[Characteristics and dynamics of pathological changes in visual evoked potentials in multiple sclerosis]. / Kharakteristika i dinamika patologicheskikh izmenenii zritel'nykh vyzvannykh potentsialov pri rasseyannom skleroze.

OBJECTIVE: Clarification of the characteristics and dynamics of changes in the main indicators of visual evoked potentials (VEP) for a reverse chess pattern in patients with multiple sclerosis (MS) at various stages of the disease and severity of disability. MATERIAL AND METHODS: The study of VEP was carried out on 477 subjects, 120 of which were healthy volunteers and 357 patients with MS, including those with clinically isolated syndrome (CIS; 22.7%), remitting course (RT; 55.7%), primary progressive course (PPT; 8.4%), secondary progressive course (VPT; 13.2%). Disability was assessed using the Expanded Disability Status Scale (EDSS). RESULTS: A high sensitivity of VEP in the detection of demyelinating damage to the visual pathways, including subclinical, was noted already at the initial stages of MS, which increases with the progression of the disease from 77.8 to 97.8%. There was a significant increase in latency (r=0.42, p<0.05) and a decrease in amplitude (r= -0.26, p<0.05) of the P100 peak as the EDSS score increased. In patients with MS, 5 patterns of VEP were identified depending on the level and severity of damage to the visual pathways, where pattern 1 is normative VEP, pattern 5 is the absence of VEP recording in case of a pronounced axonal-demyelinating lesion of the visual pathways (prechiasmal/postchiasmal levels). Patterns 1 and 2 are most typical for CIS (22.2 and 53.1%) or RT (20.1 and 26.6%). Patterns 3 and 4 are typical for APT (70 and 20%) and VPT (48.9 and 21.3%), pattern 5 - for VPT (19.1%). Patterns 3-5 predominated in patients with higher EDSS (r=0.54, p<0.05). CONCLUSION: The classification of VEP changes into patterns makes it possible to identify the dissemination of a focal lesion in the projections of the visual pathways, which increases the diagnostic efficiency of the study and makes it possible to assess the severity of MS.

[Comparison of the efficacy of Cellex and Cortexin in patients in the early recovery period of ischemic stroke]. / Sravnenie effektivnosti preparatov Tselleks i Korteksin u patsientov v rannem vosstanovitel'nom periode ishemicheskogo insul'ta.

OBJECTIVE: To compare the efficacy of Cellex and Cortexin in patients in the early recovery period of ischemic stroke (ERPIS) receiving basic therapy (BT). MATERIAL AND METHODS: Forty patients were randomized into the cellex group (n=20) and the cortexin group 2 (n=20). Cellex was administered in a dose of 0.1 mg daily SC for 10 days and cortexin in a dose of 10 mg per 2 ml of 0.9% NaCl solution IM daily for 10 days. The efficacy of treatment was assessed with NIHSS, Bartel's index (BI), MMSE, the Rivermead Mobility Index (RMI), the Frontal Assessment Battery (FAB), Beck's depression scale (BDS). RESULTS: A more pronounced positive dynamics of NIHSS: 3 [2; 4.5] vs. 5 [2; 7] (p=0.03) and MMSE scores: 24 [21.5; 25] vs. 22 [20; 23] (p=0.04) was noted in the cellex group. Also, in this group, a more significant trend towards regression of depressive disorders (BDS) was revealed: 17.5 [14.5; 21] vs. 14 [13; 16] (p=0.064). The dynamics of RMI and FAB scores did not differ significantly between the groups. CONCLUSION: The use of cellex in comparison with cortexin is more effective in terms of the dynamics of regression of neurological and neurocognitive dysfunctions in patients with ERPIS.

[The efficacy and safety of siponimod in the Russian population of patients with secondary progressive multiple sclerosis]. / Éffektivnost' i bezopasnost' siponimoda u patsientov s vtorichno-progressiruiushchim rasseiannym sklerozom v rossiiskoi populiatsii.

AIM: To study the efficacy and safety of siponimod in patients with secondary progressive multiple sclerosis (SPMS) in the Russian population of the EXPAND study. MATERIAL AND METHODS: Ninety-four patients with SPMS from Russia were included in the analysis. Sixty-three patients received siponimod and 31 patients received placebo. The primary endpoint of the study was time to 3-month confirmed disability progression (3m-CDP) events, other clinical and radiological endpoints were also evaluated. RESULTS: The siponimod group showed a 54% reduction in the risk of 3m-CDP compared with the placebo group (p=0.0334). Secondary endpoints also showed the advantage of the drug over placebo. In the siponimod group, mild adverse events associated with impaired liver function, as well as arterial hypertension, were more common. No patient left the study due to an adverse event. CONCLUSION: The use of siponimod in patients with SPMS in the Russian population reduced the risk of disability progression. Siponimod showed a favorable safety profile.

[Evaluation of efficiency and safety of adding neuromultivit to basic therapy of vertebrogenic radiculopathy]. / Éffektivnost' i bezopasnost' neiromul'tivita pri vertebrogennykh radikulopatiiakh.

