[Clinical and neurophysiological parameters in patients with epilepsy in the long-term period after COVID-19]

OBJECTIVE

Clinical and psychophysiological assessment of the dynamics of the condition of patients with epilepsy in 4-6 months after the coronavirus infection.

MATERIAL AND METHODS

An open controlled prospective comparative outpatient clinical and physiological study of patients diagnosed with epilepsy after suffering from COVID-19 (after 4-6 months) of moderate severity (n=16), patients diagnosed with epilepsy who did not suffer from COVID-19 (n=7), a control group (n=11) after confirmed COVID-19 (after 4-6 months). All groups were in the age range 23 to 50 years. Clinical/neurological and somatic research included: anamnesis, neurological examination, questioning, ECG, EEG, clinical and psychometric tests.

RESULTS

There was an increase in the representation of epileptiform activity in the background EEG and more pronounced activity in provoking samples compared with background recording in 26.5% of patients who had suffered COVID-19 compared with the group of patients with epilepsy who had not suffered COVID-19. The detection of rare epileptic seizures in 18.8% of cases in the group of epilepsy patients, who underwent COVID-19, indicates an increase in epileptogenesis and a decrease in therapeutic control over seizures. At the same time, 87.5% of patients in this group showed a statistically significant increase in the influence of the sympathetic nervous system on the regulation of heart rhythm and an increase in anxiety and depression.

CONCLUSION

The results can complement the understanding of the neuropsychiatric status of patients with epilepsy after COVID-19, which provides prerequisites for the development of optimal recovery directions in the rehabilitation period to maintain drug remission of epilepsy and reduce the possible progression of the disease.

[Impact of COVID-19 on some neurological and psychological features in epilepsy]

The new coronavirus infection spread around the world in a very short time and turned into a pandemic with a wave-like flow for more than two years. COVID-19infection affects selectively various organs and systems, including the nervous system; neurological manifestations have been reported, including anosmia, encephalopathy, stroke, epileptogenic disorders, which necessitates studies of the course of brain diseases, among which epilepsy occupies a significant place.

[Neurophysiological and functional neuroimaging methods in the assessment of migraines and epilepsy with vertigo]

A review of the current literature shows that the combined use of neurophysiological and structural-functional neuroimaging methods has significantly expanded the understanding of the mechanisms of migraine with vestibular dysfunction: functional and structural disorders were found in brain regions involved in multisensory vestibular control and Central vestibular processing. Analysis of numerous studies shows that epilepsy can also cause vestibular symptoms, they can occur both without epileptic markers, and in combination with epileptic paroxysms. In isolated epileptic vertigo, according to studies widely presented in the literature, epileptic activity was most often detected by EEG data in the temporal regions, to a lesser extent in the parietal regions. In these studies, neuroimaging findings of foci of reduced substance density were found, which could be a consequence of deafferentation, as well as violations of connections with the focus of neuronal activity. In the absence of structural abnormalities, numerous studies have shown using magnetic resonance spectroscopy, diffusion MRI, and PET that the physiological basis for impaired neuronal metabolism was a decrease in synaptic activity, a violation of maintaining the difference in membrane potentials on the surface of the hippocampus, or changes in neighboring tracts of the white matter of the brain.

[Neurophysiological methods in the assessment of different forms of migraine]

The review considers the efficacy of neurophysiological methods for the study of migraine. According to many authors, such neurophysiological methods as analysis of visual and somatosensory evoked potentials, trigeminal evoked potentials are informative for assessing the functional state of trigeminocervical and sensory systems. Analysis of bioelectric activity of the brain is used for differential diagnosis of migraine and epilepsy, evaluation of various forms and types of migraine. Studies with recording and analysis of laser evoked potentials, as well as the effects of transcranial magnetic stimulation, both diagnostic and non-pharmacological rehabilitation effects on pain syndrome, which increases the efficiency and quality of life in migraine, are considered.

[Neurophysiological and clinico-biological features of internet addiction]

AIM

To analyse neurophysiological and some physiological characteristics of people with Internet addiction.

