[The efficacy of the intravenous administration of the trometamol salt of thioctic (alpha-lipoic) acid in diabetic neuropathy]. / Effektivnost' vnutrivennogo vvedeniia trometamolovoi soli tioktovoi (al'fa-lipoevoi) kisloty pri diabeticheskoi nevropatii.

A two-central randomised single-blind placebo-controlled study was conducted to assess efficacy of intravenous administration of trometamol salt of thioctic (alpha-lipoic) acid (Thioctacid 600, "ASTA Medica", Germany) in 200 ml of physiological solution in 40 non-insulin dependent diabetic patients with symptomatic diabetic neuropathy. 10 patients of the control group received a physiological solution stained with 1% solution of riboflavin mononucleate (B2 vitamin) as placebo. Intravenous infusion was administered once daily during a period of 3 weeks. Diabetic neuropathy score was assessed at the entry as well as on days 7, 14 and 21 of therapy. Indicators of lipid peroxidation (oxidative stress)--malonic dialdehyde levels in plasma and membranes of erythrocytes. Electroneuromyography were performed. Most of the patients (29) noted symptomatic improvement after 7-10 infusions and on day 14 a significant reduction of the diabetic neuropathy score was noted in comparison to a baseline (p < 0.05). The further improvement of clinical picture had been pronounced by day 21 (p < 0.001). Improvement of symptom score was obtained in 39 patients (97.5%). The response rate in the control group was 40%. Parameters of oxidative stress and electroneuromyography improved significantly in the main group of patients, while these in placebo group remained without changes.

[Differential evaluation of excitatory conduction rats along different segments of motor nerves and functional tests in the diagnosis of diseases of the human peripheral neuromotor apparatus]. / Differentsirovannaia otsenka skorosti provedeniia vozbuzhdeniia po razlichnym uchastkam dvigatel'nykh nervov i funktsional'nye proby v diagnostike zabolevanii perifericheskogo neiromotornogo apparata u cheloveka.

In 61 patients with neurono- and neuropathies and affections of the synaptic apparatus and the muscular matter of various etiology, the state of the peripheral nerves was examined. It was found that various forms of the pathology are characterized by specific changes in the speed of the stimulus transmission along various parts of motor nerves. The changes of the functional state can be seen especially clearly on comparing the speed of the stimulus transmission along the proximal and the distal parts of a peripheral nerve (the difference being named "transmission speed gradient"). In neuronopathies the transmission speed changes are prevailing in the proximal, in neuropathies in the distal, and in synaptic structure abnormalities in the extreme distal parts of the nerve. A 15-minute artificial ischemia of the nerve (a functional test) led to characteristic changes of the transmission speed, these changes correlating with the process stage. In cases of mild changes of the transmission speed the nerve was more sensitive, while in cases of pronounced changes more resistant to the ischemia. It was shown that the transmission speed changes in ischemia manifested themselves along the whole nerve, but not only in the site of its affection. In cases of the carpal canal syndrome the ischemia-induced lowering of the transmission speed in the nerve distal part was extremely sharp.