Multimodal Assessment of the Motor System in Patients With Chronic Ischemic Stroke
Background and Purpose Despite the continuing efforts in multimodal assessment of the motor system after stroke, conclusive findings on the complementarity of functional and structural metrics of the corticospinal tract (CST) integrity and the role of the contralesional hemisphere are still missing. The aim of this work was to find the best combination of the motor system parameters, allowing classification of patients into three predefined groups of upper limb motor recovery.
Methods 35 chronic ischemic stroke patients (47 [26–66] y.o., 29 [6–58] months post-stroke) with only supratentorial lesion and unilateral upper extremity weakness were enrolled. Patients were divided into three groups depending on the upper limb motor recovery. Non-parametric statistical tests and regression analysis were used to investigate the relationships among structural and functional motor system parameters, probed by diffusion tensor imaging (DTI) and transcranial magnetic stimulation (TMS). In addition, stratification rules were tested, using a decision tree classifier to identify parameters explaining motor recovery.
Results Fractional anisotropy (FA) ratio in the internal capsule (IC) and absence/presence of motor evoked potentials (MEPs), were equally discriminative of the worst motor outcome group (96% accuracy). MEP presence diverged for two investigated hand muscles. Concurrently, for the three recovery groups’ classification, the best parameter combination was: IC FA ratio and Fréchet distance between the contralesional and ipsilesional CST FA profiles (91% accuracy). No other metrics had any additional value for patients’ classification.
Conclusions This study demonstrates that IC FA ratio and MEPs absence are equally important markers for poor recovery. Importantly, we found that MEPs should be controlled in more than one hand muscle. Finally, we show that better separation between different motor recovery groups may be achieved when considering the whole CST FA profile.
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Transcranial magnetic stimulation (TMS) is a modern non-invasive approach to study brain organization in humans. In TMS a time-varying magnetic fields generate induced electrical currents in the targeted brain regions with focal location of its maximum. Using of MRI navigation systems allows to fully realizing the advantages of TMS focality for brain mapping purposes. Due to this development, nowadays motor and speech nTMS mapping is becoming a routinely used procedure in neurosurgery. However, nTMS mapping for dynamic cortical assessment, for example, to study neuroplastic changes is still limited. An important reason for that is a lack of a standardized methodology for nTMS mapping results assessment. Here we propose TMSmap – a standalone graphical interface software for quantative analysis of the results of motor nTMS mapping (http://tmsmap.ru/), which allows considering both standard parameters like the size of the cortical muscle representation, the hotspot and the center of gravity location, as well as the additional ones such as the volume of the representation, the profile of the muscle cortical area and the overlap between the cortical representations and other user-defined parameters. The input data includes coordinates of the coil position and the response in each point of stimulation and individual structural MRI data.
Female drug users (FDU) are a vulnerable group discriminated in modern Russian society. Although criminal record increases their stigmatization and makes it more complex, it can catalyze the drug treatment process in several ways: either one can be sentenced to treatment or decide to ungergo it in order to get a lighter penalty or conditional release. Thus current research aims to investigate the interwoven experiences of sentence serving and rehabilitation of former FDU.
The report describes the evolution of the mentality of the Russian-speaking Koreans who have lived in Russia for 150 years. Despite the tragic pages of history, they preserved their culture. During this period, under the influence of foreign policy, socio-economic factors, is not dependent on them, the Korean mentality repeatedly transformed. Democratic transformation of Russian society, the rehabilitation of repressed peoples allowed Koreans get freedom both internal and external, above all, they got rid of the stigma of "Japanese spy."
Adequate assessment of individual functional motor potentials is important for developing appropriate rehabilitation strategies in ischemic stroke . Microstructural changes in corticospinal tract (CST) and corpus callosum (CC) were repeatedly correlated to post-stroke outcome [2, 3]. However, relationship between them and functional recovery remains unclear. Here we investigated relationship between integrity of CST and CC assessed with diffusion tensor imaging (DTI) and brain functional state assessed with navigated transcranial magnetic stimulation (nTMS) in chronic ischemic supratentorial stroke.
