Browsing by Author "Zdanovskis, Nauris"
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Item Amygdala Nuclei Atrophy in Cognitive Impairment and Dementia : Insights from High-Resolution Magnetic Resonance Imaging(2025-01-15) Peiseniece, Evija; Zdanovskis, Nauris; Šneidere, Kristīne; Kostiks, Andrejs; Karelis, Guntis; Platkājis, Ardis; Stepens, Ainārs; Department of Radiology; Institute of Public Health; Department of Health Psychology and Paedagogy; Department of InfectologyBackground and Objectives: Cognitive impairment affects memory, reasoning, and problem-solving, with early detection being critical for effective management. The amygdala, a key structure in emotional processing and memory, may play a pivotal role in detecting cognitive decline. This study examines differences in amygdala nuclei volumes in patients with varying levels of cognitive performance to evaluate its potential as a biomarker. Material and methods: This cross-sectional study of 35 participants was conducted and classified into three groups: the normal (≥26), moderate (15-25), and low (≤14) cognitive performance groups based on the Montreal Cognitive Assessment (MoCA) scores. High-resolution magnetic resonance imaging at 3.0 T scanner was used to assess amygdala nuclei volumes. Results: Significant amygdala atrophy was observed in multiple amygdala nuclei across cognitive performance groups, with more pronounced changes in the low-performance group. The right hemisphere nuclei, including the lateral and basal nuclei, showed more significant differences, indicating their sensitivity to cognitive decline. Conclusions: This study highlights the potential of amygdala nuclei atrophy as a biomarker for cognitive impairment. Additional research with larger sample sizes and longitudinal designs is needed to confirm these findings and determine their diagnostic value.Item Brain connections analysis using graph theory measures(Rēzeknes Tehnoloģiju akadēmija, 2019) Minejeva, O.; Markovics, Z.; Zdanovskis, Nauris; Rīga Stradiņš UniversityBrain is a part of the organism’s complex structure that performs many functions, which are responsible for the main human abilities: to talk, to hear, to move, to see, etc. The brain consists of several areas that are not only directly connected with the different body systems, but also depend and may affect each other. Researchers and doctors are trying to summarize and visualize these relationships for an important purpose – to get the information about possible reactions of the body in case of various diseases, possibilities of recovery, risks, etc. important issues. Neurologists are looking for ways to “move” through the brain in virtual space for viewing the synapses between different areas. It might be useful to get a general idea of how brain regions are interrelated. The term “connectome”, which is the complete structural description of the brain connections, or the map of connections, is used for the common perception of brain relationships. Connectome is a network of thousands of nerve fibres that transmits signals between the special regions responsible for functions such as vision, hearing, movement and memory, and combines these functions in a system that perceives, decides and acts as a whole. So, the relationships of brain neural regions can be represented as a graph with vertices corresponding to specific areas, but edges are links between these areas. This graph can be analysed using quantitative measures, like node degree, centrality, modularity etc. This article discusses the different network measures for the connections between brain’s regions. The purpose is to determine the most important areas andthe role of individual connections in the general functional brain model.Item Brain Qualitative and Quantitative Radiological Biomarker Association with Cognitive Impairment and Dementia. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2023) Zdanovskis, Nauris; Platkājis, ArdisDemographic changes in the population and timely diagnosis and treatment of neurodegenerative diseases are among the major challenges in Europe and the world in the 21st century. Within the framework of the dissertation, the possibilities of magnetic resonance (MR) examination are explored in analysing study participants with cognitive impairments. The aim of the study is to determine the relationship between qualitative and quantitative brain biomarkers and cognitive function in patients with cognitive impairments. The literature review section of the study examines the concept of cognitive impairment and dementia, commonly used cognitive