Nervous Diseases Research Articles

In-Depth Investigation on Potential Mechanism of Forest-Grown Ginseng Alleviating Alzheimer’s Disease via UHPLC-MS-Based Metabolomics

Background: Alzheimer’s disease is a central nervous system degenerative disease closely related to age with a complex pathogenesis. As a natural medicinal plant, forest-grown ginseng (GSF) contains abundant ginsenosides and offers significant neuroprotective effects. Methods: In this study, we comprehensively investigated the effect of GSF on the cell viability of PC12 cells in an AD model alongside metabolic changes in the serum and brains of mice, combined with an efficacy evaluation of PC12 cells in vitro and UHPLC-MS-based metabolomics in vivo. The goal of this study is to clarify the potential mechanism of GSF in treating AD. Results: The PC12 cell results showed that GSF can promote the proliferation of PC12 cells, reduce the content of IL-8, increase the activity of SOD, and alleviate the inflammation and oxidative stress induced by Aβ25~35. The immunohistochemical results for the mouse brain tissue also showed that GSF could reduce the inflammatory response of mouse brain tissue by reducing the overexpression of IBa1. AD was alleviated by reducing Aβ protein deposition in the mouse brain tissue. An untargeted metabolomics analysis was performed using UHPLC-Q-Exactive MS and principal component analysis (PCA) to identify the differentially expressed metabolites in the serum and brain tissue of AD mice after treatment. Twenty and seventeen different metabolites were identified in the serum and brain tissue, respectively. The pathway enrichment analysis of differential metabolites showed that GSF could treat AD by up-regulating succinic acid semialdehyde, carbamoyl phosphate, Sphingosine 1-phosphate, L-cystathionine, 2-ketobutyric acid, Vanillylmandelic acid, and D-Ribose to regulate sphingomyelin metabolism, the synthesis and metabolism of neurotransmitters and precursors, and energy metabolism. Conclusions: GSF can reduce neuroinflammation and alleviate Alzheimer’s disease by regulating the metabolic disorders of amino acids, sphingolipids, unsaturated fatty acids, and arachidonic acid in mice serum and brain tissue metabolites. These results suggest a link between metabolite imbalance and AD, and reveal the basis for the mechanism of ginsenosides in AD treatment.

Macrophage co-culture promotes cell reprogramming and prevents ferroptosis in aging fibroblasts for neurodegeneration therapy.

Ferroptosis, a form of programmed cell death associated with lipid peroxidation and iron dependency, plays a critical role in affecting neuronal function in the aging-related neurodegenerative diseases. Macrophages, influenced by these changes, contribute significantly to the progression of aging nerve diseases. Induced neuronal reprogramming is an advanced technology, which can direct convert somatic cells, such as fibroblasts, into neurons, and offers a promising approach for drug screening aimed at correcting ferroptosis and combating aging-related nerve diseases. However, the efficiency of this reprogramming process remains a significant challenge. In this study, we aimed to manipulate macrophage phenotypes to enhance the direct conversion of fibroblasts into neurons. Specifically, we sought to correct ferroptosis through screening natural compounds using aged fibroblasts and utilizing macrophages to promote induced neuronal (iN) reprogramming. Our findings demonstrate that M2 macrophages effectively promote the direct reprogramming of fibroblasts into iNs. In a novel macrophage-fibroblast co-culture system, M2 macrophages facilitate iN reprogramming by reducing fibroblast adhesion forces and promoting asymmetric cell division. Furthermore, we discovered that manipulating matrix stiffness can induce polarization of macrophages towards the M2 phenotype, thereby enhancing fibroblast reprogramming into iNs. To facilitate these findings, we developed a mechano-cue-based drug screening chip, where soft hydrogels induced and maintained the phenotype of M2 macrophages and effectively promoted cell reprogramming. Using a combinatorial approach with 36 such chips, we screened natural compounds for their anti-aging properties, focusing on reversing fibroblast aging and inducing their conversion into neuronal cells. Notably, Vitexin, an apigenin flavone glycoside with a role as a platelet aggregation inhibitor, emerged as a promising candidate to achieve our therapeutic goals. This study highlights the potential of macrophage-mediated modulation of fibroblast reprogramming as a strategy to address ferroptosis-induced neuronal dysfunction in aging-related nerve diseases. KEY MESSAGE: This study highlights the potential of macrophage-mediated modulation of fibroblast reprogramming as a strategy to address ferroptosis-induced neuronal dysfunction in aging-related nerve diseases.

