[A differentiated approach to Parkinson's disease treatment in early stage of the disease]. / Differentsirovannyi podkhod k lecheniiu patsientov s bolezn'iu Parkinsona v rannem periode.

A conception of the approach to Parkinson's disease treatment at early stage, which could be realized in practice is suggested. The conception is based on the results of dopaminergic drugs treatment of 149 patients, aged 33-87 years. The patient's state was assessed by neurological examination and clinical scales with regard to different disease types, tremor and rigid, and levodopa doses--from moderate (up to 500 mg) to high (above 500 mg). A general treatment policy, including therapy directed to activation of regulatory and compensatory influences and differentiated usage of levodopa and combined therapy with levodopa and dopamine agonists, is presented.

[Clinical features of an early stage of Parkinson's disease]. / Klinicheskie osobennosti techeniia bolezni Parkinsona v rannem periode.

One hundred and forty-nine patients with Parkinson's disease (PD), mean age 66.3 years, have been examined. It was found that the early stage of the disease might include isolated depression, minimal movement disorders and functional compensation, the latter being observed during L-Dopa treatment. In general, the peculiarities of this stage comprise polymorphism of clinical symptoms, predominance of movement disorders over high mental dysfunctions and slow progression of pathological disorders with patient's adaptation to developing defect and reversibility of some dysfunctions under the treatment. The early stage was distinguished also by independence of high mental functions damage on movement disorders severity. More pronounced disturbances were detected in akinetic PD type in the presence of depression in the older patients. Depression may be a prodrome of movement disorders manifestation. The above peculiarities of the early stage are important for early PD diagnosis.

[Levels and molecular heterogeneity of serotonin transporter protein in platelets of patients with different mental diseases: a comparative analysis with the use of monoclonal and polyclonal antibodies]. / Soderzhanie i molekuliarnaia geterogennost' belka--perenoschika serotonina v trombotsitakh bol'nykh s razlichnymi psikhicheskimi zabolevaniiami: sravnitel'nyi analiz s ispol'zovaniem monoklonal'nykh i poliklonal'nykh antitel.

Polyclonal (PAb) and monoclonal (MAb) antibodies to CT2-epitope of the C-terminal fragment of serotonin transporter (SERT) protein were used to study the levels and molecular heterogeneity of platelet SERT in healthy donors and patients with affective (AD) and somatoform (SD) disorders, schizoaffective disorder (SAD) and schizophrenia. SERT was found to exist as high molecular wight (HMW) and low molecular weight (LMW) forms separated after electrophoresis. The levels of HMW and LMW forms of SERT were significantly, decreased in mentally ill patients as compared to healthy individuals. Unlike PAb, horse radish peroxidase (HRP)-conjugated MAbs were more sensitive and specific to SERT and could detect the LMW form of SERT as a duplet protein form with MW about 40 and 43 kDa. The MAb to CT2 C-terminal fragment of SERT conjugated with HRP is considered to be a new valuable tool for further investigation of SERT expression, properties, and posttranslation modification in the controls and in patients with different psychopathology.

[The thrombocytic serotoninergic markers of the efficacy of electroconvulsive therapy in endogenous depressions]. / Trombotsitarnye serotoninergicheskie markery éffektivnosti élektrosudorozhnoi terapii éndogennykh depressii.

The changes of main platelet serotonergic parameters (maximal velocity of 3H-serotonin uptake, Vmax; and density of (3)3H-imipramine binding sites, Bmax) were followed up in 25 endogenously depressed patients before and after electroconvulsive therapy (ECT). It was found a marked decrease in the velocity of 3H-serotonin uptake into platelets (Vmax) from patients before ECT (especially in non-responder group) and the significant increase of Vmax- and Bmax-values after the course of ECT in responders but not in resistant patients (non-responders). The increase of Vmax- and Bmax-values in responders was evidence of the rise of the functional activity serotonin system after treatment. The results evidence about the significance of serotonergic-mechanisms in the therapeutic efficacy of ECT.

[Clinico-epidemiological characteristics of the ambulatory group of elderly patients with endogenous affective psychoses]. / Kliniko-épidemiologicheskaia kharakteristika dispansernogo kontingenta bol'nykh éndogennymi affektivnymi psikhozami pozdnego vozrasta.

