Pub Date : 2023-12-16DOI: 10.14412/2074-2711-2023-6-48-55
M. Matrosova, V. V. Bryukhov, E. V. Popova, G. Belskaya, M. Krotenkova
Histologically, chronic demyelinating lesions in multiple sclerosis (MS) have been shown to include inactive lesions that do not change over time and active or “smouldering" lesions that tend to enlarge over time and are surrounded by pro-inflammatory activated microglial cells that are loaded with iron. To identify “smouldering" foci of demyelination and assess the “latent” inflammatory process in the brain, MRI sequences sensitive to the detection of substances with paramagnetic properties, including iron, must be used. They include an innovative technique such as quantitative susceptibility mapping (QSM).Objective: to identify, using MRI different types of chronic demyelination foci in MS, based on iron distribution and the degree of damage (myelination) in their structure.Material and methods. The patterns of iron distribution in demyelinating lesions in 90 MS patients were investigated using QSM. In addition, two lesions with different iron distribution patterns were randomly selected on the QSM map for each patient, in which the magnetic transfer ratio (MTR), indirectly reflecting the degree of myelination, was calculated. The identified changes were also compared with visualization of lesions in standard MRI modes (T1 MPRAGE, T2 FLAIR).Results. Despite the predominantly identical visualization in T2 FLAIR mode, chronic foci of demyelination show different patterns on the QSM maps, which is due to the peculiarities of iron distribution: some foci are not detected on QSM, while others are visualized either in the form of a homogeneous or a ring-shaped pattern. When comparing QSM data with MTR, it was found that MTR indicators were highest in non-visualized lesions (demyelination is minimal), while damage was most pronounced in lesions with ring-shaped iron distribution.Conclusion. Different patterns of iron distribution in demyelination foci compared to the degree of myelination in these foci according to MTR were identified using QSM, which is of great importance for the evaluation of latent inflammation and the development of the neurodegenerative process in MS.
{"title":"MRI assessment of different types of chronic demyelinating lesions in patients with multiple sclerosis using quantitative susceptibility mapping (QSM)","authors":"M. Matrosova, V. V. Bryukhov, E. V. Popova, G. Belskaya, M. Krotenkova","doi":"10.14412/2074-2711-2023-6-48-55","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-48-55","url":null,"abstract":"Histologically, chronic demyelinating lesions in multiple sclerosis (MS) have been shown to include inactive lesions that do not change over time and active or “smouldering\" lesions that tend to enlarge over time and are surrounded by pro-inflammatory activated microglial cells that are loaded with iron. To identify “smouldering\" foci of demyelination and assess the “latent” inflammatory process in the brain, MRI sequences sensitive to the detection of substances with paramagnetic properties, including iron, must be used. They include an innovative technique such as quantitative susceptibility mapping (QSM).Objective: to identify, using MRI different types of chronic demyelination foci in MS, based on iron distribution and the degree of damage (myelination) in their structure.Material and methods. The patterns of iron distribution in demyelinating lesions in 90 MS patients were investigated using QSM. In addition, two lesions with different iron distribution patterns were randomly selected on the QSM map for each patient, in which the magnetic transfer ratio (MTR), indirectly reflecting the degree of myelination, was calculated. The identified changes were also compared with visualization of lesions in standard MRI modes (T1 MPRAGE, T2 FLAIR).Results. Despite the predominantly identical visualization in T2 FLAIR mode, chronic foci of demyelination show different patterns on the QSM maps, which is due to the peculiarities of iron distribution: some foci are not detected on QSM, while others are visualized either in the form of a homogeneous or a ring-shaped pattern. When comparing QSM data with MTR, it was found that MTR indicators were highest in non-visualized lesions (demyelination is minimal), while damage was most pronounced in lesions with ring-shaped iron distribution.Conclusion. Different patterns of iron distribution in demyelination foci compared to the degree of myelination in these foci according to MTR were identified using QSM, which is of great importance for the evaluation of latent inflammation and the development of the neurodegenerative process in MS.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"58 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967666","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 : 2023-12-16DOI: 10.14412/2074-2711-2023-6-10-17
P. V. Zhmyleva, G. R. Tabeeva