Shankhpushpi (Convolvulus pluricaulis): Exploring its Cognitive Enhancing Mechanisms and Therapeutic Potential in Neurodegenerative Disorders

Shankhpushpi (<i>Convolvulus pluricaulis</i>), also called <i>C. pluricaulis</i> Choisy (<i>C. pluricaulis</i>), is a longstanding shrub also known by the names C. microphyllus Sieb. as well as C. prostratus Forsk and it’s employed as a traditional people’s remedy for a number of illnesses such as memory enhancement in Ayurveda and Conventional Chinese Medicine system. It is primarily utilized as a memory enhancer and brain stimulant for the treatment of central nervous diseases like stress, depression, and sleeplessness. Traditional Indian medications are used. Anxiolytic, neurological (Alzheimer's, Huntington's, Epilepsy, but also Depressant) antioxidants, analgesics, immunomodulatory, antibacterial, antihyperlipidemic, and cardioprotective actions are just a few of the medicinal qualities of this herb that have been linked to them in historical publications. Therefore, identifying and scientifically validating herbal remedies helps advance Ayurvedic/ Unani studies. Various biological phytoconstituents, including the alkaloids (convolamine), flavonoids (kaempferol), and polyphenolic compounds (scopoletin, sitosterol, and ceryl alcohol), have been linked to the therapeutic benefits of this botanical. Several active substances, such as scopoletin, kaempferol phytosterol, as well as -sitosterol, which was extracted from flying sections of <i>C. pluricaulis</i>, have been demonstrated to work as GABAA agonists that might explain the antianxiety and CNS depressant properties of shankhpushpi. To compile data for this article, a Systematic Literature Review on <i>C. pluricaulis</i> was conducted.

Hyperbaric Oxygen Therapy (HBOT) for Management of Complex Regional Pain Syndrome (CRPS).

Complex regional pain syndrome remains a challenging condition characterized by severe, persistent pain and a variety of inflammatory and trophic symptoms. This study aimed to analyze the current literature to evaluate hyperbaric oxygen therapy (HBOT)'s efficacy in treating complex regional pain syndrome (CRPS), focusing on both sympathetically-maintained pain (SMP) and sympathetically-independent pain (SIP) subtypes. A comprehensive literature search was conducted in PubMed Clinical Queries using the MeSH term "Complex Regional Pain Syndromes" OR the keyword "CRPS" AND "Hyperbaric Oxygen Therapy" OR the keyword "HBOT". The selected publication types included a randomized controlled trial, a retrospective observational study, a comparative study, a retrospective case series and case reports. The search was restricted to articles published in English between January 1994 and October 2024. The results from the search were used to compile this review. Patients were categorized into SMP, SIP, or indeterminate groups based on the presence of prior sympathetic nerve block history or disease duration. Thirteen studies involving 280 subjects were reviewed. Of the patients, 42.5% were categorized as SMP, 48.2% as SIP, and 9.3% as indeterminate. HBOT treatment ranged from 3 to 63 sessions, typically using 2.4 ATA for 90 minutes. The results indicated significant symptom relief and functional improvement across both SMP and SIP subtypes, suggesting the broad efficacy of HBOT for CRPS management. This review of the current literature suggests that HBOT may offer significant symptom relief, regardless of CRPS subtype or disease duration. HBOT's anti-inflammatory and neuroplasticity promoting properties make it a valuable non-invasive option for CRPS patients, potentially improving outcomes when combined with other therapeutic modalities. Further research is necessary to refine patient selection and optimize treatment protocols.

