[Differential diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]. / Differentsial'naia diagnostika tserebral'noi autosomno-dominantnoi arteriopatii s podkorkovymi infarktami i leikoéntsefalopatiei.

Cerebral autosomal dominant arteriopathy with subcortical infarctions and leucoencephalopathy (CADASIL) is an inherited CNS disease, which is caused by mutations in the NOTCH3 gene. Selective disorders of small vessels underlie the disease pathogenesis. Clinically CADASIL is characterized by headaches, multiple stroke-like disorders (in most cases transient ischemic attacks and lacunar strokes), and different focal neurological symptoms and dementia. There are specific MRI signs of the disease: multiple lacunar infarctions located in the basal ganglia, brain steam and cerebellum, focal lesions of temporal poles, capsula externa, periventricular and subcortical areas; diffuse white matter changes and leukoaraiosis can be observed as well. The differential diagnosis of CADASIL is made with many diseases, which are manifested by multiple brain matter lesions, including demyelinating disorders. It should be taken into account that CADASIL is characterized by headaches as one of the initial symptoms, multiple lacunar and diffuse brain matter lesions based on MRI data with an absence of atherosclerosis and arterial hypertension. Family history and autosomal dominant mode of inheritance is also typical of CADASIL. Detection of the NOTCH3 gene mutation is necessary for the definite diagnosis of CADASIL.

[Mexidant increases the effectiveness of levadopa treatment of Parkinson's disease].

The efficiency of mexidant therapy in patients with Parkinson's disease (PD) has been evaluated. The study included 49 patients aged 58-65 with a trembling-rigid and trembling forms of PD at an disease duration of 6.5 +/- 3.8 years. All patients were treated with levadopa-containing drugs, dopamine receptor agonists and/or amantadine. In addition, 27 patients received mexidant at a dose of 200 mg/day (i.v.) for the first 10 days, followed by intramuscular injections of 100 mg (twice a day) for 10 days. The dynamics of symptoms in the group of patients receiving mexidat showed that the inclusion of this drug into the therapeutic regime significantly decreased the degree of levadopa therapy side effects. Mexidant reduced the oxidative damages of blood plasma lipoproteins by neutralizing the growth of lipid hydroperoxide and increased the endogenous antioxidant status. The presented data show that mexidant enhances the efficiency of PD therapy.

Effect of homocysteine on properties of neutrophils activated in vivo.

We have found that neutrophils begin to express NMDA receptors on their membranes after in vivo activation. These receptors are the target for action of homocysteine (HC). After incubation of activated neutrophils with HC, the degranulation process is stimulated and generation of reactive oxygen species is increased. We conclude that expression of NMDA receptors on neutrophil membrane makes neutrophils sensitive to HC. Thus, hyperhomocysteinemia may induce additional stimulation of immune competent cells.

Application of multipotent mesenchymal stromal cells from human adipose tissue for compensation of neurological deficiency induced by 3-nitropropionic Acid in rats.

We evaluated possible therapeutic effect of multipotent mesenchymal stromal cells from human adipose tissue differentiated to neuronal phenotype with retinoic acid on Wistar rats subjected to toxic effect of 3-nitropropionic acid. Transplantation of mesenchymal stromal cells from human adipose tissue considerably decreased neurological symptoms, normalized exploratory activity (open field test) and long-term memory (Morris test), which correlated with normalization of pathomorphological manifestations in the brain. Destructive changes in the caudate nucleus caused by treatment with 3-nitropropionic acid (reduced size of neurons, changes in their shape, and cell edema) tended to decrease under the effect of multipotent mesenchymal stromal cells: the area of neurons increased 2-fold, the cells acquired typical round shape, cell edema decreased.