Migraine is one of the most common causes of primary headache in the pediatric population. In addition to pain manifestations, episodic syndromes are also found in children, which often lack cephalgic manifestations and are difficult to verify in clinical practice.Objective: to determine the characteristics of the migraine and episodic syndromes associated with migraine in children of different age groups.Material and methods. The study included 250 children complaining of headaches (166 girls and 84 boys aged 5 to 18 years, mean age 13 years). The patients were divided into groups: Group 1 – preschool age (5–6 years) and elementary school age (7–10 years) – 20.8% (n=52) of patients; Group 2 – middle school age (11–14 years) – 45.2% (n=113) of patients; Group 3 – high school age (15–18 years) – 34% (n=85) of patients. A structured diagnostic interview was conducted with all study participants (or their parents) and pain and anxiety were assessed using special scales and tests adapted for children (visual analog scale (VAS); Digital Pain Rating Scale (DPS); Verbal Rating Pain Scale (VRPS), Faces Pain Scale (FPS), MIDAS scales, Hands scale, depression scales adapted by T.I. Balashova, Spielberger-Khanin anxiety scale).Results. The average age at onset of headache in the general structure was 11 [9; 13] years. Migraine was diagnosed in 40.4% (n=21) of the patients in Group 1, in 31.9% (n=36) of the patients in Group 2 and in 29.4% (n=25) of the patients in Group 3. An increase in age by 1 year leads to a 1.17-fold decrease in complaints for headache in combination with vomiting. With an increase in the age of the patients by 1 year, excessive sleep is significantly less likely to be a factor provoking headaches. A statistically significant inverse association was found between age and FPS scores (ρ =-0.13, 95% CI: -0.25; -0.002; p=0.0457), VAS (ρ =-0.13, 95% CI: -0.25; -0.004, p=0.0425) and Balashova scale score (ρ =-0.14, 95% CI: -0.26; -0.01, p=0.0327). The mean values for the intensity and severity of headaches decrease with age. Analysis of the prevalence of episodic syndromes associated with migraine revealed that in the general group, intestinal colic in infancy was found in 49.6% (n=124) of cases, in Group 1 – in 51.9% (n=27), in Group 2 – in 47.8% (n=54) and in Group 3 – in 50.6% (n=43) of patients. In the general group, torticollis was found in 14.4% (n=36) of patients, which increased slightly with age. Intermittent abdominal pain was found in a total of 33.2% (n=83) and spontaneous vomiting in 18% of children, and its prevalence decreased with age.Conclusion. The prevalence of migraine in children of different age groups suffering from headache varies between 40.4% and 29.4% of cases. Frequency of gastrointestinal symptoms accompanying a headache attack and the provoking effect of sleep decrease continuously with increasing age. Episodic childhood syndromes associated with migraine may vary in their characteristics between different age g
{"title":"Migraine and its childhood equivalents","authors":"P. V. Zhmyleva, G. R. Tabeeva","doi":"10.14412/2074-2711-2023-6-10-17","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-10-17","url":null,"abstract":"Migraine is one of the most common causes of primary headache in the pediatric population. In addition to pain manifestations, episodic syndromes are also found in children, which often lack cephalgic manifestations and are difficult to verify in clinical practice.Objective: to determine the characteristics of the migraine and episodic syndromes associated with migraine in children of different age groups.Material and methods. The study included 250 children complaining of headaches (166 girls and 84 boys aged 5 to 18 years, mean age 13 years). The patients were divided into groups: Group 1 – preschool age (5–6 years) and elementary school age (7–10 years) – 20.8% (n=52) of patients; Group 2 – middle school age (11–14 years) – 45.2% (n=113) of patients; Group 3 – high school age (15–18 years) – 34% (n=85) of patients. A structured diagnostic interview was conducted with all study participants (or their parents) and pain and anxiety were assessed using special scales and tests adapted for children (visual analog scale (VAS); Digital Pain Rating Scale (DPS); Verbal Rating Pain Scale (VRPS), Faces Pain Scale (FPS), MIDAS scales, Hands scale, depression scales adapted by T.I. Balashova, Spielberger-Khanin anxiety scale).Results. The average age at onset of headache in the general structure was 11 [9; 13] years. Migraine was diagnosed in 40.4% (n=21) of the patients in Group 1, in 31.9% (n=36) of the patients in Group 2 and in 29.4% (n=25) of the patients in Group 3. An increase in age by 1 year leads to a 1.17-fold decrease in complaints for headache in combination with vomiting. With an increase in the age of the patients by 1 year, excessive sleep is significantly less likely to be a factor provoking headaches. A statistically significant inverse association was found between age and FPS scores (ρ =-0.13, 95% CI: -0.25; -0.002; p=0.0457), VAS (ρ =-0.13, 95% CI: -0.25; -0.004, p=0.0425) and Balashova scale score (ρ =-0.14, 95% CI: -0.26; -0.01, p=0.0327). The mean values for the intensity and severity of headaches decrease with age. Analysis of the prevalence of episodic syndromes associated with migraine revealed that in the general group, intestinal colic in infancy was found in 49.6% (n=124) of cases, in Group 1 – in 51.9% (n=27), in Group 2 – in 47.8% (n=54) and in Group 3 – in 50.6% (n=43) of patients. In the general group, torticollis was found in 14.4% (n=36) of patients, which increased slightly with age. Intermittent abdominal pain was found in a total of 33.2% (n=83) and spontaneous vomiting in 18% of children, and its prevalence decreased with age.Conclusion. The prevalence of migraine in children of different age groups suffering from headache varies between 40.4% and 29.4% of cases. Frequency of gastrointestinal symptoms accompanying a headache attack and the provoking effect of sleep decrease continuously with increasing age. Episodic childhood syndromes associated with migraine may vary in their characteristics between different age g","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"61 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967856","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 : 2023-12-16DOI: 10.14412/2074-2711-2023-6-64-70
