Purpose. The study is focused on glioarchitectonics of the neocortex, archicortex and amygdala of Wistar white rats in normal state and after a 20-minute occlusion of the common carotid arteries.

Materials and methods. Light (stained with hematoxylin and eosin) microscopy, immunohistochemistry (GFAP), and morphometry were used to study the distribution, shape, and area of GFAP-immunopositive brain cells in the normal range (n = 5) and at days 1, 3, 7, 14, 30 (n = 25) after acute ischemia.

Results. Focal changes were found in the density of the glial network: decrease and increase in the local content of GFAP-positive material. Reactive, dystrophic and necrobiotic changes in neurons after acute ischemia were accompanied by reorganization of neuroglia and increase in the neuroglia index in certain zones by 1.2–1.5 times. The surface area of the particles in GFAP-positive astrocytes in sections of the neocortex in the control was 8.4–18.1, but after 3 days after ischemia this rate in some parts of the neocortex rose to 45.0–59.3%. In the hippocampus this rate was 8.1% and 16.2%, and in the amygdala it was 12.6% and 21.2%. Hypertrophy of mature astrocytes was manifested by the increase in the diameter, degree of branching and length of their processes.

Conclusion. The obtained data are considered as a phenomenon of ischemic preconditioning and activation of protective processes in neuro-glio-vascular microcomplexes. 

Aim. To study the relationship between the dynamics of serum concentrations of interleukin-1β, interleukin-6 and interleukin-10 with clinical data in the acute period of ischemic stroke, and the strategy of reperfusion therapy.

Materials and methods. In 28 patients with acute ischemic stroke, half of whom underwent intravenous thrombolysis, the concentration of interleukin-1β, interleukin-6 and interleukin-10 was assessed at admission, on the 3rd and 10th day of the disease.

Results. The concentration of interleukin-1β and interleukin-6 decreases during the acute period of stroke. The concentration of interleukin-10 remains unchanged for the first 10 days since the development of stroke. When thrombolysis is performed, there is a more significant decrease in interleukin-1β concentration in the hyperacute period of stroke, whereas in patients without reperfusion there is a decrease in interleukin-6 concentration from 1 to 10 days. The concentration of cytokines is associated with age, lipid spectrum, severity of carotid atherosclerosis, myocardial hypertrophy and injection fraction of the heart. Only in the subgroup of thrombolysis, correlations of cytokine concentrations with systolic blood pressure at admission, hemoglobin concentration, total cholesterol and high-density lipoproteins, hematocrit, degree of stenosis of the contralateral carotid artery, injection fraction and the number of antihypertensive drugs prescribed in the hospital were recorded. The concentration of interleukin-6 at day 10 is associated with the severity of stroke at admission, and the level of IL-10 on day 3 of the disease, with the mobility of patients at discharge.

Conclusions. In the hyperacute period of stroke, there is a decrease in the pro-inflammatory activity of blood serum, more pronounced in patients undergoing systemic thrombolysis. Concentrations of interleukin1β, interleukin-6 and interleukin-10 are associated with a wide range of parameters characterizing the cardiovascular and functional status, and the pattern of these associations differs depending on the reperfusion therapy strategy. 

Background. There is evidence that sleep disorders may be significantly linked to the development of the substance use disorders (SUD). However, data about the prevalence of the sleep disturbances among patients with SUD in Russia are relatively limited.

Aim. To evaluate the frequency of the sleep disturbances among patients (n = 196) with alcohol (ÀD, n = 102), opioid (ÎD, n = 55) and polysubstance dependence (PD, n = 39) seeking addiction medical care.

Materials and methods. We conduct a cross-sectional study of sleep disturbances among patients in St. Petersburg in 2017–2018. The modified Insomnia Severity Index (ISI) was administered to assess sleep during different periods of time: lifetime, the past 12 months, and the past 30 days.

Results. All groups demonstrated relatively high presence of different sleep disorders (range: 49.0–76.5% among 196). The sleep disturbances over the past 30 days were more common in the AD group (60.8– 73.5% among 102) with the early morning awakening as the most frequent complaint. In the PD group the prevalence of lifetime sleep disturbances was high (94.9–100.0% among 39), whereas insomnia disorders were relatively rare over the past 30 days. However, it was sleep disturbances over the past 30 days that were statistically significantly more often (p < 0,05) observed in the group of patients who actively consume narcotic substances (40.2–87.2%), compared with the group of patients in remission (0–16.7%).

Conclusion. The results demonstrated the high prevalence of insomnia among patients with SUD and suggested that the remission have a positive effect on the symptoms of sleep disorders. Further studies of the association between sleep disturbances and SUD progression are needed. 

