132 research outputs found
Arguments for equipping ΠΠ’-75Π tractor carriage with recuperative elements by means of mathematical simulation
By means of simulation dynamic model of a forest tillage machine the possibility of equipping ΠΠ’-75 Π tractor carriage with recuperative elements has been studied. In this case energy extraction in each carriage does not worsen vibration spectrum of tractor case up to 0,7 kW
Migraine and neck pain: Mechanisms of comorbidity
Neck pain and migraine are common diseases. Neck pain seldom occurs in a patient with migraine. However, the relationship between migraineΒ and neck pain has been inadequately investigated.Objective: to analyze neck pain in patients with migraine to determine possible comorbidity mechanisms of these diseases.Patients and methods. The investigation enrolled 63 patients with chronic migraine (CM) and 40 with episodic migraine (EM) diagnosed inΒ accordance with the International Classification of Headache Disorders, 3rd edition (ICHD-3). Winking reflex (WR) and nociceptive flexionΒ reflex (NFR) were examined to evaluate the function of antinociceptive systems.Results. In the patients with CM, neck pain was more common than in those with EM (53.03% versus 14.02%); and panful tenderness, sensitivity,Β and tension of neck muscles were more marked. There was also a significant reduction in WR and NFR thresholds. Neck pain was notedΒ to be an integral component of the pathogenesis of CM in a large number of patients with this condition. The authors proposed several pathophysiologicalΒ mechanisms of a relationship between migraine and neck pain. Neck muscles and craniovertebral junction areas serve as a sourceΒ for the arrival of nociceptive pain pulses in the central nervous system (peripheral sensitization), promoting pain chronization. Muscle dysfunctionΒ in this area may be, in turn, a reflection of central sensitization and impaired descending pain control
Depression is not the only cause of cognitive impairment in chronic migraine
Background.Β Patients with the chronic migraine frequently present with memory and attention complaints. However, the prevalence and phenotype of such impairment in chronic migraine have not been studied.ObjectiveΒ β to evaluate the prevalence of the objective cognitive deficit in patients with chronic migraine and factors underlying its etiology.Β Materials and methods.Β We recruited 62 subjects with chronic migraine and 36 genderand age-matched controls with low-frequency episodic migraine (not more, then 4 headache days per month) aged 18β59. All patients filled in the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20).Results.Β In this study 58 % of patients with chronic migraine complained of memory loss. Cognitive impairment was also found with PDQ-20. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rate. In 40 % of subjects with chronic migraine scored lower than 26 points on MoCA. Patients with chronic migraine more frequently had lower DSST rates as compared to episodic migraine (odds ratio 5.07 (95 % confidence interval β 1.59β16.17); p = 0.003). Depression and anxiety did not correlate with performance on cognitive tests. Chronic migraine (frequent headache) and longer headache history, but not depression, anxiety or medication overuse were independent predictors of cognitive impairment.Conclusion. Subjective and objective cognitive deficits are prevalent in the chronic migraine population. Most often memory and attention are impaired. Longer headache history and presence of chronic migraine are independent risk factors for cognitive impairment in patients with chronic migraine
Molecular Principles of Gene Fusion Mediated Rewiring of Protein Interaction Networks in Cancer
