Neurology, neuropsychiatry, Psychosomatics最新文献

{"title":"«Gut-brain» axis and multiple sclerosis","authors":"M. Omarova, A. N. Boyko","doi":"10.14412/2074-2711-2023-6-122-127","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-122-127","url":null,"abstract":"An increase in the incidence of multiple sclerosis (MS) has been reported over the last decade, possibly due to environmental factors. The purpose of this review article is to summarize current advances in the understanding of the gut-brain axis, which mediates the link between the central nervous system and the gut microbiome. It also summarizes the clinical findings from numerous studies investigating the effects of diseasemodifying therapies on the gut microbiome in patients with MS.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966395","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}

{"title":"Comorbidity of cerebral amyloid angiopathy and Alzheimer's disease. Clinical case analysis","authors":"A. Emelin, V. Lobzin, A. Y. Efimtsev, S. V. Vorobyov","doi":"10.14412/20742711-2023-6-85-94","DOIUrl":"https://doi.org/10.14412/20742711-2023-6-85-94","url":null,"abstract":"The development of cognitive impairment in old age is often caused by overlapping neurodegenerative and cerebrovascular changes which have a mutually aggravating clinical effect. In recent years, the problem of cerebral amyloid angiopathy (CAA), which is one of the variants of such an interaction, has gained importance. Despite the frequent occurrence of this pathology in the elderly, a unified approach to the treatment of these patients has not yet been developed, especially taking into account the frequent combination with other nosological forms. CAA is a disease associated with both Alzheimer's type neurodegeneration and cerebrovascular pathology. The article presents a clinical case illustrating this situation and discusses the diagnostic algorithm in detail. The characteristics of the pathogenesis and clinical manifestations of CAA and the link between neurodegenerative and cerebrovascular pathologies are discussed.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966527","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}

{"title":"Russian-Belarusian Expert Council “New opportunities in the treatment of patients with multiple sclerosis” (October 1, 2023). Main conclusions of the first meeting","authors":"A. N. Boyko, V. V. Vashchilin, O. Boyko, A. G. Bunyak, D. S. Kasatkin, D. S. Korobko, S. I. Kulikova, N. V. Mazgo, N. V. Makovskaya, S. Sivertseva, I. V. Smagina, T. N. Chernukha","doi":"10.14412/2074-2711-2023-6-146-150","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-146-150","url":null,"abstract":"A joint conclusion of the Russian-Belarusian Expert Council “New opportunities in the treatment of patients with multiple sclerosis” on the organization of medical care, diagnosis and treatment of multiple sclerosis (MS) and other autoimmune diseases is presented. 12 neurologists from different medical institutions in Russia and Belarus took part in the work of the Council. In the conclusions of the Council, special attention was paid to two new Russian original drugs, modifying the course of MS. The place of these drugs in the healthcare system of these countries was determined. Sampeginterferon beta-1a itself is an effective and safe drug of first choice (first-line treatment) for relapsing remitting MS. Divozilimab is a highly effective and safe second-line treatment indicated for rapidly progressive and highly active MS, even when substituted for a firstor second-line treatment in relapsing remitting and secondary progressive (with exacerbations) MS. The experts emphasized how promising the use of these drugs is in the complex treatment of MS.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"362 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966576","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}

{"title":"Transient global amnesia as a clinical manifestation of unilateral hippocampal infarction. Case report","authors":"O. O. Martynova, V. V. Zakharov","doi":"10.14412/2074-2711-2023-6-95-100","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-95-100","url":null,"abstract":"Transient global amnesia (TGA) is a rare symptom complex characterized by a brief episode of severe fixation, anterograde and retrograde amnesia. The prevalence of TGA increases with age. Risk factors for this disease include physical overexertion, severe emotional stress, exposure to cold or hot water, hypothermia and pain. The diagnosis of TGA is based on the Kaplan and Hodges–Warlow criteria, according to which TGA is characterized by: complete resolution of mnestic disturbances within 24 hours; absence of other neurological and cognitive impairments; absence of previous head trauma or seizures. In cases where the clinical picture of TGA does not meet the criteria for the disease, a differential diagnosis should be performed, especially with cases of ischemic stroke in the vertebrobasilar region and transient epileptic amnesia. If acute ischemia is confirmed by the brain MRI results, further comprehensive diagnostic investigation must be performed to determine the subtype of acute cerebrovascular accident with further appropriate secondary prevention of cardiovascular complications. If a non-cardioembolic stroke type is identified, antiplatelet therapy has a crucial role. The clinical case of a patient with a left-sided hippocampal infarction clinically manifested by a TGA is presented.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"357 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966757","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}

