Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-41-48
N. A. Melikova, E. Filatova, E. Filatova, A. Lila
Objective: to evaluate the impact of comorbid fibromyalgia (FM) on the quality of life (QoL) of patients with rheumatoid arthritis (RA). Material and methods. The study involved 90 patients with confirmed RA who complained of chronic pain. All patients underwent general clinical and laboratory examination. FM was diagnosed according to the 2016 ACR criteria. The questionnaires assessed the presence and severity of fatigue (FSS), anxiety and depression (HADS), sleep disorders (PSQI), cognitive impairment (DSST), symptoms of central sensitization (CSI) and the neuropathic component of pain (DN4, PD). The severity of pain syndrome (PS) was assessed by 10-cm VAS at rest. QoL was assessed using the EQ-5D questionnaire. Results. In the main (FM+) and control (FM-) groups, the average severity of PS according to VAS at rest was 7 and 4 cm (p<0.001), the average score on the CSI questionnaire was 50 and 38.5 (p<0.001), and according to the PD questionnaire – 17 and 11 (p<0.001), respectively. Analysis of the severity of comorbid disorders revealed significant differences between the groups in terms of such parameters as fatigue (p=0.003), anxiety (p=0.001), sleep quality (p<0.001) and cognitive impairment (p=0.021). The QoL of patients (according to EQ-5D) in the main group was significantly lower (0.52 vs. 0.59; p=0.003). Significant correlations were found between the QoL index according to EQ-5D and VAS, FSS and PD values in both groups, CSI, DN4, HADS-T parameters and the number of painful joints – only in the main group. Conclusion. Concomitant FM significantly reduces the QoL of patients with RA. The main factors affecting QoL in patients with RA and comorbid FM were the intensity and neuropathic phenotype of PS, increased fatigue and anxiety. Patients with FM are also significantly more likely to have sleep and cognitive impairments.
目的:探讨共病纤维肌痛(FM)对类风湿关节炎(RA)患者生活质量(QoL)的影响。材料和方法。该研究涉及90名确诊的类风湿性关节炎患者，他们抱怨慢性疼痛。所有患者均进行了一般临床和实验室检查。根据2016年ACR标准诊断FM。问卷评估了疲劳(FSS)、焦虑和抑郁(HADS)、睡眠障碍(PSQI)、认知障碍(DSST)、中枢致敏症状(CSI)和疼痛的神经性成分(DN4, PD)的存在和严重程度。静息时采用10cm VAS评估疼痛综合征(PS)的严重程度。使用EQ-5D问卷评估生活质量。结果。主组(FM+)和对照组(FM-)患者静息时VAS评分平均为7 cm和4 cm (p<0.001)， CSI问卷评分平均为50分和38.5分(p<0.001)， PD问卷评分平均为- 17分和11分(p<0.001)。对合并症严重程度的分析显示，两组在疲劳(p=0.003)、焦虑(p=0.001)、睡眠质量(p<0.001)和认知障碍(p=0.021)等参数上存在显著差异。主组患者的生活质量(按EQ-5D)显著低于对照组(0.52 vs. 0.59;p = 0.003)。两组患者EQ-5D与VAS的生活质量指数、FSS、PD值、CSI、DN4、HADS-T参数与疼痛关节数之间均存在显著相关性(仅主组存在)。结论。同时服用FM可显著降低RA患者的生活质量。影响RA合并FM患者生活质量的主要因素是PS的强度和神经病理表型、疲劳和焦虑的增加。患有FM的患者也更容易出现睡眠和认知障碍。
{"title":"Quality of life of patients with rheumatoid arthritis and comorbid fibromyalgia","authors":"N. A. Melikova, E. Filatova, E. Filatova, A. Lila","doi":"10.14412/2074-2711-2023-2-41-48","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-41-48","url":null,"abstract":"Objective: to evaluate the impact of comorbid fibromyalgia (FM) on the quality of life (QoL) of patients with rheumatoid arthritis (RA). Material and methods. The study involved 90 patients with confirmed RA who complained of chronic pain. All patients underwent general clinical and laboratory examination. FM was diagnosed according to the 2016 ACR criteria. The questionnaires assessed the presence and severity of fatigue (FSS), anxiety and depression (HADS), sleep disorders (PSQI), cognitive impairment (DSST), symptoms of central sensitization (CSI) and the neuropathic component of pain (DN4, PD). The severity of pain syndrome (PS) was assessed by 10-cm VAS at rest. QoL was assessed using the EQ-5D questionnaire. Results. In the main (FM+) and control (FM-) groups, the average severity of PS according to VAS at rest was 7 and 4 cm (p<0.001), the average score on the CSI questionnaire was 50 and 38.5 (p<0.001), and according to the PD questionnaire – 17 and 11 (p<0.001), respectively. Analysis of the severity of comorbid disorders revealed significant differences between the groups in terms of such parameters as fatigue (p=0.003), anxiety (p=0.001), sleep quality (p<0.001) and cognitive impairment (p=0.021). The QoL of patients (according to EQ-5D) in the main group was significantly lower (0.52 vs. 0.59; p=0.003). Significant correlations were found between the QoL index according to EQ-5D and VAS, FSS and PD values in both groups, CSI, DN4, HADS-T parameters and the number of painful joints – only in the main group. Conclusion. Concomitant FM significantly reduces the QoL of patients with RA. The main factors affecting QoL in patients with RA and comorbid FM were the intensity and neuropathic phenotype of PS, increased fatigue and anxiety. Patients with FM are also significantly more likely to have sleep and cognitive impairments.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89657198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-68-74