MATERIAL AND METHODS

Two groups of subjects were studied: with Internet-addiction lasted no more than two years and the control group. Spectral-correlation parameters of EEG, functional asymmetry of EEG parameters, and heart rate variability were recorded. The comparison was performed in three states: eyes-closed, eyes-open conditions and after a 15-minute Internet session.

RESULTS AND CONCLUSION

The shift in the balance of the regulation of the heart rate towards the predominance of the sympathetic nervous system is accompanied by a functional state of increased activation, anxiety as indicated by the parameters of the electric activity of the brain and the shift in the functional asymmetry of the brain in the spectral power of the fast EEG rhythms in the right hemisphere.

[Neurophysiological approaches to the diagnosis and treatment of vestibular disorders in migraine and epilepsy]

The review considers the results of domestic and foreign studies of modern neurophysiological diagnosis of vestibular disorders in migraine and epilepsy. Currently, there is a large number of physiological and clinical methods to evaluate the functions of the peripheral and central parts of the vestibular sensory system. However, among the tests, the samples for the assessment of the physiological state of horizontal semicircular canals and associated stem canals predominate. In recent years, neurophysiological techniques that reflect the work of the structures of the nervous system, previously inaccessible to direct study, are being actively introduced. Modern effective neurophysiological methods of rehabilitation of patients with migraine-associated and other various vestibular disorders have been developed. Further study of neurophysiological approaches to the diagnosis of vestibular disorders in migraine and epilepsy will significantly expands the current understanding of neurophysiological mechanisms of brain functions.

[Prevention of venous thrombosis of the lower extremities and pulmonary embolism in neurological patients in the intensive care unit using intermittent pneumatic compression]

AIM

To assess the efficacy of intermittent pneumatic compression (IPC) in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurological patients.

MATERIAL AND METHODS

The study included 101 patients with acute disorders of cerebral circulation: 52 patients underwent IPC for prevention of DVT of the lower extremities, 49 patients received only basic treatment. Clinical examination, venous duplex scan of the lower extremities and telethermography were performed.

RESULTS AND CONCLUSION

IPC significantly reduces the risk of DVT of the lower extremities and PE mortality in the first 20 days in patients with stroke and motor deficit. Ultrasound and thermography can effectively assess the dynamics of treatment.

[Neurobiological perspectives of biofeedback-therapy efficiency of migraine in patints with epilesy]

AIM

Efficiency of BFB-therapy was studied by EMG and temperature parameters under migraine in patients with epilepsy.

MATERIAL AND METHODS

14 patients with epilepsy with different localization of epileptic foci were examined. For the estimation of migraine pain syndrome the clinic-psychological scaled of pain, anxiety and depression were used.

RESULTS AND CONCLUSION

The estimation of compared efficiency of the temperature and EMG BFB therapy showed more advisable using of temperature BFB therapy in the group with migraine-epilepsy seizures in the group with localization in temporal area of the right hemisphere.

[Effectiveness of different biofeedback therapies of tension headache]

OBJECTIVE

To explore the effectiveness of treatment using biofeedback (BFB-training) technology in patients with tension headache.

METHODS

Respiratory training and EEG-BFB-therapy were used to reduce pain syndrome. Two groups of patients with different characteristics of the autonomic nervous system, according to R.M. Baevsky, during Holter monitoring of heart rate variability in the awakening period, presence of autonomic dysfunction that reflected migraine chronification were studied.

RESULTS

The statistically significant difference in the effectiveness of treatment of tension headache using respiratory or EEF parameters of BFB in regard to autonomic nervous system function and the presence of autonomic dysfunction syndrome was demonstrated.

[Neurophysiological aspects of maxillofacial pain]

The review of literature presents the contemporary neurophysiological methods of study of pain syndromes in the maxillofacial area (MFA). The authors showed that clinical/neurophysiological features of different variants of chronic headache, the functional state of afferents systems and mechanisms of afferent-efferent interactions in different kinds of chronic headache are been intensively explored. The neurophysiological studies of trigeminal system in the pathogenesis of the pain syndromes have been analyzed as well. Current neurophysiological methods and techniques for estimation of the functional MFA innervation may be used for the diagnosis of different kinds of maxillofacial pain, specification of pathogenetic mechanisms, development of treatment tactics and estimation of treatment efficacy.