{"title":"Admitting a patient with musculoskeletal pain following COVID-19 disease","authors":"I. D. Romanov, O. A. Shavlovskaya, I. A. Bokova","doi":"10.14412/2074-2711-2023-6-109-114","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-109-114","url":null,"abstract":"A significant proportion of patients who have had COVID-19 continue to suffer from persistent symptoms such as severe weakness, shortness of breath, joint pain, mood swings and memory impairment during the recovery phase. More than half of the patients experienced joint pain for the first time after recovery from COVID-19. Three months after COVID-19 episode, joint pain continued to occur in more than a third of patients. We observed a 47-year-old patient with moderate shoulder pain that occurred for the first time after COVID-19. The examination also revealed changes in the hip joint. The diagnosis was made: post-COVID syndrome with reactive arthritis of the left shoulder joint, deforming osteoarthritis of the left hip joint stage I, degenerative-dystrophic changes in the lumbosacral spine, lower back pain. The therapy was prescribed – Chondroguard® intramuscularly every other day according to the following scheme: the first three injections (day 1, 3, and 5) 1 ml (100 mg), then, from the fourth injection (day 7) – 2 ml (200 mg) every other day, a course of 30 injections. Positive dynamics were achieved. No adverse events were noted during the treatment. The patient continued taking the nutraceutical Chondroguard® TRIO orally for 2 months. During the observational period, no adverse events were noted. Thus, in cases where post COVID-19 musculoskeletal pain is caused by joint involvement, chondroprotective therapy is effective: stage 1 – injections, stage 2 – oral therapy.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"25 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966259","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}

{"title":"Chronic dizziness: modern treatment methods taking into account comorbidity","authors":"E. N. Zastenskaia, L. M. Antonenko","doi":"10.14412/2074-2711-2023-6-71-77","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-71-77","url":null,"abstract":"In most cases, chronic dizziness is persistent postural perceptual dizziness (PPPD), which is often combined with other diseases of the vestibular system and anxiety disorders. In real-life clinical practice, PPPD and comorbid disorders are rarely diagnosed and effective treatments are rarely prescribed, so the development of modern methods for managing patients with PPPD with comorbid diseases is important.Objective: to analyze the typical management practices and evaluate the effectiveness of complex therapy in patients with PPPD and comorbid disorders.Material and methods. We examined 60 patients (mean age – 42.5±13.8 years) with diagnosis of PPPD (according to the diagnostic criteria of the Barany Society) and comorbid diseases. All patients were examined twice: at the beginning and after completion of treatment, which lasted an average of 1 month. Treatment included antidepressants (serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors), anti-anxiety medications, vestibular exercises, an educational program, and cognitive behavioral therapy. Arlevert (a combination of cinnarizine 20 mg + dimenhydrinate 40 mg) was used as a drug therapy for the treatment of vestibular dizziness in 28 patients. A clinical otoneurological evaluation and videonystagmography were performed to assess vestibular disorders; the severity of dizziness was assessed using an otoneurological questionnaire and the Dizziness Handicap Inventory (DHI); the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Spielberger Anxiety Inventory (STAI) were used to assess anxiety and depressive disorders.Results. None of the 60 patients had previously been diagnosed with PPPD. They were observed with a misdiagnosis of cerebrovascular disease and/or cervical spine pathology and received ineffective treatment. Anxiety and depressive disorders were detected in 32 (53.33%) patients, migraine – in 20 (33.33%) and previous peripheral vestibular disorders – in 8 (13.33%) patients. After one month of treatment in patients with PPPD and comorbid conditions, the severity of dizziness according to DHI decreased from 45.59±15.47 to 29.9±12.56 points (p<0.001), the severity of anxiety according to BAI from 27.50±6.38 to 15.66±4.07 points (p<0.001), the severity of depression according to BDI from 11.91±6.24 to 7.06±4.12 points (p<0.001), the severity of anxiety according to HADS from 13.47±4.16 to 8.60±2.86 points (p<0.001), the severity of depression according to HADS from 6.34±3.72 to 4.31±2.82 points (p<0.001), situational anxiety according to STAI from 50.69±7.13 to 41.26±6.24 points (p<0.001), personal anxiety according to STAI from 54.66±8.21 to 43.78±6.75 points (p<0.001).Conclusion. It was found that PPPD is rarely diagnosed, and anxiety disorders, migraine and peripheral vestibular disorders are very common in PPPD patients. The integrated approach in the treatment of patients with PPPG, taking into account","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967536","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}

