Use of transcutaneous electrical nerve stimulation in the complex treatment of glossalgia

Thirty-four patients with glossalgia were studied. The painful part of tongue was electrically stimulated using an ‘élektronika-2M’ apparatus with a current of 45 μA for 10–20 min (current strength was patient-controlled to produce the sensation of local prickling); courses consisted of 10–12 treatments. The results of electrical stimulation therapy were compared with results obtained using standard methods of treatment (novocaine blockade, analgesics, etc.), which were used in a control group of 30 patients. Transcutaneous electrical nerve stimulation was highly effective: improvements were noted after the first session, and significant reductions in pain syndrome occurred after 1–3 sessions; therapeutic effects were obtained at the end of treatment in all 34 patients, i.e., in 100% of cases, as compared with 70% in the control group, with remission lasting more than one year in 20 patients and from 3–12 months in 14. Department of Nerve Diseases, Faculty of Stomatology, N. A. Semashko Moscow Medical Stomatological Institute; Department of Therapeutic Stomatology, N. N. Burdenko Voronezh State Medical Institute. Translated from Zhurnal Nevrologii i Psikhiarii imeni S. S. Korsakova, Vol. 95, No. 5, pp. 19–21, September–October, 1995.     

Comparative Analysis of Cognitive Impairments in Lewy Body Dementia and Alzheimer's Disease

Neuropsychological studies of 50 patients with Lewy body dementia (LBD) and 50 patients with Alzheimer's disease (AD) were performed to assess the characteristics of the cognitive impairments in these diseases. In patients with dementias of similar severities, patients with LBD showed greater impairment of executive and visuospatial functions and had more marked neurodynamic dysfunction. Patients with AD showed more profound memory disorders. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 105, No. 1, pp. 20–24, January, 2005.     

Transcranial Magnetotherapy in the Complex Treatment of Affective Disorders in Patients with Alcoholism

Transcranial magnetotherapy (TMT) was used in 32 patients with alcoholism (study group) on the background of basal treatment (nootropes, hepatoprotectors, vitamin/mineral formulations, etc.). The influence of this treatment was compared with a control group (30 subjects), in which TMT was replaced with an appropriate _placebo procedure. All patients, who were aged from 35 to 64 years, had second-degree alcoholism with disease durations of 4–12 years. Patients were in a post-abstinence state during the treatment period. Courses of TMT consisted of 10 daily procedures with exposures of 10–20 min. Somatic, neurological, and laboratory studies were performed before and after treatment and included cardiointervalography, electroencephalography, assessments of the state of the autonomic nervous system, and use of psychometric scales to evaluate levels of anxiety and depression. TMT was followed by improvements in wellbeing, mood, and sleep, with increases in physical exercise tolerance and decreases in alcohol craving in 75% of patients in the study group and 30% of patients in the control group. Improvements in patients’ status were supported by paraclinical investigations (electrophysiological, measures of the state of the autonomic nervous system, etc.) and psychometric scales. Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 108, No. 4, pp. 33–37, April, 2008.     

The Potential of Transcranial Magnetotherapy in Color and Rhythm Therapy in the Rehabilitation of Ischemic Stroke

A total of 116 patients with ischemic stroke were studied during the early recovery period. The patients were divided into four groups – three experimental groups and one control group. Of these, 87 patients in the first three groups received transcranial magneto- and/or color and rhythm therapy (TcMT, CRT) along with traditional treatment, while the 29 patients of the control group received basal treatment only. TcMT was performed using a bitemporal method, with a running field regime with a modulation frequency of 1–10 Hz. CRT consisted of an alternating scheme of stimulation of the left and right eyes with green and/or blue light with a period of 2–4 sec and an on time of 1 sec. Each of the three experimental groups (group 1 received TcMT, group 2 received CRT, and group 3 received TcMT + CRT) received two courses of treatment separated by 1.5 months. After treatment, all experimental groups, particularly group 3, showed more marked improvements than the control group. Regression of neurological symptomatology on the Lindmark scale in group 3 was 9.5% greater than that in controls; improvements in impairments to activity and self-care ability on the Barthel scale were greater by 8.8%; memory and intellectual changes were also seen on the MMSE and the Luriya and Schulte tests. Rheography and electroencephalography demonstrated significant improvements in hemodynamics and α-rhythm differentiation and a 14.6% reduction in the proportion of patients with dysrhythmia in group 3 compared with the control group. The best result on all measures were obtained in patients given the combination of TcMT and CRT; TcMT had the greater influence on hemodynamics, while CRT had the greater effect on psychoemotional status. Both treatments were well tolerated and produced no side effects.     

