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The aim of the work was to evaluate the pharmacological effects and therapeutic potential of individual compounds and extracts of B. monnieri based on the analysis of data from scientific periodicals regarding chemical composition and biological action. Theoretically significant were the studies of the materials of the scientific-metric database PubMed and Google Scholar over the last five years regarding the chemical composition and biological action of extracts based on B. monnieri and their individual components. The search query was carried out by the Latin name of the plant, with the exception of publications related to botanical research. In separate PubChem searches, names of individual phytocompounds were used to establish structure and distribution in plants. The SuperPred web server was used to predict therapeutic potential. The authors analyzed the chemical composition of the extracts, presented the structural and pharmacological characteristics of bacosides and their aglycones: bacosin and juubogenin, cucurbitacin E, loliolide, betulinic and asiatic acids and the flavonoid oroxindin. The mechanism of action of bacoside on β-amyloid is characterized and illustrated. Using machine learning, the prospects for using the main compounds of bacopa to create drugs were calculated taking into account the ATC classification, their biological effects and alternative plant sources were given. Experimental animal studies of whole aqueous or ethanolic extracts of B. monnieri have been found to support a cognitive enhancement effect. The extract was not toxic to humans. Numerous clinical trials show the effectiveness of the use of extracts in the treatment of anhedonia, depression, Alzheimer's disease, Parkinson's disease, dementia and hyperactivity. An analysis of clinical studies in Ukraine shows that drugs based on B. monnieri can be used in the complex treatment of cognitive impairment associated with dyscirculatory encephalopathy in adults and perinatal CNS damage in children. Considering the amphiphilicity of bacosides and the non-toxicity of extracts, they can be involved in the development of various dosage forms with a wide range of therapeutic applications. Further study of the pharmacological action of B. monnieri and the development of drug technology for solid and liquid dosage forms based on it are promising.

Background: Cognitive impairment (CI) is present in 25–50% of chronic heart failure (CHF) patients. Doctors who monitor patients with cardiovascular disorders do not have clearly set criteria for their referral to a neurologist in case of suspected CI. Therefore, CHF patients do not receive treatment for CI on time. Aim: To identify significant clinical markers of CI in patients with CHF of ischemic origin. Materials and methods: This cross-sectional cohort study included 134 patients with CHF of ischemic origin (mean age 63.36 ± 10.63 years; men, 76.12%), who were regularly monitored in a municipal polyclinic. All patients were tested for CI with the Montreal Cognitive Assessment Scale (MoCA); basic hemodynamic parameters, lipid profile, brain natriuretic peptide (NT-proBNP) were assessed, and triglyceride-glucose index (TyG) and body mass index (BMI) were calculated. Cardio-ankle vascular index (CAVI) was measured, echocardiography and a 6-minute walk test (SMWТ) were performed and past history of CHF, arterial hypertension (AH) and diabetes mellitus (DM) was collected. Results: CI (MoCA score ≤ 25) was detected in 85 (63.43%) outpatients with CHF of ischemic origin; the group without CI (MoCA score 26) included 49 (36.67%) patients. There were significant correlations between MoCA and CAVI scores (partial correlation coefficient, r = -0.802, p 0.001; adjusted squared multiple correlation coefficient (adj. R2) = 0.881, p 0.001), MoCA and TyG (r = -0.357, p = 0.029; adj. R2 = 0.363, p 0.001), MoCA and SMWТ (r = -0.211, p = 0.037; adj. R2 = 0.696, p 0.001). The multivariate test for significance of planned comparisons between CAVI and MoCA scores (Wilks' lambda) was 0.005 (F = 4.74; p 0.001). Conclusion: CAVI, TyG and SMWТ values are the clinical markers of CI in patients with CHF of ischemic origin. There is a direct association between increased CAVI and the presence of CI, regardless of age, lipid metabolism parameters, structural and functional heart parameters, CHF duration, AH and DM. Identification of these markers could be an indication for an in-depth assessment of CHF patients by a neurologist.

Background. Many COVID-19 survivors suffer from post-COVID syndrome, which significantly worsens the quality of life. Its presentation is quite diverse, with cognitive disorders being of particular importance. Liver injury due to the direct virus action and the treatment of the new coronavirus infection can persist for a long time during the recovery period and lead to hyperammonemia, which can cause cognitive disorders, including minimal hepatic encephalopathy. Aim. To study cognitive disorders in post-COVID syndrome and the possibility of their treatment with L-ornithine-L-aspartate. Materials and methods. The study included 30 students from 18 to 24 years old who had COVID-19 and decreased attention, memory impairment, and other cognitive disorders inherent in hepatic encephalopathy of latent (grade 0) or mild (grade 1) severity, without pronounced impairment of intelligence, memory, speech, and learning ability. Hyperammonemia, elevated alanine aminotransferase, aspartate aminotransferase, and -glutamyl transpeptidase, signs of hepatic encephalopathy according to psychometric tests, were reported in young people. All patients in the study were treated with L-ornithine-L-aspartate to correct the ammonia blood level and improve signs of hepatic encephalopathy and the general condition. Results and conclusion. An improvement in the objective findings, liver enzymes, a decrease in ammonia level, and an improvement in testing results for changes in cognitive functions were reported.

