№1, 2022, volume 18

Objective: to consider the clinical experience of duplex sonography in the diagnosis of brachiocephalic arterial pathology and to summarize the reference values of ultrasound markers of cerebrovascular disease (CVD). A systematic search of the scientific literature was performed in the PubMed, ProQuest Dissertations & Theses Global, and ProQuest Ebook Central databases from 1983 to the present, and included 47 relevant sources. The following search terms were formulated: "vascular neurology", "noninvasive diagnostics of CVD", "duplex sonography of head and neck vessels", "stenoocclusive lesions of cerebral arteries". Duplex scanning is an integral part of the diagnostic algorithm of screening and expert evaluation of pathological changes in CVD, which contributes to the personalization of diagnosis and treatment, significantly improving the results of primary and secondary prevention of ischemic events.

Objective: to analyze of genetic mutations in patients suffering from Parkinson's disease. To achieve this objective, domestic articles and dissertations were studied, as well as foreign literary sources placed in scientific databases such as PubMed and Medscape. The list of references consists of 25 scientific researchs published from 2015 to 2022. In a result of generalization and systematization of the data, it was found that mutations in different gene loci lead to different clinical phenotypes of Parkinson's disease, which can help predict the course of the disease. It was also determined that the mutation in the GBA gene is the most common genetic defect in the Russian population. Determination of genetic mutations that cause Parkinson's disease in real clinical practice will allow diagnosis and treatment of the disease at the premotor stage, especially in people with a burdened family history.

The SARS-CoV 2 virus infects lung tissue, blood vessels of the heart, brain (GM), peripheral and central nervous system. There is a decrease in immunity, and with damage to the kidneys, spleen, liver and pancreas, a syndrome of multiple organ failure occurs. With the defeat of the paranasal sinuses, the development of frontal sinusitis, sphenoid-itis, ethmoiditis is possible, followed by powerful necrosis of the tissues of the head and neck, the development of an abscess of the brain. The author considers her own clinical observation of patient M., 42 years old, with a diagnosis: "BM abscess in the basal parts of the frontal lobes. Ischemic stroke in the basin of the left middle cerebral artery (MCA). Novel coronavirus infection U07.1 COVID-19, severe form. Community-acquired bilateral polysegmental viral-bacterial pneumonia. Bilateral frontal sinusitis, ethmoiditis, right-sided sinusitis, right-sided sphenoiditis. This clinical case draws attention to the fact that the combination of this pathology led to formidable complications: thrombosis of the right internal carotid artery (ICA); mucormycosis of the nasal bones, thrombosis of the cavernous sinus. Peripheral nervous system lesions in the form of multiple cranial polyneuropathy were stated. Ischemic stroke in the territory of the left MCA. The presented observation will be a definite contribution to the accumulation of data and will help in organizing basic and additional studies in neurological patients with a new coronavirus infection U07.1 COVID-19.

The SARS-CoV-2 virus in U07.1 COVID-19 affects the lung tissue, blood vessels of the heart, brain and lower extremities. Against the background of a nowel coronavirus infection, cases of damage to the peripheral nervous system (PNS) have become more frequent. The article presents five clinical cases (3 men and 2 women) of the development of polyneuropathies, when patients developed tetraparesis after an average of 14 days, and the distribution of clinical variants resembles those in classical Guillain — Barre syndrome (GBS), confirming the predominance of acute inflammatory demyelinating polyneuropathy and sensorimotor syndrome. The typological characteristics of PNS lesion in patients with GBS against the background of U07.1 COVID-19 are described. Attention should be paid to the massive release of cytokines in COVID-19, which contributes to the strengthening of the dysimmune process underlying GBS. The effectiveness of the applied plasmapheresis in complex treatment indicates a postinfectious immune-mediated mechanism of GBS development. The considered variants of PNS lesion in patients with GBS clearly demonstrate the difficulties that arise in the diagnosis of PNS lesion in the conditions of departments for patients with U07.1 COVID-19. The article discusses the necessary and optimal both basic and additional laboratory and instrumental research methods. Unfortunately, not all departments are equipped with modern diagnostic equipment necessary for the timely and earliest diagnosis of neurological complications in patients with U07.1 COVID-19.

Objective: to analyze the frequency of occurrence and structure of comorbid disorders in patients with rare episodic, frequent episodic and chronic migraine without aura. Material and methods. Outpatient records of 159 patients with migraine without aura were analyzed: 52 with rare episodic migraine (REM), 54 with frequent episodic migraine (FEM), 53 with chronic migraine (CM). All patients underwent a clinical and psychological examination with an assessment of the state of the temporomandibular joint, frontal, occipital muscles, neck muscles (pericranial muscles) and chewing muscles with an emphasis on the pterygoid muscles. All patients were consulted by a clinical psychologist. Results. Additional headache symptoms have been identified in various forms of migraine. In the structure of comorbid conditions, the following were noted more often than others: disorder of pericranial muscles (REM 59.6%, FEM 72.2%, CM 90.5%), dysfunction of the temporomandibular joint (REM 21.1%, FEM 22.2%, CM 54.7%), anxiety-depressive disorders (REM 26.9%, FEM 35.2%, CM 58.5%), insomnia (FEM 22.2%, CM 39.6%). With CM, there is a high percentage of medication-overuse headache (73.6%). Conclusion. Comorbid disorders occur with varying frequency depending on the form of migraine. Among comorbid disorders, muscle dysfunction, dysfunction of the temporomandibular joint, anxiety and depressive disorders, and sleep disorders predominate.

