cerebral blood flow was not optimal in this abnormality. Computerized tomography remains the basic method for diagnosing intracranial hematomas and positron emission tomography should be used to evaluate cerebral function.

[Positron-emission tomography in the diagnosis of brain damage in patients in the late period of craniocerebral trauma]. / Pozitronno-émissionnaia tomografiia v diagnostike povrezhdenii golovnogo mozga u bol'nykh v otdalennom periode cherepno-mozgovoi travmy.

PET data were compared with the results of computerized tomography (CT) and the neurological status of patients. The areas of decreased local cerebral blood flow (LCBF) and reduced local cerebral metabolic glucose rates exceeded those of brain injury shown by CT predominantly in patients with brain posttraumatic cysts. In a group of patients with posttraumatic atrophy documented by CT, PET demonstrated cortical and/or subcortical lesions in most cases, providing objective evidence for neurological symptoms. PET is a useful technique to demonstrate regional brain dysfunction in the presence of morphological integrity as assessed by CT.