— The aim of this research was to study the dependence of poststroke motor impairments of paretic and non-paretic arm on lesion lateralization, and paresis severity. The influence of lesion lateralization and paresis severity on the recovery of motor functions (MFs) after rehabilitation using a hand exoskeleton controlled by a brain–computer interface was also investigated. The study included 24 patients, 12 with left and 12 with right hemispheric lesions. Each group included six patients with moderate paresis and six patients with severe paresis. Isolated movements in the joints of paretic and non-paretic arms were used as motor tests performed before and after the course of rehabilitation. Joint torque and movement isolation degree were used to assess MFs. It was shown that the joint torques of the non-paretic arm were greater in the case of left hemispheric lesions, characterized by more pronounced asymmetry of joint torques than in right hemispheric lesions. This might be due to a greater imbalance in the activity of hemispheres. The effectiveness of rehabilitation was manifested in: (1) an increase in joint torques in both paretic and non-paretic arms and (2) an increase in the symmetry of biomechanical parameters of paretic and non-paretic arms, potentially indicating the restoration of balance in the hemispheric activity. The biomechanical analysis of isolated movements suggested the pronation–supination movement in a vertical forearm position as a sensitive indicator of MF recovery after stroke.

The aim was to study the dependence of post stroke motor impairments of the paretic and the intact arm of lesion lateralization and paresis severity. The influence of lateralization of the lesion and the severity of paresis on the recovery of motor functions after rehabilitation using a hand exoskeleton controlled by a brain-computer interface was also studied. The study included 24 patients, 12 with left hemisphere involvement and 12 with right hemisphere involvement. Each group included 6 patients with moderate paresis and 6 patients with severe paresis. As motor tests, isolated movements in the joints of the paretic and intact hands were used before and after the rehabilitation course. Joint torque and motion isolation degree were used to assess motor function. It is shown that the muscle moments of the intact arm are greater in the case of damage to the left hemisphere; the asymmetry of the moments in the joints in this case was more pronounced than in the case of damage to the right hemisphere. This may be due to a greater imbalance in the activity of the hemispheres. The effectiveness of rehabilitation was manifested in: 1) an increase in moments in the joints in both paretic and intact hands; 2) an increase in the symmetry of the biomechanical parameters of the paretic and intact hands, which may indicate the restoration of the balance of the activity of the hemispheres. Biomechanical analysis of isolated movements allows suggests the pronation-supination in the vertical position of the arm as a sensitive indicator of motor function recovery after stroke.

The process of the functional rearrangement of the motor cortex of the brain after stroke is due to neuroplasticity, and this underlies motor recovery. Functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) are currently recognized as the most informative methods for studying these processes. The course of the neuroplastic process can be evaluated from the power levels of EEG rhythms during imagination of movements in the paralyzed arm in right-handed patients after stroke in the left hemisphere monitored at different times – before and after courses of neurorehabilitation using a brain–computer interface controlling a wrist exoskeleton. Powerful excitatory interactions in the primary motor cortex and frontoparietal areas in the lesioned and “intact” hemispheres are initially seen, and these probably reflect reorganization of neural networks. Rehabilitation courses were followed by restoration of bioelectrical activity in the primary motor cortex due to recovery of efficient connections with the premotor and superior parietal zones and decreases in the pathological influences of the contralateral hemisphere.

The process of functional restructuring of the motor cortex after a stroke is a result of neuroplasticity underlying the recovery of movements. Now functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) are recognized as the most informative methods of studying these processes. To assess the course of the neuroplastic process, we used EEG rhythms power indicators during the period of movement imagining in the paretic arm in right - handed patients after stroke in the left hemisphere in dynamics -before and after the neurorehabilitation course with use of the brain-computer interface controlling the exoskeleton of the hand. Initially, a strong exciting interaction of the primary motor cortex and the frontal-parietal regions in the affected and "intact" hemispheres was revealed, which probably reflected the reorganization of neural networks. After the treatment, we discovered restoration of bioelectric activity in the primary motor cortex as a result of effective communication with the premotor and upper parietal areas, the reduction of pathological influence of the contralateral hemisphere is revealed.

