A new approach for modelling insolation from the space perspective

In the current project we have developed a novel insolation model which allows users to incorporate the impact of space activity (solar flares, galactic radiation) on the Earth’s climate. The incoming radiation was modelled as a flux passing through a cross-section (latitudinal belt), and the changes of light throughout the year were represented by an ellipse with changing parameters. This approach has allowed us to get the results for any latitude at any particular time. Obtained results indicate an average accuracy of 97% with only a few percent less for polar regions

Локальная церебральная гипоперфузия как причина развития симптомов и прогрессирования рассеянного склероза

Background. 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. Введение. Нейродегенеративные процессы играют важную роль в развитии клинических проявленийрассеянного склероза (РС), а также в прогрессировании заболевания. В то же время механизмынейродегенерации при РС не вполне ясны, что заставляет исследователей обращать внимание наранее не изученные патогенетические аспекты заболевания. Было показано, что у больных РС могут наблюдаться изменения локального кровотока в головном мозге, однако значение выявленныхнарушений изучено недостаточно.Целью нашей работы являлись оценка особенностей перфузии в очагах демиелинизации и внешненеизменeнных структурах головного мозга и определение их взаимосвязи с клиническими проявлениями РС.Материалы и методы. В исследовании приняли участие 49 пациентов с ремиттирующим и вторич-но-прогрессирующим РС в стадии ремиссии (клинической и по данным магнитно-резонансной томографии (МРТ)), которым проводились МР-перфузия головного мозга с контрастным усилениемна томографе с индукцией магнитного поля 3 Тл, а также оценка по шкале функциональных систем(FS), расширенной шкале нетрудоспособности (EDSS), шкале утомляемости (FSS). Анализ данныхвключал в себя автоматическое построение перфузионных карт для показателям: объем мозговогокровотока CBV, объемная скорость кровотока CBF и среднее время циркуляции MTT в очагах демиелинизации и внешне неизмененных структурах головного мозга.Результаты. Большой разброс показателей CBV в очагах может свидетельствовать о гетерогенностипроисходящих в них процессов – от реактивации воспаления до ремиелинизации. Выявленное намизначимое снижение перфузии в лентикулярных ядрах вне зависимости от тяжести заболевания, которое отрицательно коррелировало с выраженностью утомляемости, позволяет предположить, чтотерапия, направленная на улучшение перфузии головного мозга, может использоваться в качествесимптоматической терапии РС. Учитывая то, что регионарная гипоперфузия опережает развитиеатрофии, мы считаем, что лечение, направленное на улучшение перфузии, способно предотвращатьразвитие нейродегенеративных изменений при РС, что требует дальнейших исследований

CLIPPERS. Обзор литературы и собственные наблюдения

CLIPPERS (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.CLIPPERS (Chronic lymphocytic inflammation with pontine perivascular enhancement responsive tosteroids) – хроническое лимфоцитарное воспаление с поражением моста, контрастным усилениемпериваскулярных пространств, отвечающее на терапию глюкокортикостероидными препаратами,представляет собой редкое воспалительное заболевание центральной нервной системы, вовлекающеепреимущественно мост головного мозга. Впервые заболевание было описано в 2010 г. S.J. Pittock исоавт. В настоящее время в литературе описано около 50 случаев. Заболевание до настоящего временивызывает диагностические проблемы. В статье приведен краткий обзор литературы и собственныенаблюдения трех клинических случаев. Показана необходимость дальнейших исследований дляповышения точности и специфичности диагностических критериев, определения биомаркеров иразработки алгоритмов эффективной терапии

Regional cerebral hypoperfusion as a cause of symptoms and progression of multiple sclerosis

Background. 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

CLIPPERS. Three clinical cases and review

CLIPPERS (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

ПРИМЕНЕНИЕ ПРЕПАРАТОВ ВНУТРИВЕННЫХ ИММУНОГЛОБУЛИНОВ У ПАЦИЕНТОВ С ВИЧ-АССОЦИИРОВАННЫМИ ПОРАЖЕНИЯМИ НЕРВНОЙ СИСТЕМЫ (Обзор литературы и анализ клинического случая ВИЧ-ассоциированной вакуолярной миелопатии)

The clinical manifestations of lesions of the nervous system found at different stages of HIV infection in most patients may be caused by compromised cell immunity, direct neurotoxic effects of HIV, and pathological immune responses. Despite of significant progress in therapy for HIV-associated neurological disorders since the highly active antiretroviral therapy had been introduced into clinical practice, the problem of drugs able to eradicate HIV and to influence autoimmune processes is still urgent. Therapeutic means rendering complex anti-infection and immunoregulatory effects include intravenous immunoglobulin administration (IIA), which can improve prognosis significantly in some cases of HIV-associated neurological disorders. The present paper briefly reviews literature about diagnostics and treatment of nervous system lesions in HIV patients. A case of HIV-associated myelopathy progression in a HAART-treated patient is considered in detail. Diagnostic algorithms and possible mechanisms of IIA effects in cases of HIV-associated neurological disorders are discussed.Клинические проявления поражений нервной системы на различных стадиях ВИЧ-инфекции наблюдаются у большинства пациентов и могут быть вызваны ослаблением клеточно-опосредованного иммунитета, прямым нейротоксическим действием ВИЧ, а также иммунопатологическими реакциями. Несмотря на значительный прогресс в лечении ВИЧ-ассоциированных неврологических расстройств с момента внедрения в клиническую практику высокоактивной антиретровирусной терапии, проблема поиска препаратов, способствующих полной эрадикации вируса и воздействующих на аутоиммунные процессы, остается крайне актуальной. К средствам, оказывающим комплексное противоинфекционное и иммунорегуляторное действие относятся внутривенные иммуноглобулины, применение которых может значительно улучшить прогноз при некоторых ВИЧ-ассоциированных поражениях нервной системы. В статье приведен краткий обзор литературных данных по диагностике и лечению поражений центральной нервной системы при ВИЧ. Подробно анализируется случай ВИЧ-миелопатии, прогрессирующей на фоне ВААРТ. Обсуждается диагностический алгоритм при поражении спинного мозга у ВИЧ-инфицированных пациентов, возможные механизмы действия ВВИГ при связанных с ВИЧ неврологических расстройствах

EFFECT OF NEURODEGENERATIVE CHANGES IN THE BRAIN ON THE FORMATION OF THE DISEASE CLINICAL PICTURE IN PATIENTS WITH MULTIPLE SCLEROSIS

The 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