PSYCHOPHYSIOLOGICAL FEATURES OF RADIATION RISK PERCEPTION. / PSYKhOFIZIOLOGIChNI OSOBLYVOSTI SPRYINIaTTIa RADIATsIINOGO RYZYKU.

OBJECTIVE: to determine the subjective and psychophysiological characteristics of the perception of radiation risk,to identify destructive individual-typological personality traits, as well as factors that can be the basis of psycho-logical compensation for victims of various radiation disasters and accidents. OBJECT AND METHOD: A comparative analysis of psychometric and neurophysiological parameters of hypertrophiedperception of radiation risk in the following groups was carried out: liquidators (clean-up workers) of the conse-quences of the Chornobyl accident and evacuees from the Chornobyl exclusion zone (CEZ) - 317 people total, par-ticipants in the anti-terrorist operation (ATO) - 101 people, and control group - 85 people. We used psychodiagnos-tic and neurophysiological (computerized electroencephalography) techniques. RESULTS: In the groups of liquidators and evacuees from CEZ there are significantly more people with hypertrophiedperception of radiation risk compared to the control group and the comparison group (liquidators - 71.88 %, liqui-dators-evacuees - 80.0 %, evacuees 76.92 %, ATO participants - 33.78 %, control group - 35.0 %). Among therespondents with hypertrophied perception of radiation risk radiation factors, and, most of all, diseases associatedwith ionizing radiation, hold the first rank places among 31 evaluated factors in all groups. The respondents withadequate perception of the radiation risk are primarily concerned about social stress and environmental factors.Correlation analysis showed that there are no correlation between hypertrophied perception of radiation risk andactual documented radiation dose. Hypertrophied perception depends on gender, level of education, family incomeand level of knowledge about ionizing radiation. It affects perception of one's health, makes you feel helpless,increase the level of distress from the Chornobyl disaster and the Fukushima-1 disaster in Japan, and is also associ-ated with the Revolution of Dignity. Hypertrophied perception of radiation risk contributes to disorders of psycho-somatic health and deformation of personality traits. Comparative analysis of the parameters of bioelectrical activ-ity of the brain of persons with hypertrophied perception of the radiation threat showed an increase in brain's delta-,theta- and beta- activity with suppression of alpha-activity and dominant frequency. CONCLUSIONS: In all examined groups a significant percentage of people with hypertrophied perception wererevealed. The key role in the process of perception of a radiation risk is played not by the real danger of the situa-tion and the documented dose of radiation, but by its perception and awareness. Hypertrophied perception of theradiation risk contributes to psychosomatic health disorders and deformation of personality traits, which is con-firmed by neurophysiological studies.

BRAIN AND EYE AS POTENTIAL TARGETS FOR IONIZING RADIATION IMPACT. Part І. THE CONSEQUENCES OF IRRADIATION OF THE PARTICIPANTS OF THE LIQUIDATION OF THE CHORNOBYL ACCIDENT. / GOLOVNYI MOZOK TA ORGAN ZORU IaK POTENTsIINI MIShENI DLIa VPLYVU IONIZUIuChOGO VYPROMINIuVANNIa. Chastyna I. TsEREBROOFTAL'MOLOGIChNI EFEKTY OPROMINENNIa V UChASNYKIV LIKVIDATsIÏ NASLIDKIV AVARIÏ NA ChAES.

BACKGROUND: Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents. OBJECTIVE: The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects. MATERIALS AND METHODS: In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used. RESULTS: The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. CONCLUSIONS: The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).

DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING IN EARLY DIAGNOSIS OF STRUCTURAL CHANGES IN BRAIN WHITE MATTER IN SMALL VESSEL DISEASE ASSOCIATED WITH ARTERIAL HYPERTENSION AND IONIZING RADIATION. / DYFUZIINO-TENZORNA MRT U RANNII DIAGNOSTYTsI STRUKTURNYKh ZMIN BILOÏ REChOVYNY GOLOVNOGO MOZKU PRY ASOTsIIOVANII Z ARTERIAL'NOIu GIPERTENZIIeIu TA IONIZUIuChYM VYPROMINIuVANNIaM KhVOROBI MALYKh SUDYN.

