Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova最新文献

{"title":"[New pathogenic treatments for myasthenia gravis].","authors":"T M Alekseeva, P S Isabekova, E I Kondratova, L U Abdulina","doi":"10.17116/jnevro202512501131","DOIUrl":"10.17116/jnevro202512501131","url":null,"abstract":"<p><p>Myasthenia gravis (MG) is an autoimmune disease caused by the production of specific autoantibodies to various components of the neuromuscular synapse, leading to muscle weakness and disabling fatigue. Treatment of MG aims to stop the symptoms and inhibit the triggers of the autoimmune process. For a long time, MG treatment included anticholinesterase agents and nonspecific immunosuppressive and immunomodulatory therapies used alone or in combinations: glucocorticosteroids, cytostatics, plasmapheresis, and intravenous immunoglobulin. Despite the fact that the above drugs are widely used in the treatment of MG, they can cause unacceptable side effects with long-term use and also are not consistent in induction of remission. The search for new effective and safe therapies for MG, especially refractory types that do not respond to standard therapy, is an urgent task. Due to advances in biotechnology and the emergence of new types of drugs, monoclonal antibodies or fusion proteins, targeted MG immunotherapy has been developed for specific pathogenetic targets. The presented review describes targeted MG therapies that are already approved In Russia and other countries, as well as those at different stages of development. Most targeted agents have some advantages over traditional immunosuppressive therapy: rapid onset of action, long-term remission, and minimal side effects. Currently, eculizumab and ravulizumab are approved In Russia.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 1","pages":"31-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392659","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 effectiveness of Botulinum toxin type A - hemagglutinin preparations of the Relatox and Botox complex in the treatment of patients with primary idiopathic blepharospasm].","authors":"V V Gusev, E A Makarov, O A Lvova","doi":"10.17116/jnevro202512502186","DOIUrl":"10.17116/jnevro202512502186","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the effectiveness of Relatox (Botulinum toxin type A - hemagglutinin complex) in comparison with Botox in the treatment of primary idiopathic blepharospasm.</p><p><strong>Material and methods: </strong>The study included clinical data for 21 patients with blepharospasm who were treated by botulinum therapy with Botox and Relatox for 3 years. The research method is a one-step retrospective analysis of medical data. Injections were carried out with a 3-month interval. On the 6th cycle, the drug was switched to Relatox. The clinical efficacy of the drugs was assessed using an 8-point Jankovich evaluation scale: the average values before the injection and 14 days after it were compared for each procedure.</p><p><strong>Results: </strong>Mean Jankovich scale scores decreased 2.5-fold for all cycles by the second week after the procedure (4.95 pre-injection vs. 1.8 post-injection), and the mean paired Student's <i>T-</i>criterion for all injections was 7.14 (with a critical value of 2.021 and a significance level of <i>p</i>=0.05). The mean paired Student's <i>T-</i>criterion for Botox was -6.63 and for Relatox -7.5 (with a critical value of 2.021 and a significance level of <i>p</i>=0.05), indicating a high efficacy of both drugs, slightly higher for Relatox.</p><p><strong>Conclusion: </strong>A consistent trend of increasing efficacy with regular botulinum toxin injections and greater efficacy of Relatox compared to Botox in the treatment of patients with primary idiopathic blepharospasm has been demonstrated.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 2","pages":"86-90"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569016","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":"[Potential of animal-derived neuropeptides in complex therapy of diabetic neuropathy in patients with type 2 diabetes mellitus].","authors":"M V Putilina","doi":"10.17116/jnevro202512504183","DOIUrl":"https://doi.org/10.17116/jnevro202512504183","url":null,"abstract":"<p><p>According to the WHO forecast, the number of patients with diabetes mellitus is expected to increase to 1.3 billion people by 2051. At the same time, we expect an increase in neurological complications of the disease, especially in polyneuropathy (DPN) and cognitive impairment (CI) are often considered as separate, independently existing complications. They can manifest at different times, at different ages, which creates certain difficulties for screening and subsequent therapy. Traditionally applied treatment standards, strict glycemic control does not allow us to talk about complete correction of manifestations and/or reducing the risk of developing DPN without CI or mild CI. In recent years, the possibilities of peptide drugs to reduce CI and chronic neuropathic pain have been actively studied. Neuropeptides of animal origin combine the functions of hormones, growth factors, neurotransmitters, ion channel ligands, and anti-inflammatory agents. The domestic drug Cortexin is one of the most promising drugs for further clinical trials.