Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova最新文献

{"title":"[Predictors of the efficacy of non-drug treatments for non-dementia vascular cognitive impairment].","authors":"M S Novikova,&nbsp;V V Zaharov","doi":"10.17116/jnevro202312305183","DOIUrl":"https://doi.org/10.17116/jnevro202312305183","url":null,"abstract":"<p><strong>Objective: </strong>To study the predictors of the efficacy of non-drug multimodal therapy in the treatment of mild vascular cognitive impairment.</p><p><strong>Material and methods: </strong>Thirty patients with mild vascular cognitive impairment, under the supervision of their physician, received a 1-month non-drug treatment program including cognitive training, detailed recommendations for physical activity, and dietary planning.</p><p><strong>Results: </strong>After the end of the course of treatment, improvements in the MoCa test were achieved by 22 patients (73%), which made up Group 1. In the remaining 8 patients, the treatment had no effect (Group 2). In Group 1, the dynamics of the MoCa test averaged 1.7±0.9, in the Group 2 it was (-0.4)±0.5. Patients of Group 1 had a significantly lower level of education (10.9±2.3) compared with Group 2 (14.9±2.0), a higher initial MoCa score, and a less pronounced white matter lesion on the Fazekas scale. After the regression analysis, the level of education (B -0.999, <i>p</i><0.05) and white matter damage (B -2.761, <i>p</i><0.01) were significant predictors.</p><p><strong>Conclusion: </strong>When using non-drug multimodal therapy in the treatment of mild vascular cognitive impairment, lower levels of education and a lower degree of white matter vascular damage are reliable predictors of treatment efficacy.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 5","pages":"83-88"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9639418","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":"[Cerebellar degeneration associated with HIV infection].","authors":"E P Nuzhnyi,&nbsp;L A Brsikyan,&nbsp;E Yu Fedotova,&nbsp;S N Illarioshkin","doi":"10.17116/jnevro2023123051123","DOIUrl":"https://doi.org/10.17116/jnevro2023123051123","url":null,"abstract":"<p><strong>Objective: </strong>To describe the features of the clinical presentation and evaluate the incidence of HIV-associated cerebellar degeneration in patients with progressive cerebellar ataxia.</p><p><strong>Material and methods: </strong>Three hundred and seventy-seven patients with progressive cerebellar ataxia were studied. Brain MRI study, assessment by the Scale for the Assessment and Rating of Ataxia (SARA), screening for cognitive impairment by the Montreal Cognitive Assessment Scale (MoCA) were performed. In patients with HIV infection, autoimmune, deficient and other causes of ataxia, as well as opportunistic infections, multiple system atrophy and frequent forms of hereditary spinocerebellar ataxias were excluded.</p><p><strong>Results: </strong>Five patients (1.3%) were identified with a combination of cerebellar ataxia and HIV infection (2 men, 3 women, aged 31 to 52 years). The median duration of HIV infection was 5 years, the duration of ataxia was 1 year. In the clinical findings, in addition to progressive ataxia, pyramidal signs, dysphagia, less often ophthalmoparesis, dystonia, postural hand tremor, affective and mild cognitive impairment were observed. In three patients, brain MRI revealed signs of olivopontocerebellar atrophy, two patients had isolated cerebellar degeneration (mainly of the vermis). All patients received combination of antiretroviral therapy in various regimens, but despite this, ataxia was progressive.</p><p><strong>Conclusion: </strong>HIV infection is a rare cause of cerebellar degeneration. This diagnosis remains a diagnosis of exclusion to this day. Cerebellar degeneration can occur and progress even after achieving a stable remission of HIV infection while taking highly active antiretroviral therapy.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 5","pages":"123-130"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692943","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":"[Tractography in functional neuronavigation].","authors":"A Yu Dmitriev,&nbsp;V G Dashyan","doi":"10.17116/jnevro202312307112","DOIUrl":"https://doi.org/10.17116/jnevro202312307112","url":null,"abstract":"<p><p>The review addresses the combined use of tractography and neuronavigation. Fundamentals of diffusion tensor imaging are given, technical aspects of fiber tracking in general and in depicting separate subcortical tracts are described. Main advantages of the method and possible causes of errors are highlighted. Precision assessment of this technology is given by comparing with results of subcortical neurostimulation. Surgical tactics is described depending on distance between the tumor and subcortical pathways.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 7","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877581","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":"[The impact of antiepileptic therapy on sleep disorders in women with epilepsy].","authors":"I V Ponomareva,&nbsp;M I Karpova,&nbsp;E I Luzanova","doi":"10.17116/jnevro2023123052105","DOIUrl":"https://doi.org/10.17116/jnevro2023123052105","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the frequency of various sleep disorders in patients with epilepsy receiving antiepileptic therapy.</p><p><strong>Material and methods: </strong>Sixty-four women were selected from the register of patients with epilepsy and other paroxysmal conditions. The group consisted of young and middle-aged women (36.9±13.5 years), all patients received antiepileptic therapy. To diagnose sleep disorders, we used a sequential algorithm for clinical examination supplemented by instrumental methods according to indications (polysomnography, respiratory monitoring).