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Vol LIV, No 1 (2022)

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Editorial

Patient with functional disorder between psychiatry and neurology

Mendelevich V.D.

Abstract

The article analyzes the modern approach to hysteria and dissociative (conversion) disorders. The validity of their inclusion in the psychiatric or neurological section of disease classifications is assessed. Particular attention is paid to the diagnosis of “functional neurological disorder”, which is included in some classification systems. From the standpoint of scientific validity, the need for a neurological approach to the diagnosis and treatment of dissociative disorders is discussed.

Neurology Bulletin. 2022;LIV(1):5-10
pages 5-10 views

Original study arcticles

Social and medical practices of gender transition in Russia

Chumakov E.M., Petrova N.N., Ashenbrenner Y.V., Azarova L.A., Limankin O.V.

Abstract

AIM. To examine the social and medical aspects of gender transition practices in Russia.

MATERIAL AND METHODS. An anonymous online survey of people living in Russia whose gender experience differed from the sex marker determined at birth was conducted. The final sample consisted of 588 respondents (aged 24.01±6.70), of whom 69.9% (n=409) were transgender male, 23.1% (n=136) were transgender female, and 7.3% (n=43) had a different gender identity.

RESULTS. There was a high frequency of social disadaptation among respondents (15.5% of the sample). Most respondents first reflected that their gender identity did not match their sex at birth and/or did not fit into the social framework during childhood or adolescence, with a peak at age 11–14 (39.8% of the entire sample). The age at which respondents began gender transition was overwhelmingly after adulthood, with a peak at age 18–25 (32.0% of the entire sample). More than half of the respondents (59.4%) who had medical body changes associated with gender transition initiated them on their own. Less than half of the respondents who were on hormone therapy (41.0%) had been monitored by an endocrinologist. The study showed a large proportion of people who already had medical body changes but had not changed sex marker on their IDs, with transgender women having the largest rate in this indicator.

CONCLUSION. The data obtained determine the relevance of developing a system of specialized medical care for transgender people with essential destigmatizing psychotherapeutic and psychiatric care for these people, as well as emphasize the need to study the availability of medical (psychiatric) care for transgender people living in Russia.

Neurology Bulletin. 2022;LIV(1):11-22
pages 11-22 views

Using of transcutaneous supraorbital nerve stimulation in the treatment of chronic tension type headache

Yakupov E.Z., Agliullina F.F.

Abstract

BACKGROUND. The clinical study was carried out as part of the scientific work “Non-drug treatment methods and optimization of coping strategies for chronic tension type headache”.

AIM. To evaluate the effectiveness of the use of transcutaneous neurostimulation of the supratrochlear and supraorbital nerves in patients with chronic tension type headache.

MATERIAL AND METHODS. The clinical study was conducted from February to August 2021. In total, 50 patients with chronic tension type headache took part in the study, which were divided into two groups: the main group (40 participants) and the control group (10 participants). In the main group, patients received transcutaneous neurostimulation of the supratrochlear and supraorbital nerves with low-frequency (60 Hz) impulses. In the control group, participants received only drug therapy. One month after the end of the course of treatment, the intensity, frequency of headache, the amount of drugs taken, and the effect of headache on work ability were assessed. Statistical processing was performed in the IBM SPSS program using tests for nonparametric data and tests of signs and Wilcoxon. The results of the data were taken as significant at p <0.05.

RESULTS. In the main group, there was a statistically significant (p <0.05) decrease in the frequency of headache episodes by 1.8 times, the number of analgesics consumed by 2.8 times, and the intensity of headache by 50%. We also observed a decrease in the effect of headache on the ability to work of patients from 79 to 47.3%. At the same time, there were patients whose headache did not affect their ability to work. In the control group we did not notice significant dynamics in the frequency of episodes and the intensity of headache.

CONCLUSION. In our opinion, non-invasive percutaneous neurostimulation of the supratrochlear and supraorbital nerves is an additional option for preventive treatment in patients with chronic tension type headache.

Neurology Bulletin. 2022;LIV(1):23-30
pages 23-30 views

The specifics of emotional dysregulation in women with various types of irritable bowel syndrome

Melehin A.I.

Abstract

BACKGROUND. To this day, relatively little is known about the specifics and mechanisms by which psychological factors, such as a general tendency to anger and the style of expressing anger, can be associated with pro-inflammatory processes and visceral hypersensitivity, which contribute to the appearance of signs of irritable bowel syndrome and lead to its refractory course.