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4","pages":"83-87"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013673","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":"[Asthenia in the acute period of ischemic stroke].","authors":"A I Akhmetova, M A Kutlubaev","doi":"10.17116/jnevro20251250325","DOIUrl":"10.17116/jnevro20251250325","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical and pathogenetic correlates of post-stroke asthenia (PSA) subtypes.</p><p><strong>Material and methods: </strong>The study included 103 patients with ischemic stroke. PSA was assessed using the Multidimensional Fatigue Inventory-20 (MFI-20). A standard set of laboratory and instrumental tests, as well as examinations for neurological deficits, cognitive functions, symptoms of apathy, depression, anxiety, and daytime sleepiness, were conducted. Linear regression analysis was performed to identify predictors of the severity of the different PSA subtypes.</p><p><strong>Results: </strong>Asthenia was reported in 79 (76.7%) of the examined patients. The frequency of general asthenia, physical asthenia, and decreased activity ranged from 60-73%. Mental asthenia and decreased motivation were reported in about 31-37% of patients. A decrease in the fibrinogen/albumin ratio and the severity of cognitive impairment were predictors of the severity of general asthenia. The severity of physical asthenia was associated with the severity of the neurological deficit and the blood levels of hemoglobin and potassium. The blood hemoglobin level and the severity of depressive symptoms determined the decrease in activity. The severity of decreased motivation and mental asthenia were associated with various symptoms of apathy and depression.</p><p><strong>Conclusion: </strong>The analysis of correlates of various asthenia subtypes made it possible to distinguish two main PSA phenotypes: «physical» associated with the severity of the neurological deficit, as well as somatogenic factors, and «mental» associated with affective-behavioral disorders. The data obtained confirm the heterogeneity of the PSA phenomenon, which must be considered when developing methods of its treatment and prevention.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 3. Vyp. 2","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694508","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":"[Animal experimental models in the study of age-dependent cerebral microangiopathy].","authors":"A A Geints, L A Dobrynina, I M Egerev, E I Kremneva, K V Shamtieva, V O Belousov","doi":"10.17116/jnevro202512503257","DOIUrl":"10.17116/jnevro202512503257","url":null,"abstract":"<p><p>The modeling of age-dependent cerebral microangiopathy (CMA) is highly relevant due to its high prevalence and the heavy burden of clinical manifestations - strokes and cognitive disorders in the elderly, as well as the lack of effective pathogenetic treatment. Experimental modeling of CMA is a promising area of preclinical scientific research that contributes to the study of the disease pathogenesis at the genetic, molecular, and cellular levels and the search for optimal methods of its treatment and prevention. This review aimed to analyze, systematize, and compare data on current experimental models of CMA. The review analyzed the results of various studies on experimental models published in journals indexed in the PubMed, Scopus, and eLibrary databases. Available CMA models reflect different CMA attributes and mechanisms. The choice of research model should be based on the experiment's objectives. Understanding available models, combining them, and developing new models should be aimed at choosing the most relevant ones, reproducing the features of modern CMA, characterized by the control of classical risk factors, to assess pathological mechanisms and develop pathogenetic treatment.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 3. Vyp. 2","pages":"57-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694420","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":"[Cytokine status of patients with Alzheimer's disease].","authors":"V V Belousov, A N Bogolepova, E A Katunina, N V Bulanova, V E Mukhin, S M Yudin","doi":"10.17116/jnevro20251250425","DOIUrl":"https://doi.org/10.17116/jnevro20251250425","url":null,"abstract":"<p><strong>Objective: </strong>To study cytokine status in patients with Alzheimer's disease (AD).