Objective: to identify constitutional and morphological predisposition to akathisia in schizophrenic patients receiving antipsychotic therapy.

Materials and methods. 250 patients with schizophrenia receiving basic antipsychotic therapy were studied, aged 40 [32; 50] years old; disease duration was 13 [7; 22] years. The age when the schizophrenic process manifested itself was 23 [19; 30] years. Clinical evaluation of akathisia was performed using the Barnes Akathisia Scale (BARS, BAS), so akathisia was detected in 92 (36.8%) patients. All persons included in the study underwent an anthropometric survey according to the Bunak’s method. Statistical analysis was performed using Statistica for Windows software (V. 12.0), the odds ratio was estimated using the MedCalc® online calculator.

Results. The comparative analysis of the Rees – Eysenk body index and Tanner stages in groups of schizophrenic patients receiving antipsychotic therapy with and without akathisia showed no significant differences between them (p = 0.317 and p = 0.347, respectively). Comparison of groups in the distribution of constitutional and morphological types also revealed no statistical differences (p = 0.189). Patients with the andromorphic type of somatic sexual differentiation increased the risk of antipsychotic-induced akathisia (OR = 1.73; 95% CI: 1.02–2.94; p = 0.039) almost twofold.

Conclusion. Attribution of patients to different constitutional and morphological types does not play a role in the development of antipsychotic-induced akathisia, unlike attribution to andromorphic somatic sexual differentiation types, which significantly increases its risk. 

The aim of the study was to investigate vegetative maintenance of the activity and state of systemic hemodynamics in patients with a first time, non-traumatic epileptic seizure during a tilt table test (TTT).

Materials and methods. TTT was performed in 42 patients with absence of seizures and 78 patients having experienced unprovoked seizures. A control group included 70 patients with non-epileptic seizures with transient loss of consciousness (TLC), defined as syncope. The control group included 38 people without episodes of loss of consciousness in their medical history. The parameters of hemodynamics and heart rate variability (HRV) were investigated at all stages of the test.

Results. In patients with absence of seizures, initial sympathicotonia was recorded along with a decrease in ergotropic activation in orthostasis. In patients with unprovoked seizures, a hypersympathicotonic response to the orthostatic test was detected in combination with impaired vagal overshoot in the clinostatic phase of the test. In patients with TLC, evidence of vegetative insufficiency in the vertical position was identified, with the indicators going back to the background values in the horizontal position.

Conclusion. The revealed features of vegetative regulation in patients with absence of seizures and unprovoked seizures will allow to differentiate the mechanism of the first-time epileptic seizure more accurately. 

Background. Using external robotic tools in rehabilitation of patients after stroke could activate neuroplasticity mechanisms, thus reducing the ischemic area and improving the neurological outcome of the disease.

Aim. To evaluate the effectiveness of early rehabilitation of stroke patients in Tomsk Regional Stroke Center using assistive robotic tools by correlational analysis of clinical and laboratory biomarkers of brain neuroplasticity.

Materials and methods. The study included 68 patients who suffered from stroke of the middle cerebral artery. Early rehabilitation was carried out in Tomsk Regional Stroke Center using assistive robotic tools according to the protocol. Neurotrophic factors in blood serum were measured by the enzyme-linked immunosorbent assay. The severity of neurological disorders was characterized based on the Fugl – Meyer assessment scale (FMA).

Results. The clinical effectiveness of early motor rehabilitation in Tomsk Regional Stroke Center is confirmed by the statistically significant increase on the FMA scale by 5.2 ± 2.4 points (p = 0.008). Positive association between neurotrophic factors in blood serum and FMA total score enables to consider the resulting data as an evidence of neuroplasticity activation associated with the use of robotic electromechanical technologies. 

Objective. To study in cross-sectional research the association of actual nutrition with estimates of cognitive function (CF) in the population of men and women of middle and older age (45–69 years).

Materials and methods. The study was conducted in the framework of the international project HAPIEE on a random subsample (2,159 men, 2,525 women) of residents of Novosibirsk. Evaluation of CF was carried out using standard methods (test for direct reproduction of 10 words, test for speech activity (associative thinking) and test for delayed reproduction). Nutrition data was obtained from population surveys in the HAPIEE project using a questionnaire to assess the frequency of food consumption. Statistical data processing was performed using the SPSS 13.0 application package. The GLM procedure was used, allowing to take into account the influence of related factors. Differences were considered statistically significant at p < 0.05.

Results. The presence of a significant correlation between the actual nutrition with standardization by age, body mass index and level of education with CF estimates was found. It has been shown that higher consumption of fruits and vegetables was significantly associated with higher scores in both men and women. Women, unlike men, also showed significantly higher CF estimates for consumption of rice, meat products and dairy products. In addition, there was a negative association of CF with the consumption of a number of products. Men showed a significant decrease in the estimates of CF with the consumption of sugar and fats; in women, in the consumption of white bread, sugar and fat.

