Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova最新文献

{"title":"[Enhancing medical rehabilitation outcomes for patients following ischemic stroke].","authors":"V V Koval'chuk, N V Molodovskaya, N L Samus, K V Nesterin, Eh O Amanova, I V Koval'chuk, A V Shulyndin","doi":"10.17116/jnevro202612608260","DOIUrl":"https://doi.org/10.17116/jnevro202612608260","url":null,"abstract":"<p><strong>Objective: </strong>To improve the efficacy of medical rehabilitation interventions for patients in the late recovery phase following ischemic stroke (IS) and its associated sequelae.</p><p><strong>Material and methods: </strong>An analysis of treatment outcomes was conducted in 250 patients with IS evaluated between 6 and 12 months post-event (136 women and 114 men, with a mean age of 63±14 years, range 28-74 years). The study participants were divided into two groups: Group 1 received standard therapy and medical rehabilitation combined with Mexidol 500 mg (10 mL) administered parenterally for 14 days, followed by Mexidol FORTE 250 mg orally TID for an additional two months. Group 2 received only the standard therapy and medical rehabilitation. Various assessments were conducted, including evaluations of neurological deficits (using the Rivermead Mobility Index and the Scandinavian Stroke Scale), social and domestic adaptation (using the Barthel Index), cognitive and emotional status, and sleep quality. Furthermore, a comprehensive analysis of changes in functioning, activity, and participation was conducted in accordance with the domains outlined in the International Classification of Functioning, Disability and Health (ICF).</p><p><strong>Results: </strong>Participants in Group 1 showed statistically significant improvements in the assessed indicators compared with the control group. Additionally, marked improvements were observed in the key domains of functioning, task performance, and social participation, according to the ICF.</p><p><strong>Conclusions: </strong>The sequential therapy with Mexidol and Mexidol FORTE 250 mg notably enhances the recovery of motor, sensory, cognitive, and other neurological functions among patients in the late recovery phase post-IS, thereby facilitating better social and domestic adaptation, increased levels of activity and participation in life and society, along with improvements in emotional well-being.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 8. Vyp. 2","pages":"60-74"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893057","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":"[Modern approaches to the medical rehabilitation of stroke patients].","authors":"V E Aprelev, N I Spiridonova, A R Gabsalilov, Iu P Sofina, M P Fedotov, A A Ischeikin","doi":"10.17116/jnevro202612608282","DOIUrl":"https://doi.org/10.17116/jnevro202612608282","url":null,"abstract":"<p><p>Stroke continues to be one of the predominant causes of disability both In Russia and globally, profoundly affecting patients' quality of life. The article presents an overview of current methods of medical rehabilitation of stroke patients. Traditional and innovative approaches to health recovery are addressed. Special emphasis is placed on the current challenges in organizing medical rehabilitation services In Russia, along with proposed strategies to enhance their accessibility and quality.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 8. Vyp. 2","pages":"82-87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893060","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":"[Aneurysmal subarachnoid hemorrhage].","authors":"F A Yusupov, A A Yuldashev, A F Yusupov","doi":"10.17116/jnevro202612608228","DOIUrl":"https://doi.org/10.17116/jnevro202612608228","url":null,"abstract":"<p><p>Aneurysmal subarachnoid hemorrhage (SAH) is among the most critical acute cerebrovascular conditions, marked by high mortality rates, significant disability, and a considerable socio-economic burden. Women over 55 years of age, as well as individuals with arterial hypertension, hereditary predispositions, congenital vascular anomalies, and a history of smoking, are particularly susceptible. This article consolidates current data on the epidemiology, risk factors, pathogenesis, clinical presentation, and diagnosis of aneurysmal SAH. Special emphasis is placed on the mechanisms of early brain injury and delayed cerebral ischemia-two crucial factors influencing disease outcomes. Contemporary therapeutic strategies, including microsurgical clipping and endovascular embolization, are discussed in depth, addressing their indications, effectiveness, and associated risks. The significance of prompt diagnosis, specialized approaches, and patient management in neurovascular centers is highlighted. A systematic, multistage, and interdisciplinary strategy for managing patients with acute aneurysmal SAH is examined, demonstrating an approach that can enhance survival and improve functional outcomes while minimizing the risk of rebleeding and severe neurological deficits.