Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova最新文献

{"title":"[Efficacy and safety of fonturacetam in asthenia: a systematic review and meta-analysis].","authors":"F I Devlikamova, D R Safina","doi":"10.17116/jnevro202512502169","DOIUrl":"10.17116/jnevro202512502169","url":null,"abstract":"<p><strong>Objective: </strong>To determine the efficacy and safety of Actitropil (fonturacetam) in asthenia.</p><p><strong>Material and methods: </strong>This meta-analysis includes the studies results on fonturacetam efficacy in asthenia. After checking for the risk of bias and the risk of systematic errors, the meta-analysis included 11 articles. The efficacy and safety of fonturacetam at a daily dose of 200 mg was assessed, since patients received this dose in all included studies.</p><p><strong>Results: </strong>The meta-analysis included 549 patients (mean age 45.9 years, 95% CI: 38.1-53.7). In all studies, the level of asthenia according to the MFI-20 scale was significantly reduced after a course of fonturacetam (one month course, assessment on the thirtieth day from the beginning of treatment), by an average of 16.3 points (95% CI: 8.85-23.85 points) (<i>p</i><0.0001). Additional effects of fonturacetam: positive effect on emotional background, sleep, cognitive functions, quality of life. High patient satisfaction with treatment was observed. During treatment with fonturacetam, the frequency of side effects averaged 5.5%. Side effects were transient and completely regressed within a week of continued treatment.</p><p><strong>Conclusion: </strong>Fonturacetam effectively reduces the level of asthenic syndrome after a month of therapy.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 2","pages":"69-79"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569024","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 diagnosis and treatment of postinfectious asthenic syndrome in children].","authors":"S A Nemkova","doi":"10.17116/jnevro202512504142","DOIUrl":"10.17116/jnevro202512504142","url":null,"abstract":"<p><p>The article is devoted to an urgent problem - the diagnosis and treatment of Postinfectious asthenic syndrome in children and adolescents. The issues of etiology and pathogenesis, classification and clinical manifestations of postinfectious asthenia in children are considered in detail. Special attention is paid to the asthenic syndrome after acute respiratory viral infections and influenza, neuroinfections, and coronavirus infection. The high efficacy of the drug Mexidol in the prevention and comprehensive correction of postinfectious asthenic disorders, as well as concomitant autonomic, cognitive and emotional disorders in children and adolescents has been shown.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4","pages":"42-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047068","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":"[Clinical and psychopathological features of treatment-resistant schizophrenia].","authors":"M A Kaydan, L V Bravve","doi":"10.17116/jnevro202512502143","DOIUrl":"10.17116/jnevro202512502143","url":null,"abstract":"<p><strong>Objective: </strong>To study the psychopathological structure of resistant schizophrenia with the distinguishing of various clinical variants.</p><p><strong>Material and methods: </strong>The study was conducted at emergency departments of the round-the-clock Psychiatric Clinical Hospital No.1, named after N.A. Alekseev. One hundred twelve patients with a diagnosis of schizophrenia were examined using clinical psychopathological and psychometric methods as standardized scales (PANSS and BFCRS).</p><p><strong>Results: </strong>Three clinical variants have been identified: impaired reasoning and perception with a predominance of delusional disorders, catatonic disorders with a predominance of oneiroid confusion, and impaired behavior and affect with a predominance of aggression. The earliest onset age of 17.1±3.2 years was found in the clinical variant with behavioral impairment (<i>p=</i>0.022). In the clinical variant with impaired reasoning, there were statistically significant differences (<i>p</i><0.05) in the sum of scores on the PANSS-P subscale - 31.7±3.1; on P1 «Delusions» - 6.5±0.6; P2 «Conceptual disorganization» - 5.9±1.6; P3 «Hallucinations» - 6±0.3; G4 «Tension» - 5.5±0.6; G9 «Unusual thought content» - 5±0.8.</p><p><strong>Conclusion: </strong>The study of resistant schizophrenia with the identification of disorders in various areas of mental activity and the determination of their quantitative indicators is a promising area of research, as it helps to identify risk groups for the development of resistance and develop new strategies for overcoming it.