[Computer-aided techniques for the treatment and rehabilitation of patients suffering vertigo and balance disorders].

A new computerized method is proposed for the correction and elimination of undesirable illusory sensations (dizziness), vestibulo-oculomotor (nystagmus), and vestibulo-postural (imbalance) reactions. The method allows to teach the subject about how to avoid generalization of afferent signals over the effector mechanisms in the central nervous system by developing a fixational reflex employing delayed biological feedback for the assessment of efforts being exerted (self-control of training results). Three variants of application of this technique were evaluated depending on the type of stimulation software intended to induce illusory and oculomotor reactions of a defined sensory modality (visual, vestibular or combined). The study involved 30 subjects divided into three groups. They had been taught using the visual (group 1), vestibular (group 2) or combined (group 3) methods. Each group was comprised of an approximately equal number of subjects with vestibulopathies of either peripheral or central origin. The study demonstrated that the proposed approach allows to invoke, with the use of a computer stimulation software, abnormal illusory and vestibulo-oculomotor responses and inhibit them by developing the adequate fixational reflex. Comparative analysis of the results obtained by teaching the patients with the help of the three different methods revealed the dependence of their effectiveness on the level of disturbances in the vestibular system. The visual method of correction proved to be especially efficacious for the patients with peripheral vestibulopathy, and the vestibular methods for the patients with central vestibulopathy. Patients with combined peripheral and central vestibulopathy required the choice of training modalities (either visual or vestibular) on an individual basis.

[The influence of phototherapy on psycho-autonomic syndromes]. / Vliianie fototerapii na psikhovegetativnye syndromy.

Therapy by bright white light was applied to 51 patients. 4 blocks of psychoautonomic syndromes of neurotic nature were analysed: 1) pronounced (14 cases) and mild (12) hypothalamic dysfunction; 2) moderate and pronounced depression (21) and the state without depression (9); 3) headache of different types--37 patients, including 21 ones with chronic headache of effort, combined with migraine--5 cases, or combined with vascular headache--11 patients; 4) paroxysmal disorders (43 individuals: 25--with typical panic attacks, 18--with atypical panic attacks). More pronounced positive effect was found in the group with atypic PA and in the group with slight hypothalamic dysfunction, accompanied by solitary neuro-endocrine symptoms with moderate or severe depression, with chronic headache of strain including a combination with migraine. Neuroendocrine, motivative, psychovegetative, algesic and psychopathologic symptomatology was decreased significantly in all the groups with positive effect together with the improvement of the objective psychophysiologic indices. Intrahemispheric interactions were also improved, exactly: the power of frequency EEG spectrum increased, in general, because of both the increase of the slow rhythms from both sides and the approach of the coefficient of asymmetry to the control. The least effect was observed in the patients with senesto-hypochondric syndrome, with prevalence of anxiety over depression, with rude hypothalamic dysfunction, with vascular headache, with typic PA.

The effects of phototherapy on psychoautonomic neurotic disorders.

Bright white light therapy (two-week courses of daily morning sessions lasting 1 h; distance from lamp 60 cm; light intensity 3300 lux) was used in 51 patients with neurotic autonomic dystonia syndrome. Improvements were obtained in 59% of patients (group 1), while treatment was not effective in 41% (group 2). Changes in virtually all neuroendocrine, motivational, psychoautonomic, pain, and psychopathological symptomatology were obtained. At the end of treatment, patients in group 1 had increases in the EEG power spectrum, increases in slow activity and reductions in rapid activity on both sides; coefficients of asymmetry approached those in controls, and there were increases in urinary excretion of catecholamine and serotonin metabolites. In group 2, initially increased EEG power spectra increased further, because of increases in theta and beta rhythms bilaterally, and the coefficient of asymmetry decreased sharply; total excretory activity decreased. Symptoms and psychophysiological measures positively and negatively affected by phototherapy were identified.