Conclusion: the results of our study showed the presence of a significant association of CF estimates with the level of consumption of a number of products, both positive and negative, in middle-aged and older people. These data may be useful in the development of nutritional recommendations for the prevention of violations of CF. 

The aim is to identify the priority directions for preventing mental disorders in disabled children following a comprehensive analysis of clinical, social, psychological, ethnic and cultural characteristics over 2009– 2017. Materials and methods. 2,204 people were included in the study: disabled children, students of remedial schools aged 7–18 years old (n = 834); parents of disabled children (n = 772); teachers working in various educational facilities (n = 217); respondents of the survey identifying people’s attitude towards children with disabilities (schoolchildren, students, adults, n = 381). Clinical, psychological and statistical methods were used in the study. To identify depression and anxiety in children, Children’s Depression Inventory (CDI), Childhood Myositis Assessment Scale (CMAS), PedsQL inventory, survey on coping strategies (E. Heim) and adapted questionnaires for suicidal risk and alexithymia were used. For adult participants, the Quality of Life Scale, Hamilton Anxiety Rating Scale, Hospital Anxiety and Depression Scale (HADS), and a questionnaire identifying the attitude towards children with disabilities were applied.

Results. A high prevalence of mental disorders in children with disabilities (62.7–95.2%) was identified, and the levels of anxiety, suicidal risk, alexithymia were determined. Children’s families were characterized by impaired structure (50%), parenting styles resulting in pathologies (71.5%), low income level (60%), low qualifications of parents and unemployment (13%), alcohol abuse (17.6%), victimized attitudes and low satisfaction with the psychological criteria of quality of life, combined with low level of anxiety. For teachers, the levels of anxiety and depression and signs of burnout were revealed, and the features of their interaction with disabled children in the educational process were described. The attitude of different social groups to children with disabilities was studied. The methodological conditions for carrying out research and organizing medical and psychological care were formulated.

Conclusion. Prevention of mental disorders in disabled children includes identification of early signs of anxiety, depression, suicidal risk and assessment of the quality of life and work. This is ensured by a reasonable choice of research methods, psychosocial rehabilitation with involvement of beloved people, and increase in the tolerance level towards children with disabilities in the society. 

Introduction. After exposure to radiation, an increase in the long-term of cerebrovascular pathology is noted in exposed individuals. Cognitive impairments have a growing importance in the pattern of cerebrovascular diseases which significantly deteriorates social and medical forecast of a patient.

The objective of the research is to study cognitive evoked potentials in exposed persons with chronic cerebral ischemia (CCI).

Materials and methods. Two groups of patients were examined: the main group consisted of 69 persons exposed to radiation as a result of the “Mayak” PA activity, the comparison group included 110 unexposed residents of the Techa riverside settlements who were diagnosed with chronic cerebral ischemia. The following methods were used in the study: clinical, evaluation method of cognitive evoked potentials (EP), and statistical methods.

Results. In the course of clinical examination, it was revealed that the number of people with organic cognitive impairment and syndrome of cognitive decline is statistically significantly higher in the group of the exposed persons with CCI (p < 0.001, p = 0.003, respectfully). It was stated that the studied groups were statistically significantly different in N1 peak latency (ð = 0.030), N2 – P3 inter-peak latency (p = 0.003), N2 – N3 inter-peak latency (p = 0.011).

Conclusion. According to the results of clinical examination and study of cognitive EP, cognitive impairments are more expressed in the group of the exposed persons with CCI which is manifested in an increase in the number of patients with syndrome of cognitive decline and organic cognitive impairment in this group; in the change of a latency period of a number of components that characterize both the perception process and the very process of recognition and decision-making.

Background. Nowadays many efforts are taken in searching for Parkinson’s disease biomarkers, especially for an early recognition of the disease. The gut microbiota is one of the potential sources of biomarkers, changes in the composition of which in PD are actively studied.

The aim of this study is to identify microbiota biomarkers in the Parkinson’s disease with an estimated accuracy of the diagnostics, including differential diagnostics, relative to other neurological diseases for patients of the Russian population.

Material and methods. One hundred ninety-two metagenomics profiles from patients with Parkinson’s disease (n = 93), people with other neurological diagnoses (n = 33), and healthy controls (n = 66) were included in this study. These profiles were obtained with amplicon sequencing of bacterial 16S rRNA genes. Classifying models were made using the naive Bayes classifier, the artificial neural network, support vector machine, generalized linear model, and partial least squares regression.

