[The relationship between immunological and psychopathological characteristics in patients with focal epilepsy depending on the profile of interhemispheric asymmetry]. / Vzaimosvyaz' immunologicheskikh i psikhopatologicheskikh kharakteristik u bol'nykh fokal'noi epilepsiei v zavisimosti ot profilya mezhpolusharnoi asimmetrii.

OBJECTIVE: To identify the possible influence of cellular immunity parameters and neurobiological variables (frequency of seizures of various semiotics and their severity) on comorbid psychopathological symptoms depending on the profile of interhemispheric asymmetry in patients with focal forms of epilepsy. MATERIAL AND METHODS: The study included 92 patients with epilepsy (38 men, 54 women, mean age 38.7+8.45 years). Focal temporal lobe epilepsy was diagnosed in 36 patients, focal frontal lobe epilepsy in 16 patients, and temporal-frontal lobe epilepsy in 40 patients. For each type of seizure, severity was assessed according to the National Seizure Severity Scale (NHS3). The mental status of patients was assessed using the SCL-90 self-report questionnaire. The Annette scale was used to assess the profile of interhemispheric asymmetry. The number of different clusters of lymphocytes was studied, including the number of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), T-cytotoxic (CD3+CD8+), T-NK (natural killers CD3+CD16+CD56+), B-lymphocytes (CD3-CD19+), as well as immunoregulatory index (CD4/CD8 ratio). In order to identify any possible relationships between neurobiological and immune variables, on the one hand, and the SCL-90 constructs, on the other hand, a separate correlation analysis of Spearman ranks within the left-handed group and the right-handed group was carried out. RESULTS: We revealed the differences between groups of patients with epilepsy with right and left profiles of hemispheric asymmetry regarding the relationship between the frequency of seizures, their severity and accompanying psychopathological variables, on the one hand, and between immunity indices and psychopathological constructs, on the other hand. It has been established that neurobiological and immune variables in left-handers can determine the psychopathological structure of the comorbid mental disorder. CONCLUSION: Prediction of concomitant psychopathological syndromes in patients with epilepsy on the basis of clinical data and data on immunity is quite possible, but only in left-handed patients.

[Personality traits as risk factors for the development of cognitive impairment and affective symptoms in patients with COVID-19]. / Osobennosti lichnosti kak faktory riska razvitiya kognitivnykh narushenii i affektivnoi simptomatiki u perenesshikh COVID-19.

OBJECTIVE: To identify possible associations between premorbid personality traits and cognitive impairment and affective symptoms in patients who have recovered from COVID-19. MATERIAL AND METHODS: The study included 30 people with the so-called post-COVID syndrome. The diagnosis of COVID-19 was previously confirmed by laboratory tests in each patient. The control group included 15 healthy individuals. The Hospital Anxiety and Depression Scale was used to assess depression and anxiety. Cognitive function was assessed using the Verbal Fluency Test (VF), the Montreal Cognitive Scale (MOCA), and the Wisconsin Card Sorting Test (WCST). The Munich Personality Test (MRT) and the Toronto Alexithymia Scale (TAS-26) were used to assess premorbid personality characteristics. Multiple stepwise regression analysis was used as the main statistical method to identify the relationship between premorbid personality constructs and cognitive test results and affective and anxiety symptoms. RESULTS: The presence of frustration tolerance in the personality structure reduced the number of incorrect answers (beta coefficient -0.811) in WCST and decreased the delay in responses with positive reinforcement (-0.630), and also reduced the level of depression (-0.465). Extraversion decreased the MOCA test score (-0.675) and increased the percentage of perseverative incorrect answers on the WCST test (0.573). The constructs of adherence to social norms and propensity to isolate lowered the final MOCA score (beta coefficients are -0.725 and -0.527, respectively). The esoteric tendencies construct decreased the latency of positive and negative reinforcement responses in WCST (-0.441 and -0.528, respectively). The severity of alexithymia was positively correlated with depression (beta 0.577), while neuroticism was positively correlated with anxiety (0.737). CONCLUSION: Low levels of frustration tolerance and esoteric tendencies have negative effects on cognition in COVID-19 survivors, while high levels of these constructs are protective against cognitive decline and depression.

