Burdenko Research Institute of Neurosurgery

Moscow, Russia

Burdenko Research Institute of Neurosurgery

Moscow, Russia
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Krylov V.V.,Moscow State University | Guekht A.B.,Pirogov Russian Natural Research Medical University | Trifonov I.S.,Moscow State University | Lebedeva A.V.,Pirogov Russian Natural Research Medical University | And 6 more authors.
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2016

Objective. To evaluate the results of surgical treatment of patients with pharmacoresistant epilepsy. Material and methods. Examination and surgical treatment of 61 patients with pharmacoresistant forms of symptomatic epilepsy were performed from 01.01.14 to 01.05.16. Results and conclusion. The results confirmed the safety and efficacy of the surgical treatment of pharmacoresistant epilepsy. After 12 months, seizures were controlled in 69% of operated patients. The necessity of complex examination of all patients with pharmacoresistant epilepsy to make a decision about possible surgery is shown. © 1998-2017, Media Sphera Publishing house. All rights reserved.


Teryaeva N.B.,Burdenko Research Institute of Neurosurgery
Neuroscience and Behavioral Physiology | Year: 2015

Adipokines are fatty tissue hormones, a relatively recently discovered class of compounds regulating energy metabolism in virtually all organs and tissues. They include leptin, discovered before and studied better than other adipokines, and evidently associated with the development of a whole series of diseases and pathological states: insulin resistance and diabetes mellitus, cardiovascular system pathology, and oncological and chronic inflammatory diseases. All these states are in one way or another mediated by the influences of leptin on the metabolism of energy substrates and the formation of a proinflammatory state. However, recent years have seen the appearance in the literature of intriguing data on fundamentally different, neurotropic, effects of leptin, suggesting that it has a direct influence on the preservation of neural structures, as well as synapse functioning and transmitter processes. These data allow leptin to be regarded as a neuroprotector, i.e., a neuroplastic factor, and possibly a significant element in realizing specific brain functions. The role of leptin deficiency in lesions to nervous structures and the establishment of the symptoms of central nervous system diseases can also be assessed from this point of view. © 2015 Springer Science+Business Media New York.


Bril E.V.,Moscow Medical Academy | Tomskiy A.A.,Burdenko Research Institute of Neurosurgery | Gamaleya A.A.,Burdenko Research Institute of Neurosurgery | Poddubskaya A.A.,Burdenko Research Institute of Neurosurgery | And 4 more authors.
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2015

Objective. To analyze pharmacotherapy accompanied by deep brain stimulation of the subthalamic nucleus. Material and methods. The study included 54 patients, who underwent bilateral STN DBS from 2003 to 2012. The severity of motor disturbances, activities of daily living and complications of dopaminergic therapy were estimated in accordance with II, III and IV parts of the Unified Parkinson’s Disease Rating Scale (UPDRS) before operation and one, three and four years after it. L-dopa equivalent daily dose (LEDD) was assessed along with an analysis of the pharmacotherapy in whole. Results and conclusion. By the end of the 1st year, the severity of motor disturbances in OFF-period decreased by 52.3% and remained stable for 3 years (51.8%), a slight increase of severity of motor disturbances was observed later, however it didn’t reach the pre-operative level. The severity of motor fluctuations and drug-induced dyskinesia fell by 64.9%, 70.7% and 42.7% by the end of the first, third and fourth year of observation. The maximal decrease in LEDD was reached by the end of the 1st year and accounted for 57.7%; by the end of the third and fourth years it was 52.4% and 38.2%, respectively. During the 1st year, 16.7% of patients didn’t take levodopa. The dose of pure levodopa decreased by the end of the 1st year by 64.6%, and by 56.7% and 43.7% by the end of the 3rd and 4th years, respectively. Monotherapy by an agonist of dopamine receptors (ADR) was received by 12.9% of patients, thus the share of ADR as part of the combined therapy increased in the postoperative period from 24.1% to 35.2%. © 2015, Media Sphera. All rights reserved.


