DISASTER MEDICINE No. 2•2022
Study of Functional Cerebral Connectivity for the Development of Treatment and Prevention Strategies in Patients with Asymptomatic Carotid Atherosclerotic Stenosis
Pospelova M.L. 1, Efimtsev A.Y. 1, Lepyokhina A.S. 1, Trufanov G.E. 1, Alekseeva T.M. 1, Ivanova N.E. 1, Efimova M.Y. 1, Voronin A.S. 1, Makhanova A.M. 1, Mikhalicheva A.A. 1
1 Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation
Abstract. The aim of the study was to investigate the condition of the connectome in patients with asymptomatic carotid atherosclerotic stenosis of more than 60% when using hirudotherapy.
Materials and research methods. The examination results of 15 patients aged 60 to 82 years with asymptomatic carotid atherosclerotic stenosis in the range of 60-75% were analyzed. The patients underwent a course of hirudotherapy of 10 sessions. All patients underwent structural and functional magnetic resonance imaging with statistical data analysis at rest, complaints and neurological status were evaluated before and after hirudotherapy course.
Results of the study and their analysis. Within the course of hirudotherapy in patients with asymptomatic carotid atherosclerotic stenosis when analyzing the neurological status and complaints, a significant improvement of well-being was noted. Functional magnetic resonance imaging identified differences in functional connectivity between medial prefrontal cortex and other brain regions. There was activation in the main structures of the network of controlling and revealing significance. The connectivity between the leading areas of the brain increased, which is a sign of the improvement of the brain activity.
Conclusion. The study of connectivity can serve for exploring the work of brain networks and for determining the effectiveness of therapy. A course of hirudotherapy significantly changed the functional connectivity of brain areas, the changes correlated with a decrease in the number of complaints. Such work is a pilot and will be continued in order to further develop treatment and prevention strategies with the inclusion of hirudotherapy in patients with high risk of vascular accidents in sanatorium-resort treatment.
Keywords: atherosclerotic stenosis, asymptomatic carotid hirudotherapy, brain, connectome, functional connectivity, magnetic resonance imaging, patients, therapeutic and preventive strategies
For citation: Pospelova M.L., Efimtsev A.Y., Lepyokhina A.S., Trufanov G.E., Alekseeva T.M., Ivanova N.E., Efimova M.Y., Voronin A.S., Makhanova A.M., Mikhalicheva A.A. Study of Functional Cerebral Connectivity for the Development of Treatment and Prevention Strategies in Patients with Asymptomatic Carotid Atherosclerotic Stenosis. Meditsina Katastrof = Disaster Medicine. 2022;2:47-51 (In Russ.). https://doi.org/10.33266/2070-1004-2022-2-47-51
- Seung S. Konnektom = Connectome. Moscow, BINOM. Laboratoriya Znaniy Publ., 2014. 440 p. ISBN 978-5-9963-1685-4 (In Russ.).
- Fornito A., Bullmore E.T. Connectomics: a New Paradigm for Understanding Brain Disease. European Neuropsychopharmacology. 2015;25;5:733-748. DOI:10.1016/j.euroneuro.2014.02.011.
- Fornito A., Zalesky A., Breakspear M. The Connectomics of Brain Disorders. Nature Reviews Neuroscience. 2015;16;3:159-172. DOI:10.1038/nrn3901.
- Porshinsky B.S., Saha S., Grossman M.D., et al. Clinical Uses of the Medicinal Leech: a Practical Review. Journal of Postgraduate Medicine. 2011;57;1:65-71. DOI: 10.4103/0022-3859.74297.
- Pospelova M.L., Barnaulov O.D. Doppler Study of the Effectiveness of Hirudotherapy in Patients with Chronic Vertebrobasilar Insufficiency and Stage 1 Discirculatory Encephalopathy. Regionarnoye Krovoobrashcheniye i Mikrotsirkulyatsiya = Regional Blood Circulation and Microcirculation. 2010;2;34:40-43. DOI:10.24884/1682-6655-2010-9-2-40-43 (In Russ.).
- Semikova T.S., Semikova M.V. Girudoterapiya v Oftalmologicheskoy Praktike = Hirudotherapy in Ophthalmic Practice. Novyye Tekhnologii Mikrokhirurgii Glaza = New Technologies of Eye Microsurgery. Materials of the XII Scientific-Practical Conference. Orenburg: IPK “Gazprompechat” Publ., 2001. P. 65–66. ISBN 5-94397-017-7 (In Russ.).
- Dobrynina L.A., Gadzhieva Z.Sh., Morozova S.N., Kremneva E.I., Krotenkova M.V., Kashina E.M., Poddubskaya A.A. Executive Functions: FMRI of Healthy Volunteers during Stroop Test and the Serial Count Test. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2018;3:64-71. DOI:10.17116/jnevro201811811164 (In Russ.).
- Pospelova M.L., Zaytsev D.YE., Lepekhina A.S., Yefimtsev A.Yu., Alekseyeva T.M., Trufanov G.Ye. Cognitive Lesion in Patients with Asymptomic Carotid Stenoses more than 70% – Indication for Surgical Treatment? Sovremennyye Problemy Nauki i Obrazovaniya = Modern Problems of Science And Education. 2019;5. URL: http://www.science-education.ru/ru/article/view?id=29046 (дата обращения: 01.06.2021) (In Russ.).
The material was received 13.10.21; the article after peer review procedure 11.05.22; the Editorial Board accepted the article for publication 23.06.22