tests, describes commonly used qualitative visual assessment scales, and evaluates the use of quantitative biomarkers in the diagnosis of cognitive impairments. The material section evaluates demographic indicators of participants, divides participants into groups, and evaluates differences between participant groups. In total, 81 participants were analysed, of which 24 had no cognitive impairment and 57 had various degrees of cognitive impairments assessed by the Montreal Cognitive Assessment (MoCA) scale. The methods section evaluates the application of statistical methods, including the Mann-Whitney U test, Kruskal-Wallis H test, post-hoc analysis, p-value correction after Bonferroni, Spearman correlation, principal component analysis. Results indicate that certain brain radiological biomarkers are associated with cognitive function outcomes, including both qualitative assessment scales and quantitative volume, cortical thickness, and white-matter fibre characteristic values. These identified relationships serve as the basis for further research on the use of quantitative radiological biomarkers in the diagnosis of cognitive impairment and to identify patients in the future who are at higher risk. In conclusion, the hypotheses that were defined during the work are confirmed – in the case of cognitive impairment and dementia, structural changes occur in the brain, which can be detected in MR images by performing a qualitative and quantitative analysis of brain structures, and cognitive impairment is associated with specific changes in the quantitative measures of the brain MR. Overall, MR examination can not only rule out large pathologies but also provide more extensive and detailed information on anatomical and structural changes in the brain that are essential for the diagnosis, control, and evaluation of interventions for cognitive impairment in the long term.Item Brain structural connectivity differences in patients with normal cognition and cognitive impairment(2021-07) Zdanovskis, Nauris; Platkājis, Ardis; Kostiks, Andrejs; Karelis, Guntis; Grigorjeva, Oļesja; Department of RadiologyAdvances in magnetic resonance imaging, particularly diffusion imaging, have allowed researchers to analyze brain connectivity. Identification of structural connectivity differences between patients with normal cognition, cognitive impairment, and dementia could lead to new biomarker discoveries that could improve dementia diagnostics. In our study, we analyzed 22 patients (11 control group patients, 11 dementia group patients) that underwent 3T MRI diffusion tensor imaging (DTI) scans and the Montreal Cognitive Assessment (MoCA) test. We reconstructed DTI images and used the Desikan-Killiany-Tourville cortical parcellation atlas. The connectivity matrix was calculated, and graph theoretical analysis was conducted using DSI Studio. We found statistically significant differences between groups in the graph density, network characteristic path length, small-worldness, global efficiency, and rich club organization. We did not find statistically significant differences between groups in the average clustering coefficient and the assortativity coefficient. These statistically significant graph theory measures could potentially be used as quantitative biomarkers in cognitive impairment and dementia diagnostics.Item Brodmann Areas, V1 Atlas and Cognitive Impairment : Assessing Cortical Thickness for Cognitive Impairment Diagnostics(2024-04) Trišins, Maksims; Zdanovskis, Nauris; Platkājis, Ardis; Šneidere, Kristīne; Kostiks, Andrejs; Karelis, Guntis; Stepens, Ainārs; Department of Radiology; Militārās medicīnas pētījumu un studiju centrs; Department of Health Psychology and Paedagogy; Department of InfectologyBackground and Objectives: Magnetic resonance imaging is vital for diagnosing cognitive decline. Brodmann areas (BA), distinct regions of the cerebral cortex categorized by cytoarchitectural variances, provide insights into cognitive function. This study aims to compare cortical thickness measurements across brain areas identified by BA mapping. We assessed these measurements among patients with and without cognitive impairment, and across groups categorized by cognitive performance levels using the Montreal Cognitive Assessment (MoCA) test. Materials and Methods: In this cross-sectional study, we included 64 patients who were divided in two ways: in two groups with (CI) or without (NCI) impaired cognitive function and in three groups with normal (NC), moderate (MPG) and low (LPG) cognitive performance according to MoCA scores. Scans with a 3T MRI scanner were