CLINICAL AND NEUROPHYSIOLOGICAL PARALLELS OF THE BRACHIAL PLEXOPATHY IN THE STRUCTURE OF NEUROGENIC THORACIC OUTLET SYNDROME.

OBJECTIVE: The aim: Was assessment of the neurophysiological data and features of clinical picture in patients with neurogenic thoracic outlet syndrome (TOS). PATIENTS AND METHODS: Materials and methods: 103 patients with upper extremity pain and/or paresthesia or hypotrophy, or a combination of these symptoms were examined. The examination algorithm included: cervical spine radiography, cervical spine and brachial plexuses magnetic resonance imaging (MRI), upper extremity soft tissues and vessels ultrasonic examination, stimulation electroneuromiography with F-waves registration. RESULTS: Results: Neurogenic TOS was diagnosed in 29 patients. A significant relationship between the following complaints and neurophysiological parameters was observed: pain, numbness during physical activity and decreased medial anrebrachial cutaneous nerve response amplitude by ≥25% compared to the contralateral side; hypothenar hypotrophy and decrease of ulnar nerve motor/sensory response amplitude; the 4-5th fingers hypoesthesia and decrease of ulnar nerve sensory response amplitude. CONCLUSION: Conclusions: Medial antebrachial cutaneous nerve amplitudes asymmetry indices of ≥25% or lack of response may be considered to be a marker of true neurogenic TOS.

ASSOCIATIONS BETWEEN THE UPPER EXTREMITY FUNCTION AND COGNITION IN POST-STROKE PATIENTS.

OBJECTIVE: The aim: Was to determine the relations between the the upper extremity function and cognition in post-stroke patients. PATIENTS AND METHODS: Materials and methods: Totally there were 86 patients examined in the 1-year period after first-ever anterior circulation ischemic stroke. Examination of the upper extremity function was performed with the Fugl-Meyer assessment (FMA). Cognitive function was assessed with the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail-making Test A and B (TMT) and the Clock Drawing Test (CDT). RESULTS: Results: Motor dysfunction mostly manifested in low "Wrist" and "Hand" subtests scores (5 and 7 , respectively) and therefore resulted in decreased "Total motor function" score of 40 . The most significant relations were found out between the FMA "Hand", "Total motor function" subtests and CI indices. MoCA score correlated with FMA "Wrist" (r=0.34; p=0.021), "Hand" (r=0.52; p=0.001) and "Total motor function" (r=0.48; p=0.003) scores. "Hand" score also correlated with the FAB (r=0.43; p=0.012), CDT (r=0.22; p=0.016), TMT-A (r=-0.31; p=0.023) and TMT-B (-0.48; p=0.009) scores. There was no significant correlation between the sensory FMA subtests. CONCLUSION: Conclusion: Our findings suggest that upper extremity motor impairment, especially hand and wrist dysfunction, are associated with cognitive impairment and executive functions disorder in particular.