A study was made of the magnetic resonance imaging (MRI) data on 7 patients with primary neuroepithelial tumors located in the peripheral parts of the hemispheres and 9 patients with convex meningiomas. Tumors were verified by histological examinations in all the cases. MRI was performed on an apparatus Magnaview (Instrumentarium Company, Finland) in different impulse sequences and planes. The images were estimated quantitatively according to the tumor-to-white matter ratio and signal-to-noise ratio. It has been shown that the use of the complex of the macromorphological signs combined with the parameters under consideration enables one to differentiate between neuroepithelial tumors and meningiomas of the brain practically with-out error.
Multiple sclerosis (MS) is a multifactorial and polygenic disorder of the central nervous system, its development being under strong influence of T-helpers type I which produce anti-inflammation cytokines. Interleukin 12 (IL12) plays a key role in such polarization of the immune response. Genotyping for polymorphism of the IL12B gene in the 3'-untranslated region, coding for the p40(IL12B) subunit, has been carried out in 62 patients with MS and 129 healthy controls. The C/C genotype frequency was twice higher in patients as compared to the controls (33.9% and 17.4%, respectively). The allele C in patients was associated with shorter duration of the first remission (p = 0.028) which was 1.79 +/- 0.28 in those with the C allele and 3.27 +/- 0.68 in other patients. Mean rate of relapses per year was also higher (p = 0.079) in patients with the C allele (0.96 +/- 0.11) comparing with the A allele (0.72 +/- 0.11). During the treatment with copaxone, a trend towards increasing of the time before the first relapse was observed in patients with the C allele. An analysis of immunologic indices revealed that they changed in opposite directions depending on the gene variant. The C-allele is suggested to have relation both to liability to MS and to its pathogenesis.
By histological method cerebral development was studied in 3 fetus obtained after 14, 14 and 15 weeks to gestation in the mothers abusing alcohol. The excessive plication, invagination and adhesions of the brain wall, porencephalia, abnormal hyperplasia and heterotopia of cells, as well as agenesis of plexus choroideus were detected. These finding were compared with the disturbances in 5- to 12-week-old embryos which had been earlier discovered by authors. It was noted their resemblance, which means the stability of the structural brain changes during ontogenesis.
A-1438-G 5-HTR2A gene polymorphism is known to be related to some clinical presentations of endogenous psychoses, in particular, of schizophrenia. The present study aim was to study association between clinical appearances of schizophrenia and A-1438-G allelic polymorphism. Alleles (A and G) and genotypes (AA, AG and GG) distribution did not significantly differ between patients and control groups. No association has been found between the genotypes and clinical characteristics of the patients, such as age at disease onset, age at psychosis manifestation, as well as positive, negative and general psychopathological symptoms severity measured by PANSS.
The SpI (1546G>T) polymorphism of the CollA1 gene and the FokI (3663T>C) polymorphism of the vitamin D receptor gene have been studied in patients with syringomyelia and controls of different ethnic origin (Tartars, Bashkirs, Russians). Ethnic differences in allele and genotype frequencies have been revealed in the control group. Frequency of the s allele of the CollA1 gene was higher in Russian patients and that of the FokI FF genotype in Tartar patients. The data obtained suggest a possible role of these genes in the pathogenesis of syringomyelia.
The results of investigation of the area 17 of visual cortex of human brain in left and right hemispheres are described in this article. The main features of the structural organization of area 17 concerning the total neurones area, neuroglial index as well as the number of big, middle and small neurons in right hemispheres are detailed.