carried out, and cortical thickness data was acquired using Freesurfer 7.2.0 software. Results: By analyzing differences between the NCI and CI groups cortical thickness of BA3a in left hemisphere (U = 241.000, p = 0.016), BA4a in right hemisphere (U = 269.000, p = 0.048) and BA28 in left hemisphere (U = 584.000, p = 0.005) showed significant differences. In the LPG, MPG and NC cortical thickness in BA3a in left hemisphere (H (2) = 6.268, p = 0.044), in V2 in right hemisphere (H (2) = 6.339, p = 0.042), in BA28 in left hemisphere (H (2) = 23.195, p < 0.001) and in BA28 in right hemisphere (H (2) = 10.015, p = 0.007) showed significant differences. Conclusions: Our study found that cortical thickness in specific Brodmann Areas—BA3a and BA28 in the left hemisphere, and BA4a in the right—differ significantly between NCI and CI groups. Significant differences were also observed in BA3a (left), V2 (right), and BA28 (both hemispheres) across LPG, MPG, NC groups. Despite a small sample size, these findings suggest cortical thickness measurements can serve as effective biomarkers for cognitive impairment diagnosis, warranting further validation with a larger cohort.Item Cerebellar Cortex and Cerebellar White Matter Volume in Normal Cognition, Mild Cognitive Impairment, and Dementia(2021-08-26) Zdanovskis, Nauris; Platkājis, Ardis; Kostiks, Andrejs; Grigorjeva, Oļesja; Karelis, Guntis; Department of RadiologyThe cerebellum is commonly viewed as a structure that is primarily responsible for the coordination of voluntary movement, gait, posture, and speech. Recent research has shown evidence that the cerebellum is also responsible for cognition. We analyzed 28 participants divided into three groups (9 with normal cognition, 9 with mild cognitive impairment, and 10 with moderate/severe cognitive impairment) based on the Montreal Cognitive Assessment. We analyzed the cerebellar cortex and white matter volume and assessed differences between groups. Participants with normal cognition had higher average values in total cerebellar volume, cerebellar white matter volume, and cerebellar cortex volume in both hemispheres, but by performing the Kruskal–Wallis test, we did not find these values to be statistically significant.Item Combined Score of Perivascular Space Dilatation and White Matter Hyperintensities in Patients with Normal Cognition, Mild Cognitive Impairment, and Dementia(2022-07) Zdanovskis, Nauris; Platkājis, Ardis; Kostiks, Andrejs; Šneidere, Kristīne; Stepens, Ainārs; Naglis, Roberts; Karelis, Guntis; Department of Radiology; Militārās medicīnas pētījumu un studiju centrs; Department of Health Psychology and Paedagogy; Department of InfectologyBackground and Objectives: Cerebral perivascular spaces (PVS) are part of the cerebral microvascular structure and play a role in lymphatic drainage and the removal of waste products from the brain. White matter hyperintensities (WMH) are hyperintense lesions on magnetic resonance imaging that are associated with cognitive impairment, dementia, and cerebral vascular disease. WMH and PVS are direct and indirect imaging biomarkers of cerebral microvascular integrity and health. In our research, we evaluated WMH and PVS enlargement in patients with normal cognition (NC), mild cognitive impairment (MCI), and dementia (D). Materials and Methods: In total, 57 participants were included in the study and divided into groups based on neurological evaluation and Montreal Cognitive Assessment results (NC group 16 participants, MCI group 29 participants, D group 12 participants). All participants underwent 3T magnetic resonance imaging. PVS were evaluated in the basal ganglia, centrum semiovale, and midbrain. WMHs were evaluated based on the Fazekas scale and the division between deep white matter (DWM) and periventricular white matter (PVWM). The combined score based on PVS and WMH was evaluated and correlated with the results of the MoCA. Results: We found statistically significant differences between groups on several measures. Centrum semiovale PVS dilatation was more severe in MCI and dementia group and statistically significant differences were found between D-MCI and D-NC pairs. PVWM was more severe in patients with MCI and dementia group, and statistically significant differences were found between D-MCI and D-NC pairs. Furthermore, we found statistically significant differences between the groups by analyzing the combined score of PVS dilatation and WMH. We did not find statistically significant differences between the groups in PVS dilation of the basal ganglia and midbrain and DWM hyperintensities. Conclusions: PVS assessment could become one of neuroimaging biomarkers for patients with cognitive decline. Furthermore, the combined score of WMH and PVS dilatation could facilitate diagnostics of cognitive impairment, but more research is needed with a larger cohort to determine the use of PVS dilatation and the combined score.Item Galvas smadzeņu kvalitatīvu un kvantitatīvu radioloģisko biomarķieru izmaiņu saistība ar kognitīvo funkciju izmaiņām un demenci. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2023) Zdanovskis, Nauris; Platkājis, ArdisPopulācijas demogrāfiskās izmaiņas un neirodeģeneratīvu slimību savlaicīga diagnostika un ārstēšana ir viens no lielākajiem izaicinājumiem Eiropā un pasaulē 21. gadsimtā. Promocijas darbā tiek aplūkotas magnētiskās rezonanses (MR) izmeklējuma iespējas, analizējot pētījuma dalībniekus ar kognitīvajiem traucējumiem. Darba mērķis ir noteikt galvas smadzeņu kvalitatīvo un kvantitatīvo biomarķieru saistību ar kognitīvo funkciju pacientiem ar kognitīvajiem traucējumiem. Pētījuma literatūras apskata sadaļā tiek raksturots kognitīvo traucējumu un demences jēdziens, biežāk izmantotie kognitīvie testi, aprakstītas biežāk izmantotās kvalitatīvās vizuālās novērtēšanas skalas un izvērtēta kvantitatīvo biomarķieru izmantošana kognitīvo traucējumu diagnostikā. Materiālu sadaļā ir izvērtēti dalībnieku demogrāfiskie rādītāji, dalībnieki tiek iedalīti grupās un izvērtētas atšķirības starp dalībnieku grupām. Kopumā tika analizēts 81 dalībnieks, no kuriem 24 nav kognitīvo traucējumu un 57 ir dažādas pakāpes kognitīvie traucējumi, kas tika izvērtēti pēc Monreālas kognitīvās novērtējuma (MoCA) skalas. Metožu sadaļā tiek izvērtēts statistisko metožu lietojums, kas ietver Manna-Vitnija U testu, Kruskala-Valisa H testu, post-hoc analīzi, p vērtību korekciju pēc Bonferoni, Spīrmena korelācijas, principiālo komponentu analīzi. Rezultāti norāda, ka noteikti galvas smadzeņu radioloģiskie biomarķieri ir saistīti ar kognitīvo funkciju rezultātiem, t. sk. gan kvalitatīvās novērtēšanas skalas, gan kvantitatīvās tilpuma, garozas biezuma un baltās vielas šķiedru raksturlieluma vērtības. Šīs noteiktās saistības ir kā pamats tālākiem pētījumiem par kvantitatīvo radioloģisko biomarķieru izmantošanu kognitīvo traucējumu diagnostikā, lai nākotnē spētu agrīni identificēt pacientus, kas ir kognitīvo traucējumu attīstības riska grupā. Secinājumos tiek apstiprinātas darba gaitā izvirzītās hipotēzes – galvas smadzenēs kognitīvo traucējumu un demences gadījumā notiek strukturālas pārmaiņas, kas ir konstatējamas MR attēlos, veicot galvas smadzeņu struktūru kvalitatīvu un kvantitatīvu analīzi, un kognitīvie traucējumi ir saistīti ar specifiskām izmaiņām galvas smadzeņu MR kvantitatīvajos rādītājos. Kopumā MR izmeklējums spēj ne tikai izslēgt lielas patoloģijas, bet arī sniegt daudz plašāku un detalizētāku informāciju par anatomiskām un strukturālām izmaiņām, kas ir būtiskas kognitīvo traucējumu diagnostikai, kontrolei un intervences izvērtēšanai ilgtermiņā.Item Galvas smadzeņu kvalitatīvu un kvantitatīvu radioloģisko biomarķieru izmaiņu saistība ar kognitīvo funkciju izmaiņām un demenci. Promocijas darbs(Rīgas Stradiņa universitāte, 2023) Zdanovskis, Nauris; Platkājis, ArdisPopulācijas demogrāfiskās izmaiņas un neirodeģeneratīvu slimību savlaicīga diagnostika un ārstēšana ir viens no lielākajiem izaicinājumiem Eiropā un pasaulē 21. gadsimtā. Promocijas darbā tiek aplūkotas magnētiskās rezonanses (MR) izmeklējuma iespējas, analizējot pētījuma dalībniekus ar kognitīvajiem traucējumiem. Darba mērķis ir noteikt galvas smadzeņu kvalitatīvo un kvantitatīvo biomarķieru saistību ar kognitīvo funkciju pacientiem ar kognitīvajiem traucējumiem. Pētījuma literatūras apskata sadaļā tiek raksturots kognitīvo traucējumu un demences jēdziens, biežāk izmantotie kognitīvie testi, aprakstītas biežāk izmantotās kvalitatīvās vizuālās novērtēšanas skalas un izvērtēta kvantitatīvo biomarķieru izmantošana kognitīvo traucējumu diagnostikā. Materiālu sadaļā ir izvērtēti dalībnieku demogrāfiskie rādītāji, dalībnieki tiek iedalīti grupās un izvērtētas atšķirības starp dalībnieku grupām. Kopumā tika analizēts 81 dalībnieks, no kuriem 24 nav kognitīvo traucējumu un 57 ir dažādas pakāpes kognitīvie traucējumi, kas tika izvērtēti pēc Monreālas kognitīvās novērtējuma (MoCA) skalas. Metožu sadaļā tiek izvērtēts statistisko metožu lietojums, kas ietver Manna-Vitnija U testu, Kruskala-Valisa H testu, post-hoc analīzi, p vērtību korekciju pēc Bonferoni, Spīrmena korelācijas, principiālo komponentu analīzi. Rezultāti norāda, ka noteikti galvas smadzeņu radioloģiskie biomarķieri ir