Aim: to study the relationship between neurotransmitter support and the degree of cognitive and psycho-emotional impairments in patients in the post-coronavirus period depending on the presence of overall obesity. Materials and methods. 44 patients aged 19 to 76 years (17 women and 27 men) with a history of moderate-to-severe COVID-19 were examined. 2 groups were allocated depending on body mass index (BMI): Group 1 – 20 non-obese patients (BMI

Multiple sclerosis (SM) is an autoimmune, demyelinating disease of the central nervous system. The disease affects patients of all ages, with a higher incidence in women. The etiopathogenesis of SM is not fully understood — it is believed that autoreactive lymphocytes play a key role in the development of the disease, although genetic predisposition and environmental factors also play a role. Diagnosis is based on the McDonald criteria, and the disease has different clinical presentations. Treatment is based on immunomodulation, aims to control the disease, and prevent recurrence. Frequent symptoms of the disease are motor, sensory, and cognitive disorders. Cognitive impairment, which is common in multiple sclerosis patients, has numerous consequences in everyday life (mental, social, economic) that significantly reduce the quality of life. Psycho-cognitive dysfunction, which can occur at any stage of the disease, is associated with changes in the central nervous system. Prevention of these disorders includes the early application of treatment methods that modify the natural course of the disease and the implication of pro-health behaviors, such as quitting smoking, proper diet and physical exercise. Pharmacological treatment shows limited effectiveness. Rehabilitation involving the use of compensatory strategies, remedial methods aimed at brain neuroplasticity and cognitive training shaping new functional networks of the brain is important. The aim of this work is to present the problem of cognitive and emotional disorders in the course of multiple sclerosis, with particular emphasis on endo- and exogenous conditions, together with modern methods of their treatment and prevention. (JNNN 2023;12(3):140–146)

Introduction: The Clock Drawing Test (CDT) is a highly effective screening tool for assessing cognitive function. It complements the Mental State Examination (MSE) in the early detection of various types of dementia and the evaluation of cognitive functions. Documenting the specific type of error in clock drawing significantly enhances the clinical evaluation of dementia patients in an economical manner. The CDT can effectively detect errors in execution and visuospatial functions associated with different types of dementia, including Alzheimer’s Disease (AD), Vascular Dementia (VD), and Frontotemporal Dementia (FTD). Additionally, it allows for a comparative analysis of the CDT with the severity of dementia assessed by the Bengal Mental Status Examination (BMSE) Scale. Aim: Present study aims to determine the ability of the CDT to scriminate these three disorders AD, VD, and FTD by analysing patterns of error in clock drawing. Materials and Methods: This cross-sectional observational study was conducted at the Department of Neuromedicine, Memory Clinic, Medical College, Kolkata, West Bengal, India, from March 2019 to February 2020. The diagnosis of dementia was made based on the Diagnostic and Statistical Manual of Mental Disorders- Fifth Edition (DSM-V) criteria for AD and VD, and the Rascovsky Criteria for FTD. A total of 80 patients were included in the study, with 40 in the AD group, 30 in the VD group, and 10 in the FTD group, considering 80% power and a 5% probability of error. Dementia severity was assessed using the BMSE [Annexure-III]. The subjects were provided with an 8.5×11-inch blank sheet of paper and a pencil, and were asked to draw a clock, including all the numbers, and set the hands to 10 minutes past 11. They were also requested to copy a clock as accurately as possible from a model. The resulting drawings were then analysed quantitatively by revised scale score and qualitatively using Rouleau’s qualitative analysis of clock drawing. Numerical variables were compared between groups using the Analysis of Variance (ANOVA) test and the Wilcoxon test, depending on the distribution’s normalcy. All analyses were two-tailed, and p

The relevance of the issue of asthenic disorders is determined by a high prevalence among patients with various chronic pathologies and its impact on the disease course, treatment efficacy, and quality of life. The purpose of the study was to analyze the dependence of cognitive disorders and the quality of life of patients with Lyme borreliosis on the level of fatigue. Materials and Methods. The study involved 48 patients with Lyme borreliosis. The MOS 36-item Short Form Health Survey (SF-36) was used to study the quality of life of patients. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), and the impact of fatigue was evaluated using the Fatigue Severity Scale (FSS). Results. According to the results of assessing asthenia/fatigue severity (FSS), the prevalence of asthenic disorders in patients with Lyme borreliosis was 45.8%. Cognitive impairment with an MMSE score of

Introduction and purpose: More and more reports suggest that diabetes plays an important role in the pathogenesis of Alzheimer's disease (AD). Understanding this link may provide a new approach to modulating the onset and progression of sporadic AD cases. The aim of the study is to present the current state of knowledge on the basic mechanisms and factors influencing the development of AD in patients with type 2 diabetes in the context of clinical practice. State of knowledge: It is estimated that up to 80% of Alzheimer's patients have glucose intolerance or diabetes. Impaired insulin signaling can lead to abnormal processing and accumulation of beta-amyloid protein, which can result in memory deficits and cognitive decline. Insulin deficiency can also cause over-activity of the GSK3 enzyme, leading to tau hyperphosphorylation and senile plaque accumulation. Diabetes can also cause fibrotic changes in cerebral vessels, disrupting brain metabolism and potentially leading to hippocampus atrophy. The release of cytokines during the metabolic syndrome can also cause oxidative stress and neuroinflammation, which may contribute to neuronal atrophy. It has been reported that healthy diet, physical exercises and prevention of metabolic diseases may reduce the incidence of AD. Conclusions: Epidemiological data and pathophysiological studies indicate a significant relationship between these diseases that AD is sometimes called Type 3 diabetes. Early detection of hyperglycemia and its proper management, may be crucial in the context of the clinical prevention of dementia diseases. It is essential to pay attention to the cognitive abilities of patients with metabolic diseases.

