[The clinical and polysomnographic characteristics of obstructive sleep apnea syndrome in the children].

The objective of the present work was to study peculiarities of the neurological, ororhinolaryngological status of the children presenting with obstructive sleep apnea syndrome (OSAS) as well as their clinical and polysomnographic (PSG) sleep characteristics. A total of 15 children at the age from 6 to 9 years with OSAS confirmed by the PSG study were included in the investigation. All the children suffered nasal obstruction of different etiology and non-specific neurological complaints of transient headache, emotional lability, impaired memory, enhanced fatigue, and poor attention; these conditions were responsible for school desadaptation. All the patients underwent dyssomnic events. The polysomnographic study revealed the disordered sleep structure manifested as the shortened drowsiness phase, lengthened latent period of the rapid eye movement (REM) sleep and its reduced representation in the overall sleep cycle, enhanced duration of delta-sleep. The sleep alertness time also increased alongside with a rise in the number of activations on the sleep electroencephalograms by virtue of increased respiratory efforts. A characteristic feature of the children presenting with obstructive sleep apnea syndrome was vegetative disorder during sleep associated with a rise in the number of tachycardia episodes. The results of this study facilitate the understanding of certain pathogenetic aspects of neurological problems in the children suffering respiratory tract obstruction and OSAS and outline the problems awaiting further investigations.

Plasma Abeta42 and Abeta40 as markers of cognitive change in follow-up: a prospective, longitudinal, population-based cohort study.

BACKGROUND: Single measurements of plasma Aß are not useful in the diagnostics of Alzheimer's disease (AD). However, changes in plasma Aß levels during repeated testing may be helpful in the prediction and evaluation of progression of the incipient AD or mild cognitive impairment. OBJECTIVE: To examine the relation of baseline and serial plasma Aß levels to cognitive change in follow-up. METHODS: 269 subjects (52 cognitively impaired and 217 controls) from a population-based cohort were clinically followed up from 3 to 6 years. Serial plasma samples were available from 70 subjects who were followed up for 3 years and 43 subjects followed for 6 years. The plasma Aß levels were measured using ELISA. RESULTS: Subjects who declined cognitively during the follow-up had lower levels of plasma Aß42 at the baseline. Plasma Aß42 and the Aß42/Aß40 ratio decreased (-2.4 pg/ml for Aß42 in 6 years) in those who declined in follow-up, whereas Aß42 and the Aß42/Aß40 ratio increased in the subjects who remained cognitively stable or improved in follow-up. Subjects using acetylsalicylic acid, dipyridamole, antidiabetic or anticoagulant drugs as well as subjects with coronary heart disease had higher levels of Aß40. CONCLUSIONS: Low or decreasing plasma Aß42 during the follow-up is associated with cognitive decline. Serial measurement of plasma Aß42 may be useful in the detection of the subjects who are at risk for cognitive decline.

[Vegetative adaptation in children presenting with chronic adenoiditis].

Publications reporting the comprehensive analysis of the psychovegetative status in children with chronic adenoiditis are practically lacking in the literature. The objective of the present work was to study the functional state of the vegetative nervous system (vegetative nerve tone, vegetative reactivity, and vegetative regulation of vital activity) and manifestations of vegetative disorders in the clinical picture of chronic adenoiditis in preschool children.

Apolipoprotein E epsilon 4 allele is associated with increased atrophy in progressive mild cognitive impairment: a voxel-based morphometric study.

BACKGROUND: The apolipoprotein E (APOE) epsilon4 allele is a risk factor for Alzheimer's disease. Earlier studies have shown differences in brain structure according to the APOE epsilon4 status. OBJECTIVE: To assess possible differences in brain structure according to the APOE epsilon4 status in mild cognitive impairment (MCI) subjects in relation to conversion to dementia. METHODS: In a follow-up study of 56 MCI subjects, 13 MCI subjects progressed to dementia (PMCI) during a mean follow-up time of 31 months. Brain structure differences in both stable MCI (SMCI) and PMCI epsilon4 carriers and noncarriers in the baseline MRI scan were assessed with voxel-based morphometry. RESULTS: The SMCI epsilon4 carriers had atrophy in the amygdala and hippocampus compared to the SMCI noncarriers. The PMCI epsilon4 carriers revealed atrophy of the left inferior frontal gyrus and parietal cortex compared to the PMCI noncarriers. CONCLUSION: The rate of brain atrophy in certain brain areas may be increased in epsilon4-positive MCI subjects progressing to dementia.

A voxel based morphometry study on mild cognitive impairment.

BACKGROUND: Mild cognitive impairment (MCI) is the most widely used concept in classifying cognitive impairment in the elderly who do not fulfil the criteria for dementia. MCI is considered to confer an increased risk of progressing to dementia and most often Alzheimer's disease (AD). Various approaches such as imaging of the brain have been applied to predict the conversion of MCI to dementia. A number of volumetric magnetic resonance imaging (MRI) studies have detected atrophy of the medial temporal lobe in subjects with MCI, but for the other cerebral regions the results have been inconsistent. OBJECTIVE: To study the pattern of brain atrophy in MCI. METHODS: Thirty two controls and 51 individuals with MCI deriving from population based cohorts were studied by MRI using voxel based morphometry. The threshold of t maps was set at p < 0.001. RESULTS: Individuals with MCI had significant unilateral atrophy in the medial temporal lobe on the right side. Less extensive atrophy was found elsewhere-for example, in the temporal lobe, left superior parietal lobule, left anterior cingulate gyrus, and bilaterally in the thalami. CONCLUSIONS: The MRI findings in MCI resemble those seen in early AD.