Parkinson’s disease (PD) is a progressive, incurable degenerative disease of the central nervous system, leading to a significant limitation of the functional state of patients. Modern medicine has several methods of medical and surgical treatment for this pathology. In the review, all stages of the surgical treatment of PD are considered, starting with the descriptions of the resection of the precentral gyrus of historical interest to stereotaxic lesions by various methods of exposure and electrical stimulation of the deep brain structures. The indications for each of the methods, their advantages and disadvantages, the principles of patient selection are presented. Indications for neurosurgical treatment are determined taking into account the international CAPSIT-PD criteria. Stereotactic lesions lead to irreversible changes in the medulla, therefore their widespread use is limited. Stimulation with deep electrodes has advantages in disease progression due to the possibility of changing the stimulation parameters and the possibility of a bilateral effect on motor symptoms. Surgical treatment of PD does not mean the cancelling of drug therapy, but it can reduce the dose of anti-Parkinsonian drugs and reduce their side effects. The best result can be achieved with timely operation and correct selection of patients by a multidisciplinary medical team with considering the characteristics of the course of the disease, the possibility of long-term postoperative observation of the patient and correction of stimulation parameters.

Background. Parkinson’s disease (PD) is one of the common neurodegenerative diseases. Several genes are known (SNCA, PARK2, PINK1, PARK7 (DJ-1) and LRRK2), mutations in which have a pathological significance in the development of monogenic PD; association with PD of other genes (for example, UCHL1, ATP13A2) requires further study. It is also known, that GBA gene is associated with an increased risk of PD developing.

Aim. Analysis of mutations and polymorphisms in the PARK2, PINK1, SNCA, ATP13A2, PARK7, LRRK2, UCHL, GCH1 and GBA genes in patients with PD from Krasnoyarsk region.

Material and methods. The 60 patients with sporadic and familial forms of PD were included in the study. The SALSA MLPA Holland P051 and P052 kits («MRC Amsterdam», The Netherlands) were used to detect deletions and duplications in the PARK2, PINK1, SNCA, ATP13A2, PARK7, LRRK2, UCHL, GCH1 genes, as well as point mutations A30P in the SNCA gene and G2019S in the LRRK2 gene. Analysis of the GBA gene was carried out by Senger sequencing.

Results. None of the 60 patients had mutations that were searched with the SALSA MLPA Holland P051 and P052 kits. 6 different mutations in the GBA gene were found in 9 out of 60 patients with PD. L444P («severe» PD — associated mutation) — in two patients, D409H («severe» PD — associated mutation) — in one patient, T369M (polymorphism, possibly associated with PD) — in two patients, E326K (polymorphism, possibly associated with PD) — in one patient, V460V (synonymous variant, which is part of the composition of the complex RecNcil mutation (p.L444P; p.A456P; p.V460V) associated with PD) — in two patients and variant C.*92g>A (3’ — UTR polymorphism, possibly associated with PD) — in one patient. Two patients had compound heterozygous carriers of two variants.

Conclusion. This paper presents the genetic analysis results of the PD associated genes among patients from the Krasnoyarsk region. No mutations were detected in the PARK2, PINK1, SNCA, ATP13A2, PARK7, LRRK2, UCHL and GCH1 genes. Genetic variants analysis of the GBA gene showed similar frequency in the patients from the Krasnoyarsk region as in European populations.

In Russia, there is a high level of alcohol consumption among women in doses that represent a high risk of developing alcoholic diseases, manifested, in particular, by damage to skeletal muscles.

The purpose of the study. Analysis of clinical, biochemical, neurophysiological, as well as morphometric and immunohistochemical features of alcoholic skeletal muscle damage in women with chronic alcohol intoxication.

Material and methods. A clinical and laboratory examination of 30 women aged 20 to 60 years with chronic alcohol intoxication was performed, which included the determination of creatine phosphokinase (CPK) and insulin-like growth factor I (IGF-I) in blood plasma, stimulation and needle electromyography (EMG), as well as morphological and immunohistochemical examination of biopsies of the quadriceps femoris.

Results. Myopathic syndrome in the form of proximal para-or tetraparesis was observed in 73.3% of the examined women in combination with a decrease in IGF-1 at normal values of CPK in blood plasma. The EMG results indicated the absence of changes in the parameters of the potentials of motor units, characteristic of primary muscular lesions, and of conduction disturbances along the femoral nerve. Morphometric and immunohistochemical studies of skeletal muscle biopsies showed a decrease in the cross-sectional area of muscle fibers of types I and II without signs of muscle tissue necrosis.

Conclusion. Chronic alcoholic myopathy is a common manifestation of alcoholic disease in women with long-term alcohol intoxication. The severity of the atrophic process in the skeletal muscle is comparable to the degree of proximal paresis. Violations of systemic protein synthesis and acceleration of apoptosis are considered as pathogenetic mechanisms of the atrophic process in the muscles in chronic alcoholic myopathy in women.

The article presents the results of the research of the features of the anticipation and prognostic function in patients with ischemic stroke of frontal localization in the early recovery period.

