Nevrologiya, Neiropsikhiatriya, Psikhosomatika最新文献

{"title":"The role of cellular immunity and systemic inflammation indices in the pathogenetic mechanisms of mental disorders","authors":"A. P. Gorbunova, G. V. Rukavishnikov, E. D. Kasyanov, G. E. Mazo","doi":"10.14412/2074-2711-2023-5-72-78","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-72-78","url":null,"abstract":"To date, inflammatory mechanisms are known to be involved in neuronal damage and increased risk of associated mental disorders, but most previous work has focused primarily on cytokines and other inflammatory markers that are difficult to replicate and not economically feasible for use in routine clinical practice. Other extremely important indicators of the systemic inflammatory process are circulating blood cells and changes in their number, composition, and ratio. Hematologic indices of systemic inflammation (HISI) are already used in somatic specialties: neutrophil-lymphocyte (NLR), monocyte-lymphocyte (MLR) and platelet-lymphocyte (PLR) ratios, as well as the Systemic Immune Inflammation Index (SII) and the System Inflammation Response Index (SIRI). In the context of psychopathology, the HISI require additional investigation, which makes it necessary to pay more attention to the possible mechanisms underlying their changes. The article provides data on the contribution of each cellular element to the mechanism of neuroinflammation and neurodegeneration and on their role in the development of psychopathological processes.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414266","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":"Vestibular migraine: issues of diagnosis and optimization of therapy","authors":"O. V. Zaitseva, T. G. Baskova, A. L. Latsinova, O. E. Wenger","doi":"10.14412/2074-2711-2023-5-87-93","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-87-93","url":null,"abstract":"Headache and dizziness are the two most common complaints with which patients turn to physicians of various specialties. A thorough examination often reveals a combination of these two symptoms. Currently, the term “vestibular migraine” (VM) is recognized by the worldwide community of otoneurologists and neurologists as the most appropriate for the combination of vestibular vertigo and migraine headaches. The difficulties in diagnosis and differential diagnosis are related to the lack of possibility to confirm the disease (and to detect) instrumentally and to the fact that the dizziness may be different in different VM episodes, even in one patient. The complexity of therapy is in the need to choose a relatively individualized treatment regimen and in the lack of an ideal vestibular suppressant (which quickly suppresses dizziness and has no significant side effects). In this context, finding the most effective drugs for emergency and elective treatment of patients with VM is undoubtedly important. For patients with VM, the use of the drug Arlevert (dimenhydrinate 40 mg + cinnarizine 20 mg) can be recommended for the relief of acute vestibular crisis at home, since the drug is highly effective and well tolerated. In addition, and most importantly, Arlevert has no known interactions with other medications used for migraine prevention.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414272","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":"Metamorphosis of a herniated lumbar disc","authors":"A. I. Isaykin, L. T. Akhmedzhanova, S. R. Fedoseev, V. D. Zagranichnaya","doi":"10.14412/2074-2711-2023-5-46-53","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-46-53","url":null,"abstract":"Compression of nerve roots by herniated intervertebral discs (IVD) is a major cause of lumbosacral radiculopathy and often causes problems in patient management. We present a case report of a patient whose initial pain was axial discogenic in nature, probably due to a fissure of the annulus fibrosus, and who later developed LIII–IV radiculopathy. The timing of formation of a sequestered IVD hernia was recorded on MRI. There was no prolonged gradual formation of IVD hernia (bulging, fissure, protrusion, extrusion/sequestration), an acute formation of disc herniation occurred. Conservative treatment, including nonpharmacological (McKenzie gymnastics, educational program) and drug treatment (nonsteroidal anti-inflammatory drugs, anticonvulsants), as well as minimally invasive measures (epidural administration of local anesthetics and glucorticoids), allowed rapid regression of clinical symptoms and improvement of functional and emotional status. MRI of the lumbar spine performed six months after onset showed complete resorption of the IVD hernia. The patient follows ergonomic recommendations and performs therapeutic exercises (Nordic walking); no deterioration was observed within 9 months.