Malignant migrating partial seizures in infancy (MMPSI) or Coppola-Dulac syndrome is a rare epilepsy syndrome with the onset in the first 6 months of life, characterized by multiple continuous electroencephalographic and electroclinical focal ictal patterns due to the involvement of different independent areas of both hemispheres with the arrest of psychomotor development. This article is based on the personal observations of 19 cases. Four subtypes of the syndrome were determined in our population of infants with MMPSI (n=19): 1) a "classic" form with pharmacoresistant migrated status epilepticus (SE) of migrating multifocal seizures, and with absolutely poor prognosis (n=7); 2) a severe pharmacoresistant mixed form (MMPSI + EME) with the combination of electroclinical characteristics of MMPSI with migrating multifocal SE and early myoclonic encephalopathy (n=5); 3) a "mild" variant (n=5); 4) a "subtle" form (n=2). In basic therapy, drugs of choice are antiepileptic drugs (AEDs) with a wide range of action (valproates, in the combination with barbiturates, benzodiazepines and levetiracetam) and also very old drugs as bromides. The preferred drugs are the valproate forms available for patients with disturbances of swallowing (depakine chronosphere or depakine syrup).
The statistics on incidence of alcoholism and alcoholic psychosis, number of patients admitted to hospitals for alcoholism and alcoholic psychosis as well as a level of alcoholic beverage consumption per capita in Belarus from 1970 to 1999 were analysed. Using correlation, factor and cluster analyses, a strong positive correlation was found between the incidence of alcoholic psychoses and level of vodka consumption per capita. The incidence of alcoholism correlates positively with a total level of alcohol consumption. The results obtained suggest that incidence of alcoholic psychosis and number of patients hospitalized for alcoholic psychoses to be a reliable indicator of alcohol-related problems in the society.
Based on the results of the epidemiological study, we estimated the prevalence and incidence of mental disorders in children and adolescents who lived in urban and rural areas in 1991-2012. These indices were higher compared to those for the adult population for the same period. High rates of the incidence for mental disorders and the prevalence of different levels of mental retardation and organic mental disorders were found in rural areas. The authors warn that the current situation demands the revision of approaches to the medical care in these groups of patients. A complex of organizational measures will need the adequate funding of territory programs warranting free medical care and grants for clinical examination, treatment and prevention of mental disorders in children and adolescents.
Based on system, correlation and regression analyses of official medical and social/economic information over 1992-2008, we developed epidemiological models linking parameters of morbidity and incidence of mental disorders in the Russia Federation with main medical-demographic and social-economic factors. These models may be used for optimal planning of medical/social programs in the field of mental health protection, its operative monitoring and optimal planning of the structure and activity of the Russian system for psychiatric aid.
At the population level, the quantitative assessment of the impact of social-economic and medical-demographic factors on the dynamics of main mental health indicators (prevalence, incidence, level of suicide, disability) in the population of the Russian Federation in 1992-2010 years is presented. Regression models relating the key indicators of mental health with the health-demographic and social-economic factors have been developed. The interpretation of the dynamics of mental health in Russia according to the social changes and living conditions in the country during 1992-2010 years is suggested. Models have good predictive performance, which allows their use as a tool for real-time monitoring and planning of health and social services.
The aim of the study was to investigate the change of NAA/Cr ratio in the brain parenchyma in patients with MS with the help of protonic multivoxel magnetic resonance spectroscopy (PMMRS) and to detect the correlation between this factor and clinical status of the patients. The study was also performed in order to investigate whether this method can be potentially used for monitoring of the severity of the disease and severity of the neurodegenerative process. On the basis of this knowledge potential neuroprotective effect of the interferon beta 1a (IFN Β1а) i.m. (avonex) was investigated. Twenty six patients with relapsing-remitting multiple sclerosis (RRMS) were included in the study. The procedures included examination of the history of the disease, neurological examination, EDSS, neuropsychological tests, dynamic MRI with PMMRS. The decrease of the NAA/Cr ratio in patients with RRMS compared to healthy controls was detected. The dynamic control in a year revealed the decrease NAA/Cr in patients with MS. Negative association was revealed between NAA/Cr in the brain and the level of neurological and cognitive deficit. The analysis of the 1 year therapy with IFN Β1а i.m. revealed neuroprotective effect which can be related to the possible positive effect of the drug on the neurodegenaration process.
