Center for Extrapyramidal and Cognitive Disorders
Content
The main goal of the extrapyramidal center is the early diagnosis and effective treatment of extrapyramidal diseases and cognitive disorders in neurodegenerative and other diseases of the nervous system, including all types of tremor, Parkinson’s disease, and parkinsonism-plus syndromes (multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration), Alzheimer’s disease, and other types of dementias (dementia with Lewy bodies, vascular dementia, frontotemporal dementia), dystonia, blepharospasm, and hereditary diseases primarily affecting the nervous system.
The center conducts clinical research in partnership with leading centers for extrapyramidal disorders (Scientific Center of Neurology, Institute of the Human Brain, Kazan, Vladivostok, etc.), and has prepared dozens of publications both in our country and abroad.
Services of the Extrapyramidal and Cognitive Disorders Center
1. Consultation with a Neurologist-Parkinsonologist
More about a consultation with a Parkinsonologist
Duration – 60 min
- Thorough collection of complaints and disease progression
- Neurological examination
- Assessment of Motor Condition Using Special Programs ( dataset)
- Neuropsychological testing (clock drawing test, cognitive status assessment, affective disorder assessment)
- Treatment Recommendations Explained
- Lifestyle Recommendations
- Answers to questions
2. Detailed Neuropsychological Examination
Assessment of Anxiety, Depression, Cognitive Functions
Duration – 60 min
What does the examination include?
- Detailed assessment of cognitive status using scales MMSE, MOCA, frontal dysfunction battery
- Development of an individual cognitive rehabilitation program (involving all cognitive domains) at home
- Selection of methodological literature and online resources
3. Observation in the day-stay ward
Duration – 2-8 hours during the day
- To clarify the nature of motor state changes in Parkinson’s disease (or suspected Parkinson’s)
- Evaluation of the effectiveness of antiparkinsonian therapy – duration of the effect of levodopa medications, presence of dyskinesias, and motor/non-motor fluctuations
- Selection of the Most Effective Antiparkinsonian Therapy Regimen
4. MRI of the brain using a neurodegenerative program with Nigrosome visualization and assessment of local atrophy
For the diagnosis of Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative diseases
- evaluation of nigrosome presence, mode SWAN (for a more accurate diagnosis of Parkinson’s disease)
- assessment of local atrophy and calculation of atrophy coefficients (for the diagnosis of diseases from the Parkinson-plus group – multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and others)
- assessment of global and regional atrophy using perfusion (for differential diagnosis of dementia and identification of Alzheimer’s disease, frontotemporal dementia, dementia with Lewy bodies, etc.)
5. Botulinum Therapy with Ultrasound Navigation
Botulinum toxin injections for local reduction of muscle spasm, effect lasts for 3-6 months.
- Consultation with a botulinum therapy specialist and dosage selection
- Injection of botulinum toxin into selected muscles under ultrasound guidance (to reduce the severity of dystonia and spasticity in the muscles of the neck, upper and lower limbs)
- Botulinum toxin injection into salivary glands (reducing the severity of drooling in Parkinson’s disease)
6. Transcranial sonography (TCS) of the substantia nigra
Ultrasound method for studying the substantia nigra; the sensitivity and specificity of the method in diagnosing Parkinson’s disease reach 95%
Non-invasive assessment of the echogenicity of the signal from the substantia nigra using ultrasound and identification of the “hyperechogenicity” phenomenon of the midbrain peduncles (a hyperechogenic signal size greater than 0.20 cm² is a biomarker characteristic of Parkinson’s disease)
7. Selection of Patients for Surgical Treatment
- Assessment of Indications and Possible Contraindications for Destruction by MRgFUS Method
- Preliminary assessment of indications/contraindications for deep brain stimulation with referral to federal neurosurgical centers (Moscow, St. Petersburg, Tyumen, Novosibirsk, Vladivostok)
- Assessment of Indications and Possible Contraindications for the Installation of an Intestinal Levodopa Pump (Duodopa)
- Patients with movement disorders: Parkinson’s disease, essential tremor, dystonia.
Work schedule
The center operates from 9:00 to 21:00, on Saturday from 9:00 to 15:00.
Payment for services is conducted on a contractual basis, within the framework of voluntary health insurance, or through charitable funds.
Head of the Center for Experimental and Clinical Neurosurgery – PhD, Akhmadeeva Gulnara Nailevna