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 2","pages":"43-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569007","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":"[Adult leukoencephalopathy with axonal spheroids and pigmented glia].","authors":"U N Rushkevich, T S Pavlovskaya, O N Levshuk, D A Antonenko, S A Likhachev, E V Malgina","doi":"10.17116/jnevro2025125021130","DOIUrl":"10.17116/jnevro2025125021130","url":null,"abstract":"<p><p>Adult leukoencephalopathy with axonal spheroids and pigmented glia is a rare neurological disease characterized by brain white matter demyelination, axonal edema, and glial cell pigmentation. The disease is associated with mutations in the <i>CSF1R</i> gene encoding the colony-stimulating factor 1 receptor. Adult leukoencephalopathy with axonal spheroids and pigmented glia is characterized by cognitive and motor disorders, rapid steady progression, and an autosomal dominant inheritance. The variability and nonspecificity of the clinical manifestations of this condition cause a high rate of misdiagnosis of diseases such as Alzheimer's disease, frontotemporal dementia, Parkinson's disease, multiple sclerosis, normotensive hydrocephalus, Creutzfeldt-Jakob disease, etc. The true prevalence of the disease is unknown due to the low awareness of doctors, and therefore, a significant proportion of cases remain unrecognized. The article presents the authors' observation of a family case of adult leukoencephalopathy with axonal spheroids and pigmented glia, identified by targeted panel sequencing.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 2","pages":"130-136"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568976","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":"[Mental disorders in military personnel at the stage of medical care in a multidisciplinary military medical organization].","authors":"A V Esipov, M A Samushia, A F Ivolgin, A Yu Kozachuk, I A Elina, I V Eremitsky, E D Kochereva, M A Koveshnikov","doi":"10.17116/jnevro202512506137","DOIUrl":"https://doi.org/10.17116/jnevro202512506137","url":null,"abstract":"<p><strong>Objective: </strong>To study the clinical and psychopathological structure of mental disorders associated with combat stress in the first 6 months from the moment of injury among the sanitary losses of servicemen receiving medical care in a multidisciplinary military hospital and to determine the relationship of the reported mental disorders with premorbid personal traits.</p><p><strong>Material and methods: </strong>A single-center cohort prospective study was conducted at the Central Military Clinical Hospital, A.A. Vishnevsky (Krasnogorsk, Russia). The study examined 27 service members hospitalized in different somatic departments from October 2022 to June 2023. The mean age of the examined subjects was 36.0 years (28.25; 45.0). The duration of commitment was 5.73 months (2.83; 10.74). The duration of the period since the injury was 2.07 months (0.47; 5.88). The clinical-psychopathological, psychometric, and statistical methods of the study were used.</p><p><strong>Results: </strong>The data obtained showed two groups of combatants, differing in the types of emotional-behavioral stress response and mental state. The first group is «military timogenies» as part of the F43 diagnosis «Reaction to severe stress and adjustment disorders» (<i>n</i>=22). In the psychopathological structure of this group, the leading role was played by anxiety disorders with a distinct hypothymic component with episodes of obsessive, realistic memories of hostilities, incomplete postconcussive syndrome, and conversion disorders. The second group included patients with reactive paranoid symptoms that developed in the prehospital or in-hospital stages (<i>n</i>=5), qualified under F23, «Acute and transient psychotic disorders.» A distinctive feature of the patients of this group was the prevailing premorbid paranoia accentuation, which was further reflected in the clinical presentation of psychosis closely related to the conditions of combat stress.</p><p><strong>Conclusion: </strong>The obtained results make it possible to draw preliminary conclusions about the absence of differences in the clinical forms of reactive psychotic disorders and adjustment disorders in the context of modern warfare in comparison with the wars of the 20th century.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 6","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512839","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":"[Clinical and instrumental diagnostics of facial neuropathy in children].","authors":"E Yu Skripchenko, M A Irikova, N V Skripchenko, A V Klimkin, Yu P Vasilyeva, P S Susloparova, V B Voitenkov","doi":"10.17116/jnevro202512506131","DOIUrl":"https://doi.org/10.17116/jnevro202512506131","url":null,"abstract":"<p><p>A review of the literature and the authors' own long-term experience of developing and implementing into practice an algorithm for clinical and instrumental diagnostics of facial nerve neuropathy in children are presented, allowing, in the early stages of the disease, taking into account the identified values of prognostically significant indicators, to predict the outcome of the disease and develop an individual medical rehabilitation program to achieve maximum restoration of nerve function. The expediency of using Cytoflavin (Inosine+Nicotinamide+Riboflavin+Succinic acid) as a drug with complex action in the treatment of severe neuropathies of the facial nerve is reflected.