</p><p><strong>Results: </strong>The duration of epilepsy was 15.7±7.6 years, the disease was represented by three forms: structural (<i>n</i>=15, 23.4%), genetic (<i>n</i>=32, 50%) and unspecified (<i>n</i>=17, 26.6%). Sleep disorders were common among female patients with epilepsy (43.7%), they are most frequently combined with genetic epilepsy (18.7%), and represented by: insomnia (43%) mild to moderately severe breathing disorders (32%) and sleep movement disorders (25%). Sleep disorders were combined with symptoms of depression in the majority of patients (71%). A 6-month follow-up evaluation of nighttime sleep parameters after treatment showed a decrease in the frequency of sleep disorders to 25%; scores on the Epworth Sleepiness Scale significantly decreased to 6.7±3.6. A change in antiepileptic therapy in patients with sleep breathing disorders resulted in a marked regression of the Apnea-Hypopnea Index (9.2±2.5 points; <i>p</i>=0.003). However, there were no significant changes in the severity of sleep movement disorders.</p><p><strong>Conclusion: </strong>Sleep disorders are common in patients with epilepsy, in most cases they are associated with mood disorders, and may regress after optimization of antiepileptic therapy.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 5. Vyp. 2","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9582659","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":"[Predicting the development of aspiration pneumonia in patients with ischemic stroke and neurogenic dysphagia].","authors":"A A Borzdyko,&nbsp;V I Ershov,&nbsp;V R Mezhebovsky","doi":"10.17116/jnevro202312306157","DOIUrl":"https://doi.org/10.17116/jnevro202312306157","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prognostic aspects of the development of pneumonia in patients with ischemic stroke of various pathogenetic subtypes.</p><p><strong>Material and methods: </strong>The study enrolled 110 patients (64 men and 46 women), aged 44-95 years, with dysphagia during the acute period of ischemic stroke (IS). The TOAST criteria were used to diagnose the pathogenetic subtype, and the MASA scale was used to determine the presence and severity of dysphagia. To predict the probability of switching to self-feeding from the severity of dysphagia, a non-linear regression method was used using the least squares method.</p><p><strong>Results: </strong>In patients with swallowing disorders in the acute period of IS, pneumonia often developed after 5 days from the onset of clinical manifestations of stroke. In the cardioembolic subtype of IS, the probability of pneumonia in groups with dysphagia severity from 90 to 120 points on the MASA was higher than in the atherothrombotic subtype of IS (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>Patients with cardioembolic stroke subtype are characterized by a worse prognosis for the developing pneumonia compared to patients with atherothrombotic stroke subtype.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 6","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736711","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":"[Optimization of secondary prevention in patients with high-risk atherothrombotic ischemic stroke or transient ischemic attacks].","authors":"A A Kulesh,&nbsp;S N Yanishevskiy,&nbsp;D A Demin,&nbsp;L I Syromyatnikova,&nbsp;O I Vinogradov","doi":"10.17116/jnevro202312306136","DOIUrl":"https://doi.org/10.17116/jnevro202312306136","url":null,"abstract":"<p><p>High and very high risk atherothrombotic ischemic stroke (ATIS) includes patients with severe extracranial atherosclerosis, any intracranial atherosclerosis, and aortic arch atheromatosis. The article discusses the most effective approaches to medical short- and long-term secondary prevention of ATIS, major vascular events and death, based on the results of modern research and current clinical guidelines. Clinical studies of recent years have proven the possibility of individualization and intensification of secondary prevention of ATIS. In the treatment of high-risk patients, it is advisable to use more widely short-term dual antiplatelet therapy (combination of ASA with clopidogrel or ticagrelor), long-term dual antithrombotic therapy (combination of ASA and rivaroxaban at a dose of 2.5 mg twice a day not earlier than 30 days from the development of stroke or TIA) to reduce the risk of recurrent stroke and death, as well as intensive lipid-lowering therapy (including the use of a combination of statins and ezetimibe or PCSK9 inhibitors).</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 6","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736713","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":"[Acetylsalicylic acid in primary and secondary prevention of atherosclerotic cardiovascular disease].","authors":"O Sh Oynotkinova,&nbsp;S T Matskeplishvili,&nbsp;O M Maslennikova,&nbsp;A I Pavlov,&nbsp;A G Poberezhskaya","doi":"10.17116/jnevro202312305158","DOIUrl":"https://doi.org/10.17116/jnevro202312305158","url":null,"abstract":"<p><p>The article is devoted to an urgent problem - primary and secondary prevention of atherosclerotic cardiovascular diseases. Modern approaches to management tactics depending on age and the appointment of antiplatelet therapy with acetylsalicylic acid in low doses from 75 to 150 mg/day are presented. At the same time, the relatively high effectiveness of the use of ASA for primary prevention in men 40-69 years old without an increased risk of bleeding from the gastrointestinal tract is shown. Low doses of ASA provide little benefit in reducing the risk of CVD in people 40 years and older, when there is no history of CVD, but at the same time they are at increased risk of CVD.