Background. Central sensitization (CS) is the mechanism underlying chronic migraine and other conditions combined into a group of central sensitivity syndromes. The most reliable method for assessing the severity of CS is Central Sensitization Inventory (CSI).
Aim. The aim of our study is the evaluation of anti-CGRP monoclonal antibodies (erenumab, fremanezumab) effect on the central sensitization level in migraine patients.
Material and methods. We recruited 90 patients over 18 years old diagnosed with episodic migraine (EM) and chronic migraine (CM) according to the International Classification of Headache Disorders, 3rd edition. All patients were from November 2020 to March 2022. Demographic data, history of migraine and previous migraine treatment were collected for each patient. All patients filled out CSI. Dynamics was followed up monthly with headache diaries.
Results. After six months of treatment the level of CS in the CM group significantly decreased from the initial level of 41 (32.0, 50.5) to 36 (25.0, 39.0), which corresponds to the absence of clinically significant CS, p = 0.02*. The analysis of points of the CSI after 3 months of treatment shows a significant decrease in the prevalence of pain syndromes, cognitive impairment, asthenic disorders, hypersensitivity and affective disorders.
Conclusions. The use of erenumab and fremanezumab is advisable in patients with migraine and comorbid conditions based on the CS mechanism.

Epilepsy caused by glioblastoma requires careful study of the combination of factors causing it, with an integrated approach to prevention and complete relief when seizures occur against the background of adequate and modern treatment regimens. Control of seizures often requires the administration of antiepileptic drugs concomitantly with other treatments, including surgery, radiation, and chemotherapy. Pharmacological interactions between antiepileptic drugs and antineoplastic agents may alter the activity of both treatments, reducing their effectiveness and increasing the likelihood of side effects associated with both therapies. The presented literature review summarizes novel pathophysiological pathways associated with glioblastoma and involved in epileptogenesis, and also describes the interaction between antiepileptic drugs and oncological treatment. The article focuses on the impact of treatment on survival and presents evidence of the effectiveness of antiepileptic treatment, including the potential usefulness of new third-generation antiepileptic drugs. The second part of the article discusses in detail aspects of both preventive and symptomatic treatment of patients with epilepsy associated with glioblastomas.

Alcoholic polyneuropathy is a pressing problem in modern society. This neurological disease is characterized by impaired functions of many peripheral nerves due to the toxic effects of alcohol and its metabolites on nerve fibers. A study was conducted to assess the effectiveness of the use of Gabapentin-SZ (North Star Co., Russia) in alcohol polyneuropathy, involving 47 adult patients (31 men and 16 women). The study found significant efficacy of Gabapentin-SZ in treating pain in patients with alcohol polyneuropathy. Significant improvement was noted after 14 days of therapy.

Perinatal damage to the central nervous system (CNS) is currently a pressing issue within the structure of neonatal pathology, leading to the development of various neurological complications and causing disability and death.

The purpose. Identifying risk factors contributing to perinatal third-degree hypoxic-ischemic damage of the CNS in newborns and to examine the data of clinical, laboratory and instrumental studies.

Results. In the course of this study, it was revealed that the leading syndromes at the birth of the majority of infants from the main group were the suppression syndrome and the syndrome of muscular hypotension. The highest proportion among extragenital pathologies was represented by infectious diseases of various etiologies, which the newborns’ mothers had suffered during pregnancy and childbirth. Most commonly reported pregnancy complications in mothers of the main group were anemia, fetal bladder abnormality and premature rupture of fetal membranes. Neurosonography revealed subependymal cysts, signs of cerebral ischemia and ventriculomegaly as most сommonly visualized abnormalities.

Conclusions. It was established during the study that the primary risk factors for the development of hypoxic-ischemic damage to the CNS were complications during pregnancy and infectious diseases of various etiologies, which the mothers had suffered during pregnancy and childbirth.

Objective. To develop technique immobilizing antibodies graphene surface of proteins that play a significant role in pathogenesis Alzheimer's disease.
Materials and methods. Graphene films were obtained sublimation surface of SiC substrates. Presence graphene monolayer was confirmed spectroscopy spectra. Graphene surface quality was evaluated cyclic voltammetry. Functionalization by amino groups was carried out method based on sorption pyrene derivatives from a solution and phenylnitrogroups electrochemical method. Graphene was kept in solutions monoclonal antibodies to human beta-amyloid peptide 1–42. Preparations were also kept in solution secondary antibodies labeled with FITZ. Results were evaluated fluorescence microscopy. Additionally, samples were kept in solution antibody with peroxidase label, which was detected chemiluminescence.
Results. For attachment specific antibodies surface of graphene, quality its surface is great importance. Optimal working concentration of antibodies of human beta-amyloid 1–42 in solution for subsequent manufacture biological sensors is 15 micrograms per 1 ml. Covalent crosslinking antibodies with glutaraldehyde with amino groups on graphene gives a slight gain in the level fluorescence compared with noncovalent sorption on graphene with nitro groups. Functionalization phenylnitrogroups is optimal for further work related to the identification specific antigens.
Conclusions. The technique of immobilization on the graphene surface of specific antibodies to beta-amyloid in concentrations detected by fluorescence microscopy and chemiluminescence is investigated. Amount antibodies sufficient to create a biosensor is immobilized on graphene. It was found that functionalization of phenylnitrogroups allows creating optimal conditions for the attachment of antibodies to the graphene surface, as well as washing resulting antibody-antigenic complexes for further reuse of graphene biosensors.