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 8. Vyp. 2","pages":"28-36"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893068","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":"[Molecular and systemic mechanisms of cognitive impairment associated with coronavirus infection].","authors":"I V Shirolapov, A V Zakharov, D P Kurmaev, S V Bulgakova","doi":"10.17116/jnevro202612608140","DOIUrl":"https://doi.org/10.17116/jnevro202612608140","url":null,"abstract":"<p><p>Cognitive dysfunction represents a prevalent and long-lasting non-respiratory symptom following a protracted course of coronavirus infection, yet its molecular basis remains inadequately characterized. This review aims to present a comprehensive and systematic examination of the pathogenic mechanisms underlying cognitive impairment associated with COVID-19 and to consolidate current evidence on the critical processes linking SARS-CoV-2 infection to long-term neurological outcomes. Evidence indicates that cognitive deficits resulting from COVID-19 arise from a multifaceted interplay, including the virus's direct neurotropic effects, the emergence of neuroinflammation characterized by microglial and astrogliosis activation, disruption of the blood-brain barrier, and cerebrovascular complications. Additionally, systemic neuroendocrine alterations - including dysfunctions of the autonomic nervous system, hypothalamic-pituitary-adrenal axis, and monoamine metabolism - as well as diminished glymphatic clearance, are significant in the pathogenesis and are intricately associated with neuropsychiatric symptoms, thereby perpetuating the pathological processes. The notable molecular similarities with the early stages of neurodegenerative diseases suggest a potential risk for long-term acceleration of neurodegenerative processes in individuals experiencing post-COVID syndrome. Future research should focus on developing integrative diagnostic algorithms that combine biomarkers representative of various pathogenic processes with advanced neuroimaging techniques, organizing longitudinal studies to assess the time course of cognitive disorders, and formulating personalized therapeutic strategies to address key components of the identified pathogenic mechanisms.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 8","pages":"40-50"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867121","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":"[Healthy young adults with a family history of alcohol dependence: Suicidal ideation, anxiety, and «novelty-seeking»].","authors":"T V Merkulova, N A Chuprova, T A Goretskaya, V E Denisov, Yu L Arzumanov, A O Kibitov","doi":"10.17116/jnevro202612608196","DOIUrl":"https://doi.org/10.17116/jnevro202612608196","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the associations between a family history of alcohol dependence (AD) and the mental health disorders and personal traits of healthy young adults.</p><p><strong>Material and methods: </strong>The study included 95 healthy subjects, with an average age of 20.68±2.45 years, of whom 80.0% were women. The study utilized a self-administered questionnaire that included a comprehensive study map and psychometric scales. Participants were categorized into two groups: individuals without a relevant family history of AD and those with a relevant family history of AD. The latter group was further divided into two subgroups based on the family history: individuals with a moderate family burden of AD (1 relative with AD), designated, and those with a high family burden of AD (2 or more relatives with AD), designated. Comparative analyses were conducted across all study variables.</p><p><strong>Results: </strong>Several significant associations were identified between a family history of AD, particularly with a high burden, and various psychological and somatic indicators. Notably, there was a correlation between a family history of AD and affective symptoms, specifically the presence and severity of anxiety symptoms (<i>p=</i>0.003) as well as the suicidal ideation (<i>p=</i>0.015), but not attempted suicides. Additionally, a relationship was established with personality traits, particularly the propensity for «novelty-seeking» behaviors (<i>p=</i>0.001), and a potential link to eating disorders. Furthermore, a family history of AD was correlated with general somatic health, including associations with familial obesity (<i>p=</i>0.0002) and overall indicators of physical health.</p><p><strong>Conclusions: </strong>Future investigations with larger samples are essential to elucidate further the specific impacts of both the presence and grade of a family history of alcohol dependence, serving as a potential marker for the risk of developing mental health and substance use disorders at a preclinical stage.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 8","pages":"96-103"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868135","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":"[Analysis of therapy for schizotypal disorder with onset in childhood and adolescence at the acute and maintenance stages: results of a retrospective observational study].","authors":"S M Ivanova, O F Pankova","doi":"10.17116/jnevro202612604181","DOIUrl":"10.17116/jnevro202612604181","url":null,"abstract":"<p><strong>Objective: </strong>To perform a retrospective analysis of the treatment of patients with schizotypal disorder (STD) with onset in childhood and adolescence.