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 5","pages":"58-64"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692942","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":"[Efficacy and safety of the drug Cellex for the treatment of patients with cognitive impairment with chronic cerebral ischemia - results of a multicenter randomized double-blind placebo-controlled clinical trial].","authors":"I A Shchukin,&nbsp;I A Koltsov,&nbsp;M S Fidler,&nbsp;V I Chubykin","doi":"10.17116/jnevro2023123051108","DOIUrl":"https://doi.org/10.17116/jnevro2023123051108","url":null,"abstract":"OBJECTIVE To evaluate the efficacy and safety of using Cellex for the treatment of cognitive impairment as part of the complex therapy of patients with chronic cerebral ischemia (CCI) compared with placebo. MATERIAL AND METHODS The study randomized 300 patients with a reliable diagnosis of CCI stage 1-2, all participants were divided into two groups, 150 participants in each - main and control. The study drug Cellex or placebo was administered as two 10-day treatment courses, 1 ml once a day. The duration of the study was 90±5 days for each participant. The primary end point for evaluating the effectiveness of the therapy was the degree of improvement in the state of cognitive functions relative to the initial state according to the Montreal Cognitive Dysfunction Scale (MoCA) on the 31st and 60th days from the start of therapy in the compared groups. Secondary endpoints were the assessment of the degree of improvement in the state of cognitive functions according to psychometric testing scales (MoCA, Correction Test, Frontal Dysfunction Test Battery) relative to the initial state on the 31st, 60th and 90th days from the start of therapy. Also, a dynamic assessment of the systemic concentration of markers of brain damage - S100β, GFAP, MMP9 and neurotrophins - BDNF and GDNF was carried out. RESULTS The primary endpoint of the study was achieved-the MoCA score in each group increased uniformly after baseline. However, in the main group, this indicator was significantly higher starting from visit 3 - 23.4±2.8 points in the main group, in the placebo group 22.7±2.3 (p<0.001), a statistically significant difference also remained at visit 5 (p<0.001). When analyzing the secondary endpoints according to the battery of frontal dysfunction tests and the correction test, a more pronounced positive trend was also noted in the main group. Changes in the emotional sphere in both groups remained within the normal range. The dynamics of the systemic concentration of markers of brain damage and neurotrophins was multidirectional, the assessment of which was possible only at the trend level. CONCLUSION Based on the statistical analysis of the results of the study, Cellex was confirmed to be superior to Placebo in the degree of improvement in cognitive functions measured by the MoCA scale after the 1st and 2nd treatment courses.","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 5","pages":"108-116"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692946","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":"[Relationship of patients with multiple sclerosis to vaccination against COVID-19].","authors":"E L Turova","doi":"10.17116/jnevro202312307229","DOIUrl":"https://doi.org/10.17116/jnevro202312307229","url":null,"abstract":"<p><strong>Objective: </strong>To study the attitude of patients with multiple sclerosis (MS) to vaccination as a method of preventing infectious diseases, in particular, COVID-19.</p><p><strong>Material and methods: </strong>The data of a survey of 408 patients with MS in the Sverdlovsk region in relation to vaccination against COVID-19, conducted using the original questionnaire, were analyzed.</p><p><strong>Results: </strong>According to the survey data, 266 (65.2%) patients with MS are positive about vaccination. 222 (54.4%) patients with MS refused vaccination. The most common reasons for refusal were - fear that the vaccine could worsen the state of health - 44.1%, coronavirus infection in the last 6 months - 14.85%, «I was always told that I should not be vaccinated» - 14.4%, a combination of the above answers - 16.65%. The accumulated world experience and our observations demonstrate the important role of vaccination of patients with MS from COVID-19.</p><p><strong>Conclusions: </strong>It is necessary to rise the awareness of vaccination among patients with MS, since until recently this has been given insufficient attention.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 7. Vyp. 2","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326933","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":"[B vitamins and brain dysfunction].","authors":"D A Iskra,&nbsp;A G Trufanov","doi":"10.17116/jnevro202312307197","DOIUrl":"https://doi.org/10.17116/jnevro202312307197","url":null,"abstract":"<p><p>An unbalanced diet and some other factors are the reason for the extreme prevalence of hypovitaminosis among the population of both developing and developed countries. The metabolic relationships of B vitamins determine the more frequent occurrence of poly-, rather than monovitamin deficiency. Since B vitamins play an important role in the processes of energy production and in the functioning of neurotransmitter systems, the first symptoms of such polyhypovitaminosis are signs of brain dysfunction: asthenia, depression, anxiety, cognitive disorders. Correct diagnosis of polyhypovitaminosis based on the identification of risk groups of patients and the determination of their subclinical or early manifesting signs of brain dysfunction is the most important task of a practicing physician. Detection of insufficient intake and vitamin content, as well as verification of the onset of symptoms of brain dysfunction and the appointment of adequate therapy can significantly increase the effectiveness of treatment, as well as prevent asthenic, psycho-emotional and cognitive disorders in patients with polyhypovitaminosis.</p>","PeriodicalId":24030,"journal":{"name":"Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova","volume":"123 7","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9872260","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}