Gene fusions are common cancer-causing mutations, but the molecular principles by which fusion protein products affect interaction networks and cause disease are not well understood. Here, we perform an integrative analysis of the structural, interactomic, and regulatory properties of thousands of putative fusion proteins. We demonstrate that genes that form fusions (i.e., parent genes) tend to be highly connected hub genes, whose protein products are enriched in structured and disordered interaction-mediating features. Fusion often results in the loss of these parental features and the depletion of regulatory sites such as post-translational modifications. Fusion products disproportionately connect proteins that did not previously interact in the protein interaction network. In this manner, fusion products can escape cellular regulation and constitutively rewire protein interaction networks. We suggest that the deregulation of central, interaction-prone proteins may represent a widespread mechanism by which fusion proteins alter the topology of cellular signaling pathways and promote cancer
Current status of the temperature and humidity regime of the troposphere in the Siberian sector in different circulation periods
The paper studies the long-term dynamics of air temperature and relative humidity anomaly indices in the surface layer and at different levels of the troposphere in Siberia and neighboring regions (European and Far Eastern sectors). As the main cause of the observed variations in climatic parameters we considered circulation factors, which were taken into account using the typification of macrocirculation processes proposed by B.L. Dzerdzeevsky. Seasonal differences were revealed in the distribution of anomaly indices and the area occupied by anomalies of different signs of annual and monthly mean temperature and relative air humidity, which are most pronounced during circulation periods of increased duration of meridional northern processes in the Siberian sector and in the Northern Hemisphere as a whole. The highest rates of change in the temperature regime in the Siberian sector over recent decades have been observed at the level of the isobaric surface ATβ700 hPa (3 km), which affects the advective-dynamic factors of surface cyclo- and frontogenesis, as well as the processes of cloud formation and precipitation. In general, an increase in the heat content of the lower and middle troposphere and a decrease in the relative moisture content near the tropopause can be accompanied by an increase in the amount of the potential energy and convective instability energy reserves and can lead to an increase in climate risks in the Siberian sector
ΠΠ°ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠ°ΠΌΡΡΠΈ ΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ
Background.Β Memory and attention deficits are prevalent in the chronic pain population. There are multiple common mechanisms in chronic pain and cognitive impairment. However, the presence, prevalence and clinical burden of such impairment are frequently underestimated.Objective:Β to evaluate subjective and objective cognitive deficits in patients with chronic migraine (CM).Materials and methods.Β We recruited 53 subjects with CM and 22 genderand age-matched controls with low-frequency episodic migraine (a maximum of 4 headache days per month) aged 18β59. All patients filled in the HADS (Hospital Anxiety and Depression Scale) anxiety and depression scale and Pittsburg Sleep Quality Inventory (PSQI). Cognitive function was assessed with Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT) and the Perceived Deficits Questionnaire (PDQ-20).Results.Β 56 % of patients with CM complained of memory problems. Decreased cognitive function was also observed during self-assessment using the PDQ-20 questionnaire. