Stroke is the second leading cause of death and one of the main causes of disability worldwide. One of the common problems that arise in patients after a stroke is post-stroke cognitive impairments (PSCI). The use of neurotechnologies to enhance cognitive functions is a rapidly developing fi eld with promising results. This article provides brief information on the prevalence and mechanisms of PSCI, as well as various activities aimed at restoring cognitive functions that can improve patient’s quality of life.

Determining the cause of an acute cerebrovascular event is important in the management of patients with ischemic stroke (IS). The distribution of pathogenic subtypes of IS can be observed in diff erent patient subgroups.
Study objective: to identify the pathogenetic characteristics of stroke associated with large cerebral artery occlusion (LCAO).
Material and methods. A total of 210 patients (110 with LCAO, 100 without) were enrolled in the study. Patients with non-lacunar stroke and a verifi ed cerebral infarction were included, undergoing a full range of diagnostic procedures. Initial classifi cation by pathogenic subtype was performed according to the SSS-TOAST classifi cation, followed by a repeat assessment of neuroimaging and angioimaging data, including evaluation for signs of intracranial atherosclerosis.
Results. In these groups, cardioembolic stroke was prevalent (46% and 47%, respectively), the most common cause of which was atrial fi brillation (AF) (96% and 87%). However, in the group without OCMA, the range of causes of cardioembolism was wider than in the LCAO group: in addition to AF, prosthetic valves, dilated cardiomyopathy, and infective endocarditis were observed. In the LCAO group, persistent (73% and 63%) and newly diagnosed AF (40% and 22%) were more common. After a detailed evaluation of neuroimaging data, the proportion of patients with intracranial atherosclerosis in this group was 19%, which reduced the proportion of patients with unknown etiology of stroke from 30% to 11% in the LCAO group and from 29% to 14% in the group without LCAO.
Conclusion. The pathogenetic structure of ischemic non-lacunar stroke does not depend on the registration of LCAO. The leading pathogenetic subtype is cardioembolic stroke. The proportion of these patients with stroke of unknown etiology can be reduced through careful analysis of angiographic and neuroimaging signs of intracranial atherosclerosis.

Study purpose. To assess the dynamics of cognitive status during the recovery period following ischemic stroke (IS) in patients with different metabolic statuses and to identify predictors of the development and progression of cognitive impairment (CI) in a group of patients with metabolic syndrome (MS).
Material and methods. 237 patients diagnosed with ischemic stroke on the 21st day and 12 months after the onset of IS were examined. The patients were divided into two groups: group 1 — 115 patients with MS; group 2 — 122 patients without MS. The Clinical Dementia Rating Scale (CDR) was used to assess CI. The relationship (correlation coefficient (r), machine learning methods (information gain, i.g.)) between the CDR score and demographic, functional and laboratory parameters, IS characteristics, the presence of premorbid CI (IQCODE questionnaire), body mass index (BMI) and degree of compliance (MMAS-8 scale) was analyzed.
Results. Twelve months after the onset of IS, a higher percent of patients with dementia was identified in group 1 (72.15%) compared to group 2 (34.51%). A correlation was found between the CDR index and LDL level (r = 0.397, i.g. = 0.346), IQCODE (r = 0.515, i.g. = 0.115), the number of metabolic factors (r = 0.468, i.g. = 0.411), MMAS-8 (r = -0.622, i.g. = 0.373), MS phenotypes: ‘hyperlipoproteinemia / hyperglycemia / obesity’, ‘hyperlipoproteinemia / arterial hypertension / obesity’ and full-factor intersection of metabolic factors in combination with the degree of IQCODE, MMAS-8 (i.g. = 0.216, i.g. = 0.221, i.g. = 0.301).
Conclusion. Dysmetabolic disorders, both individually and in the context of MS, combined with low compliance, prestroke cognitive impairment, and age, contribute to a significant deterioration in CI during the recovery period of IS.

