Swallowing disorder, or dysphagia, is a common complication of various neurological disorders. Impairment of the swallowing process is accompanied by the risk of life-threatening complications, such as aspiration pneumonia and airway obstruction. A comprehensive personalized approach is considered to be the most promising therapeutic strategy. It has been shown that noninvasive neurostimulation therapies of central and peripheral nervous system should be an integral part of a multicomponent treatment protocol of neurogenic dysphagia. Further studies are required to expand our knowledge of the combined effectiveness, tolerability and safety of neurostimulation methods in order to develop standardized guidelines for the treatment of neurogenic dysphagia.

The aim of the study. Analysis of neuropsychological characteristics of patients of different sexes with pre-mild cognitive decline (PMCD), including subjective and subtle cognitive decline.

Material and methods. The study included 388 female patients with PMCD (mean age 64.75 ± 8.71 years) and 159 male patients (mean age 65.52 ± 9.41 years). A clinical psychological study was conducted using quantitative scales — the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB), and memory tests — a 12 word test with immediate and delayed recall, mental process speed — a study of literal and categorical associations, a trail making test (parts A), an assessment of the nominative function of speech using the Boston Naming Test, attention — a forward and backward digit repetition test, visual-spatial functions — a clock drawing test, and execu- tive functions — a trail making test (parts B). The emotional state of patients was examined using the Beck Depression Inventory, the Spielberger Anxiety Scale, and the Neuropsychiatric Inventory-Questionnaire (NPI).

Results. Among patients with PMCD, women differed from men in better indicators of the speed of production pro- cesses, function management, and auditory-verbal memory. Women also had higher values of Beck Depression Inventory, depression indicators, and noise level according to the NPI. Men had higher indicators of arousal and disinhibition according to the NPI. Men with higher education had higher indicators of executive functions, speech, and visual-spatial functions compared to men with a high level of education. Women with a higher level of education diff ered in better indicators of memory, visual-spatial functions, and executive functions than women with a lower level of education. When examining men and women with secondary school education, some deviations in neuropsychological indicators were found only in relation to the 12 word memory test with direct reproduction with the help of women. When measuring the indicators of men and women with higher education, it was found that women diff ered from men in better indicators of speech speed, higher scores on screening scales — a brief scale for assessing the mental factor and a scale for assessing frontal dysfunction, better speed of mental processes, auditory-verbal memory. Men showed higher indicators of inhibition, and women also showed higher indicators of irritability according to the NPI data. Men and women without emotional disorders with PMCD had better indicators of executive functions.

Conclusion. Comparative analysis of cognitive characteristics in different gender groups with PMCD revealed differences in the performance of tests assessing executive functions, speed of cognitive processes and memory, with better results in women. Our study showed that the level of education affects the degree of cognitive decline and to a greater extent in women.

Introduction. Left atrial septal pouch (LASP) is a rare, poorly understood cause of embolic cryptogenic stroke. Along with this, there is no understanding of the role of this pathology in the development of transient global amnesia (TGA) due to possible embolism.

Aim. To present a clinical case of a patient with TGA and LASP.

Material and methods. This article presents a description of the clinical case of a young patient with TGA and a concomitant anomaly of the interatrial septum in the form of LASP and patent foramen ovale (PFO). In order to search for published clinical cases and reviews on the pathogenetic significance of LASP, the database of medical and biological publications PubMed was analyzed.

Results. Patient O., 39-year old, with a history of migraine due to provoking factors (Valsalva maneuver), suff ered an episode of TGA. Angiography did not reveal any pathology. There were no acute infarctions according to magnetic resonance imaging. During the diagnostic search, transesophageal echocardiography revealed a combined anomaly of the interatrial septum in the form of a combination of LASP with PFO.

Conclusion. LASP is a rare and little-studied anomaly of the formation of the interatrial septum. Transthoracic echocardiography is not a sensitive method for identifying this pathology. The imaging method of choice is TEE. If the presence of LASP is suspected, clinicians should be aware of the need to exclude concomitant interatrial communications using a bubble study.