Introduction. Transient ischemic attacks can be a predictor of a more severe cardiovascular event, the risk of which depends on many factors that requires a personalized approach. Neuropsychological disorders (cognitive, emotional) have a significant impact on quality of life and social activity and are often underestimated in patients with TIA. Comprehensive medical rehabilitation with the inclusion of antithrombotic therapy and psychocorrection measures may reduce the risk of recurrent cardiovascular events in patients with TIA.Purpose of the study: to substantiate the efficiency of complex medical and non-pharmacological rehabilitation in patients who underwent TIA by analyzing the characteristics of the main and leading concomitant diseases.Materials and methods. The morbidity of 351 TIA patients was studied and analyzed. The average age of the examined patients was 58.6 ± 2.2 years, there were 64.9% of women and 35.1% of men. All patients received an individualized medical rehabilitation program for 12 months with correction of identified neuropsychological disorders. Depending on background and concomitant diseases the antiplatelet or anticoagulants therapy was differently administrated.Results and dicussion. Psychological, cognitive, and physical disorders (based on subjective complaints) are common in patients with TIA. The prevalence of mental disorders in patients with TIA was 138.2 cases per 100 patients. The correction of cognitive impairment, depressive symptoms is associated with improved quality of life (p < 0.05). Repeated acute cerebrovascular events (TIA, ischemic stroke) were recorded during the first 6 months after TIA in 29 patients (10.4%) with severe stenosis of the brachiocephalic arteries, severe arterial hypertension and paroxysmal atrial fibrillation.Conclusion. The importance of comprehensive medical and social rehabilitation of patients with TIA is determined. The participation of a psychotherapist as a member of a multidisciplinary team is necessary. A significant role of the secondary prevention of acute cerebrovascular events is assigned to rational antithrombotic therapy.

Introduction. Cognitive disorders are a serious problem in the elderly that lead to the loss of functional ability and thus dependence on others. Aim. The aim of the article is to asses the cognitive disorders in people over 65 in home environment and show a correlation between age, sex, education, multiple morbidities, functional disability, and cognitive disorders. Material and Methods. The research was carried out using diagnostic survey and direct observation. Also, the following research tools were used: Abbreviated Mental Test Score (AMTS), Barthel Scale, Lawton Scale and own survey questionnaire. The research was carried out on 329 women and 175 men, aged 66–94. Results. 74.80% of the surveyed were found to have normal cognitive ability. Mild cognitive disability was found in 20.24% of the respondents, and severe — in 4.96%. It has been concluded that women with low level of education, more morbidities, and sight and hearing impairment had worse cognitive ability (p

This study aimed to evaluate the effectiveness of an educational intervention (Safe D.U.M.P) to improve the knowledge, attitude, and practice regarding the return and disposal of unused medications. Community-dwelling adults in Malaysia who could understand English were recruited from two healthcare events. Participants were asked to fill out the validated Return and Disposal of Unused Medications (ReDiUM) questionnaire (pre-intervention), view six educational intervention posters on how to dispose of unused medications (Safe D.U.M.P), then answer the ReDiUM questionnaire immediately after viewing the posters (post-intervention). A total of 390 out of 456 participants participated (response rate=85.5%). Most were female (71%) with a median age of 42 years. The overall knowledge of participants significantly increased from 60% to 80% (p

Cognitive disorders are one of the major public health issues in older population worldwide. Problems in forming and storing new memories, short-term memory impairment, and other cognitive problems are common symptoms of cognitive disorders that have no definite treatment yet. Recent studies have shown an association between gut microbiota and cognitive impairments described as microbiota-gut-brain axis. It seems that gut microbiota is able to influence behavior, brain system, and cognitive functions through this pathway in old age. In this review, the underlying mechanisms of the effect of gut microbiota on cognitive disorders and the role of dietetic intervention with probiotics in cognitive function are discussed.

Cognitive dysfunction shows higher incidence in people, suffering from epilepsy, than in general population and most likely they are related to common patho-biological processes. The use of medication in patients with epilepsy for treating cognitive functions is limited due to the potential risk of more frequent seizures. Therefore, non-pharmacological methods of cognitive correction are becoming especially important for this category of patients.Aim. The aim of the research is to study the specifics of non-dementia cognitive disorders in patients with epilepsy and to develop a set of activities for their prevention and non-pharmacological correction.Materials and methods. The study included 146 patients (61 women and 85 men), their average age was 40,73. We applied clinical anamnestic, sociodemographic, clinical-psychopathological, psycho-diagnostic and statistical research methods. The following psycho-diagnostic techniques were used: Montreal Cognitive Assessment (MoCA), Munsterberg test, MiniMult test, Hamilton depression and anxiety rating scales (HRDS, HARS) and the quality of life scale. 63 patients completed a 3-month computerized online cognitive training with daily sessions, out of which 33 patients also participated in psychoeducational activities.Results. The findings of studying patients with epilepsy using the Montreal Cognitive Assessment (MoCA) showed low levels of all parameters while the total score in the patients with epilepsy with cognitive non-dementia disorders was 20,72 versus27,36 in healthy persons; the analysis of HRDS, HARS showed high anxiety and depression symptoms levels, lower quality of life level was also observed, the average indicator was 69,45, whereas in the control group the level of life quality was 78,60. There was marked adherence to cognitive training in the patients with epilepsy compared to the healthy group.Conclusion. Reliable improvement of cognitive functioning was found in the patients under consideration after 3 months of the training. The computerized cognitive functions training in current conditions showed its benefits owing to the opportunity to complete it online. It may be advised to be introduced as a part of the social rehabilitation system for patients with epilepsy, who have cognitive non-dementia disorders.

Introduction: People with diabetes mellitus (DM) may have concurrent mental health disorders and have been shown to have poorer disease outcomes. Objective: The aim of this study to determine the prevalence of DASS in patients with diabetes mellitus without mental disorders, aged 20 years or more, in primary health care, and to determine any association between DASS and patients’ sociodemographic and clinical attributes. Methods: This was a cross-sectional study conducted in a primary health care center, in the department of general practice. Patients with DM who visited the doctor and agreed to fill in the questionnaire were included in the study. Data were collected using the questionnaire DASS-21. Descriptive statistics, the Pearson chi-square test, and logistic regression analysis were used to analyze the data. Results: Out of a total of 102 respondents with DM, 29 (28.4%) had some form of psychological symptoms. The prevalence of DASS was 16.7%, 16.6%, and 23.5%, respectively. There was no significant difference between sociodemographic variables according to stress status. Respondents aged 40–49 years more often showed emotional states of depression and anxiety. There was a significant association between emotional status of DASS and HbA1c values. Logistic regression analysis indicated that age (OR=2.57, 95% CI: 1.59-4.13) was a predictor of depression and anxiety. Conclusion: Unpleasant emotional states DASS are common in patients with DM, depression (16.7%), anxiety (16.6%), and stress (23.5%). Age is the strongest predictor of DASS status. The screening and monitoring of unpleasant emotional states in people with diabetes should be performed from a young age.