[The role of premorbid personality in the genesis of psychopathological symptomatology in patients with organic anxiety-depressive disorder, schizophrenia and endogenous depression]. / Rol' lichnosti premorbidnogo perioda v geneze psikhopatologicheskoi simptomatiki u bol'nykh organicheskim trevozhno-depressivnym rasstroistvom, shizofreniei i endogennoi depressiei.

OBJECTIVE: The current study has been performed in order to find the influence of premorbid personality traits on psychopathological symptomatology in patients with endogenous depression (ED), schizophrenia and organic anxiety-depressive disorder (OADD). MATERIAL AND METHODS: 191 patients (57 with OADD,93 with schizophrenia and 41 with ED) were included into study. The Munich personality test (MPT) and Toronto alexithymia scale (TAS) were used for the evaluation of premorbid personality; the SCL-90 - for the assessment of psychopathological structure. The multiple regression analysis has been used for the assessment of relationships between premorbid personality constructs and psychopathological status separately in each diagnostic group. RESULTS: The SCL-90 scores were maximal in ED and schizophrenia patients and minimal in OADD patients (p<0.047). Comparison of premorbid personality constructs revealed the maximal values of neuroticism and motivation in ED (p=0.005), rigidity, extraversion and esoteric tendencies in schizophrenia (p<0.007) and frustration tolerance, tendency to isolation and alexithymia in OADD (p<0.02). Regression analysis revealed the positive dependence of anxiety and depression on alexithymia score (TAS-26) (p<0.002) and negative dependence on frustration tolerance in ED and schizophrenia patients (p<0.016). The negative dependence of anxiety Zung scale score on frustration tolerance in OADD patients also has been observed (p=0.003). The rigidity construct has not stochastically significant relationships neither with anxiety, nor with depression in none diagnostic group. CONCLUSION: The analysis revealed the predominance of certain personality constructs in each of the diseases, with a universal negative effect of alexithymia and a positive effect of frustration tolerance in anxiety-depressive disorders of any etiology.

[Clinical results and prospects for the use of phenosanic acid in patients with focal epilepsy]. / Klinicheskie rezul'taty i perspektivy primeneniya fenozanovoi kisloty u vzroslykh patsientov s fokal'noi epilepsiei.

OBJECTIVE: To study the efficacy and safety of using a new original synthetic antioxidant - phenosanic acid as an adjunct therapy in patients with focal epilepsy. MATERIAL AND METHODS: A randomized, double-blind, placebo-controlled, parallel-group study evaluated the efficacy and safety of phenosanic acid as an adjunct therapy to basic antiepileptic drugs in 120 patients with focal epilepsy. Primary purpose: to study the dynamic of seizure frequency. Secondary purposes: to study the dynamic of seizure-free days, the dynamics of bilateral tonic-clonic seizures, the results of questionnaires and scales (General Dynamics Assessment, Visual Analogue Scale (VAS), Quality of Life in Epilepsy (QOLIE-31-P), European Quality of Life Questionnaire (EQ-5D), Hospital Anxiety and Depression Scale (HADS), Frontal Asstssment Battery (FAB), Mini-Mental State Examination (MMSE)). RESULTS: Phenosanic acid (Dibufelon) showed statistically significant benefit over placebo in the primary indicator of efficacy (reduction in the frequency of epileptic seizures by at least 50%) and in the secondary indicators. The drug was safe and well tolerated by the patients. CONCLUSION: The addition of phenosanic acid (Dibufelon) to base antiepileptic drugs seems to be perspective because of its positive effect on reducing the number of epileptic seizures, as well as on comorbid disorders in the emotional and cognitive spheres.

[Comparison of premorbid personality and psychopathological structure of some anxiety-affective disorders]. / Sravnenie lichnosti premorbidnogo perioda i psikhopatologicheskoi struktury nekotorykh trevozhno-depressivnykh sostoyanii.