As a result we established that an optimal classification by the composition of the gut microbiota on the validation sample (sensitivity 91.30%, specificity 91.67% at 91.49% accuracy) amid patients was demonstrated with a naive Bayes classifier using the representation of the following genera as predictors: Christensenella, Methanobrevibacter, Leuconostoc, Enterococcus, Catabacter, Desulfovibrio, Sphingomonas, Yokenella, Atopobium, Fusicatenibacter, Cloacibacillus, Bulleidia, Acetanaerobacterium, and Staphylococcus.

Conclusions. Information of the gut microbiota taxonomic composition may be used in differential diagnosis of Parkinson’s disease. 

Background. Neurodegenerative processes play an important role in the development of clinical features of multiple sclerosis (MS) as well as in the progression of the disease. At the same time, neurodegenerative mechanisms of MS are not completely clear, which makes researchers pay special attention to pathogenetic aspects of the disease that have not been studied before. Previously it was shown that MS patients can have alterations in the local cerebral blood flow, however, the meaning of the detected abnormalities is still not clear.

The aim of our work is to evaluate the perfusion character in the demyelinating lesions and normalappearing brain structures, and to determine their relation to clinical features of MS.

Material and methods. 49 patients with relapsing-remitting and secondary progressive MS with clinical and MRI remission were included in the study. The patients underwent contrast-enhanced MR perfusion of the brain on the 3 Tesla MR-tomograph, as well as the Functional System Score, Expanded Disability Status Score and Fatigue Status Score evaluation. The data analysis included automatic construction of perfusion maps of the cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) values in the normal-appearing brain structures and in the demyelinating lesions and statistical analysis.

Results. The received results allow to presume that variation of CBV values in MS lesions can indicate heterogeneity of processes in these lesions – from reactivation of inflammation to remyelination.

Significant reduction of perfusion in nucleus lenticularis was revealed. This reduction did not depend on the severity of the disease and correlated negatively with the fatigue score. This allows to suppose that the therapy focused on brain perfusion improvement can be used as symptomatic therapy of MS. Considering the fact that regional hypoperfusion precedes the development of brain structure atrophy, it is hypothesized that the improvement of perfusion may prevent neurodegeneration in MS. The obtained findings need further investigation. 

The aim was to study the clinical-psychopathological, clinical-follow-up, clinical-dynamic features of mood disorders (MD) and alcohol use disorder (AUD) with their comorbidity combinations.

Materials and methods. The study included 88 people with AUD and MD: 33 women (37.5%) and 55 (62.5%) men. The first group was 31 patients (35,0%) with AUD without comorbid affective symptoms, the second was 29 patients (33.0%) with MD without alcohol dependence, and the third was 28 patients (32.0%) with comorbid AUD and MD. There were no statistically significant differences between the groups by age and sex composition, by the level of statistical significance of differences (p = 0.115 – by sex, ð = 0.248 – by age). The study used clinical, psychopathological, clinical and follow-up, clinical, dynamic and statistical methods. Statistical processing was performed using Pearson’s χ2, Mann – Whitney U-test for comparing independent samples and Spearman’s correlation analysis (r).

Results. Patients of the second and third groups were diagnosed with dysthymia more rarely in statistically significant values by the level of statistical significance of differences (10.4% and 32.1% respectively, p = 0.023) and this testifies to MD taking chronic course in patients with AUD. The average duration of bout of heavy-drinking in the first group was longer than in the third group – 7 (4; 17) and 5,5 (3.5; 9.5) days accordingly (p = 0.043). Duration of the disease in the first and third groups was 10 (6; 18.5) and 14 (10; 19.75) years, respectively (p = 0.036). It confirms the negative impact of comorbidity on the clinicaldynamic features in the case of co-existing of AUD and MD.

Conclusion. The coexistence of alcohol dependence and affective pathology enhances the suicidal risk of certain diseases. A tendency to the early appearance of symptoms of AUD and their rapid dynamics, a shorter duration of light intervals of MD and AUC, a relatively low tolerance to alcohol and pronounced depressogenic effect of alcohol in the case of comorbidity were found. 

The aim of our study was to study the relationship between the CYP2C19 genetic polymorphism and the efficacy and safety of diazepam in patients with alcohol withdrawal syndrome in order to develop algorithms for optimizing the therapy of diazepam to reduce the risk of dose-dependent adverse drug reactions and pharmacoresistance.

Materials and methods. The study was conducted on 30 Russian male patients suffering from alcohol withdrawal syndrome. For the treatment of anxiety, fear and emotional tension, patients received diazepam in injections at a dosage of 30,0 mg / day for 5 days. Genotyping was performed by real-time polymerase chain reaction with allele-specific hybridization. The efficacy and safety assessment was performed using psychometric scales and scales for assessing the severity of adverse drug reactions: the Clinical Institute Withdrawal Assessment for Alcohol scale, the visual-analogue scale of the craving for alcohol, and the side-effect scale.