Infantile cerebral palsy is one of the most common causes of persistent disability in childhood. The main method of treatment of motor disorders in this pathology is physical rehabilitation. Objective: a comparative analysis of the effectiveness of the use of kinesiotherapy methods for various forms of infantile cerebral palsy The analysis of scientific articles in public databases was carried out: MEDLINE® (Ovid), AMED, Embase, CINAHL и АРА PsyclNFO®, published in the period 1985-2021. The following keywords and phrases were used in the search: "kinesiotherapy", "infantile cerebral palsy". A total of 102 articles were analyzed. The review includes 17 scientific papers according to the methods of kinesiotherapy used and methods for evaluating their clinical effectiveness. The results of the system analysis demonstrate the positive effects of kinesiotherapy in the rehabilitation and habilitation of children with various forms of infantile cerebral palsy. As factors that increase the effectiveness of kinesiotherapy, group forms of training in the form of a game should be noted.

Objective: to improved diagnosis and treatment of asthenic-vegetative syndrome in those who have undergone COVID-19 on the basis of studying the peculiarities of its course. Material and methods. Included in the study were 54 outpatient patients aged 21 to 59 years who underwent symptomatic laboratory-confirmed COVID-19. All patients underwent electrocardiography and laboratory studies. A questionnaire was used on the Wein Vegetative Dysfunction Scale, the Beck Depression Questionnaire, the Spielberg — Hanin Situational and Personality Anxiety Scale, the Brief Mental Status Assessment Scale (MMSE) at the first visit, and again at 1 and 3 months on the background of neuropro-tective therapy. Results. It was revealed that those who underwent COVID-19 develop asthenic-vegetative syndrome with asthenic and vegetal-dystonic manifestations and pronounced anxiety-depressive disorders in 100% of patients. Against the background of therapy, there was a significant decrease in the number and severity of asthenic manifestations (from 74.1 % of patients to 5.6%) and mental disorders (from 20.4% of patients to 3.7%), but the level of anxiety remained quite high (in 40.7% of patients). Conclusions. Treatment of patients with post COVID-19 asthenic-vegetative syndrome gives a faster effect in terms of stopping asthenic and cognitive impairment, and a delayed positive dynamics in relation to anxiety-depressive manifestations.

Objective: to evaluate changes in the concentration of 41 cytokines in patients with multiple sclerosis (MS) in comparison with healthy donors (HD). Material and methods. For the study, 55 blood serum samples from MS patients and 36 from healthy donors were used. The concentration of 41 cytokines was determined using a Human Cytokine/Chemokine Magnetic Bead Panel (HCYTMAG-60K-PX41) manufactured by Merck Millipore (Darmstadt, Germany). Statistical analysis of the obtained results (Mann —Whitney l/-test, Bonferroni correction for multiple hypothesis testing) was carried out in Origin 2021. Results. Of the 41 cytokines studied, the concentration of 12 was significantly lower than in healthy donors: GRO (p=0.003); MDC, Eotaxin (p=0.002); EGF, PDGF-AA, TGF-a, PDGF-AB/BB, VEGF, IL-8, MIP-1b, MCP-1, sCD40L (p<0.001), other cytokines did not change significantly. Conclusion. In patients with MS, a decrease in the concentration of twelve cytokines was found compared with HD. Altered cytokines can be classified into two functional groups: growth factors and "monocyte-macrophage" cytokines.

Objective: to conduct a clinical and morphological analysis of the state of the medulla oblongata of patients who died from an infection caused by SARS-CoV-2. Material and methods. The work is based on a morphological study of the medulla oblongata of 10 patients who died from the coronavirus infection COVID-19, who did not appear symptoms and signs of damage to the nervous system during their lifetime, with the exception of ageusia. Results. In the structure of neurons in the medulla oblongata, changes characteristic of infectious diseases (the "mulberry" phenomenon, chromatolysis, eosinophilic inclusions of a protein nature) were revealed. Conclusion. The results obtained indicate that when SARS-CoV-2 enters the brain structures, it triggers the process of destruction of the nuclei of neurons and the penetration of viral inclusions into the cell, which indicates a lesion of the central nervous system directly associated with SARS-CoV-2.

Objective: to analyze the clinical, psychological and methodological aspects of forming specialist's and the public's opinion about risk factors and predictors of nervous system's damage in infections. Publications in the electronic databases Google Scholar, PubMed, Springer and Elsevier for the period from 1933 to April 2022 using the keywords: «Infections», «Nervous system», «Risk factor», «Predictor», «COVID-19» were researched 39 literary sources were satisfying the search conditions. As a result of the analysis, it can be stated that there is currently no reliable information about the predictors of damage to the nervous system in COVID-19, and information about risk factors is contradictory. Previously accumulated experience (for example, during studying the infection caused by Treponema pallidum subsp. pallidum) can be useful in the analysis of information about new infections, in particular, caused by SARS-CoV-2. It is important to use the terms correctly to avoid cognitive bias. The interaction of doctors and psychologists is especially important during the pandemic period.