[Characteristics of cerebral glucose metabolism in patients with cognitive impairment in Parkinson's disease]. / Osobennosti tserebral'nogo metabolizma gliukozy u bol'nykh s kognitivnymi narusheniiami pri bolezni Parkinsona.

AIM: To study the relationship between early cognitive impairment symptoms and cerebral glucose metabolism in different brain regions (according to the positron emission tomography (PET) data) in Parkinson's disease (PD) in order to increase the diagnostic and treatment efficacy. MATERIAL AND METHODS: Two groups of patients with PD (stage I-III), including 11 patients without cognitive disorders and 13 with mild cognitive impairment (MCI), were examined. The control group included 10 age-matched people with normal cognition. To evaluate cognitive state, the Mini mental state examination (MMSE), the Frontal assessment battery (FAB) and the 'clock drawing test' were used. The regional cerebral glucose metabolism rate (CMRglu) was assessed using PET with 18F-fluorodeoxyglucose (FDG). RESULTS AND CONCLUSION: In PD patients, CMRglu were decreased in the frontal (Brodmann areas (BA) 9, 10, 11, 46, 47), occipital (BA 19) and parietal (BA 39), temporal (BA 20, 37), and cingulate cortex (BA 32) compared to the control group. Cerebral glucose metabolism was decreased in the frontal (BA 8, 9, 10, 45, 46, 47), parietal (BA 7, 39, 40) and cingulate cortex (BA 23, 24, 31, 32) in the group of PD patients with MCI compared to PD patients with normal cognition. Hypometabolism in BA 7, 8, 23, 24, 31, 40 was revealed only in comparison of PD and PD-MCI groups, and did not appear in case of comparison of cognitively normal PD patients with the control group. It is possible to suggest that the mentioned above brain areas were associated with cognitive impairment. The revealed glucose hypometabolism pattern possibly has the diagnostic value for the early and preclinical diagnosis of MCI in PD and control of treatment efficacy.

[Significance of the level of auto-antibodies for the NMDA type glutamate receptors in diagnosis of chronic cerebral circulation disorders]. / Prakticheskoe znachenie opredeleniia urovnia autoantitel k NMDA-tipu glutamatnykh retseptorov v diagnostike khronicheskikh rasstroistv mozgovogo krovoobrashcheniia.

For studying diagnostic possibilities of a new laboratory test for cerebral ischemia (CIS-test), thirty patients have been examined. The level of autoantibodies to NMDA type glutamate receptors is shown to increase significantly (3-5 times) in patients with stage 2 dyscirculatory encephalopathy. Parallel measurements of free glutamate and homocysteine levels in the patients blood plasma did not reveal any substantial changes of the given parameters, comparing to indices of autoantibodies to NR2a glutamate receptor. The titer of autoantibodies to this receptor type did not change significantly in patients with epilepsy; the titer dependence on dyscirculatory encephalopathy severity level and its decrease during treatment have been found as well. The possibilities of CIS using for diagnosis and therapy control in patients with chronic cerebral circulation disorders are discussed.

[The differentiation of the pathogenetic variants of nerve trunk lesions]. / Differentsiatsiia patogeneticheskikh variantov porazhenii nervnykh stvolov.

There are two major variants of nerve trunk disease progression: demyelinating and axonal-axial. The authors have developed a significant and rapid diagnostic procedure to differentiate the type of nerve trunk affection based on simultaneous assessment of two parameters (immunological and electroneuromyographic) carrying out correlations between them. The immunological investigation included measurement of the serum autoantibodies to galactocerebrosides titer.

[Autonomic vascular disorders in neuropathies and the methods for their pathogenetic therapy]. / Vegetativno-sosudistye rasstroistva pri nevropatiiakh i metody patogeneticheskoi terapii.

Investigations were made to examine vegetovascular disorders in patients with inherited and acquired neuropathies (regional vegetative innervation, peripheral circulation and the thermal status of the limbs). Comprehensive, pathogenetically based treatment methods were developed. Using clinico-neurological, thermography, rheovasography and electrothermography research methods the following alterations were revealed in the autonomic areas of innervation of affected nerves: the signs of vegetovascular irritation; the signs of vegetovascular depression; a phenomenon of thermovision "amputation". Bearing in mind the diagnostic data, the patients were given differentiated pathogenetic therapy including physiotherapy and vegetotropic drugs.