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rates. 44 % of subjects with CM scored lower than 26 points on MoCA. Most frequently we found impairments in attention (75 %), memory/delayed recall (50 %), language (50 %) and executive function (37 %). Depression and sleep quality correlated with only several parameters of cognitive tests.Conclusion.Β Subjective and objective cognitive deficits are prevalent in the CM population. Most often memory and attention are impaired. Cognitive complaints need to be carefully assessed, and treatment of such impairment may improve quality of life and decrease disability in CM.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅.Β ΠΠ°ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠ°ΠΌΡΡΠΈ ΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ ΡΠΈΡΠΎΠΊΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Ρ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»ΡΡ. ΠΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Ρ ΠΈΠΌΠ΅ΡΡ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²ΠΎ ΠΎΠ±ΡΠΈΡ
ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ². Π ΡΠΎ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ Π½Π°Π»ΠΈΡΠΈΠ΅, ΡΠ°ΡΡΠΎΡΠ° Π²ΡΡΡΠ΅ΡΠ°Π΅ΠΌΠΎΡΡΠΈ ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΡΡΠΈΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Π·Π°ΡΠ°ΡΡΡΡ Π½Π΅Π΄ΠΎΠΎΡΠ΅Π½ΠΈΠ²Π°ΡΡΡΡ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΒ β ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΡΡΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΈ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ² Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ (Π₯Π).Β ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ.Β Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠ½ΡΠ»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 53 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ Π₯Π ΠΈ 22 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ ΡΠ΅Π΄ΠΊΠΎΠΉ ΡΠΏΠΈΠ·ΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ (Π³ΠΎΠ»ΠΎΠ²Π½Π°Ρ Π±ΠΎΠ»Ρ Π½Π΅ Π±ΠΎΠ»Π΅Π΅ 4 Π΄Π½Π΅ΠΉ Π² ΠΌΠ΅ΡΡΡ) Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 18β59 Π»Π΅Ρ, ΠΏΠΎΠ΄ΠΎΠ±ΡΠ°Π½Π½ΡΡ
ΠΏΠΎ ΠΏΠΎΠ»Ρ ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΡ. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅: ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊ Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ, Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½Π°Ρ ΡΠΊΠ°Π»Π° ΡΡΠ΅Π²ΠΎΠ³ΠΈ ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ HADS (Hospital Anxiety and Depression Scale), ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊ Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π½ΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ½Π° PSQI (Pittsburg Sleep Quality Inventory). Π’Π°ΠΊΠΆΠ΅ Π²ΡΠ΅ΠΌ ΡΡΠ°ΡΡΠ½ΠΈΠΊΠ°ΠΌ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΠΎΠ½ΡΠ΅Π°Π»ΡΡΠΊΠΎΠΉ ΡΠΊΠ°Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ MoCA (Montreal Cognitive Assessment), ΡΠ΅ΡΡΠ° Π·Π°ΠΌΠ΅Π½Ρ ΡΠΈΡΡΠΎΠ²ΡΡ
ΡΠΈΠΌΠ²ΠΎΠ»ΠΎΠ² DSST (Digital Symbol Substitution Test), ΡΠ΅ΡΡΠ° Π Π΅Ρ Π½Π° ΡΠ»ΡΡ
ΠΎΡΠ΅ΡΠ΅Π²ΠΎΠ΅ Π·Π°ΡΡΠΈΠ²Π°Π½ΠΈΠ΅ RAVLT (Rey Auditory Verbal Learning Test) ΠΈ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° Π²ΠΎΡΠΏΡΠΈΠ½ΠΈΠΌΠ°Π΅ΠΌΠΎΠ³ΠΎ Π΄Π΅ΡΠΈΡΠΈΡΠ° PDQ-20 (Perceived Deficits Questionnaire).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ.Β ΠΠ°Π»ΠΎΠ±Ρ Π½Π° Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΠΌΡΡΠΈ ΠΏΡΠ΅Π΄ΡΡΠ²Π»ΡΠ»ΠΈ 56 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π₯Π. Π‘Π½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ ΡΠ°ΠΊΠΆΠ΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΠΏΡΠΈ ΡΠ°ΠΌΠΎΠΎΡΠ΅Π½ΠΊΠ΅ ΠΏΠΎ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΡ PDQ-20. ΠΡΠΈ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ Π² Π³ΡΡΠΏΠΏΠ΅ Π₯Π ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ΅ΡΡΠ° DSST, ΠΎΠ±ΡΠ΅Π³ΠΎ ΡΠΈΡΠ»Π° Π·Π°ΠΏΠΎΠΌΠ½Π΅Π½Π½ΡΡ