Results. Based on the results of the study, we revealed the differences in the efficacy of therapy in patients with different CYP2C19 -806C>T genotypes: (CC) –12,0 [–15,0; –8,0], (CT + TT) –7.0 [–14,0; –5,0], p = 0,001. The scores on the UKU scale, which was used to evaluate the safety of therapy, were also different: (CC) 8,0 [6,0; 12,0], (CT + TT) 6,0 [6,0; 12,0], p = 0,006.

Conclusion. The relationships between the CYP2C19 genetic polymorphism and the efficacy and safety of diazepam were demonstrated. This should be taken into consideration when prescribing this drug to such patients in order to reduce the risk of adverse drug reactions and pharmacoresistance. 

Objective: to study the probable laboratory predictors of aggressive multiple sclerosis.

Materials and methods. Antibodies to myelin oligodendrocyte glycoprotein (MOG), antibodies to thyroperoxidase and markers of endothelial dysfunction in blood serum were determined in patients with multiple sclerosis (MS). These indicators were analyzed for different courses of the demyelinating process, for different severity of neurological disorders, and for various sizes of focal lesions on magnetic resonance images.

Results. In patients with aggressive multiple sclerosis, higher titers of antibodies to both myelin oligodendrocyte glycoprotein and thyroperoxidase were detected. A relationship between von Willebrand factor (vWf) and matrix metalloproteinase-9 (MMP-9) and the stage of multiple sclerosis was identified. A higher level of matrix metalloproteinase-9 was detected in MS patients with active foci of the disease on magnetic resonance images.

Conclusion. Thus, antibodies to myelin oligodendrocyte glycoprotein, antibodies to thyroperoxidase, the levels of von Willebrand factor, matrix metalloproteinase-9 and adhesion molecule sPECAM-1 can be used as laboratory predictors of the malignant course of multiple sclerosis. 

Objective. Development of a specialized software complex that creates a controlled virtual environment as well as to capture and calculate the movement data in the process of rehabilitation.

Materials and methods. To evaluate the impact of visual stimuli created using the augmented reality system on the motor function, a software was developed that visualizes data via augmented reality glasses and processes data obtained from motion capture sensors. The study was conducted at the Department of Neurology and Neurosurgery and the Department of Medical and Biological Cybernetics of Siberian State Medical University in 2018–2019. The sample included 59 patients with acute ischemic cerebral stroke in the middle cerebral artery. The course of motor rehabilitation using augmented reality technology was ten days. The duration of one training session was 60 minutes.

Results. Motor neurorehabilitation of patients with paresis of the upper extremities using augmented reality makes it possible to improve motor skills. Analysis of the accuracy of movements showed a significant increase in the value of the spectral criterion with an increase in the number of trainings, which indicates a decrease in the number of unnecessary movements during the main task. A significant increase in the number of completed movements with each subsequent training was revealed. This indicates a rise in the speed of the task over the course of rehabilitation, as well as reduction of the rest period between the attempts performed during one training session.

Conclusion. The developed specialized software recreates a controlled virtual environment with the ability to register the parameters of human movement. The method was used for rehabilitation of motor disorders in patients with ischemic stroke of the brain and paresis of the upper extremities. The results of the study revealed a significant increase in the accuracy of movements, and a rise in endurance, which indicates the effectiveness of the approach in motor neurorehabilitation. 

Objective: to study the incidence rate of personality and anxiety disorders and their interrelationship in seniors of the medical university.

Materials and methods. The screening study for detection of personality and anxiety disorders using the Generalized Anxiety Disorder-7 (GAD-7) and Standardized Assessment of Personality – Abbreviated Scale (SAPAS) scales included 104 senior-year students of the medical university. In the studied sample, males (n = 46; 44.2%) and females (n = 58; 55.8%) (p < 0.05) were equally represented, the average age of men was 23 (23; 25) years, women – 23 (23; 23) years. Statistical processing was performed using the Pearson’s χ2 test, Mann–Whitney U test to compare independent samples, and the Spearman correlation analysis (r) with a preliminary estimate of the normal distribution.

Results. The data on the statistically significant differences in the level of anxiety and personality disorders depending on gender and age were obtained. Using the GAD-7 scale, the presence of moderate and average level of anxiety in male students was revealed in 26.1%, in female students – in 48.3% (ð = 0.001). The use of SAPAS scale revealed statistically insignificant differences in the studied groups: in males – 4 (4; 6) points, in the group of female students – 4 (3; 5) points (ð = 0.2).

Conclusion. A logistic regression model was obtained that predicted the highest likelihood of development of anxiety disorders. 

