[Clinical and electromyographical analysis of peculiarities of parkinsonian syndrome in multiple system atrophy and Parkinson's disease]. / Kliniko-élektromiograficheskii analiz osobennostei parkinsonicheskogo sindroma pri mul'tisistemnoi atrofii i bolezni Parkinsona.

Because differential diagnosis between Parkinson's disease (PD) and multiple system atrophy (MSA) may be difficult due to overlapping of clinical features, especially at the early stage of the diseases, a search for additional clinical and instrumental markers increasing reliability of etiological diagnosis appears actual. The article presents the results of comprehensive comparison of parkinsonian signs and spectral electromyography (sEMG) data in 18 patients with MSA, diagnosed clinically according to criteria of Gilman et al (1998), and in 21 PD patients. Though no between-group differences in total expression of parkinsonian signs evaluated with The Unified Parkinson's Disease Rating Scale, part III, were found, MSA patients demonstrated progressive motor deficits, severer hypokinesia in the distal regions of the extremities, more pronounced impairment of axial movements, postural instability and gait disturbances but milder resting tremor, as compared to the PD patients (p < 0.05). Besides, the MSA patients were more frequently resistant to levodopa and had axial drug-induced dyskinesia (p < 0.05). An analysis of sEMG data revealed that MSA patients had a more prominent peak in 10-17 Hz frequency band (for arm muscles) and in Hz 7-14 (for leg muscles) as well as higher amplitudes peak frequencies (p < 0.05) positively correlated to hypokinesia severity. The results may be useful for differential diagnosis between PD and MSA.

[Neurotransplantation in the treatment of Parkinson disease: follow-up]. / Neirotransplantatsiia v lechenii bolezni Parkinsona (katamnez).

The paper presents the results of follow-up of 11 patients with Parkinson's disease (PD) after neurotransplantation (NT) of fetal brain dopaminergic suspension into the caudatus and putamen on one or two sides. All the patients were clinically assessed at least 3 months before and during a follow-up (for as long as 9 years) in accordance with the Core Assessment Program for Intracranial Transplantation (CAPIT) by a Russian group of the Network of European CNS Transplantation and Restoration (NECTAR) Programme by using the Unified Parkinson's Disease Rating Scale (URDRS). An analysis of clinical findings showed that: 1) there was a slight amelioration in bradykinesia, rigidity, and smaller dosage of L-DOPA; 2) tremor and drug-induced dyskinesia remained unchanged; 3) subsequently (till 9 years), the clinical effect slightly decreased in almost all patients with PD and in some of them the clinical status became worse than that prior to surgery; 4) repeated NT (2 cases) in the striatum contralaterally did not improved the situation; 5) only neurostimulation of subcortical structures improved clinical results. So we can conclude that NT alone cannot be beneficial and requires additional interventions at the subcortical level.

[Use of neurotransplantation in the treatment of Parkinson's disease]. / Ispol'zovanie neirotransplantatsii v lechenii bolezni parkinsona.

The outcomes of transplantation of the human embryonal mid-brain into the striatum of patients with Parkinson's disease are presented. For this, a procedure for obtaining, isolating, preparing the human embryonic midbrain, as well as a method for stereotactic administration of embryonal nerve tissue suspension having high dopaminergic neuron levels into the patients' striatum are specified. Patients underwent neurological examinations by the international protocol Core Assessment Program for Intracerebral Transplantation including monthly video recording within 3 months before and 3-24 months after surgery. Electrophysiological, neuropsychological, and immunological examinations were made at the same intervals. Most patients had positive dynamics: diminution of the severity of main disease symptoms, reduction in the efficiency of a single dose of DOPA-containing drugs, decrease in the magnitude of side effects of drug therapy.

[A method for the self-assessment of social adaptation in parkinsonism patients]. / Metod samootsenki sotsial'noi adaptatsii bol'nykh parkinsonizmom.

The rating scale of self-estimation of social adaptation which permits to determine the patient's adaptation in three life spheres (professional-working, family and self-service) was described. 103 patients with different forms of parkinsonism were examined by means of this scale. High effectiveness of this scale is demonstrated for estimation of the influence of such parameters as the disease gravity, its clinical form, mnemic-intellectual disorders expression, age and the duration of disease on social adaptation. Such effect determines the validity of the scale for the prognosis of the disease development.

