I Keep a Close Watch on This Heart of Mine: Increased Interoception in Insomnia.

STUDY OBJECTIVES: Whereas both insomnia and altered interoception are core symptoms in affective disorders, their neural mechanisms remain insufficiently understood and have not previously been linked. Insomnia Disorder (ID) is characterized by sensory hypersensitivity during wakefulness and sleep. Previous studies on sensory processing in ID addressed external stimuli only, but not interoception. Interoceptive sensitivity can be studied quantitatively by measuring the cerebral cortical response to one's heartbeat (heartbeat-evoked potential, HEP). We here investigated whether insomnia is associated with increased interoceptive sensitivity as indexed by the HEP amplitude. METHODS: Sixty-four participants aged 21-70 years were recruited through www.sleepregistry.nl including 32 people suffering from ID and 32 age- and sex-matched controls without sleep complaints. HEPs were obtained from resting-state high-density electroencephalography (HD-EEG) recorded during evening wakeful rest in eyes-open (EO) and eyes-closed (EC) conditions of 5-minute duration each. Significance of group differences in HEP amplitude and their topographical distribution over the scalp were assessed by means of cluster-based permutation tests. RESULTS: In particular during EC, and to a lesser extent during EO, people with ID had a larger amplitude late HEP component than controls at frontal electrodes 376-500 ms after the R-wave peak. Source localization suggested increased neural activity time-locked to heartbeats in people with ID mainly in anterior cingulate/medial frontal cortices. CONCLUSIONS: People with insomnia show insufficient adaptation of their brain responses to the ever-present heartbeats. Abnormalities in the neural circuits involved in interoceptive awareness including the salience network may be of key importance to the pathophysiology of insomnia.

[COGNITIVE DISORDERS IN PATIENTS WITH TRAUMATIC ENCEPHALOPATHY].

As a result of examination 147, patients with traumatic encefalopatìû (TE) were explained the features of cognitive disorders, selected major psihopatologìcnì syndromes. The moderate cognitive disorders (KP) in patients THOSE, were observed in 40%bolnykh with the psikhorganicheskim syndrome, in 90.6% of patients with the asthenic syndrome, in 90.4%--by likvorodistsirkulyatornym syndrome and 76.1% in patients are cerebral--by focus syndrome. CD complicates, the progress of any post traumatic syndrome, in which they were presented. Moderate cognitive disorders are included in the structure of post traumatic psihorganìcnoo syndrome and is a significant dezadaptuûcim factor for the patient.

[FEATURES OF PTSD IN THE PARTICIPANTS OF THE ANTI-TERRORIST OPERATION--UKRAINIAN SYNDROME].

The article gives information about the results of research of characteristics of post traumatic stress disorder (PTSD) in the participants of the anti-terrorist operation (ATO), and refugees. Drawn attention to the fact that the demonstration took place in the study of PTSD patients, in the form of the following options: invasion (penetration); avoiding (displacement); hyperactivation. In the study took part 71 serviceman (69 men and 2 women) aged from 22 to 35 years (average age 26,2 years) that have closed traumatic brain injury , in the form of a brain concussions, contusions and suffered on PTSD (main group), studies conducted in 3-6 months after received closed traumatic brain injury. In the group of comparison included 37 patients (34 women and 3 men) aged 27-42 years (average age 32,2 years) that have had PTSD. In a group that included military personnel, in which in addition to PTSD, the clinical picture had existing consequences of craniocerebral injury observed in asthenic symptom complex--27 patients (38.1%); the anxious-phobic--in 19 patients (26.7%); hysterical--in 8 patients (11.3%); a depressive--in 17 patients (23.9%). In a group of patients and refugees from the ATO was: asthenic symptom complex--in 12 patients (32.4%), the anxious-phobic--in 11 patients (29.7%), hysterical--in 6 patients (16.2%), a depressive--in 8 patients (21.7%).

[Neurocirculatory asthenia: psychoautonomic features and treatment possibilities].

The authors present the results of clinical, physiological and psychological examination of 31 patients with neurocirculatory asthenia with arterial hypertension syndrome. There was an increase in the levels of state and trait anxiety correlated with a number of physiological traits that confirmed a leading role of psycho-emotional sphere in the formation of hypertensive reactions. An evaluation of the efficacy of the drug Adaptol used in daily dosage 1500 mg during 8 weeks in the treatment of these patients revealed its high efficacy (the improvement was seen in 74% of cases) confirmed by the data of clinical and psychological studies.