Y. A. Starchina, D. Grishina, E. A. Sokolov, V. A. Parfenov
Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive function (CF) and dementia. In the general population of elderly, it is diagnosed in 10–15% of cases; in patients attending outpatient appointments, the frequency of diagnosis is 70%. In our country, there is positive experience with the inhalation of nitric oxide, using a device that synthesizes it from the air, for pulmonary and cardiovascular diseases.Objective: to investigate the use of inhaled nitric oxide (Tianox device) in patients with MCI due to cerebrovascular (CVD) and neurodegenerative diseases (NDD) of the brain.Material and methods. We observed 36 patients (8 men, 28 women, mean age 66±8.9 years, from 50 to 76 years) with MCI that developed on the background of CVD and NDD. In addition to stroke prevention therapy, the patients with MCI received daily inhalation of a nitric oxideenriched air mixture via a Tianox device for 30 minutes. The patients had from 7 to 10 inhalation sessions (the first, experimental – 20 minutes, the following sessions – 30 minutes). Detailed neuropsychological tests were performed at baseline and 3 months after the end of treatment.Results. The therapy was well tolerated and no adverse events occurred. After 3 months, the average score on the Montreal Cognitive Assessment increased from 23.7±3.5 to 25.6±3.9 points (p<0.001), the ability to memorize 12 words – from 7.5±1.8 to 8.7±2.1 words (p<0.05), categorical associations – from 14.8±5.0 to 16.9±4.6 words (p<0.05), the number of words found in the Munsterberg test – from 14.9±5.8 to 18.1±5.8 (p<0.001).The emotional state of the patients improved, the signs of depression decreased according to the Beck Depression Inventory from 13.65±8.5 to 11.4±6.7 points (p<0.05), on the Hospital Anxiety and Depression Scale – from 8.6± 5.0 to 7.3±4.1 points (p<0.05); anxiety decreased on the Hospital Anxiety and Depression Scale – from 7.0±5.0 to 5.4±4.5 points (p<0.05), Insomnia Severity Index – from 11.1±7.9 to 7.8±6.3 points (p<0.05).Conclusion. Good tolerability and a positive effect of inhaled nitric oxide on CF and emotional state of patients with MCI against the background of CVD and NDD were found.
{"title":"The use of inhaled nitric oxide (Tianox device) in patients with moderate cognitive impairment","authors":"Y. A. Starchina, D. Grishina, E. A. Sokolov, V. A. Parfenov","doi":"10.14412/2074-2711-2023-6-64-70","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-64-70","url":null,"abstract":"Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive function (CF) and dementia. In the general population of elderly, it is diagnosed in 10–15% of cases; in patients attending outpatient appointments, the frequency of diagnosis is 70%. In our country, there is positive experience with the inhalation of nitric oxide, using a device that synthesizes it from the air, for pulmonary and cardiovascular diseases.Objective: to investigate the use of inhaled nitric oxide (Tianox device) in patients with MCI due to cerebrovascular (CVD) and neurodegenerative diseases (NDD) of the brain.Material and methods. We observed 36 patients (8 men, 28 women, mean age 66±8.9 years, from 50 to 76 years) with MCI that developed on the background of CVD and NDD. In addition to stroke prevention therapy, the patients with MCI received daily inhalation of a nitric oxideenriched air mixture via a Tianox device for 30 minutes. The patients had from 7 to 10 inhalation sessions (the first, experimental – 20 minutes, the following sessions – 30 minutes). Detailed neuropsychological tests were performed at baseline and 3 months after the end of treatment.Results. The therapy was well tolerated and no adverse events occurred. After 3 months, the average score on the Montreal Cognitive Assessment increased from 23.7±3.5 to 25.6±3.9 points (p<0.001), the ability to memorize 12 words – from 7.5±1.8 to 8.7±2.1 words (p<0.05), categorical associations – from 14.8±5.0 to 16.9±4.6 words (p<0.05), the number of words found in the Munsterberg test – from 14.9±5.8 to 18.1±5.8 (p<0.001).The emotional state of the patients improved, the signs of depression decreased according to the Beck Depression Inventory from 13.65±8.5 to 11.4±6.7 points (p<0.05), on the Hospital Anxiety and Depression Scale – from 8.6± 5.0 to 7.3±4.1 points (p<0.05); anxiety decreased on the Hospital Anxiety and Depression Scale – from 7.0±5.0 to 5.4±4.5 points (p<0.05), Insomnia Severity Index – from 11.1±7.9 to 7.8±6.3 points (p<0.05).Conclusion. Good tolerability and a positive effect of inhaled nitric oxide on CF and emotional state of patients with MCI against the background of CVD and NDD were found.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"52 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967311","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 : 2023-12-16DOI: 10.14412/2074-2711-2023-6-32-39
A. A. Pilipovich, O. V. Vorob’eva, S. A. Makarov, A. V. Kuchuk
