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Poster Session 2Efficacy of satralizumab as monotherapy in pre-specified subgroups of SAkuraStar, a double-blind placebo-controlled phase 3 clinical study in patients with neuromyelitis optica spectrum disorder (NMOSD)

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The aim: is to evaluate peculiarities of clinical and neurological characteristics, quality of life, brain morphometry changes and metabolic deviations of patients, who suffered from aneurysmal subarachnoid hemorrhage. Materials and methods: In the period of 2016-2019 we examined 114 patients, who signed the informed consent, taking into account their age, clinical and anatomical form of hemorrhage, disease duration, Hunt-Hess severity grade, complications of acute period. Such parameters were evaluated, as clinical and neurological characteristics, the degree of the Barthel index and the modified Rankin scale, cognitive functioning (MoCA), psycho-emotional sphere and quality of life (HADS, SF-36), morphometric parameters based on brain computed tomography measurements, explored the indicators of apoptosis, mitochondrial dysfunction, intracellular oxidative stress. Results: Сephalgia (90,35 %), pyramidal syndrome (53,50 %), sensibility deficit (36,84 %) were leading among the all neurological syndromes. Slight dependence and disability grade was found during assessment of the Barthel index and the modified Rankin scale. In 85,96 % of patiens we revealed cognitive impairment of different severity grades. The anxiety was manifested in 65,79 %, depression – in 64,91 % of patients. Due to the morphometry data, the process of cerebral atrophy was detected (central – in 26,31 % of patients, cortical – in 16,67% and mixed – in 28,07 %). AnV+ and PI+ – cells level exceeded normal values in 2,88 and 1,96 times while the level of JC-1+ and ROS+-cells – in 2,17 and 2,82 times (p<0,01). Conclusions: Having studied clinical and neurological, neuropsychological, morphometric and metabolic factors, we found their pathogenetic role in the course of late recovery and residual periods of aneurysmal subarachnoid hemorrhage, that would help us to improve the diagnostic tactics and reveal the predictors of unfavorable outcome.

Objectives. The aim of the present study was to clarify clinical neurological characteristics and different ischemic stroke subtypes unfavorable course predictors in acute phase.Material and methods. 482 patients with different ischemic stroke subtypes were observed. Among them there were 125 (25.9 %) with cardioembolic infarct (CEI), 119 (24.7 %) with large artery atherosclerosis (LAAS) infarct, 122 (25.3 %) with lacunar stroke (LAC), 116 (24.1 %) with stroke of undetermined etiology (UDE). The comparative analysis of clinical picture was performed. The predictors of unfavorable course of acute phase were established.Results. We have found out that severe neurological deficit, high mortality and the worst functional outcome during the first 14 days were observed in patients with CEI and LAAS. The highest frequency of early neurological deterioration (END) was detected at LAC (in 22.7 % of patients). There was a relationship between END and presence of transient ischemic attack (TIA) in past medical history, the level of systolic blood pressure (SBP) at the beginning of the disease and the degree of carotid arteries stenosis on the side of lesion. The patients with LAC had mild neurological deficit and better prognosis compared with other ischemic stroke subtypes. Among the clinical factors that have impact on the CEI, LAAS and UDE acute phase course were: the size of lesion, the level of consciousness on the 1st day, the baseline SBP, patient's age. At LAAS, the presence of transient ischemic attack (TIA) in past medical history and low SBP in the onset of the disease (less than 140 mm Hg) has an additional prognostic value for an unfavorable functional outcome. The severity of LAC in acute period depended on its localization and size. Localization of LAC in the internal capsule, thalamus and pons were characterized by the highest severity. Conclusions.Clinical neurological features of ischemic stroke depend on its subtype and have some prognostic value for the course of different ischemic stroke subtypes in acute phase.Клініко-неврологічні особливості перебігу підтипів ішемічного інсульту в гострому періодіМета роботи -уточнити клініко-неврологічні особливості та предиктори несприятливого перебігу різних підтипів ішемічного інсульту в гострому періоді.Матеріали та методи. У 482 осіб із різними підтипами ішемічного інсульту (125 (25,9 %) з кардіоемболічним інсультом (КЕІ), 119 (24,7 %) -з атеротромботичним інсультом (АТІ), 122 (25,3 %) -з лакунарним інсультом (ЛІ) та у 116 (24,1 %) пацієнтів -з інсультом невизначеної етіології (ІНЕ) здійснили порівняльну характеристику особливостей клінічної симптоматики та визначили предиктори несприятливого перебігу гострого періоду.Результати. Встановили, що найтяжчий неврологічний дефіцит, найвища смертність і гірший функціональний резуль-тат протягом перших 14 днів захворювання спостерігались при КЕІ та АТІ. Найвища частота раннього неврологічного погіршання (РНП) виявлена при АТІ (у 22,7 % пацієнтів). Спостерігалась залежність між РНП із наявністю в анамнезі транзиторної ...

