Nervous System In Patients Research Articles

Beta-adrenergic reactivity of erythrocyte membranes in adolescents with supraventricular and ventricular arrhythmias before and after radiofrequency ablation

Aim. To evaluate β-adrenergic reactivity of erythrocyte membranes (β-ARM) in adolescents with ventricular and supraventricular arrhythmias before and after radiofrequency ablation (RFA) of heart rhythm disturbances.Materials and methods. The study included 49 adolescents aged 11–17 years, of which 15 had Wolff – Parkinson – White pattern (WPW), 13 – WPW syndrome, 10 – atrioventricular nodal reentry tachycardia (AVNRT), and 11 – ventricular arrhythmia (VA). The control group consisted of 11 adolescents without cardiovascular pathology. All patients received surgical treatment for heart rhythm disturbances (HRD) using RFA. In patients with HRD, β-ARM was determined by a set of reagents BETA-ARM AGAT (AGAT LLC, Russia) before RFA and 3 days after it. In the control group, the parameter was determined at the stage of inclusion in the study.Results. In adolescents with supraventricular arrhythmias, median values of β-ARM did not differ significantly from the control group. RFA in adolescents in these groups did not affect the value of β-ARM on day 3 after the surgery. In adolescents with VA, the median value of β-ARM was initially higher than in the control group (p = 0.026). On day 3 after RFA, an increase in β-ARM was noted in this group (p = 0.028) compared to baseline values.Conclusion. Activation of the sympathetic nervous system plays a significant role in the pathogenesis of VA in adolescence. The study showed the possibility of using β-ARM to assess the state of the sympathetic nervous system in patients with methodological limitations in analyzing heart rate variability.

Paraneoplastic Syndromes of the Nervous System in Patients Suffering from SCLC. A Review of the Recent Literature

Background. Paraneoplastic Neurological Syndromes (PNS) constitute a heterogeneous cluster of disease manifestations related to various cancers. Small Cell Lung Cancer (SCLC) is strongly related to PNS. This narrative review conducted a survey in the available PubMed literature to highlight the appearance of PNSs in SCLC cases and discuss published research highlights on the subject so that general practitioners can be acquainted with the medical phenomenon present in SCLC patients. Method. A narrative review of the medical literature was conducted as documentary informative research in the PubMed medical database, combined with a survey of the online e-library Google Books. The key words used were: “Paraneoplastic Neurological Syndromes” and “Small Cell Lung Cancer”. Results. Paraneoplastic syndromes are related to the presence of a malignancy and are not secondary to treatment. Paradoxally, both a malignancy and its therapeutic approach may cause a series of PNSs. Paraneoplastic cerebellar degeneration, motor neuron disorders, peripheral neuropathies, hyponatremia, and syndromes such as myasthenic Lambert-Eaton, ectopic Cushing’s, Stiffman, and Opsoclonus-myoclonus syndrome may also appear in SCLC cases. Diagnosis follows specific criteria, and they are caused by tumor-directed antibodies known as onconeural antibodies. Immunosuppressants, intravenous immunoglobulins, plasma exchange, rituximab, cyclophosphamide, azathioprine, and tocilizumab could be considered as treatment agents. Conclusions. Most patients demonstrate poor PNS treatment results with common relapse. The time for beginning treatment of PNS is discussed. A multidisciplinary team is needed for potentially earlier diagnosis and PNS improvement, better prognosis, and increased overall survival and quality of life.

The impact of regular physical training on the function of the autonomic nervous system in patients with inappropriate sinus tachycardia

Introduction: Sympathetic overactivity plays a crucial role in the pathogenesis of inappropriate sinus tachycardia (IST). It has been shown that regular physical activity positively affects the balance between the sympathetic and parasympathetic nervous systems, which may benefit patients with IST.Objective: This study aimed to assess the impact of regular physical training on the autonomic nervous system (ANS) function in patients with IST, focusing on heart rate variability (HRV) as an indicator of autonomic balance.Methods:The study included 32 female patients diagnosed with IST, with 16 in the study group (Group A) and 16 in the control group (Group B). The women in Group A participated in a structured physical training program lasting 12 weeks. HRV was analyzed based on 24-hour Holter monitoring recordings before and after the intervention. The statistical data obtained were presented as graphs illustrating changes in selected HRV parameters in response to physical training.Results:The study results indicate a significant improvement in heart rate variability (HRV) after 12 weeks of regular physical training in the study group. Notably, there was an increase in parameters associated with parasympathetic activity, such as the HF (High Frequency) index. Additionally, the SDNN index, which measures overall heart rate variability, also improved. These observations suggest that physical training contributed to an improvement in autonomic balance. The graphs in the study clearly depict changes in individual HRV parameters, confirming the positive impact of physical activity on the function of the autonomic nervous system in patients with IST.