The prevalence of dry eye syndrome (DES) in Parkinson's disease (PD) reaches 87% and leads to impaired quality of life in many patients.Objective: to evaluate the lacrimal function and the effect of dopaminergic therapy in patients with PD.Material and methods: 43 patients with stage II–III PD according to Hoehn and Yahr (H&Y) receiving therapy with levodopa (n=17), amantadines (n=13) and dopamine receptor agonists (ADR) (n=28) were assessed using Schirmer's test (to estimate tear flow), sialometry, Unified Parkinson's Disease Rating Scale (UPDRSI-IV), Schwab and England Activities of Daily Living scale (Sch&En), the Parkinson’s Disease Questionnaire Summary Index (PDQ-39), the Mini Mental State Examination Scale (MMSE), the Non-Motor Symptom Questionnaire (NMSQ), the American Urological Association Symptom Scale (AUA), the Gastrointestinal Symptom Rating Scale (GSRS), the Bristol Stool Form Scale (BSFS).Results. Lacrimal insufficiency was found in 49% of patients. It occurred more frequently (χ2=9.546; p=0.003) in patients taking amantadine and correlated with the daily dose of amantadine (r-S=-0.359). It did not depend on the intake of ADR and levodopa and their doses but correlated with the UPDRS-IV score (r-S= -0.463), namely with the presence and duration of OFF-periods. Lacrimal insufficiency correlated with the Sch&En score (r-S=0.321) and non-motor parameters: UPDRSI (r-S =-0.302), NMSQ (r-S=-0.435), constipation domain of the GSRS (r-S=-0.362), BSFS (r-S=0.363). It was not related to age, gender, stage and duration of PD, motor symptoms of parkinsonism (assessed during the ON-phase) and was not related to salivation (although it was reduced in 39.5% of patients).Conclusion. Lacrimal insufficiency is observed in half of patients with stage II–III PD; it is related to the presence and duration of OFF-periods, the severity of other autonomic disorders and the use of amantadines, suggesting the role of dopamine dysregulation, neurodegeneration of autonomic centers and anticholinergic therapy in the development of DES in PD.
{"title":"Effect of dopaminergic therapy on lacrimation in Parkinson's disease","authors":"A. A. Pilipovich, O. V. Vorob’eva, S. A. Makarov, A. V. Kuchuk","doi":"10.14412/2074-2711-2023-6-32-39","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-32-39","url":null,"abstract":"The prevalence of dry eye syndrome (DES) in Parkinson's disease (PD) reaches 87% and leads to impaired quality of life in many patients.Objective: to evaluate the lacrimal function and the effect of dopaminergic therapy in patients with PD.Material and methods: 43 patients with stage II–III PD according to Hoehn and Yahr (H&Y) receiving therapy with levodopa (n=17), amantadines (n=13) and dopamine receptor agonists (ADR) (n=28) were assessed using Schirmer's test (to estimate tear flow), sialometry, Unified Parkinson's Disease Rating Scale (UPDRSI-IV), Schwab and England Activities of Daily Living scale (Sch&En), the Parkinson’s Disease Questionnaire Summary Index (PDQ-39), the Mini Mental State Examination Scale (MMSE), the Non-Motor Symptom Questionnaire (NMSQ), the American Urological Association Symptom Scale (AUA), the Gastrointestinal Symptom Rating Scale (GSRS), the Bristol Stool Form Scale (BSFS).Results. Lacrimal insufficiency was found in 49% of patients. It occurred more frequently (χ2=9.546; p=0.003) in patients taking amantadine and correlated with the daily dose of amantadine (r-S=-0.359). It did not depend on the intake of ADR and levodopa and their doses but correlated with the UPDRS-IV score (r-S= -0.463), namely with the presence and duration of OFF-periods. Lacrimal insufficiency correlated with the Sch&En score (r-S=0.321) and non-motor parameters: UPDRSI (r-S =-0.302), NMSQ (r-S=-0.435), constipation domain of the GSRS (r-S=-0.362), BSFS (r-S=0.363). It was not related to age, gender, stage and duration of PD, motor symptoms of parkinsonism (assessed during the ON-phase) and was not related to salivation (although it was reduced in 39.5% of patients).Conclusion. Lacrimal insufficiency is observed in half of patients with stage II–III PD; it is related to the presence and duration of OFF-periods, the severity of other autonomic disorders and the use of amantadines, suggesting the role of dopamine dysregulation, neurodegeneration of autonomic centers and anticholinergic therapy in the development of DES in PD.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"59 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967015","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 : 2023-12-16DOI: 10.14412/2074-2711-2023-6-78-84
A. Belopasova, P. S. Shlapakova, L. A. Dobrynina, A. Kadykov
Clarification of the aetiology of ischemic stroke (IS) in young adults (aged between 18 and 45 years) is an extremely difficult task, as rare causes that are hardly known to neurologists are very common. One of these causes is paradoxical embolism due to pulmonary arteriovenous malformation (AVM), one of the manifestations of hereditary hemorrhagic telangiectasia (HHT). The diagnosis of HHT-associated pulmonary AVMs and IS is a multistep task that requires a personalized multidisciplinary approach using high-tech ultrasound, tomographic and genetic examination methods. This article discusses the clinical case of a young patient with HHT and recurrent IS through the mechanism of paradoxical embolism from pulmonary AVMs; issues of diagnosis, treatment and prevention of both the underlying disease and recurrent vascular events are discussed.