Mitochondrial Uncoupler, 2,4-Dinitrophenol, Reduces Spinal Cord Paralysis and Retinal Ganglion Cell Loss in the Experimental Autoimmune Encephalomyelitis Model of Multiple Sclerosis

Optic neuritis is an inflammatory demyelinating disease of the optic nerve that often occurs in multiple sclerosis (MS) patients. Sixty percent of patients develop some level of permanent visual loss due to retinal ganglion cell (RGC) damage following optic neuritis, with no known treatment to prevent this loss. Prior studies showed that MP201, a prodrug of 2,4-dinitrophenol (DNP) administered in the experimental autoimmune encephalitis (EAE) mouse model of MS attenuated optic neuritis with preserved vision, increased retinal ganglion cell (RGC) survival, decreased axon loss, and reduced demyelination. Oral administration of MP201, which converts to active form DNP after entry in the portal vein, decreases mitochondrial-derived reactive oxygen species (ROS) and restores calcium homeostasis, which are both implicated in many neurodegenerative diseases. Due to the established therapeutic benefits of prodrug MP201 in EAE mice, we hypothesized that administration of DNP itself may also have significant potential for therapeutic effects. Here, effects of varying doses of DNP treatment in EAE mice were assessed by the extent of spinal cord paralysis, optokinetic response (OKR), RGC survival, and optic nerve demyelination and inflammation. Results show that daily oral doses of 5-10 mg/kg DNP initiated after onset of EAE can significantly reduce spinal cord paralysis, a marker of the EAE MS-like disease, by day 42 after disease induction. DNP treatment significantly reduces RGC loss induced by optic neuritis in EAE mice; however, effects of DNP do not significantly improve visual function, or optic nerve demyelination and inflammation. Current studies show DNP treatment promotes increased RGC survival, but continued inflammation and demyelination likely reduce visual function, suggesting future studies examining combination therapy of DNP with anti-inflammatory agents may be warranted.

Incidence of optic nerve kinking in a cohort of patients with Normal tension glaucoma.

To report on the incidence of optic nerve kinking in a series of patients diagnosed with normal-tension glaucoma (NTG) compared to an age- and gender matched control group without known optic nerve diseases. All patients with NTG who underwent imaging (computed tomography cysternography (CTC) or magnetic resonance imaging (MRI)) of the orbits and cranium between 2012 and 2022 were included, totalling 57 patients (27 females and 30 males; 57 eyes; mean age 69 ± 10 years). 57 age- and gender matched subjects without known optic nerve diseases who underwent MRI of the orbits and cranium served as controls. Radiographic images of the orbits were analysed for the presence of optic nerve kinking. In the axial plane at least one optic nerve kink was found in 49 of 57 (86%) optic nerves in patients with NTG and in 10 of 57 (18%) optic nerves in controls (p < 0.0001) while in the sagittal plane in 28 of 57 (49%) optic nerves in patients with NTG and in 1 of 57 (2%) optic nerves in controls (p < 0.0001) (Fisher's two-tailed exact test). This study demonstrates a high statistically significant incidence of optic nerve kinking in patients with NTG compared to controls without known optic nerve diseases. Its possible role involved in the pathophysiology of NTG needs to be evaluated.

The Role of Oligodendrocyte Lineage Cells in the Pathogenesis of Alzheimer's Disease.

Alzheimer's disease (AD) is a central nervous system degenerative disease with a stealthy onset and a progressive course characterized by memory loss, cognitive dysfunction, and abnormal psychological and behavioral symptoms. However, the pathogenesis of AD remains elusive. An increasing number of studies have shown that oligodendrocyte progenitor cells (OPCs) and oligodendroglial lineage cells (OLGs), especially OPCs and mature oligodendrocytes (OLGs), which are derived from OPCs, play important roles in the pathogenesis of AD. OLGs function mainly by myelinating axons, transmitting electrical signals, and regulating neural development. In addition to myelin, OPCs and OLGs can also participate in AD pathogenesis in other ways. This review summarizes the mechanisms by which OPCs and OLGs affect myelin formation, oxidative stress, neuroinflammation, the blood-brain barrier, synaptic function, and amyloid-beta protein and further elucidates the mechanisms by which oligodendrocyte lineage cells participate in AD pathogenesis and treatment, which is highly important for clarifying the pathogenesis of AD, clinical treatment, and prevention.

Immunoregulatory and antiviral effect mediated by TLR7 and BMAP28 interaction in bovine alphaherpesvirus-infected respiratory primary cultures.

