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Introduction. The application of diffusion-tensor (DT)-MRI tractography in patients with children S cerebral palsy (CP) allows to establish pathophysiological mechanisms of the development of motor and sensory impairments, to perform a clinical and neuroimaging comparison, as well as to determine correlations between lesions of the conduction tracts and neurological deficits. Aim. For the determination of changes in fractional anisotropy (FA) and mean diffusivity coefficient (MDC), obtained with DT-MRI in the corticospinal and sensory tracts, structures of the corpus callosum in spastic forms of CP. Materials and methods. There were examined 105 children with spastic forms of CP (spastic tetraparesis - 47, spastic diplegia - 38, hemiparetic form - 20) and 50 children without neurological deficit, at the age of 2-18 years. In all CP patients the severity of motor deficit was evaluated according to Gross Motor Function Classification System (GMFCS). DT-MRI was performed in all cases with the use of devices of General Electric (US), under magnetic field strength of 1.5T and 3T, with the calculation of the FA and the MDC in areas of interest - cerebral peduncles the brain stem, the posterior limb of the internal capsule, the genu and splenium of the corpus callosum, posterior thalamic radiation, postcentral gyrus, the thalamus. Results. There was established the distribution of children according to the GMFCS scale: I - 14 (13,4%), II - 19 (18,1%), III - 20 (19%), IV- 10 (9,5%), V- 42 (40%) cases. The severity of motor impairment on the GMFCS scale closely correlated with the values of FA and ADC in cerebral peduncles, posterior limb of the internal capsule, posterior thalamic radiance, genu of the corpus callosum. Conclusion. DT-MRI enables to assess adequately the changes in the white matter of the brain, structural andfunctional state of the motor and sensory conduction tracts, gives a possibility to predict the development of a child with CP.

The article examines the applicability of high-order (the third and fourth) signal variance moments for determining the characteristic properties of various standard measurement noise, sinusoidal noise and Markovian-type noise with all sorts of constraints on the noise level. The discrete model of measurement noise developed by Scientific and Production Association of Automation named after the academician N.A. Semikhatov is used as a research tool. On the basis of the high-order signal variance moments, the estimates of the asymmetry and kurtosis coefficients were obtained. The characteristic form of the indicated coefficients for some varieties of the considered noise makes it possible to use them for qualitative analysis of the noise of the measuring channels of the sensitive elements of the strapdown inertial navigation systems.

The paper considers the model of measurement data with typical measurement noise included. For some noise combinations, errors in noise parameter determination are estimated using the Allan variance method. Coefficients of approximating polynomial of Allan variance curve are obtained by multiparametric optimization of the proposed nonlinear target function.

Of the Ministry of Health of the Russian Federation Background Diffusion-tensor MRI and tractography allow to receive qualitative (visualisation) and quantitative tissue characteristics open new possibilities for studies of microstructure pathways of the brain in the process of its development. Aim We established structural changes with the assessment pathways in the white matter of the brain using structural MRI, DTI and tractography in preterm infants with outcome in cerebral palsy. patients and methods: Examined 18 patients with spastic forms of cerebral palsy (tetrapares – 12, diplegia – 4, hemipares – 2), who was born very premature (mean age at birth 29±2.5 weeks) with body weight at birth less than 1500 g. in the dynamics from 6 to 42 months. All patients underwent structural MRI and DTI (General Electric, USA, a tension of 3 and 1.5 Tesla). Quantitative (fractional anisotropy, FA) and qualitative data during commissural and corticospinal pathways were compared with matched for age and gender group of healthy children. Results: Structural MRI of all patients with cerebral palsy revealed periventricular changes of varying severity. According to DTI of patients with extremely low body mass at birth indicators FA of the corticospinal (0,17±0,04) and commissural fibres (0,24±0,08) was significantly lower compared with the group of neurologically healthy children (0,34±0,06 and 0.46±0,07, respectively). With repeated testing over 2 years in patients with cerebral palsy remained low indices FA of the corticospinal (0,29±0,02), and commissural (0,44±0,07) ways that were consistent with the presence of motor deficit, compared to a group of neurologically healthy children (0,39±0,06 and 0.5±0,08 respectively). Conclusion In children with low body weight at birth low value FA during commissural and corticospinal pathways is a statistically significant predictor of the development of cerebral palsy, which is most apparent in 12–24 months later in patients with the development of the clinical picture of cerebral palsy.