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414140","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":"Comparative analysis of the use of selective serotonin reuptake inhibitors during pregnancy and the postpartum period. Safety of sertraline","authors":"E. A. Ushkalova, A. V. Ushkalova","doi":"10.14412/2074-2711-2023-5-1-94-101","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-1-94-101","url":null,"abstract":"Depressive disorders and anxiety are the most common mental disorders in the perinatal period, occurring in 14–23% of women. Antidepressants from the selective serotonin reuptake inhibitor (SSRI) group are considered the drugs of choice for the treatment of these disorders. Although SSRIs are the best-studied antidepressants used in pregnant women, there are still conflicting opinions about their effect on pregnancy course and outcomes of pregnancy. At the same time, the risks associated with their use in pregnant women are often exaggerated, while the risks of untreated mental disorders are underestimated. SSRI use during pregnancy has been associated with a modestly increased risk of adverse events, including postpartum haemorrhage, miscarriage, preterm birth, cesarean delivery, fetuses small for their gestational age and low birth weight, low Apgar scores, and increased rates of neonatal hospitalization to intensive care units. However, depressive and anxiety disorders in the mothers themselves also contribute to similar outcomes, so it is not always possible to distinguish the contribution of medication and illness. Comparative data on the effects of different SSRI medications on outcome for the mother and fetus during pregnancy are limited, but paroxetine and fluoxetine are reported to pose the greatest risk to the fetus/neonate. Information on the safety of citalopram and escitalopram during pregnancy and lactation is limited. Citalopram has the highest concentrations in amniotic fluid of all SSRIs. According to current data, sertraline has the most favourable safety profile during pregnancy and lactation, which is explained by its low penetration through the placenta. Sertraline concentrations in the fetus are approximately 1/3 of those in maternal plasma. Sertraline has the lowest concentrations in breast milk of all SSRIs and is associated with a low risk of adverse effects in a baby, making it the drug of choice for nursing mothers. In conclusion, sertraline is one of the best studied SSRIs and has a favourable safety profile for both the mother and the fetus/neonate.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414147","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":"Migraine in perimenopausal women","authors":"D. A. Klimentova, G. R. Tabeeva","doi":"10.14412/2074-2711-2023-5-102-108","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-102-108","url":null,"abstract":"Sex hormones have a significant influence on the course of migraine in women. Perimenopause is accompanied by unstable cycle length, vasomotor, urogenital and other symptoms, while the course of migraine usually worsens. In postmenopause ovarian follicular function decreases, and the course of migraine improves in most cases. However, a number of studies have shown that the course of migraine does not change or even worsen after menopause. Perimenopausal and postmenopausal migraine patients are also more likely to suffer from vasomotor symptoms. Hormone replacement therapy is prescribed to relieve vasomotor symptoms, which may worsen the course of migraine. In this review, the influence of perimenopause and postmenopause on the course of migraine, the use of hormone replacement therapy, and methods to relieve and prevent attacks in patients with migraine are examined in detail.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135413978","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":"Comprehensive diagnosis of cervical dystonia and the efficacy of long-term (three-year) botulinum therapy","authors":"V. A. Tolmacheva, D. S. Petelin, B. A. Volel","doi":"10.14412/2074-27112023-5-35-38","DOIUrl":"https://doi.org/10.14412/2074-27112023-5-35-38","url":null,"abstract":"Cervical dystonia (CD) is common in outpatient practice but in many cases is diagnosed at late stages. The efficacy of long-term botulinum therapy (BT) in CD has been poorly studied. Objective: to analyse the typical practice of treating patients with CD and the efficacy of long-term BT therapy (three years). Material and methods . Sixty-three patients (43 women and 20 men) diagnosed with CD (mean age 51 [42; 63] years) participated in the study. We performed an analysis of typical practice of managing patients with CD before starting BT. The mean duration of disease at the time of referral was 6 [4; 10] years. Patients received repeated injections of BT at 10–20 week intervals; BT was administered under electromyographic control and ultrasound navigation. The severity of CD was assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWRSTW), quality of life using the EuroQol-5D questionnaire (EQ-5D) questionnaire, and anxiety level using the Generalized Anxiety Disorder Questionnaire scale-7, GAD-7). Patients' condition was assessed at baseline, 1 month after BT, and after 3 years against the background of regular BT. The severity of the disease before BT was 36.71±3.6 points. The control group consisted of 46 healthy subjects (39 women and 7 men, mean age 53.8±12.3 years). Results. The diagnosis of CD was made on average 2.3±1.1 years after the onset of the first symptoms, BT was started on average 5±2.6 years after diagnosis. At the first visit to the physician, CD was detected in only 32% of cases. In the CD group there was an increase in the severity of anxiety up to 9.93±4.7 points (in the control group – 4.28±3.5 points; p≤0.05) and a decrease in quality of life down to 62.53±12.1 points (in the control group – 86.38±6.4 points; p≤0.05). One month after BT, a significant decrease in the severity of the disease was observed – from 36.7±13.6 to 13.3±10.8 points (p≤0.05). After three years of regular BT the severity of the disease decreased to 12.7±10.5 points (p≤0.05), the level of anxiety decreased to 5.2±3.7 points (p≤0.05), the patients' quality of life increased up to 77.93±8.4 points (p≤0.05). Conclusion. CD is still underdiagnosed in practice, and BT is not prescribed until several years after the onset of the disease. Regular and longterm use of BT not only reduces the severity of CD, but also reduces the severity of anxiety disorders and improves patients' quality of life.