Osmotic demyelinating syndrome (ODS) is a rare disorder that occurs when the osmotic pressure of the blood changes rapidly and leads to serious neurological disorders.
Purpose: to conduct a review of literary sources of domestic and foreign authors examining ODS, and also to describe it using the example of our own clinical observation.
Material and methods. A review of literary sources in Russian and English for the period 2015–2025 was conducted, using the RSCI and PubMed databases. A clinical case of a patient with ODS is presented.
Results. A clinical case of osmotic demyelination syndrome is presented. Modern neuroimaging studies confi rmed central pontine and extrapontine myelinolysis. Neuroimaging and laboratory tests enabled the timely detection of severe multiorgan damage. This case highlights the need for timely diagnosis and a multidisciplinary approach to the management of this pathology. Conclusion. This clinical case highlights the complexity of diff erential diagnosis and the need for a comprehensive assessment of the patient’s condition, including additional diagnostic methods. The importance of interdisciplinary collaboration is evident, ensuring adequate disease management and improving treatment outcomes.

Tuberous sclerosis complex (TSC), also known as Bourneville disease, is an autosomal dominant orphan disease belonging to the group of phakomatoses. Morphologically, TSC is characterized by systemic hamartomas. This article presents a case of a patient diagnosed with TSC at the age of 24 according to the 2021 International TSC Clinical Consensus criteria. The diagnosis of TSC was established by the presence of more than three hypomelanotic macules, multiple cortical tubers and radial migration lines, and more than two subependymal nodules. This case report provides an overview of the epidemiology, clinical features, and diff erential diagnosis of TSC. Furthermore, it discusses the actual diagnostic criteria, including the value of fi nding genetic variants of unknown signifi cance in the diagnosis of TSC.

The aim of the study — an assessment of resistance to hypoxia in Parkinson’s disease (PD), relationship with demographic factors, severity of the disease, physical and functional state.
Material and methods. The study included 263 patients with PD and 145 people in the control group (CG). Patients were assessed with Barge test to determine resistance to hypoxia, motor function of PD on the scale (MDS UPDRS) — part III, grip strength, the “6-minute walk” test, cognitive status on the MOCA scale.
Results. In PD and in CG, men’s resistance to hypoxia was greater than that of women, while the indicators of men with PD and CG did not differ. The resistance to hypoxia in women with PD was less than KG and decreased with increasing severity of PD. The relationship of resistance to hypoxia in PD and CG with age has not been obtained. The resistance to hypoxia of women with PD was correlated with grip strength, “6-minute walk” test and the result of MOCA, while men’s strength was correlated with hand strength, which did not differ from CG, and the result of MOCA. No correlations were found of men and women in CG.
Conclusion. Gender dependence of resistance to hypoxia has been established: the decrease in women with PD and in CG which is more pronounced in PD, due to decrease in physical and functional status. The interrelationships with the physical and cognitive levels determine the choice of training direction to correct the reduced resistance to hypoxia in PD.

Introduction. Improving the prevention of cardiovascular complications (CVC) is an actual problem. Clinical physiological analytics (CPA) provides an evidence basis for selecting a personalized model prevention ov CVC.
Purpose: тo develop a medical organizational model for prevention of cardiovascular complications (CVC) in patients with atrial fibrillation (AF) based on the CPA of risk factors (RF).
Material and methods. A multicenter research was in period 2017–2026. The research subjects — patients with AF (n = 421), average age of 63 ± 4.2 years. The main research group (n = 303) included patients with paroxysmal AF during periods between paroxysms. The control group (n = 118) included patients with persistent AF after restoration of sinus heart rhythm using: electrical impulse therapy — control group №1 (n = 67) and thermal ablation of the pulmonary vein orifices — control group №2 (n = 51). The research objectives were the prevalence of CVC RF, the process components of a medical organizational model for CVC prevention in patients with AF, and the medical social effectiveness of the model. The follow-up period of patients was 12 months. Research methods included literature review, statistical analysis, clinical physiological analysis, systematization and comparative analysis.
Results. RF of CVC in patients with AF (more than 80% of patients in the group), with no significant differences between groups, included arterial hypertension, cardiac arrhythmia such as sinus tachycardia and extrasystole, chronic heart failure (CHF), and dorso- and cervicopathy. Compared to the control group, the main research group had significantly fewer patients with low physical activity (9% vs. 74.6%, p = 0.001) and frequent alcohol consumption (27% vs. 47%, p = 0.01). The process components of the medical organizational model for CVC prevention include a comprehensive patient-centered approach based on clinical management technology and artificial intelligence, clinical physiological analytics of the CVC RF. The proportion of patients with recurrent AF was 2% in the main group, 5% in control group №1, and 11% in control group №2. The increase in the proportion of adherent primary care patients over 12 months averaged 389%, with no significant difference between the groups. Stroke, myocardial infarction, death, or gastrointestinal bleeding were not identified in the all groups. The proportions of patients with CHF progression in the main and control groups after 12 months of follow-up were 3% and 13.56%, respectively (p = 0.025).
Conclusion. Adherence of patients to primary care and cardiovascular prevention model based on the CFA FR contributed to a low rate of AF recurrence after successful restoration of sinus heart rhythm and progression of CHF, as well as the effective prevention of adverse clinical cardiovascular outcomes.