saistīti ar kognitīvo funkciju rezultātiem, t. sk. gan kvalitatīvās novērtēšanas skalas, gan kvantitatīvās tilpuma, garozas biezuma un baltās vielas šķiedru raksturlieluma vērtības. Šīs noteiktās saistības ir kā pamats tālākiem pētījumiem par kvantitatīvo radioloģisko biomarķieru izmantošanu kognitīvo traucējumu diagnostikā, lai nākotnē spētu agrīni identificēt pacientus, kas ir kognitīvo traucējumu attīstības riska grupā. Secinājumos tiek apstiprinātas darba gaitā izvirzītās hipotēzes – galvas smadzenēs kognitīvo traucējumu un demences gadījumā notiek strukturālas pārmaiņas, kas ir konstatējamas MR attēlos, veicot galvas smadzeņu struktūru kvalitatīvu un kvantitatīvu analīzi, un kognitīvie traucējumi ir saistīti ar specifiskām izmaiņām galvas smadzeņu MR kvantitatīvajos rādītājos. Kopumā MR izmeklējums spēj ne tikai izslēgt lielas patoloģijas, bet arī sniegt daudz plašāku un detalizētāku informāciju par anatomiskām un strukturālām izmaiņām, kas ir būtiskas kognitīvo traucējumu diagnostikai, kontrolei un intervences izvērtēšanai ilgtermiņā.Item Relationship between lifestyle proxies of cognitive reserve and cortical regions in older adults(2023) Šneidere, Kristīne; Zdanovskis, Nauris; Mondini, Sara; Stepens, Ainārs; Department of Health Psychology and Paedagogy; Militārās medicīnas pētījumu un studiju centrs; Department of RadiologyIntroduction: With the rapid increase in the population over 65 years old, research on healthy aging has become one of the priorities in the research community, looking for a cost-effective method to prevent or delay symptoms of mild cognitive disorder or dementia. Studies indicate that cognitive reserve theory could be beneficial in this regard. The aim of this study was to investigate the potential relationship between lifestyle socio-behavioral proxies of cognitive reserve and cortical regions in adults with no subjective cognitive decline. Methods: Overall, 58 participants, aged 65–85 years, were included in the data analysis (M = 71.83, SD = 5.02, 20.7% male). Cognitive reserve proxies were measured using the Cognitive Reserve Index questionnaire, while cortical volumes were obtained with the Siemens 1.5 T Avanto MRI scanner and further mapped using the Desikan-Killiany-Tourville (DKT) Atlas. Estimated intracranial volume and age were used as covariates. Results: The results indicated that higher occupational complexity was associated with larger cortical volume in the left middle temporal gyrus, the left and right inferior temporal gyrus, and the left inferior parietal lobule, while a combined proxy (the total CRI score) showed a positive relationship with the volume of left middle temporal gyrus and inferior parietal lobule, and pars orbitalis in the right hemisphere. Discussion: These results might indicate that more complex occupational activities and overall more intellectually and socially active life-style could contribute to better brain health, especially in regions known to be more vulnerable to Alzheimer’s disease.Item The role of intraoperative 2D foot perfusion during percutaneous infrainguinal angioplasty in patients with critical limb ischemia(2021) Kratovska, Aina; Zdanovskis, Nauris; Zaiceva, Veronika; Ponomarjova, Sanita; Ivanova, Patrīcija; Rīga Stradiņš UniversityBackground. Critical limb ischemia (CLI) is an end stage of peripheral arterial disease. Percutaneous transluminal angioplasty (PTA) has gained a mainstream position in treatment of CLI. Frequently, multilevel hemodynamically significant atherosclerotic lesions are detected during PTA in patients with CLI. Therefore, intraoperative decision of intervention level and amount has to be undertaken based on macrovascular images acquired during intraoperative digital subtraction angiography (DSA) analysed by eye. Intraoperative 2D foot perfusion angiography (2DFPA) is a novel post-processing tool integrated in newest generation DSA equipment. It offers an objective quantitative analysis of different flow and contrast density parameters within region of interest (ROI). Consequently, it might become an additional objective intraoperative tool in estimation of operation volume. Aim. To establish basic protocol for 2DFPA in Riga East University Hospital and perform pilot evaluation of the parameters acquired during 2DFPA. Methods. In this case, the control study performed during June to November of 2020, and included 7 patients with CLI and intraoperative 2DFPA. 2DFPA performed through antegrade 6F 23 cm sheath in superficial femoral artery with automated injection volume/rate 15 ml/6 ml/s and fixed position of the foot during procedure. Following pre-intervention and post-intervention perfusion parameters analysed in whole foot ROI: arrival time (AT), time-to-peak (TTP), area under the curve (AuC), peak density (PD); Results. The mean age – 71.5 (54–85) years, 4 males, 3 females. CLI Rutherford class V in all patients. One patient excluded due to foot movements during procedure and noncomparable 2DFPA results. 