</p><p><strong>Material and methods: </strong>Using random sampling, the study included 139 patients with schizotypal disorder (STD) diagnosed in childhood or adolescence during inpatient treatment from 1999 to 2018 and subsequently followed up by psychiatrists. The following assessment tools were used: the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) scale. In 37 (26.6%) patients, the STD transformed into schizophrenia. The STD sample included 102 (73.4%) patients with a clinical presentation meeting the diagnostic criteria for schizotypal disorder (F21) according to ICD-10 at the time of the study. Based on the predominant symptoms, four types of STD were identified: with polymorphic disorders (type I); with a predominance of psychopathy-like disorders (type II); with a predominance of neurosis-like disorders (type III); with a predominance of negative disorders (type IV).</p><p><strong>Results: </strong>The daily doses of neuroleptics (as chlorpromazine equivalent doses) varied over wide ranges, with different types of STD not statistically different from each other. The maintenance dose was higher than the acute dose in 63 (65.6%) patients, lower in 31 (32.3%) patients, and equal to the acute dose in 2 (2.1%) patients. 53.9% of patients received regular therapy, 8.8% refused treatment. The highest adherence to treatment was found in patients with types I (69.6%) and III (66.7%), the lowest in those with types II (45.5%) and IV (16.7%), without significant differences (<i>χ</i>²=4.638, <i>p=</i>0.2).</p><p><strong>Conclusion: </strong>STD therapy, especially in children and adolescents, has insufficient evidence base and requires confirmation of efficacy in large randomized studies. The results emphasize the importance of a personalized approach to pharmacotherapy with careful monitoring of side effects. Psychotherapeutic and rehabilitation interventions are promising but need further standardization and validation.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943888","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":"[Early signs of cognitive impairment: Definitions and diagnostic criteria].","authors":"A Yu Emelin, V Yu Lobzin","doi":"10.17116/jnevro202612604223","DOIUrl":"10.17116/jnevro202612604223","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a comparative analysis of existing approaches to determining the early stages of cognitive impairment, and based on the results, to propose a universal practical approach to their coding and develop diagnostic criteria.</p><p><strong>Material and methods: </strong>A comparative analysis of available literature data was performed, including Russian and international sources in the PubMed and eLibrary databases addressing the issues of determining, diagnosing, preventing, and treating the predementia stages of cognitive deficits.</p><p><strong>Results: </strong>The article discusses various options for identifying the predementia stages of cognitive impairment. Based on the analysis, it is proposed to use the universal term-the early signs of cognitive impairment-in everyday practice to encode the stage of cognitive impairment preceding the moderate cognitive impairment (MCI). The following diagnostic criteria are proposed: the symptoms of decreased memory, attention, and general mental activity presented independently or identified during an interview; the symptoms are repeated at least once a week and are not associated with any obvious reasons and external factors; extended neuropsychological examination can reveal deviations from the reference indicators; the presence of risk factors for the development of cognitive impairment; the duration of symptoms is at least 6 months; concern about their condition due to a feeling of a worse cognitive activity in comparison with other people of the same age; no MCI criteria are met.</p><p><strong>Conclusion: </strong>Early objective diagnosis of the initial stages of cognitive impairment is challenging even for trained, problem-oriented specialists; therefore, it is necessary to standardize and universalize the diagnostic criteria available at all stages of medical care. A comprehensive assessment of the symptoms, the circumstances of their occurrence, and their persistence and recurrence is necessary. Objective evidence of impairment should be standardized using a universal set of neuropsychological methods.