A brain–computer interface (BCI) used to control a hand exoskeleton provides a tool for rehabilitation of the arm motor function (MF) after stroke and has proven efficacy and a potential to stimulate brain neuroplasticity. A study was made to analyze the effect of repeated rehabilitation courses with a BCI + exoskeleton (2 to 9 months after the first course) on the MF restoration in the late recovery period. MF recovery was assessed using a biomechanical analysis of the patient’s movements and clinical scales: the Fugl-Meyer Assessment (FMA) scale, the Action Research Arm Test (ARAT), and the Medical Research Council Weakness Scale sum score (MRC-SS). A positive effect of repeated rehabilitation courses with a BCI + exoskeleton on the MF recovery was observed in both patients with moderate paresis in the late recovery period and patients with severe paresis. The data may be useful for developing an appropriate protocol for the rehabilitation procedures that employ the exoskeleton controlled via a BCI with kinesthetic imagination of movements.

Целью исследования являлся сравнительный анализ эффективности и безопасности применения антидепрессантов пипофезина и венлафаксина в сопоставимых суточных дозировках в комбинации с антиконвульсантом карбамазепином при лечении перманентной (диабетическая полинейропатия) и пароксизмальной (тригеминальная невралгия) форм нейропатической боли. Обследован 48 больных с диабетической полинейропатией, 51 пациент c тригеминальной невралгией и 17 здоровых испытуемых, сравнимых с больными по полу и возрасту. Использовались клинико-неврологический и психометрический методы исследования. Показана высокая, равная эффективность приема карбамазепина в дозе 200 мг 4 раза в сутки в комбинации с венлафаксином в дозе 37,5 мг 2 раза в сутки или пипофезином в дозе 25 мг 3 раза в сутки при терапии нейропатической боли, коморбидных тревожно-депрессивных и вегетативных расстройств. При этом пипофезин обладает лучшим профилем безопасности (меньшим количеством и выраженностью побочных эффектов и более хорошей переносимостью) по сравнению с венлафаксином. Комплексная терапия является наиболее эффективной при лечении пациентов с пароксизмальной формой нейропатической боли.

The aim of the present work was to study the effects of multiple courses of “BCI + hand exoskeleton” neurorehabilitation on the restoration of movements and resocialization of patients during the fi rst year after stroke. The study included seven patients with cerebral stroke who received two or more courses of sessions. All patients had poststroke hemiparesis of severity 1–4 points. Multiple courses of “BCI + hand exoskeleton” neurorehabilitation led to maintenance of the level of motor activity with further improvements, repeated courses yielding signifi cantly better results than single courses. Appropriate personal interpretation of illness, a positive attitude to recovery, and being motivated to take active part in the rehabilitation process were fundamental for effective rehabilitation of patients.

The aim of the study was to investigate the effect of repeated courses of neurorehabilitation with the use of "BCI + exoskeleton" on the restoration of motion and resocialization of patients during the year after stroke. The study included 7 patients after brain stroke who have received 2 or more courses of training. All patients had post-stroke hemipares is with the severity from 1 to 4 points. Repeated courses of neurorehabilitation using "BCI + exoskeleton" revealed the support of the physical activity level with further positive dynamics, moreover repeated courses allowed to achieve a significantly better result than the one. Adequate personal interpretation of the disease and a positive attitude for recovery, motivation is a base for effective rehabilitation of patients.

To search for additional methods of differential diagnosis ofessential tremor (ET) and early-stage Parkinsons disease(PD), a clinical, psychometric, tremorometric, stabilometricand electrooculografic study was carried out in PD, ET andage-matched controls. Patients with ET had bilateral distributionof predominantly postural-kinetic tremor with slightprevalence in one hand, and limb tremor often combined withhead tremor. PD was characterized by asymmetric debut ofclinical manifestations, as well as by rest and postural tremorwith slight hypokinesia and rigidity. The frequency of rest andpostural tremor was significantly higher than in the PD group.Stabilometry revealed improvement of postural stability inTarget-test in patients with PD. In the dynamic Evolventatestpatients with PD showed smaller statokinetic curve lengthand lower center-of-motion velocity compared to healthy subjects.No stabilometric changes were found in ET patients. Incontrast to ET, patients with PD were characterized by significantincrease in latencies of saccadic eye movements and fractionof multi-step saccades; eye movements lateralization wasrevealed on stage I of PD. Discussed is significance of theobtained data for clinical practice.