Introduction. Modern neuroimaging methods allow to evaluate in vivo biochemical processes in the brain. Such methods include magnetic resonance spectroscopy (MRS) and positron emission tomography (PET). While PET is the “golden standard” in assessing the brain functional state and is widely used in neurodegenerative diseases, the diagnostic value of MRS remains undefined due to the inconsistency of the results obtained in different studies. At the same time, MRC allows obtaining information on the content of many metabolites in living tissues, including N-acetyl aspartate (NAA), which is considered to be a surrogate marker of neuronal integrity, choline (Cho), associated with membrane metabolism, Cr - energy metabolism, etc. The aim of this study is to compare MRS and PET data in patients with Parkinson’s disease (PD).

Materials and methods. Twenty-six patients with PD stages I to III according to the Hoehn and Yahr Scale and age-matching control group of neurologically and cognitively intact people were examined. All patients underwent neurological examination, a multivoxel MRS of the supraventricular region, including white and gray matter, and PET with 18F-fluorodeoxyglucose (FDG) to assess cerebral metabolic rate of glucose (CMRglu).

Results. Decrease of NAA/Cr and NAA/Cho in the white matter in the left hemisphere was revealed in PD group compared to control, with the NAA/Cr ratio negatively correlating with the stage of the disease of the Hoehn and Yahr Scale. The NAA content in the white matter and the cingulate cortex positively correlated with CMRglu in Brodmann fields 5–7, 8–10, 22, 23, 46. At the same time, Cho/Cr ratio negatively correlated with CMRglu in the cortical areas associated with the development of cognitive impairment in PD (Brodman areas 9, 10, 39, 47). 

The aim of the research was to reveal features of distribution of DC-potential level of the brain in patients with chronic mercury intoxication.

Materials and methods. The study involved 33 male patients with chronic mercury intoxication and 38 healthy men (comparison group) who, by the specifics of their professional activities, were not exposed to neurotropic substances. We used the electrophysiological method of neuroenergy mapping.

Results. In the group of patients with chronic mercury intoxication, persons with a low level of constant potential prevailed when compared with the comparison group (36 and 11%, respectively). With a decrease in the level of constant potential in the frontal parts, an increase was observed in the central leads (Fpz – Cz = –1,2 (–6,3–12,6) mV), and with an increase in it, a decrease in the occipital (Fpz-Oz = 4,2 (–4,8–21,4) mV) and the right temporal (Fpz-Td = 0,01 (–6,5–16,3) mV) areas.

Right hemisphere temporal asymmetry was manifested in an increase in the Td-Ts index (p = 0,03) when compared with that of the comparison group, (0,66 ± 0,01) and (–4,34 ± 1,12) mV, respectively. Using discriminant analysis, five reliable diagnostic signs were identified: the values of the parameters of the parietal (Pz), right parietal (Pd), right temporal (Td), central (Cz), occipital (Oz) leads. The most informative sign was the value of the index of the parietal lead (Pz, F = 21,1).

Conclusion. A distinctive neurophysiological sign associated with chronic exposure to metallic mercury vapors is an increase in indices of the parietal, right parietal, right temporal, central, occipital leads compared with those inherent in the normal population. 

Purpose. To analyze the results of classical and modern studies reflecting the pathophysiological mechanisms of antipsychotic-induced tardive dyskinesia.

Materials and methods. We searched for full-text publications in Russian and English in the databases of E-Library, PubMed, Web of Science and Springer published over the past decade, using keywords (tardive dyskinesia (TD), drug-induced tardive dyskinesia, antipsychotics (AP), neuroleptics, typical antipsychotics, atypical antipsychotics, pathophysiology, etiology and combinations of these words). In addition, the review included earlier publications of historical interest.

Results. The lecture proposed theories of development of AP-induced TD, examining its effect on dopaminergic receptors, dopaminergic neurons, neurons of the basal ganglia, and other theories: activation of estrogen receptors, disorders of melatonin metabolism, disorders of the endogenous opioid system, oxidative stress with predominant oxidation processes, blockade of 5-HT2-receptors, a decrease in the pyridoxine level, genetic predisposition, interaction of AP with the brain trace element – iron, carbonyl stress and immune inflammation and the role of the neurotrophic factor.

Conclusion. The disclosure of the mechanisms of AP-induced TD will allow the development of a strategy for personalized prevention and therapy of the considered neurological complication of the AP-therapy for schizophrenia in real clinical practice. 