The aim of our study was to study leukocyte apoptosis and to establish its relationship with changes of cognitive function in patients with chronic brain ischemia (CBI) and hydrocephalus (HC). A comprehensive examination of 110 patients with CBI and HC was performed. Indicators of apoptosis, mitochondrial dysfunction, intracellular oxidative stress were studied by cytofluorimetric method. Significantly higher indicators of ANV+-, PI+-, APK+- and Mito+-cells in the presence of HC. In the group of men, the inverse correlation between the content of AnV+-cells and the result of the MoCA-test — r = –0.42; p = 0.006, in women — r = –0.51; p = 0.005. A significant relationship was found between the content of APK+- and ANV+- cells (r = 0.67, p = 0.003) and between the number of APK+- and PI+-cells (r = 0.73, p = 0.002) in patients aged 60—74. In patients with dementia progression, a moderate relationship was found between the level of cognitive functioning and the proportion of cells in the early stage (ANV+-cells) (r = –0.50; p = 0.026) and late (PI+-cells) (r = –0.30; p = 0.041) apoptosis. In the group of patients with mild and moderate cognitive deficits, correlations between the MoCA scale result and the content of ANV+-cells were recorded at the level of moderate — (r = –0.37; p = 0.040) and PI+-cells at the level of weak (r = –0.24; p = 0.049). Significantly (p < 0.05) higher content of leukocytes in the stage of apoptosis and necrosis and leukocytes with increased content of intracellular APK and with reduced mitochondrial potential compared to patients without HC was found in patients with CBI with HC. There is a significant difference between the values of indicators in middle-aged and elderly patients and indicators of patients older 74 years. The progression of neurological and cognitive deficits was accompanied by an increase of the production of ANV+-, APK+- and Mito+-cells. The highest proportion of ANV+- and PI+-cells was detected in the presence of a combination of dementia, extrapyramidal syndrome and gait apraxia in patients with CBI with HC.

