Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova最新文献

{"title":"[OPRD1 gene polymorphism (rs4654327) as a potential predictor of the effectiveness of long-acting naltrexone in patients with alcohol addiction].","authors":"S S Miroshkin, V Y Skryabin, V V Shipitsyn, A V Masyakin","doi":"10.17116/jnevro202612604156","DOIUrl":"10.17116/jnevro202612604156","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of the <i>A>G (rs4654327)</i> polymorphism of the <i>OPRD1</i> gene on the clinical efficacy of long-acting naltrexone therapy in patients with alcohol addiction.</p><p><strong>Material and methods: </strong>The study included 100 patients with alcohol addiction treated with long-acting naltrexone for 180 days. The duration of remission, the recurrence rate, the completion of the treatment course, the change of pathological alcohol craving (using the Penn Alcohol Craving Scale [PACS]), and the patterns of pathological alcohol craving (PAC) (using the Altshuler scale) were assessed. Genotyping for <i>rs4654327</i> was performed using real-time polymerase chain reaction.</p><p><strong>Results: </strong>Carriers of the minor <i>G</i> allele (<i>A/G</i> and <i>G/G</i>) exhibited significantly shorter remission (<i>p</i>=0.007), higher recurrence rates (<i>p</i>=0.022), and lower treatment completion rates (<i>p</i>=0.007). The PAC decrease according to PACS was statistically significant after adjustment only in the A/A group (<i>p</i><0.001). Among <i>G</i> allele carriers, behavioral and affective components were significantly more prevalent in the phenomenological structure of PAC.</p><p><strong>Conclusion: </strong>The <i>rs4654327</i> polymorphism of the <i>OPRD1</i> gene may be associated with the variability of the long-acting naltrexone efficacy in patients with alcohol addiction. These preliminary findings suggest that genotyping at this locus could inform personalized anti-recurrence therapy strategies, although validation in larger cohorts is required.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944090","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":"[Endoscopic diagnosis of neurogenic dysphagia and quantitative visual scale assessment of posterior sialorrhea for the prevention of aspiration events in adults].","authors":"S E Khatkova, O A Pogoreltseva, V Yu Baturova, S S Agafonov, A A Belkin","doi":"10.17116/jnevro2026126041119","DOIUrl":"10.17116/jnevro2026126041119","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the efficacy and safety of intrasalivary injections of incobotulinumtoxinA for the prevention of aspiration complications in patients with neurogenic dysphagia and posterior sialorrhea of various etiologies.</p><p><strong>Material and methods: </strong>This prospective study, conducted from 2024 to 2025, included 116 patients divided into two groups. The Main group (<i>n</i>=58) received ultrasound-guided chemodenervation of four salivary glands (two parotid and two submandibular) with incobotulinumtoxinA at a total dose of 100 U. The Control group (<i>n</i>=58) comprised retrospective data from patients with similar clinical profiles who did not receive botulinum toxin injections. All participants underwent a comprehensive diagnostic evaluation, including neurological assessment, instrumental methods such as a videofluoroscopic swallow study (VFSS) and a chest computed tomography (CT) scan, and non-instrumental scales for dysphagia and cognitive function. To quantify the severity of posterior sialorrhea, a Posterior Sialorrhea Intensity Visual Scale (PSIVS) ranging from 0 to 3 points was developed and applied. Efficacy was evaluated based on changes in sialorrhea intensity, feeding route, aspiration pneumonia incidence, and timing of tracheostomy decannulation.</p><p><strong>Results: </strong>By day 28 post-injection, the majority of patients in the Main group (54 out of 58) demonstrated a significant reduction in sialorrhea intensity to 0-1 points on the PSIVS, compared to 2-3 points at baseline. Following the reduction in sialorrhea and subsequent rehabilitation, 51 patients improved their feeding route, transitioning from tube or gastrostomy to oral or combined feeding. Decannulation was successfully performed in 14 patients. The incidence of aspiration pneumonia was 5.2% (3 cases) in the Main group, compared to 20.7% (12 cases) in the Control group. No serious adverse events were observed. Two patients experienced mild dry mouth, which resolved within one month.</p><p><strong>Conclusion: </strong>The integration of salivary gland chemodenervation with incobotulinumtoxinA (100 U) into the diagnostic and therapeutic algorithm for neurogenic dysphagia and posterior sialorrhea represents an effective and safe strategy for preventing aspiration complications. This intervention significantly reduces sialorrhea intensity and the incidence of aspiration pneumonia, enhances swallowing function, facilitates patient care, and improves rehabilitation outcomes for patients with severe neurological disorders, beginning in the acute phase. Adoption of this method in routine rehabilitation practice is recommended to decrease mortality and disability rates and to alleviate the financial burden on the healthcare system.