Neurocirculatory Dystonia Research Articles

Clinical and morphological changes of the cardiovascular system in patients with cardioneurosis (neurocirculatory dystonia)

The term “cardioneurosis” (neurocirculatory dystonia (NCD)) refers to somatoform dysfunction of the autonomic nervous system, which is caused by the imbalance of the sympathetic, parasympathetic and metasympathetic parts of the nervous system. It is a polyetiological disease characterized by multiple clinical symptoms, mainly from the cardiovascular system, which occur and aggravate against the background of acute and chronic stress effects, but has a benign course and a good prognosis. Despite the functional nature of the disease, pathology of the cardiovascular system in some patients may transform into organic one after a certain period of time. Due to the significant prevalence of NCD in the overall structure of cardiovascular diseases (up to 50%), especially among young and able-bodied people, the study of clinical features and the search for a morphological substrate of cardioneurosis is relevant. The purpose of the study is to evaluate the effect of NCD on the heart connective tissue matrix (CTM) and the appearance of cardiac syndromes in NCD, their clinical manifestations on the part of the cardiovascular system. The analysis is based on a review of national and foreign original articles and research, using databases PubMed, eLIBRARY.RU, Web of Science. The article deals with the clinical features of cardioneurosis, in particular the appearance of cardiac syndromes in NCD and their clinical manifestations, as well as the role of structural disorders in CTM, as in a locus of primary neurovascular and neuroendocrine interactions. CTM changes that occur with NCD are associated with pathology which is caused by damage to the connective tissue, and in particular with non-differentiated dysplasia of connective tissue. Therefore, systemic dysplastic changes in CTM may be a marker of constitutional psycho-vegetative insufficiency and a morphological substrate of NCD.

Спектрально-корреляционный анализ ЭЭГ у ликвидаторов аварии на ЧАЭС с неврологическими нарушениями

Purpose: Comparative analysis of spectral correlation characteristics of EEG from liquidators of the Chernobyl accident and persons group, with neurological disorders. 
 Material and methods: A study carried out with the participation of 141 of the liquidator of the Chernobyl accident and 84 people group. Ionizing effects could be subject only to the liquidators. The average radiation dose in a group of liquidators was 110 ± 14 mSv. Groups were matched on age and employment. All persons have passed clinical neurological and electrophysiological examination. The focus of the article given that spectral and correlation analysis of EEG. 
 Results: Clinical examination made it possible to diagnose neurological disorders in both groups as: vegetovascular dystonia, neurocirculatory dystonia, dyscirculatory encephalopathy of different etiology. Their number and extent dominated statistically in a group of liquidators of the Chernobyl accident. It is important to note that increasing the frequency of their manifestations depending on the liquidators received radiation doses have not been identified. However, the disorder is diagnosed more often in the psychoemotional sphere among liquidators, than in the group mapping (61.7 % and 29.7 %, respectively). The analysis reveals statistically significant differences in EEG spectra in the presence of specified diagnoses compared with known characteristic of norms. Spectral and correlation analysis of EEG complements these data, demonstrating the existence of correlative considered diagnoses and significant differences between groups of liquidators and mappings. Liquidators increased delta-range observed in the authentically greater degree (as compared to a matched group) and combined with a significant reduction in the alpha-frequency index. The observed changes among liquidators are functional and non-specific in nature. Picture of the totality of the observed changes is not specific. It is regarded as one of the non-pathogenic mechanisms of development of the asthenic symptoms of different etiology.
 Conclusions: In the group of liquidators revealed a significant increase in the quantity and the degree of neurological disorders. In the spectrum of EEG liquidators reliably amplifies the index delta-activity and decreases the severity of alpha range compared to a mappings group. It is important that these changes are accompanied by a weakening of the correlations between brain structures and disruption EEG rest.

On the issue of pathogenesis of placental dysfunction in women with miscarriage

To determine the correlation of local non-progressive abruption of placenta and the development of placental dysfunction with undifferentiated connective tissue dysplasia (UCTD), we have conducted the case-consequence research with 100 patients. The research included two stages. At the first stage, all the predictors of this complication were divided into 4 groups: somatic anamnesis, obstetric, gynecological and infectious anamnesis, course of the given pregnancy and results of tests for Phase-II detoxification gene polymorphism. At the second stage, all the significant predictors were included in a multifaceted logistic regressive analysis. The most significant causes of local non-progressive abruption of placenta at placental dysfunction are the following: UCTD (OR-18.86; 6.58–54.02), its visceral markers such as scoliosis (OR 5.76; 2.08–15.97), heart diseases (mitral valve prolapse, hypertensive neurocirculatory dystonia, supplemental chord) (OR 8.61; 3.11–23.83), myopia (OR 6.25; 2.26–17.29), platypodia (OR 4.49; 1.61–12.55), renal diseases (OR 7.94; 2.87–21.98). The sheer presence of UCTD in this category of patients increases by 18 times the risk of disorder of trophoblast invasion and development of placental dysfunction. Key words: local placental abruption, undifferentiated connective tissue dysplasia, placental dysfunction, gene polymorphism.