[Neurobiological studies of gamma-band bioelectrical activity in humans]

The modem literature data were observed, which dedicated to the study of neurobiological studies of gamma-rhythm mechanisms, providing the cognitive functions in hymans: state of readiness and attention, providing of sensory indentification, perception and memorizations, decision-making, management of psychomotor response, emotional and semantic processing of an information. It was shown that synchronous gamma-activity is at integrative activity, which in deteriorated in pathology of thinking. Literature data were analysed concerning ot the changes of gamma-activity (spontaneous, evoked, provoked by photostimulation etc.) in a number of neuropsychiatric disorders: epilepsy, schizophrenia, Alzheimer's disease, attention deficit hyperactivity disorder, stroke etc. as compared with norm. The data observed testify to high significance of gamma-activity in the brain functioning.

[Neurobiological approach to brain functional asymmetry in depression]

The modern literature data were observed, which dedicated to the study of neurobiological mechanisms of depressive states of different origin. The results of the investigations of structurally functional features of depression in healthy volunteers in experiments and in patients with the neurological diseases were viewed. The data cited confirm the modern concepts of R. Davidson concerning to the role of brain functional asymmetry in depression: i.e., the associations between depression and a decrease of the functional activation of the left prefrontal lobe, and also the involving of amygdale in the processes of the forming of negative emotions and depression. The literature data observed and findings of our investigations allow us to conclude that depressive states are characterized not only by the decrease of the functional activity of the left hemisphere, especially, its prefrontal area, but also reciprocal increase of the physiological activity of the prefrontal area of the right hemisphere combined with right-hemispheric functional insufficiency, especially, of its posterior (parieto-temporal) areas.

[Neurobiological problems of brain ischemia and post stroke epilepsy]

A review. Current literature data concerning pathophysiological mechanisms of cerebral ischemia and poststroke epilepsy are presented. Results of investigations of structural-functional changes in activity of inhibitory inter neurons, mechanisms of brain plasticity, and main components of neuroprotection in ischemia are also discussed. The presented data confirm the current concept of apoptosis and necrosis as a consequence of injuring action of ischemia, the role of excitotoxicity in pathogenesis of ischemia and poststroke epilepsy, and different kinds of plasticity in recovery of brain functions.

[Personal peculiarities of epileptic patients with depersonalization in the interictal period]

Depersonalization states, expressed in interictal period, were analyzed in 23 patients. Depersonalization state occurs only in patients with partial complex seizures with epileptic focus in the temporal areas of the right hemisphere and in the mediobasal frontal areas of the left hemisphere. Also, compared to healthy subjects, schizoid personality features by MMPI and Rorshach psychological tests were found in these patients. The depersonalization states studied were defined as neurotic ones, because they manifested after psychotraumatic situation and did not recur after psychotherapy.

[Gastric tuberculosis in the past and present]

The paper presents a historical review of the literature on the rare form of extrapulmonary tuberculosis--gastric tuberculosis. It is more frequently associated with tuberculosis of other organs and observes as an isolated form. The disease has no specific clinical signs. It is diagnosed as gastric carcinoma or ulcer by X-ray and in most cases endoscopic studies. The diagnosis of gastric tuberculosis can be made only by histological study of the resected stomach or its biopsy specimen. Antibiotic treatment for tuberculosis yields a good effect.

[Impairments of different kinds of memory in patients with ischemic stroke]

27 patients aged 47-64 years with left hemispheric ischemic stroke with similar cognitive and educational levels were examined. Pharmacotherapy of the stroke directed to improvement of both memory and thinking was taken into consideration. To evaluate both different kinds of memory and a degree of the cognitive functions' impairments in the patients with a local ischemic stroke in anterior, posterior and middle parts of the left hemisphere the following tests were used: evaluation of both the immediate memory of the digits and the short-term audio-verbal memory; short-term trials of the pathological action of interference; Benton test, Meily test; evaluation of the declarative, procedure, semantic, strategic, mediated, long-term kinds of memory. It is shown that remembering of the new information concerning verbal names, digits, was worse in mediobasal, frontal and temporal location of the stroke in the left hemisphere and depended on clinical manifestations of the disorders. The working semantic and strategic kinds of the memory were also damaged, while long-term memory (autobiographic, professional) was impaired in less degree.

