Annals of Clinical and Experimental Neurology

Specific mechanisms underlying the therapeutic effects of neurostimulation in Parkinson's disease remain a topic of discussion and intense study. Understanding these mechanisms can serve as the foundation for developing and selecting more effective parameters to relieve the symptoms of Parkinson's disease, maximize the advantages, and reduce the adverse effects and need for surgical intervention. The article discusses existing models of motor control in the basal ganglia in healthy individuals and in PD from the point of view of neuromodulation (changes in the impulse flow model, oscillatory model), as well as the current understanding of the mechanisms of action of deep brain stimulation (DBS): the block depolarization hypothesis, neural interference hypothesis, synaptic depression hypothesis, synaptic modulation hypothesis, and the DBS astrocytes hypothesis. Factors such as DBS location and neurostimulation parameters, affecting the clinical outcome, are considered in detail. The neuroprotective effect of DBS is also touched on.

Ekaterina V. Bril

Elena M. Belova

Aleksey S. Sedov

Anna A. Gamaleya

Anna A. Poddubskaya

Natalia V. Fedorova

Аleksey A. Tomskiy

Current understanding of neurostimulation for Parkinson's disease

帕金森病神经刺激的当前认识

Introduction. The differential diagnosis of vertebrobasilar stroke (VBS) and vestibular neuritis (VN) is important challenge for a neurologist when a patient presents to the emergency department with acute vertigo. Current approaches and algorithms of management need to be modified, taking into account clinical practice.&#x0D; The aim of the study was to identify the clinical features of acute vestibular syndrome that are the most helpful in the differential diagnosis of VBS and VN.&#x0D; Materials and methods. We examined 80 emergency admissions to the neurological ward with suspected stroke. A detailed otoneurological examination (including the STANDING and HINTS+ algorithms) and brain imaging (DWI MRI) were performed.&#x0D; Results. Out of 80 patients, 26 were diagnosed with VBS, 30 with VN, 11 with vestibular migraine and 2 with Meniere's disease, while the cause of vertigo could not be determined in 11 patients. The most powerful indicator of VBS in the differential diagnosis was gaze-evoked nystagmus, which had a 15.9-fold association with VBS. An increased likelihood of VBS was also associated with unsteadiness (6.3 times), age over 58 years (4.1 times), dysmetria in the finger-to-nose test (3.7 times), adiadochokinesia (3.1 times), and trunk ataxia (3 times). An increased likelihood of VN was associated with a positive unilateral head impulse test (6 times), nystagmus that followed Alexander's law (3.7 times), and presence of nausea (2.5 times). A model was developed for the differential diagnosis of VBS and VNin patients presenting with acute vertigo. The model accuracy was 100% in the validation sample.&#x0D; Conclusions. Clinical approach remains crucial when differentiating between VBS and VN. The most useful criteria for a differential diagnosis in emergency neurology were the patient's age, the type of nystagmus, head impulse test, and cerebellar dysfunction.

Anna A. Monak

Aleksey A. Kulesh

Vladimir A. Parfenov

Pavel A. Astanin

Differential diagnosis of stroke and vestibular neuritis in emergency neurology

急诊神经病学中卒中和前庭神经炎的鉴别诊断

The article describes two clinical cases of stroke in the artery of Percheron territory. The difficulty in recognizing the causes of ischaemic stroke in these patients was due to the polymorphism in the mental disorders and the rare "strategic infarct dementia", as well as impaired consciousness. We hereby present the clinical features of this condition, which can be used together with neuroimaging methods (including various MRI sequences) to ensure a timely and accurate diagnosis.&#x0D; The authors describe a clinical case to demonstrate their approach to the diagnosis and management of this patient group.

Vladislav A. Annushkin

Alexey A. Nikonov

Marina Yu. Maksimova

Оlga V. Lagoda

Marine M. Tanashyan

Clinical features of stroke in the artery of Percheron territory (case series)

Percheron动脉区域卒中的临床特征（病例系列）

Aim. To examine the cerebrovascular, neuroprotective and antiarrhythmic properties of fabomotizole (brand name Afobazole).&#x0D; Materials and methods. A comprehensive study of fabomotizole's effects on the blood supply, morphology and neuropsychology of the rat brain in various experimental disorders. We recorded cerebral blood flow and studied brain morphology in models of local permanent and global transient ischaemia, haemorrhagic brain damage, combined cerebrovascular and cardiovascular pathology, cardiac arrhythmias, and assessed the neuropsychological status. We measured the levels of GABA, glutamic acid, nerve growth factor, and heat shock protein (HSP70).&#x0D; Results. Fabomotizole improves blood supply, limits the area of injury, normalizes pathological brain changes in localized cerebral ischaemia, and eliminates neuropsychological damage in models of ischaemic and haemorrhagic stroke. The drug increases cerebral blood flow in ischaemic and haemorrhagic stroke, myocardial infarction and, to a greater extent, in combined cerebrovascular and coronary disease. Fabomotizole acts through the cerebrovascular GABAAergic system, as well as having significant antiarrhythmic properties.&#x0D; Conclusions. Fabomotizole should be considered not only as an anxiolytic, but also as a drug with potential clinical efficacy in cerebrovascular disease, with concomitant coronary disease and cardiac arrhythmias.

