In Alzheimer’s disease (AD), disturbances in spatial orientation and navigation occur even at the pre-dementia stage and can have important diagnostic significance, reflecting changes in those areas of the brain that suffer earlier than others in this pathology. However, it is difficult to identify such disorders using classical neuropsychological tests, and studies in the real environment are not readily available in routine practice. These difficulties can be overcome by researches in a virtual environment.
The purpose was to summarize scientific data on the use of virtual reality computer technologies for early diagnosis. The article provides an overview of 16 papers published over the past 15 years on the use of virtual reality technologies for the assessment of visuospatial orientation and navigation in mild cognitive impairment (MCI) and mild dementia AD patients. 13 studies revealed deficit in spatial orientation and navigation already at the stage of MCI. The deterioration in in spatial orientation and navigation was more pronounced in patients with AD. The most sensitive tests for the diagnosis of orientation and navigation impairments were those that required switching between egocentric and allocentric spatial representations. Assessment of orientation in a virtual environment, carried out simultaneously with neurophysiological and neuroimaging studies of the brain, made it possible to expand the understanding of the morpho-functional basis of visuospatial disorders in humans. Early detection of deficit in spatial orientation and navigation using virtual reality technologies in Alzheimer’s disease requires the development of standardized tests aimed at assessing the various components of these disorders and their individual combinations in patients with brain damage.

Objective. To review the literature data on the comorbidity of cardiovascular disease with Parkinson’s disease (PD) and to evaluate the role of cardiovascular autonomic failure as a differential diagnostic criterion for synucleinopathy.
Material and methods. The search of scientific literature was performed in PubMed, ProQuest Dissertations & Theses Global databases, electronic library system of the Media Sphere publishing house from 2014 to the present and includes 42 relevant sources. The methodological premise of the study is the notion of the differentiating role of autonomic dysfunction symptoms in the diagnosis of PD at the premotor stage.
Conclusion. Autonomic cardiac denervation occurs at the premotor stage of PD and may be its primary manifestations. Patients with PD also develop other comorbid cardiovascular pathology: ischaemic heart disease, arrhythmias, cardiomyopathies and sudden cardiac death. Nosological substantiation of cardiovascular autonomic failure is crucial for providing specialised cardiological care to PD patients.

Acute axonal motor neuropathy (AMAN) is an axonal variant of Guillain-Barré syndrome, characterized by acute damage of motor fibers of peripheral nerves. In the acute period, therapy involves the use of specific and nonspecific methods. Specific methods include operations of high-volume program plasmapheresis and courses of high-dose intravenous immunotherapy with immunoglobulin class G preparations. Nonspecific methods consist of symptomatic therapy. It is very important to start rehabilitation treatment with a multidisciplinary team of specialists as early as possible in the period of reconvalescence.

Motor impairment, bulbar palsy and respiratory insufficiency represent main presentation of amyotrophic lateral sclerosis (ALS). The rate of symptom worsening reflects progression of the disease.
The objective: to analyze the reliability of the Russian-language version of the “ALS Impairment Multi-Domain Scale” (AIMS).
Material and methods. The study was conducted on a sample of 50 people with ALS. The reliability of the scale was analyzed, including internal consistency, retest and inter-expert reliability, and convergent validity in relation to ALS Functional Rating Scale — Revised (ALSFRS-R).
Results. AIMS has demonstrated excellent internal consistency, high retest and inter-expert reliability, and convergent validity. Compared with the ALSFRS-R, AIMS had smaller ceiling and floor effects.
Conclusion. The Russian-language version of AIMS is a reliable tool for the evaluation of severity of neurological deficit in patients with ALS and for the assessment of the disease progression rate.

Most patients with chronic migraine (CM) have musculoskeletal neck pain, which maintains the chronic course of migraine and complicates treatment. Cognitive behavioral therapy (CBT) is promising in the complex treatment of patients with CM and cervicalgia. However, few randomized trials have been conducted to evaluate the effectiveness of CBT in CM.
The aim of the study was to evaluate the effectiveness of an multidisciplinary program including CBT in the treatment of patients with CM and neck pain.
Material and methods. The study included 120 patients with CM and neck pain (41 men and 79 women), average age 35.7 ± 9.2 years. All patients underwent a clinical interview, neurological examination and testing using clinical and psychological methods. Patients were randomized into two groups: group 1 received standard treatment and CBT, group 2 — only standard treatment. All patients were assessed for clinical and psychological indicators before treatment and at 3, 6, 12 and 24 months follow-up.
Results. At 3 months follow-up, statistically significant (p < 0.05) improvement was observed in group 1: decrease in headache frequency, frequency and doses of taking painkillers (PK), neck pain intensity by the Visual Analogue Scale (VAS), the Total pericranial pain score, in the Migraine Disability Assessment (MIDAS), in the Neck Disability Index (NDI), in the Pain catastrophizing scale, the State-Trait Anxiety Inventory, the Center for Epidemiologic Studies Depression Scale. At 6, 12 and 24 months follow-up, the achieved improvements were maintained. In group 2, at 3 months follow-up, statistically significant improvement was observed in only six indicators — headache frequency, frequency and doses of taking PK, neck pain intensity by VAS, MIDAS and NDI. However, at 6, 12 and 24 months of follow-up the achieved improvements were not maintained in group 2. At 3 months of follow-upin group 1 was clinical efficacy (CE) for CM (decrease in headache frequency by 50% or more) and CE for neck pain (decrease in pain intensity by VAS and the NDI by 30% or more) achieved by 75% of patients, in group 2 — 45% (p < 0.001). At 24 months follow-up in group 1 CE for CM and neck pain was achieved by 80% of patients, in group 2 — 30%.
Conclusion. An multidisciplinary program including CBT is significantly more effective than standard treatment for chronic migraine and neck in the short and long term.

