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Biomedical subjects

A B Gekht

Publications and source records attributed to A B Gekht.

At least 19 recordsLinked to original sources
PubMed2001

[Neuropsychological deficit in chronic heroin abusers].

Neurological consequences of chronic heroin exposure are poorly known. 38 male patients with current heroin abuse or dependence were examined in withdrawal period that lasted more than 10 days, and were compared with 19 healthy controls. Wisconsin Card Sorting Test (WCST), "Delayed Alternation" Test (DAT), "Tower of London" Test (TLT), Russian version of WAIS (1995) were used. Patients were medicated and medication status was evaluated by psychomotor speed level. Patients with the duration of daily heroin abuse more than 1.5 years performed significantly less effectively TLT solutions as compared with the healthy controls (after Bonferroni correction, p = 0001). Patients with shorter duration of daily heroin abuse had a trend to perform TLT solutions poorer as compared to healthy controls and better than group with longer duration (after Bonferroni correction, p = 0.07 and 0.08). Three groups did not differ by WCST and DAT significantly, and general intelligence was in normal range in three groups. Multiple regression analysis confirmed significant influence of daily heroin abuse duration on TLT performance efficiency in our population (beta = -0.426, p < 0.05) without effect of age, education, IQ, dosage of heroin per day, withdrawal duration and current medication status (psychomotor speed level). Perseverative responses on DAT were significantly related to daily heroin dosages before treatment (beta = 0.405, p < 0.05) and negatively correlated with the withdrawal duration. These data give grounds to suppose, that chronic heroin exposure impairs planning functions of prefrontal cortex (TLT), that can be explained by cumulative neuronal damages of prefrontal cortex and VTA dopamine neurons. That was demonstrated in experimental and morphological studies of opiate addicts who died after opiate overdose. Large doses of heroin can induce more extensive functional impairment with possible involvement of orbit frontal cortex. The latter deficit may be partially reversible during short-term withdrawal.

Adult↗
PubMed1998

[Epilepsy in patients with ischemic brain disease].

The paper presents the results of follow-up study of 610 patients with ischemic stroke. In 52 patients (8.6%) there was observed symptomatic epilepsy conditioned by local causes (2 and more epileptic fits in anamnesis). The age of the onset of epileptic seizures was in the range 50-69 years, and men prevailed. From all 52 patients with episyndrome 36 had only one stroke, 16 patients-two and more strokes. 14 patients had fits before the stroke development. Meanwhile in 10 patients the fits were the first stroke symptoms (early) and in 28 individuals the fits arose 7 days after the stroke development (late). Significantly more severe disorders of dynamic praxis were revealed in psychologic examination of the patients with secondary generalized fits than of ones with partial seizures. Pathogenetic and clinical aspects of vascular epilepsy, interactions between transitory ischemic attacks and the fits which developed before the stroke are considered.

Adult↗
PubMed1998

[Clinical neuropsychological aspects of motor disorders in patients with post-CVA epilepsy].

The study included 22 patients with poststroke epilepsy (group 1) and 30 patients with stroke without epilepsy (group 2). A bilateral decrease of the time of central conduction (TCC) through pyramidal path (both on the paretic and intact side) was revealed in group 1. This was not observed in patients of group 2 with similar gravity of motor disorders (p < 0.01). Tendency to TCC decrease was also observed in patients without epileptic disorders by day 5-6 after ischemic stroke. However, TCC values were increased in such patients by day 10-14. Low indices persisted for a long time in patients with poststroke. There was also an increase of delta index of facilitation (the difference between TCC in rest and in muscle effort). It was also found that motor disorders in the group of patients with poststroke epilepsy were characterised by higher muscular tone than in poststroke patients with the same degree of the paresis.

Aged↗
PubMed1998

[Disorders of muscle tonus and their treatment with sirdalud in patients in the early recovery period of ischemic stroke].

The paper presents the results of clinical and neurophysiologic study of muscular tonus in 94 patients aged 42-70 years in early recovery after ischemic stroke. Selective role of spasticity was estimated in clinical pattern of motor disorders in groups of the patients with different disorders of muscular tonus with the same degree of paresis. Efficiency of antispastic preparation sirdalud was analyzed in 28 patients from this group. Sirdalud in daily dose of 6-12 mg in patients with prevalence of a spasticity in a clinical picture of the paresis and with either moderate or manifested degree of paresis of the extremities has significant antispastic effect without any decrease of muscular strength, which, in turn, increases the degree of restoration of motor functions.

Adult↗
PubMed1998

[Clinical and neurophysiological aspects of somatosensory afferentation system in patients with hemispheric ischemic stroke].

