Репозиторий Университета

© 2018, Media Sphera Publishing Group. All rights reserved. The article addresses gait disturbances in the elderly. It emphasizes that the system that maintains the balance in resting conditions and gait is based on the hierarchical principle and its function depends on the maintenance of integration between vestibular, visual and somatosensory information as well as on cognitive functions. Walking depends on the integrity of frontal-subcortical neuronal circles that support regulatory functions. The main pathogenetic mechanisms of age-related disturbances of balance and gait are a decrease in the efficacy of spinal motorneurons activation caused by Ia-afferentation, a decrease in cortical activation and excitability of corticospinal pathways and in the intensity of intracortical inhibition. The causes of age-related changes in walking are not confined to a single system (e.g., one sensory modality) but have a multisystem character and are involved in many structures. The author analyses the results of recent studies that use functional neuroimaging methods.

© 2018 Izdatel'stvo Meditsina. All Rights Reserved. In the review article are considered the recent data that emphasize the role of cortical disturbances in the pathogenesis of vestibular disorders. The vestibular system not only provides a link between motor and sensory processes, its functions are much more extensive. The experiments conducted in recent years on primates, as well as the data obtained by neuroimaging methods, have significantly advanced our understanding of the functioning of the vestibular system, especially its central parts. The vestibular cortex can be considered as a network of connections between all cortical areas receiving sensory input from the vestibular system, including cerebral zones in which vestibular information affects the analysis of other sensory (i.e. somatosensory and visual) and motor activity. The pathogenesis of vertigo and tinnitus is especially analyzed.

© 2018 Media Sphera Publishing Group. All rights reserved. The review considers modern ideas about the clinic and pathogenesis of minimal hepatic encephalopathy (MHE). It is discussed the present of cognitive impairment in this category of patients. The data of functional MRI are analyzed, and these results allow taking a fresh look at the origin of clinical disorders in this condition. The importance of cerebral connections disruption is emphasized. It is focused on the fact that in the functioning of the central nervous system the spontaneous activity of the brain has a significant importance. Separately is analyzed "the resting state". It is concluded that MHE, despite its minimal manifestations, is a clinically significant condition requiring attention of a specialists. With that, it is often not diagnosed on time in clinical practice, which could lead to more severe damage of the cerebral functions. As evidenced by the data obtained at the present time, quite extensive changes in the neuronal activity are underlid of the cognitive deficit.