[Peculiarities of emotional-cognitive assessment of sensations by patients with neurological diseases].

To study peculiarities of emotional-cognitive assessment of color sensations and sensation descriptors in patients with autonomic dystonia and cerebrovascular diseases, 70 healthy subjects and 113 patients including 27 with autonomic dystonia, 48 - with discirculatory encephalopathy and 38 - with ischemic stroke have been studied in the rehabilitation period. Clinical-neurological examination, assessment of headache intensity on the Visual-Analogous scale, anxiety and depression levels on the Hospital anxiety and depression scale, the level of mental maladaptation on an author's scale as well as a study of emotional-cognitive assessment of color sensations and sensation descriptors have been carried out. Assessments of color sensations were studied using 20 color standards, indices of positive and negative assessment of all groups of colors and colors of certain categories were determined. The relation to sensation descriptors was studied by showing a list of 50 words; indices of positive and negative ratings of different categories of descriptors (% to the total number of words listed) were determined. It has been shown that the system of assessment of color sensations is most substantially changed in patients with autonomic dystonia that appeared in the more negative, compared to healthy people, perception of cold color tones, dark tones and chromatically non-saturated colors. These changes were less represented in patients with cerebrovascular diseases and disappear after stroke. Changes in the system of sensation descriptors rating are evenly expressed in patients with autonomic dystonia and cerebrovascular diseases: patients' ratings of sensation descriptors are more negative compared to healthy people. These changes are related to the increase of anxiety and depression levels and may contribute to mental health problems of patients.

[The influence of psychic stress on the clinical manifestations and course of myasthenia gravis].

An aim of the study was to evaluate whether psychic stress influenced clinical manifestations and course severity in patients with myasthenia gravis (MG). Seventy-three patients with proven MG (mean age 36,6; SD 13,7 years) and 112 healthy controls (mean age 38,3; SD 10,3 years) were included in the study. The Myasthenia Symptoms Severity Scale was specially elaborated for MG symptoms quantitative assessment. Pneumotachimetric pulmonary functions, including forced expiratory volume in 1 sec (FEV1) and psychological characteristics (short version of MMPI test, Spilberger Anxiety Inventory, Zung Self-Rating Depression Scale (SDS), were measured in each patient. The main causes of daily stress by means of a special self-questionnaire were ascertained and assessment of disability severity was scored. The first examination (T1) was followed up by a second one (T2) 12 months later. In each patient, disease course was specified as mild, moderate or very severe during the T1-T2 period. In most patients (60%), the development or decompensation of MG was caused by psychogenic stressors. Reactive and personal anxiety as well as SDS index were higher in patients as compared to healthy subjects (p<0,001). There was no association between any of personality traits and MG but the patient's average personality profile was elevated comparing to the control group that suggested a presence of mild chronic stress. The main causes of daily stress were related to the consequences of MG. Reactive anxiety was correlated with myasthenia symptoms severity scores and disability scores in patients (p<0,05). The prognostic significance for severe MG course was estimated for the myasthenia symptoms severity score, reactive anxiety (more than 55 scores) and FEV1. The results obtained suggest that psychotherapy seems to be most useful for patients with severe myasthenia symptoms and high psychic stress.

[Evaluation of stress tolerance in the neurological patients].

A purpose of the study was to develop the Stress Tolerance Scale (STS) and to assess its diagnostic efficacy in neurological clinical practice. The theoretical ground for stress tolerance measurement is the concept of personal environmental interaction as a process including phases of the subjective stress event appraisal, active reaction and subjective result appraisal. The STS encompasses the response items of the descriptions of the accomplished and unaccomplished person-environment and self-personal relations that result in stress overcoming or in stress maintenance, respectively. Within each group, the additional variants of the transactions were specified according to their space-temporal characteristics. Data sets from 112 healthy people and 247 patients (60 with chronic tension headache, 72 with chronic low back pain, 51 with myasthenia gravis, 14 with progressive muscular dystrophy, 27 with hereditary polyneuropathy and 23 with torticollis) have been analyzed. The validity and quiantitation of the STS were determined by Rasch analysis and comparison of the results with those of total STS score and subscale scores of the Hospital Anxiety and Depression Scale and Russian brief version of MMPI. All correlations were at a level of significance. A decrease of stress tolerance was found in patients with chronic pain syndromes and torticollis. The results indicate that the STS allows assessing stress tolerance and a structure of person-environment interactions used by a patient. It can be utilized for optimization of short-term psychotherapy of neurological patients.

[Efficacy of combined kineso- and psychotherapy in the treatment of patients with migraine]. / Effektivnost' sochetannogo primeneniia kinezoterapii i psikhoterapii v lechenii bol'nykh migren'iu.

