Coordination Disturbances Research Articles

TABES DORSALIS: IS THE DIAGNOSIS A CHALLENGE NOWADAYS?

Purpose: To present a rare case of neurosyphilis, the tertiary form of syphilitic infection, following adequate but belated treatment and manifesting with a variety of clinical signs and further progression to tabetic neurosyphilis. Known as the "great imitator", neurosyphilis is often misdiagnosed and underestimated. Materials/methods: A 48-year-old male patient was admitted to the Neurology clinic of UMHAT "Dr Georgi Stranski" Pleven, Bulgaria, with progressive neurological deficit including numbness in the lower limbs, imbalance and wide-based gait. The T2W- MRI showed abnormally high longitudinal signals at Th12-L1 level, consistent with transverse myelitis. CSF analysis revealed leucocytic pleocytosis, elevated proteins and normal glucose. The nerve conduction studies confirmed sensory motor polyneuropathy. Results: After treatment with intravenous aqueous crystalline (IV) penicillin, 2 million intravenously every 4 hours for 20 days, the sensory symptoms reduced. The coordination disturbances persisted, but the gate showed moderate improvement. Conclusions: The diagnosis of syphilitic myelitis, known as tabes dorsalis, is always complex, not only because of its rarity but because of its unique clinical presentation with multiple clinical symptoms, mimicking other more common neurological disorders. Though confirmation of the diagnosis needs a lot of laboratory and neuroimaging studies, the option of effective specific treatment is worth all the efforts.

Laughing gas abuse causing subacute combined spinal cord degeneration with psychiatric manifestations

Background. Nitrous oxide, a nonirritating gas commonly used as an anesthetic, is increasingly abused by the young population for its euphoric effects due to its seemingly harmless nature. However, its neurological impacts can vary in intensity and sometimes result in permanent damage. Accurate diagnosis and treatment hinge on identifying nitrous oxide use through anamnesis, clinical and paraclinical findings, as demonstrated in the following case report. Case report. A 27-year-old female with psychiatric history presented with progressive paresthesia and walking difficulty, admitting to recent nitrous oxide use, alongside other substances. Clinical examination revealed mild tetraparesis, coordination disturbances, generalized hyporeflexia, and sensory deficits. Electromyography showed severe sensory neuropathy, and spinal MRI indicated subacute combined degeneration (SCD) of the spinal cord. Laboratory tests revealed hyperhomocysteinemia and elevated methylmalonic acid levels, despite normal vitamin B12 levels. Treatment included intramuscular vitamin B12, folic acid, and neurotrophic agents, along with physical rehabilitation. Psychiatric symptoms, possibly exacerbated by nitrous oxide, and complicated adherence to therapy. Conclusions. This case underscores the neurotoxic potential of nitrous oxide, particularly its disruption of cobalamin metabolism, and highlights the need for thorough patient histories to uncover substance use contributing to neurological symptoms. Despite treatment, some neurological deficits may persist, emphasizing the importance of early intervention and comprehensive care strategies.

Ce(IV)-Based Metal-Organic Gel for Ultrafast Removal of Trace Arsenate from Water.

As a potential replacement for metal-organic frameworks (MOFs), constructing metal-organic gels (MOGs) is an appealing but challenging topic since MOGs are a kind of shapeable MOF gels. Also, the rapid adsorption of trace heavy metal ions in aqueous media remains a serious challenge. Herein, a simple strategy for the synthesis of Ce(IV)-based metal-organic gel (Ce-MOG) was first developed for the rapid adsorption of trace As(V). The (NH4)2Ce(NO3)6 obtains hydroxide bridges after adding apposite NaOH, leading to [Ce6O4(OH)4]12+ clustering and inducing fast and excessive nucleation rates, which also leads to coordination disturbance of MOF nanocrystals to obtain Ce-MOG. The Ce-OH groups are the key to gel formation through hydrogen bonding and are the active site for the ultrafast adsorption of As(V). As expected, the resultant Ce-MOG has an excellent adsorption rate, making it possible to effectively decontaminate 500 ppb of As(V) to below the World Health Organization (WHO) recommended threshold for drinking water (10 ppb) within 1 min. It achieves equilibrium adsorption in 10 min, and the final arsenate-removing efficiency reaches 99.8%. For Ce-MOF, the effluent concentration of As(V) is higher than the drinking water standard, while equilibrium adsorption takes 60 min. The initial adsorption rate of Ce-MOG, h(k2qe2) is calculated and indicated to be 67.67 mg g-1 min-1, about 19.96 times that of Ce-MOF (3.39 mg g-1 min-1). As such, the excellent As(V) decontamination rate, selectivity, and reusability of Ce-MOG indicate its great potential for practical drinking water purification.

