3rd Neurology Department with Psychological and Speech Therapy Group – cerebrovascular diseases and cognitive impairments

Main areas of research, medical and diagnostic care:

• Individual strategies for recovery of impaired functions and adaptation to an existing functional deficit based on:
  • timeline of stroke recovery 
  • functional deficit (motor, verbal, other) 
  • brain reserve and its functional reorganization (according to the data of diffusion-tensor and functional neuroimaging (fMRI), transcranial magnetic stimulation (TMS)) that allow to predict outcome of recovery.
• Pharmacological therapy of stroke complications (spasticity, cognitive dysfunction, depression, seizures, urinary disturbances and other), secondary prevention of stroke
• The formation of ideas about a comfortable environment, psycho-emotional balance, as the basis for effective recovery (psychotherapy, EEG-neurofeedback)

• Definition of causes of stroke in young adults based on:
  • international criteria and diagnostic algorithms standardized in our department;
  • innovative protocols for assessment vascular wall lesions (dissection/inflammation/thrombosis) (in cooperation with Department of Radiology)
  • criteria for the immunodiagnostics of isolated central nervous system vasculitis and its activity developed jointly with the Hemorheology, Hemostasis and Pharmacokinetics Laboratory   of the Research center of neurology
• Treatment of patients with stroke due to dissection, antiphospholipid syndrome and other thrombophilia, large and small vessel vasculitis, cardiac disease, hereditary arteriopathies, arterial hypertension, atherosclerosis, mitochondrial disease.
• Diagnosis of headache, associated with increased risk of stroke in young adults based on:
  • clinical features of headache
  • clinical features of Undifferentiated connective tissue disease (original scale developed in our department) and ultrasound markers of vessel wall stiffness predisposing to dissection
  • MRI features of white matter lesions
• Pathogenetic treatment and prophylaxis of headache
  Clarification of causes of multiple vascular lesions ant their association with stroke risk, differential diagnosis with demyelinating, inflammatory diseases and others.

III. Cerebral small vessel disease associated with aging and vascular risk factors.

• Study of pathogenetic mechanisms of disease progression and development of cognitive impairments using:
  • Multimodal MRI-studies for assessment of perfusion, blood-brain barrier permeability, brain microstructure, functional connectivity, venous and  cerebrospinal fluid flow (in cooperation with Department of Radiology)
  • Elaboration of individual risk factors of disease progression using blood biomarkers associated with increased vascular permeability; individual salt-sensitivity (in cooperation with Hemorheology, Hemostasis and Pharmacokinetics Laboratory)
  • Navigated TMS (choice of a target on individual fMRI-maps while performing cognitive tasks) to improve brain functioning (in cooperation with the Department of Radiology, Department of Neurorehabilitation and Physiotherapy)

IV. Management of psychosomatic health as the basis for the prevention of cerebrovascular pathology

• Study of fMRI networks of brain functioning while performing tasks on resilience in patients with early hypertension, low working capacity and headaches.  
• Functional neurotherapy (neurofeedback, transcranial direct current stimulation).