СОВЕРШЕНСТВОВАНИЕ ОБСЛЕДОВАНИЯ ЗРИТЕЛЬНОГО АНАЛИЗАТОРА ПРИ РАССЕЯННОМ СКЛЕРОЗЕ

137 (274 eyes) relapsing-remitting multiple sclerosis patients have been given detailed neuroophthalmologic examination. 58 of these patients (74 eyes) had a previous history of optic neuritis. As a result, the most informative methods of examination have been identified. These include the estimation of the frequency characteristics of the vision (vizokontrastoperimetriya, low-contrast tests Sloan), standard static automated perimetry, pattern visual evoked potentials, and optical coherence tomography which is used to measure macular volumes and retinal nerve fiber layer thickness. The above – mentioned methods make it possible to reveal the involvement of the optic analyzer in the inflammatory and neurodegenerative process at the pre-clinical stage. The obtained results allow us to recommend inclusion of the methods in the standard algorithm for the examination of patients with probable multiple sclerosis. Проведено детальное нейроофтальмологическое обследование 137 пациентов с рецидивирующеремиттирующей формой рассеянного склероза (274 глаза). Из них 58 пациентов (74 глаза) имели в анамнезе оптический неврит. Были определены наиболее информативные методы обследования, позволяющие еще на доклинической стадии выявить вовлечение зрительного анализатора в воспалительный и нейродегенеративный процессы: оценка частотных характеристик органа зрения (визоконтрастопериметрия, низкоконтрастные таблицы Слоан), статическая автоматизированная периметрия, зрительные вызванные потенциалы на шахматный паттерн, оптическая когерентная томография для определения толщины слоя нервных волокон сетчатки. Полученные результаты позволяют рекомендовать их включение в стандартный алгоритм обследования больных с вероятным рассеянным склерозом.

Memantine increases NMDA receptor level in the prefrontal cortex but fails to reverse apomorphine-induced conditioned place preference in rats

Studies have shown that inflammation and neurodegeneration may accompany the development of addiction to apomorphine and that the glutamate NMDA receptor antagonist, memantine, may be neuroprotective. The similarity between apomorphine and dopamine with regard to their chemical, pharmacological and toxicological properties provided a basis for investigating the mechanism of action of the former agent. In this study, we investigated whether memantine would suppress apomorphine-seeking behavior in rats subjected to apomorphine-induced place preference conditioning, through modulation of NMDA receptors in the prefrontal cortex. Repeated apomorphine (1 mg/kg) treatment induced conditioned place preference (CPP) and had no significant effect on NMDA receptor levels in the prefrontal cortex. Prior treatment with memantine (5 mg/kg or 10 mg/kg) increased the levels of NMDA receptors in the prefrontal cortex but did not suppress CPP induced by apomorphine. These data give further support to the addictive effect of apomorphine and demonstrate that blockade of NMDA receptors by memantine is unable to suppress apomorphine-seeking behavior

Neuroimaging in anxiety disorders

Neuroimaging studies have gained increasing importance in validating neurobiological network hypotheses for anxiety disorders. Functional imaging procedures and radioligand binding studies in healthy subjects and in patients with anxiety disorders provide growing evidence of the existence of a complex anxiety network, including limbic, brainstem, temporal, and prefrontal cortical regions. Obviously, “normal anxiety” does not equal “pathological anxiety” although many phenomena are evident in healthy subjects, however to a lower extent. Differential effects of distinct brain regions and lateralization phenomena in different anxiety disorders are mentioned. An overview of neuroimaging investigations in anxiety disorders is given after a brief summary of results from healthy volunteers. Concluding implications for future research are made by the authors

Non-nociceptive roles of opioids in the CNS: opioids' effects on neurogenesis, learning, memory and affect.

Mortality due to opioid use has grown to the point where, for the first time in history, opioid-related deaths exceed those caused by car accidents in many states in the United States. Changes in the prescribing of opioids for pain and the illicit use of fentanyl (and derivatives) have contributed to the current epidemic. Less known is the impact of opioids on hippocampal neurogenesis, the functional manipulation of which may improve the deleterious effects of opioid use. We provide new insights into how the dysregulation of neurogenesis by opioids can modify learning and affect, mood and emotions, processes that have been well accepted to motivate addictive behaviours

The role of impulsivity in the aetiology of drug dependence: reward sensitivity versus automaticity

Journal ArticleResearch Support, Non-U.S. Gov'tCopyright © The Author(s) 2011.RATIONALE: Impulsivity has long been known as a risk factor for drug dependence, but the mechanisms underpinning this association are unclear. Impulsivity may confer hypersensitivity to drug reinforcement which establishes higher rates of instrumental drug-seeking and drug-taking behaviour, or may confer a propensity for automatic (non-intentional) control over drug-seeking/taking and thus intransigence to clinical intervention. METHOD: The current study sought to distinguish these two accounts by measuring Barratt Impulsivity and craving to smoke in 100 smokers prior to their completion of an instrumental concurrent choice task for tobacco (to measure the rate of drug-seeking) and an ad libitum smoking test (to measure the rate of drug-taking-number of puffs consumed). RESULTS: The results showed that impulsivity was not associated with higher rates of drug-seeking/taking, but individual differences in smoking uptake and craving were. Rather, nonplanning impulsivity moderated (decreased) the relationship between craving and drug-taking, but not drug-seeking. CONCLUSIONS: These data suggest that whereas the uptake of drug use is mediated by hypervaluation of the drug as an instrumental goal, the orthogonal trait nonplanning impulsivity confers a propensity for automatic control over well-practiced drug-taking behaviour.MR

New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What has been Investigated and What is in the Pipeline?