Background: Diffusion tensor tractography — a new method of magnetic resonance imaging, that allows to visualize the pathways of the brain and to study their structural-functional state. Objective : The authors investigated the changes in motor and sensory pathways of brain in children with cerebral palsy using routine magnetic resonance imaging and diffusion-tensor tractography. Methods : The main group consisted of 26 patients with various forms of cerebral palsy and the comparison group was 25 people with normal psychomotor development (aged 2 to 6 years) and MR-picture of the brain. Magnetic resonance imaging was performed on the scanner with the induction of a magnetic field of 1.5 Tesla. Coefficients of fractional anisotropy and average diffusion coefficient estimated in regions of the brain containing the motor and sensory pathways: precentral gyrus, posterior limb of the internal capsule, thalamus, posterior thalamic radiation and corpus callosum. Results : Statistically significant differences ( p

The main performance characteristics of a strapdown inertial measurement unit based on fiber-optic gyros and pendulous accelerometers are investigated in ground tests. Preliminary estimates of the unit operational and accuracy parameters are obtained.

Classical phenylketonuria (PKU) is hereditary disease, which is based on the disturbance of phenylalanine conversion to tyrosine. The basic treatment of PKU is low phenylalanine diet. Prolonged restriction of natural protein may have a negative impact to PKU patient growth and physical development. The objective was to evaluate the physical development of patients with classical PKU at birth and on the diet based on the products with different chemical composition without phenylalanine. 257 PKU patients have been examined with the computer program "WHO Anthroplus 2009". All patient were born at term. Z-score of body weight, height and body mass index (BMI) to age has been retrospectively estimated. Patients were divided into 2 groups: group 1--101 children born in 1980-1993 were fed by unadapted specialty products based on protein hydrolyzate with restricted phenylalanine, and group 2--156 children born in 1995-2012 were fed by contemporary amino acid mixtures without phenylalanine. All newborn PKU patients had the middle for age Z-score of weight and BMI, 21% of neonates had high Z-score growth. Before the diet therapy BMI Z-score was normal in 84.1% patients in group 1 and 87.2% patients of group 2. After 6 mo of treatment with low phenylalanine diet the number of patient with normal BMI Z-score was 71.3% in group 1 against 95.6% in group 2. Thus, using of modern amino acid mixtures without phenylalanine, enriched with essential nutrients can promote the normal physical development of PKU patients.

In recent years there has been an increase in the number of children incapable of adapting to the process of education. This is due to increasing difficulty of school education programs and more demanding individual requirements for schoolchildren. Some researchers have reported convincing evidence of correlation between learning problems and central nervous system developmental disorders [13, 18]. According to N. N. Zavadenko et al. [3], distinctly manifested problems of behavior and school education are observed in 31.6% of school children. The attention deficit hyperactivity disorder (ADHD) was diagnosed in 7.6% of cases [7, 12, 14, 15, 22-25]. The term “attention deficit hyperactivity disorder” was first suggested in 1980 in the classification of the American Psychiatric Association DSM-III (1980). In the last revised version of the International Classification of Diseases (1994), ADHD was attributed to clause F-90 (hyperkinesia disorders), where it is used as a substitute for the terms “motor hyperactivity” or “hyperdynamia”. According to a modern viewpoint, ADHD combines syndromes of general motor hyperactivity, motor unrest, sporadic impulsive movements, and attention disorders. The morbidity of ADHD in children ranges from 4 to 28% [6, 18]. Children with ADHD are characterized by high risk of asocial states and mental disorders [10, 17]. Cognitive and behavioral disorders persist in 70% of adolescents and more than 50% of adults diagnosed with ADHD in childhood. Adults with ADHD are characterized by slower progress in studies and career, high distress, and social skill deficiency [1, 2]. According to the literature, retardation of cognitive processes in children with ADHD is due to morphofunctional immaturity of some brain structures [4, 11, 19, 21, 26, 27]. Nevertheless, the aspects of early diagnosis of cognitive disorders in school children using special software are still urgent. Development of new instruments for examination of the cognitive sphere in children (computer testing systems Psikhomat, Ritmotest, Mnemotest, Binatest) provides a promising opportunity for detailed research into basic cognitive processes. Objective quantitative evaluation of the cognitive sphere makes it possible to prognosticate intellectual development of children and allows these methods to be used not only for diagnosis but also for prophylaxis and correction of cognitive disorders.