Neurološki simptom kao prvi znak kolorektalnog karcinoma

Aim: To present a rare case of a patient with an isolated brain metastasis from colorectal carcinoma in whom an extensive diagnostic workup failed to identify the primary tumour. Case report: A 73-year-old female patient was admitted to the Neurology Department due to weakness in the right side of her body. Imaging with multislice computed tomography (MSCT) and brain magnetic resonance (MR) confirmed an expansive lesion in the left frontal region with surrounding oedema. Radiological findings suggested either a metastasis or a high-grade primary glioma. As the diagnostic workup did not reveal the primary tumour, the patient was transferred to Clinical Hospital Dubrava for surgical treatment. An intracranial tumour resection was performed with a histopathological confirmation of colon carcinoma metastasis. Postoperative brain irradiation was administered. A positron emission tomography scan (PET) showed focal accumulation of radioisotopes without clear pathological substrate in the appendix and cecoascedent junction area. Repeated colonoscopy did not find any pathological mucosal changes. The patient declined systemic treatment. Overall survival was 11 months, in line with literature data. Conclusion: The diagnosis of brain metastases from colorectal carcinoma is very rare, and even rarer is the diagnosis of isolated brain metastases without extracranial progression, counting for <0.5%. Therapeutic options for brain metastases from colorectal carcinoma include surgery, radio-neurosurgery, stereotactic radiotherapy, and brain irradiation. In our opinion, diagnostic evaluation of the central nervous system in patients with colorectal carcinoma should be considered if the patient has neurological symptoms or if there is an increase in carcinoembryonic antigen (CEA) levels without signs of extracranial disease progression.

The level of partial pressure of carbon dioxide affects organ perfusion in respiratory failure patients undergoing pressure support ventilation with venovenous extracorporeal membrane oxygenation: a prospective study

BackgroundWe evaluated the influence of different partial carbon dioxide pressure (PaCO2) levels on organ perfusion in patients with respiratory failure receiving pressure-support ventilation with veno-venous extracorporeal membrane oxygenation (V-V ECMO).MethodsIn this twelve patients prospective study, ECMO gas-flow was decreased from baseline (PaCO2 < 40 mmHg) until PaCO2 increased by 5–10 mmHg (High-CO2 phase). Resistance indices of gut, spleen, and snuffbox artery, the peripheral perfusion index (PPI), and heart rate variability were measured at baseline and High-CO2 phase.ResultsWhen PaCO2 increased from 36 (36–37) mmHg at baseline to 42 (41–43) mmHg in the High-CO2 phase (p < 0.001), PPI decreased significantly (p = 0.026). The snuffbox artery (p = 0.022), superior mesenteric artery (p = 0.042), and spleen (p = 0.012) resistance indices increased significantly. The root mean square of successive differences (RMSSD) decreased from 19.5(18.1–22.7) to 15.9(14.4–18.6) ms (p = 0.034), and the ratio of low-frequency to high-frequency components(LF/HF) increased from 0.47 ± 0.23 to 0.70 ± 0.38 (p = 0.013).ConclusionsHigh PaCO2 might cause decreased peripheral tissue and visceral organ perfusion through autonomic nervous system in patients with respiratory failure undergoing PSV with V-V ECMO.

Composite Autonomic Symptom Score-31 for the diagnosis of cardiovascular autonomic dysfunction in long-term coronavirus disease 2019.

