A metabolome is a set of small molecules in the body: peptides, lipids, amino acids, nucleic acids, carbohydrates, biogenic amines, vitamins, minerals, as well as any chemical compounds that a person comes into contact with, including nutritional supplements, medicines, cosmetics, toxins. Metabolomics is a study of all the metabolites present in the biological system. This science has become a reality due to the development of two modern technological platforms: mass spectrometry, the unique mass-charge ratio for each metabolite that identifies thousands of compounds in one sample, and nuclear magnetic resonance spectroscopy, which makes it possible to determine metabolites in spectral arrays by shifting their signal relative to reference signal. The concepts of metabolomics and metabolome are given in the review, the methods of research and data interpretation are presented, the main applications of metabolomics in the field of diagnosis of central nervous system diseases. The search for prognostic markers and new therapeutic targets, the metabolic composition of cerebrospinal fluid in the normal state and its changes in pathology are described.

Written ofmodern classification ofmuscular dystrophies (in modification), clinical-genetic peculiarities and diagnostics of basic types ofmuscular dystrophies (limb-girdle types, distal types, ocylopharyngeal and oculopharyngodistal).

Facial neuropathy leads to gross functional disorders, which is manifested by an aesthetic defect. Face distortion may be social desadaptive of the patient. One of the new, effective and promising methods of treatment offacial neuropathy is injections of botulinum toxin type A in the facial muscles. Therapy with botulinum toxin is used both in the acute period of the disease to improve symmetry, restore muscle functions of the affected side, prevent the development of contractures, and in the chronic period — for the same purpose, as well as for the correction of synkinesias. The method can be considered as aesthetics, because it is an alternative to plastic surgery. In order to eliminate lagophthalmos and prevent the development of ophthalmic complications, injections can be carried out in the muscle that raises the upper eyelid, causing temporary reversible drug ptosis. The range of issues for study is defined.

Parkinson’s disease (PD) is a chronic, steadily progressing disease of the central nervous system (CNS) that belongs to the group of synucleinopathies, which causes significant damage to the health of the elderly and leads to disability in the process of progression. Diffusion-tensor MRI and the susceptibility-weighted imaging (SWI) protocol are modern non-invasive neuroimaging techniques that, when used together with patients with PD, can not only assess the distribution and pathological deposition of iron in the basal ganglia, but also its likely effect on the dysfunction of extrapyramidal system structures.

Goal. To determine the quantitative content of iron in the basal ganglia in patients with stage II and III (H/Y) Parkinson ’s disease and evaluate its effect on the dysfunction of the components of the extrapyramidal system.

Material and methods. We examined 67patients with PD with II (n = 32) andIII (n = 35) Hoehn/Yahr (H/Y) stages. To everyone was performed a brain scan on a Siemens TrioTim high-field MRI scanner (3T) using the pulse sequence SWI and diffusion-tensor MRI. A quantitative assessment of the degree of iron deposition was carried out using SPIN software in regions of interest (ROIs) on both sides: the dentate nucleus (DN), the substantia nigra (SN), the red nucleus (RN), the putamen (PUT), the globus pallidusm (GP), the head of the caudate nucleus (CN). Also, in the projection of ROIs, the fractional anisotropy (FA) values was calculated.

Results. Significant (p <0,05) lower FA values were found in left GP and right RN in patients with stage III (H/Y) in comparison with patients with stage II (H/Y). In patients with stage II (H/Y), significant positive correlations were found between the FA values in the left PUT and the hypointensity of SN, GP, RN (all on both sides) and right CN. The FA value in the right PUT correlated with hypointensity of the left SN. The FA value in the left RN had correlations with the hypointensity of the SN, GP (all on both sides), the right RN, the left PUT, and the right CN. In patients with stage III (H/Y), the only reliable positive correlations were found between the FA values and the hypointensity of the ROIs: left CN and left PUT, right PUT and left CN, left SN and right CN, respectively. SWI hypointensity of the left RN, the right PUT, the left CN, and the right GP correlated positively with the FA value in the right SN. The decrease FA value in the left internal GP correlated with the hypointensity of the right DN and right RN.