The study aimed at determining the efficacy of combined kineso- and psychotherapy in the treatment of patients with migraine in between-attacks periods. Forty-one patients with migraine (3 males, 38 females, mean age 38.2 +/- 1.5 years) were examined. The patients were randomly divided into 2 age-matched groups. No significant between-group differences in the intensity and duration of migraine attacks, autonomic and psychological status and level of tolerability to physical loading were found. The patients of group 1 (23) recurred individual kineso- and psychotherapy, and patients of group 2 (18) received a course of standard physical therapy and explanatory psychotherapy. After the treatment course, a significant decrease in intensity of headaches of tension, increased bicycle exercise tolerance, equalizing of the ratio between activities of ergo- and trophotropic systems, sympathic and parasympathic tones evaluated by mathematical analysis of heart rhythm variability, a decrease of the level of emotional tension measured by psycho diagnostic testing were observed in both groups. In the patients of group 1, global estimation of therapeutic effect (2.7 +/- 0.2) was significantly higher (p < 0.003), comparing to those of group 2 (1.8 +/- 0.2). Two months after treatment finishing, there was a reduction of migraine attacks frequency in both groups without significant between-group differences in regression extent of this index. The results obtained indicate efficacy of combined physical therapy and psychocorrection in the treatment of migraine patients. Moreover, individual approach to kineso- and psychotherapy improves the immediate results of the treatment.

[Characteristics of psychological features in patients with spinal pains, cerebrovascular pathology and fibromyalgia]. / Kharakteristika psikhologicheskikh osobennostei bol'nykh s khronicheskimi boliami v spine, tserebrovaskuliarnoi patologiei i fibromialgiei.

Three hundred thirty-seven patients with neurological symptoms of lumbar osteochondritis (163 patients, mean age 40.3 +/- 0.51 years), fibromyalgia (32 patients, mean age 45.3 +/- 1.15 years), initial forms of cerebrovascular pathology (142 patients, mean age 46.8 +/- 0.56 years) and 40 healthy controls (mean age 43.2 +/- 1.07 years) have been examined using cliniconeurological and psychological diagnostic methods. Higher frequency of emotional tension was found in patients of all the groups (53.4, 65.6 and 61.3% respectively). Similar personality characteristics predominated both in patients with chronic back pain and in those with cerebrovascular pathology. Along with reaction to disease, other factors (chronic psycho-traumatizing influences, interpersonal conflicts of needs and personal reactivity deficit) promoted psychic dysadaptation.

[The characteristics of the development of immunity with a primary immunization complex using adsorbed DTP vaccine]. / Osobennosti formirovaniia immuniteta pri pervichnom komplekse immunizatsii AKDS-vaktsinoi.

The intensity of immunity, depending on immune response variants characterized by the definite composition of the T and B lymphocyte subpopulation in peripheral blood, was studied in 70 practically healthy young children after the primary complex of immunization with adsorbed DPT vaccine. The most stable immune reaction was shown to appear in children with the hyperergic and normoergic variants of immune response to diphtheria and tetanus toxoids, while the reaction to pertussis antigen was essentially weaker both after the second vaccination and after the first revaccination. In children with the hypoergic variant of immune response to all components of adsorbed DPT vaccine the resulting immune reaction was 2.5-3 times weaker than in children of other groups.

[The role of emotional pressure in the development of the early forms of chronic cerebrovascular insufficiency]. / Rol' émotsional'nogo napriazheniia v razvitii nachal'nykh form khronicheskoi tserebrovasculiarnoi nedostatochnosti.

The paper presents a comparative analysis of the results of biochemical, neuropsychological and neurophysiological examination of initial chronic cerebrovascular insufficiency in patients without significant psycho-emotional tension (the 1-st group--37 individuals) and with significant emotional tension (the 2-nd group--44 persons). Statistically significant differences between the groups concerned both cerebral hemodynamic parameters and EEG data. On the basis of the results obtained several possible pathogenetic variations of chronic cerebral circulatory insufficiency are suggested on the domination of either primary damages of the structures of the brain and its vessels or the secondary disorder of energetic metabolism and cerebral blood circulation. That, in turn, may be conditioned both by supertension of cerebral systems in chronic stress, and by somatic disturbances. More precise definition of the main pathogenetic factors of initial chronic cerebrovascular insufficiency may be useful for improving efficiency of rehabilitation in these patients.

[The role of personality aspects in patients with chronic neurological symptoms of vertebral osteochondrosis and psychological rehabilitation methods]. / Rol' lichnostnykh osobennostei bol'nykh v khronizatsii nevrologicheskikh proiavlenii osteokhondroza pozvonochnika i puti psikhokorrektsii.