Composite Autonomic Symptom Score-31 (COMPASS-31) is an easy-to-use screening tool for the evaluation of autonomic dysfunction in various diseases affecting neural function but has rarely been used in the assessment of long coronavirus disease 2019 (COVID-19). This study aimed to evaluate the diagnostic accuracy of the COMPASS-31 score in detecting dysfunction of the autonomic nervous system in patients 3 months after COVID-19 infection. Fifty-nine subjects were recruited and grouped into 2: (a) controls (n = 31) who had never had positive polymerase chain reaction results for COVID-19 before and (b) the post-COVID-19 patients (n = 28) who had confirmed COVID-19 infection 3-6 months before recruitment. COMPASS-31 questionnaire was utilized to evaluate subjective symptoms or evidence of autonomic dysfunction. Autonomic dysfunction was assessed objectively by cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV). For comparison of quantitative variables between two groups, t-test or Mann-Whitney U test, as appropriate, were used. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), negative likelihood ratio (LR), and positive LR were used as measures of diagnostic accuracy. Receiver operating characteristic (ROC) curve analysis determined the overall accuracy of COMPASS-31. The median COMPASS score was found to be significantly higher in post-COVID-19 participants than controls (15.5 vs. 10, P = 0.021). The median total CART score was also significantly higher in post-COVID-19 participants (0 vs. 1, P < 0.001). Out of 6 domains of the COMPASS score, the median value for orthostatic dysfunction was found to be significantly higher in post-COVID-19 participants than controls (12 vs. 0, P = 0.008). There was significantly fair accuracy of the COMPASS score with an area under the receiver operating curve 0.68 (0.54-0.82) following the total CART score ≥2 as the gold standard in the diagnosis of autonomic dysfunction (P = 0.021). The best cutoff point of the total COMPASS score was 12.5, where the optimal values of sensitivity, specificity, and positive and negative predictive values were achieved. Nonsignificant and weak correlations between CARTs, HRV parameters, and COMPASS score were found. COMPASS-31 could be used as a user-friendly screening tool to detect autonomic dysfunction in post-COVID-19 cases with acceptable sensitivity and specificity.

Impaired Modulation of the Autonomic Nervous System in Adult Patients with Major Depressive Disorder.

Patients with major depressive disorder (MDD) have an increased risk for cardiac events. This is partly attributed to a disbalance of the autonomic nervous system (ANS) indicated by a reduced vagal tone and a (relative) sympathetic hyperactivity. However, in most studies, heart rate variability (HRV) was only examined while resting. So far, it remains unclear whether the dysbalance of the ANS in patients with MDD is restricted to resting or whether it is also evident during sympathetic and parasympathetic activation. The aim of this study was to compare the responses of the ANS to challenges that stimulated the sympathetic and, respectively, the parasympathetic nervous systems in patients with MDD. Forty-six patients with MDD (female 27 (58.7%), mean age 44 ± 17 years) and 46 healthy controls (female 26 (56.5%), mean age 44 ± 20 years) underwent measurement of time- and frequency-dependent domains of HRV at rest, while standing (sympathetic challenge), and during slow-paced breathing (SPB, vagal, i.e., parasympathetic challenge). Patients with MDD showed a higher heart rate, a reduced HRV, and a diminished vagal tone during resting, standing, and SPB compared to controls. Patients with MDD and controls responded similarly to sympathetic and vagal activation. However, the extent of modulation of the ANS was impaired in patients with MDD, who showed a reduced decrease in the vagal tone but also a reduced increase in sympathetic activity when switching from resting to standing. Assessing changes in the ANS during sympathetic and vagal activation via respective challenges might serve as a future biomarker and help to allocate patients with MDD to therapies like HRV biofeedback and psychotherapy that were recently found to modulate the vagal tone.

Nervous system functioning disorders in patients with mandible fractures

Relevance. Fractures of the mandibular fracture are a stressor on the body and lead to changes in the functioning of the autonomic nervous system. At the same time, patients with mandibular fractures often experience local changes in the nervous system associated with the anatomical and physiological features of the location of the third branch of the trigeminal nerve and its damage. These changes affect the course of the post-traumatic period and may increase the likelihood of complications of mandibular fractures.Purpose: to determine the significance of disturbances in the functioning of the nervous system during the post-traumatic period of fractures of the mandibular fracture.Materials and methods. When examining 130 patients with fractures of the mandibular fracture, the state of the autonomic nervous system and local neurological changes were studied.Results. In patients with mandibular fractures, dysfunction of the autonomic (autonomic) nervous system and local neurological changes were revealed.The severity of these changes is reflected in the development of complications of fractures. When studying the autonomic nervous system in patients with mandibular fractures, there was an increase in the activity of the sympathetic nervous system, which increased the likelihood of developing complications of mandibular fractures. A high incidence of injury to the inferior alveolar nerve was also found. The most pronounced deviations in autonomic balance indicators – pathological increased excitability of the autonomic nervous system – were diagnosed in patients with complicated fractures of the mandibular fractures. In most patients with complicated mandibular fractures, damage to the trigeminal nerve was detected, confirming the role of neurotrophic disorders in the development of complications.Conclusion. With fractures of the mandible, there is an increase in the activity of the sympathetic nervous system, which increases the likelihood of complications. The most pronounced deviations in autonomic balance indicators were diagnosed in patients with complicated fractures of the mandible. In addition, in patients with mandibular fractures, a high incidence of damage to the inferior alveolar nerve was revealed; in complicated fractures, neuropathy is severe, which confirms the role of neurotrophic disorders in the development of complications. Thus, methods for preventing purulent-inflammatory complications in jaw fractures should include correction of neurological disorders.