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 6","pages":"31-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512874","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":"[Cognitive impairment in patients with multiple sclerosis].","authors":"O S Levin, M N Zakharova, A V Shemiakina","doi":"10.17116/jnevro202512504267","DOIUrl":"https://doi.org/10.17116/jnevro202512504267","url":null,"abstract":"<p><p>Cognitive impairment (CI), along with physical disability, is the most important clinical manifestation of multiple sclerosis MS and is detected in 40-70% of patients. Present in all types and forms of MS, it has a significant negative impact on social adaptation, ability to work and daily activity. Most often, CI includes problems with information processing speed, memory, visual-spatial perception and regulatory functions. At the moment, there is no single theory explaining the pathogenesis of CI. It is believed to be associated with lesions in white and gray matter, which are not visible on MRI, as well as neuroimmunological processes that disrupt synaptic transmission and plasticity. Therapeutic strategies in the treatment of CI are also ambiguous: there is evidence of minimal to moderate efficacy of drugs that alter the course of MS (PITMS), especially PITMS 2 lines, and symptomatic therapy. However, the greatest effect was noted in cognitive training. Screening for CI during routine examination of patients with MS becomes more convenient thanks to short scales and tools, which in turn allows specialists to carry out timely therapeutic and preventive measures. In our review, we tried to analyze updated data on the prevalence, structure, pathogenesis and therapy of CI in MS patients.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4. Vyp. 2","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152806","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 patients with Lewy body dementia and Parkinson's disease].","authors":"K A Kolmakova, A Yu Emelin, V Yu Lobzin, T V Bodrova, I V Litvinenko","doi":"10.17116/jnevro202512504281","DOIUrl":"https://doi.org/10.17116/jnevro202512504281","url":null,"abstract":"<p><p><i>The</i> article discusses the features of sleep disorders in patients with Lewy body dementia and Parkinson's disease. The focus is on behavioral disorders during the rapid eye movement phase, which are manifested by active movements and aggressive sleep behavior, as well as other sleep disorders, such as insomnia and excessive daytime sleepiness. The mechanisms of development of these disorders and their impact on the quality of life of patients and their relatives are described. Current approaches to diagnosing and treating these conditions, including pharmacotherapy and non-drug correction methods, are discussed.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4. Vyp. 2","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152765","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 main mechanisms of development of cognitive impairment].","authors":"A N Bogolepova","doi":"10.17116/jnevro202512504213","DOIUrl":"https://doi.org/10.17116/jnevro202512504213","url":null,"abstract":"<p><p>Cognitive impairments (CI) are one of the most important problems of modern clinical neurology, which is due to their high prevalence and degree of disability. In most cases, cognitive impairments progress. The development of CI is inevitably associated with the loss of neurons and interneuronal synaptic connections. Possible mechanisms for the development of CI include a deficiency of neurotrophic factors, disorders of neurotransmitter systems, impaired energy metabolism and mitochondrial dysfunction, oxidative stress, neuroinflammation, and damage to the blood-brain barrier. Chronic cerebral hypoperfusion is probably one of the main causes, since it occurs at the initial stages of not only cerebrovascular but also neurodegenerative damage. It links together some of the mechanisms of cognitive impairment, such as chronic inflammation, oxidative stress, neurodegeneration, and brain atrophy. One of the drugs for the treatment of CI is Mexidol, a drug with a multimodal effect, including antioxidant, antihypoxant and membrane-protective properties. The clinical efficacy of Mexidol in relation to moderate CI was confirmed by meta-analysis data from 10 prospective clinical studies.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 4. Vyp. 2","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152769","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":"[Treatment features of patients with vascular cognitive impairments].","authors":"G N Belskaya","doi":"10.17116/jnevro202512505169","DOIUrl":"https://doi.org/10.17116/jnevro202512505169","url":null,"abstract":"<p><p>Vascular cognitive impairment (CI) is an urgent medical problem due to its high prevalence, progressive course, and high degree of disability. CI may be associated not only with the direct effects of stroke, but also with the presence of premorbid cognitive decline of both vascular and neurodegenerative nature. In addition to vascular risk factors, there are a number of factors leading to dementia, and the heterogeneity of the nature of CI is noted. The management of patients with CI is complicated due to the comorbidity of most of them, as well as low adherence to medical recommendations. The review is devoted to the consideration of the possibility of complex therapy, including non-drug, medical treatment methods, as well as lifestyle changes that affect modifiable risk factors for vascular dementia. Data are presented on the expediency of using a prolonged form of pentoxifylline (Vasonit) in a daily dosage of 600-1200 mg in the complex treatment of patients with CI (including those caused by chronic cerebral ischemia) in terms of efficacy and safety, as well as improving patient compliance. To illustrate, a clinical example is given based on our own experience using Vasonite.</p>","PeriodicalId":56370,"journal":{"name":"Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova","volume":"125 5","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210320","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}