Material and methods. The total sample group was represented by 60 patients who had suffered an ischemic stroke of frontal or parietal localization. The average age of the research subjects was 53.00 ± 5.44 years. The study was conducted with the use of functional neuropsychological tests (by A.R. Luria, L.S. Tsvetkova), methods of predictive function research (time estimation test, spatial anticipation test, Maze test, London Tower test, “incomplete images” test), as well as statistical methods of quantitative and qualitative data processing.

Results. In patients with prefrontal localization of ischemic stroke a specific impairment of prognostic function and a non-specific decrease in anticipation were revealed. It is due to disorders of mental activity purposefulness and preliminary orientation in the conditions of the task. When the lesion was localized in the premotor areas, a less significant decrease in the rate and accuracy of the prognostic function due to the inertia of the mental processes was revealed. In the localization of ischemic stroke in the associative parietal cortex, a specific decrease in the rate and accuracy of sensorimotor, perceptual, and temporal anticipation was revealed, as well as a non-specific decrease in the rate of planning, while maintaining its accuracy of implementation.

Conclusion. In terms of practical significance, taking into account the features of prognostic function that have arisen in a particular form of brain damage can serve as a basis for restoring other gnostic or motor impaired functions, increasing the effectiveness of correctional and rehabilitation measures.

Many women in menopause experience discomfort in the oral cavity — burning, dysesthesia, xerostomia, taste changes, which lead to a reduction in the quality of life.

Aim: to identify clinical and psychological factors associated with the development of burning mouth syndrome in menopausal women.

Material and methods. Were examined 67 women aged 45–67 years. Assessment of oral pain performed using the Visual analog scale (VAS). Assessment of dry mouth symptoms severity performed using the Challacombe Scale of Clinical Oral Dryness (CSCOD). Psychometric tests was carried out with Spielberger’s Anxiety Test, Montgomery–Asberg Depression Rating Scale (MADRS), Hospital Anxiety and Depression Scale (HADS), Mini-Mental State Examination (MMSE). The Psychological stress measure-25 scale was also used to assess the impact of stress on somatic, behavioral, and emotional indicators of life. The quality of life was measured using the Oral Health Impact Profile-14 (OHIP-14).

Results. Clinically, burning mouth syndrome in menopausal women manifested with various oral symptoms include paresthesias and pain in the tongue, oral cavity, as well as xerostomia and taste disorders. Painful sensations in the tongue developed 1–3 years after the menopause onset and was preceded by stressful life events. The pain scores on the VAS was 63.1 ± 11.8 mm. Depressive disorders were characterized by an average level of personal and situational anxiety, instability to stressful influences. The quality of life assessment in menopausal women using the OHIP-14 scale, the total score was 17.1 ± 5.21 points and corresponded to the sufficient quality of oral health.

Conclusion. Burning mouth syndrome and neuropsychiatric disorders (anxiety, asthenia, depression, phobia, sleep disorders) in menopausal women are pathophysiologically related conditions.

Introduction. In chronic cerebrovascular diseases (CVD), neuroprotective medications, the effectiveness of which requires further study, are widely used. The effectiveness of Cytoflavinum in patients with chronic CVD was evaluated.

Material and methods. The data of 60 patients (35 women and 25 men) with chronic CVD were analyzed. 30 patients, included in the main group (mean age 61 ± 5.87 years old), in addition to basic therapy (antihypertensive, antithrombotic drugs, statins), received Cytoflavinum according to the following scheme: 1 time a day in the morning intravenously 10.0 ml for 10 days, then 2 tablets 2 times a day for 30 days. 30 patients in the comparison group (mean age 59.8 ± 8.7 years old) received only basic therapy. An analysis of patient complaints, neurological status was carried out. Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) were used.

Results. In the group of patients taking Cytoflavinum, there was a decrease in the frequency and intensity of headache, dizziness, an increase in MMSE score from 26.32 ± 0.86 to 28.05 ± 1.36 (p ≤ 0.05), in MoCA score from 25.35 ± 0.96 to 27.88 ± 1.13 (p ≤ 0.05), decrease in anxiety score from 8.82 ± 1.31 to 5.2 ± 2.82 (p ≤ 0.05) and decrease in HADS depression score from 8.31 ± 1.85 to 4.6 ± 3.15 (p ≤ 0.05).

Conclusion. The inclusion of Cytoflavinum in the treatment regimen for patients with chronic CVD helps to reduce the frequency and intensity of headaches and dizziness, improve cognitive functions, and reduce the level of anxiety and depression.

The review deals with approaches to the differential diagnosis of the causes of vertigo in emergency neurology. The main causes of episodic and acute vestibular syndrome are discussed. Clinical diagnostic methods for acute vestibular syndrome (evaluation of nystagmus, test of skew, head-impulse test and neurological status) are considered. Clinical signs of “benign” acute vestibular syndrome and symptoms indicating a stroke in the vertebrobasilar system are presented. Differential diagnostic criteria for peripheral and central vestibular disorders are presented. Transient ischemic attacks, features of the otoneurologic status in vestibular neuronitis and different localizations of cerebral infarction focus are considered. Errors in the diagnosis of the vertigo causes are discussed.