Bipolar affective disorder (BAD) is one of the most pressing problems of modern psychiatry; cognitive impairment has one of the leading places in the structure of symptoms of bipolar disorder. The aim of the study was to compare the structure of cognitive disorders in patients with a primary episode (PE) of BAD, based on sex and clinical version of the disease debut. Results and discussion. Based on clinical examination of 65 men and 88 women with PE of BAD was revealed that the basis of cognitive manifestations of depressive type of disorder constitute of slowing of cognition, attention deficit and executive functions: slow thinking, impaired attention concentration, difficulties in planning and decision making, rigidity of thinking. Cognitive symptoms of manic type of PE of BAD were based on disorders of thinking: accelerated thinking, increased self-esteem, exaggeration of own possibilities, disturbance of concentration of attention, difficulties in planning and decision making. The mixed version of PE of BAD was characterized by a complex combination of cognitive symptoms, the spectrum of which included both manifestations of thinking disorders and difficulty of attention concentrating. Conclusions. In the PE of BAD, the spectrum of cognitive symptomatology is determined by the clinical variant: in depressive the phenomena of cognitive slowing, attention deficit and performance functions are dominated, in the manic – the disorder of thinking, and in the mixed variant, all the spectrum of disorders are present; gender influence has no significant effect on the structure of cognitive symptomatology.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare but potentially life-threatening and disabling autoimmune encephalitis mainly affecting young women. We report the case of a male in his early thirties who developed behavioral and neurocognitive manifestations of anti-NMDAR encephalitis. This case highlights the unique behavioral challenges in a male patient during the course of rehabilitation, including impulsivity, inappropriate sexual behavior, and hyperphagia, which has not been well-described in the literature. This presented complex problems for the rehabilitation team and amelioration of these clinical issues required a multidisciplinary approach. The behavioral and pharmacological strategies employed, which had a pronounced positive contribution in this patient, are described. A brief review of the epidemiology, course, and common complications of anti-NMDAR encephalitis is also presented.

Traumatic brain injuries due to hostilities inEastern Ukrainein 2017 accounted for 30.8% of all mechanical combat damage and injuries and are an important problem because of postconcussion syndrome manifestation in the long-term period. Purpose – to study the features of postconcussion symptoms recovery among combatants during their rehabilitation in hospital conditions based on electroencephalography and the dynamics of psychophysiological characteristics assessment. Materials and methods. 42 combatants aged 35–45 years who suffered a closed craniocerebral injury during 2017–2018 (more than 3 months after head injury) and 76 healthy men the same age, constituted group II (control), were involved in the study. The study evaluated and analyzed the results of electroencephalography (EEG), manifestations of postconcussion symptoms using К. Cicerone modified special questionnaire as well as the characteristics of attentiveness and short-term memory using a special computer program. Results. Among individuals with postconcussion syndrome, the functioning of non-specific brain systems was found to be impaired making dysregulation changes in the electrical activity of the brain stable and long-lasting. It was shown that the applied rehabilitation programs had a positive effect on the balance and improvement of the brain bioelectrical activity rhythms and, accordingly, the functional activity of these structures (θ and δ characteristics of EEG spectrum improved after rehabilitation (P < 0.05), which may indicate the inclusion of neuro-emotional stress coping mechanisms during rehabilitation in inpatient conditions). Somatic manifestations which very often occur and impair performance, as well as definite complaints from the cognitive sphere, reliably decreased (P < 0.05), but complaints due to sensory functions impairment remained almost unchanged in 17 % of people after the rehabilitation course. The characteristics of attentiveness and short-term memory had a positive (P < 0.001) dynamics after the rehabilitation course and did not exceed the calculated standard indicators. Conclusions. The features of postconcussion symptoms recovery among combatants during their rehabilitation in hospital conditions in terms of θ and δ characteristics of the EEG spectrum have been revealed. The presence of significant (P < 0.001) differences in objective characteristics of cognitive functions in patients before rehabilitation compared with the control group (below standard values), as well as significant (P < 0.001) positive dynamics of attentiveness and short-term memory after rehabilitation of military personnel with postconcussion symptomatology and approximation of these characteristics to standard values have been found. It has been noted that the diagnosis of cognitive disorders associated with traumatic brain injury should be essentially based on the results of neuropsychological objective testing of attentiveness and short-term memory, since they are more dynamic (P < 0.001) indicators compared with complaints relating to cognitive function changes.