The studies were carried out on the basis of the Gerontopsychiatry Center servicing patients aged 60 and more years in one of the districts of Moscow. 163 persons suffering from endogenous affective diseases were identified. The disease prevalence was 3.75 per 1000 population and the incidence 32.2 per 100,000 population. The data were obtained, indicating the rise of the disease prevalence and incidence with age (mainly at the expense of women). In the majority of patients (71.8%), different psychopathological disturbances were detected. 37.4% manifested affective disorders within the structure of the successive disease attack. The number of inpatients was only 4.3%. These data point to the necessity of the development of outpatient specialized forms of gerontopsychiatric assistance.

[Interhemispheric correlations of electric activity of the brain in late depression]. / Mezhpolusharnye sootnosheniia élektricheskoi aktivnosti mozga pri pozdnikh depressiiakh.

A chronometric EEG analysis was made in 60 patients aged 50 to 86 years with affective psychosis in different stages of the depressive phase. It has been demonstrated that the development of depressive conditions gives rise not only to changes in the frequency and amplitude characteristics of the EEG but also in the ratios of interhemispheric asymmetry of the parameters of brain electric activity, attesting to a higher tone of the right hemisphere. This interhemispheric asymmetry was determined to a considerable measure by the presence in the reference EEG of generalized discharges of slow-wave activity. The use of the dipolar analysis of the EEG permitted detecting foci of maximum generation of discharges in the left temporal area and brain stem structures. These areas of generation were preserved after removing the depressive symptomatology with antidepressants. It is suggested that the superstem generators of discharges exert a more appreciable effect on right hemisphere function, which is specified by cortico-diencephalic relations.

[Comparative study of age-related effectiveness of tri- and tetracyclic antidepressants]. / Sravnitel'no-vozrastnoe izuchenie éffektivnosti trekh- i chetyrekhtsiklicheskikh antidepressantov.

A comparative age-associated study of the efficacy and side effects of amitriptyline and maprotyline was carried out in a group of 93 patients over 50. The health status of the patients was assessed with the aid of Hamilton's depression scale and the scale of side effects on days 0, 7 and 28 of the therapy. It has been discovered that on day 28 maprotyline caused a more complete reduction of depressive disorders as compared to amitriptyline. Maprotyline produced a more intensive action on the anxious component of depression. There were differences in the intensity and range of side effects evoked by amitriptyline and maprotyline. Unlike maprotyline, the antidepressive effect of amitriptyline developed in a group of patients over 70, at later stages of the therapy. Therefore, it is more advisable that tetracyclic antidepressants be used for the treatment of senile patients.

[Comparative age-related studies of mono- and bipolar forms of late affective psychoses]. / Sravnitel'no-vozrastnoe issledovanie mono- i bipoliarnykh form techeniia pozdnykh affektivnykh psikhozov.

As many as 38 patients with the bipolar and 70 patients with the monopolar types of affective psychosis manifesting at an age over 45 years were examined. A comparative age-associated examination of the given patients has demonstrated that the differences in the clinical characteristics and regularities of the mono- and bipolar disease forms are age-restricted and can be elucidated more frequently in the involutional period (from 45 to 59 years). In the senile age proper (after 60 years) there is a tendency towards approximation of both the types of late affective psychosis in terms of their main clinical parameters.

[Dynamics of the lipid peroxidation process in the body of patients with manic-depressive psychosis]. / Dinamika protsessov perekisnogo okisleniia lipidov v organizme bol'nykh maniakal'no-depressivnym psikhozom.

Using gas chromatography the authors have studied the time course of lipid peroxidation (LPO) in patients with manic depressive psychosis (a depressive phase) during a course of antidepressive therapy. The results indicate that the levels of LPO in young patients (up to 30 years) with a disease standing of up to 5 years are significantly higher than in age-matched controls whereas with increasing duration of the disease the levels of this parameter decrease and in elderly patients (over 50 years) with a longer duration of the disease (over 15 years) this parameter is significantly lower than in age-matched controls. A decrease of LPO is particularly pronounced in a bipolar course of manic depressive psychosis.