The aim of the study is to define mechanisms of influence of the most typical personal traits on chronization of vertebroneurological signs. 100 chronic patients with vertebroneurologic pathology were examined. Early signs of psychic dysadaptation, hypostenic or mixed types of psychological reactivity, low lability of intellectual processes and nonspecific signs were found in the most of the patients. It is suggested that insufficiency of psychological defence might contribute to the development of psychic dysadaptation. Both mechanisms of psychological defence and attitude toward disease were conditioned by predominant personal peculiarities. It is personal characteristics that cause predisposition to development of psychic dysadaptation and to unfavourable attitude toward disease. That in turn contribute to the development of the disorders of motor stereotype. Psychocorrection of such patients is discussed.

[The psychological characteristics of patients with neurological manifestations of lumbar osteochondrosis]. / Psikhologicheskaia kharakteristika bol'nykh s nevrologicheskimi proiavleniiami poiasnichnogo osteokhondroza.

Both clinical-neurological and psychological examinations of 42 patients with neurological manifestations of lumbar osteochondrosis with chronic or chronic recurring course were carried out. The main features of personality in most cases were anxiety, hypochondria, passivity and demonstrativity. The clinical signs of nonspecific psycho-emotional tension was found in 70% of cases. Its level correlated negatively with the effectiveness of the treatment. It was established that the negative influence of personality on the course of disease and on the effectiveness of its therapy was connected with the predisposition of such individuals to unfavourable type of reaction toward disease and to development of psychic adaptation disorders.

[The clinico-psychological aspects in the decompensation of the initial forms of a cerebral vascular lesion]. / Kliniko-psikhologicheskie aspekty dekompensatsii nachal'nykh form sosudistogo porazheniia golovnogo mozga.

Clinico-neurological, instrumental and psychological methods were used to examine 35 patients at the of 55-70 years with early stages of cerebrovascular insufficiency. It was found out that subjective signs of cerebral vascular disorders were likely to be due to nonspecific cerebral dysfunction and associated with psychical dysadaptation. The degree of memory and attention disorders negatively correlated with intensity of mental activity. The results of the work may be used in prophylaxis of decompensation of cerebrovascular pathology.

[Functional radiothermometry in the diagnosis of the autonomic dystonia syndrome]. / Funktsional'naia radiotermometriia v diagnostike sindroma vegetativnoi distonii.

The purpose of the study was to examine potentialities of functional radiothermometry in the diagnosis of a syndrome of vegetodystonia. 56 patients with vegetodystonia and 31 practically healthy subjects were examined. All the test subjects underwent the thermal radiothermometry test with the heating of the right hand and forearm in water bath at a temperature of 45-46 degrees C for 5 min and simultaneous recording of the temperature of the fingers of the intact hand. Analysis of the results demonstrated the predominance of manifest positive and negative temperature reactions in patients with vegetodystonia. In this patients' group, anxiety and hypochondria were encountered less frequently than in persons with moderate temperature deviations. Introduction of radiothermometry and psychological methods of examination allow planning the treatment in accordance with the signs of vascular and psychoemotional disadaptation.

[Reaction to physical load in persons with a varying vestibular-autonomic resistance]. / Reaktsiia na fizicheskuiu nagruzku u liudei s razlichnoi vestibulo-vegetativnoi ustoichivost'iu.

The level of vestibular stability (tolerance to the double rotation test according to I. I. Bryanov) was compared with the pattern of changes in the heart rate and arterial pressure during exercise tests (20 squatting per 30 sec). The test subjects were 136 healthy male volunteers--representatives of different professions, aged 21--40. The subjects with high vestibular stability showed greater changes in heart rate (+29%) and a relatively stable diastolic pressure. The subjects with low vestibular stability displayed, on the contrary, greater changes in the diastolic (-9%) and pulse (+71%) pressure and a relatively low increase in heart rate. The time of recovery of the pressure level was significantly longer in the susceptible people. The possibility of predicting vestibular tolerance on the basis of responses to exercise tests was explored. Mathematical formulas of the theory of image recognition were used to develop a rule that makes it possible to identify 84.4% subjects with low vestibular stability in a given group.

[The epidemiologic significance of tuberculosis mycobacteria of the avian type]. / K voprosu ob épidemiologicheskom znachenii tuberkuleznykh mikobakterii ptich'ego tipa

Reaction to intradermal injection of tuberculin from Mycobacteria tuberculosis of the avian type proved to be negative in all the 505 students examined who never came in contact with fowl farms. Of 738 local residents it was found to be positive in 23.8% and of 320 workers of fowl farms--in 54.5% of cases. In response to the injection of Koch tuberculin and PPD-L the number of positive reactions in all the mentioned groups constituted 69-80%. A conclusion was drawn on the epidemiological danger of Mycobacteria of the avian type for the workers of fowl farms and, to a certain degree, for the surrounding population.