Varicellovirus bovinealpha 1 and 5 (formerly bovine alphaherpesvirus type 1 and 5, BoAHV-1 and BoAHV-5) are closely related and can be isolated from similar clinical conditions, including respiratory and nervous diseases, genital infections and abortion. Pathogens' activation of toll-like receptors (TLRs) induces the expression of proinflammatory cytokines and antimicrobial peptides such as cathelicidins. Cathelicidins are presumed to act as endogenous ligands of TLRs, stimulating, in turn, their activation. Cattle's innate immune responses mediated by TLRs and cathelicidins remain undefined. This work aimed to study the interaction mechanisms between TLR7 and a bovine cathelicidin (bovine myeloid antimicrobial peptide (BMAP)28 and their influence on the replication of BoAHV-1 and BoAHV-5. It was shown that in vitro infection by BoAHV-1 and BoAHV-5 induces the innate immune responses associated with TLR7 and BMAP28 in primary cultured bovine fetal lung cells. Pretreatment with TLR7 agonist (imiquimod) or an endogenous cathelicidin inductor (sodium butyrate) enhanced the innate immune response to BoAHV mediated by TLR7 signalling, BMAP28, TNFα, IFNβ and IFNγ. It exerted an antiviral effect, decreasing BoAHV replication. Inhibition of endosomal TLRs and downstream signalling molecules MAPK, NF-κβ, IKK-2, and JNK II counteracted these antiviral effects. Therefore, BMAP28 shows novel roles in modulating the immune response induced by TLR7 activation through signalling pathways involving kinases and NF-κβ. Enhancing TLR7 and endogenous cathelicidin expression could be a complementary tool for the prevention and/or control of BoAHV infections.

Computerized Decision Support System and Fuzzy Logic Rules for Early Diagnosis of Pesticide-Induced Diseases.

Many reflexologists employ outdated concepts that do not align with modern anatomy, physiology, and biophysics. Those concepts undermine physicians' confidence in their diagnosis. This study aims to improve the quality of medical care for workers in the agro-industrial complex who are exposed to pesticides by a fuzzy mathematical model using acupuncture points reflexes. Data obtained from reflex diagnostic methods are utilized in hybrid fuzzy decision rules to build a predictive classification model that integrates medical diagnosis with artificial intelligence. Pesticide exposure leads to cardiovascular and nervous system bronchopulmonary diseases, as well as kidney and liver tissue pathology. The developed model generates decision rules for early prediction of nervous system disorders, particularly when the primary risk factor is exposure to agricultural pesticides containing nitrates. In modern medical practice, there is a growing interest in ancient methods of reflex diagnostics and therapies based on maintaining the energy balance of an organism's meridian structures. However, the lack of a solid theoretical foundation explaining the mechanisms of interaction between internal and surface meridian structures poses a significant obstacle to wider adoption of reflex diagnostic techniques. This limitation severely hampers the potential of acupuncture. Moreover, many reflexologists in practice tend to overstate the benefits of acupuncture, which may lead to errors, that undermine the appropriate approach to diagnosis and treatment. The proposed model proves valuable for the healthcare of agro-industrial complex workers, as its decision-making process achieves an accuracy rate of over 85% in forecasting nervous system disorders.

АНАЛИЗ ОБЪЕМА ПОТРЕБЛЕНИЯ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ ПРИ ЛЕЧЕНИИ ЭПИЛЕПСИИ В СТАЦИОНАРЕ

The article presents the results of the study of the volume of consumption of medicinal drugs for the treatment of patients diagnosed with epilepsy. As a result of retrospective processing of case histories (continuous sampling for 2021-2023) obtained in the inpatient department of the Clinic of Nervous Diseases named after A.Y. Khlebnikov of Sechenov University, the dynamics of drugs consumption from 2021 to 2023 was analyzed. The range of antiepileptic drugs in the clinic in 2022-2023 compared to 2021 was supplemented with such names as: topiramate, oxcarbazepine. Increased consumption of levetiracetam in 2023 compared to 2021 by 4 times. Based on the data obtained, it is obvious that there are no 3rd generation antiepileptic drugs in the assortment. Among other pharmacotherapeutic groups the leading position is occupied by B vitamins, the volume of consumption of these drugs in 2023 amounted to 496.86 NDDD/100 bed days. In addition, a decrease in the consumption of myorelaxants should be noted. The results obtained can be the basis for the development of recommendations to optimize the use of drugs and improve the quality of drug care for patients with epilepsy at the inpatient level.

