[Cognitive impairment in multiple system atrophy - exclusion criteria or an integral part of the clinical picture?] / Kognitivnye narusheniya pri mul'tisistemnoi atrofii ­ kriterii isklyucheniya ili neot"emlemaya chast' klinicheskoi kartiny?

Multiple system atrophy (MSA) is a severe, orphan disease characterized by a steady increase in symptoms of parkinsonism, cerebellar disorders, and autonomic failure. In addition to autonomic failure, which is considered the defining symptom of this type of atypical parkinsonism, there are a range of other non-motor clinical manifestations, such as sleep disorders, pain syndrome, anxiety-depressive disorders, cognitive impairment (CI). CI, especially severe CI, has long been considered as a distinctive feature of MCA. Recently, there have been many clinical studies with pathomorphological or neuroimaging confirmation, indicating a high prevalence of cognitive disorders in MCA. In this article, we discuss the pathogenetic mechanisms of the development of MCA and CI in MCA, as well as the range of clinical manifestations of cognitive dysfunction.

[Mechanisms of development of constipation in Parkinson's disease and therapeutic approaches]. / Mekhanizmy razvitiya i vozmozhnosti korrektsii konstipatsii pri bolezni Parkinsona.

Constipation is one of the most common non-motor symptoms of Parkinson's disease. The pathogenetic mechanisms of constipation, diagnostic criteria, approaches to investigations and treatment are discussed in the paper.

[A rare clinical case of comorbidity of early-onset Parkinson's disease and remitting multiple sclerosis]. / Redkii klinicheskii sluchai sochetaniya rannego nachala bolezni Parkinsona i remittiruyushchego rasseyannogo skleroza.

Comorbidities of extrapyramidal disorders and multiple sclerosis (MS) are rare. The chance of a combination of MS and Parkinson's disease (PD) is less than 1 in 12.5 million. In total, 42 cases of joint development of these disorders are described in the literature. All described patients had no initial changes in the basal ganglia on MRI, and the development of MS was diagnosed after 1-8 years. Possible common links in the pathogenesis of neurodegenerative disease and MS, as well as the cumulative effect of the two diseases on the severity of axonal degeneration and neuronal loss are discussed. A description of a clinical case of a combination of early onset PD and relapsing-remitting multiple sclerosis is presented.

[Creativity in patients with Parkinson's disease]. / Tvorcheskie sposobnosti u patsientov s bolezn'iu Parkinsona.

In some cases, a variety of creative abilities appear in patients with Parkinson's disease receiving dopaminergic therapy. These are the creativity of thinking, unusual motivation and efficiency, which are not inherent to the patients before. The author considers a spectrum of these changes, as well as their possible pathobiochemical and pathophysiological basis. The connection between creativity in art and impulsive-compulsive disorders is discussed. Specific personality traits, type of temperament and emotional stability can play a significant role in the development of creative abilities. It is important to recognize and control the severity of the creative potential of patients with Parkinson's disease, improving the quality of life, and to increase self-esteem, psychological attitude and social adaptation among these patients preventing the excesses of this process.

[A clinical and genetic study of impulsive-compulsive disorders in patients with Parkinson's disease]. / Kliniko-geneticheskoe issledovanie impul'sivno-kompul'sivnykh rasstroistv u bol'nykh bolezn'iu Parkinsona.

AIM: To evaluate the frequency and spectrum of impulsive-compulsive disorders (ICDs) in patients with Parkinson's disease (PD) without dopaminergic medication and among patients receiving dopaminergic replacement therapy, depending on personality type, genetic factors, and to determine the influence of ICDs on the development of other non-motor manifestations of the disease. MATERIAL AND METHODS: Three hundred and eighty-six consecutive patients with idiopathic PD, including untreated patients with PD (de novo) and patients receiving dopaminergic replacement therapy during one year, were examined. ICDs were evaluated with QUIP and diagnostic criteria. Personality type and temperament features were assessed by the Eysenck personality inventory. Genotyping for the single nucleotide polymorphism rs141116007 in the DBH gene involved in the pathogenesis of PD and ICDs was performed. RESULTS AND CONCLUSION: ICDs were identified in 20.2% patients with PD and in 4% patients of the de novo group. The most common (10.36%) behavioral disorder was a binge eating. The frequency of ICDs among patients with PD before the onset of dopamine replacement therapy increased by 1.03 times after one year treatment. Smoking and young age were risk factors for ICDs (p<0.05). The results of the study allowed the determination of social and neuropsychological risk factors for ICDs in patients with PD. The account of these features, as well as early detection of ICDs using screening questionnaires may help to personalize treatment of patients with PD and to prevent the risk of developing comorbid non-motor manifestations of the disease.