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4. Vyp. 2","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790399","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":"[Post-stroke paralysis of the upper limb and non-contact computer control].","authors":"S V Prokopenko, D O Savchits, S A Subocheva","doi":"10.17116/jnevro202612603278","DOIUrl":"10.17116/jnevro202612603278","url":null,"abstract":"<p><p>Restoring upper limb functions in patients after a stroke remains a challenging medical and social task. The introduction of a human-computer interface based on computer vision enables combining motor training with the performance of practical tasks on a computer, laying the foundation for a new approach integrating rehabilitation into the patient's daily activities, thereby increasing adherence to treatment. The article presents two clinical cases of using the author's method of rehabilitation in male patients (47 and 73 years) with post-stroke paralysis of the upper limb. The method is based on non-contact computer control via shoulder joint movements, which provides core muscle training. After the training course, patients showed improvements: increased shoulder joint range of motion as measured by goniometry, decreased muscle spasticity, and improved performance on the Fugl-Meyer (upper limb) and Frenchay functional scales. The use of non-contact computer control via shoulder movements is promising for restoring motor function of the paretic limb and contributing to the patient's social adaptation.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 3. Vyp. 2","pages":"78-83"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629372","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":"[Influence of cognitive status on the effectiveness of geriatric rehabilitation: Data from the POSTSCRIPTUM study].","authors":"O N Tkacheva, N K Runikhina, M A Cherdak, N V Sharashkina, S N Lysenkov, E A Mkhitaryan, M S Arefyeva, E E Popov","doi":"10.17116/jnevro202612604213","DOIUrl":"10.17116/jnevro202612604213","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the influence of baseline cognitive status on the outcomes of geriatric rehabilitation in patients with different geriatric statuses, including patients with «cognitive frailty» syndrome.</p><p><strong>Material and methods: </strong>Subanalysis of a multicenter prospective POSTSCRIPTUM study evaluating the efficacy of 21-day geriatric rehabilitation programs based on the results of a comprehensive geriatric assessment (CGA) in patients 60 years of age and older. Based on CGA results, groups with the senile asthenia (AS) and preasthenia were identified; with a combination of cognitive impairment and AS, the «cognitive frailty» was diagnosed.</p><p><strong>Results: </strong>The analysis included 483 patients; AS syndrome was present in 35% of patients, and preasthenia was present in 60%. Mild cognitive impairment was diagnosed in 307 patients (64%); «cognitive frailty» syndrome was present in 125 subjects. Patients with cognitive impairment had poorer somatic status and a greater burden of cardiovascular diseases at baseline. The presence of cognitive impairment was associated with a poorer functional status even in the absence of dementia syndrome. The intervention resulted in a significant improvement in the geriatric status in all groups, including those with «cognitive frailty».</p><p><strong>Conclusion: </strong>Cognitive impairment is an important factor affecting the functional status of elderly patients. A 3-week multicomponent geriatric intervention improved functional, physical, and cognitive status, supporting further study to evaluate its potential to prevent dementia and optimize geriatric patient management.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 4. Vyp. 2","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790353","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":"[Problematic internet use by children with attention deficit hyperactivity disorder].","authors":"L S Chutko, E A Yakovenko, S Yu Surushkina, M D Didur, D V Cherednichenko, L V Scheglova, I B Sosnina, E V Snegova","doi":"10.17116/jnevro202612601169","DOIUrl":"10.17116/jnevro202612601169","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the clinical and psychophysiological characteristics of children with attention deficit hyperactivity disorder (ADHD), characterized by «problematic internet use» (PIU).</p><p><strong>Material and methods: </strong>The study group included 43 children aged 12-14 years with the most common combined type of ADHD and comorbid manifestations of PUI. The comparison group included 40 children aged 12-14 years with combined ADHD without signs of PUI. The control group consisted of 30 children aged 12-14 years without neuropsychiatric disorders. The following research methods were used in the study: the SNAP-IY questionnaire for quantitative assessment of ADHD manifestations, the CIAS scale for quantitative assessment of signs of tendency toward internet-addicted behavior, the CMAS (Comprehensive Anxiety Scale), the Strengths and Difficulties Questionnaire and the TOVA (Test of Variables of Attention) for assessing attention and impulsivity in relation to age-specific norms.</p><p><strong>Results: </strong>The study results showed that children with combined ADHD and PII had higher scores on inattention and impulsivity compared to children with isolated ADHD. Furthermore, children with combined ADHD and PUI were characterized by higher levels of anxiety and more pronounced social difficulties compared to children with isolated ADHD.</p><p><strong>Conclusion: </strong>Thus, more pronounced executive function impairments can be noted in the group of children with combined disorders.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"126 1","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144907","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}