AIM. The purpose of the work. to identify the specifics of differences in the presence and severity of depression, anxiety, anger expression and satisfaction with the quality of life in women (average age 39.2±10.6) with refractory IBS of constipated, diarrheal and mixed types (duration of the disease 33.8±48.1 months), based on the hypothesis that women with different types of IBS may have different styles of expressing negative emotions (for example, anger) and ways of controlling behavior.

MATERIAL AND METHODS. PHQ-15 — Patient Health Questionnaire-15; GAD-7 — General Anxiety Disorder-7; PHQ-9 — Patient Health Questionnaire-9; IBS-QOL — Irritable Bowel Syndrome Quality of Life; STAXI — State–Trait Anger Expression Inventory.

RESULTS. Correlations between subtypes of IBS and negative aspects of the emotional sphere are observed and it is shown that subtypes of IBS-C and IBS-D demonstrate affective profiles characterized by a higher level of anxiety, depression and changes in the expression of anger with difficulties of expression both verbally and nonverbally. All types are characterized by autoaggression, suppression of anger, but these aspects are more pronounced in IBS-D and IBS-C. There is intense control of anger expression. With IBS-C and IBS-M, there is greater control over the expression of anger externally than with IBS-D. Women with IBS-C have more pronounced indicators of anger as a mental state. There are difficulties in verbal expression of anger, hetero- and autoaggression. Anger is a trait of character and is included in the structure of temperament. Women with IBS-D have pronounced indicators of anger as a reaction to a current life event, autoaggression, anger control inside. The level of affect somatization, the presence and severity of generalized anxiety disorder, depression, changes in life satisfaction are among the predictors that determine both the level of anger and the ways of its expression.

CONCLUSION. Intestinal motility can be considered as an indicator of behavior control, as an indicator of the regulatory function of the patient, the intensity of affective involvement in a particular situation. Changes in the cognitive, emotional and executive components of the mental organization play only a significant role in the refractory course of IBS.

Neurology Bulletin. 2022;LIV(1):31-44
pages 31-44 views

Clinical aspects of hypomimia in Parkinson’s disease

Khomchenkova A.A., Prokopenko S.V., Ismailova S.B.

Abstract

BACKGROUND. Hypomimia is a distinct symptom of Parkinson’s disease manifested by reduced facial expression and slowness of movement in mimic muscles. Clinical aspects of this symptom remain underinvestigated to the date.

AIM. Based on correlation analysis, to determine the association between hypomimia, general manifestations of hypokinesia and the quality of life in patients with Parkinson’s disease as well as to evaluate the influence of therapy with L-DOPA pharmaceuticals on hypomimia.

MATERIAL AND METHODS. Clinical aspects of hypomimia were studied in 30 patients with stage 1.5–3.0 PD according to Hoehn and Yahr Rating Scale. The mean age of the patients was 69. Analysis of hypomimia was carried out using a proprietary method of computer video-analysis of facial muscle movement in performance of 6 tests: smiling, drawing of the letter “O”, winking, eyebrow raising, frowning and text reading. The gait function was assessed using the laser analyser of kinematic parameters of gait. Mean step length, step time and gait velocity were evaluated. Manifestations of general hypokinesia were analysed via the Unified Parkinson’s Disease Rating Scale licensed by the International Parkinson and Movement Disorder Society. Statistical processing of the data was performed using the IBM SPSS Statistics 23 software package. The Wilcoxon test and the Spearman’s correlation coefficient were used. The statistical significance level was set at p <0.05.

RESULTS. The correlation between the degree of hypomimia and the severity of general hypokinesia has been confirmed, which determines the prospect in objective analysis of mimics as a possible screening test for general hypokinesia. We have obtained data confirming the association between hypomimia and general hypokinesia: in particular, step time, step length and gait velocity.

CONCLUSION. While using the proprietary method of objective hypomimia diagnosis, we have revealed the presence of correlation between manifestations of hypomimia and general hypokinesia. Additionally, manifestations of hypomimia have been found to decrease against the background of dopaminergic therapy.

Neurology Bulletin. 2022;LIV(1):45-53
pages 45-53 views

Efficiency of manual therapy methods in treatment of patients with chronic tension type headache

Yakupov E.Z., Agliullina F.F.