Bril' E.V.,Moscow Medical Academy | Tomskii A.A.,Burdenko Research Institute of Neurosurgery | Gamaleya A.A.,Burdenko Research Institute of Neurosurgery | Poddubskaya A.A.,Burdenko Research Institute of Neurosurgery | And 4 more authors.
Neuroscience and Behavioral Physiology | Year: 2017

Objective. To analyze pharmacotherapy on the background of stimulation of the subthalamic nucleus (STN). Materials and methods. A total of 54 patients with implanted STN stimulation systems (Medtronic) were investigated from 2003 to 2012. The severity of motor disorders, daily activity, and complications of pharmacotherapy were evaluated using parts II, III, and IV of the Unified Parkinson’s Disease Rating Scale (UDPRS) before surgery and at one, three, and four years of continuing stimulation. The equivalent daily dose of levodopa was evaluated, along with analysis of pharmacotherapy overall. Results and conclusions. The severity of motor impairments in off periods decreased by 52.3% by one year of observation and remained stable for three years (51.8%), after which there was a small increase in the severity of motor symptoms, though not to the pre-operative level. The severity of motor fluctuations and iatrogenic dyskinesia decreased by 64.9%, 70.7%, and 42.7% at the ends of years 1, 3, and 4, respectively. The levodopa equivalent dose showed the greatest decrease by one year (57.7%), with decreases by 52.4% and 38.2% at three and four years, respectively. During the first year, 16.7% of patients took no levodopa. The levodopa dose decreased by 64.6% at one year and then by 56.7% and 43.7% at three and four years, respectively. Dopaminergic receptor agonist monotherapy was used in 12.9% of patients, the proportion receiving agonists in combined therapy increasing from 24.1% to 35.2% during the post-operative period. © 2017, Springer Science+Business Media New York.


Chelyapina M.V.,Institute of Higher Nervous Activity and Neurophysiology | Sharova E.V.,Institute of Higher Nervous Activity and Neurophysiology | Zaytsev O.S.,Burdenko Research Institute of Neurosurgery
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2016

Objective. To determine the clinical and electrophysiological (EEG) signs of cholinergic deficiency in the process of recovery of consciousness in patients with severe brain injury. Materials and methods. Thirty-seven people (24 men and 13 women, mean age 32±14 years) were studied. A comprehensive study included assessment of neurological status, mental activity, and EEG. Results and Conclusion: A set of neurological symptoms, including reduced muscle tone, autonomic disorders (dry mucous membranes and skin, tachycardia, hypotension, gastrointestinal tract), eye movement disorders, that were,in accordance with the literature, characteristicof the cholinergic deficiency syndrome was found. This syndrome was detected against the background of a comatose state, akinetic mutism and mutism with understanding of speech, disintegration of speech, disorientation and amnestic decline. EEG revealed stable over time (months) characteristic changes: slowing and asymmetric alpha activity, equivalent dipole sources of hippocampal and stem localization, persistent strengthening of intra-hemispheric coherent connections, especially on the left side. The regression of the cholinergic deficiency syndrome was accompanied by an increase of regularity, capacity and frequency of alpha-activity (from 7-8 to 9-10 Hz), prevalence of equivalent dipole sources in the hippocampus with their appearance in the occipital cortex, normalization of connections with right-brain coherence with the preservation of their pathologically high values on the left side. © 2016, Media Sphera. All rights reserved.


PubMed | Burdenko Research Institute of Neurosurgery and Institute of Higher Nervous Activity and Neurophysiology
Type: Journal Article | Journal: Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova | Year: 2016

To determine the clinical and electrophysiological (EEG) signs of cholinergic deficiency in the process of recovery of consciousness in patients with severe brain injury.Thirty-seven people (24 men and 13 women, mean age 3214 years) were studied. A comprehensive study included assessment of neurological status, mental activity, and EEG.A set of neurological symptoms, including reduced muscle tone, autonomic disorders (dry mucous membranes and skin, tachycardia, hypotension, gastrointestinal tract), eye movement disorders, that were,in accordance with the literature, characteristicof the cholinergic deficiency syndrome was found. This syndrome was detected against the background of a comatose state, akinetic mutism and mutism with understanding of speech, disintegration of speech, disorientation and amnestic decline. EEG revealed stable over time (months) characteristic changes: slowing and asymmetric alpha activity, equivalent dipole sources of hippocampal and stem localization, persistent strengthening of intra-hemispheric coherent connections, especially on the left side. The regression of the cholinergic deficiency syndrome was accompanied by an increase of regularity, capacity and frequency of alpha-activity (from 7-8 to 9-10 Hz), prevalence of equivalent dipole sources in the hippocampus with their appearance in the occipital cortex, normalization of connections with right-brain coherence with the preservation of their pathologically high values on the left side.