[Gliotrophic effect of the total peptide fraction isolated from the urine of healthy subjects and patients with manic-depressive psychosis]. / Gliotroficheskoe vliianie summarnoi peptidnoi fraktsii, vydelennoi iz mochi zdorovykh liudei i bol'nykh maniakal'no-depressivnym psikhozom.

The authors studied the effect of the total peptide fraction of the urine of healthy donors and patients with manic-depressive psychosis on the development of glioneuronal aggregates of the cerebral cortex cultivated in collagen gel. Urine peptides from the patients dramatically increased the migration and differentiation of glioblasts while the action of healthy donors' peptides was less marked. The growth of neurites under the effect of peptides significantly differed from the control values.

[Activation of lipid peroxidation in the bodies of schizophrenic and manic-depressive patients]. / Aktivatsiia perekisnogo okisleniia lipidov v organizme bol'nykh shizofreniei i maniakal'no-depressivnym psikhozom.

The intensity of lipid peroxidation was studied in schizophrenic and manic-depressive patients. Peroxidation was found to be activated in these diseases as assessed by the content of peroxidation products in the lipid fraction of blood plasma. Manic-depressive patients showed a significant decrease in the intensity of peroxidation processes with improvement in the clinical symptoms of the disease.

[Age factors and patterns in senile depression]. / K voprosu o vozrastnykh zakonomernostiakh depressii pozdnego vozrasta.

On the basis of a comparative age-specific analysis of 115 patients with depression which first manifested itself at the age over 60, the author shows the dependence of a number of clinical characteristics (typology of manifest attacks, their duration, as well as the likelihood of the development of individual nosological forms of affective psychoses) on the age at which the disease first manifested itself. The nature of the modifying effect of the age factor on the clinical manifestations of late-age depression is discussed.

[International clinico-pharmacokinetic study of individual predictions of the therapeutic effect of leponex (methodology and organization)]. / Mezhdunarodnoe kliniko-farmakokineticheskoe issledovanie individual'noi prediktsii terapevticheskogo éffekta leponeksa (metodologiia i organizatsiia).

Multicentre international studies make it possible to amass rapidly and reliably the necessary amount of representative data allowing for the verification of the results obtained by different scientific schools. They also represent the most effective approach to the search for attaining the mutual understanding among specialists of different scientific schools and for the elaboration of uniform clinical outlooks . Guidelines were developed to be adhered to while organizing and conducting multicentre psychopharmacological studies. The authors describe the general scheme and the basic stages of a multicentre psychopharmacological study of leponex which involved specialists from ten centres from six countries (CSSR, GDR, HPR, PRB , PPR, USSR).

[Paranoid disorders in the debut and further course of late schizophrenia]. / Paranoiial'nye rasstroistva v debiute i dal'neishem techenii pozdnei shizofrenii.

A study of 60 schizophrenic patients permitted to clinically analyze the state of late paranoic psychoses, which is difficult for differential diagnosis due to pronounced age syndromological atypicity. The allocation of these prevalently slowly progressive forms to late schizophrenia is based on studies of the regularity of the disease, particular clinico-psychopathological traits of the paranoic syndrome as well as on the hereditary loading data, premorbid traits and signs of mental abnormality in the past. The data obtained indicate a relationship between pronounced age atypicity of the psychoses and the degree of progression of the schizophrenic process.

[So-called small-scope delusions]. / O tak nazyvaemom brede malogo razmakha.

Analysis of psychopathological traits of the paranoiac syndrome in 60 patients with late schizophrenia permitted to distinguish certan signs which can be allocated to the differentiation of late schizophrenia from other delusional psychoses in the elderly. The following differential signs were underlined: initial symptoms, such as rudimentary cenesthopathia, stable insomnia, etc., preceding the formation of delusions; appearance of episodic exacerbations in the form of short-time acute paranoiac states; a combination of paranoiac delusion with stable phasic affective disorders; unusual possession of delusional patients expressed in bizarre delusional behaviour, etc. Using this example as a model, the necessity of further profound and differentiated psychopathological studies of syndromes distinguished as predilective for old age is indicated.