Effects of transcranial direct current stimulation and sensorimotor training in anterior cruciate ligament patients: a sham-controlled pilot study.

Studies showed changes in the central nervous system in patients who sustained an anterior cruciate ligament tear. There is a lack of evidence regarding the effectiveness of transcranial direct-current stimulation in such patients. A sham-controlled randomised study. One group of patients (n = 6) underwent 6 weeks of sensorimotor training after an anterior cruciate ligament tear during transcranial direct-current stimulation. The stimulation consisted of 20 minutes (3 sessions/week; 2 weeks) of 2 mA anodal transcranial direct-current stimulation over the primary motor and premotor cortex. The second group (n = 6) received sham stimulation with 6 weeks of sensorimotor training. Centre of pressure deviations in the medio-lateral and anterior-posterior direction and centre of pressure velocity were measured. The results demonstrated a significant effect of sensorimotor training on the centre of pressure in medio-lateral and anterior-posterior direction (p=0.025) (p=0.03) in the leg in which an anterior cruciate ligament tear occurred. The type of training did not affect the results. Post-hoc tests showed no significant effect of training in the subgroups (p≥0.115). Sensorimotor training led to a decrease in sway of the centre of pressure in patients who sustained an anterior cruciate ligament tear, but the addition of anodal transcranial direct-current stimulation placed over the primary motor cortex did not potentiate the adaptive responses of the sensorimotor training.

Hypercapnic hypoxia as a rehabilitation method for patients after ischemic stroke

ABSTRACT Introduction Experimental studies on animals have demonstrated a higher neuroprotective efficacy of hypercapnic hypoxia compared to normocapnic hypoxia. Respiratory training with hypercapnic hypoxia has shown a positive impact on the functional state of the nervous system in children with cerebral palsy (CP). It can be presumed that the combined effect of moderate hypercapnia and hypoxia will be promising for clinical application within the context of early rehabilitation after ischemic stroke. Methods A randomized triple-blind placebo-controlled study was conducted on 102 patients with ischemic stroke, aged 63.07 ± 12.1 years. All patients were diagnosed with ischemic stroke based on neuroimaging criteria and/or clinical criteria within the 48–72 hour timeframe. The experimental group (n = 50) underwent daily respiratory training with hypercapnic hypoxia (FetCO2 5–6%, FetO2 15–16%) using the ‘Carbonic’ device for 7–11 sessions of 20 minutes each day during the treatment process. The control group (placebo, n = 52) underwent training on a similar device modified for breathing atmospheric air. Neurological examinations were conducted on all patients before the study and on the day after completing the training course. Results The standard treatment demonstrated effectiveness in terms of neurological status scales in both groups. Intermittent exposure to hypercapnic hypoxia proved more effective in improving neurological function indicators in patients compared to the placebo group: NIHSS scale scores were 40% lower than in the placebo group (p < 0.001); mRS scale scores were 35% lower (p < 0.001); B-ADL-I and RMI indices were higher by 26% (p < 0.01) and 36% (p < 0.001), respectively; MoCA scale results were 13% higher (p < 0.05); HADS and BDI-II scale scores were lower by 35% (p < 0.05) and 25% (p < 0.05), respectively. The increase in MMSE scale scores in the intervention group was 54% higher (p < 0.001), and MoCA scale scores increased by 25% (p < 0.001). Conclusion Respiratory training with hypercapnic hypoxia improves the functional state of the nervous system in patients with ischemic stroke. After conducting further clarifying studies, hypercapnic hypoxia can be considered as an effective method of neurorehabilitation, which can be used as early as 48–72 hours after the onset of stroke.

