INTRODUCTION: Members of the coronavirus family can affect the human central nervous system, causing various neurological complications in patients with SARS-CoV-2. Proton magnetic resonance spectroscopy (1H-MRS) seems to be a promising technique for assessing the prognosis of persistent neurological manifestations and complications, determining the completeness of a patient’s recovery during long-term follow-up. OBJECTIVE: To study changes in the metabolites profile in the brain with relation to cognitive impairment in patients with COVID-19.MATERIALS AND METHODS: 68 patients with verified COVID-19 and neurological complaints underwent a diagnostic workup, including a psychoneurological assessment and MRI of the brain with multivoxel proton magnetic resonance spectroscopy (1H-MRS), starting in the first 2 weeks from the onset of the disease. In 11 patients, a complex examination was repeated 7–8 months after the onset of the disease. The exclusion criteria were acute severe neurological symptoms, age over 65 years, artificial lung ventilation, lung CT score III–IV, as well as information about pre-Covid neuropsychiatric disorders. As a control group, earlier collected data of 10 healthy volunteers (age 30–67 years) were taken from a local database. Statistics: Intergroup differences in the ratios of metabolites peak areas determined by the 1H-MPC method were assessed using the nonparametric Mann-Whitney test with Bonferroni’s correction for multiple comparisons. Values were considered statistically significant at p<0.05. RESULTS: According to 1H-MRS, all patients with COVID-19 showed metabolic changes in the brain: a statistically significant increase in mI/Cr in the white and gray matter and a diffuse decrease in the levels of Cho/Cr in the supraventricular white matter, even in the absence of any changes in structural MRI. DISCUSSOIN: Patients were divided into three subgroups according to the severity of neurological symptoms that arose with the onset of the coronavirus infection. The most pronounced metabolic changes were found in the group with severe neurological manifestations (NM). At follow-up, a gradual recovery of the metabolite profile was noted, but in our sample group complete normalization was not achieved within the specified time frame. CONCLUSION: The obtained data indicate metabolic changes associated with SARS-CoV-2 infection, as well as the prospects for using the 1H-MPC technique in the diagnosis of neurological complications of the new coronavirus infection, including manifestations of a psychoneurological syndrome associated with COVID-19.><0.05.RESULTS: According to 1H-MRS, all patients with COVID-19 showed metabolic changes in the brain: a statistically significant increase in mI/Cr in the white and gray matter and a diffuse decrease in the levels of Cho/Cr in the supraventricular white matter, even in the absence of any changes in structural MRI.DISCUSSOIN: Patients were divided into three subgroups according to the severity of neurological symptoms that arose with the onset of the coronavirus infection. The most pronounced metabolic changes were found in the group with severe neurological manifestations (NM). At follow-up, a gradual recovery of the metabolite profile was noted, but in our sample group complete normalization was not achieved within the specified time frame.CONCLUSION: The obtained data indicate metabolic changes associated with SARS-CoV-2 infection, as well as the prospects for using the 1H-MPC technique in the diagnosis of neurological complications of the new coronavirus infection, including manifestations of a psychoneurological syndrome associated with COVID-19.
Introduction. Managing patients with relapsing-remitting multiple sclerosis (RMS) remains a pressing issue. Objective. To detect the reversible metabolic changes of the brain matter in patients with clinically exacerbated RMS and to follow them up after intravenous glucocorticoid (IVGC) treatment. Materials and methods. Neurological examination and neuroimaging in the RMS patients included expanded disability status scale (EDSS) scoring, conventional brain magnetic resonance imaging (MRI), and proton nuclear magnetic resonance spectroscopy (1H-NMR spectroscopy) before and after IVGC treatment. Multivoxel 1H-NMR spectroscopy was used to assess metabolism in the centra semiovale and cingulate gyri. Results. Based on the multivoxel 1H-NMR spectroscopy, relative metabolite concentrations in the grey and white matter statistically differed within the study cohort before and after the IVGC treatment. The N-acetylaspartate/choline ratio significantly recovered and the choline/creatine ratio decreased in the anterior cingulate gyri in 27% of patients. The brainstem function score significantly improved in the metabolic response group as compared to the non-metabolic response group. Conclusion. We should study the potential predictors of RMS activity and the IVGC response to select the RMS relapses when pulse-therapy with IVGCs is definitely indicated. Spectroscopy may reveal RMS pathogenesis variability earlier than conventional MRI.
The onset of progressive deficit in multiple sclerosis (MS) was often determined retrospectively with difficulties in diagnostic. This is a case report with subtle MS progression. Clinical and structural MRI anamnesis was complemented with multivoxel 1HMRS examination. The patient complained of the walking distance reducing, gradually increasing spasticity in the distal parts of lower extremities, unsteadiness when walking, clumsy movements. Choline and myoinositol levels were predominantly increased in the area of the cingulate gyrus versus other gray matter regions and the same picture was observed in adjacent white matter. Multivoxel 1H-MRS represents a diagnostic tool that can be very useful in complex diagnostic of MS progression. Measuring chemical-pathological changes diffusely in brain tissues may detect distinctive for progression metabolic patterns.
Статья посвящена вопросу развития и формирования основных компетенций, интеллектуальных умений и профессиональных навыков у будущих международников, дипломатов и политологов и представляет учебник по языку профессии «Основы политологии по-испански. Учебный курс по языку профессии для политологов и международников» (ABC de las Ciencias Políticas en espñol). Уровни В2-С1. Авторы доцент Е. В. Астахова и доцент Е. В. Крюкова. The article is devoted to the question of formation and development of core competencies, intellectual abilities and professional skills of future international relations experts, diplomats and political analysts. The article presents the manual on the language of the profession "The principles of political science in Spanish. Training course on the language of the profession for political scientists and international relations experts" (ABC de las Ciencias Poíticas en espñol). Levels B2-C1. Moscow state Institute of International Relations
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