[Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson's disease]. / Primenenie transkranial'noi magnitnoi stimulyatsii v lechenii depressivnogo rasstroistva pri bolezni Parkinsona.

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

[PROSPECTS FOR THE TREATMENT OF IDIOPATHIC AND NEUROGENIC OVERACTIVE BLADDER].

Overactive bladder (OAB) is a common problem in modern population. The main line of medical treatment of this condition is the use of M-cholinoblockers. Solifenacin has shown high selectivity for the bladder in preclinical studies. Data on the efficacy and safety of high-dose (10 mg/day) of solifenacin are insufficient. The study was aimed to the comparative evaluation of the effectiveness and safety of solifenacin at a dose of 5 and 10 mg/day. The study included 28 patients (17 women and 11 men), mean age was 41.3±6.7 years. All patients were divided into two groups. In Group 1 included 12 patients with idiopathic overactive bladder, the Group 2 (n=16) - with neurogenic overactive bladder. Depending on the effect obtained, in some patients the dose was increased to 10 mg/day 1 month after starting treatment. The duration of treatment was 12 weeks. Application of solifenacin at a dose of 5 mg in patients with overactive bladder significantly reduces the severity of symptoms. Increasing the dose was required in 3 (25%) patients with idiopathic OAB and in 10 (62.5%) - with neurogenic OAB. Patients unsatisfied by therapy with solifenacin 5 mg/ day initially had more severe symptoms of the disease - significantly more urgency frequency, incontinence episodes, and nocturia. The use of high doses of solifenacin increased the effectiveness of treatment. Statistical significance was achieved for all parameters evaluated. Against the background of increasing doses, the number ofadverse effects may increase, but within a month of therapy in most cases they are reduced.

[Apathy in the structure of mental and neurological disorders of the old age].

The studies on apathy, a common phenomenon in psychiatry, are summarized. The definitions of this term suggested by different authors are presented. The difference between apathy as a symptom and apathy as a syndrome is described. Main pathogenetic mechanisms of the development and epidemiology of this disorder, the results on the differential diagnosis of apathy and depression in patients with neurological and mental diseases as well as methods of treatment are presented.

[Clinical and pharmacoeconomic peculiarities of the treatment with cerebrolysin in the period of rehabilitation of is ischemic stroke.].

The results of the clinical and pharmacoeconomic study of cerebrolysin in the rehabilitative therapy of ischemic stroke presented in the paper revealed the statistically significant regress of neurological disturbances in patients receiving cerebrolysin in daily dosages of 10 and 20 ml as compared to the control group. The rehabilitation of motor functions was more rapid than sensitive ones in patients receiving cerebrolysin comparing to those switched to the basic antihypertensive and antiaggregate therapy. The positive dynamics of speech rehabilitation was observed, the regress of aphatic disturbances being more significant for daily dosage of 20 ml. Rehabilitation rate in the period of treatment with cerebrolysin was higher for daily dosage of 20 ml than that of 10 ml. A prolonged effect of the drug during the long period after its withdrawal was found that resulted in higher rates of rehabilitation to the 11th week in patients receiving cerebrolysin as compared to the control group. Average total cost of direct medical expenses per a patient estimated in the pharmacoeconomic analysis for the groups receiving cerebrolysin and the control group was higher in the former groups, in particular in that with 20 ml dosage of cerebrolysin. A cost-efficacy analysis revealed that the cost of cerebrolysin treatment per effective unit (a cost of one score on the Lindmark scale and the Barthel scale) was less or comparable in patients receiving cerebrolysin comparing to the control group. The study suggests clinical and pharmacoeconomic expediency of cerebrolysin treatment in rehabilitative period of ischemic stroke.