Premenstrual dysphoric disorders in women of Russian Federation and risk factors for their development. Epidemiological study of1,326 women

The epidemiology of premenstrual dysphoric disorders (PMDD) and the risk factors for PMDD in women of the Russian Federation are still not fully resolved. Objective: to assess the prevalence of PMDD among women in the Russian Federation and to identify risk factors for PMDD. Materials and methods. An anonymous questioning using the questionnaire was carried out by 1326 women of the reproductive period of different regions of the Russian Federation: Moscow (880), Ural (150), Rostov (146) and Novosibirsk (150) regions. Inclusion criteria were: age of 15-45 years, regular menstrual cycle of 25-35 days, lack of psychiatric diagnoses in history. The results. It was found that 15.6 % of Russian women meet the criteria for PMDD. The primary age of the first appearance of PMDD symptoms is 15-19 years. The statistically significant risks of developing PMDD are ages 15-24 years, education at a higher education institution, lack of regular sexual life, history of neurocirculatory dystonia, complication of heredity in neuropsychiatric diseases and premenstrual syndrome, painful periods and complications in childbirth or abortion. Conclusions: the high prevalence of PMDD (15.6 %) in young women of the reproductive period, the presence of psychosocial and biological risk factors for PMDD requires the development of a modified tool for the early diagnosis of PMDD for general practitioners, obstetrician gynecologists, and psychiatrists.

Physical Rehabilitation of Girls with Neurocirculatory Dystonia

Neurocirculatory dystonia is a syndrome of disorders of the cardiovascular system and its functions, in the etiology of which there are disorders of neuroendocrine regulation. The disease has several options for development, the symptoms are also varied. The most common symptoms of cardiovascular disorders due to stress. In the initial state, with neurocirculatory dystonia, signs of general asthenia, hypotension and bradycardia are characteristic, which sharply weakens the adaptive capacity of the organism. As a result of the course of traditional physical rehabilitation in girls with neurocirculatory dystonia, it was possible to achieve a slight increase in the reserve capacity of their cardiac and respiratory systems, with some weakening of the manifestations of hypotension and bradycardia. This did not allow, however, to reach the indicators at the level of the control group. The effectiveness of the author's version of the physical rehabilitation of the tested girls with neurocirculatory dystonia showed the possibility of developing more pronounced positive changes in the body due to the powerful activation on their background of the backup capabilities of the main life support systems. The leveling in this group of manifestations of hypotension and bradycardia when the considered indicators reach the level of the control group during the application of the author's rehabilitation option proved its advantages and high health potential.

ОЦІНКА ПСИХІЧНОГО ТА ФУНКЦІОНАЛЬНОГО СТАНІВ СТУДЕНТОК, ХВОРИХ НА НЕЙРОЦИРКУЛЯТОРНУ ДИСТОНІЮ

ОЦІНКА ПСИХІЧНОГО ТА ФУНКЦІОНАЛЬНОГО СТАНІВ СТУДЕНТОК, ХВОРИХ НА НЕЙРОЦИРКУЛЯТОРНУ ДИСТОНІЮ

Сравнительные исследования мозгового кровотока у детей и подростков, проживающих в северном и арктическом регионах

Functional Doppler ultrasonography was used to study cerebral blood flow in 177 children and adolescents 7-18 years old living in the European North (Arkhangelsk region), Subarctic (Kola Peninsula) and Arctic (Svalbard) regions. It was established that the number of functional abnormalities in the system of regulation of cerebral circulation depends on the degree of severity of the environment. Based on the data obtained, a hypothesis has been suggested that in the harsh conditions of the Arctic in children and adolescents a special disadaptation state of the systemic regulation of cerebral circulation can be formed, which can be called as the syndrome of the polar neurocirculatory dystonia. The main signs of this condition are: a) a decrease in the metabolic hemodynamic response under the brain activation; b) manifestations of cerebral angiodystonia in the form of asymmetry of blood flow velocities in the brain base arteries, arterial tone disturbances and high vegetative lability of cerebral blood flow; c) pronounced signs of venous discirculation, including increased intracranial venous outflow along the basal veins.