M. Kutlubaev, D. K. Areprintceva, E. V. Pervushina, L. Brylev
Cognitive disorders (CD) are observed in more than half of patients with amyotrophic lateral sclerosis (ALS), but rarely reach the degree of dementia. Currently, a classification of ALS has been proposed depending on the presence of cognitive and/or behavioral disorders. CD in ALS can be represented by speech fluency disorders, various aphasic disorders, disorders of regulatory functions, social cognitive functions, and verbal memory. The most diagnostically sensitive are special scales, such as the Edinburgh Cognitive and Behavioral Impairment Screening Scale for ALS. CD in ALS have a negative impact on the outcome of the disease and the quality of life of patients and their families. This issue requires further study.
{"title":"Cognitive disorders in amyotrophic lateral sclerosis","authors":"M. Kutlubaev, D. K. Areprintceva, E. V. Pervushina, L. Brylev","doi":"10.14412/2074-2711-2023-2-68-74","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-68-74","url":null,"abstract":"Cognitive disorders (CD) are observed in more than half of patients with amyotrophic lateral sclerosis (ALS), but rarely reach the degree of dementia. Currently, a classification of ALS has been proposed depending on the presence of cognitive and/or behavioral disorders. CD in ALS can be represented by speech fluency disorders, various aphasic disorders, disorders of regulatory functions, social cognitive functions, and verbal memory. The most diagnostically sensitive are special scales, such as the Edinburgh Cognitive and Behavioral Impairment Screening Scale for ALS. CD in ALS have a negative impact on the outcome of the disease and the quality of life of patients and their families. This issue requires further study.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76690805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-120-125
Y. Belova, S. Kotov
Improvement of therapy of patients with ischemic stroke (IS) remains a relevant problem, despite the widespread use of drug and mechanical revascularization methods during recent years. One of the pathogenetic mechanisms of IS is oxidative stress as one of the components of brain tissue damage in the acute period and a factor that prevents the processes of repair and neuroplasticity in the recovery period. This is the rationale for the use of antioxidant drugs in the acute and recovery periods of stroke. Data from clinical studies on the use of antioxidants in the treatment of patients with IS are presented. We describe the use of the domestic drug dimephosphone (dimethyloxobutylphosphonyl dimethylate), a synthetic non-anticholinesterase organophosphorus compound, which has a wide range of effects: antioxidant, antacidotic, vasodilating, membrane stabilizing, anti-inflammatory, etc. Data are given on the use of dimephosphone in the acute period of IS in patients with no indications for thrombolytic therapy, there was a decrease in neurological deficit and a decrease in disability. The positive results of the use of dimephosphone in the recovery period of IS and in chronic cerebrovascular insufficiency are described. The data of our own study on the use of dimephosphone in the complex therapy of cognitive rehabilitation of patients in the recovery period of IS are presented. A statistically significant recovery of cognitive functions was registered according to the Montreal Cognitive Scale (MoCA), and an increase in the MoCA score by 2 points or more in 59.6% of patients. An improvement in executive functions, an increase in the flexibility of cognitive control of cognitive processes, and the predominance of verbal thinking over sensory-perceptual were noted.