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4","pages":"119"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944008","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 first experience of using tenecteplase for the thrombolytic therapy in ischemic stroke in the Russian Federation].","authors":"N A Glotova, R T Tairova, N A Marskaya, M A Soldatov, I L Gubskiy, K Yu Orlov, N A Shamalov","doi":"10.17116/jnevro202612602153","DOIUrl":"10.17116/jnevro202612602153","url":null,"abstract":"<p><p>Thrombolytic therapy (TLT) is an effective treatment for ischemic stroke (IS). Three fibrinolytic agents are currently registered in the Russian Federation for the treatment of IS, including tenecteplase, which has demonstrated high efficacy and safety in several randomized controlled trials. We present three clinical case reports of patients with IS who, for the first time in the Russian Federation, underwent TLT with the domestically produced biosimilar of tenecteplase, Nektelisa. In all three patients with IS, we observed significant regression of neurological deficits after administration of tenecteplase within the first hour after TLT. The dose was adjusted according to the instructions for use, taking into account the patient's body weight. In all three cases, the same neuroimaging method was used 24 hours after TLT as upon admission. No increase in the ischemic area was observed in any of the patients after 24 hours. In one case, a minor, clinically asymptomatic subarachnoid hemorrhage was detected, accompanied by rapid and complete recanalization of the occluded artery within the first 30 minutes after drug administration. In all three cases, we did not observe any other extracerebral hemorrhagic events. All patients were admitted with significant impairment of neurological functions and were discharged with mild or no significant impairment.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 2","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357447","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":"[Rapidly progressive cognitive impairment as a single clinical manifestation of anti-NMDA receptor encephalitis].","authors":"L L Korsunskaya, E B Pilipenko, A A Mikliaiev, N A Matyazhova, O S Levin, E E Vasenina","doi":"10.17116/jnevro202612604270","DOIUrl":"10.17116/jnevro202612604270","url":null,"abstract":"<p><p>Autoimmune encephalitides (AE) comprise a group of autoimmune diseases of the nervous system that primarily affect the brain's gray matter. The pathogenesis of AE is largely driven by the production of autoantibodies targeting intracellular and extracellular structures within the nervous system. The most extensively studied forms are those associated with antibodies targeting the NMDAR, AMPAR-, GABA<i>β</i>R-, LGI1, and Caspr2 extracellular antigens. Evidence suggests that anti-NMDA receptor encephalitis occurs more frequently than viral encephalitis in individuals under 30 years of age. Anti-NMDA receptor encephalitis is typically considered in young patients presenting with a primary psychotic episode, catatonia, or epileptic syndrome. However, literature indicates that anti-NMDA receptor encephalitis may present with only a single group of clinical manifestations, rather than the full spectrum of symptoms outlined in the diagnostic criteria, which include abnormal behavior, mental disorders or cognitive dysfunction, impaired consciousness, speech disorders, epileptic syndrome, motor disorders, and autonomic dysfunction. Such monosymptomatic variants can be challenging to diagnose due to mild, nonspecific symptoms and the limited diagnostic value of paraclinical data. We present a case of a patient with rapidly progressive cognitive and behavioral disorders, with no other clinical symptoms, who was diagnosed with anti-NMDA receptor encephalitis and was suspected of having a high titer of anti-NMDA receptor antibodies in both blood and cerebrospinal fluid. A good clinical response to immunosuppressive therapy, along with a recurrent course and repeated detection of autoantibodies in the cerebrospinal fluid, confirmed the primary assumption that the patient had a rare monosymptomatic variant of anti-NMDA receptor encephalitis.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4. Vyp. 2","pages":"70-77"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790418","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":"[Sleep disorders in Alzheimer's disease].","authors":"K A Kolmakova, V Yu Lobzin, A Yu Emelin","doi":"10.17116/jnevro202612604256","DOIUrl":"10.17116/jnevro202612604256","url":null,"abstract":"<p><p>This article investigates the progression of sleep disturbances in Alzheimer's disease (AD) and the mechanisms by which these disturbances may accelerate neurodegeneration. Key electrophysiological patterns identified through polysomnography in patients with AD and sleep disorders are analyzed. Therapeutic interventions are reviewed, with non-pharmacological and pharmacological approaches considered separately. The roles of cognitive behavioural therapy, relaxation techniques, and optimization of sleep conditions are emphasized. Current pharmacological treatment options are discussed, highlighting the need for careful drug selection due to the high risk of adverse effects and the potential dangers of certain medications, such as benzodiazepines and cyclopyrroles, in elderly patients with cognitive impairment. The use of memantine as a foundational therapy is given particular attention, as it may improve both cognitive function and sleep quality.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4. Vyp. 2","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790364","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":"[Clusterin as a biomarker for Alzheimer's disease].","authors":"O V Alpidovskaya, B V Tikhonov","doi":"10.17116/jnevro202612607122","DOIUrl":"https://doi.org/10.17116/jnevro202612607122","url":null,"abstract":"<p><strong>Objective: </strong>To examine and systematically review the existing literature regarding clusterin (CLU) as a potential biomarker for Alzheimer's disease.