Impairment of gaze fixation and holding in patients with neurocirculatory asthenia syndrome and associated vestibular dysfunction.

The study was performed with a hardware-software complex for the monitoring of human motor functions. Saccadic eye movements and vestibulo-oculomotor interactions were studied in patients with neurocirculatory asthenia and associated vertigo. No changes in saccadic eye movements were found in these patients. Abnormalities of cervico-vestibulo-oculomotor interactions were manifested in the impairment of gaze fixation and holding.

Cardiac function fluctuates during exacerbation and remission in young adults with chronic fatigue syndrome and "small heart".

BACKGROUND: "Small heart syndrome", previously referred to as so-called "neurocirculatory asthenia" associated with a small heart shadow on the chest roentgenogram, is characterized by weakness or fatigue even after mild exertion, palpitation, dyspnea, and fainting, many of which resemble symptoms in patients with chronic fatigue syndrome (CFS). METHODS AND RESULTS: The study population comprised 42 patients with CFS younger than 40 years of age. Cardiothoracic ratio was determined on the chest roentgenogram and echocardiographic examination was performed to evaluate both the cardiac chamber size and function. "Small heart" (cardiothoracic ratio < or = 42%) on the chest X-ray photograph was noted in 26 (62%) of the study CFS patients. Echocardiographic examination demonstrated significantly smaller mean values of both the left ventricular (LV) end-diastolic and end-systolic dimensions, stroke volume indexes and cardiac indexes in CFS patients with "small heart" than in those without it and also in 20 control subjects. Thus, CFS patients with "small heart" had an actually small LV chamber and poor cardiac performance. During a long follow-up period of 10 CFS patients with "small heart", all echocardiographic parameters mentioned above improved and cardiothoracic ratios increased significantly during the remission phase as compared with exacerbation phase. CONCLUSIONS: "Small heart" on the chest X-ray photograph was prevalently noted in CFS patients. Echocardiographic examination revealed that CFS patients with "small heart" had an actually small LV chamber and poor cardiac performance. Cardiac functional changes evaluated by repeated examinations appeared to be directly associated with the severity of their symptoms. Small heart syndrome with impaired cardiac function may contribute to the development of CFS through low cardiac output as a constitutional factor.

[Standardized load test in the diagnostics of neurocirculatory dystonia].

Thirty-five men with neurocirculatory dystonia (NCD) aged 24.4 +/- 1.8 and 22 practically healthy men of comparable age were examined. All the patients underwent standard load veloergometric test by step-up technique until submaximum heart rate was achieved. The study found significant increase in myocardial oxygen consumption both at rest and during physical exercise. The author offers quantitative criteria that allow for objective evaluation of disturbances in the regulatory systems that provide response to measured physical load and thus contribute to clinical diagnostics of NCD.

[Hemodynamic correlation between the reaction of circulatory system on physical activity and exogenic adrenaline in liquidators of Chernobyl accident with neurocirculatory dystonia syndrome].

The article presents a correlation analysis between hemodynamic changes occurred after performing submaximum physical activity using bicycle ergometer (physical stress) and intravenous injection of adrenalin (pharmacological stress) in 30 liquidators of Chernobyl accident and who have a neurocirculatory dystonia syndrome. It enables to establish interrelations for a number of maximal values of parameters of hemodynamics which is determined by the same shifts in circulatory system with sympathoadrenal direction during these two kinds of stress influence.

[Specific course of neurocirculatory dystonia in pregnancy].

AIM: To study specific features of a course of neurocirculatory dystonia (NCD) in pregnancy, effects of NCD on a gestational process. MATERIAL AND METHODS: The examination of 50 pregnant women with NCD and 30 healthy pregnant women in trimesters I, II and III included clinical, laboratory, ultrasonic, dopplerometric and cardiotocographic investigations. RESULTS: Pregnancy deteriorates NCD by enhancing such clinical syndromes as respiratory, asthenic, hemorrhagic, aggravating peripheral vascular disorders. NCD women develop gestosis, placental insufficiency, had spontaneous abortions more frequently. Neonates have abnormal neonatal adaptation. CONCLUSION: In spite of enhanced clinical symptoms, pregnancy for NCD patients is not contraindicated. Management of pregnancy in NCD women should be conducted by an obstetrician together with a therapist (cardiologist).

