This paper presents an overview of current pharmacological and non-pharmacological treatment options available for narcolepsy. Antidepressant medications, including selective serotonin reuptake inhibitors and selective serotonin and norepinephrine reuptake inhibitors, have demonstrated efficacy in mitigating cataplexy episodes. Additionally, various pharmaceutical agents, including psychostimulants and anesthetics, are effective in alleviating excessive daytime sleepiness. Among the behavioral interventions for narcolepsy, adherence to a consistent sleep schedule and the incorporation of scheduled naps throughout the day remain the most widely implemented strategies.

Transcranial electrical stimulation (tES) is often used in clinical practice as an adjunct to other treatments. However, it is still unclear how the combination of different methods affects the overall effectiveness of therapy and how effective tES is compared to other therapeutic approaches. A search and systematic review of studies according to the PRISMA criteria were conducted in the PubMed database up to April 4, 2025. At the primary search stage, the following articles were included: articles on the treatment of mental disorders using various types of tES as part of combination therapy or compared to therapy with psychopharmacological agents, psychotherapy methods, and cognitive training. One thousand six hundred eighty-nine publications were retrieved, of which 46 were included in the review. The anodic tES of the left dorsolateral prefrontal cortex (DLPFC) remains the most studied tES method. Its effectiveness in depression is likely to be comparable to antidepressants in medium therapeutic dosages. The augmentation of anodic tES of the left DLPFC with antidepressant therapy, but not cognitive-behavioral therapy, also demonstrated an advantage over monotherapy in non-resistant depression. Anodic tES of the left DLPFC combined with cognitive training in mild cognitive impairment is probably more effective than either method alone. There are a few studies both on individual nosologies and on other types of tES. The limitation of many studies is a small sample size. Therefore, TES is a promising therapeutic approach that can take its place in the treatment of mental disorders; however, further studies of the diversity of TES approaches are required both in different nosologies and in various combinations with other treatment methods.

This article examines the relationship between cognitive impairment and neurodegeneration in patients with Alzheimer's disease, with particular attention to the presence or absence of bilingualism. The concepts of cognitive and cerebral reserve are explored, along with findings from studies evaluating the effects of bilingualism on cognitive reserve and on the preservation of brain function during neurodegeneration. Bilingualism is identified as a multifaceted phenomenon encompassing various components of language experience, such as proficiency level, functional language use, language of education, age of second-language acquisition, societal status of languages, and language switching. These factors complicate research on how bilingualism influences the progression of cognitive impairment in neurodegenerative settings. The article discusses the methodological challenges inherent in bilingualism research and considers the potential influence of learning additional languages on the development of cerebral structures and neuronal connections, as shaped by language experience. The review details findings from studies investigating the impact of bilingualism on the onset and progression of Alzheimer's disease. Overall, the evidence suggests that the relationship between bilingualism and Alzheimer's disease is complex and multifactorial. Current data indicate that bilingualism is likely a significant contributor to cognitive reserve, although interpretation of research findings is frequently complicated by methodological limitations.

Postpartum depression (PPD) is among the most prevalent mental disorders, affecting approximately 17% of women worldwide. This condition represents a significant medical and social concern, negatively influencing both the psychophysiological health of mothers and the cognitive and emotional development of their newborns. The ongoing relevance of this issue is underscored by the persistent gap between evidence-based diagnostic methods and the actual care coverage for affected women. Multi-level barriers, particularly stigma, frequently compel women to conceal symptoms and avoid seeking assistance. This review aims to systematize recent international scientific findings on the principal obstacles to diagnosing PPD and to evaluate effective strategies to overcome these challenges. The literature search included PubMed, Scopus, ScienceDirect, and Web of Science, covering publications from 2016 to 2025. Addressing stigma is essential for improving the health of millions of mothers and their families. An interdisciplinary approach within a destigmatized environment can facilitate early detection, comprehensive risk assessment, and timely intervention, thereby enhancing outcomes.

There is no clear data available on the prevalence of Charcot-Marie-Tooth disease due to wide genetic diversity, the presence of sporadic cases, and the low awareness among specialists of hereditary diseases in adults. Given the diversity of presentation and age of onset, it is important to report Charcot-Marie-Tooth disease cases to identify triggers and progression factors. The article presents a clinical case of Charcot-Marie-Tooth disease type IA in a patient with late-onset disease (49 years of age). The clinical diagnosis was established according to the classical clinical triad, in combination with signs of diffuse symmetrical demyelination, a significant decrease in conduction along the motor fibers of the extremities measured by electroneuromyography, and the identified duplication of the PMP22 gene on chromosome 17p11.2-p12. The paper focuses on the differential diagnosis with chronic inflammatory polyradiculoneuropathy.

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.