Current Safety Data of the Complex Herbal Medicine with Sedative and Cardioprotective Actions

Background. The risk management plan is the one of main documents of pharmacovigilance system – a document focuses on the planning of pharmacovigilance activities and minimization of risks. As the use of herbal medicines has increased, so too have the reports of suspected toxicity and adverse events. As many herbal products on the market have not been thoroughly tested for their pharmacology and toxicology, pharmacovigilance has paramount importance in detecting unwanted reactions. One of the herbal preparations widely used to support the cardiovascular system under stress, neurocirculatory dystonia, cardiac neurosis, in the complex treatment of arterial hypertension, angina pectoris, arrhythmia is a complex medicinal product Carvelis, oral drops, solution. The active pharmaceutical ingredients of the drug are: extract from a mixture of hawthorn leaves, flowers and fruit (Сrataegi folii cum flore, fructus extractum); herb extract of canine nettle (Leonuri herbae extractum); melissae herbia extract Melissae herbae extractum); valerian root extract (Valerianae radix extractum). Objective. Сritical analysis of current scientific data on the benefit/risk ratio of a complex herbal medicine with sedative and cardioprotective effects. Results. Pathophysiological and epidemiological characteristic of following nosological forms have been analyzed: stress, neurocirculatory dystonia, cardiac neurosis, arterial hypertension, angina pectoris, arrhythmia. Current data on phytopreparation safety and estimation benefit/risk ratio have been generalized. Available clinical data were analyzed for individual phytocomponents or its combinations. Conclusions. The prevalence, seriousness and severity of the course of all manifestations of neurocirculatory dystonia, stress, nervous excitement, heart neurosis, especially with disproportionate approaches to the treatment of these diseases, is a serious medical and social problem. Given the proven efficacy of the use of Carvelis preparation components, and also that the risks are predictable, and their occurrence can be countered, and if they occur it can be effectively suppress with other drugs, the benefit of using the phytopreparation prevails above the risks.

Clinical CHARACTERISTICS of children with neurocirculatory dystonia ON hypertonic type

Objective: to study clinical characteristics of children with neurocirculatory dystonia (NCD) on hypertonic type. Material and methods . The study included 30 children aged 7-16 with NCD on hypertensive type who were undergoing a check-up or treatment at the Cardiologic Ward of Gomel Regional Children's Clinical Hospital. Results. According to the data of the clinical examination of the children with NCD on hypertensive type, it was found that the majority of the patients had neurological and cardiac complaints; intensive physical development, clinically non-significant arrhythmias, hypersympathicotonic vegetative reactivity, moderate exercise tolerance and labile arterial hypertension according to the data of 24-hour blood pressure monitoring were predominant. Conclusion . The described clinical characteristics of the children with NCD on hypertonic type testify to the presence of functional shifts in the vegetative regulation in the patients of this group, which makes it possible to select a pathogenetically grounded therapy and to control its effectiveness.

Rational approaches to the diagnosis and treatment of neurocirculatory dystonia

Rational approaches to the diagnosis and treatment of neurocirculatory dystonia

Rational approaches to the diagnosis and treatment of neurocirculatory dystonia

The article presents the data about the medical and social significance of the problem neurocirculatory dystonia (NCD). The relevance of the problem stated in the article comes from the significant increase in the prevalence of the functional cardiovascular disorders having been documented during the past years. The NCD has the most frequently affects the young people of the working age suffering from the systemic neurogenic imbalance in the organism. The disease has a negative effect on the quality of life. This disorder is usually diagnosed in young and mature patients, who do not have any organic pathology and present various somatic complaints such as dizziness, headache, sleep disturbances, palpitations, shortbreathing, etc. The modern possibilities of therapy in patients with NСD have been presented and analyzed.

Influence of electromagnetic radiations of the radio-frequency range on vegetative maintenance of cardiovascular reactions of the human body

With the help of questionnaires, medical exam and functional examination of students was found a positive correlation between the formation of vagotonic reactions of the cardiovascular system and the exposure time of the EMR radio frequency range, as well as the appearance of signs of neurocirculatory dystonia and other pre-nosological symptoms of adverse effects radio waves.