Hyperammonemia induced gut microbiota dysbiosis and motor coordination disturbances in mice: new insight into gut‑brain axis involvement in hepatic encephalopathy.

Hepatic encephalopathy (HE) is a neuropsychiatric hepatic‑induced syndrome in which several factors are involved in promoting brain perturbations, with ammonia being the primary factor. Motor impairment, incoordination, and gut dysbiosis are some of the well‑known symptoms of HE. Nevertheless, the link between the direct effect of hyperammonemia and associated gut dysbiosis in the pathogenesis of HE is not well established. Thus, this work aimed to assess motor function in hyperammonemia and gut dysbiosis in mice. Twenty‑eight Swiss mice were distributed into three groups: two‑week and four‑week hyperammonemia groups were fed with an ammonia‑rich diet (20% w/w), and the control group was pair‑fed with a standard diet. Motor performance in the three groups was measured through a battery of motor tests, namely the rotarod, parallel bars, beam walk, and static bars. Microbial analysis was then carried out on the intestine of the studied mice. The result showed motor impairments in both hyperammonemia groups. Qualitative and quantitative microbiological analysis revealed decreased bacterial load, diversity, and ratios of both aerobic and facultative anaerobic bacteria, following two and four weeks of ammonia supplementation. Moreover, the Shannon diversity index revealed a time‑dependent cutback of gut bacterial diversity in a treatment‑time‑dependent manner, with the presence of only Enterobacteriaceae, Streptococcaceae, and Enterococcaceaeat at four weeks. The data showed that ammonia‑induced motor coordination deficits may develop through direct and indirect pathways acting on the gut‑brain axis.

Therapeutic Strategies for Spinocerebellar Ataxia Type 1.

Spinocerebellar ataxia type 1 (SCA1) is an autosomal dominant neurodegenerative disorder that affects one or two individuals per 100,000. The disease is caused by an extended CAG repeat in exon 8 of the ATXN1 gene and is characterized mostly by a profound loss of cerebellar Purkinje cells, leading to disturbances in coordination, balance, and gait. At present, no curative treatment is available for SCA1. However, increasing knowledge on the cellular and molecular mechanisms of SCA1 has led the way towards several therapeutic strategies that can potentially slow disease progression. SCA1 therapeutics can be classified as genetic, pharmacological, and cell replacement therapies. These different therapeutic strategies target either the (mutant) ATXN1 RNA or the ataxin-1 protein, pathways that play an important role in downstream SCA1 disease mechanisms or which help restore cells that are lost due to SCA1 pathology. In this review, we will provide a summary of the different therapeutic strategies that are currently being investigated for SCA1.

Behavioral encoding across timescales by region-specific dopamine dynamics

The dorsal (DS) and ventral striatum (VS) receive dopaminergic projections that control motor functions and reward-related behavior. It remains poorly understood how dopamine release dynamics across different temporal scales in these regions are coupled to behavioral outcomes. Here, we employ the dopamine sensor dLight1.3b together with multiregion fiber photometry and machine learning-based analysis to decode dopamine dynamics across the striatum during self-paced exploratory behavior in mice. Our data show a striking coordination of rapidly fluctuating signal in the DS, carrying information across dopamine levels, with a slower signal in the VS, consisting mainly of slow-paced transients. Importantly, these release dynamics correlated with discrete behavioral motifs, such as turns, running, and grooming on a subsecond-to-minute time scale. Disruption of dopamine dynamics with cocaine caused randomization of action selection sequencing and disturbance of DS-VS coordination. The data suggest that distinct dopamine dynamics of DS and VS jointly encode behavioral sequences during unconstrained activity with DS modulating the stringing together of actions and VS the signal to initiate and sustain the selected action.