ΡΠ»ΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ. Π£ 44 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π₯Π Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½Ρ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π° ΠΏΠΎ ΡΠΊΠ°Π»Π΅ MΠΎCA. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠΌΠΌΡ Π±Π°Π»Π»ΠΎΠ² ΠΏΠΎ ΡΠΊΠ°Π»Π΅ MoCA Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΎΡΡ ΠΏΠΎ ΡΡΠ½ΠΊΡΠΈΡΠΌ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ (75 %), ΠΏΠ°ΠΌΡΡΠΈ/ΠΎΡΡΡΠΎΡΠ΅Π½Π½ΠΎΠ³ΠΎ Π²ΠΎΡΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½ΠΈΡ (50 %), ΡΠ΅ΡΠΈ (50 %) ΠΈ ΠΈΡΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ (37 %). ΠΡΠΌΠ΅ΡΠ΅Π½Π° ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΡ ΡΡΠΎΠ²Π½Ρ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΡΠ½Π° Π»ΠΈΡΡ Ρ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΠΌΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌΠΈ ΡΠ΅ΡΡΠΎΠ² ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅.Β Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π₯Π Π²ΡΡΠ²Π»Π΅Π½Π° Π²ΡΡΠΎΠΊΠ°Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΡΡΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
(56 %) ΠΈ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
(44 %) Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ. Π ΠΏΠ΅ΡΠ²ΡΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ ΠΎΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΠΌΡΡΠΈ ΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ. ΠΠ΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΎΠ±ΡΠ°ΡΠ°ΡΡ ΠΎΡΠΎΠ±ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π½Π° ΠΏΡΠ΅Π΄ΡΡΠ²Π»ΡΠ΅ΠΌΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌΠΈ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠΈΠ΅ ΠΆΠ°Π»ΠΎΠ±Ρ, Π° ΡΠ΅ΡΠ°ΠΏΠΈΡ Π΄Π°Π½Π½ΡΡ
ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ² ΠΌΠΎΠΆΠ΅Ρ ΠΏΠΎΠ²ΡΡΠΈΡΡ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΆΠΈΠ·Π½ΠΈ ΠΈ ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π₯Π
ΠΠ΅ΠΏΡΠ΅ΡΡΠΈΡ β Π½Π΅ Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½Π½Π°Ρ ΠΏΡΠΈΡΠΈΠ½Π° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ
Background.Β Patients with the chronic migraine frequently present with memory and attention complaints. However, the prevalence and phenotype of such impairment in chronic migraine have not been studied.ObjectiveΒ β to evaluate the prevalence of the objective cognitive deficit in patients with chronic migraine and factors underlying its etiology.Β Materials and methods.Β We recruited 62 subjects with chronic migraine and 36 genderand age-matched controls with low-frequency episodic migraine (not more, then 4 headache days per month) aged 18β59. All patients filled in the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20).Results.Β In this study 58 % of patients with chronic migraine complained of memory loss. Cognitive impairment was also found with PDQ-20. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rate. In 40 % of subjects with chronic migraine scored lower than 26 points on MoCA. Patients with chronic migraine more frequently had lower DSST rates as compared to episodic migraine (odds ratio 5.07 (95 % confidence interval β 1.59β16.17); p = 0.003). Depression and anxiety did not correlate with performance on cognitive tests. Chronic migraine (frequent headache) and longer headache history, but not depression, anxiety or medication overuse were independent predictors of cognitive impairment.Conclusion. Subjective and objective cognitive deficits are prevalent in the chronic migraine population. Most often memory and attention are impaired. Longer headache history and presence of chronic migraine are independent risk factors for cognitive impairment in patients with chronic migraine.