Method of somatosensory evoked potentials (SSEP) was applied for examination of 36 patients in early restorative period of ischemic stroke located in internal capsule, in cortical-subcortical area of parieto-temporal cerebral regions or in cortical-subcortical areas of frontal areas. 15 healthy individuals formed a control group. Electrophysiologic SSEP pattern was not homogeneous and depended on the location of a damage focus in cerebral hemispheres. Peculiarities of generatory mechanisms of SSEP components' forming in ischemic stroke, are presented.

Adult↗
PubMed1997

[The metabolic therapy of ischemic stroke: the use of nootropil].

54 patients were treated by notropil (pyracetam). The results of therapy were evaluated statistically according to a number of clinical scales and neurophysiologic indices (EEG and evoked potentials with mapping of bioelectric activity). The results were compared with the data about 56 patients of the control group which were treated by traditional method without application of notropil. Notropil was applied by two ways: small doses (4-12 g daily) during 5 days or high doses (10-12 g daily) during 30 days from the moment when the patient admitted to the hospital. Intravenous injections of the drug were used in all cases as well as its internal administration. It was showed either efficiency of the drug, especially in high doses, in early beginning of the treatment and its duration for at least 30 days or good tolerance of the drug. Authors supposed that application of pyracetam is not adequate in strokes with severe disorders of consciousness and cerebral edema.

Acute Disease↗
PubMed1997

[Nootropil in the treatment of disorders of the higher mental functions in patients with an ischemic stroke].

47 patients with acute ischemic stroke were treated with nootropil (pyracetam, UCB, Belgium) from the first day of the disease (12 g, intravenously, by drops during 2 weeks, then 4.8 g, per os) on the background of basic therapy. There was revealed increase of spontaneous activity, expressive and impulsive speech, audio- and speaking memory (especially delayed memory), tactile, acoustic and visual gnosis, space praxis. There was observed more pronounced positive dynamics of functions of damaged hemisphere in patients with localisation of ischemic focus in left hemisphere. Meanwhile restoration was slower when ischemic focus was localized in right hemisphere. Restoration of high mental functions occurred to be faster during nootropil treatment as compared with basic therapy only. The conclusion was made that nootropil can be prescribed for the patients with hemispheric ischemic stroke and especially for the patients with alterations of cerebral circulation in system of internal carotid artery including such disturbances on the background of insufficiency of circulation in vertebrobasilar system.

Acute Disease↗
PubMed1995

[An analysis of the data from the neurophysiological examination of patients with bronchial asthma and hyperventilation].

Bronchial asthma (BA) patients with hyperventilation (HV) were examined by means of evoked cutaneous sympathetic potential (ECSP) and short-latency evoked stem potentials to acoustic stimulation (SLESP to AS). Measurements of these parameters allowed quantitation and differentiation of hyperventilation disorders in BA patients. The latter were divided into 4 groups: BA patients with HV syndrome (HVS), BA patients with functional HV (FHV), BA patients with spontaneous HV (SHV) and BA patients without HV. BA patients with HVS exhibited a significant increase of latent ECSP period and latent periods III and V SLESP to AS peaks. This evidences for vegetative neuropathy and dysfunction of the pons and mesencephalic brain compartments. In BA patients with FHV there was a longer latent period II of SLESP to AS peak indicating dysfunction of caudal brain stem. BA patients with SHV and without HV had no significant shifts.

Adolescent↗
PubMed1994

[The clinico-neurophysiological study of the effect of cerebrolysin on brain function in the acute and early recovery periods of hemispheric ischemic stroke].

Thirty patients with acute ischemic stroke and at early terms of postapoplectic recovery received cerebrolysin in daily doses 10, 20 and 30 ml for 5 days or 10 ml, i. v. for 10 days, respectively. The patients were examined for neurological status and cerebral function. In acute stroke the highest effect occurred in the affection of moderate severity. In severe stroke the drug stimulated recovery of impaired functions which tended to restore more quickly than in control subjects. In early convalescents cerebrolysin improved motor functions. Details of the results of the combined neurophysiological examination in the course of the treatment are discussed.

Acute Disease↗
PubMed1993

[The complex clinico-electrophysiological assessment of the motor disorders in patients in the early period of recovery from an ischemic stroke].

A neurophysiological analysis of motor affections has been made in post-apoplectic patients during early convalescence. Altogether 26 patients aged 45-68 were examined on week 3-4 since ischemic hemispheric apoplexy. Magnetic stimulation of cerebral cortex motor zones, measurements of M-response and evoked skin sympathetic potential. Mild or moderate motor dysfunctions were characterized by reduced amplitude of the M-response and prolonged central pyramid conduction on the affected side. Severe paresis is associated with no M-response to magnetic stimulation of the cortex on the affected side. Pathogenetic mechanisms of the above disorders and their implications for treatment and rehabilitation are discussed.

Aged↗