АУТОИММУННЫЕ ЗАБОЛЕВАНИЯ НЕРВНОЙ СИСТЕМЫ: СОСТОЯНИЕ ПРОБЛЕМЫ И ПЕРСПЕКТИВЫ

This review highlights the achievements in the field of autoimmune diseases of the nervous system over the last 15 years. It became possible to deepen the understanding of medical and social significance of these diseases, form the concept of nosologic unit heterogeneity, describe new and atypical forms of demyelinating diseases of the central and peripheral nervous system, autoimmune diseases of the neuromuscular synapse. Also, it is important to mention, that the new antigens were identified, the diagnostic panel of autoantibodies was developed and put into practice. Furthermore, the clinical practice guidelines for the diagnosis and management of patients were developed, the new drugs were tested and included in these guidelines. The scientists of the biggest Russian neurological centre, Research Centre of Neurology (Moscow), developed a vaccine for immunotherapy of multiple sclerosis, studied pathomorphosis of Guillain–Barre syndrome, specified the components of its pathogenesis, improved the programs of pathogenetic therapy, which led to the decrease in mortality from 30 to 3%, helped to decrease the AVL period by 2 times, hasten the recovery of independent walking by 2.5 times. Nowadays different biomarkers of diseases of the central and peripheral nervous system are studied and modern technologies in neurorehabilitation are applied. В статье освещены достигнутые за последние 15 лет результаты в области аутоиммунных заболеваний нервной системы: укрепилось понимание медико-социальной значимости этих болезней, сформировалась концепция гетерогенности нозологических единиц, описаны новые и атипичные формы демиелинизирующих заболеваний центральной и периферической нервной системы, аутоиммунных болезней нервно-мышечного синапса. Идентифицированы новые антигены, разработаны и внедрены в практику диагностические панели аутоантител. Сформулированы клинические рекомендации по диагностике и ведению, апробированы и включены в стандарты новые лекарственные препараты. В крупнейшем неврологическом центре России, Научном центре неврологии (Москва), разработана вакцина для иммунотерапии рассеянного склероза, исследуются биомаркеры болезней центральной и периферической нервной системы, внедряются современные технологии реабилитации. Приоритетными достижениями являются изучение патоморфоза синдрома Гийена–Барре, детализация звеньев патогенеза, совершенствование программы патогенетической терапии, позволившей снизить летальность с 30 до 3%, сократить в 2 раза сроки пребывания на искусственной вентиляции легких и в 2,5 раза ― сроки восстановления самостоятельной ходьбы.

Validation of the boston carpal tunnel questionnaire in Russia

International scales and questionnaires have become widespread in Russian neurology. Validation is a procedure of top priority necessary before applying this kind of diagnostic instrument in Russian-speaking population. In this article, validation of the Boston Carpal Tunnel Questionnaire (BCTQ) intended for patients with this disease is described. Use of validated Russian version would allow to objectively evaluate severity of clinical manifestations of carpal tunnel syndrome and follow patient dynamics. We present the official BCTQ version recommended for use in Russia, as well as data that showed high sensitivity and reliability of this instrument for clinical evaluation of carpal tunnel syndrome. © 2018 ABV-Press Publishing House. All rights reserved

Validation of the boston carpal tunnel questionnaire in Russia

International scales and questionnaires have become widespread in Russian neurology. Validation is a procedure of top priority necessary before applying this kind of diagnostic instrument in Russian-speaking population. In this article, validation of the Boston Carpal Tunnel Questionnaire (BCTQ) intended for patients with this disease is described. Use of validated Russian version would allow to objectively evaluate severity of clinical manifestations of carpal tunnel syndrome and follow patient dynamics. We present the official BCTQ version recommended for use in Russia, as well as data that showed high sensitivity and reliability of this instrument for clinical evaluation of carpal tunnel syndrome. © 2018 ABV-Press Publishing House. All rights reserved

Validation of the Leeds Assessment of Neuropathic Symptoms and Signs Pain scale (LANSS) in Russia

Background. Objectivization of the characteristics of neuropathic pain is an important component of differential diagnosis in various diseases. Scales and questionnaires are topical diagnostic tools for assessing subjective symptoms for patients and health professionals. Objective to development and validation of the Russian version of the the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANSS). Materials and methods. The study included two stages: linguocultural ratification and assessment of the psychometric properties of the developed Russian version. Results. The study showed a high level of reliability, validity and sensitivity of the developed Russian-language version of the scale. Conclusion. By the results of the study, the official validated Russian-language version of the scale is presented and recommended for use in work with Russian-speaking patients. © ABV-Press Publishing House. All rights reserved