Monitoring differences in the function of the autonomic nervous system in patients with chronic insomnia using a wearable device

Study objectivesto characterize possible differences in the function of the ANS in patients with chronic insomnia compared to a control group, using a wearable device, in order to determine whether those findings allow diagnosing this medical entity. MethodsThirty-two patients with chronic insomnia and nineteen patients without any sleep disorder, as a control group, were recruited prospectively. Both groups of patients underwent an in-patient night with simultaneous polysomnography and wearable device recording Empatica E4 a diverse array of physiological signals, including electrodermal activity, temperature, accelerometry, and photoplethysmography, providing a comprehensive resource for in-depth sleep analysis. ResultsIn polysomnography, patients suffering from insomnia showed a significant decrease in sleep efficiency and total sleep time, prolonged sleep latency, and increased wakefulness after sleep onset. Accelerometry results were statistically significant differences in the three axis (x, y, z) just in stage N3, no differences were observed between both groups in REM sleep. The lowest temperature was reached in REM sleep in both groups. Peripheral temperature did not decrease during the different sleep phases compared to wakefulness in insomnia, unlike in the control group. Heart rate was higher in patients with insomnia than in controls during wakefulness and sleep stage. Heart rate variability was lower in stage N3 and higher in REM sleep compared to wakefulness in both groups. Sweating was significantly higher in patients with insomnia compared to the control group, as indicated by Skin Conductance Variability values and Sudomotor Nerve. ConclusionsOur study suggests that patients with insomnia have increased sympathetic activity during sleep, showing a higher heart rate. Temperature and sweating significantly influence the different sleep phases.

Nervous system damage in breast cancer patients receiving chemotherapy

This article presents modern ideas about the problem of damage to the nervous system in patients with breast cancer receiving chemotherapy. Breast cancer is the most common cancer of women worldwide. To date, chemotherapy is increasingly used in treatment regimens. However, many chemotherapeutic drugs are potentially neurotoxic, which increases the risks of acute and delayed side effects, including damage to both the central and peripheral nervous systems in the form of cognitive impairment and post-chemotherapeutic polyneuropathy, which significantly worsen the quality of life of patients. Due to the increased survival rate of patients, knowledge of the potential neurotoxic effect of chemotherapeutic drugs and timely diagnosis of damage to the nervous system is of particular relevance.

Assessment of the state of autonomic dysfunction in patients with tuberculosis of the respiratory system and in combination with HIV infection in modern conditions

The autonomic nervous system (ANS) is an important part of the human nervous system responsible for regulating internal organs and maintaining the internal environment of the body. Adequate functioning of the ANS supports homeostasis is the internal stability of the body and regulates many functions in it, such as cardiac activity, breathing, etc. TB-related stress and inflammation affect have influence at the balance of sympathetic and parasympathetic activity. Affecting the work of the peripheral nervous system, it becomes possible to influence at the system of homeostasis of the body through its regulatory systems. Improving the diagnostics of autonomic dysfunction and identifying its dysfunction will provide an integrated individualized approach to treatment and will make a significant contribution to increasing the effectiveness of therapy for patients with tuberculosis.Aim. Diagnosis of the state of the autonomic nervous system by its main indicators using available informative methods for assessing its functional state in patients with respiratory tuberculosis, including in combination with HIV infection at the beginning of treatment and detecting the level of its damage for further correction with the prescription of pathogenetic therapy.Materials and methods. The functional state of the autonomic nervous system has been investigated in 260 people. In the study, 2 groups were formed: a control group (CG) of 70 healthy persons and a monitoring group (MG) of 190 newly diagnosed patients with tuberculosis. There are 3 subgroups in MG. The 1 subgroup included 65 patients with pulmonary tuberculosis, in whom the function of ANS was studied by conventional examination methods, and in 64 patients with tuberculosis 2 subgroups and 61 patients with tuberculosis in combination with HIV infection 3 subgroups using Varikard 2.51. Calculations were carried out in the program SPSS Statistics v. 23.Results and discussion. Comparison of the frequency of autonomic dysfunction in patients with MG, subgroup 1 with that in the CG according to questionnaires No. 1 (χ2=36.346; p&lt;0.001) and No. 2 (χ2=50.885; p&lt;0.001), HR per minute (χ2=31.989; p&lt;0.001), Kerdo index (χ2=30.008; p&lt;0.001), cold sample (χ2=36.549; p&lt;0.001) revealed high reliability of differences and indicated the predominance of sympathicotension, which was determined 7 times more often in patients. At the beginning of treatment, in patients with concomitant HIV infection was detected a more pronounced dysfunction of ANS with a predominance of its sympathetic link, which was found 9.3 times more often than in healthy persons and 2.3 times more often than in patients without HIV infection. Comparing the frequency of PARS in the «normal zone» in the CG and in the 2 subgroup of MG (t1=5.01; p1&lt;0,001; t2=3,69; p2&gt;0.001), in CG and in MG subgroup 3 (t1=3.61; p1&lt;0.001; t2=3.61; p2&lt;0.001) high significant differences were identified, indicating a significant predominance of regulatory process disorders in patients with tuberculosis and especially when combined with HIV infection.Conclusion. The revealed disorders in the work of ANS patients with tuberculosis and in combination with HIV infection are associated with intoxication and asthenovegetative syndrome. Monitoring of heart rate variability can be used in medical research, as well as in clinical practice to assess the state of the autonomic nervous system in patients with tuberculosis and when combined with HIV infection, determine the application point for the effects of pathogenetic therapy in order to improve the results and effectiveness of the treatment.