Ruben S. Mirzoyan

Marine G. Balasanyan

Hakop V. Topchyan

Vilen P. Hakobyan

Tamara S. Gan'shina

Nikita A. Khaylov

Il'ya N. Kurdyumov

Antonina I. Turilova

Тatyana A. Antipova

Valentina A. Kraineva

Sergey B. Seredenin

The cerebrovascular, neuroprotective and antiarrhythmic properties of the anxiolytic fabomotizole

抗焦虑药法莫替唑的脑血管、神经保护及抗心律失常特性

Introduction. Increased functional activity of the P-glycoprotein transporter (ABCB1) in the blood-brain barrier (BBB) is a possible reason why neuroprotective pharmacotherapy is ineffective after ischaemic stroke.&#x0D; Study aim to develop a way to inhibit the functional activity of ABCB1 at the BBB.&#x0D; Materials and methods. The study was performed on 60 male Wistar rats weighing 200-280 g. The functional activity of ABCB1 at the BBB was assessed by measuring the plasma and cortical levels of the marker transporter substrate fexofenadine (intravenous administration of 10 mg/kg). Thirty minutes before the administration of fexofenadine, 1 ml/kg of intravenous saline (n = 30) or 17.6 mg/kg of omeprazole, the transporter's systemic inhibitor (n = 30), was administered to the rats. The total amount of fexofenadine in the systemic circulation and the cerebral cortex was assessed using high performance liquid chromatography, by calculating the area under the blood concentrationtime curve (AUC0-t(plasma)) or the cerebral cortex concentration (AUC0-t(brain)). BBB permeability was calculated using the ratio AUC0-t(brain)/AUC0-t(plasma).&#x0D; Results. The administration of omeprazole before fexofenadine did not affect the plasma level of the latter at any time point under analysis. Fexofenadines AUC0-t(plasma) also did not differ between the series. However, the administration of omeprazole increased the cortical level of fexofenadine by 2.96 times (p = 0.009), 5 minutes after administration of the latter, and increased the AUC0-t(brain) by 1.49 times (p = 0.012). AUC0-t(brain)/AUC0-t(plasma) increased by 1.71 times when omeprazole was used (p = 0.003). Therefore, omeprazole inhibits the functional activity of ABCB1 at the BBB.&#x0D; Conclusions. We developed and tested a method for inhibiting ABCB1 activity at the BBB.

Ivan V. Chernykh

Alexey V. Shchulkin

Pavel Yu. Mylnikov

Ekaterina E. Kirichenko

Maria V. Gatsanoga

Elena N. Yakusheva

A method of inhibiting the ABCB1 protein in the blood-brain barrier &lt;i&gt;in vivo&lt;/i&gt;

一种抑制血脑屏障中ABCB1蛋白的在体方法

Magnetic resonance imaging (MRI) is the method of choice in diagnostics and differential diagnosis of spinal cord arterial infarction and venous insufficiency. However, imaging of vascular myelopathy is complicated by the lack of clear diagnostic criteria. Basic MRI sequences have low sensitivity at disease onset, and described MR patterns do not sufficiently increase imaging specificity for spinal cord ischemia, so imaging protocols are to be elaborated. Diffusion-weighted imaging is a key additional sequence that allows establishing the ischemic nature of myelopathy. Inclusion of spinal MR angiography in comprehensive MR examination allows visualization of aorta abnormalities, its large branches or spinal arteriovenous fistulas, so that they can be treated early. We presented an optimal MRI protocol for patients with suspected ischemic spinal stroke. Promising high-tech MR sequences for visualization of vascular myelopathies were reviewed.

Grigory V. Ponomarev

Andrey O. Agafonov

Nikolay L. Barilyak

Alexander V. Amelin

Alexander A. Skoromets

Magnetic Resonance Imaging Diagnostics of Vascular Myelopathies: from Basic Sequences to Promising Imaging Protocols

磁共振成像诊断血管性脊髓病：从基本序列到有前景的成像方案

Introduction. Dysfunction of the glymphatic system glymphatic system of the brain is considered a pathogenetic factor in some age-dependent neurodegenerative diseases, including Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson's disease (PD), and normal pressure hydrocephalus (NPH). The innovative method for calculating DTI-ALPS (Diffusion Tensor Image Analysis ALong the Perivascular Space) allows non-invasive assessment of the glymphatic system status using magnetic resonance imaging (MRI). The aim of the study is to compare DTI-ALPS in patients with AD, DLB, PD, and NPH and to evaluate its potential use as a biomarker of the glymphatic system status in these diseases. Materials and methods. The study included 116 subjects: 32 patients with AD, 15 patients with DLB, 31 patients with PD, 11 patients with NPH, and 27 healthy volunteers. Cognitive testing was performed for patients in the main groups using the Montreal Cognitive Assessment (MoCA) score. All subjects underwent diffusion tensor imaging (DTI) of the brain. DTI-ALPS was then calculated. Results. DTI-ALPS index significantly differed across groups (p 0.001). Patients with AD, DLB, and NPH had a significantly lower DTI-ALPS index on both sides compared to the PD group and healthy volunteers (p 0.01). Analysis of the entire sample showed a direct correlation between MoCA score and DTI-ALPS index (p 0.05). Conclusion. This is the first comparison of DTI-ALPS across such a broad range of age-dependent neurodegenerative diseases. Since our DTI-ALPS results were comparable to previously reported data, we believe that this parameter can be used as an indirect marker of the glymphatic system status.