Validation of a Russian version of the Berg Balance Scale

Objective: linguistic and cultural adaptation of the original version of Berg Balance Scale (BBS) and assessment its psychometric properties. Patients and methods. The staff of the Validation Center of International Scales and Questionnaires of the Research Center of Neurology received consent from Katherine Berg to validate the BSS in Russia. We carried out the linguocultural ratification during the validation study and prepared a Russian version of the scale. To assess the psychometric properties of the scale (reliability, validity, and sensitivity), we evaluated 55 patients (30 females and 25 males) aged 22–88 years with different neurological disorders (vascular and demyelinating diseases of the central nervous system, peripheral neuropathy, and movement disorders). We analyzed the differences of the total BBS score and the number of patients with high and low risk of falls at the end of rehabilitation compared to baseline to assess the dynamics of changes. Results and discussion. We successfully performed the translation and linguocultural adaptation of the BBS. The scale represents a high level of validity (expert score: 8.6 out of 10 points), reliability (Pearson's correlation coefficient r=0.98, р<0.0001; Cronbach's alpha α=0.94, р<0.001; Cohen's kappa κ=0.71, p<0.0001) and sensitivity (р<0.0001). After a two-week rehabilitation course, the risk of falls significantly decreased (χ2=4.42; р=0.035); however, the level of independence of movement did not change significantly (F=0.94; р=0.636). Conclusion. The Russian version of the BBS was officially adapted based on the results of the accomplished validation study and is recommended for use both in routine clinical practice and in clinical trials by neurologists and rehabilitologists. The scale is available for downloading by QR code and on the website of Validation Center of International Scales and Questionnaires of the Research Center of Neurology. © 2021 Ima-Press Publishing House. All rights reserved

Full Outline of UnResponsiveness (FOUR) scale: Translation and linguistic and cultural adaptation of the Russian language version

Introduction: The assessment of the level of consciousness in patients with acute brain injury is a mandatory first step of neurological examination. There is a need for clinical scales which allow to assess the level of wakefulness and degree of patient non-responsiveness in 2-3 minutes. The Full Outline of UnResponsiveness (FOUR) scale is an optimal tool for such clinical assessment, which focuses on eye response, motor response, brainstem reflexes, and respiratory pattern. The absence of an officially translated and validated version impedes the use of FOUR scale in Russia, while the use of non-validated clinical scales carries a risk of erroneous diagnosis and reduces the quality and information value of research studies. Study aim: to develop an official Russian language version of the FOUR scale, taking into account its linguistic and cultural characteristics as part of the validation st udy. Materials and methods: The first stage of the validation process was completed, consisting of the linguistic and cultural adaptation of the FOUR scale. Medical professionals (Russian and English native speakers) performed forward and back translations of the original scale. The developed version then underwent review by the Expert Commission, which included a linguist, neurologists, anaesthesiologists and intensive care specialists. The next step was a pilot test of the scale. Results: The main difficulties in the translated text of the scale were solved during the first meeting of the Expert Commission. Then, taking into account the inclusion and exclusion criteria, a pilot test was performed by assessing 15 patients with the developed version of the FOUR scale. The statistics of this cohort are presented. Investigators had no difficulties in understanding and interpreting the scale instructions during the pilot test. Based on the results, the final version of the scale was adopted. The Russian version of the scale text with instructions and illustrations is presented in this paper. Conclusion: Translation, linguistic and cultural adaptation of the FOUR scale was conducted at the Research Centre of Neurology (Moscow, Russia). For the first time, the Russian version of the scale is officially presented and recommended for widespread use in clinical and research practice in Russia and other Russian-speaking countries based on the results of pilot testing. The next publication will present the results of the evaluation of psychometric properties (reliability, sensitivity, etc.) of this version of the scale. © 2019 Sovero Press Publishing House. All rights reserved

Validation of the Russian version of the Fugl-Meyer Assessment of Physical Performance for assessment of patients with post-stroke paresis [Validatsiya russkoyazychnoi versii shkaly Fugl-Meiera dlya otsenki sostoyaniya patsientov s postinsul'tnym parezom]