Improving walking remains the most important goal of rehabilitation, and the effectiveness of previously proposed methods of practicing the motor skill requires further improvement.
The aim of the work is to evaluate the results of walking training according to «the period of support» in the comprehensive rehabilitation of patients with central hemiparesis in the early recovery period of ischemic stroke, as well as to identify factors concomitant with gait improvement.
Material and methods. 49 patients with central hemiparesis (mild and moderate in the foot) in the early recovery period of ischemic stroke were examined. The patients were randomized into the main group of 28 patients and the comparison group of 21 patients. The patients of the main group in addition to the standards of care were trained with visual biofeedback on the period of support. Functional testing, assessment of biomechanical indicators of walking and taking surface electromyograms from the thigh and lower leg muscles were performed twice. The training course consisted of 10 sessions of 15 [10;20] minutes each.
Results. Training with the use of biofeedback in patients in the early recovery period of stroke was accompanied by improvement of walking as a daily activity and optimization of biomechanical indices of support period, step cycle length, double support, lateral deviation of the foot, as well as neurophysiological — EMG amplitude of EMG m.Quadriceps femoris.
Conclusion. In patients with central hemiparesis in the early recovery period of ischemic stroke, walking training was accompanied by its improvement simultaneously with an increase in the dynamic component of balance.

Encephalomyelitis associated with antibodies to myelin oligodendrocyte glycoprotein (MOG) is a rare inflammatory demyelinating disease of the central nervous system.
Purpose: to review domestic and foreign works examining the issues of etiology, pathogenesis, clinical picture and differential diagnosis of demyelinating diseases of the central nervous system; to present a clinical case of a patient with encephalomyelitis associated with antibodies to MOG.
Results. The article describes the disease in a 24-year-old female patient with a primary diagnosis of multiple sclerosis. Given the activity of the process and the ineffectiveness of the therapy, 5 years after the onset of the disease, antibodies to GOM were examined in the patient’s blood and found, a diagnosis of encephalomyelitis associated with antibodies to GOM was established, and therapy with rituximab was prescribed according to the scheme. Positive dynamics in the form of persistent remission of the disease was noted. The most important element of accurate diagnostics of GOM-IgG-associated diseases is the detection of pathogenic serum antibodies to GOM using specific and sensitive methods, preferably using optimized cellular analysis. Neuroimaging helps to conduct differential diagnostics with other neuroinflammatory diseases.
Conclusion. MOG-demyelinating diseases are a pressing problem in modern neurology, requiring further study and development of effective diagnostic and treatment methods.

Alzheimer’s disease (AD) is a chronic neurodegenerative disease, that is the most common cause of dementia. Late on-set AD is usually associated with the classic picture of short-term memory deficits, while early onset AD demonstrates atypical symptoms. The frontal variant is the rarest non-amnestic AD phenotype, which associated with selective neurodegeneration in frontal control networks, which is confirmed by the presence of biomarkers of amyloid pathology. The clinical picture includes a wide variety of symptoms, including disinhibition, apathy, compulsive behavior and executive dysfunction, which often leads to difficulties in making a differential diagnosis with the behavioral variant of frontotemporal dementia) and, as a result, underestimation of the true prevalence of AD. The article provides a brief review of modern literature and a description of two clinical cases of the frontal variant of AD, confirmed by the study of cerebrospinal fluid biomarkers.

Migraine is a common neurological disease, a type of headache. Currently, the etiology and pathogenesis of the disease are known, a detailed classification of migraine pain has been developed, and pathogenetic methods of treatment have been created. But it was not always so. The accumulation of knowledge about migraine and its separation from other headaches has been quite slow over the centuries. In this article we will try to identify this hidden and unobvious process, based on the texts of ancient authors or their translations. At the same time, we will study the etymology of the word “migraine”, tracing its transformation to the 16th century.