[The course of pregnancy in women with mitral valve prolapse].

The paper is devoted to the study of the course of pregnancy in women with mitral valve prolapse of various severity. With progression of pregnancy (especially the period from II to III trimester) symptoms increase. This is manifested as appearance or intensification of signs of neuro-circulatory dystonia (characteristic for patients with mitral valve prolapse irrespective of pregnancy). However these signs do not interfere with normal delivery.

Conscious and unconscious sensory inflows allow effective control of the functions of the human brain and heart at the initial ageing stage.

The authors of the present article based their assumption on the concept that the sensory systems are the "windows to the brain" through which various functions of the human organism can be controlled. Comprehension of the fundamental mechanisms of the optimization of the sensory systems, brain, and cardiac functions has increased based on the prolonged sensory flows using conscious and unconscious aromatherapy and multimodal sensory activation. Sensory flow evoked stable systemic responses, including adaptive alteration of psycho-emotional state, attention, memory, sensorimotor reactions, intersensory interaction, visual information processing, statokinetic stability, and autonomic heart rhythm control. The efficacy and expediency of the use of sensory flow for non-medicinal correction of vital functions of the human organism at the initial stages of ageing was revealed.

Conscious and unconscious sensory inflows allow effective control of the functions of the human brain and aeart at the initial ageing stage

The authors of the present article based their assumption on the concept that the sensory systems are the «windows to the brain» through which various functions of the human organism can be controlled. Comprehension of the fundamental mechanisms of the optimization of the sensory systems, brain, and cardiac functions has increased based on the prolonged sensory flows using conscious and unconscious aromatherapy and multimodal sensory activation. Sensory flow evoked stable systemic responses, including adaptive alteration of psycho-emotional state, attention, memory, sensorimotor reactions, intersensory interaction, visual information processing, statokinetic stability, and autonomic heart rhythm control. The efficacy and expediency of the use of sensory flow for non medicinal correction of vital functions of the human organism at the initial stages of ageing was revealed (AU)

Los autores de este artículo se basan en el concepto de que los sistemas sensoriales son las «ventanas al cerebro» a través de las cuales se pueden controlar varias funciones del organismo humano. La comprensión de los mecanismos fundamentales de la optimización del sistema sensorial, del cerebro, y de las funciones cardíacas ha aumentado gracias a los flujos sensoriales prolongados empleando la aromaterapia consciente y no consciente y la activación sensorial multimodal. El flujo sensorial evocó respuestas sistémicas estables, incluyendo la alteración adaptativa del estado psico-emocional, la atención, la memoria, reacciones sensorimotores, la interacción intersensorial, el procesamiento de la información visual, la estabilidad estatoquinestésica y el control del ritmo cardíaco autonómico. Se observa la eficacia y la conveniencia del empleo del flujo sensorial para la corrección no farmacológica de las funciones vitales del organismo humano en los estadios iniciales del envejecimiento (AU)

Suppressed working memory on the WMS-III as a marker for poor effort.

The purpose of this study was to examine the clinical utility of memory minus Working Memory Index (memory-WMI) discrepancy scores on the WMS-III for detecting poor effort in 145 personal injury litigants (19 poor effort, 126 adequate effort). On average, participants in the poor effort group performed significantly lower on all WMS-III memory indexes and demonstrated larger memory-WMI discrepancy scores compared to participants in the adequate effort group. Discriminant function analyses using memory-WMI discrepancy scores as independent variables revealed poor overall classification rates (60.0% to 63.4%). Based on the prevalence of unusually suppressed attention-concentration ability relative to memory functioning using unidirectional memory-WMI discrepancy scores, high specificity and negative predictive power values were found. However, there was unacceptably low sensitivity and positive predictive power. These results suggest that memory-WMI discrepancy scores on the WMS-III do not provide clinically useful information regarding response set and should be used cautiously as an indicator of poor effort.

