[Clinical and neurophysiological manifestations of sluggish cognitive tempo in children]. / Kliniko-neirofiziologicheskie proyavleniya nizkogo kognitivnogo tempa u detei.

OBJECTIVE: To study the clinical and neurophysiological features of children with low cognitive tempo (NCT), as well as the effectiveness of the drug Pantogam in the treatment of this pathology. MATERIAL AND METHODS: A total of 90 children aged 8 to 10 years were examined. Of these, the main study group consisted of 30 children with NCT, the comparison group consisted of 30 children with a combined type of attention deficit hyperactivity disorder ADHD (ADHD-K), the control group consisted of 30 children without neuropsychiatric disorders. The study used clinical, neurophysiological (electroencephalography (EEG)) and parametric methods. The CMAS scale of apparent anxiety (The Children's Form of Manifest Anxiety Scale), the SNAP-IY scale (assessment of the degree of inattention, hyperactivity and impulsivity), the TOVA computer test (the Test of Variables of Attention), the scale «SCT¼ (Sluggish Cognitive Tempo) for assessing manifestations of low cognitive tempo, the «RAM¼ technique for quantifying working memory. Pantogam was used to treat patients at a dose of 750 mg per day for 8 weeks. RESULTS: Patients with NCT are characterized by more pronounced attention disorders compared with healthy peers and with children with ADHD-K, and they have a decrease in mainly not selective attention, but the overall level of functional activity. Also, the group of children with NCT has an increased level of anxiety compared to the group of children with ADHD. A comparative analysis of the level of impulsivity showed that children with NCT are less characterized by a deficit in inhibition processes. According to the quantitative analysis of the EEG, specific changes in functional activity in the frontal and central regions of the cerebral cortex were revealed (a statistically significant increase in the ratio of absolute theta rhythm to beta1 rhythm, compared with other groups), reflecting insufficient cortical arousal and less focused neural states. When re-evaluating the condition of children with NCT after a course of therapy with Pantogam, an improvement in the form of a decrease in the degree of inattention, the severity of memory impairment and a decrease in reaction time was recorded in 60% of cases. According to quantitative EEG analysis, there was a significant decrease in the ratio of absolute theta rhythm to beta1 rhythm in the central leads of both hemispheres and in the parietal-temporal leads of the left hemisphere, indicating an increase in the level of overall activation of the cerebral cortex after a course of treatment. CONCLUSION: Clinical and neurophysiological differences were revealed in patients with NCT and with combined ADHD. It has been shown that the use of Pantogam for the treatment of children with NCT leads not only to a decrease in the main manifestations of this disorder, but also to an improvement in the functional state of the brain.

[Cognitive impairment in children with organic asthenic disorder]. / Kognitivnye narusheniya u detei s organicheskim astenicheskim rasstroistvom.

OBJECTIVE: To study cognitive impairment and neurophysiological characteristics in children with organic asthenia, as well as the effectiveness of the drug Cogitum in the treatment of this pathology. MATERIAL AND METHODS: The main study group included 40 children aged 8 to 10 years with a diagnosis of «Organic asthenic disorder¼ (F06.6). The control group consisted of 30 children aged 8 to 10 years without manifestations of asthenia. The following research methods were used in the work: the asthenic state scale (ASS) by L.D. Malkova to assess the severity of asthenic syndrome, the S. Lee «SCT¼ (sluggish cognitive tempo) scale to assess manifestations of low cognitive tempo, the «Random Access Memory¼ method to quantify working memory, the TOVA (The Test of Variables of Attention) computer test to quantify assessment of attention disorders and impulsivity level, electroencephalogram (routine and spectral analysis) (p<0.05). For the treatment of patients from the study group, the drug Cogitum was used at a dose of 10 ml of a drinking solution per day for 30 days. RESULTS: In was shown that children from the study group were characterized by a decrease in working memory (7.8±2.9 vs 14.9±5.4), a statistically significant increase in SCT scores (p<0.05), a significantly greater degree of inattention and impulsivity with a tendency to an increase in the number of errors in the second half of the TOVA test (p<0.05). Comparative analysis of EEG relative power data showed a statistically significant increase in the power of waves in the alpha and theta ranges in the fronto-central leads of both hemispheres in the group of children with organic asthenic disorder (p<0.05). When re-evaluating the condition of children after treatment, a statistically significant decrease in the manifestations of asthenia on the ASS scale was recorded in 77.5% of cases. At the same time, there was a significant improvement in attention, memory, and indicators characterizing a low cognitive pace. The results of an electroencephalographic study after a course of treatment showed a decrease in the relative power of the EEG in the theta and alpha ranges in the anterior sections of the cerebral cortex (p<0.05), which indicates an increase in the level of activation of neocortical structures. CONCLUSION: Thus, the use of the drug Cogitum for the treatment of organic asthenic disorder leads not only to a decrease in asthenia and cognitive impairment, but also to an improvement in the functional state of the brain.