OBJECTIVE: To compare premorbid personality and structure of psychopathological status of organic anxiety-depressive disorder in comparison with endogenous depression and anxiety neurotic disorders. MATERIAL AND METHODS: One hundred and twelve patients, including 57 with organic anxiety-depressive disorder (OADD), 41 with endogenous depression (ED) and 14 with anxiety neurotic disorder (AND) were studied. have been included into the study. The Munich personality test (MPT) and Toronto alexithymia scale (TAS) were used for the evaluation of premorbid personality. Psychopathological structure was assessed with SCL-90. The correlation between premorbid personality and current structure of psychopathological states was studied. RESULTS: OADD patients were characterized by higher scores of frustration tolerance, rigidity and isolation tendency and less expression of neuroticism, esoteric tendencies and motivation compared with ED. In the AND patients, the values of neuroticism and motivation predominated compared with OADD, while the value of frustration tolerance was higher in OADD. A correlation analysis revealed the strong positive relationships of alexithymia, neuroticism and isolation tendency with depression, anxiety, somatization, obsessions and sensitivity in AND group. CONCLUSION: The comparison of correlations between OADD and ED revealed no significant differences. It implies the similarity in the pathogenesis of OADD and ED.

[Characteristics of psychopathological symptomatology in HIV-infection schizophrenic patients]. / Nekotorye osobennosti psikhopatologicheskoi simptomatiki u bol'nykh shizofreniei s VICh-infektsiei.

AIM: To study the psychopathological structure of psychotic syndromes in HIV-infected schizophrenic patients and in patients without HIV infection. MATERIAL AND METHODS: Forty HIV-infected patients, 23 women and 17 men, with confirmed diagnosis of schizophrenia were included in the study. The control group consisted of 40 patients without HIV infection, 23 women (48%) and 17 men (52%). The psychopathological state in all patients was assessed with the PANSS. Flow cytometry was used to measure immunological parameters in HIV-infected patients. Data analysis included principal component analysis. RESULTS AND CONCLUSION: There were independent positive, negative and affective symptoms in the structure of syndromes of schizophrenic patients without HIV. The structure of syndromes in HIV-infected schizophrenic patients included cognitive deficit as well.

[The changes in cognitive impairment in patients with epilepsy during the disease course (on example of executive functions)]. / Dinamika kognitivnogo snizheniya u bol'nykh epilepsiei na protyazhenii bolezni (na primere ispolnitel'skikh funktsii).

AIM: To identify the relationship between executive functions (EF), personality traits and clinical characteristics of disease course. MATERIAL AND METHODS: One hundred and five patients with partial epilepsy, including temporal lobe epilepsy (61%), lobe epilepsy (33%) and other forms (6%), were examined. Mean age of the patients was 30.24±8,67 years. EF were studied using the the Wisconsin Card Sorting Test (WCST) in 25 out of 105 patients of the main group. The patients were followed-up after 5.5 years. RESULTS: Correlations between the EF decline and the age, illness duration and disability was found. Seizure remission and its duration have a positive effect on EF indices. There were no correlations with the age at seizure onset, severity of seizures, amount of medications used, psychopathological symptoms and left-handedness. The WCST scores were worse in patients with temporal lobe epilepsy and patients with alexithymia. A follow-up examination showed the relationship between the further EF decline and the left-sided localization of the epileptic focus as well as the absence of seizure remission. No relationship between the EF deficit and antiepileptic treatment was found. CONCLUSION: The EF deficit was observed in all forms of epilepsy, it was correlated with disability of patients, may be aggravated by personality and neurobiological characteristics and increased with the persistence of seizures. Based on the results of the study, the achievement of remission is needed in treatment tactics for epilepsy to preserve cognitive functioning and social well-being of patients.

[Brugada Syndrome: Possibilities of the Use of Noninvasive Electrocardiographic Mapping. A Case Report].

Patient P., 50 years old, male, with type I Brugada syndrome was examined. The patient had aborted sudden death event (2006) in his clinical history, ICD Gem III VR was implanted in 2006, ICDLumax DR was reimplanted in 2012. The patient had coved type pattern in right precordial ECG-leads. The p.E553X mutation in SCN5A gene, whish encodes the sodium channel α-subunit, was found. Noninvasive electrocardiographic mapping was performed. Significant changes of local unipolar electrograms including QRS fragmentation, ST segment elevation and late ventricular potentials were identified in the epicardium of the right ventricle outflow tract. Thus, the presented case demonstrates that noninvasive electrocardiographic mapping methodology allows to determine and visualize arrhythmogenic substrate in patients with inherited channelopathies.

[Prediction of the changes of immunological status and psychopathological data in HIV-infected schizophrenia patients].