Neuropharmacological Effects in Animal Models and HPLC-Phytochemical Profiling of Byrsonima crassifolia (L.) Kunth Bark Extracts.

B. crassifolia is a species that grows in various areas of Latin America. It was known to be useful for the treatment of different human ailments. The present work evaluated the neuropharmacological and analgesic effects of hydroalcoholic and dichloromethane extracts of B. crassifolia. The effect on the central nervous system (CNS) of both extracts obtained from bark, administered by the intraperitoneal route in mice, was evaluated by different tests: spontaneous motor activity, hole-board, motor coordination, pentobarbital induced hypnosis, and rectal temperature. Analgesic activity was evaluated using a hot plate test. Phytochemical analysis was performed by high-performance liquid chromatography (HPLC) using reversed-phase and gradient of elution. The hydroalcoholic extract (dose 0.5 g dry plant/kg weigh) administration caused an important reduction of the head-dipping response in the hole board test. A decrease in spontaneous motor activity test and a disturbance of motor coordination in the rotarod test was observed. The hydroalcoholic extract produced a significant prolongation of pentobarbital induced sleeping time. This extract prevented hot plate test induced nociception. The phytochemical analysis revealed the presence of catechin, epicatechin, and procyanidin B12. Therefore, this study revealed that the hydroalcoholic extract of B. crassifolia possesses analgesic and sedative CNS activity.

Clinical Practice Guidelines for Assessment and Management of Patients with Substance Intoxication Presenting to the Emergency Department.

Clinical Practice Guidelines for Assessment and Management of Patients with Substance Intoxication Presenting to the Emergency Department.

Longitudinal changing relationships between growth tempo and vertical stiffness in movement across maturation

PurposeTo determine whether average growth tempo influenced longitudinal relationships between maturity status and coordination capability using a 15-s hopping task (Aim 1). To investigate how differences in absolute growth tempo were associated with change in coordination capability within and across peak growth (Aim 2). MethodsParticipants were N1 = 110 (Aim 1) and N2 = 71 (Aim 2) Australian male competitive swimmers, aged 10–15 years, exposed to repeated-measures tracking (2-years, and 12-months respectively) of maturity status, growth tempo and movement coordination capability. Coordination capability was estimated via vertical stiffness (KV) in a hopping task, reflected by participant mean KV and between-jump coefficient of variation (CV). ResultsFor Aim 1, log-linear mixed model trends identified maturity status and growth tempo were significantly associated with KV mean and KV CV. For a given maturity status, mean KV was 9% lower in the ‘High’ average growth tempo group than the ‘Low’ average tempo group. For Aim 2, mixed repeated-measures analyses of variance identified how time points of increased growth tempo were significantly associated with 7–11% reductions in mean KV, with similar mean KV decrements irrespective of growth tempo group. Meanwhile, KVCV only illustrated progressive longitudinal reductions. ConclusionsWithin maturational progression, short-term accelerations in growth tempo corresponded with short-term decreases in KV mean, suggesting temporary disruptions to movement coordination capability. Measuring growth tempo and applying hopping tasks in specific movement contexts could help consistently identify disturbances in motor coordination.

Performance Index for in Home Assessment of Motion Abilities in Ataxia Telangiectasia: A Pilot Study

Background. It has been shown in the very recent literature that human walking generates rhythmic motor patterns with hidden time harmonic structures that are represented (at the subject’s comfortable speed) by the occurrence of the golden ratio as the the ratio of the durations of specific walking gait subphases. Such harmonic proportions may be affected—partially or even totally destroyed—by several neurological and/or systemic disorders, thus drastically reducing the smooth, graceful, and melodic flow of movements and altering gait self-similarities. Aim. In this paper we aim at, preliminarily, showing the reliability of a technologically assisted methodology—performed with an easy to use wearable motion capture system—for the evaluation of motion abilities in Ataxia-Telangiectasia (AT), a rare infantile onset neurodegenerative disorder, whose typical neurological manifestations include progressive gait unbalance and the disturbance of motor coordination. Methods. Such an experimental methodology relies, for the first time, on the most recent accurate and objective outcome measures of gait recursivity and harmonicity and symmetry and double support subphase consistency, applied to three AT patients with different ranges of AT severity. Results. The quantification of the level of the distortions of harmonic temporal proportions is shown to include the qualitative evaluations of the three AT patients provided by clinicians. Conclusions. Easy to use wearable motion capture systems might be used to evaluate AT motion abilities through recursivity and harmonicity and symmetry (quantitative) outcome measures.