3 patients underwent PTA of superficial femoral artery, 3 patients – infrageniculate PTA. In 4 PTA procedures defined by operator as successful based on DSA, the following 2DFPA parameters were acquired: decrease of AT and TTP, and increase of PD and AuC was found corresponding with good technical result. 2DFPA showed no improvement of parameters in one PTA defined by operator as successful and in one PTA defined by operator as not successful. Conclusion. 2DFPA is an easy and safe intraoperative analysis tool to be applied, although adaptation of protocol and patient positioning is required. Acquisition of intraoperative perfusion parameters pre- and post-treatment might serve as a marker for operation volume, if the desired perfusion goals are not achieved. Following larger scale trials have to be conducted to establish specific perfusion value ranges as treatment end-points. Medicina (Kaunas) 2021;57(Supplement 1):200 201Medicina (Kaunas) 2021;57(Supplement 1) The role of Transcranial Doppler sonography for neuromonitoring in cardiac surgery with cardiopulmonary bypass Mackevics Davis1, Leibuss Roberts2,3, Oss Elvijs2, Kalejs Martins2,3, Strike Eva2,3, Stradins Peteris2,3 1University of Latvia, Faculty of Medicine, Riga, Latvia 2Riga Stradiņš University, Faculty of Medicine, Riga, Latvia3Pauls Stradiņš Clinical University Hospital, Riga, Latvia Background. In patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), blood pressure (BP) excursions outside the limits of cerebral autoregulation are associated with organ and brain dysfunction. The use of TCD has been reported in intraoperative monitoring of cerebral blood flow and air emboli by providing instant visual feedback. Individualized mean arterial pressure (MAP) management targeted to optimize cerebral autoregulation by TCD might provide a more neuroprotective approach to patient care during CPB than standardized BP management. Aim. The study aimed to analyse MAP excursions during non-pulsatile CPB effects on cerebral blood flow parameters and primary postoperative outcomes. As well as identify possible other factors affecting TCD. Methods. 50 elective cardiac surgeries with CBP performed in a University Clinical Hospital. The right and left middle cerebral artery blood flow velocity was assessed using TCD and analysed for spectrum. Measurement intervals: after anaesthesia induction, 15 minutes after aortic cross-clamping, and 15 minutes after CBP. The average pulsatility index (PI), time-averaged peak velocity (TAPV), resistance index (RI), end-diastolic velocity (EDV), peak systolic velocity (PSV) were recorded and compared. Results and discussion. A total of 50 patients were included. The mean age 64.76 (42–81) years; CPB 101.14 (54–184) minutes; Ejection fraction 52.50 (20–72); Body mass index 29.08 (19.48–44.41); Diabetes occurred in 38 patients; Pulmonary arterial hypertension (PAH) I occurred in 18 patients, 21 patients – PAH II; Blood transfusions were performed in 22 patients; Catecholamines was required in 21 patients; Patients who stayed longer in the ICU had more comorbidities – nine patients stayed in the ICU for 9–65 days (median 4.64). MAP during CPB was 66.18 (50–80). The blood transfusion rate showed no significant differences. Hematocrit was decreased postoperatively (mean 29) compared to preoperative values (mean 37.7); during CPB 25.6. CPB during cardiac surgery has been demonstrated to cause alterations of the cerebral blood flow. RI was affected by gender (p=0.08), type of operation (p=0.09) and CHF (p=0.08); PI was affected by gender (p=0.02), diabetes (p=0.06) and PAH (p=0.02); PSV was affected by presence of diabetes (p=0.04), PAH (p=0.006), heart rate (p=0.04), TAPV (p=0.05); Conclusion. TCD method can be considered for multimodal neuromonitoring in cardiac surgery. TCD can be a useful guiding instrument for adequate hemodynamic parameters, confirming the adequacy of cerebral perfusion strategy or the need for its optimization. Acknowledgements. The authors declare the absence of conflict of interest. Medicina (Kaunas) 2021;57(Supplement 1):201 202Medicina (Kaunas) 2021;57(Supplement 1) Evaluation of STEMI caused by the atherosclerotic disorder of the specific coronary artery Rėkus