{"title":"Antioxidant therapy in the complex treatment of patients with ischemic stroke in the acute and recovery period","authors":"Y. Belova, S. Kotov","doi":"10.14412/2074-2711-2023-2-120-125","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-120-125","url":null,"abstract":"Improvement of therapy of patients with ischemic stroke (IS) remains a relevant problem, despite the widespread use of drug and mechanical revascularization methods during recent years. One of the pathogenetic mechanisms of IS is oxidative stress as one of the components of brain tissue damage in the acute period and a factor that prevents the processes of repair and neuroplasticity in the recovery period. This is the rationale for the use of antioxidant drugs in the acute and recovery periods of stroke. Data from clinical studies on the use of antioxidants in the treatment of patients with IS are presented. We describe the use of the domestic drug dimephosphone (dimethyloxobutylphosphonyl dimethylate), a synthetic non-anticholinesterase organophosphorus compound, which has a wide range of effects: antioxidant, antacidotic, vasodilating, membrane stabilizing, anti-inflammatory, etc. Data are given on the use of dimephosphone in the acute period of IS in patients with no indications for thrombolytic therapy, there was a decrease in neurological deficit and a decrease in disability. The positive results of the use of dimephosphone in the recovery period of IS and in chronic cerebrovascular insufficiency are described. The data of our own study on the use of dimephosphone in the complex therapy of cognitive rehabilitation of patients in the recovery period of IS are presented. A statistically significant recovery of cognitive functions was registered according to the Montreal Cognitive Scale (MoCA), and an increase in the MoCA score by 2 points or more in 59.6% of patients. An improvement in executive functions, an increase in the flexibility of cognitive control of cognitive processes, and the predominance of verbal thinking over sensory-perceptual were noted.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79116904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-63-67
Yu. A. Shpilyukova, A. O. Protopopova, N. Abramycheva, E. Fedotova, S. Illarioshkin
Rapidly progressive dementias are a rare group of cognitive disorders that primarily require the exclusion of a large number of potentially reversible causes. Prion diseases are frequent in this group of disorders. Some hereditary forms of Alzheimer's disease can also be aggressive, with onset at a young age and autosomal dominant inheritance in the family. The article presents the first case report of a patient with a verified Ile143Thr mutation in the PSEN1 gene in a Russian family with a phenotype similar to the hereditary form of Creutzfeldt–Jakob disease. The specific features of the disease, diagnostic methods, and possible pathogenesis of the development are discussed.
{"title":"Rapidly progressive dementia with early onset associated with the I143T mutation in the PSEN1 gene: a clinical case in a family from Russia","authors":"Yu. A. Shpilyukova, A. O. Protopopova, N. Abramycheva, E. Fedotova, S. Illarioshkin","doi":"10.14412/2074-2711-2023-2-63-67","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-63-67","url":null,"abstract":"Rapidly progressive dementias are a rare group of cognitive disorders that primarily require the exclusion of a large number of potentially reversible causes. Prion diseases are frequent in this group of disorders. Some hereditary forms of Alzheimer's disease can also be aggressive, with onset at a young age and autosomal dominant inheritance in the family. The article presents the first case report of a patient with a verified Ile143Thr mutation in the PSEN1 gene in a Russian family with a phenotype similar to the hereditary form of Creutzfeldt–Jakob disease. The specific features of the disease, diagnostic methods, and possible pathogenesis of the development are discussed.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80793220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-98-105
D. Petelin, A. Gamirova, O. Sorokina, D. V. Troshina, S. A. Semin, M. S. Boltueva, B. A. Volel
Obsessive-compulsive spectrum disorders are widely represented in the population and often encountered in clinical practice, but they are not well diagnosed and many patients do not receive proper treatment. This review discusses the prevalence of obsessive-compulsive spectrum disorders, their negative impact on the level of functioning of patients, comorbidity with other mental disorders, diagnosis and differential diagnosis. The emphasis is put on changes in approaches to the diagnosis of obsessive-compulsive disorders that will occur after the introduction of the International Classification of Diseases of the 11th revision (ICD-11). Approaches to the treatment of obsessive-compulsive spectrum disorders are discussed in accordance with the principles of evidence-based medicine, and the use of selective serotonin reuptake inhibitors and cognitive behavioral therapy as first-line therapy is justified.