OBJECTIVE: to determine the early signs of structural changes in brain white matter in small vessel disease associated with arterial hypertension and exposure to ionizing radiation using DTI-MRI. MATERIALS AND METHODS: 45 patients (mean age (57.56 ± 6.34) years) with small vessel disease (SVD) associatedwith arterial hypertension (AH) were examined: group I - 20 patients, participants of liquidation of the accident atthe Chornobyl nuclear power plant (Chornobyl clean-up workers); group II - 25 patients not exposed to ionizingradiation. MRI was performed on an Ingenia 3T tomograph («Philips¼). The fractional anisotropy (FA) was determined in the main associative and commissural pathways, periventricular prefrontal areas (fasciculus fronto-occipitalis superior / anterior - f. FO ant., corona radiata anterior - CR ant.) and semioval centers (SC). RESULTS: No signs of cerebral cortex or brain white matter (WM) atrophy, intracerebral microhemorrhages, and widespread areas of leukoaraiosis consolidation were observed in the examined patients. In the Chornobyl clean-up workers a larger number of foci of subcortical leukoaraiosis was visualized (80 %) on MRI images including multiple -8 (40 %), > 0.5 cm - 10 (50 %), with signs of consolidation - 5 (25 %). The results of the FA analysis in semiovalcenters showed its significant decrease in the patients of groups I and II (p < 0,007), regardless of the presence orabsence of visual signs of subcortical leukoaraiosis (ScLA) (III gr.: 253-317, p < 0.00001; IV gr.: 287- 375,p < 0.001). FA indicators in f. FO ant. and CR ant. in the patients of groups I and II differed insignificantly but weresubstantially lower than controls (p < 0.05). FA was significantly lower, compared to reference levels, in visuallyunchanged f. FO ant. (0.389-0.425; p = 0.015) and CR ant. (0.335-0.403; p = 0.05). In patients with AH-associated SVD of middle age, regardless of the effects of ionizing radiation, no significant changes in FA in the mainWM associative and commissural pathways were found (p > 0.05). CONCLUSIONS: DTI-MRI allows to detect early signs of structural changes in the white matter of the brain - a significant decrease in fractional anisotropy indicators in visually unchanged periventricular and subcortical areas. Themain associative and commissural pathways of the brain remain intact in the absence of widespread consolidatedfoci of leukoaraiosis and lacunar infarctions. The negative impact of ionizing radiation on the course of SVD associated with arterial hypertension is manifested by more active processes of WM disorganization: the prevalence andtendency to the consolidation of periventricular and subcortical leukoaraiosis foci, a significant FA decrease in semioval centers.

NEUROPSYCHOBIOLOGICAL MECHANISMS OF AFFECTIVE AND COGNITIVE DISORDERS IN THE CHORNOBYL CLEAN-UP WORKERS TAKING INTO ACCOUNT THE SPECIFIC GENE POLYMORPHISMS. / NEIROPSYKhOBIOLOGIChNI MEKhANIZMY AFEKTYVNYKh I KOGNITYVNYKh ROZLADIV V UChASNYKIV LIKVIDATsIÏ NASLIDKIV AVARIÏ NA ChORNOBYL'S'KII AES Z URAKhUVANNIaM POLIMORFIZMU GENIV.