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅.Β ΠΠ°Π»ΠΎΠ±Ρ Π½Π° ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΠΌΡΡΠΈ ΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ ΡΠΈΡΠΎΠΊΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Ρ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. ΠΡΠΈ ΡΡΠΎΠΌ ΡΠ°ΡΡΠΎΡΠ° Π²ΡΡΡΠ΅ΡΠ°Π΅ΠΌΠΎΡΡΠΈΒ ΠΈ ΡΡΡΡΠΊΡΡΡΠ° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΏΡΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΠΈ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈ Π½Π΅ ΠΈΠ·ΡΡΠ΅Π½Ρ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ βΒ ΠΈΠ·ΡΡΠΈΡΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΡΠΊΡΡΡΡ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ°ΠΊΡΠΎΡΠΎΠ², ΠΈΠΌΠ΅ΡΡΠΈΡ
Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π΄Π»Ρ ΠΈΡ
ΡΠ°Π·Π²ΠΈΡΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ.Β Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΡΠΈΠ½ΡΠ»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 62 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ ΠΈ 36 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅Π΄ΠΊΠΎΠΉ ΡΠΏΠΈΠ·ΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ (Π½Π΅ Π±ΠΎΠ»Π΅Π΅ 4 Π΄Π½Π΅ΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠΉ Π±ΠΎΠ»ΠΈ Π² ΠΌΠ΅ΡΡΡ) Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 18 Π΄ΠΎ 59 Π»Π΅Ρ, ΠΏΠΎΠ΄ΠΎΠ±ΡΠ°Π½Π½ΡΡ
ΠΏΠΎ ΠΏΠΎΠ»Ρ ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΡ. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΎΠ²Π΅Π»ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊ, Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Ρ ΡΡΠ΅Π²ΠΎΠ³ΠΈ ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ (Hospital Anxiety and Depression Scale, HADS), ΡΠΊΠ°Π»Ρ Π½Π΅ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ Π¨ΠΈΡ
Π°Π½Π° (Sheehan Disability Scale). Π’Π°ΠΊΠΆΠ΅ Π²ΡΠ΅ΠΌ ΡΡΠ°ΡΡΠ½ΠΈΠΊΠ°ΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ²Π΅Π»ΠΈ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ ΠΏΡΠΈ ΠΏΠΎΠΌΠΎΡΠΈ ΠΠΎΠ½ΡΠ΅Π°Π»ΡΡΠΊΠΎΠΉ ΡΠΊΠ°Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ (Montreal Cognitive Assessment, MoCA), ΡΠ΅ΡΡΠ° Π·Π°ΠΌΠ΅Π½Ρ ΡΠΈΡΡΠΎΠ²ΡΡ
ΡΠΈΠΌΠ²ΠΎΠ»ΠΎΠ² (Digital Symbol Substitution Test, DSST), ΡΠ΅ΡΡΠ° Π Π΅Ρ Π½Π° ΡΠ»ΡΡ
ΠΎΡΠ΅ΡΠ΅Π²ΠΎΠ΅ Π·Π°ΡΡΠΈΠ²Π°Π½ΠΈΠ΅ (Rey Auditory Verbal Learning Test, RAVLT) ΠΈ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° Π²ΠΎΡΠΏΡΠΈΠ½ΠΈΠΌΠ°Π΅ΠΌΠΎΠ³ΠΎ Π΄Π΅ΡΠΈΡΠΈΡΠ° (Perceived Deficits Questionnaire, PDQ-20).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ.Β Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ 58 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ ΠΏΡΠ΅Π΄ΡΡΠ²Π»ΡΠ»ΠΈ ΠΆΠ°Π»ΠΎΠ±Ρ Π½Π° Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΏΠ°ΠΌΡΡΠΈ. Π‘Π½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ ΡΠ°ΠΊΠΆΠ΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ ΠΏΡΠΈ ΡΠ°ΠΌΠΎΠΎΡΠ΅Π½ΠΊΠ΅ ΠΏΠΎ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΡ PDQ-20. ΠΡΠΈ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π² Π³ΡΡΠΏΠΏΠ΅ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΠΈ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΡΠ΅ΡΡΠ° DSST, ΠΎΠ±ΡΠ΅Π³ΠΎ ΡΠΈΡΠ»Π° Π·Π°ΠΏΠΎΠΌΠΈΠ½Π°Π΅ΠΌΡΡ