The experience of the treatment of patients with remitting multiple sclerosis (MS) with intramuscular introduction of beta-interferon-1a (avonex) is presented. Seventeen children and adolescents, aged from 11 to 18 years, and 55 adults, aged over 55 years, were treated for at least one-year period. Results revealed a significant reduction of exacerbations in both groups (from 1.35 to 0.06 in average in adolescents and from 0.86 to 0.17 in adults). The changes were accompanied by the stabilization of MS severity index: EDSS scores have decreased in 23.6% of adults and in 17.6% of adolescents. In both groups, good tolerability of the treatment was noted. There was a low probability of side-effects with the exception of increased frequency of a flu-like syndrome (47% cases) in patients younger than 18 years that demands special attention from children neurologists. The high efficacy and good tolerability and safety profile of beta-interferon-1a give grounds for administering this drug to children and adolescents with MS.
To evaluate clinical perspectives of proton multi-voxel magnetic-resonance spectroscopy (PMMRS) for monitoring the severity of multiple sclerosis (MS) and neurodegenerative process, we studied the changes of the NAA/Cr ratio in the brain tissue of patients with MS and calculated the correlations between this parameter and the clinical state of patients. Based on these results, we studied the potential neuroprotective effect of Β-interferon 1a (avonex) for intramuscular injection in patients with remitting MS. Twenty-six patients with remitting MS were enrolled in the study. The study of anamnesis, neurological examination using EDSS, neuropsychological testing and dynamic MRI using PMMRS were performed. The NAA/Cr ratio was decreased in patients compared to controls. An analysis of the NAA/Cr ratio after one year revealed the significant decrease of this parameter. The negative correlation between the NAA/Cr ratio in the brain tissue and the level of neurological and cognitive deficits was noted. The analysis of existing treatment of MS with Β-interferon 1a for intramuscular injection revealed the neuroprotective stabilizing effect during one year of treatment that is probably associated with the effect of this drug on the neurodegenerative process in MS.
We summarized the 1-year experience of using the Russian Β-interferon-1b biosimilar (infibeta) in 123 patients including 65 patients with relapsing-remitting multiple sclerosis (RMS) and 58 patients with secondary progressive multiple sclerosis (SPMS). The significant decrease in the frequency of exacerbations per year was seen during the first year of treatment. We also noted the stabilization of the process of disability without the rise in EDSS scores in more than 50% of patients. Good tolerability comparable to that of the original drug was observed during the first year of treatment. There was no refusal from therapy with infibeta, which indicated sufficiently strong adherence to this type of treatment.
The use of beta-interferons for immunomodulating treatment of multiple sclerosis (MS) in children is rstudied. We present results of the prospective study of 22 children, aged 13-17 years, with MS treated with beta-interferon-1b (betaferon) during 2-15 (mean 10,72) months. High efficacy and good tolerability of beta-interferon-1b is demonstrated.
Results of annual comparative clinical research of the Russian biosimilar of beta-IFN - 1в at 122 patients with multiple sclerosis are presented. There were positive dynamics on EDSS scores in both groups (in the main group and group of control) in a year of treatment. There were positive dynamics in frequency of relapses in the main group (with 1.5 to 0.4 in a year) and in group of control (with 1.4 to 0.37 in a year). Positive dynamics according to MRI was also fixed in both groups. In both groups, good tolerability of the treatment was noted. This research didn't reveal essential distinctions on efficiency and safety parameters in both groups.
Recently, beta-interferons have become the first line medicine of pathogenic treatment of multiple sclerosis (MS). 75 MS patients from Moscow received the treatment with beta-interferon-1b (betaferon). Clinical, genetic and MRI data on 48 of them were included in detailed statistical analyses. High basic frequency of relapses, absence of atrophy of the brain at the first MRI scans and the presence of HLA-DRB1*15 (less significant DRB1*0301 and DRB1*04) were associated with better clinical effects of one year Betaferon course--decrease of relapses frequency and delay in EDSS progression.