IMPACT OF THE WAR AND THE COVID-19 PANDEMIC ON THE MORTALITY RATE OF CHILDREN UNDER THE AGE OF 1 YEAR IN UKRAINE IN UKRAINE

Background. The war and the consequences of the COVID-19 pandemic have an extremely negative impact on the morbidity and mortality of the child population. The aim of the study is to analyse the impact of the war and the consequences of the COVID-19 pandemic on the dynamics of infant mortality and its components in Ukraine from 2020 to 2023.Study materials and methods. Retrospective analysis and assessment of infant mortality and its components in Ukraine for theperiod from 2020 to 2023 was carried out on the basis of the data of the sectoral statistics of the state institution «Public Health Centre of the Ministry of Health of Ukraine». The methods of systematic approach, statistical data processing and epidemiological analysis of graphical representation were used.Results and discussion. In 2023, after three years of the COVID-19 pandemic and against the background of the ongoing Russian invasion of Ukraine, the infant mortality rate increased to 7.45 ‰ or 11.69 % compared to 2020. This increase was mainly due to a relatively higher increase in postneonatal mortality and late neonatal mortality in the current environment compared to early neonatal mortality. Certain conditions occurring in the perinatal period, congenital anomalies (malformations), malformations and chromosomal disorders, respiratory diseases, especially acute respiratory diseases of the upper airways, pneumonia, infl uenza, some infectious and parasitic diseases and diseases of the nervous system are the main causes of mortality in children in the fi rst year of life in 2023. In the structure of infant mortality, the proportion of deaths of children under 1 year of age due to infectious and parasitic diseases, respiratory diseases and external causes (injuries, poisoning, accidents), diseases of the nervous system and diseases of the circulatory system has increased signifi cantly in the last 4 years, which may also be a result of the direct and indirect synergistic eff ects of the war and the COVID-19 pandemic. The highest infant mortality rates were observed in Kherson (28.27 per cent), Zakarpattia (11.5 per cent), Dnipropetrovsk (9.29 per cent), Kirovograd (9.19 per cent), Donetsk (9.12 per cent), Zhytomyr (8.93 per cent) and Chernihiv (8.71 per cent) regions, which may indicate inadequate staffi ng and resources for paediatric services, particularly as a result of the war. Of particular concern is the 11.5 per cent increase in out-of-hospital mortality in the fi rst year of life compared with 2020, which may be due to the deterioration in the availability of medical care for children as a result of the hostilities in the east and south of the country.Conclusion. After three years of the COVID-19 pandemic and against the background of the ongoing Russian invasion, Ukraine has experienced an increase in infant mortality, with an increase in the incidence of children under one year of age and a greater increase in postneonatal and late neonatal mortality compared with a relatively small increase in early neonatal mortality.

Fibromyalgia and Somatic Symptom Disorder: Two Sides of the Same Coin?

Fibromyalgia affects about 1.78% of the population worldwide and has been recognized and studied since the 16th century. Despite that, the etiopathogenesis of fibromyalgia is still unknown. Consequently, there is still an ongoing debate whether fibromyalgia should be considered within the category of somatization disorders, or as a central pain sensitization syndrome, or even as a peripheral nerve disease. We consider that this is a relevant issue, since it impacts the referral of these patients to the different healthcare professionals, the type of assessment that is provided and the therapeutic approaches that are proposed to them.Several aspects point to similarities between fibromyalgia and somatic symptom disorder: both diagnoses share high comorbidity with several psychiatric disorders, a history of childhood trauma, the presence of alexithymia and other personality traits, insecure attachment styles and comorbidity with the so-called chronic overlapping pain conditions. Therefore, we hypothesize that fibromyalgia can be conceptualized as a somatic symptom disorder. However, the debate continues, since there is still a lack of scientific evidence supporting either in favor or against this perspective. More studies are needed to unveil the etiopathogenesis behind these two diagnoses.

Ultra High-Frequency Ultrasound of Median Nerve Fascicles at the Wrist in Amyotrophic Lateral Sclerosis: An Exploratory Study.

