[Dementia processes at an advanced age and changes in the subcortical substantia alba (leukoaerosis) (a review)].
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Biomedical subjects
Publications and source records attributed to A V Medvedev.
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Hemosorption was included in the complex treatment of 30 patients (age: 25-50 years) suffering of rheumatoid arthritis. It was found that the most sensitive laboratory tests of treatment efficacy were erythrocyte sedimentation rate, reduction of the level of gammaglobulins. Clinical improvement was pronounced as result of hemosorption treatment.
Rat embryonal fibroblasts of the second passage have been immortalized or transformed with the E1A region of the human adenovirus type 5 and the cloned c-Ha-ras oncogene. Several cell lines obtained greatly differ according to the criteria of the transformed phenotype: saturation cell density, the ability to be cloned on a substrate and in soft agar, the ability to give tumors in nude mice. We have transiently transfected these immortalized and transformed cell lines with CAT-plasmids containing the CAT gene under the control of promoters of the "cell-cycle dependent" genes (human hsp70 and protooncogene c-fos). The results showed that the expression of hsp-CAT and fos-CAT plasmids differed in great extent depending on whether the cells were immortalized (E1Aad5) or transformed (E1Aad5+Ha-ras). The role of cellular genes and cellular transcription factors influencing the expression of transiently transfected CAT-plasmids has been discussed.
Paranoid and hallucination syndromes were studied in 71 cases of senile non-dementia psychoses located at the patients' house. Two major variants were singled out: paranoid and hallucinatory (the latter subdivided into patterns with or without the persecution delusion, and physical affection delusion). Paranoid variant was shown to be based upon a special transformation of visual perception with formation of delusions of penetration of a "stranger" into the patients' home. Hallucinatory variants were based predominantly on primitive physically-straining hallucinations with protopathic meaning. As the paranoid syndrome increased in severity, the space of its projection onto housing place expanded. It is suggested that housing conditions themselves could influence the psychopathology of housing paranoid.
Spectral signs of genetically conditioned convulsibility of rats of the Krushinskiĭ-Molodkina (KM) strain were determined when studying the background electrical brain activity. These signs were: an increase of the delta-activity power in motor and visual cortical zones; considerable increase of the hippocampal potential power; weakening of the caudate nucleus potential power. Spectra of biopotentials being approximated by theoretical spectral function, model parameters simulating physiological characteristics of neural networks were estimated (an inverse problem of modelling). Spectral signs of convulsibility were shown to reflect changes in properties of the neural network. On the basis of calculations it is supposed that genetically determined convulsibility of KM rats results from weakening of inhibitory functions of the caudate nucleus as well as from increased excitability (reactivity) of hippocampal and neocortical neurons.
Rats of the Krushinskiĭ-Molodkina (KM) strain genetically predisposed to audiogenic seizures were repeatedly injected camphor for 4-5 months in gradually increasing doses (beginning from those below the seizure threshold up to those above it). As a result of "adaptation" to the convulsant action rats endured without seizures camphor doses 1.5-3 times higher than seizure threshold ones. Parallel with this "adaptation" the motor cortex of KM rats accumulated properties peculiar to the epileptic focus: spontaneous epileptiform spikes were recorded there after the camphor application. Estimation of the neural network parameters from spectra of the motor cortex biopotentials using the network model has shown a decrease of a parameter reflecting efficacy of the recurrent inhibition mechanisms. It is supposed that development of compensatory processes making rats able to avoid generalized camphor seizures are related to an increase of inhibitory functions of the caudate nucleus and weakening of the hippocampal excitability.
The authors investigated the impact of single CT investigation of senile dementia patients. CT was assessed visually. Investigated were 214 patients (23 with senile dementia, 29 with Alzheimer disease, 14 with Pick disease, 90 with vasculogenic dementia, 58 with other forms of dementia). The overall high efficiency of CT was shown in diagnosis of senile dementia. Depending on peculiar clinico-morphological relations different patterns of CT contribution to dementia diagnosis are determined: its verification, detection of concomitant (clinically latent) pathology, establishment of an alternative diagnosis, reduction of the number of diagnostic hypotheses, correction of a diagnostic error.
Selective attention was studied by registering cortical evoked potentials to acoustic stimuli in mental patients and mentally healthy subjects of old age. Disorder of selective attention in the patients was manifested in an impaired ability of the higher portions of the central nervous system to differentiate between essential and non-essential external stimuli as well as in a weakened inhibition of irrelevant information.
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The authors studied 62 patients with late schizophrenia with the predominance of elementary misperceptions. The main variants of such psychoses with auditory, olfactory and tactile perceptive disturbances have been identified. The authors also ascertained common typological signs distinguishing these psychoses from the classical paranoids of late age. A possible role of the age and environmental factors in the formation of the above psychoses is considered.
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Thirty-eight patients with late mentally deteriorating processes were studied. Using a standardized neuropsychological method, the authors have outlined four major variants of neuropsychological syndromes characteristic of damage to definite zones of the brain. Comparison of these data with the results of clinical and computer-aided tomographic examination showed that the neuropsychological approach is an adequate method in the combined study of senile dementia.
On the basis of examining 86 senile schizophrenics with defective initial conditions two groups of such conditions were specified: 1) defect conditions retaining the structure specific for schizophrenia (apathic defect, apathic mental deficiency and its variant with pseudosenile disturbances); 2) defect conditions, approaching by their manifestations to the picture of psychic disintegration associated with senile dementia. The psychopathological structure of the first group of defect conditions primarily reflects the degree of the schizophrenia progression. Their time course in old age was limited to insignificant age-related modifications and decompensation. Deficit conditions in the second group develop the more frequently, the closer to old age the period of the maximum activity of the schizophrenic process and the older the patients.
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Ecmnestic disturbances were revealed in 170 out of 260 schizophrenic patients who have lived up to the old age. In all the patients the disease took an unfavourable course (paranoid and malignant schizophrenia). The ecmnestic disturbances appeared to be rather diverse in their contents, and were encountered in the structure of various psychopathological manifestations both productive and deficient. Two types of the ecmnestic disturbances were differentiated, and namely, ecmnesia of delay and ecmnesia of regression of the psychic development. The role of the age factor in the formation of each type of those disturbances is demonstrated.
Under examination there were 100 patients with paranoid schizophrenia who had reached an old age. In all the patients signs of delusion reduction were observed at the late stages of the disease. It was shown that most delusional disorders tended to transform into residual ones and to become peculiar manifestations of the derangement. Against this background it was actual delusional experiences that persisted most frequently. More and more place in their structure took psychopathological elements that reflected various aspects of the ageing of the patients' psychosis.