Elucidation of the medico-social portrait of contemporary children has revealed a twofold increase in the rate of psychosomatic pathology, a 50-80% increase in the level of neurotization, and a 40% decrease in the level of intellectual development relative to normal values typical of their age. Development of methods of automatic prophylactic screening and prognosis of adequate adaptation of schoolchildren is an urgent problem. New objective methods for testing of cognitive functions in schoolchildren are of particular interest. The goal of this work was to describe the application of computer-assisted psychodiagnostic systems to diagnosis of cognitive disorders in schoolchildren 8-15 years of age. Using these systems, we obtained quantitative age-related characteristics of the prerequisite of high level of intellect development in children with high scores. The results of comparison of the tests of standard reference tests of cognitive functions (CF: perception, attention, memory, psychomotor and mental activities) in successful schoolchildren with such results in schoolchildren with low scores would reveal parameters correlating with difficult learning and reduced quality of life.

Studies of higher mental functions in children are shown to present great difficulties in many parameters. Analysis has provided a number of requirements for medical devices and complexes and principles of their construction. Based on these data, the authors have developed and put computer test systems into practice, their advantages being shown. The studies of cognitive functions in children by using computer test systems are dealt with.

One hundred and sixty-seven patients with cerebral palsy (CP), aged 11-16 years, with spastic diplegia (n=87) and hemiparetic forms (n=80), with subgroups of mental retardation (MR) or intellectual delay (ID) have been studied. Standard treatment and application of a method of dynamic proprioceptive correction (MDPC) in the complex rehabilitation with the use of a medical and loading Adeli suit were used. Cognitive deficit in patients was characterized by the relative integrity of short-term nonverbal memory and marked impairment of verbal memory, verbal and nonverbal intellect. CP patients with intellectual delay demonstrated the predominant impairment of verbal functions. CP patients with mental retardation have the deficiency of both verbal and non-verbal cognitive functions. An individual profile of brain functional asymmetry in patients with CP was more lateralized than in healthy peers that can represent a mechanism for irregular development of cognitive functions in CP. Implementing the MDPC into comprehensive rehabilitation promotes the improvement of postural regulation and cognitive functions in children with CP compared to traditional methods of treatment. This is accompanied by the changes in functioning of the associative brain areas and hemispheric interaction.

The article represents the results of neurocognitive development study in progress. Clinical methods of investigation are supplemented with examination of children with Russian computer psychophysiological complex "Psichomat", which allows to examine a number of cognitive functions--perception, attention, memory, visual-motor coordination, processes of analysis and synthesis--in mathematical function expression: milliseconds and percentage of mistakes. A child's intrauterine and postnatal development is determined by various factors. Cognitive processes, which are ascending accordingly to a child's age, play significant role in social development. The standard charts of children psychoneurological development, worked out by the authors, must become key factors both for pediatricians of different subspecialities and for parents and psychologists, in order not to miss the beginning of some pathology condition--from development delay to retardation. During the analysis of cognitive status of a child, speech development, behavior and emotions should be assessed. The deficiency of cognitive functions causes difficulties in education and contact with a child, which in some cases leads to formation of syndromal pathological conditions and disease entities (from mild development delays to different stages of oligophrenia). It is necessary to educate pediatricians of various subspecialities and pediatric neurologists the methods of children examination in order to determine the "cognitive profile" according to the age, health condition, presence of somatic and/or psychoneurological diseases and influence of the drug therapy both on a child's organism and cognitive processes.