High-frequency ultrasound (HFUS) of muscle and nerve has the potential to be a reliable, responsive, and informative biomarker of disease progression for individuals with amyotrophic lateral sclerosis (ALS). High-frequency ultrasound is not able to visualize median nerve fascicles to the same extent as ultra-high-frequency ultrasound (UHFUS). Evaluating the number and size of fascicles within a nerve may facilitate a better understanding of nerve diseases. This exploratory study aims to image median nerve fascicles at the wrist in individuals with ALS using UHFUS and compare these findings with those from previously observed controls. Fifteen individuals with ALS underwent sonographic examination of the median nerves on each upper limb using UHFUS with a 48-MHz linear array transducer. Fascicle count and density in each examined nerve were determined by a single rater. Demographic and sonographic data from 20 previously studied controls were compared. In individuals with ALS, the average fascicle number was 22.4 (SD 5.2) and average fascicle density 1.7 (SD 0.5). There was no significant difference in fascicle counts between individuals with ALS and controls. Fascicular quantification using UHFUS is possible in individuals with ALS. Given the lack of appreciable difference between fascicle counts in individuals with ALS and controls, UHFUS of the median nerve at the wrist may not be a responsive biomarker for ALS disease progression.

Causes and Outcome of Neurogenic Vision Loss

Background: Neurogenic vision loss is often a medical emergency. Early evaluation and urgent treatment of the causes is the key to better visual prognosis.Methods: This was a retrospective cross-sectional study based on hospital records of patients admitted to the Neurology department of Tribhuvan University Teaching Hospital with complain of diminution of vision from April 2023 to March 2024. The visual outcome of the patients was recorded based on telephone interviews with the patients or their family members. Results: A total of 64 patients were identified of which 62 were interviewed for visual outcome. The median age was 38 years of which 62.5% were female. Bilateral eye involvement was reported in 59.4% of the cohort and half of the patients had normal optic disc. The distribution of visual acuity at presentation was 39.1% for 6/60 or better, 9.4% for 3/60 to less than 6/60, 32.8% for 3/60 and 18.8% having no perception of light. The commonest diagnosis in decreasing order of frequency was idiopathic intracranial hypertension, neuromyelitis optica spectrum disorder, idiopathic optic neuritis and myelin oligodendrocyte glycoprotein antibody disease with the frequency being 17.2%, 15.6%, 10.9% and 9.4% respectively. Of 62 patients interviewed, 67.7% reported a complete recovery of vision, 14.5% reported a partial recovery and 17.8% reported no visual recovery. Severity of visual loss at presentation was associated with poor visual outcome (p=0.021) whereas age, gender, number of eyes affected and duration of visual symptoms had no significant relation to visual recovery. Conclusions: Idiopathic intracranial hypertension, neuromyelitis optica spectrum disorder, Idiopathic optic neuritis, myelin oligodendrocyte glycoprotein antibody disease were the commonest causes of neurogenic visual loss. The severity of visual loss at onset is a prognostic marker of the visual recovery in these patients.Keywords: Blindness; Vision Disorders; Optic Nerve Diseases; Neural Optical Lesion

A devastating nerve disease stalks a mountain village

A devastating nerve disease stalks a mountain village

COVID-19 in the Central Nervous System - clinical manifestations and post-COVID syndrome - an update

Introduction: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), represents a significant global public health challenge. While respiratory symptoms dominate, the virus's impact on other systems, particularly the central nervous system (CNS), has gained increasing attention. SARS-CoV-2 demonstrates tropism for Angiotensin-Converting Enzyme 2 (ACE2) receptors, expressed in the olfactory epithelium, lungs, endothelium, kidneys, enterocytes, and neurons, contributing to neurological manifestations observed during the acute phase of the disease. Materials and Methods: A literature review was conducted using PubMed, Scopus, Web of Science, and ScienceDirect databases. Keywords included: COVID-19, Post Acute COVID-19 Syndrome, SARS-CoV-2 Virus, Neurological Manifestations, and Central Nervous System Viral Diseases. A total of 58 articles were selected for analysis based on relevance and quality of evidence regarding neurological symptoms and complications associated with COVID-19. Basic Results: The acute phase of COVID-19 frequently involves neurological symptoms such as frontal and holocranial headaches, dizziness, gustatory and olfactory dysfunctions, and alterations in consciousness. Severe complications, though less common, include encephalitis, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and myelitis. These conditions often present as altered mental status, seizures, aphasia, headaches, or focal deficits, contributing substantially to patient morbidity and mortality. Conclusions: Neurological symptoms and complications constitute a significant aspect of COVID-19, highlighting the virus's potential to affect the CNS. While severe complications are rare, their profound impact on prognosis underscores the importance of early recognition and management. Further research is essential to understand the pathophysiology and optimise therapeutic approaches for affected patients.

