[A comparative study of the efficacy of deep brain stimulation of the subthalamic nucleus and pharmacological treatment in advanced Parkinson's disease]. / Sravnitel'noe issledovanie éffektivnosti neirokhirurgicheskogo lecheniia (élektrostimuliatsiia subtalamicheskogo iadra) i medikamentoznoi terapii na razvernutoi stadii bolezni Parkinsona.

Objective. To assess the clinical efficacy of deep brain stimulation (DBS STN) of the subthalamic nucleus in patients with Parkinson´s disease (PD) compared to pharmacological treatment. Material and methods. DBS STN was applied to 22 patients (mean age 53.2 years, mean disease duration 9,6 years). The control group included 28 patients (mean age 54.2 years, mean disease duration 9,6 years) with PD who received pharmacological treatment. Patients were examined in OFF-medication and ON-medication conditions at 3, 6, 9, 12, 24, 36 months. The Unified Parkinson's Disease Rating Scale (UPDRS) part II, III, IV, the Hoehn and Yahr scale, the Schwab and England Scale, PDQ-39, the Hamilton Rating Scale for depression and the Spielberger Anxiety Scale were administered. All patients had motor fluctuations and dyskinesias. Results and conclusion. We demonstrated that DBS STN improved UPDRS II, III scores, reduced dyskinesias and motor fluctuations. After surgery, dopaminergic therapy was reduced by approximately 54.5%. In the control group, levodopa dose was increased by 20.5% to 36th month.

[Cognitive functions in patients with primary torsion dystonia treated with pallidal deep brain stimulation].

Forty-three patients with primary dystonia underwent neuropsychological assessment according to the method of A.R. Luria. Twenty-three patients with generalized dystonia and 20 with local forms (cervical and craniocervical) were included in the study. All patients were evaluated before pallidal deep brain stimulation (DBS GPi), 32 patients were examined 3-6 days after surgery, and 26 patients - during the first two years of the postoperative follow-up. The evaluation before surgery revealed cognitive impairment in 41 patients. The most common were mnemonic impairment, inertness and preservation in different tests, and spatial function decline. Thus, patients with local forms more frequently had troubles with performance memory tests, whereas spatial function disorders were more common in patients with generalized forms. The deterioration of cognitive functions was observed in 28 patients in the early postoperative period. Moreover, the group of patients with local forms had poorer results. The neuropsychological evaluation after 3-6 months of the postoperative follow-up showed the restoration of cognitive functions to the preoperative level. Neuropsychological syndrome observed in patients with dystonia was generally similar to that found in patients with lesions of the frontal lobe, the caudate nucleus, and the cerebellum.

[Camptocormia in patients with Parkinson's disease].

Parkinson's disease (PD) is the most frequent among a broad spectrum of neurologic etiologies of саmptocormia. Camptocormia (CC) is characterized by an abnormal posture with involuntary forward flexion of the trunk, which appears in erect position, increases during prolonged standing or walking, and abates in supine position. CC leads to malposition, increasing postural instability and risk of falling. Treatment of CC in PD includes adjustment of antiparkinsonian medication, injections of botulinum toxin and orthopedical interventions. In this study, CC occurred in sitting position in 62.9% patients and in vertical position in 30% patients, however it disappeared in all patients in a dorsal position. CC was observed throughout the day in 77.1% patients. In 78.6% of PD patients with CC, the pose changed and encouraged with the various factors including weariness and stress; 37.1% patients used a walking stick; 5.7% used a walking aid. CC was accompanied with the painful syndrome in the majority of patients (88.6%). Moreover, 66% of patients had a history of vertebrogenic disorders. The association between CC and the start of dopaminergic treatment was found in 25.7% of patients.

[Speech disorders in right-sided brain stroke].

The clinical picture revealed that right-sided brain stroke is often accompanied by some speech disturbances. The present paper aims at the analysis of literature devoted to speech disturbances in right-sided brain stroke. The paper addresses issues on lateralization of speech functions, in particular the role of the right hemisphere in speech activity and structure of speech pathology in right hemispheric foci are specified. Such clinical variants of speech disturbances as aphasia, disprosodia, dysartria, mutism and stammering are analyzed in depth. Types of speech disorders as well as possible mechanisms of their formation in dependence of the lesion localization on the brain axis (cortex, subcortical structures, stem, cerebellum) and size of brain lesion are reviewed.

[Method for determining dopamine and morphine binding sites in lymphocytes from human peripheral blood]. / Metod vyiavleniia uchastkov sviazyvaniia dofamina i morfina na limfotsitakh perifericheskoi krovi liudei.

A histochemical method was designed to detect the regions of binding the dopamine and morphine in human peripheral blood lymphocytes. It is based on incubating the suspension of lymphocytes and conjugated dopamine or morphine with bull serum albumin (BSA) marked by horse-radish peroxidase. After incubation, smears are prepared from the lymphocyte suspension, which are stained by diaminobenzidine in the presence of hydrogen peroxide for peroxidase. The light microscope with oil immersion is used to count the number of lymphocytes (from among 100 hundred of them), which contain the peroxidase granules. Smears from the lymphocyte suspension, which were incubated with the BSA-peroxidase conjugate, were controls. The binding of peroxidase-marked ligands of dopamine and mu-opioid receptors with lymphocytes was oppressed by the dose-dependant preliminary incubation with antagonists (haloperidol, naloxone), on the basis of which the presence of the ligand-receptor interaction can be suggested. The number of bindings of dopamine and morphine in lymphocytes was shown to be reliably higher in the alcoholic-intoxication state versus the healthy subjects without any signs of alcohol consumption. The designed method is simple enough in use and does not require any special equipment for the receptor detection in a moderate blood quantity.

[Neuronal and extraneuronal noradrenaline uptake and the state of the adrenoreactive structures of the isolated rat heart with compensatory myocardial hypertrophy]. / Neironal'nyi i ékstraneironal'nyi zakhvat noradrenalina i sostoianie adreno-reaktivnykh struktur izolirovannogo serdtsa krys s kompensatornoi gipertrofiei miokarda.

It was demonstrated on an isolated heart preparation that the intensity of neuronal noradrenaline uptake by a hypertrophied heart diminishes as compared to that by a control in 6 and 30 days after constriction of the abdominal aorta and that extraneuronal uptake tends to intensify in 6 days and decreases significantly in 30 days. These changes, together with the reduced adrenoreactivity of a hypertrophied heart in vitro may in 30 days contribute to weakening of the adrenergic control of the heart in its compensatory hypertrophy and hyperfunction under conditions of chronic overloading by pressure.