Preview

Acta Biomedica Scientifica

Advanced search

ДИФФЕРЕНЦИРОВАННОЕ КОМПЛЕКСНОЕ ЛЕЧЕНИЕ ПАЦИЕНТОВ, СТРАДАЮЩИХ БОЛЕЗНЬЮ ПАРКИНСОНА, С УЧЁТОМ СТЕПЕНИ АТРОФИЧЕСКИХ ИЗМЕНЕНИЙ ВЕЩЕСТВА ГОЛОВНОГО МОЗГА

https://doi.org/10.12737/article_5955e6b4c2a202.26751657

Abstract

The objective of this study was to compare the results of complex (medicinal and surgical), and only medicinal treatment of patients with rapidly progressive and dyskinesia associated forms of Parkinson's disease. Three atrophy indices (IA) of the brain matter were proposed to justify a differentiated approach to the treatment of each form. Multivariable regression analysis showed, that patients, who were treated with complex method and had IA-1 less than 0.16, IA-2 - less than 0.115, IA-3 - less than 0.06, had the best improvement of the clinical status during the follow-up period. There were also multiple correlation coefficients obtained in the range 0.911-0.943, which indicates a significant linear relationship between the factors of influence (IA) and response (clinical presentation). In groups with only conservative treatment, the coefficients were in the range of 0.331-0, 423, indicating low and medium dependence on clinical manifestations of atrophy indexes. The status of all patients was assessed after 3, 6, 12 and 18 months. It turned out that in case of the earlier mentioned indices values the result of the treatment was constant during the entire period of observation. It was statistically confirmed by the assessment of the squares of the Mahalanobis distance.

About the Authors

V. A. Chipizubov
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education; Irkutsk Regional Clinical Hospital
Russian Federation


S. I. Petrov
Irkutsk Regional Clinical Hospital
Russian Federation


I. M. Mikhalevich
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation


References

1. исследованиях с применением ППП Statistica): пособие для врачей. -Иркутск: РИО ГБОУ ДПО ИГМАПО, 2015. - 44 с.

2. Михалевич И.М. Регрессионный анализ (использование в медицинских исследованиях с применением ППП Statistica): пособие для врачей. - Иркутск: РИО ИГИУВа, 2009. - 32 с.

3. Саютина С.Б., Шпрах В.В., Рожкова Н.Ю. Цитиколин в комплексной терапии болезни Паркинсона // Тихоокеанский медицинский журнал. - 2013. -№ 4. - С. 76-78.

4. Саютина С.Б., Шпрах В.В. Возможности комплексной коррекции немоторных проявлений болезни Паркинсона в сочетании с дисциркуляторной энцефалопатией // Матер. II нац. конгр. по болезни Паркинсона и двигательным расстройствам. - М., 2011. - С. 359-363.

5. Coban A., Hanagasi H.A., Karamursel S., Barlas O.B. (2009). Comparison of unilateral pallidotomy and subthalamotomy findings in advanced idiopathic Parkinson’s disease. J. Neurosurg., 23 (1), 23-29. doi: 10.1080/02688690802507775.

6. Guridi J.I., Obeso J.A., Rodriguez-Oroz M.C., Lozano A.A., Manrique M. (2008). L-dopa-induced dyskinesia and stereotactic surgery for Parkinson’s disease. Neurosurgery, 62 (2), 311-323, discussion 323-5. doi: 0.1227/01.neu.0000315998.58022.55.

7. Jourdain V.A., Schechtmann G., Di Paolo T. (2014). Subthalamotomy in the treatment of Parkinson’s disease: clinical aspects and mechanisms of action. J. Neurosurg., 120 (1), 140-151. doi: 10.3171/2013.10.JNS13332.

8. Munhoz R.P., Cerasa A., Okun M.S. (2014). Surgical treatment of dyskinesia in Parkinson’s disease. Front. Neurol., 29 (5), 65. doi: 10.3389/fneur.2014.00065.

9. Obeso J.A., Jahanshahi M., Alvarez L., Macias R., Pedroso I., Wilkinson L., Rothwell J.C. (2009). What can man do without basal ganglia motor output? The effect of combined unilateral subthalamotomy and pallidotomy in a patient with Parkinson’s disease. Exp. Neurol., 220 (2), 283-292. doi: 10.1016/j.expneurol.2009.08.030.

10. Sako W., Miyazaki Y., Izumi Y., Kaji R. (2014). Which target is best for patients with Parkinson’s disease. A meta-analysis of pallidal and subthalamic stimulation. J. Neurol. Neurosurg. Psychiatry, 85 (9), 982-986. doi: 10.1136/jnnp-2013-306090.

11. Tarsy D. (2009). Does subthalamotomy have a place in the treatment of Parkinson’s disease? J. Neurol. Neurosurg. Psychiatry, 80 (9), 939-940. doi: 10.1136/ jnnp.2008.163949.


Review

For citations:


Chipizubov V.A., Petrov S.I., Mikhalevich I.M. . Acta Biomedica Scientifica. 2017;2(1):48-51. (In Russ.) https://doi.org/10.12737/article_5955e6b4c2a202.26751657

Views: 655


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2541-9420 (Print)
ISSN 2587-9596 (Online)