AIM: To predict the immunological status in HIV-infected patients with schizophrenia based on a set of clinical and psychopathological characteristics of the endogenous process. MATERIAL AND METHODS: The study included 28 patients with confirmed diagnosis of schizophrenia and HIV status. Authors used psychopathological method, along with psychometric scales (PANSS), in patients with schizophrenia and an immunological method for the determination of HIV-associated status and viral load. RESULTS: Affective syndromes with severe depressive symptoms, volitional impairment, high impulsivity and social features of autism can be prognostically favorable factors for the immune status of HIV-infected patients with schizophrenia that obviously indicates an acute psychotic state. Negative (deficit) symptoms were prognostically unfavorable for the immune status of HIV-infected patients with schizophrenia and for psychosis course. CONCLUSION: Favorable immune status corresponds to acute psychosis whereas the forms with severe deficit are associated with immunosuppression in HIV-infected patients.

[About the comorbidity of affective and conversion disorders in epilepsy]. / O komorbidnosti affektivnykh i konversionnykh rasstroistv pri épilepsii.

In this literature review, special attention is drawn to the pathogenesis of conversion disorders in patients with epilepsy, in particular, with psychogenic non-epileptic seizures. Diagnostic issues and pharmacotherapy of affective and conversion disorders in patients with epilepsy is discussed.

[Brugada Syndrome: Possibilities of the Use of Noninvasive Electrocardiographic Mapping].

Patient P., 50 years old, male, with type I Brugada syndrome was examined. The patient had aborted sudden death event (2006) in his clinical history, ICD Gem III VR was implanted in 2006, ICDLumax DR was reimplanted in 2012. The patient had coved type pattern in right precordial ECG-leads. The p.E553X mutation in SCN5A gene, whish encodes the sodium channel -subunit, was found. Noninvasive electrocardiographic mapping was performed. Significant changes of local unipolar electrograms including QRS fragmentation, ST segment elevation and late ventricular potentials were identified in the epicardium of the right ventricle outflow tract. Thus, the presented case demonstrates that noninvasive electrocardiographic mapping methodology allows to determine and visualize arrhythmogenic substrate.

[Personality and neurobiological factors as predictors of treatment efficacy in patients with partial epilepsy].

In the present study, we attempted to find predictors of the response to antiepileptic treatment with the adjustment for individual constitutional characteristics of patients including the profile of hemispheric asymmetry (right- and left handedness), premorbid personality, predisposition to affective and other mental disorders. We administered a large battery of tests (MMSE, HAM-A, HAM-D, TAS-26 and others). Treatment efficacy was assessed by the degree of seizure frequency reduction and remission duration. Two groups of patients, with 100% reduction of seizures after 12 months of treatment with antiepileptic drugs and with the absence of reduction of seizures, were singled out. It has been shown that left-handedness, cognitive impairment in right-handers, alexithymia and affective disorders in left-handers predict poor treatment efficacy.

[The role of sex hormones in the development of affective disorders in women with epilepsy].

The objective of this study was the comprehensive assessment of the association between the level of hormones, reproductive disorders, symptoms of epilepsy and psychopathological symptoms in female patients with epilepsy and affective disorders. We studied 101 women using clinical and psychopathological examination, hormone measurement and statistical analysis. The data analysis showed correlations between scores on the scales measuring the mental health status and the level of hormones in the blood of patients. It has been concluded that the effect of female sex hormones on affective symptoms depends on characteristics of depressive affect.

[Mental disorders and cerebral sensomotor asymmetry in patients with epilepsy].

A neurological, psychiatric and instrumental (electroencephalography, computer tomography, etc.) study of 84 patients was aimed at assessing an effect of sensomotor asymmetry profile and side of the epileptic focus on semiotics of seizures and psychopathological presentations in partial epilepsy. A data analysis included 111 variables, i.e., psychometric and neuropsychological ones. Groups of patients with left and right profiles of functional interhemispheric asymmetry (LHA and RHA) were singled out. No between-group differences were found in severity of mental disturbances. However, cognitive functions were mostly affected in RHA and psychopathological phenomenon emerged mostly in LPA. The formation of multiple epileptic foci with the involvement of frontal and temporary lobes was the best predictor of mental disorders manifestation compared to age at disease onset, illness duration, frequency and severity of seizures.

[Memory and intellectual disorders in patients with epilepsy: an analysis of the relationship between clinical characteristics and brain asymmetry].