明确青壮年（18 至 45 岁）缺血性脑卒中（IS）的病因是一项极其困难的任务，因为神经科医生几乎不了解的罕见病因非常常见。其中一个原因是肺动静脉畸形（AVM）导致的矛盾性栓塞，这是遗传性出血性毛细血管扩张症（HHT）的表现之一。诊断与 HHT 相关的肺动静脉畸形和 IS 是一项多步骤的任务，需要采用高科技超声、断层扫描和基因检查等多学科的个性化方法。本文讨论了一名年轻的 HHT 患者通过肺动脉畸形的矛盾性栓塞机制复发 IS 的临床病例；讨论了基础疾病和复发性血管事件的诊断、治疗和预防问题。
{"title":"A rare cause of stroke at a young age: ischemic stroke by the mechanism of paradoxical embolism in a patient with hereditary hemorrhagic telangiectasia","authors":"A. Belopasova, P. S. Shlapakova, L. A. Dobrynina, A. Kadykov","doi":"10.14412/2074-2711-2023-6-78-84","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-78-84","url":null,"abstract":"Clarification of the aetiology of ischemic stroke (IS) in young adults (aged between 18 and 45 years) is an extremely difficult task, as rare causes that are hardly known to neurologists are very common. One of these causes is paradoxical embolism due to pulmonary arteriovenous malformation (AVM), one of the manifestations of hereditary hemorrhagic telangiectasia (HHT). The diagnosis of HHT-associated pulmonary AVMs and IS is a multistep task that requires a personalized multidisciplinary approach using high-tech ultrasound, tomographic and genetic examination methods. This article discusses the clinical case of a young patient with HHT and recurrent IS through the mechanism of paradoxical embolism from pulmonary AVMs; issues of diagnosis, treatment and prevention of both the underlying disease and recurrent vascular events are discussed.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138968007","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 : 2023-12-16DOI: 10.14412/2074-2711-2023-6-56-63
A. B. Danilov, A. A. Pilipovich, M. V. Pyastolova
Pain and sleep disorders are interrelated problems that significantly affect patients’ quality of life (QoL) and daily functioning.Objective: to evaluate the efficacy and safety of the use of the combination of diphenhydramine + naproxen (NOVEMA® NIGHT) in patients with acute pain syndrome or exacerbation of chronic pain syndrome and sleep disorders.Material and methods. The study included 4365 outpatients with acute pain (musculoskeletal pain, post-traumatic pain, headache) and sleep disorders who took naproxen 275 mg, 1 tablet in the morning and diphenhydramine 25 mg + naproxen 220 mg (NOVEMA® NIGHT) for 5 days before bedtime. Pain intensity, using a visual analogue scale (VAS), and sleep disorders were assessed before and after treatment; QoL was assessed after treatment using a five-point scale.Results. During treatment, a reduction or complete regression of pain was observed in 92% of cases (60 [50; 61] points on the VAS before treatment versus 10 [0; 20] after treatment; p<0.0001) and normalisation of sleep in most patients: faster falling asleep – in 81% (χ2=9650.2; p<0.0001), an increase in total sleep duration – in 75.5% (χ2=7351.2; p<0.0001), a decrease in the number of nocturnal awakenings – in 84% of patients (χ2=10,568; p<0.0001). At the end of treatment course, the majority of patients rated their quality of life as 4 out of 5 possible points (4 [4; 5]): 41% of patients – “high quality of life”; 48% – “above average”; 11% – “average”; 0.09% – “below average”). None of the patients had a low QoL. The therapy was well tolerated and no patient discontinued treatment due to adverse events (AEs).Conclusion. Short-term treatment (5 days) with naproxen 275 mg and a combination of diphenhydramine 25 mg + naproxen 220 mg (NOVEMA® NIGHT) at bedtime effectively reduces the pain syndrome associated with insomnia. This therapy significantly improves patients’ QoL and has a low risk of AEs, so that we can recommend NOVEMA® NIGHT as an additional analgesic for patients with concomitant sleep disorders.