Cognitive function and the emotional state of stroke patients on antihypertensive therapy

Combined antihypertensive therapy based on 2.5–5 mg of cilazapril (an angiotensin-converting enzyme inhibitor) to normalize arterial pressure (ABP) was studied in 22 patients (12 male, 10 female) aged 49–74 years (mean 63 ± 7 years) with stroke (18 patients) or transient ischemic attacks (three patients). Magnetic resonance tomography (MRT) including perfusion studies, along with neuropsychological studies and assessment of emotional status (Beck depression inventory, Spielberger anxiety scale), were performed before and after treatment. After six months of treatment, patients showed normalization of ABP (systolic pressure decreased from 154.7 ± 12 to 128 ± 23 mmHg, diastolic from 90.3 ± 9.6 to 79.4 ± 23 mmHg). There were no side effects and no patient experienced stroke. MRT revealed no signs of new foci and there were no significant changes in brain blood flow. By the end of treatment, improvements in cognitive functions were noted on the Mini Mental State Examination, the 10-word memory test, the Boston naming test, or the Wisconsin card-sorting test, though there were no changes in the patients’ emotional status. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Stroke, Supplement issue, No. 15, pp. 39–44, 2005.     

Effects of Amantadine Sulfate on Cognitive Impairments in Patients with Parkinson’s Disease

Cognitive impairments in patients with Parkinson’s disease (PD) lead to occupational, social, and psychological maladaptation of patients and their relatives. This article presents the epidemiology, structure, and nature of cognitive impairments in PD; the main pathogenetic factors involved in the development of moderate cognitive impairment and dementia in PD are discussed, as are the methods of diagnosis and assessment of cognitive impairments and approaches to the correction of memory and intellectual impairments. Results obtained from our own studies of the effects of treatment with amantadine sulfate at a dose of 300 mg for 6 months on changes in cognitive impairments in 25 patients with PD are presented. Treatment results were evaluated using neuropsychological questionnaire and scales (Mini Mental State Evaluation, Frontal Assessment Battery, Matiss Dementia Rating Scale). In patients with PD and moderate cognitive impairments, six months of treatment with amantadine sulfate produced significant improvements in neuropsychological test results.     

Experience of the use of velaxin (venlafaxine) in anxious depression

Thirty patients (seven men and 23 women, mean age 35.3 ± 7.8 years) with anxious and anxious-apathic depression were studied. Of these, 24 patients were treated in hospital and six in out-patient clinics. Patients were treated for eight weeks with venlafaxine at doses of 225–375 mg/day. Mental state was assessed using a series of scales (CGI, HDRS, BDI, HADS-21). A total of 27 patients (90%) completed treatment. There were 25 (83.3%) responders on the CGI scale: “improvement” in mental state occurred in 16 (59.3%) of patients and “marked improvement” occurred in nine (33.3%). “Insignificant improvement” was seen in two cases (7.4%). Complete elimination of symptoms of depression occurred in 33.3% of cases. Velaxin was found to be safe at intermediate therapeutic doses and there were improvements in laboratory results characterizing patients' somatic status. Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 108, No. 3, pp. 24–28, March, 2008.     