Abstract

BACKGROUND. The treatment of chronic tension headache mainly includes pharmacological methods, but the frequent side effects of medications and the presence of contraindications in some categories of patients determine the relevance of the search for alternative methods. One of them is the use of soft techniques of manual therapy with an impact on the myofascial structures of the head and cervical spine.

AIM. To determine the effectiveness of manual therapeutic use in patients with chronic tension headache.

MATERIAL AND METHODS. The clinical study was conducted in the period from 2019 to 2021. The study involved 49 patients with chronic tension headache, who were divided into 2 groups: the main (37 participants) and control (12 participants). In the main group, patients received 3 manual therapy sessions. In the control group, patients received drug therapy. After 1month and 6 months, the intensity, frequency of headache, the amount of drugs taken, and the effect of headache on work ability were assessed. Statistical processing was performed using the IBM SPSS software. The Friedman test and the Kendall coefficient of concordance were used; the Wilcoxon test and signs were used for the significance of the shift. The results of the data were taken as significant at p <0.05.

RESULTS. After the therapy in the main group of strong intensity headaches decreased 6 times (p <0.05). The number of patients with an insignificant effect of headache on work ability increased 2 times (p <0.05), there were patients (21.6%) whose headache did not influence with their ability to work, while the differences were significant (p <0.05).There was a decrease in the frequency of headache attacks in more than half of the patients (62%) and for 4 times decrease of the number of painkillers (p <0.01). There were no significant changes in the incidence and intensity of headache in the control group.

CONCLUSION. The use of manual therapy in patients with chronic tension headache reduces the frequency, intensity of headache, the amount of drugs used and the negative effect of headache on working capacity.

Neurology Bulletin. 2022;LIV(1):54-62
pages 54-62 views

Reviews

Dysfunctional use of social networks: can we talk about addiction?

Abdrakmanova A.E., Efremov I.S., Gizatullin T.R., Asadullin A.R.

Abstract

The article presents materials from Russian and foreign literature indicating the similarity between certain types of behavior in social networks and addictive behavior, as well as demonstrating the negative consequences of problematic use of social networks for the physical, mental and social well-being of users. Biological, personal and social factors predisposing to problematic use of social networks are considered. The data on the comorbidity of social media addiction with other types of addiction behavior and mental disorders, such as technological, eating, consumer addiction, depression, mania, anxiety disorder, episodes of psychotic-like experiences are presented.

Neurology Bulletin. 2022;LIV(1):63-71
pages 63-71 views

Case reports

Side effects of vaccination against COVID-19: description of a case of isolated oculomotor nerve damage with a literature review

Gaifutdinov R.T., Kamalova D.S.

Abstract

In the era of the COVID-19 pandemic, unprecedented efforts have been made by governments and the scientific community to develop vaccines. Vaccines developed on the basis of new technologies have proven to be effective and safe. The accumulated experience in vaccine development on the basis of human adenovirus DNA has allowed domestic scientists to develop and launch the world’s first vaccine against a new coronavirus infection, Sputnik V, in a short period of time, which has received worldwide recognition. Pre-registration trials may be insufficient to detect rare post-vaccination complications, and the lack of information about them may cause distrust in vaccination companies among part of the population. A review of the worldwide literature on SARS-CoV-2 vaccine-related complications is presented. It concludes that vaccination is superior to their risks. An oculomotor nerve injury following vaccination with Sputnik Lite in a 67-year-old woman with a favourable outcome is described.

Neurology Bulletin. 2022;LIV(1):72-85
pages 72-85 views

Discussions

Effectiveness of therapies for mental disorders: real clinical practice versus scientific evidence

Gazizullin T.R., Zhidyaevskij A.G.

Abstract

The article provides information on particular issues of treatment of mental disorders. An analysis was made of the issues of therapeutic resistance and compliance among mental patients, which play an important role in possible discrepancies between the results of randomized placebo-controlled trials and the use of psychotropic drugs in routine clinical practice. The main aspects of clinical pharmacology are presented in an accessible form, which determine the complexity and at the same time professionalism in the practice of a psychiatrist. Grouped and deciphered are the factors that have a direct impact on the therapeutic response of the drug, including the primary pharmacological properties of the drug, nosological, general biological, social, subjective-psychological factors.

Neurology Bulletin. 2022;LIV(1):86-94
pages 86-94 views


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