{"title":"NOVEMA® NIGHT (diphenhydramine + naproxen) in patients with pain and insomnia: results of a multicenter non-interventional observational study","authors":"A. B. Danilov, A. A. Pilipovich, M. V. Pyastolova","doi":"10.14412/2074-2711-2023-6-56-63","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-6-56-63","url":null,"abstract":"Pain and sleep disorders are interrelated problems that significantly affect patients’ quality of life (QoL) and daily functioning.Objective: to evaluate the efficacy and safety of the use of the combination of diphenhydramine + naproxen (NOVEMA® NIGHT) in patients with acute pain syndrome or exacerbation of chronic pain syndrome and sleep disorders.Material and methods. The study included 4365 outpatients with acute pain (musculoskeletal pain, post-traumatic pain, headache) and sleep disorders who took naproxen 275 mg, 1 tablet in the morning and diphenhydramine 25 mg + naproxen 220 mg (NOVEMA® NIGHT) for 5 days before bedtime. Pain intensity, using a visual analogue scale (VAS), and sleep disorders were assessed before and after treatment; QoL was assessed after treatment using a five-point scale.Results. During treatment, a reduction or complete regression of pain was observed in 92% of cases (60 [50; 61] points on the VAS before treatment versus 10 [0; 20] after treatment; p<0.0001) and normalisation of sleep in most patients: faster falling asleep – in 81% (χ2=9650.2; p<0.0001), an increase in total sleep duration – in 75.5% (χ2=7351.2; p<0.0001), a decrease in the number of nocturnal awakenings – in 84% of patients (χ2=10,568; p<0.0001). At the end of treatment course, the majority of patients rated their quality of life as 4 out of 5 possible points (4 [4; 5]): 41% of patients – “high quality of life”; 48% – “above average”; 11% – “average”; 0.09% – “below average”). None of the patients had a low QoL. The therapy was well tolerated and no patient discontinued treatment due to adverse events (AEs).Conclusion. Short-term treatment (5 days) with naproxen 275 mg and a combination of diphenhydramine 25 mg + naproxen 220 mg (NOVEMA® NIGHT) at bedtime effectively reduces the pain syndrome associated with insomnia. This therapy significantly improves patients’ QoL and has a low risk of AEs, so that we can recommend NOVEMA® NIGHT as an additional analgesic for patients with concomitant sleep disorders.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967934","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 : 2023-08-21DOI: 10.14412/2074-2711-2023-1s-65-70
V. Rogovskii, A. D. Kukushkina, A. N. Boyko
Multiple sclerosis (MS) is a chronic demyelinating autoimmune disease. MS therapy does not always allow slowing of disease progression and also has significant side effects, such as immunosuppressive effects (especially when second-line disease-modifying therapies (DMT) are used). In this context, it is important to explore novel approaches to MS therapy that may improve the therapeutic potential of first line DMTs and reduce the likelihood of switching to switch to second line DMTs. Curcumin is one of the promising candidates for such application. Several anti-inflammatory and neuroprotective effects of curcumin have been reported in the literature, which could be considered for such applications. The favorable safety profile of this compound is also important. Over the past decade, encouraging clinical data have been obtained on the use of curcumin as part of adjunctive therapy for MS. However, to date, there are inadequate clinical studies on the use of curcumin in the therapy of MS. This may be due to the fact that curcumin, like other polyphenols, has low bioavailability, which limits its therapeutic potential. Recently, new highly bioavailable forms of curcumin have been developed (e.g., nanoemulsions). In this regard, it is promising to conduct new clinical trials of curcumin as an adjunctive therapy in MS, especially using its forms with increased bioavailability.