{"title":"In-hospital mortality in patients with ischemic stroke and a large cerebral artery occlusion, who underwent mechanical thrombectomy","authors":"D. M. Murtazalieva, A. R. Zakaryaeva, M. A. Zolotov","doi":"10.14412/2074-2711-2023-6-27-31","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-27-31","url":null,"abstract":"Occlusion of a large cerebral artery in ischemic stroke (IS) is associated with a high mortality rate. Despite the results of studies that have demonstrated the beneficial effect of endovascular therapy on functional outcome in IS, little research has been conducted on its impact on hospital mortality in IS, its timing and structure.Objective: to investigate hospital mortality in patients with IS and large cerebral artery occlusion, who underwent mechanical thrombectomy (MTE).Material and methods. The retrospective study included data from 233 patients with IS and confirmed occlusion of a large cerebral artery (internal carotid artery, M1 and M2 segments of the middle cerebral artery, basilar artery) treated at the regional vascular center V.V. Veresaev Hospital, Moscow, 2018 and 2022. A comparison of hospital mortality in the group of patients who underwent MTE and the group of patients who received basic therapy was performed.Results. MTE was performed in 107 patients (46%); 126 patients (54%) received only basic therapy. The mortality rate of all patients included in the study was 44.2%. Among all deaths, the proportion of patients with MTE was only 7.2%, while the proportion of patients on basic therapy was 36.9% (p<0.001). Mortality in the MTE group was four times lower than in the basic therapy group – 15.8% compared to 68.2% (p<0.001). We observed that certain manifestations were significantly more frequent in the basic therapy group: cerebral edema (42% vs. 18.6%), hemorrhagic transformation (19.9% vs. 12.9%), venous thromboembolism (6.3% vs. 3.7%) and infectious complications (42.8% vs. 14.3%). The mortality of patients in the basic therapy group was higher on the first day, on days 2–3 and also on days 4–7, while no differences in mortality were observed after the first week of the disease.Conclusion. Admission of a patient with IS within the “therapeutic window” creates the conditions for a significant reduction in hospital mortality and the incidence of stroke complications.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"65 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967652","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}

{"title":"Non-interventional epidemiological program for investigating the real-life practice of using quetiapine (Seroquel®) in patients with schizophrenia and bipolar affective disorder (EPIDEMICUS)","authors":"V. E. Medvedev, I. G. Kuznetsova","doi":"10.14412/2074-2711-2023-6-18-26","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-18-26","url":null,"abstract":"The polymorphism of the clinical manifestations of schizophrenia and bipolar affective disorder (BD), late referral to the doctor, comorbidity with somatic diseases and the use of somatotropic medications by psychiatric patients, as well as the frequent development of adverse events (AEs), require constant analysis and improvement of the methods and means of psychopharmacotherapy.Objective: to study the characteristics of the use of quetiapine (Seroquel®) in real outpatient clinical practice.Material and methods. A patient was enrolled in the program if there was a need to prescribe quetiapine (Seroquel®) or to switch from the current therapy to quetiapine. During the program visit, the doctor filled in an individual registration card with information about patient and therapy. The data were statistically analyzed.Results. Quetiapine is prescribed by practicing psychiatrists in Russia not only according to the official indications, but also for psychopathological disorders of other nosology with similar clinical manifestations, such as dementia, organic and affective (depressive episode, recurrent depressive disorder), as well as psychogenic disorders. Up to 27.3% of physicians consider the effect of quetiapine to be quite sufficient in a mixed affective state within the framework of BD dynamics. Quetiapine is used by physicians to treat patients with varying duration of mental disorder (mean 5.1–13.5 years), severity of current mental state (mean CGI-S score 4.3–4.97) and a wide age range (mean age 34.5–60.8 years). When prescribing quetiapine, physicians note that the drug has antidepressant, anxiolytic, sedative and hypnotic effects, regardless of the type of mental disorder. Quetiapine is mainly prescribed as a monotherapy, either primary or resumed after a break – 815 (64.5%) observations. At the same time, quetiapine is used significantly more frequently as monotherapy for BD (69.4%) and mental illnesses of other origin (64.7%) than for schizophrenia (53.8%; p <0.005).Conclusion. In real clinical practice, quetiapine is perceived by psychiatrists as a highly effective and well-tolerated antipsychotic with a broad spectrum of activity that goes beyond the official indications. The practical experience of physicians in Russia shows that in addition to sedative, antipsychotic, antimanic and antidepressant effects, the drug also has antinegative, procognitive, anxiolytic, antiresistant and mood-stabilizing properties.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"15 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967004","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}