Indirect short-term influences of alternating magnetic fields on the brain in epilepsy

Changes the bioelectrical activity of the cerebral hemispheres were studied in 20 patients with epilepsy and 18 healthy subjects subjected to local alternating magnetic fields (MF) applied to the hand. MF produced increases in epileptic activity in terms of the bioelectrical characteristics of foci and the level of generalization. This suggests that alternating MF can be used to identify the localization of epileptic foci. The most stable changes in response to alternating MF were seen in the posterior parietal parts of the right hemisphere. It is concluded that the effects of alternating MF are produced mainly by processes in the right hemisphere.

[The influence of hypogeomagnetic field on bioelectric activity of the brain in epilepsy]

An influence of geomagnetic field (GMF) on bioelectric activity of the brain was studied in 20 epileptic patients by the use of "hat", which attenuated GMF. A short-term attenuated GMF increased a EEG synchronisation by alpha-rhythm, generalized slow-waves discharges. Some similarities and differences were found in attenuated GMF effects and in the results of hyperventilation trial. The main role in perception of attenuated GMF belongs to the parietal area of the right hemisphere.

[Disorders of speech and imagery functioning in children with epilepsy in the right or left cerebral hemisphere as primary loci of lesions]

The paper presents the relationship between the disorders of speech and a drawing. 40 epileptic 5-12 year-old children as well as 9 healthy children (a control group) were examined. There were analysed the disorders of speech, alterations of drawing in children with epilepsy, mechanisms of participation of the right or the left hemisphere in forming of speech and descriptive activity on different stages of ontogenesis and its compensation in dependence on the severity of the disease. In younger preschool age disorders of a speech and deficiency in drawing were determined by the damages of the right hemisphere, while a role of the left hemisphere in such processes increased later.

[The bioelectrical correlates of the personality anxiousness of 2 strong types of higher nervous activity]

Bioelectrical correlates of personality anxiety were studied in subjects with strong types of higher nervous activity. It was shown that the index of general power of the alpha-rhythm inversely depended on the level of anxiety. In sanguine persons the low level of anxiety and incapacity for vivid reproduction of fear were associated with frequent change of asymmetry sign in all EEG recordings. Choleric persons were characterized by the high level of anxiety and the stable dominance of one of the hemispheres manifested in EEG of the frontal and temporal areas.

[The interhemispheric integrative activity of the frontal and parietal areas in the model of epilepsy]

The study was aimed to reveal the character of interaction between the frontal and parietal areas of both brain hemispheres in patients with epileptic foci either in the frontal or parietal cortical areas. Right-handed patients were examined. Clinical, bioelectrical, and psychological techniques were applied. Functional relation between the frontal and parietal areas of the contralateral hemispheres were established on the basis of the obtained results. It is substantiated in the paper that described phenomenon of interhemispheric "criss-cross" is not pathognomonic for epilepsy. It reflects one of the forms of the brain functional plasticity aimed to organization of integrative brain activity at the new level.

[The effect of motivational and emotional aspects of work on the structure of operator's errors]

The paper studies a motivation effect on an effectiveness of occupational activities of the operators with a different level of anxiety. To do this, the role of professional motivation under co-existence of competing motives as well as the dynamics of interactions of the operators with different level of anxiety under complicated working conditions have been studied. It is indicated that the results of operator activity depends on hierarchical structure of motivation sphere. Emotional tension induced by the main motive may lead to an increment of by-work failures. In a motives conflict situation highly anxious operators are more immune to disturbances than the low anxious persons. A reliability of joint activity of the operators exhibiting a close level of anxiety is higher than in operators with different values of an anxiety level.