Induction of autoantibodies to glutamate in patients with Alzheimer’s disease

Autoantibodies to glutamate were found in blood plasma from patients with Alzheimer’s disease. The content of autoantibodies to glutamate in blood plasma from patients with moderate and severe dementia was 2-fold higher compared to patients with mild dementia. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 143, No. 2, pp. 140–141, February, 2007     

Efficacy and safety of memantine in Lewy body dementia

Lewy body dementia (LBD) is a progressive brain disease manifest as dementia and parkinsonism, along with psychotic and autonomic disorders. Although studies in recent years have demonstrated the positive effects of cholinesterase inhibitors in LBD, the search for therapeutic agents with other mechanisms of action remains relevant. An open, controlled, 16-week study was performed with the aim of evaluating the efficacy and safety of memantine in patients with clinically diagnosed LBD (criteria of McKeith et al., 1999). The study included 23 patients (mean age 69.2 ± 5.9 years), who were divided into two groups: 14 patients received memantine at a dose of 20 mg/day and nine patients constituted the control group. Efficacy was evaluated using a battery of quantitative neurospychological tests, clinical scales for assessment of fluctuations in mental states, scales for assessment of behavioral and psychotic disorders, and the general clinical impression scale. The results demonstrated that memantine had positive effects on the patients’ general status and cognitive functions (increases on the mini mental state examination by 1.5 points), mainly because of improvements in attention and control functions. There were also reductions in the severity of fluctuations in mental state, aggressivity, lack of spontaneity, and disinhibition. The severity of psychotic and motor disorders did not change significantly. Tolerance of the agent was good, only two patients withdrawing from the study because of episodes of confusion during the dose titration period. Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 108, No. 5, pp. 39–46, May, 2008.     

Dementia in Swedish Twins: Predicting Incident Cases

Thirty same-sex twin pairs were identified in which both members were assessed at baseline and one twin subsequently developed dementia, at least 3 years subsequent to the baseline measurement, while the partner remained cognitively intact for at least three additional years. Eighteen of the 30 cases were diagnosed with Alzheimer’s disease. Baseline assessments, conducted when twins’ average age was 70.6 (SD = 6.8), included a mailed questionnaire and in-person testing. Which twin would develop dementia was predicted by less favorable lipid values (higher apoB, ratio of apoB to apoA1, and total cholesterol), poorer grip strength, and—to a lesser extent—higher emotionality on the EAS Temperament Scale. Given the long preclinical period that characterizes Alzheimer’s disease, these findings may suggest late life risk factors for dementia, or may reflect changes that are part of preclinical disease.     

Depressive Disorders in Stroke Patients

Post-stroke depression is a serious complication of ischemic stroke which has negative influences on patients’ quality of life and on recovery from symptoms and the prognosis of the underlying disease. We report here a study of the efficacy of treatment of patients with post-stroke depression with Opra, showing improvements in status in 93.3% of patients. Along with its antidepressant action, Opra had a marked anxiolytic effect. The agent had no adverse effects on the activities of daily living or cognitive functions, and produced minimal side effects. Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Stroke Supplement, No. 22, 2008, pp. 10–15.     

Basis for a method of dynamic proprioceptive correction in the restorative treatment of patients with residual-stage infantile cerebral palsy

A new method for the restorative treatment of patients with residual-stage infantile cerebral palsy is described; the method is based on proprioceptive correction using an “Adeli-92” device, which is a modified space suit used in weightless conditions. The “Adeli-92” allows intensification and some extent of normalization of afferent proprioceptive mobility-controlling input. Positive clinical effects were obtained in 70% of patients, with improvements in walking and self-care ability. The positive effects of this method were demonstrated objectively using electroencephalography, electroneuromyography, studies of somatosensory evoked potentials, and studies of the vestibular system. Science Research Institute of Pediatrics, Russian Academy of Medical Sciences, Pediatric Clinical Psychoneurological Hospital No. 18, Moscow. Translated from Zhurnal Nevropatologii i Psikhiatrii imeni S. S. Korsakova, Vol. 96, No. 3, pp. 47–50, May–June, 1996.     