Algirdas1, Jaruševičius Gediminas2, Aldujeli Ali2 1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania 2 Lithuanian University of Health Sciences, Department of Cardiology, Kaunas, Lithuania Background. ST-elevation myocardial infarction (STEMI) is an acute condition best treated by percutaneous coronary artery (CA) intervention. This retrospective study attempted to assess the association between STEMI caused by CA and disease risk factors, studies conducted and treatment data. Aim. To evaluate the connections between CA and of STEMI – experienced patients’ data of those admitted to the Lithuanian University of Health Sciences Department of Cardiology. Methods. A retrospective single-centre study was conducted of 745 STEMI patients. Patients were divided into four groups, depending on CA induced STEMI: right coronary artery (RCA), left main artery (LM), left anterior descending (LAD), left circumflex (LCx). Gender, age, history of smoking, diabetes mellitus (DM), obesity, arterial hypertension (AH), TIMI flow before and after reperfusion, total number, length and diameters of stents used, initial laboratory tests: haemoglobin, glucose, creatinine, troponin I (TnI), potassium, leukocytes, total (TC), high (HDC) and low (LDC) – density cholesterol, triglyceride levels (TG) and mortality were evaluated. Chi-square test, Student’s t-test, independent – samples Kruskal- Wallis test, ANOVA were used for analysis. The value of p≤0.05 was considered statistically significant. Results. The study evaluated 756 STEMI patients. No statistical significance was found between the CA and data: gender (p=0.217), age (p=0.466), smoking (p=0.378), DM (p=0.296), obesity (p=0.095), AH (p=0.194), TIMI flow before (p=0.173) and after intervention (p=0.488), number of stents used (p=0.629), initial laboratory tests: glucose (p=0.690), creatinine (p=0.156), TnI (p=0.808), potassium (p=0.185), leukocytes (p=0.912), TC (p=0.217), LDC (p=0.187), TG (p=0.4) and mortality (p=0.461). The statistical significance of the following data was determined: the total length of stents used in RCA was longer than LCx (p=0.03), the total diameter of the stents used in LAD was larger than RCA (p=0.02), the initial haemoglobin concentration was lower in LAD than RCA (p=0.02), HDC was found to be higher in LAD than in RCA (p=0.004). Conclusion. For the RCA, longer stents were used in general than the LCx, but the total stents’ diameter for the LAD was larger than in case of the RCA. The haemoglobin concentration was lower in the LAD than in the RCA. HDC was found in higher concentration among LAD than the RCA. Medicina (Kaunas) 2021;57(Supplement 1):202 203Medicina (Kaunas) 2021;57(Supplement 1) Platelet activity and its correlation with inflammation and cell count readings in chronic heart failure patients with reduced ejection fraction Mongirdienė Aušra1, Laukaitienė Jolanta1,2, Skipskis Vilius3 1Lithuanian University of Health Sciences, Institution Department of Biochemistry, Kaunas, Lithuania 2Lithuanian University of Health Sciences, Cardiology Clinic, University Hospital, Kaunas, Lithuania 3Lithuanian University of Health Sciences, Institute of Cardiology, Laboratory of Molecular Cardiology, Kaunas, Lithuania Background. There has been an increasing interest in the role of inflammation in thrombosis complications in chronic heart failure (HF) patients. The incidence of thrombosis in HF is shown to be the highest in patients classified as NYHA IV. It is stated that inflammation is regulated by platelet-induced activation of blood leukocytes. Aim. The objective of the current study was to compare the platelet and cell count readings in chronic HF with reduced ejection fraction (HFrEF) patients according to NYHA functional class and to evaluate the correlation between those readings. Methods. Total of 185 patients were examined in complete blood cell count, platelet aggregation, C reactive protein (CRP), NT-proBNP, cortisol, fibrinogen concentration. Results. Mean platelet volume (MPV) increased with deterioration of a patient’s state (p<0.005). Lymphocyte count and percent were the lowest in NYHA IV group (p<0.005). Neutrophil percent and count, monocyte percent and count were the highest (p<0.045) in NYHA IV. ADP and ADR-induced platelet aggregation was higher in NYHA III group compared to NYHA II and I group (p<0.023). NYHA functional class correlated with MPV (r=0.311, p=0.0001), lymphocyte count (r=-0.186, p=0.026), monocyte count (p=0.172, p=0.041), and percent (r=0.212, p=0.011). CRP concentration correlated with NT-proBNP (r=0.203, p=0.005). MPV correlated with fibrinogen concentration (r=0.244, p=0.004). Neutrophil count correlated with fibrinogen concentration (r=0.308, p=0.0001), evening cortisol concentration (r=0.256, p=0.009), and CRP (r=0.378, p=0.0001). Lymphocyte percent correlated with fibrinogen concentration (r=-0.174, p=0.03), CRP (r=-0.220, p=0.028), and evening cortisol concentration (r=-0.246, p=0.012). Monocyte percent correlated with fibrinogen concentration (r=0.175, p=0.03). Monocyte count correlated with morning cortisol, fibrinogen concentration (r=0.279, p=0.004 and r=0.315, p=0.0001, respectively) and CRP (r=0.315, p=0.0001). Conclusion. 