</p><p><strong>Material and methods: </strong>A comprehensive analysis of data, including generalization, comparison, and systematization, was conducted to review findings from both Russian and international publications. The study included a thorough search of the PubMed (MEDLINE) database and other scientific information sources over the last decade. The collected data underwent analytical scrutiny to elucidate the potential significance of CLU in AD pathogenesis.</p><p><strong>Results: </strong>This article presents evidence indicating that clusterin (CLU) may play a significant role in AD pathogenesis through various mechanisms, including regulation of inflammation, modulation of cellular apoptosis, facilitation of clearance of pathological proteins, and affecting oxidative stress and the aggregation and folding of extracellular proteins. CLU plays a vital role in promoting cell survival under stressful conditions. It offers protection against oxidative stress, ensuring both immediate resistance to damage and prolonged cellular viability. A loss of soluble clusterin (sCLU) protective function in response to ROS-induced damage may render neurons more susceptible to additional insults, such as A<i>β</i>, which generates H₂O₂ and other reactive oxygen species. Furthermore, CLU can activate the PI3K/Akt signaling pathway, which functions as an effector of mTOR and NF-<i>κ</i>B. Inhibition of mTOR has been associated with a slowing of AD progression. Notably, elevated plasma levels of CLU in healthy older adults may precede significant A<i>β</i> deposition in the brain by as much as ten years, suggesting an early elevation of CLU within the pathogenesis of AD and its potential pathological implications.</p><p><strong>Conclusions: </strong>Clusterin should be considered a significant biomarker for Alzheimer's disease, supporting the use of enzyme-linked immunosorbent assays to measure plasma CLU concentrations. This approach may serve as an additional tool for early screening and therapeutic interventions in Alzheimer's disease.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 7","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686864","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":"[Measurement of platelet enzymatic activities in assessing the clinical response to antipsychotic therapy in patients with late-onset schizophrenia-like psychoses].","authors":"O K Savushkina, I S Boksha, V V Pochueva, T A Prokhorova, E B Tereshkina, V S Sheshenin, E A Vorobyeva, G Sh Burbaeva","doi":"10.17116/jnevro2026126071123","DOIUrl":"https://doi.org/10.17116/jnevro2026126071123","url":null,"abstract":"<p><strong>Objective: </strong>To identify correlations between the levels of platelet enzyme activity and clinical responses to antipsychotic pharmacotherapy in patients diagnosed with late-onset manifesting schizophrenia-like psychosis (late-onset schizophrenia, LOS) and very late-onset manifesting schizophrenia-like psychosis (VLOSLP).</p><p><strong>Material and methods: </strong>The mental health status of 76 hospitalized patients with LOS and VLOSLP was evaluated using standardized psychometric scales at two time points: prior to the initiation of treatment and after a 28-day course of psychotropic therapy. Prior to treatment commencement, the activity levels of platelet enzymes involved in glutamate metabolism, energy metabolism, and glutathione antioxidant metabolism were measured for all subjects. A statistical analysis of the database with clinical and biochemical examination results, was conducted.</p><p><strong>Results: </strong>A comprehensive psychopathological assessment enabled the identification of patients exhibiting specific small-range delusions within their psychosis, notably «dwelling paranoid» delusions. It was observed that this type of delirium was predominantly present in patients with VLOSLP (X²=9.8, <i>p=</i>0.0018 with Yates correction). When participants were categorized into subgroups based on the presence or absence of «dwelling paranoid» delusions, a significant difference in platelet glutamate dehydrogenase activity was noted: patients exhibiting this type of delirium demonstrated significantly higher activity levels (<i>p=</i>0.009). Furthermore, several notable clinical and biological correlations were established between platelet enzyme activity levels and the clinical response to psychotropic therapy.</p><p><strong>Conclusions: </strong>The significant correlations identified between platelet enzyme activity levels prior to therapy and individual clinical responses to psychotropic interventions hold potential for prognostic applications in clinical psychiatry, particularly for patients with disorders along the schizophrenia spectrum in later life.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 7","pages":"123-132"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686946","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":"[Methods of surgical reinnervation of the facial nerve at different levels of traumatic injury: A prospective cohort study].","authors":"I M Shpitser, Yu I Makarova, F A Seleznev, O B Kulakov, D N Reshetov, R V Kutsenko","doi":"10.17116/jnevro202612607186","DOIUrl":"https://doi.org/10.17116/jnevro202612607186","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of various surgical strategies for reinnervating the facial nerve in patients who have sustained post-traumatic paralysis of the facial muscles.