Use of Coaxil (tianeptine) in elderly patients with combined mild cognitive and depressive-anxiety disorders

The studies reported here addressed 20 patients aged 60–69 years whose clinical picture combined the manifestations of mild dementia with those of mild depression and anxiety. Patients were treated with Coaxil (tianeptine) for 60 days at a dose of 37.5 mg/day. Patients were assessed by clinical-psychological investigations with addition of the Hamilton scales and neuropsychological testing by the Luriya method. Coaxil was found to be highly effective in relation to all psychopathological components. Recommendations for the use of Coaxil in elderly patients with cognitive and depressive-anxiety disorders are formulated. Translated from Zhurnal Nevrologii i Psikhatrii imeni S. S. Korsakova, Vol. 108, No. 1, pp. 36–39, January, 2008.     

Transcranial Micropolarization in the Combined Therapy of Speech and General Psychomotor Retardation in Children of Late Preschool Age

The efficacy of a method of combined treatment, developed by ourselves, using transcranial micropolarization in patients with delayed development of speech and general mental development, was studied in 30 children aged 4–6 years. High therapeutic effects were seen with this method in 60–80% of children, with accelerated development of communicative behavior and formation of speech-motor functions, along with increases in the stability of attention and improvements in the processes of perception and the productivity of cognitive activity. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 104, No. 11, pp. 34–41, November, 2004.     

Neuroimmune Aspects of the Pathogenesis of Tourette’s Syndrome and Experience in the Use of Immunoglobulins in Children

A total of 60 patients aged 6–16 years with tics and Tourette’s syndrome were studied. Antibodies to caudate nucleus proteins were assayed by western blot hybridization. Ten patients with Tourette’s syndrome were found to have antibodies to caudate nucleus protein. Seven patients with neuroleptic-resistant types of Tourette’s syndrome received single transfusions of immunoglobulin preparations, which produced regression of vocal and motor hyperkinesias and improvement in behavior (remission for more than six months). The observation of antibodies to caudate nucleus proteins and the positive effects seen on administration of immunoglobulins to patients with Tourette’s syndrome support previous data on the possibility of using immunoglobulin therapy in the treatment of tic-type hyperkinesias and provide evidence of the involvement of autoimmune mechanisms inducing damage to the dopaminergic system of the striatum. Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 108, No. 8, pp. 10–13, August, 2008.     

The effect of empiric antibiotic therapy on mortality in debilitated patients with dementia

The purpose of this investigation was to assess the effect of empirical antibiotic treatment on 30-day mortality among debilitated inpatients with dementia and Gram-negative bacteremia. A retrospective cohort study in the years 2005–2007 was undertaken. Data were collected through patient chart review. The association between individual variables and 30-day mortality was assessed through univariate analysis. Variables significantly associated with mortality (p < 0.05) were entered into a logistic regression analysis. Adjusted odds ratios (ORs) for mortality with 95% confidence intervals (CIs) are shown. Subgroup analysis of patients with and without decubitus ulcers was performed. In our cohort of 378 patients with dementia and Gram-negative bacteremia, the 30-day mortality was 39% overall and 61% in the subgroup of patients with decubitus ulcers. Inappropriate empirical therapy was associated with higher mortality, although this effect was not statistically significant (OR 1.41, 95% CI 0.86–2.29). Inappropriate empirical therapy did not affect mortality in the subgroup of patients with decubitus ulcers (OR 0.37, 95% CI 0.11–1.28). Other factors found to independently affect mortality included age, co-morbidities, source of infection, sepsis severity, and hospital-acquired infection. Appropriate empirical antibiotic therapy for patients with dementia and severe bacterial infection did not have a clear advantage, especially in the sickest group of patients with decubitus ulcers.     

New approaches to the rehabilitation of patients with neurological movement defects

Results were obtained using a new method, based on the “Adeli-92” therapeutic space suit, for the rehabilitation of patients with movement disorders due to acute lesions of the cerebral circulation, head trauma, and other causes. A variety of methods was used to assess the state of patients before and after treatment, including clinical studies, psychological tests, EEG recordings, evoked potential studies, stabilography, and heart rhythm analysis. The results obtained demonstrate the high efficacy of this new method. Department of Neurological Diseases, Faculty of Postgraduate Professional Education and Clinic of Neurological Diseases, I. M. Sechenov Moscow Medical Academy. A. A. Ostroumov City Clinical Hospital No. 33. Translated from Zhurnal Nevropatologii i Psikhiatrii imeni S. S. Korsakova, Vol. 96, No. 3, pp. 51–54, May–June, 1996.     