[The effect of phototherapy on psychoautonomic disorders of a neurotic nature]. / Vliianie fototerapiia na psikhovegetativnye rasstroistva nevroticheskoi prirody.

Bright white light therapy was applied to 51 patients with syndrome of autonomic dysfunction of neurotic origin (1 hour of light exposure every day in the morning, during 2 weeks, 60 sm from the lamp, 3300 lux). Improvement occurred in 52% of the patients (responders--group 1, nonresponders--2). Changes occurred in nearly all symptoms: neuroendocrine, motivation, psychoautonomic, pain, psychopathologic. After the treatment in group 1 there was an increase of power of EEG spectrum, intensification of manifestations of the slow activity and decrease of the fast one from the two sides, an approach of the coefficient of asymmetry to the control levels as well as elevation of the urine excretion of metabolites of both catecholamines and serotonin. Initially higher power of EEG spectrum in group 2, became still more increased due to intensification of manifestations of theta and beta-2 rhythms from the two sides. Meanwhile coefficient of asymmetry was sharply decreased as well as general secretory activity inhibited. There were such symptoms and indices which had changed either negatively or positively under the influence of phototherapy.

[The phototherapy of psycho-autonomic disorders]. / Fototerapiia psikhovegetativnykh rasstroistv.

26 patients with psychovegetative disorders of neurotic origin (vegetative dystonia syndrome, hyperventilation syndrome, panic attacks, headache, insomnia, motivation disorders) were treated. Light therapy (LT) was carried out every day during 2 weeks. The light of 4500-5000 lux was applied during 1 hour (the distance-60 cm). As a result positive effect was revealed in 11 patients while there was no effect in 15 individuals. The positive effect was observed as a decrease of clinical manifestations. Patients with positive treatment results were characterised by short disease duration, weak hypothalamus dysfunction, astheno-depressive disorders prevalence. Negative effect of LT was observed in patients with longer duration of disease, more severe hypothalamic dysfunction together with anxious and astheno-hypochondriac syndrome. The conclusion a made that LT effect is associated with the character and the degree of psychovegetative disorders, but not with presence or absence of hypothalamic dysfunction.

[Current concepts of the hypothalamic syndrome]. / Sovremennye predstavleniia o gipotalamicheskom sindrome.

Current views on the hypothalamic syndrome are presented as derived from the review of recent advances in neuroendocrinology and autonomic function studies, and the authors' personal experience as well. The data on etiology, pathogenic mechanisms of hypothalamic disorders are presented. Diagnostic criteria for hypothalamic syndrome are given and results of the combined psychophysiological investigation of its major forms are summarized. The data suggest the leading role of constitutional-acquired neurotransmitter deficiency in the hypothalamic syndrome. The organic defect had a residual character with no topical correlates, was relatively stable and of no substantial influence on the shaping of clinical signs and their course.

[Autonomic provision for some forms of activity in focal lesions of the limbo-reticular complex (results of a mathematical analysis of cardiac rhythm)]. / K voprosu o vegetativnom obespechenii nekotorykh form deiatel'nosti pri ochagovom porazhenii limbiko-retikuliarnogo kompleksa (dannye matmematicheskogo analiza serdechnogo ritma)

The author studied vegetative provisions in different forms of activiity (mental, physical and emotional) detected in focal lesions of the limbico-reticular structure of 91 patients and 9 normals. Among the studied contingent 38 had focal lesions of the temporal lobe, 31 -- of the hypothalamus and 22--of the brain stem. Vegetative activity was studied by registrations of the frequency of heart contractions and by a subsequent mathematical processing. It was possible to demonstrate an excessive degree of vegetative provision in all groups the following factors: the localization of the process, the initial degree of vegetative disturbances, the expressiveness of emotional changes. In a moderate expressiveness of psycho-vegetative disturbances there is a higher degree of vegetative provisions than in expressed psychovegetative syndromes. These data may serve as an explantation to the origination of such clinical conditions as asthenical states and disorders of adaptation in different forms of activity.