{"title":"Diagnosis and therapy of obsessive-compulsive spectrum disorders in general medical and neurological practice","authors":"D. Petelin, A. Gamirova, O. Sorokina, D. V. Troshina, S. A. Semin, M. S. Boltueva, B. A. Volel","doi":"10.14412/2074-2711-2023-2-98-105","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-98-105","url":null,"abstract":"Obsessive-compulsive spectrum disorders are widely represented in the population and often encountered in clinical practice, but they are not well diagnosed and many patients do not receive proper treatment. This review discusses the prevalence of obsessive-compulsive spectrum disorders, their negative impact on the level of functioning of patients, comorbidity with other mental disorders, diagnosis and differential diagnosis. The emphasis is put on changes in approaches to the diagnosis of obsessive-compulsive disorders that will occur after the introduction of the International Classification of Diseases of the 11th revision (ICD-11). Approaches to the treatment of obsessive-compulsive spectrum disorders are discussed in accordance with the principles of evidence-based medicine, and the use of selective serotonin reuptake inhibitors and cognitive behavioral therapy as first-line therapy is justified.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83895843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-75-82
V. V. Osipova, A. Artemenko, D. Shmidt, E. Antipenko
Headache, which is often present in patients with epilepsy, can occur outside of epileptic seizures as well as have a temporary connection with them – occur immediately before, during or after an attack. Clinical types of headache in epilepsy are considered in the International Classification of Headache, but not in the classification of epileptic seizures and types of epilepsy. Meanwhile, the presence of concomitant headache and its clinical phenotype should be taken into account when choosing treatment tactics in patients with epilepsy. The article presents data on the prevalence of different types of headache in patients with epilepsy and a modern classification of cephalalgia depending on the temporal relationship with an epileptic attack. Diagnostic criteria for four clinical variants of cephalgia are given: interictal, preictal, ictal and postictal. The comorbid relationship between epilepsy and migraine is considered in more detail, including the pathophysiological mechanisms underlying the combination of these paroxysmal conditions.
{"title":"Headache and epilepsy: prevalence and clinical variants","authors":"V. V. Osipova, A. Artemenko, D. Shmidt, E. Antipenko","doi":"10.14412/2074-2711-2023-2-75-82","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-75-82","url":null,"abstract":"Headache, which is often present in patients with epilepsy, can occur outside of epileptic seizures as well as have a temporary connection with them – occur immediately before, during or after an attack. Clinical types of headache in epilepsy are considered in the International Classification of Headache, but not in the classification of epileptic seizures and types of epilepsy. Meanwhile, the presence of concomitant headache and its clinical phenotype should be taken into account when choosing treatment tactics in patients with epilepsy. The article presents data on the prevalence of different types of headache in patients with epilepsy and a modern classification of cephalalgia depending on the temporal relationship with an epileptic attack. Diagnostic criteria for four clinical variants of cephalgia are given: interictal, preictal, ictal and postictal. The comorbid relationship between epilepsy and migraine is considered in more detail, including the pathophysiological mechanisms underlying the combination of these paroxysmal conditions.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87978919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-49-56
M. Tanashyan, R. Medvedev, P. Anufriev, E. Gemdzhian, V. Shchipakin, A. Koshcheev, M. Krotenkova
Carotid stenting is an effective method for improving cerebral perfusion; risk assessment of cerebral embolism associated with this intervention remains a hot research topic. Objective: to identify predictors of cerebral embolism associated with carotid angioplasty with stenting (CAS). Material and methods. A prospective exploratory research included 46 patients (age from 44 to 81 years, median 65 years) with atherosclerotic stenosis of the internal carotid artery, who underwent CAS and were treated at the Scientific Center of Neurology (Moscow). The study did not include patients with restenosis, stroke with severe disability, contraindications for antiplatelet therapy, statins, and MRI examination. All patients underwent preoperative ultrasonographic (US) examination and postoperative histological examination of particles in carotid stent embolic protection devices. The state of the brain was assessed before and 24 hours after CAS using diffusion-weighted MRI. To identify predictors of the development of cerebral embolism, the clinical characteristics of patients, together with ultrasonographic and morphological data, were examined in a multivariate statistical analysis.Results. Preoperative US signal from an atherosclerotic plaque of high (estimated above 35 dB) intensity was associated with dense matter (in a protective device) of the "fibrosis with calcification" and "calcification" type and with a high probability (80%; 95% confidence interval 71–85% ) predicted intraoperative embolization of cerebral vessels with the acute ischemic lesions (AIL) formation. In a low (not higher than 35 dB) intensity of the preoperative ultrasound signal, the probability of AIL formation was statistically significantly lower (50%). Conclusion. There is a direct correlation between the intensity of the ultrasound signal and the density of the substance in the protective device. A high intensity of the preoperative ultrasound signal (estimated above 35 dB) is an unfavorable predictor of AIL, associated with CAS (with a probability of about 80%).