TREATMENT OF PERIPHERAL FACIAL PARALYSIS AS PART OF MOTOR NEUROREHABILITATION

The disease of the facial nerve (n.facialis) is in the first place among peripheral neuritis, both in terms of frequency and significance of functional dysfunctions and post-paralytic facial synkinesis can develop in any paralysis of the face and is associated with significant functional and psychosocial consequences for sick patients. The type and severity of nerve injury determine the degree of pathologic change, capacity for regeneration and prognosis for recovery. In the case of facial nerve neuritis, the greatest emphasis is placed on early detection, correct diagnosis of the damage and starting rehabilitation as soon as possible. In addition to drug therapy in the rehabilitation of facial nerve paralysis, the application of physiotherapeutic means, as well as acupressure, a technique from traditional Chinese medicine, has a significant place. Both basic concepts are holistic, with a comprehensive approach to the patient and the determination of treatments based on the differentiation of symptoms. The aim of the research is to analyze the impact of physiotherapeutic means combined with acupressure - a technique from traditional Chinese medicine, in patients with peripheral paralysis of the n.facialis with a moderate degree of functional disorder. Material and methods: Six patients (3 women and 3 men) diagnosed with peripheral paralysis of the facial nerve (4 left side / 2 right side) with a moderate degree of functional impairment are included in the study. For the purposes of the research, the following physiotherapeutic means were applied: thermotherapy, light therapy, electrotherapy - electrophoresis with Novocain and electrostimulation, therapeutic exercises and acupressure on the following points: Zanzhu (BL2), Yangbai (GB14), Taiyang (EX-HN5), Zygoma (SL18), Xiaguan (ST7), Yingxiang (LI20) and Yifeng (TE17). For the purposes of the research, a functional examination with a manual muscle test (MMT) for facial muscles and a test for the subjective feeling of pain is applied to all subjects at the beginning, during the therapies and at the end of the overall motor neurorehabilitation. Results: From the processed results, the influence of physiotherapeutic means in combination with acupressure in patients with peripheral paralysis of n.facialis with a moderate degree of functional disorder on muscle strength and pain intensity is observed and is most pronounced in the first month from the beginning of treatment. Discussion and conclusion: This is a complex research on physiotherapeutic possibilities combined with acupressure as part of modern motor neurorehabilitation to overcome muscle weakness, pain and asymmetry in patients with unilateral peripheral n.facialis. The presence of a positive change in the examined functional parameters is observed after the application of the combination of physiotherapy and acupressure and is most significant in the first month after the beginning of the treatments.

Clinical prognostic factors in patients with diffuse gliomas of the brain

BACKGROUND: Diffuse gliomas of the brain represent a heterogeneous group, which differs in age of the disease onset, histologic characteristics, tumor grade, molecular genetic markers and prognosis. AIM: of the present study is to identify the factors, which affect the duration of the relapse-free period and life expectancy in patients with diffuse brain gliomas, based on a comprehensive analysis of clinical syndromes and symptoms. MATERIALS AND METHODS: The study was carried out at the Departments of Neurosurgery and Nerve Diseases of the S.M. Kirov Military Medical Academy (Saint Petersburg, Russia). It included 390 in-patients with diffuse brain gliomas who underwent treatment over the periods of 2014–2022 and 2004–2006. Age at time of diagnosis was 45.26 ± 15.72 years old. The study included 218 (55.9%) male and 172 (44.1%) female patients. It was a single-centre prospective study. RESULTS: of the author’s research. Favourable demographic factors include the age range of 18–39 (relapse-free period duration p 0.01, life expectancy p 0.001) and female sex (relapse-free period p = 0.02, life expectancy p = 0.03). Prognostically favourable clinical manifestations include epileptic seizures before surgery (relapse-free period p 0.01, life expectancy p 0.02); unfavourable clinical manifestations are pyramidal syndrome (relapse-free period p 0.01, life expectancy p 0.001), sensitive disorders (relapse-free period p = 0.045–0.12, life expectancy p = 0.09–0.17), speech pathology (relapse-free period p 0.02, life expectancy p = 0.02–0.12) and cerebellar syndrome (relapse-free period p 0.02, life expectancy p 0.001). Clinical signs such as headache, nausea and vomiting, asthenia, diffuse neurological symptoms, craniocerebral nerve involvement and visual impairment do not affect (p 0.05) the outcomes of the patients with diffuse brain gliomas. CONCLUSION: Thus, favourable demographic prognostic factors include female sex and age range of 18–39, favourable clinical prognostic factors include epileptic seizures before surgery. Unfavourable clinical prognostic factors include presence of motor, sensory disorders, speech impairment and cerebellar syndrome.