Clinical experience of observation and tactics of management of a patient with ectodermal angydrotic dysplasia

The concept of ectodermal dysplasias covers a group of rare hereditary developmental anomalies that have a variety of phenotypic variants, but are characterized by common signs of underdevelopment or abnormal formation of organs and tissues derived from the ectodermal layer (skin and its derivatives - nails, hair, teeth, nervous system and sensory organs) ... Approximately 25% of ectodermal dysplasias known to date are inherited in an autosomal dominant or autosomal recessive manner; in other cases, the mode of inheritance is unclear. The syndrome is characterized by a wide range of clinical manifestations and may include additional symptoms of damage to other ectodermal, mesodermal, and endodermal structures. Ectodermal anomalies are a manifestation of disturbances in spatial-temporal coordination during the development of the epidermis. They involve genes such as EGF (epidermal growth factor), ED1 (ectodisplasin), EDAR (anhydrotic receptor ectodysplasin 1) and others that regulate the activity of genes involved in epidermal morphogenesis by activating or suppressing transcription factors (in particular, pb3; Koster). So far, only about 20% of genes have been identified that are responsible for about 200 ectodermal dysplasias of various symptoms and severity. This article describes the clinical observation of a patient with a rare disease - ectodermal anhydrotic dysplasia. The literature data on the clinical features of the course of this dermatosis, as well as the features of the course in this patient are presented.

ЧАСТОТНО-РЕГУЛЬОВАНИЙ ЕЛЕКТРОПРИВОД КОНВЕЄРА ЗЕРНОМЕТАЛЬНОЇ МАШИНИ З ПОКРАЩЕНИМИ ЯКІСНИМИ ПОКАЗНИКАМИ

Purpose. The article explored options for control systems for the electric drive of grain-metal machine conveyor to stabilize the speed of conveyor belt when the load changes. Methodology. A control system is proposed that implements the principles of subordinate regulation and is supplemented by compensatory feedbacks in the control channels of active and reactive energy. The calculation of the regulators and the modeling of the system operation have been completed. The analysis of the obtained characteristics showed that the synthesized system is characterized by good quality indicators. However, the characteristics were obtained for the case of known parameters of an asynchronous machine and adjusting the regulators for these parameters. Studies have shown that for the proposed structure, the most significant is the incorrect determination of the inductive reactances of the stator and rotor of asynchronous machine. So, when the inductance de- viates by 30%, significant fluctuations occur in the subordinate regulation system. Complex solution to the problem of providing low sensitivity to parametric and coordinate disturbances and an increase in dynamic and static accuracy can be obtained in a class of systems, that are stable with an unlimited increase in the gain, as a solution to the problem of ana- lytical design of optimal regulators based on the modified symmetry principle. The regulators of the reactive energy transmission channel with series-parallel correction, which are modified PID structures, have been synthesized. Regulators with sequential correction with PID and PIDD2 structures are synthesized for the active energy transmission channel. Results. Analysis of the obtained results of characteristics showed, that the optimal control system is characterized by better quality indicators in comparison with the classical system of subordinate regulation and practically insensitive to changes in the parameters of the electric drive. Originality. The results of mathematical modeling confirmed the possi- bility of using control systems synthesized as a solution to the problem of analytical design of optimal controllers based on the modified symmetry principle, to improve the quality indicators of the AC electric drive of the grain thrower con- veyor. Practical value. The use of the proposed optimal control system will provide the possibility of stabilizing the speed of the conveyor belt of the grain thrower, which will reduce the percentage of injured and damaged grain. References 16. Figures 14.