Entrectinib in the treatment of ROS1-positive lung cancer

The possibilities in the treatment of patients with non–small cell lung cancer are constantly expanding – thanks to high-performance genomic profiling methods, we are discovering new targets in the tumor for drug action, as a result, new targeted drugs appear, some of them have several application points. Multipurpose drugs have a number of advantages and therefore have become the main direction of drug development. Entrectinib is an oral low molecular weight multikinase inhibitor that blocks three targets at once – the receptors of tyrosine kinases ROS1, NTRK1/2/3 and ALK, in 2023 was approved by the Ministry of Health of the Russian Federation for the treatment of adult patients with ROS1-positive metastatic non-small cell lung cancer. This form of lung cancer is classified as a rare orphan disease, which usually occurs in younger people (about 50 years old), more often in women and non-smokers. Until recently , we had the only active targeted drug – crizotinib. It provided a sufficiently high immediate effect and long-term control of the disease. However, his intracranial activity was not evaluated prospectively, and a retrospective analysis showed modest results. Entrectinib is distinguished from its competitor by high intracranial activity, and, as is known, metastatic brain damage in patients with activating mutations is quite common. With comparable indicators of objective response, its duration and time to progression, entrectinib provides a high level of intracranial control and reduces the risks of progression in the central nervous system in patients who did not have brain metastases at the beginning of therapy. In addition, entrectinib demonstrates good tolerability.

Metastases to lymph nodes from monofocal and multifocal papillary thyroid malignant tumors in patients with autoimmune thyroiditis

The aim of this work was to study the risk factors for metastasis to the central and lateral neck lymph nodes in papillary thyroid carcinoma (PTC) and multifocal papillary thyroid carcinoma (MPTC), especially in patients with Hashimoto’s thyroiditis (TH).Methods: A retrospective analysis of 763 patients after thyroidectomy with bilateral central lymphadenectomy (CLE) was performed at the interterritorial Center for Endocrine Surgery in Krasnodar during the period from October 2011 to October 2021. All patients had official histological diagnoses of TH. To identify risk factors for metastasis (Mts) to the lymph nodes of the neck, a multifactorial logistic regression analysis was performed.Results: In our study, 277 patients with SCLC and TC showed relatively low rates of Mts to the central lymph nodes (CLU) compared with patients with SCLC without TC (37.2 % vs. 54.7 %, P 140 IU / ml was established as the most sensitive and specific level for predicting MPCT based on the study. Antibodies to AT-TPO, age, tumor size, and multifocal tumor shape demonstrated the ability to predict Mts in the central nervous system in patients with PCT on the background of TC with a probability of 81.1 % based on a multidimensional model. TH was associated with an increased prevalence of multifocal tumor with invasion of the gland capsule.Conclusions: TH detection demonstrated the reduced risk of metastases to the CLN in patients with PCT and MPCT and indicated a potential protective effect. We found that the prognostic model is applicable for predicting a multifocal tumor and metastasis to the central nervous system in patients with PCT and TH.

