[Early diagnosis of diabetic polyneuropathy based on the results of corneal nerve fibers examination]. / Vozmozhnosti rannei diagnostiki diabeticheskoi polineiropatii na osnove issledovaniya nervnykh volokon rogovitsy.

Laser corneal confocal microscopy (CCM) is a method of objective visualization of thin corneal nerve fibers (CNF), the structure of which changes in patients with diabetes mellitus (DM). PURPOSE: To conduct comparative analysis of the results of CNF assessment using CCM and other known neurological instrumental techniques as well as evaluate their applicability to the early diagnosis of diabetic polyneuropathy (DPN). MATERIAL AND METHODS: We examined a total of 46 patients (85 eyes) with type 1 DM and either subclinical (24 patients), or clinical-stage DPN (22 patients) and 50 patients (87 eyes) with type 2 DM (subclinical DPN in 27 patients and clinical-stage DPN in 23 patients). The control group consisted of 34 healthy volunteers (68 eyes). All patients underwent standard ophthalmological examination, CCM with nerve tortuosity assessment (including calculation of coefficients of CNF orientation anisotropy, KΔL, and symmetry, Ksym) and interocular asymmetry, electroneuromyography (ENMG), and quantitative sensory testing (QST). RESULTS: Analysis of the CCM results revealed a reliable decrease in the average KΔL values in patients with type 1 and type 2 DM compared with the control group. In the group of patients with type 1 DM and subclinical DPN, correlations were revealed between the CNF tortuosity coefficients and a number of ENMG parameters, such as the M-response amplitude of the peroneal nerve (r=0.73, p≤0.02), M-response amplitude of the tibial nerve (r=0.58, p≤0.01), residual latency (r= -0.62, p≤0.05), and peroneal nerve conduction velocity (r=0.57, p≤0.01). Ksym values correlated with the warm sensitivity threshold (r=0.6, p≤0.008). Among patients with type 2 DM and subclinical DPN, the KΔL coefficient correlated with the peroneal nerve conduction velocity (r=0.46, p≤0.02), M-response amplitude of the tibial nerve (r=0.6, p≤0.04), and residual latency of the peroneal nerve (r=-0.56, p≤0.05). CONCLUSION: The state of thin corneal nerves correlates with functional changes in the peripheral nerves. Pathological changes in CNF in patients with DM can be detected at an early (subclinical) stage of DPN using laser CCM and a program for corneal nerve tortuosity analysis.

[Efficacy of thiolepta in diabetic polyneuropathy: results of the study ETIKA].

Thiolepta (alpha-lipoic acid preparation) was used in treatment of 205 patients, 134 women and 71 men, mean age 59.3±10.1 years; 196 patients with diabetes mellitus (DM) type II and 9 patients with DM type I. Treatment duration was 4 weeks. Dosage of the drug was 600 mg daily. Patients were assessed neurologically and with psychometric scales. Special attention was drawn to the severity of positive and negative symptoms of neuropathy and sleep disorders. The results demonstrated the efficacy of thiolepta in diabetic polyneuropathy assessed by all parameters. The effect remained during 3 months after the end of treatment. Good tolerability and safety of the drug are highlighted.

[Use of controlled respiratory rhythm to enhance stress resistance in pupils].

To enhance stress resistance in pupils is now a very urgent problem. The influence of a method affecting the central nervous system as acquisition of the averaged value of intrinsic respiratory rhythm has been studied. There has been a positive result of using the procedure to increase working capacity during performance by pupils and positive changes in electroencephalographic readings, by optimizing the autonomic provision for their activity.