</p><p><strong>Material and methods: </strong>The main group of patients with a confirmed AD included 23 patients with a mean age of 69 [66.2; 77.5] years (6 males, 17 females). Data from 163 apparently healthy subjects (data from the archive of the Centre for Strategic Planning and Management of Biomedical Health Risks of the Federal Medical Biological Agency of Russia) were used as a control. A multiplex enzyme immunoassay (xMAP technology) was performed using a FlexMap 3D multiplex flow fluorimeter. Samples were analyzed for the following cytokines: epidermal growth factor (EGF), fibroblast growth factor (FGF-2), eotaxin, transforming growth factor (TGF-α), granulocyte and granulocyte-macrophage colony-stimulating factors (G-CSF, GM-CSF), Flt-3L, fractalkine, interferon (IFN)-α2, IFN-γ, GRO, interleukins (IL)-10, -12p40, -12p70, -13, -15, -17A, -1RA, -1α, -9, -1β, -2, -3, -4, -5, -6, -7, -8, IP-10, sCD40L, monocyte chemoattractant protein (MCP)-3,-1, macrophage-derived chemokine (MDC), macrophage inflammatory protein (MIP)-1a, MIP-1b, tumor necrosis factors (TNF)-α, TNF-β, vascular endothelial growth factor (VEGF).</p><p><strong>Results: </strong>The median levels of FGF-2, eotaxin, G-CSF, Flt-3L, GM-CSF, fractalkine, IFN-α2, IFN-γ, MCP-3, IL-1RA, -4, -8, TNF-α in the AD group was higher (more than 2-fold) than in the control group. Of note, the median values of eotaxin, G-CSF, GM-CSF, Flt-3L, IFN-α2, IFN-γ, and TNF-α in the AD group exceeded the 90th percentile of those in the control group.</p><p><strong>Conclusion: </strong>The obtained data indicate significant changes in cytokine status in AD, with increased pro-inflammatory cytokines and activated neuroprotective mechanisms.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4. Vyp. 2","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152809","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":"[A clinical case of X-linked adrenoleukodystrophy].","authors":"D A Mochalova, A A Agliullina, P I Dranitsyna, K O Zhuravleva","doi":"10.17116/jnevro2025125041102","DOIUrl":"10.17116/jnevro2025125041102","url":null,"abstract":"<p><p>X-linked adrenoleukodystrophy is the most common peroxisomal disease among primary leukodystrophies, characterized by a progressive course and combined damage to the adrenal glands and central and peripheral nervous systems. The disease is caused by mutations in the <i>ABCD1</i> gene, which encodes the ALDP transmembrane peroxisome protein, which is involved in transporting very long-chain fatty acids (VLFAs). Dysfunctions of peroxisome metabolism occur due to a lack of acyl-CoA synthetase, reducing the efficiency of beta-oxidation of VLFAs with a carbon chain length ≥C22 and resulting in the accumulation of toxic substances in the adrenal cortex and the white matter of the brain and spinal cord. We present a clinical case of X-linked adrenoleukodystrophy in a male patient with a disease onset at the age of 22 years in the form of progressive lower spastic paraparesis and neurogenic dysfunction of the pelvic organs with long-term preservation of cognitive functions. Four years after the onset of symptoms (in 2021), multiple sclerosis was clinically diagnosed. The patient received therapy with multiple sclerosis disease-modifying drugs and glucocorticosteroids. Despite treatment, disability progressed. In January 2024, a brain MRI was performed, and a diagnosis of «Leukodystrophy, Alexander's disease?» was made. Blood serum was sent to the Research Center for Medical Genetics in Moscow under the program «Study of Genetic Heterogeneity of Leukodystrophies» for testing. In May 2024, dysphagia and apnea occurred, and after 1.5 months, the patient died outside the hospital. No necropsy was performed. Information on the course of the disease was obtained during the review of medical documentation. The diagnosis was made after the patient's death based on the results of gas chromatography of plasma (GCP), massive parallel panel sequencing, and neuroradiological and clinical presentations. The article discusses the main MR patterns and an algorithm for diagnosing leukodystrophies.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999023","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":"[Change of subjective cognitive decline in first-degree relatives of patients with Alzheimer's disease: results of a 15-year prospective study].","authors":"N D Selezneva, I F Roshchina, I V Kolykhalov, S I Gavrilova","doi":"10.17116/jnevro202512504236","DOIUrl":"10.17116/jnevro202512504236","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the change of cognitive functioning for 15 years in non-treated first-degree relatives of patients with Alzheimer's disease (AD) with symptoms of memory loss.</p><p><strong>Material and methods: </strong>The observation cohort included 66 relatives of the first-degree relatives of patients with AD (Centre For Mental Health Research) with subjective cognitive decline (SCD), who agreed to a routine psychometric and in-depth neuropsychological examination and subsequent participation in the prolonged observation program but refused to use any drug therapy.