[Clinical and psychological manifestations of emotional burnout in mothers of children with neuropsychiatric diseases (on a model of ADHD)]. / Kliniko-psikhologicheskie proyavleniya emotsional'nogo vygoraniya u materei detei s psikhonevrologicheskimi zabolevaniyami (na modeli SDVG).

OBJECTIVE: To evaluate the therapeutic efficacy of Pantogam aktiv in the treatment of clinical manifestations of burnout in mothers of children with ADHD. MATERIAL AND METHODS: Under observation were 108 mothers of children with attention deficit hyperactivity disorder (ADHD) aged 25 to 50 years, who had symptoms of burnout in the clinical picture during the initial visit. The following research methods were used in the work: clinical history taking, neurological examination, S. Maslach questionnaire for assessing the burnout manifestations, subjective asthenia rating scale (MFI-20) with five subscales, digital fatigue rating scale (10-point variant), quantitative assessment of autonomic changes (questionnaire A.M. Wein), Spielberger-Khanin Scale for assessing emotional disorders, psychophysiological study of cognitive functions: test of attention variables TOVA (the Test of Variables of Attention). For the treatment of patients, the drug Pantogam Active was used in capsules of 300 mg, at a daily dose of 900 mg (2 capsules in the morning and 1 capsule in the afternoon) for 8 weeks. RESULTS: A re-examination after a course of treatment showed improvement in 68.5% of patients. After treatment, there was a significant decrease in the severity of such indicators of burnout as emotional exhaustion and depersonalization, a significant decrease in the average values according to the A.M. Wayne, a decrease in reactive anxiety, a statistically significant improvement in attention and a decrease in impulsivity (p<0.05). CONCLUSION: Thus, the results of the study indicate that the use of Pantogam active in the treatment of clinical manifestations of parental burnout is characterized by high efficiency. After treatment, there is a significant decrease in fatigue, asthenia, anxiety, and total indicators characterizing burnout. The data obtained make it possible to recommend the use of Pantogam aktiv in the treatment of clinical manifestations of parents burnout in children with neurological diseases.

[Executive functions disorders in children with dyslexia]. / Narusheniya upravlyayushchikh funktsii u detei s disleksiei.

