№1, 2020, volume 16

The review presents the results of studies evaluating the eectiveness and safety of rehabilitation using virtual real- ity to restore stato-locomotor function in patients at dierent periods after suering an acute cerebrovascular accident. The analysis of works published for the period 2011–2019 and available for study according to the main scientic data- bases: MEDLINE (Ovid), Amed, EMBASE, CINAHL and PsycINFO.

Purpose: to develop an algorithm for the clinical diagnosis and treatment of a little-known Moya-Moya disease. This disease is manifested by a transient ischemic attack in childhood and subarachnoid hemorrhage in the young. The analysis of the patient's own clinical observation of N., aged 14, with Moya-Moya disease, is presented. The disease debuted at the age of 9, the clinical manifestation was a transient ischemic attack. On the basis of MRI data, lacunar infarctions in "silent zones" were detected. Conclusion. With the introduction of modern methods of neuroimaging in medical institutions, it became possible to reliably diagnose such a rare neurological pathology as Moya-Moya disease and conduct adequate optimal therapeutic measures.

The review is devoted to the analysis of studies on the problem of pain syndrome in adult patients with cerebral palsy. The authors studied the literary sources contained in the databases PubMed, eLibrary, Scopus, Web of Science, MEDLINE and published over the past ten years. Modern views on the prevalence, etiology, pathogenesis, structure and treatment of pain in adult patients with cerebral palsy are presented. The main comorbid diseases that contribute to the development of chronic pain syndrome in these patients are described. The review focuses on the relevance of the problem, its medical and social significance.

Objective: to evaluate the eŸectiveness of the cognitive rehabilitation program in the treatment of patients with cognitive impairment. Material and Methods. The study included 95 patients in Federal Research and Clinical Center of FMBA of Russia, Moscow, with cognitive impairment, of which 57 were men and 38 were women, the average age was 56.8±7.5 years, and the average duration of the disease was 5.7±3.4 years. Patients were divided into 2 groups: the main one, where, along with drug treatment, the cognitive rehabilitation program developed by the authors was used, and the control one, in which only drug treatment was carried out. Results. The main group showed a statistically signi2cant improvement in cognitive functions on the SCOPA-Cog and MMSE scales, and an improvement in the qual- ity of life on the PDQ-39 scale (p<0.05). Conclusion. Against the background of the cognitive rehabilitation program, patients in the main group showed a positive dynamics compared to the control.

Purpose: introduction of the examination protocol into neurosurgical practice and evaluation of the results of micro-vascular decompression of the trigeminal nerve root in patients with type I trigeminal neuralgia. Material and Methods. The results of 86 operations of microvascular decompression of the trigeminal nerve root in patients with primary trigeminal neuralgia were studied. The preoperative examination protocol for all patients included a general clinical examination, assessment of neurological status, brain MRI with contrast enhancement and a cranial nerve imaging program (CISS or FIESTA). Particular attention was paid to the criteria for the diagnosis of trigeminal neuralgia type I (classical), recommended by the International Headache Society (IHS) in the International Classification of Headache Disorder (ICHD-3, 2018). The pain syndrome was evaluated according to the Visual Analogue Scale (VAS)from 0 to 100 points before surgery, at the time of discharge of the patient from the hospital, after 6 months and after 1 year. Microvascular decompression was performed according to a standard technique using, in all cases, a retrosigmoid suboccipital access, under general anesthesia. A Russian-made fluoroplastic felt was used as a tread. In most cases (98%), the main surgical techniques for isolation of the trigeminal root were used. Results. The effectiveness of surgical treatment was 95% Conclusion. Patients with a diagnosis of trigeminal neuralgia require examination according to a specific protocol that allows you to determine the indications for surgical treatment. The expediency of surgical intervention (microvascular decompression of the trigeminal nerve root) in patients with type I trigeminal neuralgia has been shown.

Purpose: conducting EEG (electroencephalography) with a cognitive load to identify specific markers of mild cognitive impairment (MCI) in cerebrovascular pathology. Material and Methods. Object of study: 63 people with a diagnosis of discirculatory encephalopathy (DE), including 36 people with stage II DE and concomitant MCI (group A), 27 people with stage I DE, cognitively healthy (group B). Results. When presenting of a cognitive load in patients of group A, an increase in the spectral power of slow-wave activity in the 6- and 9-range was noted mainly in the frontal, central, temporal, parietal leads with an emphasis on the left (when performing the "Plants" and "Count" tests). The "What is in common" test revealed a statistically significant increase in a-rhythm. The "Word" test demonstrated significant differences in the a-range in the parieto-occipital leads and a statistically significant increase in the 6-rhythm of the frontal leads of the left hemisphere. Conclusion. A cognitive-loaded EEG is a sensitive method for detecting specific markers. The results can serve as criteria for the early diagnosis of discirculatory encephalopathy at the stage of MCI.

