20 research outputs found
Factor analysis of the reorganization of the brain structures in patients with multiple sclerosis: A positron emission tomography study
No full textPotential of Positron Emission Tomography for Studies of the Mechanisms of Development of Multiple Sclerosis (published data and authors’ results)
No full textDiagnostic Value of Short and Long Echo Time in 1H-MRS for Patients with Multiple Sclerosis
No full textRegional cerebral hypoperfusion as a cause of symptoms and progression of multiple sclerosis
No full textBackground. Neurodegenerative processes play an important role in the development of clinical features of multiple sclerosis (MS) as well as in the progression of the disease. At the same time, neurodegenerative mechanisms of MS are not completely clear, which makes researchers pay special attention to pathogenetic aspects of the disease that have not been studied before. Previously it was shown that MS patients can have alterations in the local cerebral blood flow, however, the meaning of the detected abnormalities is still not clear.The aim of our work is to evaluate the perfusion character in the demyelinating lesions and normalappearing brain structures, and to determine their relation to clinical features of MS.Material and methods. 49 patients with relapsing-remitting and secondary progressive MS with clinical and MRI remission were included in the study. The patients underwent contrast-enhanced MR perfusion of the brain on the 3 Tesla MR-tomograph, as well as the Functional System Score, Expanded Disability Status Score and Fatigue Status Score evaluation. The data analysis included automatic construction of perfusion maps of the cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) values in the normal-appearing brain structures and in the demyelinating lesions and statistical analysis.Results. The received results allow to presume that variation of CBV values in MS lesions can indicate heterogeneity of processes in these lesions – from reactivation of inflammation to remyelination.Significant reduction of perfusion in nucleus lenticularis was revealed. This reduction did not depend on the severity of the disease and correlated negatively with the fatigue score. This allows to suppose that the therapy focused on brain perfusion improvement can be used as symptomatic therapy of MS. Considering the fact that regional hypoperfusion precedes the development of brain structure atrophy, it is hypothesized that the improvement of perfusion may prevent neurodegeneration in MS. The obtained findings need further investigation
ОСОБЕННОСТИ РЕГИОНАРНОГО МЕТАБОЛИЗМА В ГОЛОВНОМ МОЗГЕ ПРИ РАССЕЯННОМ СКЛЕРОЗЕ
No full textApplying the advanced techniques in MRi diagnostic of multiple sclerosis (MS) open an opportunity to assess functional changes in tissue without anatomical changes that conventional MRi provides. One of this techniques is proton magnetic resonance spectroscopy (1H-MRS) that provides tissue metabolic information in volume of interest (voxel). Multi-voxel mode allows simultaneous acquisition of 1H-MRS data from multiple voxels not only in lesions, but also in the normal-appearing white matter. At the same time results of 1H-MRS researches of numerous groups are contradictory, in present study metabolite concentrations ratio of N-acetylaspartate (NAA) and choline (Cho) to creatine (Cr) in supraventricular plane were assessed by multi-voxel 1H-MRS in 10 patients with relapsing-remitting MS and 10 healthy subjects. Statistical analysis showed than metabolic changes occuring in patients with MS are inhomogeneous and depends on localization of volume of interest. This fact allow to explain inconsistency in literature results. 1H-MRS provides the existence of metabolic changes even in normal-appearing regions and demonstrate dissemination of pathological process outside lesions even on early stages of MS
CLIPPERS. Three clinical cases and review
No full textCLIPPERS (Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) is a rare inflammatory disease of the central nervous system, during which the pons of the brain is damaged. This disease was described for the first time in 2010 by S.J. Pittock et.al. At present, there have been around 50 described cases of the disease. Up to the present moment, there are difficulties diagnosing this disease. In the article, a literature review and three clinical cases are presented. Furthermore, the necessity of further research is shown for improving the accuracy and specificity of the diagnostic criteria, as well as for defining biomarkers and developing algorithms of effective therapy
ОСОБЕННОСТИ РЕГИОНАРНОГО МЕТАБОЛИЗМА В ГОЛОВНОМ МОЗГЕ ПРИ РАССЕЯННОМ СКЛЕРОЗЕ