OBJECTIVE: To study the severity of disorders of executive functions in children with dyslexia and to assess the effectiveness of treatment of this pathology with cortexin. MATERIAL AND METHODS: The main study group included 60 children, aged 8-11 years, with a specific reading disorder (F.81.0). Reading skills were assessed using methods of T.A. Fotekova, T.V. Akhutina. Diagnostic examination included neurological examination with dyspraxia test, electroencephalography with visual and quantitative analysis. To objectify the severity of memory impairments, the «Working memory¼ technique was used. Attention and impulsivity disorders were quantified using SNAP-IY and the Test of Variables of Attention (TOVA). The control group consisted of 60 children of the same age without symptoms of dyslexia. Cortexin was used to treat 30 patients from the study group, 30 patients received encephabol. A control study to analyze the effectiveness of the therapy was carried out one month after the end of therapy. RESULTS AND CONCLUSION: Children with dyslexia are characterized by a higher level of inattention and impulsivity, as well as significantly lower indicators of working memory compared to children from the control group. The decrease in attention and working memory as well as an increased level of impulsivity are manifestations of impaired executive functions in children with dyslexia. The results of the control study after treatment showed a significant increase in reading skills in both groups. In addition, there was an improvement in indicators of attention and working memory. However, the effectiveness of treatment with cortexin was slightly higher compared to encephabol (improvement was noted in 73.3% and 60.0%of patients, respectively). According to a comparative analysis of EEG results, after a course of treatment with cortexin, children with dyslexia have significant neurophysiological changes that indicate the activation of the brain regulatory systems.

[Cognitive disturbances in children with chronic tics and their treatment]. / Kognitivnye narusheniia u detei s khronicheskimi tikami i ikh lechenie.

AIM: To clarify the severity of cognitive disturbances in children with chronic tics and to evaluate the efficacy of cortexin as part of complex therapy in the treatment of this pathology. MATERIAL AND METHODS: The main study group included 50 children, aged 6-8 years, with chronic motor tics. Twenty patients of these group received phenibut and 30 patients received cortexin in addition to phenibut. The comparison group consisted of 30 children with transient tics, aged 6-8 years, the control group consisted of 40 children of the same age without tics and other neuropsychiatric disorders. Clinical assessment of tick manifestations and their frequency was performed using the Tourette Syndrome Global Scale (TSGS), neurological examination, electroencephalography. Severity of asthenic and cognitive disorders was evaluated using the Subjective Asthenia Scale (MFI-20), the memorization technique by A.R. Luria and the TOVA test. RESULTS AND CONCLUSION: Children with chronic tics show signs of asthenia, they are characterized by a higher level of inattention and significantly lower levels of long-term memory compared to children from the comparison group and the control group. The level of impulsivity in children with chronic tics is significantly higher than in the control group but significantly lower than in children in the comparison group. A comparative analysis of EEG data in children with chronic tics reveals the following significant differences from the control and comparison groups: a higher amplitude and higher values of the peak frequency of the alpha-rhythm in the posterior regions of both hemispheres, a significant increase in the alpha-range of the frontal temporal leads of both hemispheres. Complex therapy with the addition of cortexin significantly improves treatment efficacy: improvement is noted in 60,0% of patients in monotherapy and in 83.3% of patients in complex therapy.

[Experience with "AFAVIT Diabetes" used in the treatment of diabetic peripheral polyneuropathy in adolescents].

AIM: To evaluate the efficiency of using the vitamin and mineral complex (VMC) ALFAVIT Diabetes in the combination therapy of diabetic polyneuropathy (DPNP) in adolescents. SUBJECTS AND METHODS: A study group comprised 30 children with diabetic peripheral polyneuropathy, whose combination therapy included ALFAVIT Diabetes as one tablet t.i.d. for 2 months. A comparison group consisted of 20 adolescents with DPNP who did not take the complex. Before and 2 months after the study, the children's state was assessed from the data of a physical examination with mandatory blood pressure and pulse measurements and a neurological study, from carbohydrate (basal glycemia, glycemic variability, glycated hemoglobin) and lipid (total cholesterol and its fractions) metabolic parameters, and from the findings of electromyography (EMG). RESULTS: Incorporation of the VMC ALFAVIT Diabetes into the combination therapy contributed to the ameliorated clinical manifestations of DPNP. There were positive electrophysiological changes, as evidenced by EMG. The VMC ALFAVIT Diabetes showed good tolerability and caused no adverse reactions. CONCLUSION: The performed trials have indicated that it is expedient to use the VMC ALFAVIT Diabetes in adolescents with type 1 diabetes mellitus and DPNP.