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414149","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":"Problems in the selection of effective analgesics for migraine","authors":"G. R. Tabeeva","doi":"10.14412/2074-2711-2023-5-109-116","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-109-116","url":null,"abstract":"Pharmacologic symptomatic treatment of headache attacks is an essential strategy for effective management of patients with migraine. Choosing a medication requires an individualized approach and consideration of patient profile, characteristics of ictal manifestations of migraine, and personal experience in headache relief. Among the recommended medications, triptans are the first choice therapy. The pharmacologic differences among triptans allow selection of the most effective drug depending on the individual needs of the patient. Considering the primary importance of characteristics such as speed and duration of pain relief, as well as the consistency of effect in interrupting successive attacks, the choice of rizatriptan may be optimal for migraine patients.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414390","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":"Depressive disorders and their pharmacotherapy in routine clinical practice","authors":"S. N. Mosolov, V. A. Parfenov, A. V. Amelin, V. E. Medvedev, V. D. Mendelevich, G. M. Usov, Yu. P. Sivolap, A. N. Bogolepova, E. A. Mkhitaryan, D. S. Petelin","doi":"10.14412/2074-2711-2023-5-54-64","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-54-64","url":null,"abstract":"Depression is one of the most common medical causes of disability and mortality in patients of all ages. Depressive disorders are common in the practice of physicians of a variety of specialties, including psychiatrists, neurologists, and physicians. This paper provides a summary review of the literature on modern ideas about the epidemiology, classification, and clinical picture of depression. Current approaches to the diagnosis and treatment of depressive disorders in neurological and psychiatric practice are discussed. Modern pharmacotherapeutic strategies for the treatment of depression in various patient populations are described in detail. Current clinical practice indicates the high importance of an interdisciplinary approach in the diagnosis and management of patients with depressive symptoms in Russia. The paper suggests organizational and educational strategies that can be recommended to improve the effectiveness of medical care for patients with depressive disorders.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414385","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":"Review of the monograph by D.S. Danilov “History of antidepressants. Book one: Irreversible non-selective monoamine oxidase inhibitors”","authors":"S. Yu. Tsikin","doi":"10.14412/2074-2711-2023-5-125-126","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-125-126","url":null,"abstract":".","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414271","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":"Possibilities of combined use of peptides in the treatment of post-stroke asthenia","authors":"A. Yu. Emelin, V. Yu. Lobzin","doi":"10.14412/2074-2711-2023-5-117-124","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-5-117-124","url":null,"abstract":"Among the various syndromes in the post-stroke period, asthenic disorder plays an important role, the presence of which is associated with unfavourable course of the disease. Post-stroke fatigue is, on the one hand, the result of organic brain lesions and, on the other hand, a person's emotional reaction to the clinical manifestations of stroke and its consequences. Affective and cognitive disorders are common comorbidities of fatigue after stroke. To correct asthenic manifestations, a holistic approach with pharmacological, physical, and psychological treatments is used. The main components in the pathogenesis of fatigue are hypoxia and energy imbalance, so it seems reasonable to include in the complex therapy of post-stroke fatigue the drug Cytochrome C, which is a key peptide of the mitochondrial respiratory chain. Considering the frequent combination with cognitive disorders of different modality, the use of bovine cerebral cortex polypeptides in patients with post-stroke fatigue is pathogenetically reasonable. Inclusion of drugs with a complex mechanism of action on hypoxia, oxidative stress, energy deficiency, and neuroplasticity processes in the therapeutic algorithm may increase the effectiveness of treatment.","PeriodicalId":37732,"journal":{"name":"Nevrologiya, Neiropsikhiatriya, Psikhosomatika","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414141","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}