The author of the article analyzes the issues of human freedom from exploitation as a value, being a subject to criminal enforcement, that is, its protection from criminal attacks by suppression, prevention, and warning of the latter, as well as through criminal prosecution, punishment and rehabilitation of the perpetrators of such abuse, and recovery of the beached by such encroachments justice. The author also justifies the system of exploitation and relevance to counter them by means of criminal law.
We investigated the time-course of cortical activation during comprehension of literal and idiomatic sentences using MEG and anatomically guided distributed source analysis. Previous fMRI work had shown that the comprehension of sentences including action-related words elicits somatotopic semantic activation along the motor strip, reflecting meaning aspects of constituent words. Furthermore, idioms more strongly activated temporal pole and prefrontal cortex than literal sentences. Here we show that, compared to literal sentences, processing of idioms in a silent reading task modulates anterior fronto-temporal activity very early-on, already 150-250 ms after the sentences' critical disambiguating words ("kick the habit"). In parallel, the meaning of action words embedded in sentences is reflected by somatotopic activation of precentral motor systems. As neural reflections of constituent parts of idiomatic sentences are manifest at the same early latencies as brain indexes of idiomatic vs. literal meaning processing, we suggest that within ¼ of a second, compositional and abstract context-driven semantic processes in parallel contribute to the understanding of idiom meaning.
Cervical artery dissection (CeAD), a mural hematoma in a carotid or vertebral artery, is a major cause of ischemic stroke in young adults although relatively uncommon in the general population (incidence of 2.6/100,000 per year)1. Minor cervical traumas, infection, migraine and hypertension are putative risk factors1, 2, 3, and inverse associations with obesity and hypercholesterolemia are described3, 4. No confirmed genetic susceptibility factors have been identified using candidate gene approaches5. We performed genome-wide association studies (GWAS) in 1,393 CeAD cases and 14,416 controls. The rs9349379[G] allele (PHACTR1) was associated with lower CeAD risk (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.69–0.82; P = 4.46 × 10−10), with confirmation in independent follow-up samples (659 CeAD cases and 2,648 controls; P = 3.91 × 10−3; combined P = 1.00 × 10−11). The rs9349379[G] allele was previously shown to be associated with lower risk of migraine and increased risk of myocardial infarction6, 7, 8, 9. Deciphering the mechanisms underlying this pleiotropy might provide important information on the biological underpinnings of these disabling conditions.
This book presents the results of analysis of human capital in Murmansk and Archangelsk regions, republics of Komi and Karelia, and Nenets Autonomous Region. The authors considered migration processes and their trends; some of these were analyzed at municipal level. Having taken in account the importance of life expectancy as a complex indicator of sustainable development, the authors identified the periods of its growth and decline. Age-specific differences were also scrutinized. The relative contributions of major causes of mortality in life expectancy at birth were estimated. The authors described the dynamics of population of small indigenous peoples of the North (Vepsians, Nenets, Komi), the problems associated with their self-identification, census administration, migration, childbirth and life expectancy. The authors analyzed climate change as the new health risk factor, which affects safety of food and drinking water, accessibility of medical services and specific practices of deer-herding. A separate chapter of the book is devoted to current and future trends in working-age population until 2002. Each territory of Barents Sea Region displayed its own peculiar behavior of this indicator. The authors compared selected social, economic and demographic indicators in European part of Russian Arctic with those in foreign countries which belong to Barents Sea Region. This monograph was a product of collaborative efforts of the researchers from Economic Forecasting Institute and Institute of Demography of Higher School of Economics. B. A. Revich, Doctor of Medicine, and B. N. Porfiryev, Corresponding Member of Russian Academy of Sciences, edited this book.
This prototype development explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. MD act as X73 agent. Second one is focused on more powerful device X73 manager, which do not have the MDs' memory and processor usage constraints. The protocol between Agent and Manager is point-to-point and we can distribute the functionality between devices.
Developed both implementation X73 Agent and Manager will cut developing time for applications based on ISO/EEE 11073.
In the internal medicine wide spectrum the gastroenterology is one of the chapters, less enlightened by the scientific evidence. It does not mean that the practice of the grasntroenterology may ot be improved by the systematic use of the approaches of the evidence based medicine