The main principles of long-term rehabilitation of children and adolescents with cerebral paralysis, related neurologic disorders, aftereffects of a neuroinfection, and some rare genetically determined diseases are the earliest possible initiation of remedial measures and the regular combined use of different forms of rehabilitative treatment. The proposed approach allowed to reduce severity of motor and speech disturbances and improve social and cognitive functions in 50.5% of the patients. Quality of life of the patients and their families also improved; healthy infants were born in 98 (19%) families.

The instrumental methods of evaluation of the cognitive ability of child by means of test computer systems open up real opportunities for the objective and thorough examination of main processes of the cognitive ability. An objective quantitation of the cognitive sphere makes it possible to prognosticate the intellectual development of child and to use such methods not only in the diagnosis and prevention but also in the correction of cognitive disorders.

Described in the paper is the instrumental examination of the psychoemotional condition of schoolchildren with esogastroenterologic pathology, who underwent, for the diagnostic purpose, esogastroduodenoscopy. It is demonstrated that the determination of the psychoemotional status in the course of dynamic follow-up optimizes the preparation of a child for endoscopy and smooths the anxiety during the procedure.

An agreement accepted worldwide for treatment of multiple sclerosis (MS) in adult patients has not been achieved so far for children and adolescents, mostly due to the insufficient information on the features of MS with early age-at-onset. New methods of immunomodifying treatment and the conception of early MS treatment have changed the attitude to prognosis of MS with early onset. In such cases, a course of the disease is less aggressive and characterized by more intensive remyelination as well as brain plasticity and less neurological deficit that may predict highest efficacy of the disease modifying treatment timely started in these patients. Such drugs, as beta-interferons, glatiramer acetate and high-dosage intravenous immunoglobulines G, which are able to decrease MS relapse frequency and disability progression in adult patients, are poorly studied in children and adolescents. Preliminary positive results of international and Russian investigations on the efficacy and tolerability of immunomodulating therapy of MS with early age-at-onset require further investigations in this field.

Recently, a novel leukoencephalopathy syndrome was described in eight patients with a distinct pattern of MRI abnormalities. Here we describe the clinical, laboratory, and MRI findings in five new, unrelated patients. The clinical picture was homogeneous with onset in childhood, a slowly progressive course, variable mental deficits, signs of pyramidal and cerebellar dysfunction and sometimes dorsal column dysfunction. In two patients, a minor head trauma was followed by neurological deterioration and fever. No underlying metabolic defect was found. In two patients serum lactate was elevated, but no evidence of a mitochondrial defect was found. MRI showed variably extensive, diffuse, or spotty cerebral white matter abnormalities and a selective involvement of particular brainstem tracts. The tracts involved included the pyramidal tracts, sensory tracts, superior and inferior cerebellar peduncles, and intraparenchymal trajectories of the trigeminal nerve. In four patients spinal MRI was performed and revealed involvement of tracts over the entire length depicted. Single voxel proton MRS in three patients revealed increased lactate within the abnormal white matter. The uniform and highly characteristic MRI findings, in combination with the similarities in clinical and MRS findings, provide evidence for a distinct nosological entity.

The aim of this study was to determine the role of the HLA-DRB1 gene [6p21] in susceptibility to juvenile MS (JMS) (age at onsetor =15 years) of children of Russian descent. Association of DR2(15) with JMS has been found by the comparison of patients with JMS with both unrelated and affected family-based healthy controls. The linkage of DR2(15) with JMS was shown by transmission disequilibrium test. There were no significant differences in the frequencies of DRB1 alleles and genotypes between 56 patients with JMS and 234 patients with MS with age at onsetor =16 years.

Studies were performed using 80 children aged 1-3 years with lesions to mental development. Patients were divided into three groups according to the severity and structure of lesions of mental development: those most strongly characterized by delayed speech development (group 1), those with delayed mental development due to organic CNS lesions (group 2), and those with abnormal mental development and high levels of psychopathological symptoms (group 3). There were significant increases (p0.001) in blood levels of autoantibodies to nerve growth factor (NGF) in children in each of these groups as compared with a control group (0.75 +/- 0.24 OD units). The levels of anti-NGF autoantibodies increased from group 1 to group 3 (0.95 +/- 0.24 OD units in group 1, 1.13 +/- 0.27 OD units in group 2. and 1.24 +/- 0.4 OD units in group 3). These correlations suggest that the level of anti-NGF autoantibodies can, taken in conjunction with a number of other parameters, be regarded as a potential molecular marker demonstrating abnormal development of the nervous system.