By the WHO data,Ukraineis country number1 inEuropeand number2 inthe world according to the cardiovascular mortality rate. In the structure of the prevalence of cardiovascular diseases in Ukraine, the percentage of persons of working age with arterial hypertension is 36.7%. The improvement of the prognosis of patients with arterial hypertension depends not only on long-term effective control of blood pressure, but the diagnosis and initiation of therapy at the initial stage of the development of the disease, when the target organs have not yet undergone hypertensive damage is also an important condition. The article presents the results of neuropsychological examination of 509 outpatients with a controlled second stage arterial hypertension, with an integrated assessment of cognitive functions using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MCA) methods. It has been established that even in patients with controlled arterial hypertension stage II with a low cardiovascular risk, by SCORE scale cognitive disorders were revealed in 32,2%. The peculiarities of the development of cognitive disorders in arterial hypertension in connection with the history and course of the disease are analyzed. The majority of patients with hypertension have an increased level of anxiety, especially personality, and this is not due to the presence or absence of cognitive disorders. In patients with hypertension and cognitive disorders, on the basis of testing data by the SF-36 scale, there was a significant (p

Background: Intrauterine growth restriction (IUGR) lead to abnormalities in fetal central nervous system, till hippocampal and cortical cells became apoptotic. The goal of this research is investigating the effects of Gallic acid on improvement of cognitive impairments and nuclear factor kappa B (NFƙB) in animal model of IUGR. Material and Methods: In this experimental study, 32 female rats from wistar race with weighing approximately 180±25g were divided into 4 groups of 7 .Control group: that did not receive any treatment . IUGR group: To induce IUGR of pregnant rats were under 50 % restricted diet from the 14th day of pregnancy to childbirth. Experimental groups 1 and 2: pregnant rats subjected to a 50 % dietary restriction for induction IUGR from 14th day of pregnancy to childbirth and from 12th day of pregnancy to the birth of newborns, received 200 and 400 mg/kg gallic acid doses daily by gavage method. After the birth of pups, morphological evaluations were checked. Then, in 30 postnatal days working and passive avoidance tests and anxiety test were assessed. The serum level of NFƙB was analyzed by ELISA. Results: The working memory and fear-based memory of IUGR rats was reduced significantly compared to the controls. In addition restricted diet leads to increase in NFƙB and anxiety levels. Gallic acid was ameliorated working and fear-based memories and reduced serum level of NFƙB and anxiety in treated rats. Conclusion: The findings suggest that restricted diet during pregnancy can cause behavioral cognitive disorders in rats. This is likely due to increased levels of pro-apoptic cytokine such as NFƙB. The results also suggest that the neuroprotective effect of Gallic acid is likely to improve memory disorders in IUGR rat model.

The article presents data from various studies on the incidence of chronic diseases and conditions among adults, which is a serious public health problem today. The problem of comorbidity in the conditions of demographic aging of the population is highlighted. The results of recent studies on the frequency of side effects depending on the number of drugs taken are presented. It is shown that in old age another problem is the development of cognitive impairment. The results of detection of cognitive disorders among patients of general hospitals are described. Data on the efficacy of the drug application from the standardized extract of ginkgo biloba leaves EGb 761® for prophylaxis and treatment of cognitive disorders are presented. The question of the effect of EGb 761® preparation on blood coagulation properties in comorbid patients taking antiagregants and anticoagulants was considered.

Когнитивные расстройства представляют собой одну из ключевых групп расстройств при шизофрении, формируются еще на этапе продрома и рассматриваются в качестве важного прогностического фактора исхода расстройства. В данной обзорной статье сопоставлены данные исследований и обзоров публикаций за последние 10 лет о динамике когнитивных расстройств при шизофрении и нейробиологических основах их формирования. Когнитивные расстройства при шизофрении представляются гетерогенными и относительно специфичными для разных этапов заболевания. Продемонстрировано значение формирующегося нейробиологического дефицита для формирования позитивных и негативных симптомов шизофрении. Проведен анализ возможности коррекции когнитивных расстройств при шизофрении с помощью различных терапевтических модальностей.

The article discusses clinical symptoms, diagnostic criteria and basic principles of managing patients with dementia. It also provides the classification of cognitive disorders by severity degrees and considers the differences between the different degrees of dementia severity. The main features of the pathogenesis of cognitive disorders in dementia, the most important approaches to managing patients with dementia are highlighted. The article presents a detailed review of modern drugs used to correct cognitive and other manifestations of dementia.

Актуальность. В настоящее время эффективность антипсихотической терапии негативных расстройств при шизофрении многие авторы оцени вают как недостаточную, что обусловливает поиск лекарственных препаратов или их комбинаций, направленных на повышение переносимости и эффективности антипсихотиков. Анализ результатов исследования аугментации D, L гопантеновой кислотой (препарат Пантогам актив) в дозе до 1200 1800 мг/сут при лечении больных шизофренией с негативными расстройствами атипичными антипсихотиками указывает на статистически значимое умень шение выраженности психопатологических расстройств по шкалам CGI S ( 13,7 против –9,6 %, p < 0,05), PANSS ( 25,3 против –20 %, p < 0,05) и BPRS. Динамика когнитивных функций у пациентов двух групп свидетельствуето более выраженном положительном эффекте те рапии с применением Пантогама актив. Пантогам актив предупреждает развитие и нивелирует симптомы нейролептической депрессии (умень шение на –45,4 % в основной группе по шкале HDRS против увеличения на 5,3 % – в контрольной). Включение Пантогама актив в схему терапии негативных шизофренических расстройств снижает выраженность экстрапирамидных расстройств. Повседневное функционирование пациентов врача (шкала GAF) в основной группе улучшается на 60,8 % исходного против 35 % в контрольной группе (p < 0,01), психическое самочувствие (опросник SF 36) – на 73,9 против 49,5 % (p < 0,01), соматическое – на 46,4 против. 34,4 %. Вывод. Включение DL гопантеновой кислоты (препарат Пантогам актив) способствует повышению эффективности и переносимости комби нированной терапии, позволяет достичь достоверно более значимого улучшения качества жизни больных шизофренией как с точки зрения врача, так и с точки зрения самих пациентов.