БЕЗДАВАЧЕВЕ КЕРУВАННЯ ДВИГУНОМ ПОСТІЙНОГО СТРУМУ

In this paper, a new speed control algorithm for a permanent magnet DC motor which does not require implementation of the angular speed sensor is presented. Three steps are performed to develop the control system: design of speed tracking control algorithm assuming the speed measurement; design of speed observer; design of sensorless speed control algorithm based on the principle of separation. Information about speed is taken from the speed observer using the motor current value. The stability of the composite system dynamics consisting of three subsystems (the speed regulation loop, current regulation loop, and speed observer) is analyzed. The feedback gains tuning procedure for decoupling of three subsystems is given. The simulation results show that the dynamic performance of the designed system is similar to the performance of the system with angular speed measurement. The resulting closed-loop system has structural robustness properties with respect to parametric and coordinate disturbances. References 12, figures 2.

Pharmacology of Cenobamate: Mechanism of Action, Pharmacokinetics, Drug-Drug Interactions and Tolerability.

Cenobamate is one of the latest antiseizure medications (ASMs) developed for the treatment of focal onset seizures in adult patients. The recommended starting dose is 12.5mg/day, titrated gradually to the target daily dose of 200 mg, which may be increased to a maximum of 400 mg/day based on clinical response. Although the high rate of seizure freedom observed in randomized, placebo-controlled clinical trials has resulted in exciting expectations, further clinical studies are needed to better define its clinical profile. Cenobamate is characterized by a peculiar pharmacology regarding both pharmacodynamics and pharmacokinetics. The mechanism of action has only partly been described, with the drug acting on voltage-gated sodium channels through a pronounced action on persistent rather than transient currents. Cenobamate also acts as a positive allosteric modulator of GABAA receptors independently from the benzodiazepine binding site. The bioavailability of cenobamate is not influenced by other drugs, except phenytoin; it can inhibit cytochrome P450 (CYP)2C19 and induce CYP3A4 and 2B6, and hence can potentially interact with many drugs (e.g. dose adjustments may be required for lamotrigine, carbamazepine and clobazam). The pharmacokinetics of cenobamate are not linear and dosage increases imply a disproportional increase in plasma levels, particularly at doses higher than 300mg. The most common and dose-related adverse effects associated with cenobamate include central nervous system-related symptoms, mainly somnolence, dizziness, diplopia, and disturbances in gait and coordination. A somewhat higher incidence of adverse events has been observed in patients concomitantly treated with sodium channel blockers. The most relevant safety issues are currently represented by the risk of severe skin reactions (apparently avoidable by a slow titration) and QT shortening (the drug is contraindicated in patients with familial short QT syndrome or taking QT-shortening drugs). Overall, cenobamate is a promising ASM with an intriguing and not fully understood mechanism of action; pharmacokinetic issues need to be considered in clinical practice.

Influence of the upper limb motor deficit on the functional independence in patients with cerebral palsy

Cerebral palsies (CPs) disturb the voluntary movement control at extremities’ level, entailing various disability degrees. In over 80% of the CP cases there is an upper limb disorder, mainly manifested by the decrease in hand control and the presence of contractures, which, in time, lead to the adoption of abnormal postures which affect the abilities of the CP patients’ hands. The aim of this study was to identify the way the motor deficit at upper limb level – reflected by coordination disturbances and by the condition of the three fingered (tripod) grasp – influences the CP patient’s functional independence. The study demonstrated the existence of significant correlations between Functional Independence Measure (FIM) score, coordination and three fingered grasp. It was proven that the unilateral coordination dysfunctions have a strong negative influence on the coordination of the opposite side and lead to a decrease of the functional independence level. Therefore, the rehabilitation treatment is recommended to be based on a bilateral training, both in order to improve coordination and to obtain a functional level of the three fingered grasp power and of the physiological amplitude at wrist flexion level.

First symptom guides diagnosis and prognosis in neurodegenerative diseases-a retrospective study of autopsy proven cases.

