The article is devoted to the study of the possibility of using tolperisone (Kalmirex) in local pain therapy. It is shown that the local mode of administration of Kalmirex allows to influence the pathogenetic links in the formation of biomechanical disorders, thus preventing chronic pain. The use of muscle relaxants in local therapy provides regress pain and shortens the duration of treatment.

The effect of Ipigrix® on motor, sensory and cognitive impairments in patients with peripheral and central nervous system diseases was studied under actual clinical practice. 218 centres in 30 cities of the Russian Federation participated in the study. The number of participants was 13,840 patients. All the groups of neurological patients presented for analysis were highly sensitive to the anti-cholinesterase therapy Ipigrix in assessing the dynamics of motor functions. Addition to the standard therapy of the preparation of ipidacrine (Ipigrix) had a positive effect on the dynamics of sensory disorders in all study groups. The most pronounced was the dynamics of cognitive symptoms in patients with cerebrovascular disease and polyneuropathy. According to the results of the study, the use of ipidacrine (Ipigrix) seems very appropriate for treating both peripheral nervous system diseases and diseases accompanied by disturbances of memory and other cognitive functions.

The purpose of the research was to study the prognostic value of clinical and neuropsychological characteristics of the pathological process at a typical rhythmic PC for 5 years longtime illness prediction. The research of the cognitive function was held with the use of quantitative (A. R. Luriya tests) and qualitative assessment methods (verbal and colorStroop test, Encryption test). The retrospective analysis showed that cognitive disturbances, even subclinical, displayed in the form of neuropsychological test s changing, are authentically bound with the more likely of secondary progressing and at a prime PS weight according to the EDSS scale. Among the used neuropsychological tests the most sensing and informative in respect of the forecast of PS weight for the next 5 years is the Stroop test.

10.5 % of the population in Russia suffers from chronic headache, which is complicated by a drug abusus and significantly reduces the quality of life. The search remains for highly effective non-pharmacological methods of treatment. The most evidential method for the prevention of headache is biofeedback (BFB). The aim of this study was to evaluate the effectiveness of isolated biofeedback therapy and its combination with other methods of the stress management program (SM) compared with standard drug therapy in patients with chronic migraine (CM) and chronic tension type headache (CTTH) based on neurological and psychological studies. Materials and methods. The study included 44 patients suffering from CTTH (n = 22) and CM (n = 22). Patients were divided into two groups. The treatment method in the main group was a complex SM program which includes biofeedback course, self-help relaxation techniques, lifestyle and thinking modification, art therapy; in the second group patients received standard drug therapy. According to a single scheme the examination included: clinical and neurological survey, study of qualitative and quantitative headache characteristics and its impact on life (psychological examination, stress diagnostics). Additionally, patients’ compliance was assessed. Results. In both treatment groups there was a statistically significant decrease in the headache frequency (p ≤ 0.01), pain intensity (in SM group p ≤ 0.01, in drug therapy group p < 0.05), anxiety and depression level (p ≤ 0.01), pain catastrophizing (p ≤ 0.01), increase in the General Health Index WHO-5 (p ≤ 0.01). But only in SM group there was a statistically significant decrease in stress level by PSM-25 (p < 0.01), pericranial muscles tention (p ≤ 0.01), and increase in stress resistance (p ≤ 0.01). At the same time, effectiveness of the complex SM program directly depended on the patients’ compliance: treatment effectiveness was significantly reduced using biofeedback exclusively. Conclusion. The combination of the BOS method with other CM methods is required to achieve a clinically significant high-level effect on the prevention of chronic headache. The complex program of CM (BF, relaxation techniques, lifestyle modification and thinking, art therapy) leads to the clinical improvement in the qualitative and quantitative characteristics of headache comparable to the results of drug therapy, whereas the effect obtained from stress management on the psychological state of patients and the quality of their life far exceeds the action of standard drugs used to prevent headaches.

A variety of lacunar strokes localization in the brain is reflected in the forms of psychopathology at the patients with this pathology. Noteworthy, the presence of cognitive impairment there was even in the presence of a single lacunar stroke. MMSE cannot help in presсrining process of cognitive impairment in this patients group.

The article is devoted to the problem of vertebral diseases of the peripheral nervous system among adolescents and young men. On the basis of generalization of available information about degenerative-dystrophic processes, the authors describe various clinical forms of diseases. They present the results of a survey on over 200 patients with pain in the lumbar spine in the Chechen Republic and the Republic of Dagestan, analyze the conditions that contributed to the onset of the disease, its clinical manifestations and therapeutic methods. The authors conclude - back pain of young patients is a symptom requiring close attention.

Neuromyelitis optica (NMO) can lead to persistent disability in a short period of time. Persistent neurological deficit in demyelinating disorders is determined by neurodegeneration. As has been shown earlier neurodegeneration is characterized by changes in enzymes activity and shifts in b- amyloid levels. The aim of our study was try to check are there any difference in neurodegeneration of NMO and Multiple Sclerosis (MS) according to b-amyloid 1-40 and 1-42 levels in cerebrospinal fluid. Method. B-amyloids 1-40 and 1-42 were measured by an enzyme-linked immunosorbent assay in patients with MS (n = 52), NMO (n = 5) and control group (n = 26). Results. There was not any difference between NMO and MS (exacerbation). Level of b-amyloid 1-42 was higher in MS remission group than in NMO, but the same difference was detected between remission and exacerbation MS groups.

Prevalence of the neurodegenerative disorders is progressively increasing. This demands search for the approaches to modifying their progression. Caffeine is one of the most widely consumed psychoactive substances globally. Its effects are dose-dependent, and among caffeine’s mechanisms of action the main one is non-specific antagonism to adenosine receptors. In this review, current knowledge on use of caffeine in such neurodegenerative disorders as Parkinson’s disease, Alzheimer’s disease, Huntington's disease, and amyotrophic lateral sclerosis is summarized.

The article reviews indications and basic principles of migraine preventive treatment. Preventative drug selection should be based on the evidence from randomized clinical trials, the drug's mode of action and potential adverse events, as well as migraine comorbidities. Monotherapy is preferable and should be aimed at reducing headache frequency and treatment of comorbid conditions.

The study analyzed the level of vitamin D(OH) in the blood serum in patients with depression aged 18-27 years, studied its relationship with clinical characteristics and features of the course of depression, suicidal behavior. There is a parallelism between the decrease in D(OH) level and the severity of depressive disorder. In assessing the risk of suicide, depending on the serum vitamin D(OH) concentration, it was found that a high risk of suicide in the group of patients with severe vitamin D deficiency was significantly more frequent than in the group of patients with normal vitamin D(OH) levels. When assessing the intensity of suicidal ideology, it was found that actual suicidal ideals with a specific plan and the intention to implement it were met only in the group with severe vitamin D deficiency. It was shown that a decrease in the vitamin D(OH) concentration in the blood is associated with a decrease in the cognitive abilities of patients. The determination of the level of vitamin D(OH) in serum can be used in assessing the severity of depressive states.