Purpose. The aim of this study was to assess a different pattern of inflammatory mediators in relation of ischemic stroke subtypes in acute period. Materials and Methods.The study involved 482 patients with different ischemic stroke (IS) subtypes. We studied the content of inflammatory interleukins (IL-1β, IL-2, IL-6, IL-8, CRP, TNF-α) and anti-inflammatory interleukin IL-10 in blood serum.Results. The study revealed increasing content of pro-inflammatory cytokines in acute period of IS subtypes, especially at Large Artery Atherosclerosis (LAAS) and Cardioembolic Infarct (CEI). In patients with LAAS the level of IL-2, IL-6 and CRP was significantly higher compared to other IS subtypes. The content of IL-10 was significantly lower compared to patients with Undetermined Etiology (UDE) stroke and LACunar (LAC) stroke. We established the relationship between the concentration of IL-1β and IL-6 with the severity of LAAS, CEI and UDE on the 1 st day of stroke. On the 7 th day the concentration of IL-1β and IL-8 was significantly decreased at LAC, IL-2 -at LAC and LAAS, IL-6 and TNF-α at LAC and UDE. At LAAS the content of inflammatory mediators depended on the degree of arteries stenosis, the presence of unstable atherosclerotic plaques, the intima-media thickness. We found a direct relationship between the severity of LAAS and CEI on the 14 th day with the CRP concentration on the 1 st day (at LAAS -(r = 0.73, p = 0.003), at CEI -(r = 0.71, p = 0.002), indicating predictive value of CRP-content on the course of acute period of IS subtypes. We established the dependence between cardiac morphometric parameters with the level of pro-inflammatory interleukins in acute period of UDE. We found the relation between the content of IL-1β, IL-6 with left ventricular myocardial mass index at UDE. Conclusions.The content of inflammatory mediators in acute period of ischemic stroke depends on the pathogenic subtype of stroke.Зміни цитокінового статусу при різних підтипах ішемічного інсульту в гострому періодіМета роботи -оцінити особливості змін медіаторів запалення в гострому періоді різних підтипів ішемічного інсульту (ІІ).Матеріали та методи. Обстежили 482 особи, які хворі на різні підтипи ІІ (125 -із кардіоемболічним (КЕІ), 119 -з атеротромботичним (АТІ), 116 -з інсультом невизначеної етіології (ІНЕ) та 122 -з лакунарним (ЛІ)). Хворим здійснили клініко-неврологічне обстеження, вивчена динаміка вмісту прозапальних цитокінів (IL-1β, IL-2, IL-6, IL-8, СРП, ФНП-α) та протизапального цитокіну ІL-10 у сироватці крові.Результати. Встановили, що в гострому періоді всіх підтипів ІІ на 1 добу зростає вміст прозапальних цитокінів, зокрема найбільшою мірою при АТІ та КЕІ. У хворих з АТІ рівень ІЛ-2, ІЛ-6 і СРП був вірогідно вищим, ніж при інших підтипах ІІ, а вміст ІЛ-10 -вірогідно нижчим порівняно з ІНЕ та ЛІ. Встановлений зв'язок між концентрацією IL-1β та IL-6 із тяжкістю АТІ, КЕІ та ІНЕ на 1 добу захворювання. На 7 добу концентрація IL-1β та IL-8 вірогідно знижувалася при ЛІ, IL-2 -при ЛІ та АТІ, IL-6 і ФНП-α -при ЛІ та ІНЕ. Концентр...

ÑÐÏ òà ÔÍÏ-α ó ãîñòðîìó ïåð³îä³ ³øåì³÷íîãî ³íñóëüòó (²²) çàëåaeíî â³ä â³êó õâîðèõ, òÿaeêîñò³ ²² òà ðîçì³ð³â ³íôàðêòó. Âèÿâëåíî, ùî â íàéá³ëüøîþ ì³ðîþ âì³ñò óñ³õ âèçíà÷óâàíèõ ïîêàçíèê³â çðîñòຠó ïàö³ºíò³â, ñòàðøå 60 ð., ïðè òÿaeêîìó ñòóïåí³ ²² òà âåëèêèõ ðîçì³ðàõ ³íôàðêòíîãî âîãíèùà (>100 ñì 3).Âì³ñò ²Ë-6, ²Ë-8 òà ÑÐÏ çàëåaeàâ â³ä â³êó õâîðîãî, ñòóïåíÿ òÿaeêîñò³ ²² òà ðîçì³ð³â ³íôàðêòíîãî âîãíèùà. Âì³ñò ²Ë-1β çíàõîäèâñÿ â ò³ñíîìó çâ'ÿçêó ç³ñòóïåíåì âàaeêîñò³ ²². гâåíü ²Ë-2 çàëåaeàâ â³ä òÿaeêîñò³ òà ðîçì³ð³â ²², ÔÍÏ-α ëèøå â³ä ðîçì³ðó ³íôàðêòó.