According to the World Health Organization, the prevalence of epilepsy in the world is high, at about 0.5–1% of the world’s population. In 20–40% of cases, according to various sources, it is not possible with standard treatment methods to achieve control over attacks, which significantly impairs the patient’s quality of life, increases economic costs, and poses a difficult task for the doctor to select the optimal treatment to reduce the frequency of attacks. This explains the urgency of creating new and modifying classical antiepileptic drugs (AEDs), as well as finding optimal and safe ways of administering and delivering the drugs. To study the mechanisms of AEDs’ effect on various pathways of epileptogenesis, simulation of convulsive seizures and chronic epilepsy in animals is used; for this purpose, mechanical, physical, chemical, and genetic models of epilepsy are used. The present review discusses chemical models of chronic epilepsy, which are most often used in experimental neuroscience today. It also describes the characteristics, advantages and disadvantages of each of them, the specificity of the study where they can be used and the assessment scales for epileptic seizures in animals.

Background. Schizophrenia is a socially significant mental illness with insufficiently studied etiology and pathogenesis. A number of hypotheses of schizophrenia pathogenesis (dopamine, glutamate, kinurenin and serotonin hypotheses) bring together the fact that amino acids are precursors or intermediate metabolic products of these metabolites. Amino acids and their metabolites play an important role as significant substrates and regulators in many metabolic pathways.

The aim of this review is to analyze the literature data on the studies of amino acids and acylcarnitines in patients with schizophrenia.

Methods. A literature search was conducted using PubMed databases for articles published in English and covering the period from the first articles on this topic, dated 1977 to April 2019. Combinations of the following keywords were used to search for “schizophrenia”, “antipsychotics” and “amino acids”, “acylcarnitines”, “metabolomics”.

Results. The review summarizes the data on the content of amino acids and acylcarnitines in the peripheral blood of schizophrenia patients and their dynamics in the course of pharmacotherapy with antipsychotic drugs. The potential of determining amino acids as biomarkers of therapeutic response and side effects, as well as their use in the treatment of patients with schizophrenia, are considered.

Conclusion. Further investigation of the spectrum of amino acids and their metabolites with the using of mass spectrometric methods of metabolic analysis can lead to the discovery of new therapeutic targets and strategies, assess their role in the pathophysiology of schizophrenia, identify mechanisms that ensure the development of antipsychotic antipsychotics, and drug-induced side effects antipsychotics, in particular, metabolic syndrome. 

The aim is to study the influence and assessment of mental and emotional states in patients with arrhythmias.

Materials and methods. Literature search was performed using the following resources: PubMed, Web of Science, Scopus, as well as in the search system Google Scholar by the key words “psychoarrhythmology”, “neural-cardiac axis”, “psychocardiology”, “arrhythmogenesis”, and “stress-induced arrhythmia”. Articles should be freely available and should represent the most relevant information on the topic. Studies were selected by the largest sample and citation index.

Results. In this review of studies on the correlation of psychosocial factors and constitutional features of personality in patients with arrhythmias, the available data on the pathogenesis of cardiac pathology, including the main arrhythmological disorders in nervous excitation caused by negative emotions and stress are presented. The article also reflects the importance of a multidisciplinary approach to risk prediction, potential risk modifiers and approaches to the treatment of cardiac pathology, taking into account the psycho-emotional state of the patient.

Conclusion. Reducing the severity of the disease requires a comprehensive approach, in particular, psychodiagnostics, psychocorrection, psychotherapy and psychopharmacotherapy. Further development of this approach to this problem will lead to the creation of new programs for early diagnosis, prevention and treatment of cardiac pathology. 

Non-motor symptoms are an essential manifestation of the clinical picture of Parkinson's disease (PD). This literature review is devoted to the study of recent advances in the field of clinical and pathophysiological aspects of the non-motor manifestations of Parkinson's disease.

Aim. The aim was to study and generalize the wide range of non-motor manifestations of PD and their features in this pathology, and to reveal the pathophysiological link between motor and non-motor manifestations of the disease and the role of the neurodegenerative process in the clinical picture of PD.

Materials and methods. Keywords (Parkinson's disease, non-motor symptoms, apathy, anxiety, depression, sleep disorder, pain) search in the Web of Science, Core Collection, Scopus, Pubmed databases.

Results. Knowledge about the presence of PD non-motor symptoms, characteristics of their manifestations improve their diagnosis and help to choose the correct treatment strategy. This survey comprises nonmotor manifestations of PD, such as: mood disorders (apathy, anxiety, depression), impulse control disorders (dopamine disregulation syndrome), sleep disorders (insomnia, excessive daytime sleepiness, bouts of sleepiness, conduct disorder in REM phase of sleep), autonomic disorders (constipation, enuresis, thermoregulatory dysfunction, cardiovascular disorders, orthostatic hypotension), and cognitive impairment. 