The relationship between the functional state of the brain and clinical and constitutional factors in schizophrenia

To establish the relationships of functional changes of the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. One hundred and eighteen patients with schizophrenia (64 men and 54 women), aged 33 [29; 40], years were examined. The following clinical and dynamic parameters were used: age of manifestation of the disease, duration of the disease, severity of clinical and psychopathological symptoms according to the PANSS. The anthropometric examination of patients was carried out according to V.V. Bunak's method in V.P. Chitetsov's modification for adult samples with calculation of Rees-Eysenk and Tanner indices. The EEG was recorded and analyzed in a state of calm, relaxed wakefulness with closed eyes with the calculation of the absolute spectral power for theta (4-7 Hz), alpha (8-13 Hz) and beta (14-30 Hz) rhythms. Significant (p<0.05) direct correlations between the age of the disease manifestation and the spectral power of the beta rhythm in the frontal leads (Fp1, Fp2, F3 and F4) were revealed. Inverse correlations (p<0.05) were found between the duration of the disease in patients with schizophrenia and the spectral power of the alpha rhythm in the left temporal (T3) and right central leads (C4), the spectral power of the beta rhythm in the parietal-occipital (P3, P4, O1,O2) and temporal leads (T3, T4, T5), the spectral power of the theta rhythm in the left occipital (O1) and posterior temporal leads (T5). Significant inverse correlations were also found between the Tanner index and the spectral power of the alpha rhythm in the frontal and temporal leads, between the Rees-Eysenk index and the spectral power of the theta rhythm in the frontal leads. The results indicate the presence of the conjugation of functional changes in the brain of patients with schizophrenia with clinical manifestations of the disease and their constitutional and morphological features. Thus, the assessment of the functional state of the central nervous system in patients with schizophrenia is an important component of the diagnostic search.

КЛІНІЧНІ ТА ДЕЯКІ ІМУНОЛОГІЧНІ ОСОБЛИВОСТІ ПРОЯВІВ ГЕРПЕСВІРУСНИХ УРАЖЕНЬ НЕРВОВОЇ СИСТЕМИ НА ФОНІ ПОСТКОВІДНОГО СИНДРОМУ

The article presents data from the current literature on the relevance of a serious health problem, problems in the diagnosis of post-COVID syndrome, complications, complex T-cell and cross-talk immune system responses. A detailed analysis of the manifestations of central and peripheral nervous system lesions in herpesvirus infections with post-COVID syndrome is carried out and substantiated by the literature. The manifestations of immune responses and autoimmune changes in COVID-19 are presented. The aim of the study was to investigate the clinical and immunological features of the course of herpesvirus lesions of the nervous system in patients with and without post-COVID syndrome. We examined 96 patients with nervous system lesions of herpesvirus etiology who had a history of COVID-19 (on average 2-2.5 months before admission to the department). Patients who have had COVID are much more likely to have lesions of individual CNS (2.14 times), PTO dysfunction (2.1 times), diffuse neurological symptoms (2 times), mental disorders (1.8 times), sleep disorders (3.5 times) and fever (2.4 times). The authors of the article found that in patients with nervous system lesions against the background of post-COVID syndrome and activation of neurotropic pathogens, headac he, ataxia and autonomic dysfunction, diffuse neurological symptoms and pyramidal insufficiency were most common. The activity of autoantibodies to neuroantigens (myelin basic protein, NSE, S-100, and human general brain antigen) was determined in all patients. In patients with post-COVID syndrome, a statistically significant increase in the level of autoantibodies to myelin basic protein, S100 protein, and neurospecific enolase was detected compared to the control group. These data indicate a more severe course of nervous system lesions in the setting of post-COVID syndrome, which in turn is associated with deeper damage to the structures of the nervous system. Keywords: Long-COVID, nervous system injures, autoimmune response, herpesviruses.