The effects of phototherapy on psychoautonomic neurotic disorders

Bright white light therapy (two-week courses of daily morning sessions lasting 1 h; distance from lamp 60 cm; light intensity 3300 lux) was used in 51 patients with neurotic autonomic dystonia syndrome. Improvements were obtained in 59% of patients (group 1), while treatment was not effective in 41% (group 2). Changes in virtually all neuroendocrine, motivational, psychoautonomic, pain, and psychopathological symptomatology were obtained. At the end of treatment, patients in group 1 had increases in the EEG power spectrum, increases in slow activity and reductions in rapid activity on both sides; coefficients of asymmetry approached those in controls, and there were increases in urinary excretion of catecholamine and serotonin metabolites. In group 2, initially increased EEG power spectra increased further, because of increases in θ and β rhythms bilaterally, and the coefficient of asymmetry decreased sharply; total excretory activity decreased. Symptoms and psychophysiological measures positively and negatively affected by phototherapy were identified. Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 97, No. 11, pp. 22–27, November, 1997.     

Age-related features of the interaction of learning success and characteristics of auditory operative memory

The characteristics of the interaction between learning success and measures of auditory operative memory were studied by psychoacoustic testing of 42 medical workers aged 20–65 years trained to work in areas new to them (information science). Three age groups were identified: 20–35 years, 36–50 years, and 51–65 years. The acoustic test consisted of a single presentation via headphones of 12 sequential target words from information science with subsequent presentation of 12 target and 12 masking words in random order. The subjects’ task was to recognize the target words. Stepwise linear regression analysis identified a relationship between the efficiency with which the new material was learned and measures of auditory operative memory, whose role in learning success increased with age. Since subjects older than 35 years showed a reduction in remembering efficiency, it was suggested that age-related changes in the characteristics of auditory operative memory are one of the major reasons for degradation of the ability to learn new material. __________ Translated from Zhurnal Vysshei Nervnoi Deyatel’nosti imeni I. P. Pavlova, Vol. 57, No. 3, pp. 268–275, May–June, 2007.     

Lost for Words or Loss of Memories? Autobiographical Memory in Semantic Dementia

Recent reports have suggested that patients with semantic dementia show a loss of early (remote) auto‐biographical memories with pronounced sparing of recent memories (Graham & Hodges, 1997; Snowden, Griffiths, & Neary, 1996), i.e., a ‘reversed’ temporal gradient or ‘Ribot effect’. At first sight, these findings suggest that the deficits in ‘semantic’ dementia go beyond the semantic domain, involving aspects of autobiographical (episodic) memory. It has also been proposed that there is a ‘step‐like’ function with personal memories preserved for 18 months to 2 years in the immediate past. This view is consistent with the theory that the hippocampal complex/medial temporal lobe (relatively intact in semantic dementia) plays a time‐limited role in the acquisition and storage of memories, while the temporal neocortex (damaged in semantic dementia) is required for long‐term storage and retrieval. In this study we ask whether (a) previous tests have underestimated the integrity of remote memory in semantic dementia as a result of not allowing for these patients' comprehension and language production difficulties, and (b) whether a recency effect, if obtained, is genuinely step‐like or more graded. We used a cued autobiographical memory interview with semantic dementia patient, IH, to examine the effect of providing increasingly specific lexical cues to probe salient events throughout his lifespan. Results demonstrated that the provision of specific cues enabled IH to access and express memories from his childhood and early adulthood as well as from more recent times. There was a gentle recency effect only for intermediate levels of cueing, indicating that recent memories were easier to retrieve and/or express in the absence of specific cues, but this effect was graded, with no evidence of a step‐like cut‐off at 18 months or 2 years before testing. In brief, our findings are consistent with the view that the deficits in semantic dementia are predominantly or exclusively semantic, rather than involving the storage of autobiographical memories per se.