Relevance of the present work is determined by the considerable prevalence of both affective and cognitive disor-ders in the victims due to the Chornobyl accident, the pathogenesis of which is insufficiently studied.Objective is to identify the neuropsychiobiological mechanisms of the formation of the remote affective and cog-nitive disorders following exposure to ionizing radiation taking into account the specific gene polymorphisms.Design, object and methods of research. The retrospective and prospective cohort study with the external andinternal control groups. The randomized sample of the male participants in liquidation of the consequences of theaccident (Chornobyl clean-up workers, liquidators) at the Chornobyl nuclear power plant (ChNPP) in 1986-1987(n = 198) recruited from the Clinico-epidemiological registry (CER) of NRCRM aged 39-87 (M ± SD: 60.0-8.5 years)with the external irradiation dose ranged 0.6-5900.0 mSv (M ± SD: 456.0 ± 760.0 mSv) was examined. The compar-ison group (n = 110) consisted of the unexposed patients of the Radiation Psychoneurology Department with thecorresponding age and sex (the external control group). The internal control group included the liquidators irradi-ated at doses < 50.0 mSv (n = 42). The standard diagnostic neuropsychiatric scales, psychodiagnostic questionnairesand tests, neuropsychological methods (including the Wechsler Adult Intelligence Scale (WAIS) with premorbid IQ(pre-IQ) assessment), neuropsychiatric and psychophysiological methods (quantitative EEG (qEEG) and the audito-ry cognitive evoked potentials (Event-Related Potentials, ERP) were applied. The genotypes of the serotonin trans-porter gene SLC6A4 were determined by the 5_HTTLPR and rs25531 polymorphisms. The methods of descriptive and vari-ation statistics, non-parametric criteria, regression-correlation analysis, survival analysis by Kaplan - Meier and riskanalysis were used.Results. Cerebrovascular diseases, organic mental and depressive disorders, mainly of radiation-stress-relatednature, prevail among the liquidators. The overall risk of neuropsychiatric pathology increases (Pv < 0.001) with theirradiation dose. The verbal memory and learning are impaired, as well as the full IQ is reduced at the expense of theverbal one. The frequency of both mild cognitive impairment and dementia is risen. The cognitive impairment atdoses > 0.3 Sv is dose-dependent (r = 0.4-0.7; p = 0.03-0.003). Affective disorders (depression) and neurocogni-tive deficit are more severe at higher doses of irradiation (> 50 mSv). In the left posterior temporal region(Wernicke's area) the qEEG indices changes become dose-dependent at doses greater than 0.25-0.3 Sv. The dis-turbed brain information processes lateralized to the Wernicke's area are observed even at doses > 50 mSv. The car-riers of intermediate and low-level genotypes (LА/S, LА/LG, LG/LG, LG/S, S/S) of the serotonin transporter gene SLC6A4have more depressive disorders, especially severe ones, and tend to have more frequent and severe cognitive andstress-related disorders.The debut of depressive disorders in the carriers of the intermediate and low-activity genotypes occurs much earli-er (Log-Rank Test = 4.43, p = 0.035) in comparison with the carriers of the high-performance genotype LА/ LА.Conclusions. The radiation-induced dysfunction of the cortico-limbic system in the left dominant hemisphere ofthe human brain with a specific involvement of the hippocampus is considered to be the key cerebral basis of post-radiation organic brain damage. The association of genotypes by 5_HTTLPR and rs25531 polymorphisms of the SLC6A4gene with affective and cognitive disorders suggests the presence of neuropsychobiological features of these dis-orders associated with ionizing radiation depending on the certain gene polymorphisms.

COMPARATIVE CHARACTERISTIC OF «ALCOHOL DEPRESSION¼ IN PERSONS WHO PARTICIPATED IN COMBAT OPERATIONS (COMBATANS) AND AFFECTED BY RADIATION CATASTROP. / PORIVNIaL'NA KhARAKTERYSTYKA «ALKOGOL'NYKh DEPRESII¼ V OSIB, IaKI BRALY UChAST' U BOIOVYKh DIIaKh (KOMBATANTIV) I POSTRAZhDALYKh PRY RADIATsIINII KATASTROFI.