</p><p><strong>Material and methods: </strong>The cohort included six male patients with a mean age of 29±7 years. Depending on the level of nerve lesion-whether intra- or extratemporal-patients underwent either triple selective reinnervation or reinnervation via the hyoid nerve (XII), accompanied by intraoperative neurophysiological monitoring.</p><p><strong>Results: </strong>Evaluations using the House-Brackmann scale, needle electromyography, and eFACE scores indicated statistically significant improvements (<i>p</i><0.05) by 12 months of follow-up for all patients. These findings underscore the effectiveness of a tailored approach and the importance of neuromonitoring.</p><p><strong>Conclusions: </strong>The findings from this prospective study demonstrate the clinical efficacy of a differentiated surgical approach to facial nerve reinnervation in patients with post-traumatic paralysis of the facial muscles.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 7","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686999","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":"[High effectiveness of cognitive rehabilitation in the late recovery period after revascularization].","authors":"E V Isakova, S V Kotov, E S Guts, A D Chervinskaya, E S Ponomareva","doi":"10.17116/jnevro2026126042100","DOIUrl":"10.17116/jnevro2026126042100","url":null,"abstract":"<p><p>The article presents a clinical case of recovery of a patient after ischemic stroke with cognitive impairment, including aphasic disorders, and hemiparesis after systemic thrombolytic therapy and total selective endovascular mechanical thromboextraction, stent placement in the left ICA in the acute period, with a delayed start of further rehabilitation activities after nine months. The comprehensive rehabilitation program included classes with a computerized complex for training the upper limb with cognitive modules, modified mirror therapy, and classes with a speech therapist-neuropsychologist, and was aimed primarily at restoring cognitive functions, including all forms of impaired speech activity, through the cognitive load components of the program and restoring the movement function of the paretic right limb. Excellent outcomes were observed, confirmed by clinical and neuropsychological evaluations and electroencephalographic data, indicating a decrease in abnormal slow-wave activity and interhemispheric asymmetry after treatment.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4. Vyp. 2","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790392","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":"[Ketogenic diet in the treatment of drug-resistant epilepsy in children: Assessment of clinical efficacy, health care resource consumption, and direct medical costs].","authors":"E G Lukyanova, A G Tolkushin, S O Ayvazyan, K V Osipova, E A Pyrieva, A I Krapivkin, V A Zhestkov","doi":"10.17116/jnevro202612608186","DOIUrl":"10.17116/jnevro202612608186","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of the ketogenic diet (KD) on clinical outcomes, health resource consumption, including medication burden, hospitalization rates, and outpatient care, and direct medical costs (DMCs) in pediatric patients with drug-resistant epilepsy (DRE).</p><p><strong>Material and methods: </strong>A retrospective, non-interventional observational study was conducted at a specialized medical center. Data were collected from 58 children diagnosed with DRE: 29 patients received the ketogenic diet, while 29 patients comprised the comparison group. The clinical characteristics of epilepsy, frequency of seizures, efficacy of treatment, duration of the ketogenic diet, occurrence of adverse events, history of drug therapy, and the number of hospitalizations and outpatient consultations with a neurologist over two years were systematically evaluated. Based on the data obtained, the DMCs were calculated over 10 years.</p><p><strong>Results: </strong>The administration of the KD resulted in an average reduction of 83% in the number of epileptic seizures as compared to baseline (<i>p</i>=0.037) and a 78% decrease relative to the comparison group (<i>p</i>=0.013). The mean number of hospitalizations over two years was significantly lower in the KD group, with 2.70±3.22 hospitalizations compared to 10.14±7.79 in the comparison group (<i>p</i>=0.0001). Additionally, the number of consultations with a neurologist was markedly reduced (<i>p</i>=0.00001). By decreasing the consumption of health care resources - specifically, hospitalizations and outpatient neurological consultations - the DMCs over a ten-year horizon, excluding the cost of the ketogenic diet, were 3.05 times lower when utilizing the ketogenic diet; while maintaining observed trends in clinical efficacy, and taking into account the cost of the ketogenic diet, DMCs were reduced by approximately 130.000 rubles. The cost of antiepileptic medications accounted for a smaller share of DMCs, contributing 15% to overall expenditure.</p><p><strong>Conclusions: </strong>The application of the KD in children with DRE yielded favorable clinical outcomes, characterized by a significant reduction in seizure frequency, decreased consumption of health care resources, and financial savings on DMCs. These findings support the consideration of the KD as a clinically effective and cost-effective treatment approach compared to standard management practices for patients not receiving the KD.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 8","pages":"86-95"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868146","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}