OBJECTIVE: To perform linguistic and cultural adaptation of the Fugl-Meyer Assessment of Physical Performance. MATERIALS AND METHODS: The study for assessment of psychometric properties included 53 post-stroke patients with neurological deficit presented by hemiparesis of different severity. The patients were assessed twice: at admission and after 14 days of treatment and rehabilitation procedures. The Russian version of the Fugl-Meyer Assessment of Physical Performance was developed with consideration of language and cultural characteristics. RESULTS AND CONCLUSION: Results of assessment of psychometric properties of the Russian-language version show its high validity, reliability and sensitivity. The developed Russian-language version of Fugl-Meyer Assessment of Physical Performance is recommended for using by neurologists and rehabilitation specialists both in everyday clinical practice and in clinical studies of patients with post-stroke paresis. The results obtained in the study show necessity for pre-training of specialists who perform assessment of patients with post-stroke paresis using the Fugl-Meyer Assessment of Physical Performance.ЦЕЛЬ ИССЛЕДОВАНИЯ: Лингвокультурная адаптация шкалы оценки физического состояния Фугл-Мейера (Fugl-Meyer Assessment of Physical Performance). МАТЕРИАЛ И МЕТОДЫ: В исследование по оценке психометрических свойств разработанной русскоязычной версии было включено 53 пациента, перенесших нарушение мозгового кровообращения с развитием гемипареза различной степени выраженности. Все пациенты были осмотрены дважды: в первый день поступления и через 14 дней после лечебно-восстановительных мероприятий. С учетом языковых и культурных особенностей подготовлена русскоязычная версия шкалы оценки физического состояния Фугл-Мейера. РЕЗУЛЬТАТЫ И ЗАКЛЮЧЕНИЕ: Данные, полученные при оценке психометрических свойств русскоязычной шкалы, отражают высокую степень ее содержательной валидности, надежности и чувствительности. Разработанная валидированная русскоязычная версия шкалы Фугл-Мейера является инструментом, рекомендованным к использованию врачами-неврологами и реабилитологами как в повседневной практике, так и при проведении клинических исследований с участием пациентов с постинсультным парезом. В ходе исследования были получены данные, свидетельствующие о необходимости предварительной подготовки (обучения, тренинга) специалистов, проводящих оценку больных с постинсультным гемипарезом с использованием шкалы Фугл-Мейера

Validation of the modified rankin scale in Russia

Objective: to develop a Russian version of the modified Rankin Scale (mRS) and to assess its psychometric properties. Patients and methods: The investigation involved 50 patients (25 women, 25 men) over 18 years of age (mean age, 56 years) with an acute cerebrovascular accident diagnosis. During the validation procedure, the authors carried out the linguocultural ratification of mRS, prepared its Russian-language version, and then assessed its psychometric properties (reliability, sensitivity, validity). Results and discussion: Translation and linguistic adaptation of mRS was successfully completed. The results obtained in assessing the psychometric properties of the developed Russian version of the scale reflect its high reliability and the valid and reliable indicators of its sensitivity. A statistical study of constructive and content validity also determined the high significance of differences. Conclusion: The investigation has resulted in the official Russian version of mRS, which is recommended for use by neurologists and rehabilitation specialists in both daily clinical practice and in clinical trials. © 2018 Ima-Press Publishing House. All Rights Reserved

Glasgow coma scale: Linguistic-cultural adaptation of the Russian version [Шкала комы Глазго (Glasgow Coma Scale, GCS): лингвокультурная адаптация русскоязычной версии]

INTRODUCTION Determination of the degree of depression of consciousness in patients with brain damage upon admission to the intensive care unit and intensive therapy is a primary task. In order to carry out a quick and at the same time sufficiently complete assessment of this kind, in 1974 neurosurgeons Graham Teasdale and Bryan Jennett from the University of Glasgow developed an algorithm consisting of a sequential series of tests in the form of eye opening, speech and motor responses, called Glasgow Coma Scale. This scale has received worldwide recognition and for many decades has been the main one for determining the state of consciousness in the most severe patients with brain damage. The absence of a validated version of this scale complicates its application in Russia, and the use of currently available versions that have not passed all the necessary stages of validation distorts the originally intended meaning of the scale and does not allow obtaining reliable clinical results when examining patients with acute impairment of consciousness. AIM OF STUDY Development of the official Russianlanguage version of the Glasgow Coma Scale, taking into account linguistic and cultural characteristics (1st stage of the validation study). MATeRIAL AND MeTHODS The staff of Center for Validation of Health Status Questionnaires and Scales in Russia, Research Center of Neurology obtained consent from G. Teasdale to validate Glasgow Coma Scale in Russia. Two Russianspeaking professional certified translators in the field of medicine performed a direct translation of the original Englishlanguage scale, and a reverse translation was carried out by native speakers with a medical education. Pilot study was performed in 15 patients with acute impairment of consciousness, two meetings of the expert committee were held (before and after pilot study). ReSULTS Based on the results of the first meeting of the expert commission, a linguistic and cultural adaptation of the text of the scale was carried out. During the pilot testing of the researchers did not have difficulties in understanding and interpreting instructions. As a result, the second meeting of the expert commission was held and the final Russianlanguage version was approved, which is presented in this article and is available on the website of Center for Validation of Health Status Questionnaires and Scales in Russia, Research Center of Neurology. CONCLUSION For the first time, the Russian language version of the Glasgow Coma Scale was officially presented and recommended for use both in clinical and research practice in Russia and other Russian speaking countries. The next publication will highlight the result of assessing the psychometric properties (reproducibility, interexpert agreement and sensitivity) of the Russianlanguage version of the scale. © 2021 Sklifosovsky Research Institute for Emergency Medicine. All rights reserved