The article is devoted to the basic principles of diagnosis and treatment of anxiety-depressive disorders. The indications, features of the use of antidepressants are considered separately on the example of drugs of the class of selective serotonin reuptake inhibitors. The advantages of Sertraline as the only dopamine-sparing’ antidepressant with a high degree of safety and a minimal risk of unwanted drug interactions are described.

Modern approaches to the management of advanced stages of Parkinson's disease include deep brain stimulation (DBS). Adequate selection of candidates for DBS is a key factor for the effectiveness and safety of this method. Selection criteria are mainly based on data from large multicenter studies. It is known that the use of DBS can be accompanied by the development of side effects, the most common of which is neuropsychiatric disorders. Suicide is an extreme manifestation of neuropsychiatric disorders and a potentially reversible cause of death in patients with Parkinson's disease. Patients with chronic diseases, including neurological diseases, have an increased risk of suicide or suicide attempts. Depression and impulse control disorders following DBS are likely key contributors to suicidal behavior in patients. The authors present a clinical case – an attempt to commit suicide after DBS with the use of levodopa with an analysis of the factors contributing the development of suicidal behavior and an analysis of the management of neuropsychiatric disorders.

Headache and dizziness are common causes of applicion for neurological care. Migraine, being one of the most common causes of primary headaches, may lead to development of vestibular disorders both transient and persistent. Pathogenesis of vestibular migraine is poorly investigated. It is remarkable, that the high comorbidity between migraine and peripherial vestibular disorders, such as Meniere disease and benign paroxysamal positional vertigo is observed. Metabolic factors may be such an integrative common element of pathogenesis for these conditions. The crucial research works of recent years, devoted to this problem, are considered in this manuscript.

Providing remote medical care in a telemedicine center (TMC) is a fundamentally new approach to organizing interaction between patients and doctors in Russia. Subjectively significant stress factors in medical workers of classical types of organizations (polyclinic, hospital) well studied. The importance of these factors may shift in the shopping center, and the study of these factors will help to develop recommendations for reducing the risk of professional burnout. Purpose of research. To research the relationship between professional burnout and subjectively significant stress factors among physicians of a telemedicine center. Material and methods. Assessment of the presence of professional burnout was carried out using a questionnaire: questionnaire of labour stress (Ch. Spielberger, 1994; A. B. Leonova, S. B. Velichkovskaya, 2002); questionnaire Professional burnout for medical workers (N. E. Vodopyanova, 2009). The survey involved 137 doctors who provided remote consultations to patients diagnosed with SARS-CoV-2. Results. It was found that working with the use of telemedicine technologies is one of the predictors of the development of burnout syndrome. There was a statistically significant positive correlation between work experience, age, and the degree of burnout. The main factors of stress development that are predictors of burnout were identified. Analysis of the results of the study showed that among doctors who provide remote medical consultations, the main symptom of burnout was depersonalization.

The article is devoted to the current problems of fatigue during the new coronavirus infection pandemic. The pathogenetic mechanisms of fatigue in the acute period of infection are considered, as well as potential mechanisms and factors influencing post-viral fatigue development after COVID-19 infection. A biopsychosocial approach to the pathogenesis and treatment of post-viral fatigue is proposed. In conclusion, the factors contributing to quarantine fatigue development and methods of its therapy are considered.

Objective. To study the features of psychoemotional disorders and the attitude to the disease of patients with acute and chronic leukemia. Materials and methods. 40 patients with acute leukemia (AL) (24 men, 16 women, average age 34.6 ± 9.4 years), 100 patients with chronic leukemia (CHL) (59 men, 41 women; average age 67.9 ± 10.3 years) were examined. The presence and severity of asthenia were determined according to the item ‘general asthenia’ of the MFI-20 asthenia scale, insomnia – according to the criteria of the International Sleep Classification (ICDS-2). To study anxiety, C. Spielberger–Y.L. Khanin test was used, and the Zung scale was used for depression. To determine the type of attitude to the disease, the method ‘Type of attitude to the disease’ (TOBOL) was used. Results. Asthenia, reactive anxiety, and moderate depression were significantly more frequently registered in patients with OL than in patients with CHL, and sleep disorders and severe depression were recorded in patients with CHL. Correlation analysis revealed links between the level of asthenia, depression, reactive and personal anxiety in patients with AL and CHL. Patients with AL are more likely to have an adaptive attitude to the disease, compared with patients with CHL, which is associated with a shorter duration of the disease and a younger age of patients.