A wide range of support is available to help smokers to quit and aid attempts at harm reduction, including three first-line smoking cessation medications: nicotine replacement therapy, varenicline and bupropion. Despite the efficacy of these, there is a continual need to diversify the range of medications so that the needs of tobacco users are met. This paper compares the first-line smoking cessation medications to: 1) two variants of these existing products: new galenic formulations of varenicline and novel nicotine delivery devices; and 2) twenty-four alternative products: cytisine (novel outside of central and eastern Europe), nortriptyline, other tricyclic antidepressants, electronic cigarettes, clonidine (an anxiolytic), other anxiolytics (e.g. buspirone), selective 5-hydroxytryptamine (5-HT) reuptake inhibitors, supplements (e.g. St John’s wort), silver acetate, nicobrevin, modafinil, venlafaxine, monoamine oxidase inhibitors (MAOI), opioid antagonist, nicotinic acetylcholine receptors (nAChR) antagonists, glucose tablets, selective cannabinoid type 1 receptor antagonists, nicotine vaccines, drugs that affect gamma-aminobutyric acid (GABA) transmission, drugs that affect N-methyl-D-aspartate receptors (NMDA), dopamine agonists (e.g. levodopa), pioglitazone (Actos; OMS405), noradrenaline reuptake inhibitors, and the weight management drug lorcaserin. Six criteria are used: relative efficacy, relative safety, relative cost, relative use (overall impact of effective medication use), relative scope (ability to serve new groups of patients), and relative ease of use (ESCUSE). Many of these products are in the early stages of clinical trials, however, cytisine looks most promising in having established efficacy and safety and being of low cost. Electronic cigarettes have become very popular, appear to be efficacious and are safer than smoking, but issues of continued dependence and possible harms need to be considered

Balo's concentric sclerosis: a clinical case

This paper describes a case of Balo's concentric sclerosis, a rare demyelinating disease of the central nervous system (CNS), which is currently classified as multiple sclerosis. In recent years, there has been a more favorable clinical course of Balo's sclerosis. The significant polymorphism of clinical manifestations of the disease, its neuroimaging pattern, and laboratory tests cause difficulties diagnosing this pathology. Its differentiation with CNS tumors presents a particular challenge. So it also happens in the described clinical case, when computed tomography revealed the signs of space-occupying lesion, the histological pattern of concentric focus biopsy specimen indicated the presence of protoplasmic astrocytoma. However, immunohistochemical analyses of the biopsy specimen, immunological examination of cerebrospinal fluid, as well as the typical magnetic resonance imaging changes of Balo's sclerosis could suggest the demyelinating nature of the pathological process. The article shows that immunohistochemical techniques for examining a brain biopsy specimen and immunological assays of blood and cerebrospinal fluid are of great diagnostic value

Взаимосвязь между вирусом SARS-COV-2 и аутоиммунными неврологическими заболеваниями

Since the onset of the SARS-CoV-2 infection, there has been an increase in the number of reports of patients who have experienced the development of autoimmune neurological disorders. It is assumed that such an increase in the incidence rate may occur due to an abnormal immune-mediated response of the body to the pathogenic impact of SARS-CoV-2. This article discusses the possibility of the influence of SARS-CoV-2 on the onset and exacerbation of the course of autoimmune neurological disorders, possible pathogenetic factors and mechanisms, and analyzes the features of the clinical picture and therapy. The article includes foreign and Russian scientific data and clinical observations of cases of Guillain-Barré syndrome, multiple sclerosis, acute disseminated encephalomyelitis, myasthenia gravis and other autoimmune diseases that have changed their typical course on the background of COVID-19.С начала массового распространения инфекции, вызванной вирусом SARS-CoV-2, возросло количество сообщений об увеличении частоты аутоиммунных неврологических расстройств. Предполагается, что подобное повышение уровня заболеваемости может возникать вследствие аномального иммуноопосредованного ответа организма на патогенное воздействие SARS-CoV-2. В данной статье рассматривается возможность влияния вируса SARS-CoV-2 на возникновение и обострение течения аутоиммунных неврологических расстройств, обсуждаются возможные патогенетические факторы и механизмы, анализируются особенности клинической картины и терапии. Представлены зарубежные и российские научные данные, клинические наблюдения случаев синдрома Гийена – Барре, рассеянного склероза, острого диссеминированного энцефаломиелита, миастении и других аутоиммунных заболеваний, возникших или изменивших свое типичное течение на фоне COVID-19