Kinsbourne’s syndrome or opsoklonus-myoclonus syndrome is an autoimmune disease of the central nervous system mainly affecting the cerebellum and its connections. The disease is characterized by progressive course and is rarely observed. There is no accurate data on the prevalence of opsoklonusmyoclonus syndrome in Russia. The etiology and pathogenesis of the disease are being studied. This disease can develop against the background of cancer, infectious diseases and vaccinations. The article presents a ñlinical case of this rare pathology.

Lafora disease is a hereditary, autosomal recessive progressive myoclonus epilepsy caused by mutations in the EPM2A (laforin) and EPM2B (malin) genes, with no substantial genotype-phenotype differences between the two. Clinical manifestations of the disease are determined by the accumulation of specific cytoplasmic “amyloid inclusions” consisting of polyglycosans (an abnormally branched glycogen molecule). Polyglycosans, or Lafora bodies, are typically found in the brain, hepatocytes of the liver, skeletal and cardiac muscles, in the ducts of sweat glands, and in the skin. The diagnosis is made following visual, generalized tonic-clonic and myoclonic seizures, progressing dementia, cerebellar ataxia, detection of specific Lafora bodies during sweat gland biopsy and data of genetic testing.

The article describes a clinical case of Lafora disease in a patient with disease onset at 11 years old caused by the mutation in the EPM2A (laforine) gene with focal sensory visual seizures with subsequent generalized tonic-clonic seizures, progressive motor impairments in the form of ataxia and gait abnormality as well as behavioral and cognitive disorders. The presented clinical case demonstrates the need for additional research, such as biopsy and genetic testing, for diagnosing diseases proceeding with resistant epileptic seizures and progressive motor and cognitive impairments. 

Neuronal ceroid lipofuscinoses (NCL, Batten disease) are a group of inherited neurodegenerative diseases characterized by age-related onset, progressive myoclonus epilepsy, visual impairment and progressive intellectual and motor disorders. In all forms of NCL, the pathological autofluorescent lipopigment accumulates in the brain and other tissues. The diagnosis is made following determination of the activity of specific enzymes in blood leukocytes or cell culture of skin fibroblasts and investigation of biopsy specimens with electron microscopy as well as molecular genetic research. The article presents a patient with the onset of the disease at the age of 3 with epileptic tonic-clonic seizures, with further progression of the disease in the form of myoclonic seizures, motor pyramidal and cerebellar disorders, as well as intellectual, mnestic and speech disturbances. The presented clinical case demonstrates difficulties in the diagnosis of neurodegenerative diseases at onset, as well as the absence of pathognomonic signs of the disease during neurophysiological and neuroimaging examinations, which makes it necessary to conduct additional molecular and genetic research

The article deals with a clinical case description of a female patient with toxic encephalopathy against the background of Ph-negative myeloproliferative diseases. The article discusses symptoms and neuroimaging of hepatic encephalopathy developed as a result of a shunt placed after portal vein thrombosis. The issues of etiology and pathogenesis of hepatic encephalopathy, principles of therapy, as well as the unique clinical picture of nervous system damage in this condition are also discussed. Data on the role of manganese in development of toxic encephalopathy, accumulation of paramagnetic substance in the basal ganglia of the brain and development of extrapyramidal symptoms are presented. The pathogenesis of toxic damage to neurons, increase in their sensitivity to hypoxia, and the relationship with the risk of cerebrovascular disorders and development of chronic cerebral ischemia, contributing to reduction of cognitive functions, are described.

CLIPPERS (Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) is a rare inflammatory disease of the central nervous system, during which the pons of the brain is damaged. This disease was described for the first time in 2010 by S.J. Pittock et.al. At present, there have been around 50 described cases of the disease. Up to the present moment, there are difficulties diagnosing this disease. In the article, a literature review and three clinical cases are presented. Furthermore, the necessity of further research is shown for improving the accuracy and specificity of the diagnostic criteria, as well as for defining biomarkers and developing algorithms of effective therapy.

We described a case of anti-NMDA-receptor encephalitis presenting as febrile catatonia in a 22-year-old patient with no somatic burden. We looked into the dynamics of the disease and treatment strategy. In the discussion, we provided analysis of the presented case, as well as issues related to research perspectives in this field.

The article provides information about the XIX World Congress of Psychiatry (August 21-24, 2019, Lisbon, Portugal). The issues of implementing the new ICD-11 diagnostic principles are considered; the main results of changes and modifications in schizophrenic disorders, mood disorders and new diagnostic categories in the new concept of “obsessive-compulsive disorders (OCD) and obsessive-compulsive related disorders” are presented.

The clinical utility of ICD-11 consists in the ability to use the diagnostic criteria more accurately than before. The talks of the keynote congress speakers are highlighted, the bottom line in the speeches of experts from many countries is finding effective ways of improving the mental health of a person.