No full textApplying the advanced techniques in MRi diagnostic of multiple sclerosis (MS) open an opportunity to assess functional changes in tissue without anatomical changes that conventional MRi provides. One of this techniques is proton magnetic resonance spectroscopy (1H-MRS) that provides tissue metabolic information in volume of interest (voxel). Multi-voxel mode allows simultaneous acquisition of 1H-MRS data from multiple voxels not only in lesions, but also in the normal-appearing white matter. At the same time results of 1H-MRS researches of numerous groups are contradictory, in present study metabolite concentrations ratio of N-acetylaspartate (NAA) and choline (Cho) to creatine (Cr) in supraventricular plane were assessed by multi-voxel 1H-MRS in 10 patients with relapsing-remitting MS and 10 healthy subjects. Statistical analysis showed than metabolic changes occuring in patients with MS are inhomogeneous and depends on localization of volume of interest. This fact allow to explain inconsistency in literature results. 1H-MRS provides the existence of metabolic changes even in normal-appearing regions and demonstrate dissemination of pathological process outside lesions even on early stages of MS.В представленном исследовании обследовали 10 пациентов с ремиттирующе-рецидивирующим типом РС (РРРС), с тяжестью заболевания по шкале инвалидизации EDSS от 1 до 2,5 баллов (средняя длительность заболевания 2,4 года, средний возраст 29 лет) и 10 здоровых добровольцев (средний возраст 27 лет) методом мультивоксельной 1Н-МРС на томографе с напряженностью поля 3T. Оценивались следующие метаболиты: N-ацетиласпартат (NAA) - маркер функциональной целостности нейронов, холин (Cho) - входит в состав фосфолипидов мембран клеточной стенки, креатин (Cr) - участник энергетического метаболизма; зона интереса располагалась в суправентрикулярных пространствах головного мозга и составлял 8х9х1,5 см=108 см3 (2D-мультивоксельная 1Н-МРС). Оценка метаболических изменений проходила с использованием отношений NAA/Cr и Cho/Cr. Используя регионарный подход при оценке полученных результатов, мы установили, что происходящие при РС изменения концентрации метаболитов имеют неоднородный, зависящий от локализации области интереса характер, что является возможным объяснением противоречивости данных литературы. Использование данного метода в диагностике пациентов с РС позволяет обнаружить изменения уровней метаболитов в областях, удаленных от очагов, и наглядно демонстрирует распространение патологического процесса за пределы очаговых изменений на самых ранних стадиях заболевания
EFFECT OF NEURODEGENERATIVE CHANGES IN THE BRAIN ON THE FORMATION OF THE DISEASE CLINICAL PICTURE IN PATIENTS WITH MULTIPLE SCLEROSIS
No full textThe aim of the study was to determine the relationship of global and regional cerebral atrophy and volume of demyelination lesions in the brain with a clinical picture in patients with multiple sclerosis (MS). The study involved 55 patients with MS. Control group included 22 healthy volunteers. Patients were divided into groups according to the severity of disability, the type and duration of disease. Assessment of general and regional atrophy was performed by post-process volumetric segmentation of MRI data, which was acquired at 3T Philips Achieva scanner. The post-processing was done with the FreeSurfer software. It is shown that in MS patients brain atrophy develops both by means of gray matter (including the cortex and subcortical structures), and white matter, along with demyelination. Global and regional atrophy is associated with the severity of disability of patients according to EDSS scale, but not with the duration and type of the disease. Neurodegenerative changes of brain structures evolve with different rates, have different intensity and determine the set of symptoms of neurological impairment and severity of disability, which indicates the presence of certain patterns of the process of atrophy in the brain, forming the clinical picture of the disease
ЛУЧЕВАЯ ДИАГНОСТИКА ИНТРАМЕДУЛЛЯРНЫХ ОПУХОЛЕЙ СПИННОГО МОЗГА: СОБСТВЕННЫЕ КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ И ОБЗОР ЛИТЕРАТУРЫ
No full textIntramedullary spinal cord neoplasms are rare, accounting for about 4-10% of all central nerve system tumors. Despite their rarity, they should always be kept in mind in case of focal spinal cord lesions detection. Magnetic resonance imaging is the study of choice to narrow the differential diagnosis between neoplastic and nonneoplastic lesions and guide surgical resection. The article presents a literature review of primary intramedullary spinal cord tumors and our own clinical observations.Интрамедуллярные опухоли составляют около 4-10% всех опухолей центральной нервной системы. Несмотря на такую редкую встречаемость, их неизменно следует иметь в виду при обнаружении очагового поражения спинного мозга. Магнитно-резонансная томография (МРТ) является методом выбора для диагностики интрамедуллярных опухолей и позволяет не только провести дифференциальную диагностику между опухолевыми и неопухолевыми причинами поражения спинного мозга, но и играет важную роль в планировании оперативного вмешательства. В статье представлен обзор данных литературы о современных методах диагностики различных видов интрамедуллярных опухолей, а также собственные клинические наблюдения