Karlov V.A.,Moscow State University | Lebedeva A.V.,Vladimirsky Moscow Regional Research Clinical Institute | Stepanenko A.Y.,Vladimirsky Moscow Regional Research Clinical Institute | Rudakova I.G.,Russian National Research Medical University | And 5 more authors.
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2014

The literature data on using intravenous forms of AEDs that expand treatment possibilities for patients with epilepsy are presented. AEDs can be used in different situations, when patients are not able to take AEDs in per os. These situations can include seizure emergencies (recurrent seizures, clusters, status epilepticus), caused by disease decompensation; acute symptomatic seizures; perioperative preparation in the case of surgery; dysphagia; gastrointestinal problems; psychiatric disorders, and others. This article is based on a review of International and Russian expert consensus practice guidelines for management of clinical situations mentioned above. The authors present data on available Russian parenteral forms of drugs used today (valproats, levetiracetam, lacosamide, diazepam, midazolam, propofol, thiopental potassium). It has been concluded that an ideal intravenous AED should be highly effective, acts fast, has no severe adverse effects, has low drug-drug interactions, does not require frequent plasma concentration monitoring, and should be easily switched to a per os form without any additional titration. The importance of separate treatment approaches on different stages of medical help is emphasized. The choice of drug used can be influenced by a particular clinical situation, indications/contraindications, the recommended infusion speed, side effects, possible drug-drug interactions with other AEDs and other drugs used for the treatment of concomitant diseases, availability of a particular drug at the moment and the level of a physician's knowledge of usage of intravenous forms of AEDs.


Chelyapina M.V.,Russian Academy of Sciences | Sharova E.V.,Russian Academy of Sciences | Zaitsev O.S.,Burdenko Research Institute of Neurosurgery
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2015

Objective. To determine electroencephalographic signs of dopamine deficiency syndrome during the recovery after severe brain injury (SBI). Material and methods. We studied 35 patients with SBI (23 men and 12 women, mean age 29±13 years). Results and conclusion. We identified a set of neurological symptoms (increased muscular tone of extrapyramidal type, rest tremor, autonomic disorders, which were most characteristic of the autonomic state, and some forms of mutism associated, according to current conceptions, with the dopaminergic system deficiency syndrome. This clinical picture was accompanied by stable EEG changes: an increase in the severity of beta activity of 13-14 Hz, enhanced in the frontal and anterior temporal areas, synchronized with equivalent dipole source localization in subcortical and frontal/basal areas. Dopamine deficiency regression syndrome was accompanied by an increase in beta EEG activity (from 13 to 16 Hz), but with the persistent abnormal enhancement of coherent hemispheric relations, especially in the occipital- temporal areas. © 2015, Media Sphera. All rights reserved.


Osipov G.S.,Russian Academy of Sciences | Smirnov I.V.,Russian Academy of Sciences | Molodchenkov A.I.,Russian Academy of Sciences | Nazarenko A.G.,Burdenko Research Institute of Neurosurgery
Scientific and Technical Information Processing | Year: 2013

This paper presents a multifunctional support system for evidence-based medical technology that permits medical publications and reference information to be searched for in external information resources, makes it possible to formulate questions in medically accepted formats and to perform a critical analysis of publications according to the principles of evidence-based medicine, enables clinical and statistical calculators to be used, and permits answers to clinical questions to be automatically formed and archived. The system has been tested at a multi-profile hospital and demonstrated efficiency in clinical decision-making support. © 2013 Allerton Press, Inc.


Koshkin P.A.,Russian National Research Medical University | Chistiakov D.A.,Russian National Research Medical University | Nikitin A.G.,Russian National Research Medical University | Konovalov A.N.,Burdenko Research Institute of Neurosurgery | And 6 more authors.
Clinica Chimica Acta | Year: 2014

Background: MicroRNAs (miRNAs) are a class of small non-coding RNA molecules involved in the regulation of key biological processes. Different miRNAs with pro-oncogenic and anti-oncogenic properties have been identified in glioblastomas. We decided to analyze expression profiles of 10 mature miRNAs (miR-7-1, miR-10a, miR-17, miR-20a, miR-21, miR-23a, miR-26a, miR-137, and miR-222) in post-surgery glioma specimens of different grades in order to find whether the expression level correlates with tumor grades. We also measured expression of six key genes such as PTEN, p21/CDKN1A, MDR1, ABCG2, BAX, and BCL-2 involved in the regulation of critical glioma signaling pathways to establish the effect of miRNAs on these signaling mechanisms. Methods: Using RT-PCR, we performed expression analysis of 25 tumor fresh samples (grades II-IV). Results: We found gradual increase in miR-21 and miR-23a levels in all tumor grades whereas miR-7 and miR-137 were significantly down-regulated depending on the glioma grade. MDR, ABCG2, and p21/CDKN1A levels were significantly up-regulated while expression of PTEN was down-regulated in tumor samples compared to the normal brain tissue. Conclusions: These observations provide new insights into molecular pathogenic mechanisms of glioma progression and suggest about a potential value of miRNAs as a putative diagnostic marker of brain tumors. © 2014 Elsevier B.V.

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