{"title":"Prediction of cerebral ischemia during carotid stenting depending on the intensity of the preoperative ultrasound signal from the plaque","authors":"M. Tanashyan, R. Medvedev, P. Anufriev, E. Gemdzhian, V. Shchipakin, A. Koshcheev, M. Krotenkova","doi":"10.14412/2074-2711-2023-2-49-56","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-49-56","url":null,"abstract":"Carotid stenting is an effective method for improving cerebral perfusion; risk assessment of cerebral embolism associated with this intervention remains a hot research topic. Objective: to identify predictors of cerebral embolism associated with carotid angioplasty with stenting (CAS). Material and methods. A prospective exploratory research included 46 patients (age from 44 to 81 years, median 65 years) with atherosclerotic stenosis of the internal carotid artery, who underwent CAS and were treated at the Scientific Center of Neurology (Moscow). The study did not include patients with restenosis, stroke with severe disability, contraindications for antiplatelet therapy, statins, and MRI examination. All patients underwent preoperative ultrasonographic (US) examination and postoperative histological examination of particles in carotid stent embolic protection devices. The state of the brain was assessed before and 24 hours after CAS using diffusion-weighted MRI. To identify predictors of the development of cerebral embolism, the clinical characteristics of patients, together with ultrasonographic and morphological data, were examined in a multivariate statistical analysis.Results. Preoperative US signal from an atherosclerotic plaque of high (estimated above 35 dB) intensity was associated with dense matter (in a protective device) of the \"fibrosis with calcification\" and \"calcification\" type and with a high probability (80%; 95% confidence interval 71–85% ) predicted intraoperative embolization of cerebral vessels with the acute ischemic lesions (AIL) formation. In a low (not higher than 35 dB) intensity of the preoperative ultrasound signal, the probability of AIL formation was statistically significantly lower (50%). Conclusion. There is a direct correlation between the intensity of the ultrasound signal and the density of the substance in the protective device. A high intensity of the preoperative ultrasound signal (estimated above 35 dB) is an unfavorable predictor of AIL, associated with CAS (with a probability of about 80%).","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82573272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-57-62
V. Tolmacheva, E. Dudnik, R. Shishorin, D. Petelin, V. Bezrukov, A. Gamirova, Yu. V. Dolgopolova, B. A. Volel
Functional movement disorders (FMD) are widespread and have a significant negative impact on the quality of life of patients. The pathogenesis is not completely clear, but currently there is ongoing research on searching for biological markers using methods such as functional magnetic resonance imaging and electroencephalography (EEG). Objective: detection of the features of the amplitude-frequency characteristics of the readiness potential (RP) formed during FMD. Material and methods. We examined 22 patients with a clinically diagnosed FMD and 22 healthy volunteers (all participants were right-handed). Both patients and the control group underwent an EEG in Erickson's Flanker paradigm with registration of the RP. RP was recorded in the projection area of the precentral gyrus (electrodes C3/C4/C5/C6 in the standard 10–20 overlay scheme). Results. Comparative analysis of RP parameters showed the presence of significant frequency-amplitude differences between the main group and the control group in the right hemisphere in the absence of significant differences in the left hemisphere. At the same time, significant differences were demonstrated between the FMR group and the control group both in terms of the latent period (time to the onset of RP): 33.66±23.69 ms versus 276.28±176.1 ms (p<0.05), and its amplitude: -0.85±0.294 μV versus -0.35±0.26 μV (p<0.05). Conclusion. The results of the present study suggest that neurophysiological parameters such as RP can be considered as a potential diagnostic marker to improve the diagnosis of FMR.