Objective: to evaluate the role of a complex of markers of inflammatory processes and free radical oxidation, an immunoreactivity profile, stabilographic indicators in the pathogenesis of Parkinson's disease (PD) for possible use as clinically significant markers of early diagnosis of the disease. Material and Methods. 139 patients with PD, 31 patients as the control, and 11 patients as the comparison with Parkinson's syndrome were examined. The following parameters were evaluated in blood serum: antidodies to NF-200, GFAP, S100, MBP, voltage-dependent-Ca-chan-nel, Na-Choline, glutamate, dopamine, serotonin, Mu-Opiate, GABA receptors, (3-Endorphin; total antioxidant activity; malondialdehyde's accumulation; determination of small, medium, large and giant circulating immune complexes and medium-weight molecules. Postural functions were evaluated using a biofeedback computer stabilizer. Results. Significant differences in the profiles of immunoreactivity, neuroinflammation and endogenous intoxication in patients and in the control group were revealed. The stabilometric indicator of the quality of the equilibrium function significantly varied depending on the stage of PD. Conclusion. The results indicate a possible role of activation of the immune system and neuroinflammation in the process of neurodegeneration in PD. The autoimmune response is specific in nature, progressively changing depending on the stage of the disease.

Objective: to determine the effectiveness of therapy for acute nonspecific vertebrogenic pain and anxiety, as related conditions, using a non-invasive method of biological feedback, in particular neurofeedback technique. Material and Methods. The study included 60 patients with nonspecific vertebrogenic pain in the acute phase and with easily increased anxiety. Patients were divided into two equal groups (30 people in each group) by random sampling depending on the treatment protocol. The neurofeedback technique and basic therapy was applied for patients of the main group while 30 patients of the control group had only basic therapy applied to them. The effectiveness of treatment was evaluated by reducing the assessment of pain on a Visual Analogue Score (VAS), by reducing the anxiety on a Simptom Chek List-90-Revised (SCL-90-R) and to increase the alpha rhythm index. Results. In the main group, there was a greater regression of pain syndrome (p<0.05) and a significant increase in the power of alpha vibrations, recorded in the bioelectric activity of the brain. All investigated factors (anxiety level, severity of acute nonspecific pain and alpha rhythm index) are moderately related. Conclusion. It is advisable to use the non-invasive neuromodulating method of biological feedback (neurofeedback) to reduce anxiety and correct acute moderate vertebrogenic pain.

The purpose of the study was to examine the relation between the state of macular area and optic disc in fellow eyes of patients after rhegmatogenous retinal detachment (RRD) and the development of epiretinal fibrosis in association with silicone tamponade. Material and Methods. The study included 18 patients operated on for RRD using vitreous cavity tamponade by silicone oil. The examination was performed by means of optical coherence tomography-angiography for fellow eyes of patients. Results. Analysis of retinal thickness and volume revealed that the indices were lower in the group with epiretinal fibrosis. When assessing relative vascular density, area and perimeter of foveal avascular zone (FAZ) the indices were prevailed in the group with epiretinal fibrosis. Conclusion. The study revealed a significant decrease in retinal thickness in the fovea of fellow eyes in patients with epiretinal macular fibrosis. A statistically significant decrease in the thickness of the reticular membranes is revealed in patients with epiretinal macular fibrosis. A statistically significant enlargement of the area and an increase in the perimeter of FAZ, an increase in the relative vascular density in the foveal and deep plexuses in the fellow eyes of patients with epiretinal macular fibrosis were revealed as well.

The purpose of the study is to increase the efficacy of surgical treatment of severe stages of proliferative diabetic retinopathy in combination with circular retinotomy. Material and Methods. The operations performed in 2016-2018 on patients with proliferative diabetic retinopathy in combination with traction retinal detachment (17 eyes). The patients' age ranged from 24 to 69 years. Tractional retinal detachment was diagnosed alongside with PDR3-4 in all eyes. In 10 (58.8%) previously operated eyes we diagnosed the relapse of retinal detachment. In 14 eyes (82.3%), vitrectomy was performed in combination with phacoemulsification, 3 eyes (17.6%) were already pseudophakic. Results. We obtained complete anatomical attachment of the retina in all 17 cases (100%). All patients we kept on 5700 cSt silicone tampon-ade. Circular retinotomy was performed on 10 (58.8%) eyes with a relapse. The period of keeping silicone oil 5700 cSt in the vitreous cavity after a circular retinotomy varied (from 1 to 3 years), emulsification of silicone oil occurred in none of the cases. Secondary glaucoma developed in 3 eyes. Conclusion. Circular retinotomy in combination with prolonged tamponade of the vitreous cavity with silicone oil provides stable anatomical effect.