Оценка эффективности комплекса методов медицинской реабилитации пациентов с двигательной дисфункцией кисти вследствие острых нарушений мозгового кровообращения

МЕДИЦИНСКАЯ РЕАБИЛИТАЦИЯКИСТЬ РУКИКИСТЬПСИХОМОТОРНАЯ АКТИВНОСТЬДВИГАТЕЛЬНЫХ НАВЫКОВ РАССТРОЙСТВА /РЕАБИЛРЕАБИЛИТАЦИЯ /МЕТОДЫМОЗГОВОГО КРОВООБРАЩЕНИЯ РАССТРОЙСТВА /ОСЛ /РЕАБИЛЛЕЧЕБНАЯ ГИМНАСТИКАМЕЛКАЯ МОТОРИКАЦелью исследования являлось изучение эффективности комплекса медицинской реабилитации, разработанного на основе зеркальной визуальной обратной связи, элементов двигательной терапии индуцированным ограничением, метода тренировки двигательных навыков кисти с использованием латексных резинок и авторского метода тренировки мелких моторных навыков у пациентов с двигательной дисфункцией кисти вследствие острого нарушения мозгового кровообращения различной степени выраженности. В исследовании приняли участие 62 пациента, разделенные на 2 группы сравнения, сопоставимые по полу, возрасту, реабилитационному периоду и потенциалу. Для анализа результатов использовались методы оценки эффективности медицинской реабилитации пациентов с двигательной дисфункцией кисти, утвержденные министерством здравоохранения Республики Беларусь. По результатам исследования было выявлено межгрупповое различие в восстановлении мелкой моторики, показателей кистевой динамометрии, уровне самооценки пациентом утраты функции верхней конечности, степени выраженности тревожной и депрессивной симптоматики, проявляющееся в более качественном результате у пациентов клинической группы. Также выявлено преобладание увеличений показателей и при оценке качества жизни у респондентов, проходящих предложенный комплекс методов медицинской реабилитации над пациентами контрольной группы. Разработанный комплекс, в условиях применения в соответствии с алгоритмом, позволяет более качественно по сравнению с пациентами, проходящими стандартный курс медицинской реабилитации, восстановить двигательный навык, утраченный вследствие острого нарушения мозгового кровообращения, улучшить степень самообслуживания, качества жизни и приводит к снижению выраженности тревожно-депрессивной симптоматики.Objectives. To study the efficacy of the medical rehabilitation complex developed on the basis of mirror visual feedback, elements of constraint induced movement therapy, the method of hand motor skills’ training with the use of latex rubber bands and the author’s own method of fine motor skills training in patients with motor dysfunction of the hand caused by acute cerebral circulation of different severity degree. Material and methods. The study involved 62 patients, divided into 2 comparison groups, matched by sex, age, rehabilitation period, and potential. To analyze the results we used methods for assessing the effectiveness of medical rehabilitation of patients with motor dysfunction of the hand, which were approved by the Ministry of Health of the Republic of Belarus. Results. The study revealed an intergroup difference in restoring fine motor skills, hand dynamometry indices, the patient’s self-assessment of the upper limb function loss, the severity of anxiety and depression symptoms, which manifests itself in a better result in patients of the clinical group. The prevalence of the increased indicators was also revealed when assessing the life quality of respondents undergoing the proposed complex of medical rehabilitation methods over patients of the control group. Conclusions. The developed complex, in terms of application in accordance with the algorithm, allows more qualitatively compared with patients undergoing a standard course of medical rehabilitation, to restore the motor skill lost because of acute cerebral circulation disturbance, to improve the degree of self-care, quality of life and leads to a decrease in anxiety-depression symptoms

Gender-Specific Association of Galanin Polymorphisms with HPA-Axis Dysregulation, Symptom Severity, and Antidepressant Treatment Response

Galanin (GAL) is an estrogen-inducible neuropeptide, highly expressed in brain regions reported to be involved in regulation of mood and anxiety. GAL possibly has a direct modulatory effect on hypothalamic–pituitary–adrenal (HPA)-axis regulation. Recent data from pharmacological and genetic studies indicate a significant function of GAL in stress-related disorders. By using a tag SNP approach covering the locus encoding preprogalanin (PPGAL), earlier findings of female-specific associations of polymorphisms in this locus with panic disorder were expanded to a larger sample of 268 outpatients with anxiety disorders (ADs). Within a larger sample of 541 inpatients with major depressive disorder (MDD), we then tested associations of one PPGAL tag SNP with specific depression symptom clusters and HPA-axis activity assessed by the combined dexamethasone-suppression/CRH-stimulation test both at inpatient admission and discharge (n=298). Gender specificity as well as dependence of the association on levels of circulating estrogens was analyzed. Genotyping revealed high linkage disequilibrium in the promoter area of the PPGAL gene, which includes several estrogen-response elements. Confirming earlier results, rs948854, tagging this promoter region, was associated with more severe anxiety pathology in female AD patients, but not in males. In premenopausal female MDD patients, the same allele of rs948854 was associated with more severe vegetative but not cognitive depressive symptoms at discharge and worse treatment response on antidepressant medication. Furthermore, this allele was associated with higher HPA-axis activity at admission. No significant case–control associations could be observed. However, because of power limitations of both patient samples, small effects cannot be excluded. The reported associations in independent samples of AD and MDD support an estrogen-dependent function of GAL in pathophysiology of anxiety and depression, affecting response to antidepressant treatment

Chemical neuroanatomy of the hypothalamo-hypophyseal system in sturgeons

International audienceThe preoptic-hypothalamo-hypophyseal system of sturgeons, located at the base of the brain, has a neurosecretory role exerted by hypophysiotropic neurons most of them located in the preoptic and hypothalamic periventricular region. The majority of those cells are of the cerebrospinal fluid-contacting type and exhibit short processes reaching the ventricular lumen. Moreover, the processes of those hypophysiotropic neurons course along the hypothalamic floor toward the hypophysis forming a preoptic-hypothalamo-hypophyseal tract. This chapter summarizes available data on the distribution of several hypophysiotropic factors, such as galanin, neurophysin, somatostatin, or gonadotropin-releasing hormone, in the preoptic-hypothalamo-hypophyseal system of sturgeons obtained by the use of immunohistochemical techniques. Immunoreactive neurons to those substances were found in the preoptic and hypothalamic nuclei, and immunoreactive fibers were observed along the preoptic-hypothalamo-hypophyseal tract and in the hypophysis, indicating their hypophysiotrophic role in the brain of sturgeons. Thus, most of the neuropeptides and neurohormones found in tetrapods are also present in sturgeons, suggesting that their common ancestors already possessed such regulatory systems. Unfortunately, because of the difficulty in approaching the physiology of sturgeons (size, cost, etc.), the number of experimental studies aiming at deciphering the roles of such neuropeptides and neurohormones is very limited, although we can speculate that part of the functions supported by these neurohormones would be similar. © Springer International Publishing AG, part of Springer Nature 2018. All rights reserved