ABSTRACT
AIM: The objective of the present study was the evaluation and comparison of the effectiveness of the differential approaches to the neurorehabilitation of the somatosensory disturbances in the patients presenting with the spinal cord lesions. MATERIALS AND METHODS: A total of 68 patients with spinal cord lesions were enrolled in the study, including 38 suffering from vascular myelopathy, 18 with the consequences of extramedullar meningioma surgery, 12 with the sequelae of acute transverse myelitis. The control groups was comprised of were 55 subjects. All the participants of the study underwent rehabilitation which included robotized mechanotherapy, stabilography, neuro-muscular stimulation, kinesiotherapy, physical therapy, ergotherapy, massage, etc. Transcranial magnetic stimulation (TMS) and evaluation of somatosensory evoked potentials (SSEP) were carried out before and after the therapy. RESULTS: In those patients who received personalized therapy, significant changes of TMS parameters (central motor conduction time at rest and in facilitation probe), but not SSEP ones were registered. Moreover, the patients who had undergone personalized therapy exhibited better clinical results than in the absence of such treatment. CONCLUSION: The results of the study gave evidence that neurorehabilitation had produced the more pronounced beneficial influence as regards the correction of motor disturbances even though the disturbances of the somatosensory functions proved to be more resistant to therapy. The data obtained suggest that taking into consideration the afferent deficit has to be mandatory for the purpose of planning the neurorehabilitative treatment of the patients suffering from sensorimotor disturbances associated with the lesions of the central nervous system at the spinal cord level. TMS and SSEP have to be utilized as the tools for the objective evaluation of the effectiveness of the neurorehabilitation process in such patients.
Subject(s)
Evoked Potentials, Somatosensory/physiology , Neuromuscular Monitoring/methods , Spinal Cord Ischemia/rehabilitation , Spinal Cord/physiopathology , Transcranial Magnetic Stimulation/methods , Humans , Magnetic Resonance Imaging , Middle Aged , Motor Activity/physiology , Neurological Rehabilitation/methods , Physical Therapy Modalities , Spinal Cord/diagnostic imaging , Spinal Cord Ischemia/diagnostic imaging , Spinal Cord Ischemia/etiology , Spinal Cord Ischemia/physiopathology , Treatment OutcomeABSTRACT
A total of 136 patients with clinical symptoms of thoracic osteochondrosis and reflex vertebrocardiac disorders were examined. 100 of them presented with vertebrogenic cardialgia and CHD, 36 had no CHD. 56 patients with clinical symptoms of thoracic osteochondrosis and CHD received traditional therapy and a course of intraosseous blockade (IOB). 56 patients with clinical symptoms of thoracic osteochondrosis and CHD received traditional therapy and a course of paravertebral blockade (PVB). 36 patients with clinical symptoms of thoracic osteochondrosis without CHD received a course of IOB. Efficiency of therapy was assessed from dynamics of pain syndrome parameters, data of the visual analog scale, McGill and body diagram questionnaires, changes of cardiac function and heart rhythm recorded by 24-hr Holter monitoring. Therapeutic efficiency of IOB in patients with vertebrogenic cardialgia with and without CHD was higher than that of PVB in patients with clinical symptoms of thoracic osteochondrosis and CHD. It is concluded that osteogenic factor plays a key role in the mechanism of development of vertebrogenic cardialgia.
Subject(s)
Chest Pain/etiology , Spinal Osteochondrosis/complications , Thoracic Vertebrae , Analgesics/therapeutic use , Chest Pain/diagnosis , Chest Pain/therapy , Diagnosis, Differential , Electrocardiography, Ambulatory , Female , Humans , Male , Middle Aged , Nerve Block/methods , Pain Measurement , Spinal Osteochondrosis/diagnosis , Spinal Osteochondrosis/therapy , Surveys and QuestionnairesSubject(s)
Cervical Vertebrae , Dexamethasone/administration & dosage , Lidocaine/administration & dosage , Nerve Block/methods , Spinal Osteophytosis/complications , Thoracic Vertebrae , Vertebrobasilar Insufficiency/drug therapy , Adult , Anesthetics, Local/administration & dosage , Cerebrovascular Circulation/physiology , Drug Therapy, Combination , Female , Glucocorticoids/administration & dosage , Humans , Infusions, Intraosseous , Male , Middle Aged , Spinal Osteophytosis/drug therapy , Treatment Outcome , Ultrasonography, Doppler, Transcranial , Vertebrobasilar Insufficiency/etiology , Vertebrobasilar Insufficiency/physiopathologyABSTRACT
The content of mRNA for alpha-synuclein (a key protein of the dopaminergic system) was elevated in the peripheral lymphocytes of patients with alcohol dependence syndrome. Increased level of alpha-synuclein mRNA was not associated with changes in the expression of NR4A2 gene encoding Nurrl, one of the main transcription factors of dopaminergic neurons.
Subject(s)
Alcoholism/genetics , Genetic Predisposition to Disease , Lymphocytes/metabolism , alpha-Synuclein/genetics , Adult , Analysis of Variance , DNA-Binding Proteins/genetics , Humans , Male , Middle Aged , Nuclear Receptor Subfamily 4, Group A, Member 2 , Transcription Factors/geneticsSubject(s)
Cerebrovascular Disorders/drug therapy , Nootropic Agents/therapeutic use , Piracetam/therapeutic use , Vasodilator Agents/therapeutic use , Vinca Alkaloids/therapeutic use , Administration, Oral , Adult , Blood Flow Velocity/drug effects , Calcium Channel Blockers , Cerebrovascular Circulation/drug effects , Cerebrovascular Disorders/diagnosis , Cerebrovascular Disorders/physiopathology , Dose-Response Relationship, Drug , Drug Combinations , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nootropic Agents/administration & dosage , Piracetam/administration & dosage , Plethysmography, Impedance , Treatment Outcome , Ultrasonography, Doppler, Transcranial , Vasodilator Agents/administration & dosage , Vinca Alkaloids/administration & dosageABSTRACT
Sixty-seven patients with clinical symptoms of cervical-thoracic osteochondrosis and ischemic disease have been studied. In the main group included 43 patients, paravertebral blockades (PVB) were applied and in the control group (24 patients) - antianginal and metabolic therapy was used. Treatment efficacy was assessed by the dynamics of pain syndrome parameters as measured with the visual analogue scale and by changes of heart rhythm variability, ischemic disturbances and arrhythmia measured by Holter monitoring. The higher therapeutic efficacy of PVB in the complex treatment of these patients comparing to traditional treatment of ischemic disease was found.