Clinical characteristics and cognitive functions have been studied during the examination and treatment of 132 patients with epilepsy. It has been shown that both the epileptic process by itself and the antiepileptic therapy are predictors of the memory-intellectual impairment. The key risk factors of cognitive impairment are the younger age of patients at the onset of seizures, the higher frequency of seizures and the secondary generalization. We found the effect of left-sided motor asymmetry on the intellectual impairment that was more pronounced in men. The left-sided profile of brain asymmetry is an unfavorable prognostic factor of the disease development.

Monotherapy of epilepsy in women: psychiatric and neuroendocrine aspects.

The aim of the present work was to perform a comparative assessment of the efficacy and safety of traditional and contemporary antiepileptic agents in women of reproductive age. The experimental group consisted of 65 patients, of whom 48 had partial epilepsy and 17 had idiopathic generalized epilepsy. A number of issues were addressed in studies of a larger group of patients (110), including both women (65) and men (45). The following agents were studied: Topamax, valproates, carbamazepine, and barbiturates, all used as monotherapy. Patients' status was evaluated using clinical (neurological, psychiatric), psychometric, neuropsychological, and hormonal parameters. The data led to the general conclusion that Topamax had advantages over the other study agents in the treatment of women with epilepsy.

[Anticonvulsant and psychotropic effects of topamax capsules].

Anticonvulsant and psychotropic effects of "Topamax capsules"(TC) were compared to a traditional form of topiramate (TFT) and some other anticonvulsant drugs (ACD). Thirty-six patients (12 men and 24 women) with partial temporary epilepsy were examined. Sixteen patients received TFT in tablets and 20 patients received ACD before the beginning of the study. Drug effect was assessed by frequency of seizures and some neuropsychiatric parameters. The results revealed that TC was comparable to TFT and ACD in the reduction of seizures of any semiotics. After 3 months of therapy, total MMSE scores increased from 27 to 28. There were less perseverant errors and more right responses in the WCST. Verbal fluency and memory measured with Sunderland test improved as well. TC led to decreased latencies of negative responses in the WCST and increased verbal fluency compared to TFT. Patients who received TFT prior to TC did fewer errors in the WCST than patients who received ACD prior to TC. Verbal fluency improved compared to patients who received other ACD. At the same time, a somewhat increase of paranoid signs on the scale SCL-90 was noted in the group treated with topiramate only. It has been concluded that TC has an activating effect on frontal brain areas.

[Monotherapy of epilepsy in women: psychiatric and neuroendocrine aspects].

An aim of the study was a comparative evaluation of efficacy and safety of traditional and modern antiepileptic drugs in women of reproductive age. A main group of patients consisted of 65 women, including 48 patients with partial epilepsy and 17 - with idiopathic generalized epilepsy. Some issues are solved in the study of a larger group comprising 110 patients (65 female and 45 male). The following drugs have been studied: topamax, valproates, carbamazepines and barbiturates. All of them were used as a monotherapy. Patient's state was assessed using clinical, neuropsychological and hormonal parameters. A general conclusion is that topamax is most beneficial, comparing with other drugs studied, in the treatment of women with epilepsy.

[Psychotropic and cognitive effects of topiramate in the treatment of epileptic patients].

To study a character of topiramate (TPM) effect on psychopathological and neurocognitive processes in patients with temporal partial epilepsy, 83 patients (33 men and 50 women, mean age 29.1 +/- 10.6 years) were examined. Fifty-three patients were diagnosed with temporal cryptogenic epilepsy and 20 with temporal symptomatic epilepsy. Thirty-three patients received TPM (124 +/- 35.6 mg daily), 26--carbamazepine (819 +/- 274.2 mg daily), 15--phenobarbital (154.6 +/- 95.1 mg daily) and 11 patients received no therapy. The statistically significant difference between the groups treated with TPM and phenobarbital were found only for cognitive traits (total MMT scores, total scores on the executive functions scale, latencies of positive and negative answers in WCST, verbal fluency). TPM was more effective than phenobarbital for all traits, with the exception of verbal fluency. The comparison of patients by some parameters before and during the treatment with TPM revealed the favorable effect of the drug in the reduction of obsessive symptoms, aggressiveness and social isolation on the SCL-90 as well as higher scores on the executive functions scale and the lower latency of positive answer in WCST. The monotherapy with TPM leads to the improvement of executive functions, reduction of aggressive and obsessive symptoms that may be explained by the improvement of prefrontal brain function in epilepsy.