Objective: to investigate the state of cognitive functions in victims with combat trauma on the background of reamberin using. We studied 37 patients, injured simultaneously in different parts of the body during fighting, divided into treatment and control groups. The severity of the injury was determined by the ISS and EmTraS scales. The severity of the condition – according to generally accepted clinical and laboratory indicators, as well as by SAPS II scale. Cognitive functions were determined by the CFQ questionnaire (retrospectively the condition before the trauma and 3 months after was determined), MoCA (on day 2, when trans­ferred from the intensive care unit and at discharge from the hospital). Results: It was established that by the severity of the injury and the incoming severity of the somatic state two groups did not differ statistically. The state of cognitive functions before wound in the wounded of both groups was not statistically different and was not beyond the norm. On the second day in the control group, the cognitive functions decreased to the level of dysfunction (82.7±5.0%), while in the main one they did not cross the control limit of 10% of the baseline level (89.0±2.2%). Further dynamics in the reamberin group confirmed its protective properties with respect to cognitive functions, but this effect was not prolonged after the end of therapy. Conclusion: The use of reamberin in the complex intensive care of severe combat trauma can prevent a significant decrease of cognitive functions in the early post-traumatic period, but this effect is of short aftereffect time, therefore, its prolonged usage is necessary for the stable recovery of cognitive functions.

The brain is one of the natural target organs of arterial hypertension (AH). According to the data of numerous studies, the most early and common signs of brain damage in hypertension is cognitive disorder (CD). These are usually subcorticalfrontal in nature, which is expressed in reducing the rate of cognitive activity, fluctuations of concentration, lack of planning and control, moderate memory impairment and constructive praxis. Development of more severe and progressive mental disorders, lack of nominative speech function may indicate the accession of a concomitant neurodegenerative process, the risk of which in hypertension is increased as well. Early and correct treatment of the underlying disease significantly reduces the probability of CD progression in patients with hypertension. For the prevention of CD progression non-pharmacological methods are widely used such as cognitive training, systematic exercise, optimization of diet. Medication includes neurometabolic drugs with neuroprotective and neurotrophic properties (Cerebrolysin, etc.), memantine, acetylcholinesterase inhibitors and some other drugs.

Aim of the work – to evaluate the effectiveness of thiocetam as a medicine that prevents cognitive impairments in patients with polytrauma, as well as to compare the scales of cognitive function assessment - MoCA and MMSE. We examined 50 victims with polytrauma without severe intracranial lesions, randomly divided into a control group (26 patients) and a main (24 patients) group. Patients of the control group received conventional intensive therapy for traumatic illness, patients of the main group in addition to this therapy received thiocetam. The somatic status was assessed according to the generally accepted clinical and laboratory indicators. The level of cognitive functions before the injury was assessed by the CFQ questionnaire for 2-3 days after the injury; The MoCA and MMSE scales were used on the 2nd day, when patients weretransferred from the intensive care unit and before the discharge. The severity of injury was assessed by the ISS scale. The severity of the response to traumatic stress was assessed by the IES-R scale. In both groups, the baseline level of cognitive function was within the age range. On the second day after the trauma, significant inhibition of cognitive functions in both groups was noted, but in the maingroup this decrease was un­reliably less. At subsequent stages a gradual increase in both groups was noted, however, in the main group recovery of cognitive functions occurred more rapidly. After 3 months, decrease in cognitive functions preserved at a level when patients were discharged from the hospital. In the maingroup there were significantly fewer pa­tients whose posttraumatic stress after 3 months increased from minimal to low. When using the MoCA scale, there was a more pronounced decrease in cognitive functions than with the MMSE scale, but it in the less degree consider pecu­liarities of thinking. Thiocetam prevents the decrease of cognitive functions in patients with polytrauma and, due to that, also reduces the severity of posttraumatic stress reaction. For practical using in intensive care units it is preferable to use the MMSE scale.

Objective. Case report of a rare form of multiple sclerosis, Balo’s concentric sclerosis (BCS).Materials and methods. 66 year old female patient L., admitted with complaints of gait disorder with tendency to fall towards the left side, left upper limb weakness and decreased memory. Neurological examination revealed left sided hemiparesis, and left sided positive Romberg’s test. Contrast brain magnetic resonance imaging (MRI) was performed. Treatment was prescribed as well as dynamic follow up during the course of 1.5 years.Results. Based on complaints, clinical picture and MRI result, patient was diagnosed with an atypical form of multiple sclerosis, Balo’s concentric sclerosis. The main diagnostic method used confirm the diagnosis was contrast brain MRI: Non homogenous circular-form space occupying lesion with dimensions 3.7 × 3.4 × 3.5 cm was visualized in the supraventricular area of right parietal lobe with increased and decreased signals on T2 and T1 weighted images respectively. Following intravenous administration of contrast substance, an increased T1-WI signal is observed along the periphery of the described lesion in the right parietal lobe. MRI conclusion: brain demyelination disease with large foci in the right post-frontal lobe region, typical of Balo’s concentric sclerosis. Following the acute clinical state, cytostatic and immunomodulation therapy was prescribed. MRI dynamic observation revealed decrease in dimensions of the significantly enhanced concentric areas. Follow up demonstrated marked remission.Conclusion. This clinical case is of interest due to the rarity of this disease. The basis of diagnosis in our study was MRI investigation which allows for in vivo diagnosis of this pathology. These observations confirm the fact that timely use of modern methods of treatment can achieve not only stabilization of the patients’ state, but also positive clinical and MRI dynamics.

Cognitive disorders are often associated with epilepsy and are a result of a combination of various factors. This review describes scientific advances in the field of cognitive disorders in patients with juvenile myoclonic epilepsy (JME), the most common form of idiopathic generalized epilepsy. Data in this review were collected through an extensive literature search of available full-text publications in PubMed and eLIBRARY.RU databases. We selected four theories of the origin of cognitive impairment in JME patients for discussion, based on the analysis of available studies. Our findings highlight the etiological heterogeneity of cognitive disorders in JME and the importance early screening for them.