Assessment of the autonomic nervous system in patients with chronic low back pain

Assessment of the autonomic nervous system in patients with chronic low back pain

КЛІНІЧНІ ТА ДЕЯКІ ІМУНОЛОГІЧНІ ОСОБЛИВОСТІ ПРОЯВІВ ГЕРПЕСВІРУСНИХ УРАЖЕНЬ НЕРВОВОЇ СИСТЕМИ НА ФОНІ ПОСТКОВІДНОГО СИНДРОМУ

The article p in the diagnosis of post-COVID syndrome, complications, complex T-cell and cross-talk immune system responses. resents data from the current literature on the relevance of a serious health problem, problems A detailed analysis of the manifestations of central and peripheral nervous system lesions in herpesvirus infections with post-COVID syndrome is carried out and substantiated by the literature. The manifestations of immune responses and autoimmune changes in COVID-19 are presented. The aim of the study was to investigate the clinical and immunological features of the course of herpesvirus lesions of the nervous system in patients with and without post-COVID syndrome. We examined 96 patients with nervous system lesions of herpesvirus etiology who had a history of COVID-19 (on average 2–2.5 months before admission to the department). Patients who have had COVID are much more likely to have lesions of individual CNS (2.14 times), PTO dysfunction (2.1 times), diffuse neurological symptoms (2 times), mental disorders (1.8 times), sleep disorders (3.5 times) and fever (2.4 times). The authors of the article found that in patients with nervous system lesions against the background of postCOVID syndrome and activation of neurotropic pathogens, headac he, ataxia and autonomic dysfunction, diffuse neurological symptoms and pyramidal insufficiency were most common. The activity of autoantibodies to neuroantigens (myelin basic protein, NSE, S100, and human general brain antigen) was determined in all patients. In patients with post-COVID syndrome, a statistically significant increase in the level of autoantibodies to myelin basic protein, S100 protein, and neurospecific enolase was detected compared to the control group. These data indicate a more severe course of nervous system lesions in the setting of postCOVID syndrome, which in turn is associated with deeper damage to the structures of the nervous system. Keywords: Long-COVID, nervous system injures, autoimmune response, herpesviruses.

Assessment of neurofunctional activity in patients with vibration disease caused of local vibration

Introduction. The stressful effect of local vibration contributes to the development of cerebral dysfunction with the formation of a sensorineural deficit in patients with vibration disease associated with exposure to local vibration.&#x0D; The study aims to identify the features of changes in somatosensory evoked potentials, neuroenergocarting and neuropsychological testing in patients with local vibration.&#x0D; Materials and methods. Scientists examined 103 patients with local vibration (group one), 35 healthy men (comparison group). We used methods of registration of somatosensory evoked potentials (SSEP), constant potential level (CPL), neuropsychological testing.&#x0D; Results. The authors revealed in the first group, in comparison with the other group, a significant increase in cerebral energy metabolism in the form of an increase in the level of constant potential in the frontal right and left (Fd, Fs), central (Cd, Cz, Cs), parietal (Pd, Pz, Ps), occipital (Oz), right and central temporal (Td, Tz) brain regions, increased latency of peaks N10, N11, N13, N30, peak interval N13–N18 at p&lt;0.04, cognitive dysfunction with mild damage to prefrontal frontal lobes, inferior temporal and inferior parietal regions, parietal-temporal-occipital zone of the left hemisphere, as well as subcortical structures. The data of the correlation analysis indicate that the slowing down of the ascending somatosensory flow from the level of the brachial plexus ganglia to the ventroposterolateral nucleus of the thalamus contributes to the emergence of a compensatory state in the form of an increase in energy processes in the frontal-central and parietal parts of the cerebral cortex, causing the development of cognitive disorders.&#x0D; Limitations. The limitations of the study were the lack of studying the effects of local vibration on cerebral hemodynamics and the state of efferent pathways of the central nervous system in patients with local vibration.&#x0D; Conclusion. Signs of impaired neurofunctional activity in local vibration are an increase in the duration of peak intervals N10–N13 and N11–N13, the latency of peak N10, the level of constant potential of the frontal right and central left leads, the level of constant potential of interhemispheric relations in the central department, a decrease in categorical and conceptual thinking, short-term (auditory) memory, visual gnosis, expressive speech.&#x0D; Ethics. The study was conducted in compliance with Ethical standards developed in accordance with the Helsinki Declaration of the World Medical Association "Ethical principles of conducting scientific medical research with human participation" as amended in 2000 and "Rules of Clinical Practice in the Russian Federation" approved by Order of the Ministry of Health of the Russian Federation No. 266 dated 06/19/2003. Informed consent was received from each person to participate in the survey, approved in accordance with the established procedure by the Local Ethics Committee.