Clinical diagnostic criteria for neurodegenerative diseases have been framed based on clinical phenomenology. However, systematic knowledge about the first reported clinical symptoms in neurodegenerative diseases is lacking. Therefore, the aim was to determine the prevalence and clinical implications of the first clinical symptom (FS) as assessed by medical history in neuropathologically proven neurodegenerative diseases. Neuropathological diagnoses from the Neurobiobank Munich, Germany, were matched with clinical records for analyses of the diagnostic and prognostic values of FSs. In all, 301 patients with the neuropathological diagnoses Alzheimer disease (AD), progressive supranuclear palsy (PSP), frontotemporal lobar degeneration (FTLD), Lewy body disease (LBD) including the neuropathologically indistinguishable clinical phenotypes Parkinson disease and dementia with Lewy bodies, multiple system atrophy (MSA) and corticobasal degeneration (CBD) were studied. Memory disturbance was the most common FS in AD (34%), FTLD (19%) and LBD (26%), gait disturbance in PSP (35%) and MSA (27%) and aphasia and personality changes in CBD (20%, respectively). In a model adjusting for prevalence in the general population, AD was predicted by memory disturbance in 79.0%, aphasia in 97.2%, personality changes in 96.0% and by cognitive disturbance in 99.0%. Gait disturbance and tremor predicted LBD in 54.6% and 97.3%, coordination disturbance MSA in 59.4% and dysarthria FTLD in 73.0%. Cognitive FSs were associated with longer survival in AD (12.0 vs. 5.3years; p<0.001) and FTLD (8.2 vs. 4.1years; p=0.005) and motor FSs with shorter survival in PSP (7.2 vs. 9.7; p=0.048). Assessing FSs in neurodegenerative diseases may be beneficial for accuracy of diagnosis and prognosis and thereby may improve clinical care and precision of study recruitment.

Cerebellar Syndrome Revealing a Giant Postero Inferior Cerebellar Artery Aneurysm: A Case Report and a Review of Literature

Context: Cerebellar syndrome caused by disturbances of balance and coordination is not an uncommon neurological disorder. It has varied etiologies usually caused by tumor processes or suppurative collections. Vascular causes remain very rare, especially when it is a giant aneurysm of PICA representing 1% of intracranial aneurysms. Treating giant PICA aneurysms is a very difficult task for neurosurgeons because the surgical dissection can lead to severe damage due to the intimate relationship of PICA with the brainstem or nerve structures. We report a case of giant PICA aneurysm responsible for cerebellar syndrome successfully treated with surgery. The objective of this work is to draw the attention of practitioners to this unusual cause which can lead to diagnosis wandering and a lack of planning at the time of management. Case report: A 65 years old hypertensive patient was seen for a progressive disturbance of balance and walking disorder, but worsened in the last three months with no notion of fever. On admission, the patient was lucid, oriented in time and space and presented with static and kinetic cerebellar syndrome. Brain CT-scan without and with contrast revealed a tissular mass in the posterior fossa suggesting a tumor process, however, CT angiography showed a giant aneurysm of the PICA after reconstruction. A careful microdissection by a sub-occipital approach was decided. Opening the large cistern made it possible to visualize the aneurysm sack surrounded by a yellowish gliosis. The reclining and microdissection revealed the neck of the aneurysm, which was clipped to exclude the giant aneurysm in block. Postoperative follow-up was simple with progressive improvement in the cerebellar syndrome and walking over three months. Conclusion: Giant aneurysm of the PICA is rare. The localization in the posterior cerebral fossa can be confusing. Microsurgery gives a good result.