功能性运动障碍(FMD)广泛存在，对患者的生活质量有显著的负面影响。发病机制尚不完全清楚，但目前正在使用功能磁共振成像和脑电图(EEG)等方法寻找生物标志物。目的:检测口蹄疫形成的准备电位(RP)的幅频特征。材料和方法。我们检查了22名临床诊断为口蹄疫的患者和22名健康志愿者(所有参与者都是右撇子)。患者和对照组均采用Erickson's Flanker范式进行脑电图，并记录RP。RP记录在中央前回投影区(电极C3/C4/C5/C6，标准10-20叠加方案)。结果。RP参数对比分析显示，主组与对照组在右半球存在显著的频幅差异，而左半球无显著差异。同时，FMR组与对照组的潜伏期(到RP发作的时间)分别为33.66±23.69 ms和276.28±176.1 ms (p<0.05)，其振幅分别为-0.85±0.294 μV和-0.35±0.26 μV (p<0.05)。结论。本研究结果提示，RP等神经生理参数可作为一种潜在的诊断指标，以提高FMR的诊断水平。
{"title":"Readiness potential as a neurophysiological marker of functional movement disorders","authors":"V. Tolmacheva, E. Dudnik, R. Shishorin, D. Petelin, V. Bezrukov, A. Gamirova, Yu. V. Dolgopolova, B. A. Volel","doi":"10.14412/2074-2711-2023-2-57-62","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-57-62","url":null,"abstract":"Functional movement disorders (FMD) are widespread and have a significant negative impact on the quality of life of patients. The pathogenesis is not completely clear, but currently there is ongoing research on searching for biological markers using methods such as functional magnetic resonance imaging and electroencephalography (EEG). Objective: detection of the features of the amplitude-frequency characteristics of the readiness potential (RP) formed during FMD. Material and methods. We examined 22 patients with a clinically diagnosed FMD and 22 healthy volunteers (all participants were right-handed). Both patients and the control group underwent an EEG in Erickson's Flanker paradigm with registration of the RP. RP was recorded in the projection area of the precentral gyrus (electrodes C3/C4/C5/C6 in the standard 10–20 overlay scheme). Results. Comparative analysis of RP parameters showed the presence of significant frequency-amplitude differences between the main group and the control group in the right hemisphere in the absence of significant differences in the left hemisphere. At the same time, significant differences were demonstrated between the FMR group and the control group both in terms of the latent period (time to the onset of RP): 33.66±23.69 ms versus 276.28±176.1 ms (p<0.05), and its amplitude: -0.85±0.294 μV versus -0.35±0.26 μV (p<0.05). Conclusion. The results of the present study suggest that neurophysiological parameters such as RP can be considered as a potential diagnostic marker to improve the diagnosis of FMR.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85031500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-29DOI: 10.14412/2074-2711-2023-2-19-26
I. Gribacheva, T. Popova, E. Petrova, A. V. Zvonkova
hronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. Correct and timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are important, among other things, for slowing down the progression of cognitive deficits. Objective: to study the efficacy and safety of Mexidol administered intravenously by drip infusion (500 mg 1 time per day) for 14 days, followed by oral administration of the drug Mexidol FORTE 250 at a dose of 250 mg 3 times a day for 60 days in middle-aged patients with chronic cerebral ischemia (CCI) on the background of arterial hypertension and atherosclerosis. Material and methods. The open observational program included 60 patients aged 45 to 59 years with CCI, confirmed by the results of a neuropsychological and neuroimaging examination. Patients received Mexidol first intravenously (14 days), and then orally in pills – Mexidol FORTE 250 (60 days). Patients underwent neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger–Khanin scale), of vegetative disfunction (A.M. Wayne's autonomic response scale modified by V.L. Golubev), of the severity of general, mental and physical asthenia (MFI-20) and quality of life (MOS SF-36 questionnaire). Results. The results of the treatment made it possible to establish relief of asthenic syndrome and vegetative dysfunction on the background of Mexidol use. The differences were statistically significant both when comparing with the baseline and with the comparison group (p<0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The combination of positive effects led to an increase in indicators of quality of life (p<0.05). The treatment was well tolerated. Conclusion. Patients with CCI have significant emotional, vegetative and asthenic disorders. The use of Mexidol can reduce the severity of these disorders, which gives reason to recommend it for the treatment of such patients.