Multiple sclerosis (MS) is a chronic disease of the central nervous system with recurrent exacerbations, leading to irreversible disability, the development of which is based on axonal damage and demyelination. It is assumed that one of the candidate biomarkers of axonal damage may be a peptide component of the neuronal cytoskeleton — neurofilament light chain (NFL). Traumatic brain injury (TBI) before the onset of MS is associated with an increased rate of progression of neurological which may be due to increased astrogliosis as a late consequence of TBI. Objective: to evaluate the relationship between the level of NFL in the blood and the RP and exacerbation frequency MS in the presence/absence of TBI before the onset of MS.

Material and methods. Caucasians born and living in the Altai region of Russia with relapsing-remitting MS in remission took part in a cross-sectional observational randomized study: 43 patients without a history of TBI and 43 patients with TBI before the onset of MS (MS duration 7.6 ± 6.6 and 5.9 ± 4.6 years, respectively, p = 0,113). Intracranial injury occurred 14.8 ± 7.8 years before the onset of MS and was documented as a concussion in 76% of patients.

Results. The patient groups did not differ in the frequency of MS exacerbations, while RP was higher in the group with a history of TBI (p = 0.013). There were no intergroup differences in NFL levels (p = 0.613), as well as no correlations between NFL levels and RP (p = 0.499 and p = 0.776 groups with/without TBI, respectively) and the exacerbation frequency. No differences were found between subgroups of patients with different clinical forms of TBI in RP and NFL levels (H = 5,07; p = 0,679).

Conclusion. The results of the study indicate a low probability of a connection between the level of NFL in the blood of patients with MS during the period of remission, both with the possible long-term consequences of a TBI received before the onset of MS, and with the course of MS.

Objective. The aim of the study was to investigate gamma activity in patients with hemispheric ischemic stroke (HIS) in the acute and subacute periods in correlation with cognitive and anxiety-depressive disorders.

Material and methods. The study included 32 patients with hemispheric ischemic stroke. All patients underwent comprehensive clinical, neurological, instrumental and laboratory studies. EEG was recorded on the 1st and 21st days of the disease for 20 minutes. EEG was analyzed visually and by mathematical analysis. The method of mathematical analysis was used to estimate the average values of the gamma rhythm power spectrum in the range of 30-45, 50–70 and 80–100 Hz for all leads and the peak frequency of the γ rhythm of the background EEG.

Results. Mathematical analysis of bioelectrical activity (BEA) of the brain of patients with HIS showed deviations in gamma rhythm indices in the range of 30–100 Hz, in comparison with the control group. Statistically significant correlations were established between cognitive, anxiety-depressive disorders and the gamma rhythm index in the frontal and central-temporal areas in the frequency range of 30–100 Hz.

Conclusion. Mathematical analysis of BEA of the brain along with clinical and neuropsychological studies is recommended for use in identifying cognitive and emotional (anxiety-depressive) disorders in patients with HIS in the in the acute and subacute periods.

Recent years we observed the growth of clinical cases of children hospitalized with clinical features of infectious encephalitis who further after laboratory and instrumental diagnostics do not confirm typical encephalitis features. More often clinical diagnosis in such cases are encephalitic reaction or encephalopathy. In the article we give modern view about specific diagnostical features of encephalitis, encephalopathy and encephalitic reaction and authors’ experience of clinical observation of 400 children, hospitatlized with the diagnosis “encephalitis” during 2000–2025. Modern view on differential diagnostical aspects of each syndrome are described in the article. Diagnostic criteria clinical, laboratory and instrumental specific for each nosology is given. The experience of antihypoxant therapy with Cytoflavin in acute period of the disease and its influence on neurological outcomes of the disease is shown. The use of Cytoflavin in earliest period of the disease onset has shown in children without adverse premorbid background fast positive clinical dynamics on etiopatogenic therapy, and minimal cognitive and motor deficit. In 13% children with unadequate early therapy the use of cytoflavin on late stage of the disease helped to dicrease the severity of post-infectoius encephalopathy.

Conclusion. The presence of a general infectious syndrome, the results of laboratory and instrumental examination of the patient in most cases allow establishing a final diagnosis, however, in some cases, the simultaneous or sequential presence of encephalitis and encephalopathy in the patient may be observed, which require a revision of the patient management tactics.