{"title":"Prospects for the use of curcumin as an additional treatment for multiple sclerosis","authors":"V. Rogovskii, A. D. Kukushkina, A. N. Boyko","doi":"10.14412/2074-2711-2023-1s-65-70","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-1s-65-70","url":null,"abstract":"Multiple sclerosis (MS) is a chronic demyelinating autoimmune disease. MS therapy does not always allow slowing of disease progression and also has significant side effects, such as immunosuppressive effects (especially when second-line disease-modifying therapies (DMT) are used). In this context, it is important to explore novel approaches to MS therapy that may improve the therapeutic potential of first line DMTs and reduce the likelihood of switching to switch to second line DMTs. Curcumin is one of the promising candidates for such application. Several anti-inflammatory and neuroprotective effects of curcumin have been reported in the literature, which could be considered for such applications. The favorable safety profile of this compound is also important. Over the past decade, encouraging clinical data have been obtained on the use of curcumin as part of adjunctive therapy for MS. However, to date, there are inadequate clinical studies on the use of curcumin in the therapy of MS. This may be due to the fact that curcumin, like other polyphenols, has low bioavailability, which limits its therapeutic potential. Recently, new highly bioavailable forms of curcumin have been developed (e.g., nanoemulsions). In this regard, it is promising to conduct new clinical trials of curcumin as an adjunctive therapy in MS, especially using its forms with increased bioavailability.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77356223","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 : 2023-08-21DOI: 10.14412/2074-2711-2023-1s-22-25
A. Khaibullina, F. Khabirov, T. Khaibullin
Multiple sclerosis (MS) in children and adolescents is a genuine concern of pediatric neurology that specialists in all countries are dealing with. To date, neither the causes of onset nor the individual components of the pathogenesis of the disease have been reliably clarified, and the modern, changing picture of the clinical manifestation of the disease sometimes complicates timely diagnosis even in adult patients. There are more such questions in pediatric MS.Objective: to study the prevalence and clinical features of MS in children in the Republic of Tatarstan.Material and methods. We conducted a survey and data analysis of 128 children and adolescents aged 0 to 18 years inclusive. The examination of patients included neurological examination according to the classical scheme, neuroimaging examination, neurophysiological examination and cerebrospinal fluid examination. The diagnosis was based on the current (as of the time of diagnosis) criteria of McDonald and the International Pediatrics MS Study Group criteria. The severity of the patients' clinical condition was assessed using the Expanded Disability Status Scale (EDSS).Results. MS was diagnosed in 99 cases (77.3%), clinically isolated syndrome – in 10 (7.8%), acute disseminated encephalomyelitis – in 5 (3.9%), bilateral optic neuritis – in two patients (1.6%), disseminated encephalomyelitis – in one case (0.8%); other central nervous system diseases were diagnosed in 11 (8.6%) patients. After a detailed examination, the group “other diseases of the central nervous system” included such conditions as cerebral angiopathy, neurofibromatosis, brain mass, structural focal epilepsy, sequelae of viral encephalitis, and hereditary leukodystrophy. Among the patients, girls aged 15–17 years predominated. Monofocal manifestations were more frequently observed at debut. Moreover, the absolute predominance of the remitting type of course was also noted.Conclusion. The data obtained suggest a predominance of the predominantly remitting course type of MS with a monofocal onset, which is consistent with data from other studies of MS in pediatric practice.
{"title":"Features of multiple sclerosis in childhood in the Republic of Tatarstan","authors":"A. Khaibullina, F. Khabirov, T. Khaibullin","doi":"10.14412/2074-2711-2023-1s-22-25","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-1s-22-25","url":null,"abstract":"Multiple sclerosis (MS) in children and adolescents is a genuine concern of pediatric neurology that specialists in all countries are dealing with. To date, neither the causes of onset nor the individual components of the pathogenesis of the disease have been reliably clarified, and the modern, changing picture of the clinical manifestation of the disease sometimes complicates timely diagnosis even in adult patients. There are more such questions in pediatric MS.Objective: to study the prevalence and clinical features of MS in children in the Republic of Tatarstan.Material and methods. We conducted a survey and data analysis of 128 children and adolescents aged 0 to 18 years inclusive. The examination of patients included neurological examination according to the classical scheme, neuroimaging examination, neurophysiological examination and cerebrospinal fluid examination. The diagnosis was based on the current (as of the time of diagnosis) criteria of McDonald and the International Pediatrics MS Study Group criteria. The severity of the patients' clinical condition was assessed using the Expanded Disability Status Scale (EDSS).Results. MS was diagnosed in 99 cases (77.3%), clinically isolated syndrome – in 10 (7.8%), acute disseminated encephalomyelitis – in 5 (3.9%), bilateral optic neuritis – in two patients (1.6%), disseminated encephalomyelitis – in one case (0.8%); other central nervous system diseases were diagnosed in 11 (8.6%) patients. After a detailed examination, the group “other diseases of the central nervous system” included such conditions as cerebral angiopathy, neurofibromatosis, brain mass, structural focal epilepsy, sequelae of viral encephalitis, and hereditary leukodystrophy. Among the patients, girls aged 15–17 years predominated. Monofocal manifestations were more frequently observed at debut. Moreover, the absolute predominance of the remitting type of course was also noted.Conclusion. The data obtained suggest a predominance of the predominantly remitting course type of MS with a monofocal onset, which is consistent with data from other studies of MS in pediatric practice.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"194 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83090596","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 : 2023-08-21DOI: 10.14412/2074-2711-2023-1s-43-48
A. D. Kukushkina, A. N. Boyko
Multiple sclerosis (MS) is a chronic disease whose pathogenesis is based on autoimmune neuroinflammatory and neurodegenerative components. The goal of therapy of MS is to reduce the risk of exacerbations and progression of the disease. In recent years, treatment options have expanded significantly with the advent of a greater number of highly effective drugs that alter the course of MS (disease-modyfyung therapies, DMTs) and in the context of the development of a new direction – immune reconstitution therapy (IRT). IRT has a number of advantages, including short treatment courses with long-term effects on immune mechanisms. Cladribine tablets are a selective, highly effective oral form of IRT for MS patients with exacerbations that targets lymphocytes while preserving innate immune cells. Given the increasing number of patients receiving cladribine therapy, questions are increasingly being raised about further tactics for managing these patients, particularly in cases of persistent disease activity despite ongoing pathogenetic therapy. In this review, we publish the results of the consensus opinion of international experts on the analysis of long-term experience with cladribine.