The features of hemodynamic support of exercise stress in patients with neurocirculatory dystonia

Neurocirculatory dystonia occupies a special place among the most common cardiovascular diseases. On the one hand, it is almost the most often diagnosed cardiologic ambulatory disease in young patients, on the other hand, its clinical-nosological framework and diagnostic criteria have remain not completely defined just as decades ago. One of the characteristic manifestations of neurocirculatory dystonia is a reduction in physical capacity of patients, due both to the lack of strong-willed qualities and detraining, and disorders of oxygen and hemodynamic support of physical activity. In this study, it was shown that one of the factors limiting exercise tolerance in patients with neurocirculatory dystonia, is the lack of growth of parameters of cardiac output at all levels of exercise stress. These features of hemodynamic support of physical activity were most pronounced in patients with low tolerance to the load, while in the group with high physical ability they were in limits of statistically non-significant trends. The recovery period in patients neurocirculatory dystonia was extended: heart rate, in contrast to the healthy persons, did not return to initial values even for 10 minutes. Throughout the recovery period, patients remained observed at the peak of the load relative reduction in stroke and cardiac indexes. Perhaps one of the causes of hemodynamic dysadaptation in NDC patients to physical activity and reduced physical performance is a violation of their orthostatic reactions, the lack of mechanisms that ensure adequate venous return and cardiac output. Hyper-reactivity of the cardiovascular system, manifested in a consistent trend of tachycardia and increased peripheral vascular tone, may play a compensatory role.

EFFECT OF STRESS ON DEVELOPMENT OF ABNORMALITIES OF LABOR

Aim. To study stress factors influence on labor course. Materials and methods. 1542 deliveries of term pregnancies were analyzed, in 425 women the assessment of regulatoryadaptive status on parameters of cardio-respiratory synchronism tests have been performed, in 154 of these cases the clinical laboratory parameters have been determined. Results. The low stress resistance could be the prognostic marker of abnormalities of labor, which is characterized by the regular menstrual cycle and painful menstruation. The rate of operative delivery in abnormalities of labor was 66,88%. The neurocirculatory dystonia takes the lead among the other extragenital pathologies. Conclusion. The low stress resistance, which was assessed by the dynamics of regulatory-adaptive status, could be one of the prognostic markers of abnormalities of labor.

ФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ ЗАНЯТИЙ ФИЗКУЛЬТУРОЙ ПЕРВОКЛАССНИКОВ С ПАТОЛОГИЕЙ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ

The analysis of the physiological aspects of conducting physical education classes with first graders who have cardiovascular disease is given. The research urgency is caused by the fact that recently the rate of child disability in Russia has doubled. Prevalent disabilities associated with cardiovascular diseases and their manifestations. The data analysis of morbidity and disability of children in Voronezh Region over the past five years is given, one could argue about the increase in the number of first-graders, divided in consequence to the special medical group and their reduction to the core. According to the Health Department of the Voronezh Region the highest prevalence of pathologies of the cardiovascular system in children of 7–8 years are cardiomyopathy and myocarditis various, as well as dysregulation of vascular tone, occurring in the form of neuro-circulatory dystonia. On average, pupils in the first grades of secondary institutions observed pathology of the cardiovascular system at 23.4 % of cases.We have developed a technique of physical training of correctional orientation for first graders having pathology of the cardiovascular system, including developing, gymnastic and breathing exercises that are adapted to individualisierung and dosing of the training load. The developed program allows to improve the process of physical education at physical culture lessons with first graders who have cardiovascular system disease.

Особенности показателей ЭКГ у лиц моложе 45 лет, перенесших инфаркт миокарда

We conducted a retrospective study of EchoCG from 33 males who had the myocardial infarction. Patients with a diagnosis of "neurocirculatory dystonia" (30 people) entered the control group. We studied the size of the left ventricle, the left atrium, the right ventricle, their relationship to each other, the mass of the myocardium and the mass index of the myocardium of the left ventricle. The study of the morphological structures of the heart revealed a change in the size of the left ventricle, the left atrium and the right ventricle in patients who had an acute myocardial infarction, manifested by an increase in the end-diastolic and end-systolic dimensions of the left ventricle, the left atrium, and the right ventricle. In 2/3 of the patients who had an acute myocardial infarction, the normal geometry of the left ventricle was observed. Around one-quarter of the patients had a concentric remodeling (24%), an eccentric hypertrophy of the left ventricle was the least common (15%). The heart of patients who had an acute myocardial infarction demonstrates a lower functionality being compared to the subjects in the control group. In these groups, the maximum value of the DAC / DDR ratio is observed, the ejection fraction is reduced. To a greater extent, the onset of acute myocardial infarction was determined by the size and mass of the left ventricular myocardium. Important meaning had also the body weight, BMI, surface area of the body, the size of the left atrium, and the right ventricle.