Synthesis of a robust control system for two-mass electric drive by H∞-theory

The practice of designing and operating control systems for industrial facilities has shown that systems synthesized according to the criteria of modular and symmetric optima, as well as by quadratic quality criteria, are sensitive to changes in the parameters of the controlled object, incoming characteristics, disturbing influences, the structure and parameters of the object model changing, which used in control loops. Such systems can lose optimality as well as productivity, if information about the object and operating environment is known with some probability or uncertainty. For an industrial electric drive, changes in load torque, moment of inertia of rotating parts, supply voltage and environmental characteristics (temperature, vibration) are especially significant. These changes affect both the mechanical characteristics rigidity and the transients’ quality.&#x0D; Robust control systems provide a required quality of work when changing the characteristics of impacts and instability of the control object parameters in a wide range. In the presence of uncertainties, a robust controller provides robust stability and quality for all admissible uncertainties.&#x0D; The synthesis of robust control systems with an H∞-speed controller of a two-mass electric drive by methods of H∞-theory is presented in order to prove the possibility of using algorithms for a given stabilization and speed control, as well as providing the necessary degree of sensitivity to parametric and coordinate disturbances acting on the control object. Application of the method of robust controllers’ synthesis taking into account the requirements for the quality of a controlled coordinate transient processes in the control system. The analysis of the operation of a synthesized robust system with an H∞-speed controller using digital modeling on mathematical models in the MATLAB / Simulink environment is carried out. The possibility of the speed independent control, the steady-state error and the nature of the transient processes of the controlled coordinate in the synthesized electric drive control system is shown.

MULTIPLE SCLEROSIS AND AGING

The aim of this article is to study the aging of patients with multiple sclerosis (MS), as well as the clinical course, neurological status, comorbidities, and therapeutic aspects in elderly people with MS. Materials and research methods. The study was carried out by 356 patients, whose examination and treatment was carried out by a special expert commission at the Neurological Center of the Ministry of Health of the Republic of Azerbaijan at the Republican Clinical Hospital named after academician M.Mirgasimov for one year (01.07.2013-30.06.2014) within the framework of the “State Program for the Treatment, Prevention and Control of Multiple Sclerosis” (SPTPCMS). Results and discussion. 7.3% (26 patients) with MS were ≥50 years of age. The average age of patients was 53.04±2.89 years, and the average age at which the first MS attack occurred was 38.73±9.47 years. At the time of diagnosis, the average age of the patients was 47.54±4.76 years. In patients included in the study, the mean duration of MS was 14.31±10.10 years. Secondary progressive MS was detected in half of the patients (50.0%), relapsing remmiting MS was observed in 38.46% of patients. It was demonstrated that secondary progressive MS in patients over 50 years of age prevailed over relapsing remmiting MS. As MS developed, there was an increase in the frequency of disturbances of the pelvic functions, sensory, motor and coordination disturbances. 15.4% of patients suffered from type 2 diabetes mellitus and 11.5% from ischemic heart disease. In single cases, gastrointestinal pathologies, degenerative diseases of the spine, and gynecological diseases were detected. Conclusions. Given the increasing incidence of other age-related pathologies, special attention should be paid to the timely detection and treatment of comorbid conditions in elderly patients with MS. After the implementation of the SPTPCMS, attention to MS patients and measures for the timely detection of the disease increased. At the same time, significant advances have been made in the treatment and rehabilitation of elderly patients with long-term MS.

DEVELOPMENT OF A CONCEPTUAL MODEL OF A ROBOTIC COMPLEX FOR THE PRODUCTION OF RAVIOLI OF SPECIAL FORMS

The article provides a substantiation of the conceptual model of the production process of special forms of dumplings. It is the first stage in the development of a model of this process as a control object. The purpose of which is to form an objective basis for the development of an effective system for automatic process control. The development of the conceptual model presupposes the specification and description of the properties of control channels and acting disturbances to the level of their mathematical model, which can be implemented in a simulation environment. Problems of identification of the mathematical model of the process of the production of dumplings, i. e. obtaining a mathematical description of processes based on the results of its purposeful experimental research, due to its complexity as a control object.The experimental approach, in this case, gives much more reliable results on the properties of the process. An attempt to obtain such general properties on the basis of experimental data would inevitably lead to the need for very complex and lengthy multifactorial experiments and nontrivial procedures for their processing. But this will leave open the question of the adequacy of the model for those conditions of the process and types of raw materials that were not covered by the experiments. Fundamentally important is the fact that the mathematical model of the process is developed as a model of the control object.Model can be used in two ways. This is due to the fact that in the closed circuits of the SAC, the discrepancy between the models can be considered as a manifestation of uncontrolled coordinate and parametric disturbances. It is in conditions of this kind of disturbances that the SAC must fulfill its functional purpose. The developed mathematical model of the production process of special forms of dumplings will be used by us only in the direction, when it is of great importance not so much quantitative as its qualitative correspondence to the original object.