</p><p><strong>Materials and methods: </strong>An open-label 15-year observational study of the change of cognitive functioning in first-degree relatives of AD patients with symptoms of memory loss (SCD) was conducted. The baseline indicators of cognitive functioning of the study were compared with similar indicators after 5, 10, and 15 years. For psychometric assessment, routine psychometric scales and tests were used (Mini-Mental State Examination; the Montreal Cognitive Assessment Test; a Clock Drawing test, a scale of general deterioration; a test of random memorization of 10 words; the Boston naming test; subtest 6 of the Wechsler test; a test of memorizing 5 geometric shapes; the Benton test; the subtest sound and categorical associations, and the G. Münsterberg test.</p><p><strong>Results: </strong>A prospective study of a cohort of first-degree relatives of AD patients with symptoms of cognitive dysfunction showed a high risk of subsequent cognitive deterioration up to dementia. After 5 years of observation, 16.7% of subjects developed mild cognitive impairment (mci) syndrome. By year 10 of the study, mci syndrome was diagnosed in 42.4% of subjects, and in 7.6%, AD was diagnosed; in 50.0% of subjects, the initial condition did not worsen. By year 15 of observation, 30.3% of patients were diagnosed with dementia in AD and 34.85% with mci syndrome; in 34.85% of cases, the condition remained at the SCD level.</p><p><strong>Conclusion: </strong>The results of a 15-year cognitive study in first-degree relatives of AD patients with SCD who did not receive prophylactic therapy showed a significant decrease in cognitive functioning parameters with a quite high conversion rate to MCI and/or to dementia in ad. Subsequent analysis of a complex of demographic, clinical, neuropsychological, and other risk factors for dementia due to ad contributes to determining the hereditary risk of SCD progression and developing personalized approaches to the prevention of dementia in individuals with a genetic risk of AD.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4. Vyp. 2","pages":"36-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152601","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 role of the study of neurocognitive mechanisms for maintaining and restoring mental health in the setting of uncertainty of the psychopathology boundaries].","authors":"O V Ipatyuk, G L Kozunova","doi":"10.17116/jnevro20251250517","DOIUrl":"https://doi.org/10.17116/jnevro20251250517","url":null,"abstract":"<p><p>In the last century, fundamental and applied psychology has established a view of mental health as a qualitatively distinct condition, determined not only by the absence of symptoms of psychopathology but also by several positive characteristics. These include subjective well-being, positive emotions, psychological resilience, emotional competence, and a person's social maturity appropriate for the age and cultural expectations. However, modern epidemiological and experimental studies operate mainly with a negative definition of mental health, compiling control groups of so-called «neurotypical volunteers» based on the absence of a history of mental disorders in them and sometimes also in their blood relatives. There are no explicit criteria for mental health or patient recovery in clinical protocols for diagnosing mental disorders. The gap between the theoretical and operational definitions of mental health is due to the insufficient popularity of tools for assessing the parameters of mental activity necessary for a person to function optimally in everyday life. The purpose of the review is to analyze recent empirical studies on the neurocognitive mechanisms for maintaining and restoring mental health. The paper justifies the need to develop practice methods for diagnosing a person's mental health within a modern humanistic approach.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 5","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210318","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":"[Therapeutic potential of quercetin and its derivatives against COVID-19].","authors":"A B Katasonov","doi":"10.17116/jnevro202512505144","DOIUrl":"https://doi.org/10.17116/jnevro202512505144","url":null,"abstract":"<p><p>Quercetin is a natural flavonoid with a wide range of biological activity. This compound does not penetrate the brain well, but under stress, it exhibits neuroprotective properties, probably associated with its effect on the blood-brain barrier (BBB). BBB disruption may be responsible for the invasion of the causative agent of the new coronavirus infection (COVID-19) into the brain with the development of neurological symptoms. Quercetin can suppress viral replication, oxidative stress, and inflammatory response, as well as prevent the formation of microthrombi. This potential of quercetin may help treat COVID-19 and its long-term sequelae.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 5","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210319","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}