The realities of modern practice and prospects for the implementation of standards of secondary care for patients with acute stroke in the Left Bank of Kyiv Region according to the data of the hospital register (literature review and own research)

Background. The purpose of our work is to study the main indicators of the quality of care for patients with an acute stroke in individual hospitals of the Left Bank of the Kyiv Region of Ukraine. Materials and methods. The research was carried out at the Department of Nervous Diseases of the Shupyk National Healthcare University of Ukraine, on the basis of CNCE “Brovary Multidisciplinary Clinical Hospital”, angioneurological department with 85 beds (hereinafter — BMCH), and 4 secondary care centers with decentralized localization in the Kyiv Region (hereinafter — CDHKRLBU). The named departments are located 80–100 km, and BMCH is 15 km away from the regional center. They work according to an approved local protocol that meets industry standards for the management of patients with acute cerebral stroke and existing clinical guidelines. A total of 10,608 hospitalized patients with acute cerebral stroke were included in the prospective, cohort study (5,818 patients in BMCH and 4,790 patients in CDHKRLBU). For each case, the RES-Q (version 1.2) was filled out — a report form in an international program developed by the ESO-EAST initiative. Results. The study showed that the quality of care for stroke patients can be influenced by the material and technical base of the institution, as well as availability of diagnostic equipment, bed capacity and, of course, the logistical location, distance from the regional center. All quality indicators point to the leadership of BMCH compared to CDHKRLBU, and this has explanations. Conclusions. The study identified both positive and negative aspects of the therapeutic and diagnostic work in healthcare facilities, as well as factors influencing the success of treatment outcomes for patients with acute stroke. These findings have convincingly confirmed the relevance of studying quality care indicators and support the further implementation of the hospital registry method (based on RES-Q registry principles) in other areas of Kyiv Region and across Ukraine to evaluate and monitor the quality of medical care, including the analysis of the effectiveness of new technologies. During the study, BMCH purchased a new SCT, Philips Intera 1.5T MRI scanner (Netherlands), and Siemens angiograph in 2021, which improved the diagnosis of cerebral strokes and the use of treatment of thrombolytic therapy, thrombus extraction within the Left Bank of the Kyiv Region of Ukraine. Neighboring hospitals acquired SCT and expanded thrombolytic therapy for ischemic stroke. Of course, the research conducted is positive, because it becomes possible to identify certain shortcomings in the work and formulate recommendations for planning measures to improve medical care for stroke patients, as well as to compare the results of activities at the international and national levels.

Nutraceuticals in veterinary ophthalmology: fact, fiction or both?

This review examines the use of nutraceuticals in canine and feline ocular diseases, highlighting their potential benefits and the dangers of misinformation. While certain products like curcumin, beta-glucans and resveratrol show promise against feline herpesvirus, false claims surrounding L-carnitine for cataracts are emphasised. While L-carnitine may slow cataract progression, it cannot reverse cataracts or replace surgery. Alpha-lipoic acid, an antioxidant, holds potential for diabetes-related cataracts, while lutein, zeaxanthin and other carotenoids might slow age-related changes. Despite limited evidence, neuroprotective substances like grape seed extract, omega-3 fatty acids, lutein, zeaxanthin and vitamins are used for degenerative retinal and optic nerve diseases, aiming to slow or prevent vision loss. Future research is crucial to solidify their efficacy and avoid misleading pet owners.