Clinical assessment of detection of ventricular extrasystoly in patients without structural changes of heart: a prospective study

Aim. The aim of the study was a clinical assessment of the integrated determination of predictors of life-threatening ventricular arrhythmias (LVA) in patients with ventricular extrasystole (VE) without structural changes in the heart to predict the development of cardiovascular disease in a prospective study.
 Material and methods. From 1997 to 2014 199 patients with neurocirculatory dystonia (NCD), complicated with VE II-V class EE at the age of 18-35 years (mean 27.3-2.6 years) were observed in District Military Clinical Hospital of the Ministry of Defense of the Russian Federation, City Hospital named after St. Martyr Elizabeth. All patients, in addition to a general clinical examination, determined late potentials of the ventricles (LPV), QT interval variability (QTd), heart rate turbulence (HRT), and also indicators reflecting the possible mechanism of VE development.
 Results. The results of the study showed that in patients with NCD complicated by VE, the detection of indicators reflecting the presence of VE caused by the mechanisms of early post-depolarization and re-entry is a predictor of the development of coronary heart disease (CHD) and hypertension (HB). The positive prognostic significance of the indicators showing the presence of VE with these development mechanisms for the development of CHD and HB averaged 74% and 44% respectively, and with the appointment of сlass III drugs for elimination of VE and (or) development of unstable ventricular tachycardia, the risk of developing CHD increased to an average of 93%. Identification of NDC patients with indicators reflecting the presence of VE due to delayed post-depolarization is a predictor of the development of gastrointestinal tract (GT) diseases with positive prognostic significance, averaging 61%. Positive prognostic significance with respect to the development of CHD, HB, GT diseases for the detected LPV, QTd > 80 ms, pathological values of HRT VE did not exceed 30%. Indicators and predictors, which characterize the mechanism of development of VE and the risk of LVA occurrence in patients with NCD complicated by VE, were highly correlated (r > 0.50) with risk factors for cardiovascular and gastrointestinal system diseases.

Ретроспективный анализ гестационных осложнений и перинатальных исходов у женщин с дисфункцией щитовидной железы

The objective: A study of features of the course of pregnancy and perinatal outcomes in women with thyroid dysfunction. Analysis of the risk prediction of gestational and perinatal complications, depending on the level of antibodies to thyroid peroxidase (AB-TPO). Patients and methods. A retrospective study of 526 histories and stories birth of generations of women-carriers of antibodies to thyroid peroxidase and 489 of their newborns The group of comparison was formed of 40 stories birth somatically healthy women without the elevated levels of AB-TPO and 40 stories of their newborns. The analysis of the course of pregnancy and perinatal outcomes, evaluation of risk prediction of gestational and perinatal complications, depending on the level of AB-TPO. Results. Established that women carriers of AB-TPO age has the older category; among extragenital diseases most often identified diseases of otolaryngology and neurocirculatory dystonia. Obstetric anamnesis burdened by the pregnancy miscarriage and perinatal losses. In the structure of gestational and perinatal complications, the principal place is the threatened miscarriage, preeclampsia, fetal distress, asphyxia of newborns. Discovered the effect of the starting threshold level of AB-TPO on the risk of occurrence impendence interruption of pregnancy (AB-TPO=315 IU/ml); the risk of miscarriage (AB-TPO=339.8 IU/ml); the risk of fetal distress (AB-TPO = of 247.5 IU/ml); the risk of neonatal asphyxia (AB-TPO=234.8 IU/ml). Didn’t discovere influence of starting threshold level of AB-TPO on the risk of preeclampsia and pathological birht. Conclusion. Women carriers of the AB-TPO constitute a group of high risk of obstetric and perinatal pathology. Discovered the influence of the starting threshold level of AB-TPO on the risk of gestational complications. Key words: pregnancy, level of antibodies to thyroid peroxidase, miscarriage, gestational and perinatal complications.

The Clinical Course of Irritable Bowel Syndrome in Young Patients with Neurocirculatory Dystonia

The clinical picture of the combined course of irritable bowel syndrome (IBS) and neurocirculatory dystonia (NCD) in young patients has been described in the article. Features of abdominal pain syndrome and disorders of defecation, depending on the type of NCD (hypertonic or hypotonic) were shown.
 The conditions under which the exacerbation of IBS occurred in these patients were reviewed. The role of the family doctor in monitoring of the comorbid conditions was shown.

Study of phytocomposition of medical plants on functional indicators of cardiovascular system

A phytocomposition based on roots of wild rose for the treatment of functional disorders of the cardiovascular system is designed, the application performance is improved vascular tone and cardiac students with special physical training group who were registered with diagnosis of vegetative-vascular dystonia and neurocirculatory dystonia.