Celiac disease is an autoimmune disease in people with a genetic predisposition resulting from the consumption of gluten proteins from wheat, rye, barley and characterized by inflammation of the mucous membrane of the small intestine and atrophy of the villi. Neuropathy, migraine, chronic cerebellar ataxia and fibromyalgia are the most common extraintestinal celiac disease syndromes. The study of small nerve fibers is necessary for painful celiac disease syndromes such as gluten neuropathy and fibromyalgia, as well as for gluten autonomic neuropathy. The study of antineuronal antiganglioside antibodies is necessary for such lesions of both the central and peripheral nervous systems as gluten neuropathy and gluten cerebellar ataxia. A gluten-free diet directly affects the disappearance of headache attacks or a decrease in their frequency and intensity. There is little research on the effect of a gluten-free diet on headache risk.

Rehabilitation of patients after acute cerebrovascular accident or severe traumatic brain injury is one of the priority areas of modern medicine. Motor disorders occur in 77–81 % of patients after stroke. The development of spasticity in the lower limb in the early recovery period contributes to the deterioration of the rehabilitation prognosis and potential, limits the volume of voluntary movements, creates difficulties in patient care, reduces daily activity, creates difficulties in wearing orthoses, and reduces the effectiveness of rehabilitation measures. The article discusses aspects of the pathophysiology of spasticity in focal brain damage, discusses the possibility of early diagnosis and treatment of spasticity in the lower limb. demonstrates results of evaluation of spasticity in the lower limb using clinical scales, as well as the results of monosynaptic testing in dynamics in patients in the early recovery period after focal brain damage. The obtained data allow us to conclude that the combined use of several diagnostic techniques allows the earliest verification of spasticity in the lower limb in a patient. Discussed, that botulotoxin therapy can be used as the most targeted and effective method of treating spasticity in the lower limb after focal brain damage as part of complex therapy.

The article presents a review of the scientific literature containing data on the features of neuropsychiatric disorders – complications from the nervous system against the background of viral load caused by SARS-CoV-2 COVID-19. Indirect effects of the virus such as encephalopathy, myopathy, and critical neuropathy can be caused by hypoxia, respiratory and metabolic acidosis, dysregulation of homeostasis due to organ failure, and autoimmune inflammatory and demyelinating processes. Binding to the receptors of APF2, which is a cardiovascular protection factor for various organs, the nervous system and skeletal muscles is a target for various types of coronaviruses, including SARS-CoV-2 can cause an increase in blood pressure- the main risk factor for ONMC. Thus, prospective neuropsychiatric monitoring of people exposed to SARS-CoV-2 at various stages of the life cycle, as well as their neuroimmune status, is necessary to fully understand the long-term impact of COVID-19 and to provide a basis for integrating psychoneuroimmunology into epidemiological studies of pandemics.

Filamin is an actin-binding protein that, by forming flexible molecular cross-links, stabilizes the three-dimensional F-actin networks and gives them the mechanical properties of a gel. It is represented by three isoforms: filamine A (FLNA), filamin B (FLNB), and filamin C (FLNC), derived from 3 homologous genes. Laminopathies caused by mutations in the FLNA, FLNB, and FLNC genes represent an extensive allelic series of diseases. The review discusses in detail the genotype-phenotypic correlation of all types of phylaminopathies. The neuromuscular and cardiac clinic of C-type phylaminopathy is described in detail. Three variants of C phylaminopathy known at the moment are analyzed.