[Motor rehabilitation of patients in the acute period of stroke using virtual reality technology]. / Dvigatel'naya reabilitatsiya patsientov v ostrom periode insul'ta s ispol'zovaniem tekhnologii virtual'noi real'nosti.

OBJECTIVE: To study an effect of adjuvant rehabilitation using implicit virtual reality on the dynamics of the motor function of the lower extremities in patients in the acute period of ischemic stroke. MATERIALS AND METHODS: The study was carried out to assess the effectiveness and safety of rehabilitation using virtual reality in 60 patients with lower central paresis in the acute period of ischemic stroke, lasting from 3 to 5 days. Patients of the study group additionally received rehabilitation using the hardware-software complex ReviVR, which allows to stimulate the patient's plantar surface by means of pneumo cuffs synchronously with the step of his animated body. Animation of movement was demonstrated to the patient using virtual reality glasses. The duration of the classes was 10 days, 20-25 minutes each. The total duration of rehabilitation measures in the study and comparison groups was 3-4 hours. RESULTS: A significant regression on NIHSS (3 [-4; -1] and -1 [-2; 0], p<0.001) and a progress on RMI (3 [1; 3] and 2 [0; 2], p<0.001, respectively), between the study group and the control group were found. Changes on FMA-LE section (E-F) occurred on day 10, between the study and comparison groups (9 [5; 16] and 4 [0; 7], respectively, p=0.04). The improvement in FMA-LE out of synergy, in the standing position, indicated an increased readiness of the patient to form an independent walk. CONCLUSION: The study has shown that the use of virtual reality rehabilitation increases the effectiveness of motor rehabilitation in patients with lower central paresis in the acute period of stroke.

[Sleep disorders in synucleinopathy]. / Narushenie sna pri sinukleinopatiyakh.

The article highlights the current state of the problem of sleep disorders in various neurodegenerative diseases. The clinical picture and diagnosis of these disorders are described in detail. Separately, the emphasis is made on the mechanisms underlying development of these disorders and their features in various forms of synucleinopathies. The mediator and physiological changes that underlie sleep disorders in various nosological units of synucleinopathies are discussed in detail. The current attitude to certain sleep disorders as predictors of neurodegenerative diseases is evaluated. The role of the glymphatic system in the development of these disorders is considered. Also, modern therapeutic strategies for sleep disorders in neurodegenerative diseases are discussed.

[Disorders of arousal: the mechanism of occurrence, neurophysiological features]. / Parasomnii, sviazannye s narusheniem probuzhdeniia iz medlennogo sna: mekhanizm vozniknoveniia, neirofiziologicheskie osobennosti.

The article covers the current state of the problem of disorders of arousal (DOAs). The clinical features and diagnostics of the disease are described in detail. Separately, emphasis is placed on the mechanisms of the occurrence of DOAs and the characteristic changes in the central nervous system. The question of neurophysiological changes preceding the clinical manifestation of DOAs and the concept of local sleep as a physiological basis for the occurrence of DOAs are considered. Current therapeutic approaches in the treatment of these forms of parasomnias are reviewed.

[Melatonin - known problems and perspectives of clinical usage]. / Melatonin - izvestnye i novye oblasti klinicheskogo primeneniia.

The article discusses well-known and ongoing studies of mechanisms of action of melatonin. The main clinical effects of melatonin are discussed. The emphasis on the chronobiological effect of melatonin, its adaptogenic and anti-carcinogenic properties has been done in the article. The most frequent manifestations of epiphyseal melatonin deficiency are various functional disorders in the form of insomnia, anxiety or depressive disorders. Recommendations on the effective use of melatonin in its deficiency due to pathology are given.

[The quality of nighttime sleep in patients with multiple sclerosis]. / Kachestvo nochnogo sna u patsientov s rasseyannym sklerozom.

OBJECTIVE: to study the quality of nighttime sleep in multiple sclerosis (MS) using the PSQI. MATERIAL AND METHODS: The quality of nighttime sleep was compared in 48 patients with relapsing MS. Patients were divided into 2 groups according to the PSQI scores. RESULTS AND CONCLUSION: Sleep disturbances were more frequent in patients with MS. Women had higher risk of sleep disturbances. In the group with a poor quality of nighttime sleep, complaints about the increase in latency and low quality of sleep and daily activities were more common. The global severity of neurological deficit and disturbance of motor activity affected the quality of nighttime sleep.

[Posture disorders in patients with multiple sclerosis]. / Osobennosti postural'nykh narushenii u bol'nykh rasseiannym sklerozom.

Impairment of stability in the vertical posture is one of the most common or, sometimes, a key symptom in patients with multiple sclerosis (MS). Reduction of postural control is often correlated with the severity of neurological deficit and is thought to be a leading factor that impacts on social and working activities of the patient with MS. We studied disturbances of postural control depending on the lesion of a functional system and evaluated the involvement of a corresponding system in the functions of postural control in 61 patients with confirmed MS. Patients were stratified into five groups according to lesion location: visual, motor, sensory, cerebellar or spine stem systems. The maximal impairment of static postural control corresponded to the maximal lesion of the sensory system. Compensatory mechanisms of the activation of central and neuromuscular.

[Assessment of the high cost drug program on an example of the interferon treatment of multiple sclerosis].

Currently in Russia, there is a rather complicated situation with the distribution of expensive disease modifying drugs (DMD) purchased by the state for treatment of patients with multiple sclerosis. In this regard, it is necessary to carry out a serious organizational work in the direction of assessment of equivalence of biosimilars and original drugs concerning, first of all, efficacy and safety. Also, there is a problem of the replacement of one biosimilar by another in connection with organizational problems of shipping DMD to country regions. We present the results of the sociological research on the assessment of expensive drug provision by patients. The research has been carried out in 35 regions of the country. Based on these results, a strategy of the development of the program of provision with DMD should be developed all over the country.