慢性脑血管病表现为认知、情绪和自主神经障碍的结合。正确及时地评估和准确诊断情绪和自主神经障碍，并及时纠正它们，对于减缓认知缺陷的进展非常重要。目的:探讨以动脉高血压和动脉粥样硬化为背景的中年慢性脑缺血(CCI)患者，经静脉滴注(500 mg 1次/天)给药14 d后，口服药物Mexidol FORTE 250 250 mg 3次/天，连续60 d的疗效和安全性。材料和方法。开放观察项目包括60例年龄在45 - 59岁的CCI患者，经神经心理学和神经影像学检查结果证实。患者首先静脉注射墨西哥idol(14天)，然后口服丸剂——墨西哥idol FORTE 250(60天)。患者接受神经心理测试，评估反应性和个人焦虑水平(Spielberger-Khanin量表)，植物功能障碍水平(V.L. Golubev修改的A.M. Wayne自主反应量表)，一般、精神和身体虚弱的严重程度(MFI-20)和生活质量(MOS SF-36问卷)。结果。治疗的结果使得在使用墨西多的背景下建立衰弱综合征和植物功能障碍的缓解成为可能。与基线及对照组比较，差异均有统计学意义(p<0.05)。使用墨西多后，主诉和主观症状的严重程度有所下降。综合积极效应导致生活质量指标的提高(p<0.05)。这种治疗耐受性良好。结论。CCI患者有明显的情绪、营养和衰弱障碍。使用墨西多可减轻这些疾病的严重程度，因此有理由推荐用于此类患者的治疗。
{"title":"Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis","authors":"I. Gribacheva, T. Popova, E. Petrova, A. V. Zvonkova","doi":"10.14412/2074-2711-2023-2-19-26","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-19-26","url":null,"abstract":"hronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. Correct and timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are important, among other things, for slowing down the progression of cognitive deficits. Objective: to study the efficacy and safety of Mexidol administered intravenously by drip infusion (500 mg 1 time per day) for 14 days, followed by oral administration of the drug Mexidol FORTE 250 at a dose of 250 mg 3 times a day for 60 days in middle-aged patients with chronic cerebral ischemia (CCI) on the background of arterial hypertension and atherosclerosis. Material and methods. The open observational program included 60 patients aged 45 to 59 years with CCI, confirmed by the results of a neuropsychological and neuroimaging examination. Patients received Mexidol first intravenously (14 days), and then orally in pills – Mexidol FORTE 250 (60 days). Patients underwent neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger–Khanin scale), of vegetative disfunction (A.M. Wayne's autonomic response scale modified by V.L. Golubev), of the severity of general, mental and physical asthenia (MFI-20) and quality of life (MOS SF-36 questionnaire). Results. The results of the treatment made it possible to establish relief of asthenic syndrome and vegetative dysfunction on the background of Mexidol use. The differences were statistically significant both when comparing with the baseline and with the comparison group (p<0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The combination of positive effects led to an increase in indicators of quality of life (p<0.05). The treatment was well tolerated. Conclusion. Patients with CCI have significant emotional, vegetative and asthenic disorders. The use of Mexidol can reduce the severity of these disorders, which gives reason to recommend it for the treatment of such patients.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89138122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-29DOI: 10.14412/2074-2711-2023-2-27-33
H. I. Navumava, P. Vlasov, A. I. Prusakova, A. A. Usoltseva, N. Shnayder, D. Dmitrenko
Objective: to analyze the course of epilepsy in women after withdrawal of valproic acid (VA) during pregnancy. Material and methods. The study was conducted in the Center of paroxysmal conditions of Vitebsk Regional Clinical Diagnostic Center. The study included 58 women with epilepsy who gave birth in 2018–2020; a prospective analysis was also done using the Russian Register of Pregnancy and Epilepsy (RRPE) data. The study group included 112 women with epilepsy who were taking VA at the time of conception. In 16.1% of cases (n=18 out of 112) VA was discontinued in the first trimester (withdrawal group), in 83.9% of cases (n=94) VA therapy was continued. We analyzed the frequency of epileptic seizures depending on the use of VA during pregnancy for each trimester and for the entire pregnancy as a whole. Results. According to the Vitebsk Regional Clinical Diagnostic Center, 32 out of 58 (55.2%) patients took VA, all of them had generalized tonicclonic seizures in the structure of epileptic seizures. Seven of 32 patients (21.8%) received VA at a dose of <700 mg/day; 10 (31.3%) – 700–1000 mg/day, 15 (46.9%) – 1000–1500 mg/day. VA was canceled in two cases, in one of them a tonic-clonic seizure developed. According to the RRPE data, in 9 out of 65 (13.8%) cases VA was discontinued in the first trimester (withdrawal group), in 55 out of 65 (84.6%) cases