Modern criteria for Alzheimer’s disease (AD) suppose a clinical-biological nature of the disease. The increasingly widespread adoption of biomarker-based diagnostics for AD necessitates a clearer clinical profile of patients, particularly given a range of complex clinical, organizational and financial-economic issues.
Aim. To present a profile of the patient recommended for referral for biomarker-based diagnosis of AD, in accordance with international guidelines and the authors’ own experience with biomarker-based diagnosis in real-world clinical practice.
Material and methods. We analyzed the results of the RCNN Cognitive Health Center’s operations over one calendar year, specifically the total number of patients and the distribution of disease etiologies. During the same period, we analyzed a local database of patients referred for AD biomarker diagnostics in CSF (Aβ1-42 and p-tau181) using Elecsys assays on the Cobas e 411 platform.
Results. A total of 598 patients attended the initial consultation: MCI NDD 25% (n = 149), SCD 13% (n = 78), mixed CI 10% (n = 62), uNDD 10% (n = 58), vCI 9% (n = 54), LBD 8% (n = 50), AD 8% (n = 48), other causes of cognitive impairment 8% (n = 46), FTD 5% (n = 29), 4R-tauopathies 4% (n = 23), and the at-risk group — 0.002% (n = 1). AD biomarker analysis was performed on 93 patients (16%), most frequently in the MCI NDD group (39%).
Conclusion. Our real-world clinical practice aligns with the recommendations of the Alzheimer’s Association international working group, prioritizing the phenotypic profiling of patients. The article presents a potential algorithm for selecting patients for referral to biomarker-based diagnosis of Alzheimer’s disease. Mild cognitive impairment with a neurodegenerative nature is the most typical clinical profile for referring a patient for the assessment of biomarkers associated with the AD pathological process.

The article analyzes the activities of neurologist Vladimir Abramovich Lichtenstein during the Great Patriotic War through the prism of his memoirs. It examines the organization of medical services in the rear regions as well as the role of specialists from the Dagestan Medical Institute and evacuated physicians in aiding wounded Red Army soldiers. Special attention is paid to V.A. Lichtenstein’s scientific and practical work, his participation in the development of neurosurgical care and his contribution to new approaches in the treatment of gunshot injuries of the nervous system. There are described the working conditions of hospitals, the specifics of evacuation and the provision of medical care in extreme conditions based on archival materials and personal testimonies. It is emphasized that V.A. Lichtenstein advocated early surgical intervention in peripheral nerve injuries and contributed to the development of classification system for traumatic brain injuries. A significant part of the study is devoted to Lichtenstein’s own recollections, which reflect the circumstances of evacuation from front-line areas, movement with retreating troops, and the organization of hospital work under extremely difficult conditions. These memoirs make it possible to reconstruct the everyday practice of a physician, demonstrate the scale of difficulties associated with treating the wounded, and highlight the features of medical support in the first months of the war.