{"title":"Association of cognitive impairment and arterial hypertension","authors":"O. Isaykina, K. A. Vekhova, G. S. Drobotov, R. A. Takhirov, M. A. Isaykina, V. M. Gorbunov","doi":"10.14412/2074-2711-20236-4-9","DOIUrl":"https://doi.org/10.14412/2074-2711-20236-4-9","url":null,"abstract":"Impaired cognitive function (CF) is a common manifestation of brain damage as a target organ of arterial hypertension (AH). The presence of hypertension in middle age increases the risk of developing cognitive impairment (CI) and dementia in old age. At the same time, changes in certain indicators characteristic of AH may serve as predictors of CI and dementia in the future. The review presents data on the effects of endothelial dysfunction and increased arterial stiffness on CF. The small number of papers on the effects of hypertension in middle-aged people on the development of CI emphasizes the importance of investigating this topic, as the incidence of CI in young and middle-aged people has increased in recent years.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"50 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995650","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}

{"title":"Atrial cardiomyopathy in patients with cryptogenic embolic stroke: incidence, instrumental diagnostic features, impact on prognosis","authors":"S. A. Chazov, S. Mekhryakov, A. Kulesh, L. Syromyatnikova, P. Astanin","doi":"10.14412/2074-2711-2023-6-40-47","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-40-47","url":null,"abstract":"Latent atrial fibrillation (AF), whose substrate is atrial cardiomyopathy (AC), is considered the main potential pathogenetic mechanism of cryptogenic embolic stroke (CES). Early detection of AC allows to intensify the search for AF in such patients.Objective: to compare the characteristics of patients with CES in terms of clinical and anamnestic data, echocardiographic parameters, MRI patterns of infarction foci and disease outcomes depending on the presence of the major markers for AC.Material and methods. We studied 103 patients in the acute phase of CES with a lesion confirmed by MRI data, who were divided into two groups according to the presence (n=17) or absence (n=86) of AC. A comprehensive clinical, laboratory, and instrumental examination was performed and long-term outcomes were assessed. The median follow-up period was 32 months.Results. The incidence of AC in the CES population was 17%; the most common markers were an increase in left atrial volume index and paroxysms of supraventricular tachycardia. Patients with AC-CES were characterised by older age and a two-fold increase in the prevalence of coronary heart disease. Patients with AC-CES were nine times more likely to have a \"black artery\" symptom on MRI than patients without AC. The predictive accuracy of this clinical pattern was 84%, the sensitivity was 60% and the specificity was 86%. Patients with AC-CES had a significantly higher risk (odds ratio 3.4; 95% confidence interval 1.1–9.9; p=0.023) for a composite outcome that included the development of recurrent ischemic stroke, transient ischemic attack, myocardial infarction or death.Conclusion. AC diagnosed by a combination of echocardiographic and electrocardiographic signs is present in 17% of patients with CES. Patients with AC-CES are characterised by elderly age, the presence of atherosclerosis-associated disease, a specific MRI pattern (the “black artery” symptom) and an unfavourable prognosis during the 2.5-year follow-up period.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138966857","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}