the therapy with VA was continued, and in one case - the drug was changed. The number of women with epilepsy taking VA during pregnancy has decreased from 38.9% (275 out of 707) in 2017 to 24.9% (112 out of 450) by January 2023. According to the RRPE, the majority of patients continued VA therapy during gestation if pregnancy occurred while taking this antiepileptic drug. A high fraction of prescribing VA in patients with focal epilepsy was registered – 58.9% (66 out of 112) with continuation of VA therapy during pregnancy in 61.7% of cases. Among patients with generalized form of epilepsy, VA drugs were taken by 36.6% (41 out of 112). The majority of patients (35.1%; 33 of 94) continued to take VA throughout the entire gestation. About half of the patients took VA at a dose of >700 mg/day in the first trimester and throughout gestation. There were no statistically significant differences in the frequency of tonic-clonic and other types of epileptic seizures during pregnancy in patients who canceled VA and continued therapy, according to RRPE. Conclusion. Further prospective and controlled studies with large sample sizes are needed to determine the most effective and safe strategy for VA withdrawal.
{"title":"Withdrawal of valproic acid during pregnancy in women with epilepsy","authors":"H. I. Navumava, P. Vlasov, A. I. Prusakova, A. A. Usoltseva, N. Shnayder, D. Dmitrenko","doi":"10.14412/2074-2711-2023-2-27-33","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-27-33","url":null,"abstract":"Objective: to analyze the course of epilepsy in women after withdrawal of valproic acid (VA) during pregnancy. Material and methods. The study was conducted in the Center of paroxysmal conditions of Vitebsk Regional Clinical Diagnostic Center. The study included 58 women with epilepsy who gave birth in 2018–2020; a prospective analysis was also done using the Russian Register of Pregnancy and Epilepsy (RRPE) data. The study group included 112 women with epilepsy who were taking VA at the time of conception. In 16.1% of cases (n=18 out of 112) VA was discontinued in the first trimester (withdrawal group), in 83.9% of cases (n=94) VA therapy was continued. We analyzed the frequency of epileptic seizures depending on the use of VA during pregnancy for each trimester and for the entire pregnancy as a whole. Results. According to the Vitebsk Regional Clinical Diagnostic Center, 32 out of 58 (55.2%) patients took VA, all of them had generalized tonicclonic seizures in the structure of epileptic seizures. Seven of 32 patients (21.8%) received VA at a dose of <700 mg/day; 10 (31.3%) – 700–1000 mg/day, 15 (46.9%) – 1000–1500 mg/day. VA was canceled in two cases, in one of them a tonic-clonic seizure developed. According to the RRPE data, in 9 out of 65 (13.8%) cases VA was discontinued in the first trimester (withdrawal group), in 55 out of 65 (84.6%) cases the therapy with VA was continued, and in one case - the drug was changed. The number of women with epilepsy taking VA during pregnancy has decreased from 38.9% (275 out of 707) in 2017 to 24.9% (112 out of 450) by January 2023. According to the RRPE, the majority of patients continued VA therapy during gestation if pregnancy occurred while taking this antiepileptic drug. A high fraction of prescribing VA in patients with focal epilepsy was registered – 58.9% (66 out of 112) with continuation of VA therapy during pregnancy in 61.7% of cases. Among patients with generalized form of epilepsy, VA drugs were taken by 36.6% (41 out of 112). The majority of patients (35.1%; 33 of 94) continued to take VA throughout the entire gestation. About half of the patients took VA at a dose of >700 mg/day in the first trimester and throughout gestation. There were no statistically significant differences in the frequency of tonic-clonic and other types of epileptic seizures during pregnancy in patients who canceled VA and continued therapy, according to RRPE. Conclusion. Further prospective and controlled studies with large sample sizes are needed to determine the most effective and safe strategy for VA withdrawal.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"348 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75489904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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