The relevance of work is conditioned by the considerable prevalence of depressive disorders and alcohol abuseamong people who participated in combat operations (combatants) and affected by a radiation emergency, whichneeds to be optimized for providing them with a comprehensive social, psychological-psychiatric, medication andsomato-neurological help on the basis of a biopsychosocial paradigm.The objective of the study was to increase the level of medical care to combatants of the Antiterrorist Operation /Joint Forces Operation (ATO/JFO) and person affected by the catastrophe at the Chornobyl NPP (ChNPP) with depres-sion associated with alcohol abuse through theoretical substantiation, development and implementation in theinstitutions of public health and other agencies involved of new principles and algorithms for diagnosis, treatmentand prevention.The object and methods of the study were 160 ATO/JFO combatants from the age of 22 to 56 years old (M ± SD:(41.5 ± 16.5) years) with alcohol and depressive disorders the main group. The comparison groups included 81Chornobyl catastrophe clean-up workers (liquidators) with post-traumatic stress disorder and comorbid chroniccerebrovascular pathology, as well as other contingents affected by the Chornobyl catastrophe. Clinical-anamnestic,socio-demographic, clinical psychopathological, psychodiagnostic, neurophysiological and neuroimaging methodswere used. Somato-neurological clinical examinations and laboratory tests have been applied. The analysis of thedata was performed using MS Excel spreadsheets and statistical package Statistica 10.0 (StatSoft) with the Studentt-criterion, paired t-test, criterion χ2, and Fisher exact test.The study design of the main group consisted of 5 stages: 1) screening; 2) inclusion; 3) randomization; 4) treat-ment and 5) catamnestic (follow-up) observation.Results. In the main group the distribution of depressive syndromes was revealed as follows: depressive-hypochon-dric - in 68 (42.5 %) patients; 2) asthenic-depressive - in 33 (20,6 %); 3) anxiety-depressive - in 31 (19.4 %); 4)depressive-dysphoric - in 14 (8.8 %); 5) apathetic-depressive - in 7 (4,35 %); and 6) simple depressive - in7 (4,35%). The combatants after participation in the ATO/JFO had personality deformation and irritative changes of thebrain bioelectric activity, thickening of the intima-media complex and venous dyshaemia in the basal veins ofRosenthal. In liquidators there is an excess of depressive disorders, the frequency and severity of which increase inproportion to the radiation dose. These disorders are characterized by progressive course, personality changes withpsychosomatic pre-disposition, comorbidity with cerebrovascular pathology, neurocognitive deficits and high fre-quency (24 %) of secondary alcohol abuse. The relationship between depressive disorders and alcohol dependencein the examined patients is diverse. Their variants differ in certain clinical manifestations and to a large extentdetermine the differential diagnosis and differentiated approaches to treatment, prevention and medical and socialrehabilitationConclusions. The comorbidity of depressive disorders with the abuse of alcohol by combatants and person affectedby the catastrophe at the ChNPP is gaining an increasing significance first of all because of the increased risk of suicidal behavior. The proposed diagnostic complex and differentiated approaches to treatment, prevention and med-ical and social rehabilitation may increase the level of medical care for the ATO /JFO combatants and the Chernobylcatastrophe survivors with depression associated with alcohol abuse.

Psychophysiological characteristics in the ChNPP accident clean-up workers, exclusion zone evacuees and anti-terrorist operation servicemen. / PSYKhOFIZIOLOGIChNI OSOBLYVOSTI UChASNYKIV AVARIÏ NA ChAES, EVAKUY̆OVANYKh IZ ZONY VIDChUZhENNIa TA UChASNYKIV ANTYTERORYSTYChNOÏ OPERATsIÏ.