Intensive maturation of arbitrary attention occurs in the making of higher mental functions in children in transition to schooling. The study has yielded standard indices of changes in some higher mental functions at the age of 6-8 years, which makes it possible to make a timely objective diagnosis in mental and neurological practice to predict the child's development, and to provide a required complex of medical and pedagogical corrective measures.

The paper considers how to obtain quantitative characteristics of sensomotor responses while tracing, learning, and reproducing rhythmical stimuli of different frequency and modality which can be used to assess psychomotor activity, perception, attention, short-term memory in schoolchildren with infantile cerebral paralysis. The results of examinations of children with this condition are given and analyzed.

The cognitive sphere was studied in schoolchildren with good study progress by using computer test systems. This provided age-dependent standards of major cognitive functions: perception, attention, memory, psychomotor activity, and thinking that determine the quality of cognitive activity. Comparatively, this may objectify age-specific prognosis of schoolchildren and specify causes of learning difficulties in children.

Studies of higher mental functions in children are shown to present great difficulties in many parameters. Analysis has provided a number of requirements for medical devices and complexes and principles of their construction. Based on these data, the authors have developed and put computer test systems into practice, their advantages being shown. The studies of cognitive functions in children by using computer test systems are dealt with.

The frequency of multiple sclerosis (MS) with clinical onset before 16 years of age in different regions of Russia fluctuates from 2 to 10% of all MS patients. One of the most frequent signs of MS manifestation and/or exacerbation at this age is optic neuritis (ON). Forty-seven children with MS were observed in Moscow. Diagnosis of MS in every case was clinically definite and proved by serial MRI. Clinico-tomographic dissociation was noticed: numerous large lesions, typical for MS on T2 images were often seen in children with mild or moderate residual neurological symptoms. All patients had relapsing/remitting MS course, mean EDSS was 2.24+/-0.26. Thirty-eight children (80%) had ON at least once, ten (21.3%) - twice or more times. In several cases ON had subclinical course or might be missed and the damage of the optic nerve with partial atrophy was found only after complex ophthalmological investigation including visual evoked potentials. Thus, the clinical course of MS and ON have some peculiarities in children and may be genetically based. Analyses of allelic polymorphisms of HLA-DR and TNF loci on chromosome 6 was performed. Data from children with MS were compared with data from their parents, healthy controls and other MS patients from the same ethnic group. Children with MS had increased frequency of DR2(15) and TNF-a11, but not TNF-a9 as adult MS patients from the same ethnic group. The presence of TNF-a7, rare in adult patients, could be proposed as a marker of early MS onset.

80 children aged 1-3 years were examined. They were divided into 3 groups by the degree and structure of disorders of mental development: children with predominant delay of speech development (group 1); with a delay of psychic development due to organic damage of CNS (group 2); with deviation of psychic development and the most pronounced psychopathologic symptomatology (group 3). There was a significant (p0.001) elevation in the blood level of autoantibodies to nerve growth factor (NGF) in children from all groups as compared with control one (0.75 +/- 0.24 OD units). The level of such autoantibodies also increased during transition from the 1st to the 3d group (0.95 +/- 0.24 in group 1; 1.13 +/- 0.27 in group 2; 1.24 +/- 0.4 in group 3). The correlations allow us to suppose that the level of autoantibodies to NGF might be considered, together with some other signs, as a potential molecular marker indicating a disorder in the development of nervous system.

The informative value of comprehensive psychophysiological examinations of children and adolescents who suffered from varying intellectual performance impairments was defined by using the testing computer systems "Rhythmotest", "Mnemotest", "Binatest" which may qualitatively scan cognitive and psychomotor activities in a child. Examinations are listed. The paper gives the indices showing the most significant differences between ill and healthy examinees, which may be the key points in detecting intellectual defect in a patient.