1) MPV could be considered as additional reading reflecting patient’s condition; use of MPV identifying patients at risk of hypercoagulable state should be evaluated in more extensive studies; 2) increasing neutrophil and monocyte count could indicate a higher inflammatory state in chronic HFrEF. Acknowledgements. The authors declare the absence of conflict of interest. No outside funding has been received for the current study. Medicina (Kaunas) 2021;57(Supplement 1):203Item Structural analysis of brain hub region volume and cortical thickness in patients with mild cognitive impairment and dementia(2020-10-01) Zdanovskis, Nauris; Platkājis, Ardis; Kostiks, Andrejs; Karelis, Guntis; Department of RadiologyBackground and Objectives: A complex network of axonal pathways interlinks the human brain cortex. Brain networks are not distributed evenly, and brain regions making more connections with other parts are defined as brain hubs. Our objective was to analyze brain hub region volume and cortical thickness and determine the association with cognitive assessment scores in patients with mild cognitive impairment (MCI) and dementia. Materials and Methods: In this cross-sectional study, we included 11 patients (5 mild cognitive impairment; 6 dementia). All patients underwent neurological examination, and Montreal Cognitive Assessment (MoCA) test scores were recorded. Scans with a 3T MRI scanner were done, and cortical thickness and volumetric data were acquired using Freesurfer 7.1.0 software. Results: By analyzing differences between the MCI and dementia groups, MCI patients had higher hippocampal volumes (p <0.05) and left entorhinal cortex thickness (p <0.05). There was a significant positive correlation between MoCA test scores and left hippocampus volume (r = 0.767, p <0.01), right hippocampus volume (r = 0.785, p <0.01), right precuneus cortical thickness (r = 0.648, p <0.05), left entorhinal cortex thickness (r = 0.767, p <0.01), and right entorhinal cortex thickness (r = 0.612, p <0.05). Conclusions: In our study, hippocampal volume and entorhinal cortex showed significant differences in the MCI and dementia patient groups. Additionally, we found a statistically significant positive correlation between MoCA scores, hippocampal volume, entorhinal cortex thickness, and right precuneus. Although other brain hub regions did not show statistically significant differences, there should be additional research to evaluate the brain hub region association with MCI and dementia.Item Whole Brain and Corpus Callosum Fractional Anisotropy Differences in Patients with Cognitive Impairment(2023-12-16) Kaļva, Kalvis; Zdanovskis, Nauris; Šneidere, Kristīne; Kostiks, Andrejs; Karelis, Guntis; Platkājis, Ardis; Stepens, Ainārs; Department of Radiology; Militārās medicīnas pētījumu un studiju centrs; Department of Health Psychology and Paedagogy; Department of InfectologyDiffusion tensor imaging (DTI) is an MRI analysis method that could help assess cognitive impairment (CI) in the ageing population more accurately. In this research, we evaluated fractional anisotropy (FA) of whole brain (WB) and corpus callosum (CC) in patients with normal cognition (NC), mild cognitive impairment (MCI), and moderate/severe cognitive impairment (SCI). In total, 41 participants were included in a cross-sectional study and divided into groups based on Montreal Cognitive Assessment (MoCA) scores (NC group, nine participants, MCI group, sixteen participants, and SCI group, sixteen participants). All participants underwent an MRI examination that included a DTI sequence. FA values between the groups were assessed by analysing FA value and age normative percentile. We did not find statistically significant differences between the groups when analysing CC FA values. Both approaches showed statistically significant differences in WB FA values between the MCI-SCI and MCI-NC groups, where the MCI group participants showed the highest mean FA and highest mean FA normative percentile results in WB.