[The evaluation of the vasomotor cerebrovascular action of vasoactive substances by using gamma scintigraphy]. / Otsenka vazomotornogo tserebrovaskuliarnogo deistviia vazoaktivnykh sredstv s pomoshch'iu gamma-stsintigrafii.

A method of assessing relative changes in the head blood content under the influence of medicines is described. The method is based on an analysis of deviations of the equilibrium part of the radioactivity curve recorded with the aid of gamma-scintigraphy and injection in the form of bolus of the radiopharmaceutical agent 99mTc-pertechnetate to the ulnar vein. Changes in the blood content under the influence of nitroglycerin, duzodril, adalate and cavinton were examined in 37 patients suffering from dyscirculatory encephalopathy.

[Comparison of the effectiveness of treatment with diverse doses of cinnarizine of patients with circulatory encephalopathy]. / Sravnenie éffektivnosti lecheniia razlichnymi dozami tsinnarizina bol'nykh distsirkuliatornoi éntsefalopatiei.

A single-dose cinnarizine (25 and 75 mg) was compared to its course administration (75 and 225 mg/day) in 35 patients with circulatory encephalopathy. Upon a 3-fold increase in conventional doses, there appeared more profound clinical, vasomotor cerebral and functional cerebral effects as evidenced by EEG and neuropsychological tests.

[Clinico-rheographic study of the cerebrovascular effect of alpha-adrenergic blockers in vascular diseases of the brain]. / Kliniko-reograficheskoe issledovanie tserebrovaskuliarnogo éffekta al'fa-adrenergicheskikh blokatorov pri sosudistykh zabolevaniiakh golovnogo mozga.

The effect of the alpha-adrenoblockers, nicergoline (N) and dihydroergotoxin (DHET), on the cerebral vessels and the systemic hemodynamics was studied in 152 patients with acute and chronic vascular diseases of the brain. It was established that the hypotensive action of alpha-blockers was the greater the higher was the initial arterial hypertension. REG conducted during an hour after the intravenous administration of N and DHET revealed an increase in the pulse blood filling and an improvement of the arterial tone. Changes in vascular resistance were heterogeneous. Both drugs induced the venous outflow but there were no signs of venous hypotension. An improvement in the systemic and cerebral hemodynamics correlated with clinical improvement.

[Effect of nifedipine (adalate) in neurology patients with arterial hypertension]. / Deistvie nifedipine (adalata) u nevrologicheskikh bol'nykh s arterial'noi gipertenziei.

Using rheoencephalography and gamma-scintigraphy, the cerebrovascular action of nifedipine was studied in 38 patients with an ischemic stroke and chronic cerebrovascular insufficiency. In patients with a crisis-like increase in the blood pressure, the drug induced a rapid and considerable drop in the blood pressure, a decrease of the tone and an elevation of the blood content of the cerebral vessels. In patients with a moderately elevated stable BP, this effect was less marked. An increase in the cerebral blood content was mostly seen in the zones of the arteries of the predominantly muscle type. It was effected by both the vasodilating action of nifedipine and the autoregulatory mechanism. Nifedipine did not induce the effect of intracerebral steal and did not impede the outflow of blood from the intracranial veins.

[Clinical study of the cerebrovascular action of pentoxifylline]. / Klinicheskoe issledovanie tserebrovaskuliarnogo deistviia pentoksifillina.

Clinical trials of pentoxiphylline (trental) used in the treatment of 164 patients were carried out. Of these patients, 32 were suffering from acute cerebral circulation disorders, 25 from chronic cerebrovascular insufficiency, 50 from cerebrovascular dystonia of various genesis, 12 from peripheral vasculopathy, and 5 from migraine. A favourable effect of pentoxiphylline on the course of the cerebrovascular disorders (except migraine) was noted. Rheographic examinations confirmed the improvement of the cerebral and peripheral circulation and revealed a two-phase effect of the drug on the vascular tone that manifested in alternations of periods of short-time moderate vasodilatation and vasoconstriction. Pentoxiphylline was also found to produce a venotonic effect. The pharmacodynamic mechanisms of the hemovascular effects of the drug are discussed. The optimal dose of pentoxyìphylline for a single intravenous injection is assumed to be 10 ml of solution containing 200 mg of the drug dissolved in physiological saline. The optimal dose for drop infusion is up to 15--20 ml of the same solution. In addition the drug is to be given orally in a dose of 400 mg (two dragees of 200 mg) two or three times a day. The treatment lasts 3 to 5 weeks.