{"title":"Prolonged observation after the use of cladribine in multiple sclerosis: efficacy and safety","authors":"A. D. Kukushkina, A. N. Boyko","doi":"10.14412/2074-2711-2023-1s-43-48","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-1s-43-48","url":null,"abstract":"Multiple sclerosis (MS) is a chronic disease whose pathogenesis is based on autoimmune neuroinflammatory and neurodegenerative components. The goal of therapy of MS is to reduce the risk of exacerbations and progression of the disease. In recent years, treatment options have expanded significantly with the advent of a greater number of highly effective drugs that alter the course of MS (disease-modyfyung therapies, DMTs) and in the context of the development of a new direction – immune reconstitution therapy (IRT). IRT has a number of advantages, including short treatment courses with long-term effects on immune mechanisms. Cladribine tablets are a selective, highly effective oral form of IRT for MS patients with exacerbations that targets lymphocytes while preserving innate immune cells. Given the increasing number of patients receiving cladribine therapy, questions are increasingly being raised about further tactics for managing these patients, particularly in cases of persistent disease activity despite ongoing pathogenetic therapy. In this review, we publish the results of the consensus opinion of international experts on the analysis of long-term experience with cladribine.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85475761","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 : 2023-08-21DOI: 10.14412/2074-2711-2023-1s-26-30
S. A. Ryabov, A. N. Boyko
Objective: to identify characteristic gait parameters by video analysis in patients with multiple sclerosis (MS) that allow the most reliable discrimination of the dominant profile in functional systems.Material and methods. We examined 45 patients (37 women, 8 men) with relapsing-remitting (n=38) and secondary progressive MS before and after a course of medical rehabilitation. Gait parameters were recorded with the Physiomed Smart video analysis system Physiomed Smart («Physiomed», Germany, Davis protocol).Results. Only one indicator allowed reliable differentiation between ataxic and spastic-paretic gait patterns in MS in the EDSS range up to 5.5 points – the step width, the value of which is greater in patients with ataxia dominance. A significant difference in gait pattern asymmetry was also found in the mild disability group, namely, a greater value in the spastic-paretic pattern.Conclusion. Comprehensive profiling of gait impairment, primarily through objective analysis of locomotor patterns, may be helpful in monitoring therapy and may reveal sensitive end points for further study in MS.
{"title":"Distinctive parameters of gait in patients with multiple sclerosis, depending on the profile of its dysfunction","authors":"S. A. Ryabov, A. N. Boyko","doi":"10.14412/2074-2711-2023-1s-26-30","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-1s-26-30","url":null,"abstract":"Objective: to identify characteristic gait parameters by video analysis in patients with multiple sclerosis (MS) that allow the most reliable discrimination of the dominant profile in functional systems.Material and methods. We examined 45 patients (37 women, 8 men) with relapsing-remitting (n=38) and secondary progressive MS before and after a course of medical rehabilitation. Gait parameters were recorded with the Physiomed Smart video analysis system Physiomed Smart («Physiomed», Germany, Davis protocol).Results. Only one indicator allowed reliable differentiation between ataxic and spastic-paretic gait patterns in MS in the EDSS range up to 5.5 points – the step width, the value of which is greater in patients with ataxia dominance. A significant difference in gait pattern asymmetry was also found in the mild disability group, namely, a greater value in the spastic-paretic pattern.Conclusion. Comprehensive profiling of gait impairment, primarily through objective analysis of locomotor patterns, may be helpful in monitoring therapy and may reveal sensitive end points for further study in MS.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79592543","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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