To assess the diagnostic significance of the UCHL1 protein in mine-blast traumatic brain injury (TBI), to determine its correlation with the severity of brain damage, and to compare its use with conventional diagnostic methods. The study included 253 servicemen with mine-blast TBI of varying severity: mild (n=53), moderate (n=50), and severe (n=150). The serum level of UCHL1 was measured 1, 3, 6, and 12 hours after injury using an enzyme-linked immunosorbent assay. TBI severity was assessed using the Glasgow Coma Scale and neuroimaging data. Statistical processing included analysis of variance (ANOVA), Kruskal-Wallis test, Spearman correlation analysis, logistic regression, and ROC analysis. UCHL1 levels statistically significantly correlated with TBI severity (ρ=0.66, p<0.001). The levels were significantly higher in patients with severe TBI compared with those with mild or moderate TBI. Analysis of the ROC curve showed high diagnostic sensitivity of UCHL1 for severe TBI (AUC=0.83). However, the temporal change in UCHL1 demonstrated limited predictive value, highlighting the need for a multi-biomarker approach. UCHL1 is a promising biomarker for the early diagnosis and stratification of patients with mine-blast TBI. However, its limited change variability reduces its value for monitoring. The combined use of UCHL1 with other biomarkers (GFAP, NSE, and MAPt) and neuroimaging can improve the accuracy of diagnosis and outcome prediction, especially during the prehospital stage of medical care.

Post-stroke depression (PSD) is a common and clinically significant stroke complication associated with impaired rehabilitation potential and increased mortality risk. The prevalence of PSD varies from 25% to 59% depending on the duration of observation, reaching a peak in the first years after a stroke. The pathogenesis of PSD results from a complex interplay of biological and psychological factors that extends well beyond monoamine deficiency. Damage to monoaminergic pathways, neuroinflammation, hypothalamic-pituitary-adrenal axis dysfunction, decreased neuroplasticity (including BDNF deficiency), and impaired neural network integrity play a key role. The clinical presentation includes a complex of affective (apathy, anhedonia), cognitive (impaired executive functions), and dyssomnia disorders. While selective serotonin reuptake inhibitors remain the first choice for treatment of PSD, the current therapeutic approach requires targeting all pathogenesis links. A promising direction is the use of antidepressants with a complex mechanism of action, such as the original fluvoxamine, which combines serotonergic effects with anti-inflammatory and neuroprotective properties through sigma-1 receptor agonism. Optimizing PSD treatment is possible through a personalized approach that includes thorough screening and comprehensive correction of identified disorders.

To compare the effectiveness of three non-pharmacological interventions - binaural beats (BB) combined with suggestive instructions (SI), diaphragmatic breathing (DB), and BB combined with DB - for improving sleep, with consideration of sex differences among participants. The study included 217 healthy participants. Each participant completed four tasks in randomized order on separate nights before bedtime: (1) BB+SI, (2) DB, (3) BB+DB, and (4) monotonous sound without beats as a control (imitation, IM). Sleep latency (SL) was measured using a smartphone screen-touch test. Statistical analyses of SL values were conducted by task and sex factors. Analysis revealed a statistically significant effect of the task factor on sleep latency (SL) (p<0.05). Post-hoc comparisons showed that the DB task significantly reduced mean SL compared to IM for the overall group (p<0.05). Additionally, a significant decrease in mean SL following the BB+SI intervention was observed in females compared to IM (p<0.05). No statistically significant changes were found in males. The findings confirm the effectiveness of deep diaphragmatic breathing (DB) and suggestive instructions (SI) combined with binaural beats (BB) as non-pharmacological interventions for improving sleep in a large sample. The SI combined with BB demonstrated efficacy exclusively in females.

Traumatic brain injury is an urgent problem of modern healthcare, as it affects the most able-bodied part of the population. Mild traumatic brain injury is the most common traumatic brain injury. Generally, clinical recovery after a mild brain injury occurs within two weeks, but in some cases, the symptoms that occur after the injury persist for a prolonged period. This condition is called post-concussion syndrome. A search and review of Russian and foreign literature was conducted using the keywords «treatment of post-concussion syndrome», «rehabilitation of post-concussion syndrome», and «approach to managing patients with post-concussion syndrome» in the search engines PubMed, Google Scholar, and eLibrary for 2013-2024. The review included 21 papers that fit the selection criteria. The actual causes and mechanisms of the development of post-concussion syndrome are not well known. Presumably, both organic damage to the brain substance and psychological factors accompanying the injury or preexisting in the patient's history may be significant risk factors. Therefore, there are no unified algorithms for the treatment of post-concussion syndrome. This literature review provides information on modern methods of treatment and rehabilitation of the post-concussion syndrome. Both drug and non-drug methods are used to treat it. Among the medications, amantadine, methylphenidate, and selective serotonin reuptake inhibitors have a certain effect. However, many patients discontinue their medications due to side effects. Of non-drug methods, subsymptomatic aerobic activity and vestibular physical therapy can be effective. Other methods, such as manual therapy and hyperbaric oxygenation, did not improve post-concussion syndrome. Psychological counseling is also beneficial in the treatment of post-concussion syndrome. There is evidence on the effectiveness of cognitive-behavioral therapy and training patients on the features of the period after traumatic brain injury, and feedback. Post-concussion syndrome is a complex condition that requires a combined approach, involving several specialists to address various symptoms of this syndrome.