Conclusion. The deposition of iron in the basal ganglia in PD makes a significant contribution to the progression of the disease and affects the formation of most motor manifestations in this category of patients. A dynamic non-invasive assessment of the degree of iron accumulation in the components of the extrapyramidal system will more closely monitor the course of the neurodegenerative process and form observation groups for the risk of PD complications.

Daytime sleepiness has great medical and social significance and depends on a variety of internal and external factors. The disadvantage of existing modern questionnaire methods is that they do not include many clinical manifestations of somnolence.

The purpose of the study was creation and testing of an original scale for assessing daily sleepiness (Clinical Sleepiness Scale — СSS) using a wider range of clinical manifestations.

Material and methods. 28 clinical questions were included in the questionnaire, assessing the severity of the physical and mental manifestations of daytime sleepiness. The CSS was approbated on 72 healthy students of a medical university (average age — 22 years). The results were compared with the Epworth sleepiness scale e and Insomnia severity index.

Results. It is shown that CSS has a high degree of coherence. The Alpha-Cronbach correlation coefficient was 0,86, the standardized Alpha coefficient was 0,79. More pronounced daytime sleepiness in CSS was observed in students with reduced quality of sleep. The Epworth scale correlated with CSS (+0,488, p < 0,001), and could not reliably distinguish between different levels of sleepiness in students with different sleep quality, whereas CSS significantly distinguished the severity of sleepiness associated with the quality of night sleep of students.

Conclusion. The created original CSS is a complete questionnaire supplementing the ability to assess daytime sleepiness. CSS compared with the Epworth scale turned out to be a more sensitive indicator of sleepiness.

Introduction. faring loss may be a predictor or a kind of catalyst for cognitive disorders. This may indicate that audiological research methods can take their place in the diagnosis of cognitive impairments or in assessing the risk of their occurrence.

The aim is to determine the sensitivity and specificity of audiological methods for the diagnosis of postoperative cognitive dysfunction (POCD).

Material and methods. The study involved 40 patients (17 women and 23 men) aged 22 to 77 years. All patients underwent planned abdominal surgery or reconstructive operations on the vessels of the lower extremities using different types of anesthesia. Before and after the operation, all patients underwent neuropsychological assessment of their cognitive status and audiological examination (otoscopy, tonal threshold audiometry, speech tests).

Results. The hearing thresholds in a tonal audiometry in all young patients were within normal limits. Peripheral hearing loss was detected in 11,8% of middle-aged patients and 81,8% of the elderly. Initial cognitive impairment based on the results of the MoCA test was also most often observed in a group of elderly patients. POCD was diagnosed in 63,6% of elderly patients, 35,3% of middle-aged and 8,3% of young patients. The results of preoperative speech testing revealed pronounced signs of a deficit in central processing of acoustic information in patients of all age groups. In all elderly patients, there were deviations in at least one of the speech tests, and in 63,6% ofpatients — in both tests (dichotic, RuMatrix). The high sensitivity of speech tests to the assessment of the probability of occurrence of POCD was revealed: for the dichotic test, the sensitivity was 85,7%, for the RuMatrix test 78,6%.

Conclusions. Speech audiological tests are highly sensitive, which makes it appropriate to use them at the stage of preoperative diagnosis. Identify deviations from the norm in both speech tests at the preoperative stage may indicate a high probability of development of POCD.

Tinnitus (ringing in the ears) is the perception of sound in the absence of an auditory stimulus. Tinnitus is perceived by about one in 10 adults, and for at least 1 in 100 tinnitus severely affects their quality of life. Objective is to present a review of pathophysiology and treatment approaches for the patients with tinnitus. Currently available options range from medications to the cognitive behavioral rehabilitation and the use of hearing aids. The review provides the overview of the approaches to tinnitus patients, based on national experience and national and international guidelines.