Alina A. Liaskovik

Rodion N. Konovalov

Yulia A. Shpilyukova

Kseniya V. Nevzorova

Anna N. Moskalenko

Ekaterina Yu. Fedotova

Marina V. Krotenkova

Glymphatic System Assessment Using DTI-ALPS in Age-Dependent Neurodegenerative Diseases

年龄相关性神经退行性疾病中基于DTI-ALPS的淋巴系统评估

Introduction. Philadelphia-negative myeloproliferative neoplasms (MPNs) are a rare blood disorder characterized by pancytosis and thrombohemorrhagic complications. The aim of this article is to describe clinical and neuroimaging patterns of brain changes in patients with MPN. Materials and methods. The study included 152 patients with an established diagnosis of MPN (according to WHO criteria 2008, 2016). A clinical and neurological examination, laboratory tests, and magnetic resonance imaging of the brain were performed. Results. In patients with polycythemia vera and primary myelofibrosis, neuroimaging patterns are represented by small (up to 1.5 cm) post-infarction lesions in the brainstem, cerebellum, and cortex in adjacent perfusion territories after hemorheological microocclusive stroke. In patients with essential thrombocythemia, the neuroimaging pattern is more often represented by massive post-infarction changes in cortical-subcortical brain tissue with atherosclerotic lesions of the major head arteries, which appear to be atherothrombotic. Stroke preceded hematologic diagnosis in 30% of polycythemia vera cases, 40% of essential thrombocythemia cases, and 25% of primary myelofibrosis cases.

Мarine М. Tanashyan

Polina I. Kuznetsova

Anton A. Raskurazhev

Anait L. Melikyan

Irina N. Subortseva

Аlla A. Shabalina

Sofia N. Morozova

Clinical and Neuroimaging Patterns of Ischemic Stroke in Ph-negative Myeloproliferative Neoplasms

Ph阴性骨髓增殖性肿瘤的缺血性卒中临床及神经影像学特征

The ability to adequately perceive and recognize emotions is a key and universal tool in interpersonal communication, which allows people to understand feelings, intentions, and emotional reactions of themselves and others. Throughout their life, people have to make inferences about mental state of others by interpreting subtle social signals, such as facial expressions, to understand or predict others’ behavior, which is crucial in constructive social interactions. Therefore, emotional memory associated with the ability to identify emotions based on one’s life experience is the cornerstone of social cognition and interpersonal relationships. Oxytocin and vasopressin are neurohypophysial peptides that have attracted scientific attention due to their role in the emotional and social aspects of behavior. Variable and contrasting effects of oxytocin and vasopressin may be related to the sites of the brain where they exert their activity. Aim. This review aimed to evaluate neural mechanisms underlying oxytocin-mediated and vasopressin-mediated modulation of emotional memory; to assess how cerebral oxytocin-signal and vasopressin-signal transduction mediates emotional and social behavior; to discuss the role of the two neuropeptides in non-verbal interpersonal communication; and to present their cerebral effects in relation to an ability for “face reading” in patients with mental disorders.

Yana V. Gorina

Olga L. Lopatina

Larisa V. Mararitsa

Oxytocin and Vasopressin in Emotional Memory and “Face Reading”: a Neurobiological Approach and Clinical Aspects

催产素和加压素在情绪记忆和“面孔识别”中的作用：神经生物学方法与临床方面

Motor and non-motor symptoms of Parkinson’s disease (PD) and their management have been evaluated in numerous studies. Four classical symptoms, including bradykinesia, tremor, rigidity, and postural abnormalities, are used to establish a clinical diagnosis of PD. However, this research is aimed at exploring the range of non-motor symptoms with an emphasis upon their ability to affect the patients with PD and their quality of life. With a slow onset of the known symptoms like tremor or rhythmic shaking of limbs called “pill-rolling tremor”, slowed movement (bradykinesia), muscle rigidity, stooped and altered posture, loss of the ability to blink or smile, and various speech and writing changes; the disease takes a leap into the non-motor symptoms like dementia, drooling, swallowing issues, difficulty urinating, and constipation. The dopaminergic pathophysiology of PD explains the anxiety, slowness of thought, fatigue, and dysphoria. Knowing the non-motor symptoms is crucial to help the clinician to make early diagnosis and to better understand the prognosis of the spectrum of this disease.

Publication Information	Publisher: Research Center of Neurology，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2019，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%
Average review cycle	18 weeks

Annals of Clinical and Experimental Neurology

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