The study is being conducted at the 1st Department of Anaesthesiology, the Centre of Abdominal Surgery, the Centre of Anaesthesiology, Intensive Care and Pain Management of Vilnius University Hospital Santaros Klinikos. Background. These are primary results of a randomized double-blinded study comparing postoperative changes in cognitive functions and the effect of desflurane and sevoflurane on these changes. Materials and methods. The study includes patients of ≥40 years of age undergoing elective thyroid surgery under general anaesthesia. Patients were randomly allocated to either sevoflurane or desflurane group. Cognitive testing (memory, attention, and reasoning tasks) was performed a day before surgery and repeated 24 hours postoperatively. A decrease of 20% in the postoperative score was considered as postoperative cognitive dysfunction (POCD). Results. At present 38 patients are included in the study. Median decrease in the postoperative score was 2.7% (IQR 16.7). The incidence of POCD was 2.6%. Significantly decreased memory scores were observed in 15.8% of patients. Both study groups were comparable based on demography, duration of anaesthesia, intraoperative opioids, postoperative pain, and satisfaction. No difference was found in the cognitive score comparing sevoflurane and desflurane groups, except for memory tasks where the sevoflurane group performed worse (p = 0.01). The age or the duration of anaesthesia did not affect postoperative scores. Postoperative satisfaction negatively correlated with the memory score (r = –0.35, p = 0.03). Postoperative satisfaction correlated with the reasoning score (r = –0.55; p < 0.01) and the total score (r = –0.42; p = 0.03) in the sevoflurane group. Likewise, temperature in the sevoflurane group correlated with the memory score (r = –0.58; p = 0.02). Conclusions. The desflurane group performs better in memory tasks, but no such advantage is found in the total cognitive score. In contrast to the age or anaesthesia duration, intraoperative temperature and postoperative satisfaction may affect postoperative cognitive performance.

Objective: To evaluate the cognitive status and sleep quality and their association in patients with Parkinson’s disease (PD). Materials and Methods: In this analytical cross-sectional study, 120 patients with PD were selected from 22-Bahman and 17-Shahrivar hospitals. Demographic information was recorded on a form and Parkinson’s severity was determined using the Hoehn and Yahr scale (HY). Pittsburgh Sleep Quality Index (PSQI) and Epworth sleepiness scale (ESS) were used for the assessment of sleep quality and excessive daytime sleepiness, respectively. Cognitive status was assessed using the Montreal Cognitive Assessment questionnaire. Results: The mean age of patients with PD was 65.9±11.7 years, and 67.5% were men. Cognitive impairment was found in 113 (94.2%) patients, poor sleep quality in 87 (72.5%), and excessive daytime sleepiness in 27 (22.5%) patients. The mean PSQI and ESS scores were 9.03±4.70 and 7.38±3.73, respectively. There was a significant association between cognitive status and sleep quality, as well as daytime sleepiness (independent sample t-test, p

The article is devoted to the peculiarities of clinical course of dyscirculatory encephalopathy in patients with non-valvular atrial fibrillation. Clinical-and-instrumental data were analyzed and compared between patients with dyscirculatory encephalopathy associated with atrial fibrillation and patients with dyscirculatory encephalopathy due to hypertension and cerebral atherosclerosis without rhythm disturbances. The studies conducted are indicative of the necessity of complex treatment for all patients with atrial fibrillation to predict cerebral stroke and vascular dementia.

The article presents a current view on pathogenesis, diagnostic methods and treatment of cognitive disorders in patients with arterial hypertension. Choline alfoscerate drugs, precursors for choline drugs, are characterized. Prescription of the drugs for patients with hypertensive encephalopathy is discussed. Results of clinical trials of the efficacy and safety of the national choline alfoscerate under the brand name Cerepro® are demonstrated.

Effective pathogenetic therapy of ischemic stroke - reperfusion intervention - is largely restricted by mandatory careful selection of patients and availability of specialized care. Pharmacological treatments are therefore becoming especially relevant as they are aimed at maintaining viability of neurons in the ischemic area. The most studied and promising neuroprotectives are citicolines. They improve outcomes in individual groups of patients with acute ischemic stroke, and have beneficial effects on cognitive function in the recovery period. The drug also proved to be effective in the recovery of upper limb function in patients with hemiplegia. Citicoline can be recommended both for acute ischemic stroke and at the rehabilitation stage.

A comparative analysis of the impact of citicoline, ±-lipoic acid, nicergoline, donepezil and colloidal solution of nano-silver (CSNS) on the processes of learning and consolidation of memorable track in the test of the conditional reaction of passive avoidance (CRPA) in conditions of experimental allergic encephalomyelitis (EAE) was conducted. Testing of passive defensive skill was performed on days 12 and 20 after the induction of EAE. To assess the impact of drugs on the inputted information processes the investigated substances were administered intragastrically (CSNS - intraperitoneally) once daily in the definite dose from the second to the day 10 after the induction of EAE (latent phase of the disease), and assessing processes of conditional skill preserving, further administration of drugs by the day 20 of the experiment (average duration of EAE) was used. A positive effect of citicoline, ±-lipoic acid, nicergoline and donepezil on the input information processes and the ability to prevent accelerated extinction of acquired contingent skill in the conditions of experimental pathology was established. Drugs statistically significantly increased duration of the latent period of CRPA in comparison with a group of active control by 49%, 43%, 39% and 34%, respectively. Here with preparations were characterized by a high coefficient of antiamnesic activity, by the end of the experiment it was recorded at the level of 95% (citicoline), 81% (±-lipoic acid), 76% (nicergoline) and 53% (donepezil). It is shown that the ability to prevent development of cognitive impairment in conditions of experimental equivalent of multiple sclerosis decreases in the number of citicoline (500 mg/kg) > ±-lipoic acid (50 mg/kg) H nicergoline (10 mg/kg) > donepezil (10 mg/kg).