AIM: To evaluate the efficacy and safety of neuromultivit (valiant, Russia) as add-on to the basic therapy of vertebrogenic radiculopathy (VR) L5-S1. MATERIAL AND METHODS: The open clinical trial included 100 patients with VR L5-S1 randomized into 2 groups. In group 1, patients received neuromultivit and basic therapy; in group 2 only basic therapy. Treatment efficacy was assessed by the dynamics of regression of pain intensity on the visual analogue scale (VAS), McGill pain questionnaire (MGPQ), Aberdeen back pain scale (ABPS), the Quebec Back Pain Disability Scale (QBPDS), the dynamics of neurologic symptoms, the need for additional treatment with NSAID. Safety was assessed by evaluation of vital functions, laboratory tests, ECG, registration of adverse events (AE). RESULTS: In both groups, a significant positive changes on VAS, MGPQ, ABPS, QBPDS were observed. Nevertheless, the positive effect of therapy was more pronounced in group 1 p<0.05). The AE spectrum between two groups did not differ significantly (p<0.05). CONCLUSION: Addition of neuromultivit to basic therapy increased the efficacy of treatment of VR L5-S1.

[Primary progressive multiple sclerosis: current issues of timely diagnosis]. / Pervichno-progressiruiushchii rasseiannyi skleroz: sovremennoe sostoianie problemy svoevremennoi postanovki diagnoza.

This article presents a review of international data on primary progressive multiple sclerosis (PPMS) and an analysis of factors influencing timely diagnosis of PPMS in a number of regions of the Russian Federation.

[Comparative, placebo-controlled clinical study of efficacy and safety of glatiramer acetate 20 mg in patients with relapsing-remitting multiple sclerosis: results of the first year of the study]. / Sravnitel'noe platsebo-kontroliruemoe klinicheskoe issledovanie effektivnosti i bezopasnosti preparatov glatiramera atsetata 20 mg u patsientov s remittiruyushchim rasseyannym sklerozom: rezul'taty pervogo goda nablyudeniya.

The article presents the results of international multicenter randomized double-blind, active and placebo-controlled, comparative phase 3 trial. The goal of the study was to demonstrate non-inferiority of BCD-063 (glatiramer acetate, manufactured by JSC «BIOCAD¼, Russia) to copaxone-Teva (Teva Pharmaceutical Enterprise Co., Ltd., Israel) in patients with relapsing-remitting multiple sclerosis. METHODS: 158 patients with relapsing-remitting multiple sclerosis were randomly assigned into 3 groups: BCD-063, copaxone-Teva and placebo, at a ratio of 2:2:1, respectively. RESULTS AND CONCLUSION: Efficacy analysis after 48 weeks of therapy demonstrated no differences between BCD-063 group and copaxone-Teva group in both MRI parameters and frequency of relapses. The mean (SD) of number of MRI-confirmed relapses per patient per year (the primary endpoint) in BCD-063 group was 0.098361 (0.351422), in copaxone-Teva group - 0.098361 (0, 351 422) and in placebo group - 0.178571 (0.390021). There were also no differences between the groups for all other efficacy parameters (EDSS and MSFC). Both investigational BCD-063 and copaxone-Teva demonstrated a favorable safety profile. The data obtained from the present study confirm the therapeutic equivalence of BCD-063 (CJSC BIOCAD, Russia) and copaxone-Teva, that is important for further implementation of glatiramer acetate generic in the clinical practice of multiple sclerosis therapy.

[Biosimilar of interferon-beta 1b in the treatment of multiple sclerosis and the own experience in the use of ronbetal].

The results of using ronbetal, the Russian biosimilar of interferon-beta 1b, in the treatment of multiple sclerosis (MS) are presented. The study included outpatients followed up from February 2008 to March 2012. All patients were assessed neurologically with additional evaluation using the EDSS; a number of exacerbations and their outcomes, disease progression, tolerability of the drug were recorded. No significant differences in the efficacy of ronbetal and betaferon were found. The frequency of exacerbations and MS progression were comparable for both drugs. The same was with the tolerability, with the exception of higher frequency of the flu-like syndrome at the beginning of treatment with ronbetal. A single-step substitution of betaferon for ronbetal often caused the discontinuation of treatment by patients because they were not fully informed about the new drug, need to use a new dose titration scheme and were anxious about side-effects.

[The complex approach to the rehabilitation of post-stroke patients with movement disorders in the early rehabilitation period].

We studied 110 patients, aged 34-71 years, in the early rehabilitation period after stroke who were admitted to a rehabilitation neurologic department of Kazan. The rehabilitation approach was based on the combination of several methods: kinesitherapy, transcranial magnetic stimulation and cerebrolysin treatment. This complex reanimation allowed to achieve the marked functional restoration of movement abilities in many cases that was correlated with the normalization of brain bioelectric activity (the increase of alpha-rhythm spectral power, the decrease of slow-wave EEG components). The combined use of these three methods was more effective than a combination of any two of them.

[Influence of complex rehabilitation on the social adaptability and quality of life in people with multiple sclerosis].

The article presents results of complex rehabilitation in people with multiple sclerosis. We have studied the effect of rehabilitation measures on quality of life and self-sustenance adaptability of patients with multiple sclerosis as compared to standard therapeutic interventions. Factors influencing the effectiveness of rehabilitation measures are discussed.