[Hyperventilation syndrome in bronchial asthma, essential hypertension and organic neurosis. Clinical picture and external respiration function]. / Giperventiliatsionnyi sindrom pri bronkhial'noi astme, gipertonicheskoi bolezni i organnom nevroze. Klinicheskaia kartina i funktsiia vneshnego dykhaniia.

The external respiration function was studied in 100 patients with hyperventilation syndrome (HVS) divided into 3 groups: 40 patients with HVS and bronchial asthma (group 1) consisting of 15 males and 25 females (age median--45 years, 25 percentile--37 years, 75 percentile--53 years); 39 patients with HVS and essential hypertension (group 2) consisting of 8 males and 31 females (age median 49, 25 percentile--40 years, 75 percentile--57 years); 21 patients with HVS without concurrent somatic diseases of group 3 (7 males, 14 females, age median 45 years, 25 percentile--28 years, 75 percentile--45 years). It is shown that different disorders of pulmonary ventilation correspond to different clinical manifestations of HVS. Thus, in bronchial obstruction (group 1) HVS manifests with "weak respiration", in restrictive pulmonary disorders (group 2) HVS manifests as "heavy respiration", in high parameters of bronchial permeability (group 3)--"shallow respiration".

[Effect of oxygen baths and massage on hemodynamics in patients with neurocirculatory dystonia]. / Vliianie kislorodnykh vann i massazha na protsessy gemodinamiki u bol'nykh neirotsirkuliatornoi distoniei.

56 patients with neurocirculatory asthenia (NCA) of a hypertensive and cardial type aged 30 to 55 years took general oxygen baths and collar zone massage, no drugs were used. The baths and the massage improved the disease course in 92.6% patients: improved hemodynamics, relieved high vascular resistance, lowered high diastolic blood pressure, decreased heart rate in tachycardia. More effective was the treatment in hypertensive NCA.

[Role of asthenoneurotic syndrome in the clinical picture of unstable stenocardia]. / Rol' astenonevrotychnoho syndromu v klinichnii kartyni nestabil'noï stenokardiï.

With the purpose of ascertaining the impact the asthenoneurotic syndrome has on specificties of ischemic heart disease, 132 patients with unstable angina (UA) were examined. In 34.8 percent of cases, it was found to be accompanied by manifestations of somatophorme vegetative dysfunction. UA patients with objective evidence (transesophageal electrocardiostimulation--TEES, veloergometry--VE, stress-echocardiometry--EchoCG) of the asthenoneurotic syndrome display a higher polymorphism of complaints and subjective manifestations while single UA is accompanied by a lower level of frequency of the stimulation discontinuance as evidenced by TEES, lesser load gotten to as evidenced by VE, decrease in the ejection fraction by EchoCG.

[Neurotic disorders in adolescents with vegetative dysfunction]. / Nevrozopodibni stany u pidlitkiv z vehetatyvnymy dysfunktsiiamy.

The main disorders in juveniles who are resident in the zone of small doses of ionizing radiation are vegetative dysfunctions. Of these, there prevail vegetovascular dysfunction comprising 45.7%, with neurocirculatory and vegetovisceral dysfunctions occurring less frequently (26.3% and 19.7% respectively). The major proportion of juveniles present with neurosis-like states, asthenic and asthenodepressive ones being the most common type.

[Spectral analysis of cardiac rhythm as an indicator of the autonomic cardiovascular regulation]. / Spektral'nyi analiz serdechnogo ritma kak pokazatel' vegetativnoi reguliatsii serdechno-sosudistoi sistemy.

AIM: To study cardiovascular function at rest and during exercise by spectral analysis of heart rhythm in patients with spinal osteochondrosis and cardialgia, in patients with excessive body weight, and with cardial type neurocirculatory dystonia (NCD). MATERIAL AND METHODS: A total of 223 patients were examined. Spinal osteochondrosis with cardialgia was diagnosed in 80, excessive body weight in 78, and cardial type NCD in 65. Heart rhythm wave structure was evaluated using VKK-12 Ergometer complex before and after bicycle ergometry. RESULTS: Submaximal exercise did not induce changes in the heart rhythm wave structure of normal subjects. In cardial type NCD the intensity of first order slow waves increased during the recovery period, while in patients with spinal osteochondrosis and cardialgia and in those with excessive body weight, heart rhythm centralization index increased.