The rehabilitation potential of post-stroke patients was evaluated after a rehabilitation procedure using a hand exoskeleton controlled via a brain–computer interface (BCI). Examples are given for parameters describing the motor and cognitive functions and the capacity for kinesthetic movement imagination. It is emphasized that instrumental quantitative methods are important to use for adequate assessment of both the rehabilitation potential and the effectiveness of the BCI + exoskeleton procedure.

The results of biomechanical analysis of the motor function of the arm of poststroke patient in the process of neuroreha bilitation with exoskeleton of the hand controlled by brain – computer interface are presented in this paper. At the beginning and end of the course it was registered the kinematic portrait of the patient– isolated random movements for each of the seven degrees of freedom as the paretic and intact arms.Angular accelerations were taken as an assessment of muscle forces, the number of reverse movements was taken as an assessment of joint spasticity, and the kinematic content of the movement as a description of pathological synergy arising after stroke. These parameters give an objective numerical asses sment of motor function as well as of rehabilitation technology effectiveness.

We studied the dynamics of motor function recovery in a patient with severe brain damage in the course of neurorehabilitation using hand exoskeleton controlled by brain-computer interface. For estimating the motor function of paretic arm, we used the biomechanical analysis of movements registered during the course of rehabilitation. After 15 weekly sessions of hand exoskeleton control, the following results were obtained: a) the velocity profile of goal-directed movements of paretic hand became bell-shaped, b) the patient began to extend and abduct the hand which was flexed and adducted in the beginning of rehabilitation, and c) the patient began to supinate the forearm which was pronated in the beginning of rehabilitation. The first result is an evidence of the general improvement of the quality of motor control, while the second and third results prove that the spasticity of paretic arm has decreased.

Background: Rehabilitation of patients with poststroke motor disorders with the use of a brain-computer interface (BCI)+exoskeleton may raise the rehabilitation to a new high-tech level and allow for an effective correction of the post-stroke dysfunction. Aim: To assess the efficacy of BCI+exoskeleton procedures for neurorehabilitation of patients with post-stroke motor dysfunction. Materials and methods: The study included 40 patients with a history of cerebral stroke (mean age 59±10.4 years, 26 male and 14 female). Thirty six of them had had an ischemic stroke and 4, a hemorrhagic stroke from 2 months to 4 years before the study entry. All patients had a various degree post-stroke hemiparesis predominantly of the arm. The main group patients (n=20), in addition to conventional therapy, had 10 sessions (3 times daily) of BCI+exoskeleton. The BCI recognized the hand ungripping imagined by the patient and, by a feedback signal, the exoskeleton exerted the passive movement in the paretic arm. The control group patients (n=10) had 10 BCI+exoskeleton sessions without imaginary movements, and the exoskeleton functioned in a random mode. The comparison group included 10 patients who received only standard treatment. Results: At the end of rehabilitation treatment (day 14), all study groups demonstrated an improvement in the function of the paretic extremity. There was an improvement of functioning and daily activities in the main group, compared to the control and the comparison groups: the change in the modified Rankin scale score was 0.4±0.1, 0.1±0.1 and 0±0.2 (p<0.05), in the Bartel scale score, 5.6±0.8, 2.3±0.3 and 1±0.2 (p<0.001), respectively. In the BCI+exoskeleton group the motor function of the paretic arm assessed by the ARAT scale, improved by 5.5±1.3 points (2.4±0.6 points in the control group and 1.9±0.7 in the comparison group, р<0.05), and as assessed by the Fugl-Meyer scale, by 10.8±1.5 points (3.8±1.05 points in the comparison group, p<0.001). Conclusion: Rehabilitation of patients with post-stroke paresis with the use of BCI+exoskeleton led not also to a decrease in neurological deficit and an improvement of the paretic arm motor function, but also improved parameters of daily activities. Further studies of the effects of BCI+exoskeleton rehabilitation procedures on the course of motor function restoration are planned.