OBJECTIVE: Evaluation of interdependencies between psychometric parameters and spontaneous cerebral electric activity in the ChNPP accident clean up workers, evacuees from exclusion zone, and anti terrorist operation service men. OBJECT AND METHODS: Psychometric and neurophysiological parameters were reviewed in the study subjects retro spectively and in comparison. Study population included the ChNPP accident clean up workers (ACUW), evacuees from the 30 kilometer exclusion zone, specifically in a sample from a cohort of the NRCRM Clinical Epidemiological Register (n=316), and anti terrorist operation servicemen (n=81) undergoing rehabilitation in the NRCRM Radiation psychoneurology department. A control group of persons (n=84) was also involved in the study. Diagnostic method ology for the characteristic personality features, namely the personality test of character accentuation by G. Shmishek and K. Leonhard, and Eysenck Personality Inventory (by H. J. Eysenck) were applied. Computer EEGs were registered and analyzed on the 16 channel electroencephalograph DX 4000 (Kharkiv, Ukraine). RESULTS: In the aftermath of the emergency period, a personality deformation occurs in the clean up workers and survivors of the ChNPP accident, which is characterized by aggravation of such personality traits as jam (fixedness), emotiveness, pedantry, anxiety, cyclothymia, excitability and disthymia, with diminished hyperthymia and ostenta tion (demonstrability). Increased incidence of fixedness, pedantry, cyclothymia, affectability and disthymia with decreased hyperthymia were revealed in the group of ATO participants. Cerebral bioelectrical activity in the ChNPP ACUW was characterized by an increased delta activity power with decreased beta and theta activity power and dom inant frequency in comparison with all groups of survivors and control group. The ATO group was different from groups of survivors and control group with a lower power of delta, theta and beta activity, and a higher dominant frequency. Introversion featured a negative correlation with delta and theta activity index along with positive cor relation with alpha activity index. The absolute spectral power of beta, alpha and theta bands positively correlated with introversion. Increase in neuroticism featured a decrease in theta activity index and an increase in beta activ ity index along with decreased theta and delta band absolute spectral power. CONCLUSIONS: There is a deformation of personality in the group of ChNPP ACUW, evacuees from the 30 kilometer zone and ATO servicemen. Deformation of personality correlates with abnormal cerebral bioelectrical activity.

Pathological personality development after the Chornobyl disaster and the anti terrorist operation. / PATOLOGIChNYY̆ ROZVYTOK OSOBYSTOSTI PISLIa ChORNOBYL'S'KOÏ KATASTROFY TA ANTYTERORYSTYChNOÏ OPERATsIÏ.

Objective of the study was to determine pathological changes of the personality of the clean up workers (liquida tors) of the Chornobyl accident and the participants in the anti terrorist operation (ATO) in Eastern Ukraine and radiation threat perception assessment.Design, object and methods. The cross sectional and retrospective assessments of the clean up workers of the Chornobyl accident (n = 185), evacuees from the Chornobyl Exclusion Zone (n = 112) from the randomized sample of individuals who are registered in the Clinical and epidemiological registry (CER) of the State Institution «National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine¼ [NRCRM] and partici pants of the ATO in Eastern Ukraine (n = 62) who underwent treatment and rehabilitation in the Department of Radiation Psychoneurology of the NRCRM Clinic have been done. The neuropsychiatric clinical and psychometric methods as General Health Questionnaire, GHQ 28; Eysenck Personality Inventory, EPI; method of personality diag nostic by H. Schmischek - K. Leongard, and modified social psychological questionnaire (Joint Study Project 1993) - «dangers questionnaire¼ were used. RESULTS: Extraversion, hyperthymia and demonstrativity in the clean up workers of the Chornobyl accident and evac uees decreased, while emotiveness, pedantry, anxiety, cyclothymia, excitability and dysthymia increased. Extraversion and hyperthymia decreased in the ATO participants while jams, pedantry, cyclothymia, excitability and dysthymia increased. According to the social psychological assessment («dangers questionnaire¼) there were found that at present the «national conflict¼ factor takes among the clean up workers the 22th rank place, evacuees - the 18th, while the participants ATO - the 11th, however the risk perception of disease associated with the presence in the environment of radioactive substances in the ATO participants takes the 6th place, the liquidators - the 8th, the evac uees - the 7th. Hypertrophic radiation threat perception in the clean up workers and evacuees correlates with increasing concern about the nuclear industry (p < 0.001); the degree of psychological stress related to the Chornobyl disaster (p < 0.001); the degree of psychological stress of evacuation (p < 0.01); with concern of radia tion impact on health (p < 0.001); negative social and economic changes due to the Chornobyl disaster (p < 0.001). The ATO combatants do not trust to the competence of those responsible for the events in Eastern Ukraine (46.3 %), while quite strongly concerned about the future (48.8 %) and hostile attitude to themselves (25.0 %). CONCLUSIONS: There are signs of personality exacerbation/maladjustment and personality accentuation increasing in all studied groups. In ATO combatants the pathological personality development of frustration is forming, that social stress, post traumatic stress and psychosomatic disorders integrates. Hypertrophic radiation risk perception is inherent in all groups surveyed.