There was analyzed the extent and structure of cognitive disorders in outpatient conditions by the data of examination of 118 hypertension patients stage II with arterial hypertension of 1-2 degrees, which were under the supervision of General Practitioners. Neuropsychological examination was carried out by MMSE (Mini-Mental State Examination) and FAB (Frontal Assessment Battery) scales, verbal memory was studied by the method of Luria, concentration and speed of sensorimotor reactions - by techniques of Schulte and Rybakov. It was found that 28.8% of patients had cognitive disorders, mainly of neurodynamic nature, in particular, the ability of concentration and speed of psychomotor reactions was reduced. The presence of verbal memory disorders of varying severity associated with hypertension was revealed. Analysis of medical records testifies to the absence of attention to this issue in rehabilitation programs of hypertensive patients at the primary stage of care. The importance of timely diagnosis of cognitive disorders as a marker of early disorders of cerebral circulation and the functional state of the brain, the target organ in hypertension of 1-2 degrees was demonstrated.

There was analyzed the extent and structure of cognitive disorders in outpatient conditions by the data of examination of 118 hypertension patients stage II with arterial hypertension of 1-2 degrees, which were under the supervision of General Practitioners. Neuropsychological examination was carried out by MMSE (Mini-Mental State Examination) and FAB (Frontal Assessment Battery) scales, verbal memory was studied by the method of Luria, concentration and speed of sensorimotor reactions - by techniques of Schulte and Rybakov. It was found that 28.8% of patients had cognitive disorders, mainly of neurodynamic nature, in particular, the ability of concentration and speed of psychomotor reactions was reduced. The presence of verbal memory disorders of varying severity associated with hypertension was revealed. Analysis of medical records testifies to the absence of attention to this issue in rehabilitation programs of hypertensive patients at the primary stage of care. The importance of timely diagnosis of cognitive disorders as a marker of early disorders of cerebral circulation and the functional state of the brain, the target organ in hypertension of 1-2 degrees was demonstrated.

A comparative analysis of the impact of citicoline, α-lipoic acid, nicergoline, donepezil and colloidal solution of nano-silver (CSNS) on the processes of learning and consolidation of memorable track in the test of the conditional reaction of passive avoidance (CRPA) in conditions of experimental allergic encephalomyelitis (EAE) was conducted. Testing of passive defensive skill was performed on days 12 and 20 after the induction of EAE. To assess the impact of drugs on the inputted information processes the investigated substances were administered intragastrically (CSNS - intraperitoneally) once daily in the definite dose from the second to the day 10 after the induction of EAE (latent phase of the disease), and assessing processes of conditional skill preserving, further administration of drugs by the day 20 of the experiment (average duration of EAE) was used. A positive effect of citicoline, α-lipoic acid, nicergoline and donepezil on the input information processes and the ability to prevent accelerated extinction of acquired contingent skill in the conditions of experimental pathology was established. Drugs statistically significantly increased duration of the latent period of CRPA in comparison with a group of active control by 49%, 43%, 39% and 34%, respectively. Here with preparations were characterized by a high coefficient of antiamnesic activity, by the end of the experiment it was recorded at the level of 95% (citicoline), 81% (α-lipoic acid), 76% (nicergoline) and 53% (donepezil). It is shown that the ability to prevent development of cognitive impairment in conditions of experimental equivalent of multiple sclerosis decreases in the number of citicoline (500 mg/kg) > α-lipoic acid (50 mg/kg) ≈ nicergoline (10 mg/kg) > donepezil (10 mg/kg).

The importance of studying the effects of traumatic brain injury is due to the fact that TBI is mainly noted in persons young and middle age, that is, the most active in the social and labor proportion of the population. The importance of studying this nosology determines high lethality, prolonged incapacity, as well as a variety of clinical manifestations. Purpose: Based on the study of the current state of the problem of recovery of patients with traumatic brain injury, to determine the features of physical rehabilitation of this category of persons. Methods of research: analysis, synthesis and generalization of scientific and methodical literature concerning the issue of restoration of functional capabilities of persons with traumatic brain injury. Results. Persons suffering from traumatic brain injury undergo physical, psychological, emotional and behavioral changes that require bio-psycho-social interception of rehabilitation interventions. The process of physical rehabilitation is aimed at increasing the tolerance to physical activity, improving vestibular oculomotor functions, level of balance and postural control, reducing the manifestations of cognitive impairment, which in turn will increase the activity of everyday life of patients. Conclusions. Physical rehabilitation of individuals allows to effectively realize and increase the functional potential of patients after a traumatic brain injury, using adequate means and methods in the process of recovery, and the main purpose of rehabilitation is to return the patient to work and social activity.

Ageing is a natural phenomenon and decline of physiological and structural changes are incurable in advancing years of human life. When such degenerative changes occur in the brain they may lead to dementia and other memory related conditions. The Ayurvedic classics identified the importance of higher faculties dealing with memory and introduced a separate group of drugs namely Medhya Rasayanas. Regular intake of such drugs will help to prevent the onset of degenerative changes in the brain prematurely. Ayurveda can play a useful role in the management of such geriatric conditions. The current review has been done with a view to update documented Ayurvedic therapeutic modalities for certain geriatric conditions suggested by Ayurvedic classics in the management of diseases called Vātavyādhi (nervous system disorders), which also include conditions related to memory functions. Recent studies have started validating the claims recorded in Ayurvedic texts. The pathogenesis and remedies for Vātavyādhi documented in Ayurvedic classics have been reviewed with special emphasis on disorders related to dementia. A review of recent researches on the herbs mentioned in management of vāta disorders including dementia have been done to understand their role in management of Alzheimer′s disease (AD). There are many herbs of ethno-medicinal source studied experimentally for their potential in treatment of AD. A judicious combination of modern research methodology and Ayurvedic principles could go a long way in the management and care of AD which is going to be a heavy burden on the society in the future.