The article provides an analysis of modern literature sources devoted to the biochemical aspects of the pathogenesis of migraine. The role of the trigeminovascular system, etc. is described. biologically active substances involved in this process. Understanding the described processes makes it possible to increase the duration and quality of life of patients.

Postischemic neuroinflammation is a critical pathophysiological process within the entire pattern of cerebral ischemia, spanning early injury and tissue repair. According to recent experimental data, autophagy is involved in the regulation of neuroinflammation, influencing the outcome of the acute period of ischemic stroke (IS).
Objective. To evaluate the relationship between autophagy biomarkers and inflammation indicators in the dynamics of the acute period of atherothrombotic IS.
Materials and methods. 112 patients in the acute period of newly developed atherothrombotic IS and 56 donors (control group) were examined. Patients underwent dynamic clinical and neurological examination on the 1st, 7th and 14th days from the onset of the disease (magnetic resonance imaging, testing using the NIHSS scale, modified Rankin scale). At the same time intervals, blood was drawn for testing. The number of active autophagosomes in peripheral blood was assessed by flow cytometry using a specific Cyto-ID dye. The serum concentrations of proinflammatory cytokines IL‑1β, IL‑8, IL‑18 (interleukins‑1β, -8, -18), TNFα (tumor necrosis factor-α), autophagy biomarkers Beclin‑1, LC 3 and p62 were determined by enzyme-linked immunosorbent assay analysis. C-reactive protein was assessed by a highly sensitive immunoturbidimetric method.
Results. A statistically significant increase in the studied parameters was revealed compared to the control group. The maximum increase in inflammation biomarkers was observed on the 1st day, and the maximum increase in key indicators of autophagy (LC 3, Beclin‑1, Cyto-ID) – on the 7th day after the development of ischemia. A direct relationship was established between the level of autophagy and the concentration of inflammatory biomarkers (CRP, IL‑1β, IL‑18, TNF-α) on the 1st and 7th days of acute IS.
Conclusions. The identified correlations indicate the participation of activated autophagy in the regulation of post-ischemic neuroinflammation and its involvement in ischemic brain damage in the early stages of the acute period of IS (days 1–7). The results obtained confirm the literature data on the influence of autophagy on the outcome of the acute period of the disease.

Despite the presence of antiepileptic drugs with different mechanisms of action and application points, almost a third of patients still remain resistant to drug therapy. In such patients, the risk of physical and mental injuries, depression, premature death increases, and the quality and standard of living decreases.
Objective. To study the mechanisms of formation of pharmacoresistance in epilepsy and to evaluate possible ways to overcome it based on the analysis of current scientific publications containing information on this topic.
Results. The proposed pathophysiological mechanisms of the formation of drug resistance reflect the target hypothesis, the carrier hypothesis, pharmacokinetic theory and neural network theory. However, they are based on preclinical studies and do not have a comprehensive explanation for the appearance of this phenomenon. Surgical treatment remains the most studied and most commonly used approach. Both the usual resection of the epileptogenic part of the brain and new less crippling interventions are used: laser ablation and stereotactic radiosurgery. As an alternative, polytherapy schemes, invasive and non-invasive neurostimulation techniques, and diet therapy can be considered.
Conclusions. Insensitivity to antiepileptic drugs remains a major problem in epileptology, and to overcome it, new methods are being sought and developed to influence the presumed pathogenetic targets of pharmacoresistant epileptogenesis. Vagus, deep, transcranial neurostimulation, stereotactic surgery, and laser ablation should be considered as new safe and potentially effective techniques.

Background. Cognitive impairment is a public health problem. Polymorbid patients with arterial hypertension (AH), atrial fibrillation (AF), and chronic kidney disease (CKD) are at high risk of developing cognitive impairment, resulting in impaired quality of life, difficulty in medication adherence, and increased risk of mortality.
Objective. To evaluate the cognitive status of polymorbid patients aged 60 years and older with essential AH and FP depending on the presence and stage of CKD.
Materials and methods. 165 patients aged 60 years and older with essential AH and AF (80 [48.5 %] men, 85 [51.5 %] women, mean age was 82 [76; 85] years) were included and divided into three groups depending on the presence and stage of CKD: 55 (33.3 %) patients with AH and AF without CKD, 55 (33.3 %) patients with AH, AF, and CKD C 3a, and 55 (33.3 %) patients with AH, AF, and CKD C 3b. All patients included in the present study were examined for cognitive functions using a series of neuropsychological tests.
Results. In the study of cognitive functions (Mini-mental State Examination, MMSE, Alzheimer Disease Assessment Scale-Cognitive (ADAS-cog), Digit Symbol Substitution Test (DSST), literature Association Test), it was found that the severity of cognitive impairment increased with increasing stage of CKD.
Conclusions. The obtained results of the study indicate an unfavorable effect of CKD on cognitive functions in elderly and elderly patients with AH and FP. Thus, there is a need for regular monitoring and examination of patients with concomitant CKD for cognitive impairment.