ΡΠ»ΠΎΠ², Π° ΡΠ°ΠΊΠΆΠ΅ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ. ΠΠ΅ΡΠΎΡΡΠ½ΠΎΡΡΡ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ° ΠΏΠΎ ΡΠ΅ΡΡΡ DSST ΠΏΡΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΠΈ Π±ΡΠ»Π° Π·Π½Π°ΡΠΈΠΌΠΎ Π²ΡΡΠ΅ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΡΠΏΠΈΠ·ΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ (ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ ΡΠ°Π½ΡΠΎΠ² 5,07 (95 % Π΄ΠΎΠ²Π΅ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΈΠ½ΡΠ΅ΡΠ²Π°Π» 1,59β16,17); p = 0,003). Π£ 40 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π° ΠΏΠΎ ΡΠΊΠ°Π»Π΅ MΠΎCA. ΠΠ΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½Π° ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΡ ΡΡΠΎΠ²Π½Ρ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ ΠΈ ΡΡΠ΅Π²ΠΎΠ³ΠΈ Ρ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ ΡΠ΅ΡΡΠΎΠ² ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ. ΠΠ°Π»ΠΈΡΠΈΠ΅ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΠΈ (ΡΠ°ΡΡΠΎΠΉ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠΉ Π±ΠΎΠ»ΠΈ) ΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ Π°Π½Π°ΠΌΠ½Π΅Π·Π° ΡΠ΅ΡΠ°Π»Π³ΠΈΠΈ (Π½ΠΎ Π½Π΅ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΡ) ΡΡΠ΅Π²ΠΎΠ³Π° ΠΈ Π·Π»ΠΎΡΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΠ΅ Π°Π½Π°Π»ΡΠ³Π΅ΡΠΈΠΊΠ°ΠΌΠΈ ΡΠ²Π»ΡΡΡΡΡ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ.ΠΡΠ²ΠΎΠ΄Ρ. Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ ΠΎΡΠΌΠ΅ΡΠ΅Π½Π° Π²ΡΡΠΎΠΊΠ°Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΡΡΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΈ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ, Π² ΠΏΠ΅ΡΠ²ΡΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΠ°ΠΌΡΡΠΈ ΠΈ Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ. ΠΠ»ΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π°Π½Π°ΠΌΠ½Π΅Π· Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠΉ Π±ΠΎΠ»ΠΈ ΠΈ Π½Π°Π»ΠΈΡΠΈΠ΅ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΠΈ ΡΠ²Π»ΡΡΡΡΡ Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΌΠΈΠ³ΡΠ΅Π½ΡΡ
Π₯ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Ρ, Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΡ ΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ: ΡΠ΅ΡΠ½ΡΠ΅ Π²Π·Π°ΠΈΠΌΠΎΡΠ²ΡΠ·ΠΈ
Over a half of chronic pain (CP) patients present with cognitive complaints, which increase their disability and impact quality of life. The paper reviews objective impairments in memory, attention, processing speed and executive function demonstrated in the CP population. The paper also reviews common pathology underlying cognitive impairment and CP: neuroplasticity in the shared brain areas, neurotransmitter and other molecular mechanisms. Common mechanisms in CP and depression precipitating cognitive impairment are also discussed. The paper also compares the potential of different antidepressants to improve cognitive functions in depression and CP.ΠΠΎΠ»Π΅Π΅ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»ΡΡ (Π₯Π) ΠΏΡΠ΅Π΄ΡΡΠ²Π»ΡΡΡ ΠΆΠ°Π»ΠΎΠ±Ρ Π½Π° ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ (ΠΠ), ΠΊΠΎΡΠΎΡΡΠ΅ cΠ½ΠΈΠΆΠ°ΡΡΒ ΠΈΡ
ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΆΠΈΠ·Π½ΠΈ. Π ΡΡΠ°ΡΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΠΎΠ±Π·ΠΎΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ, ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π²ΡΠΈΡ
ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠ°ΠΌΡΡΠΈ, Π²Π½ΠΈΠΌΠ°Π½ΠΈΡ, ΡΠΊΠΎΡΠΎΡΡΠΈ ΠΌΡΡΠ»Π΅Π½ΠΈΡ ΠΈ ΠΈΡΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΏΡΠΈ Π₯Π. Π’Π°ΠΊΠΆΠ΅ ΠΎΠ±ΡΡΠΆΠ΄Π°ΡΡΡΡ ΠΎΠ±ΡΠΈΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π° ΠΠ ΠΈ Π₯Π: Π½Π΅ΠΉΡΠΎΠΏΠ»Π°ΡΡΠΈΡΠ½ΠΎΡΡΡ Π² ΠΎΠ±ΡΠΈΡ
Π·ΠΎΠ½Π°Ρ
Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°, Π½Π΅ΠΉΡΠΎΠΌΠ΅Π΄ΠΈΠ°ΡΠΎΡΠ½ΡΠ΅ ΠΈ Π΄ΡΡΠ³ΠΈΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΠΎΠ±Π·ΠΎΡ ΠΎΠ±ΡΠΈΡ
ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ, Π₯Π ΠΈ ΠΠ. Π’Π°ΠΊΠΆΠ΅ ΠΏΡΠΈΠ²Π΅Π΄Π΅Π½ΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π°Π½ΡΠΈΠ΄Π΅ΠΏΡΠ΅ΡΡΠ°Π½ΡΠΎΠ² Π² ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΠΠ ΠΏΡΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ ΠΈ Π₯Π
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