[Identifying the neurostimulation target for treatment of cognitive impairment in aging and early cerebral small vessel disease]. / Vybor misheni neiromodulyatsii dlya korrektsii kognitivnykh rasstroistv pri starenii i rannei tserebral'noi mikroangiopatii.

OBJECTIVE: To develop individualized approaches to the use of neuromodulation as a non-pharmacological treatment of cognitive impairment (CI) based on the assessment of compensatory brain reserves in functional MRI (fMRI). MATERIAL AND METHODS: Twenty-one adults over 45 years of age, representing a continuum from healthy norm to mild cognitive impairment due to aging and early cerebral small vessel disease, were studied. All participants underwent fMRI while performing two executive tasks - a modified Stroop task and selective counting. To assess the ability to compensate for CI in real life, functional activation and connectivity were analyzed using the BRIEF-MoCA score as a covariate, which is the difference in ratings between the Behavior Rating Inventory of Executive Function (BRIEF) and the Montreal Cognitive Assessment Scale (MoCA). RESULTS: Both fMRI tasks were associated with activation of areas of the frontoparietal control network, as well as supplementary motor area (SMA) and the pre-SMA, the lateral premotor cortex, and the cerebellum. An increase in pre- SMA connectivity was observed during the tasks. The BRIEF-MoCA score correlated firstly with connectivity of the left dorsolateral prefrontal cortex (DLPFC) and secondly with involvement of the occipital cortex during the counting task. CONCLUSIONS: The developed technique allows identification of the functionally relevant target within the left DLPFC in patients with CI in aging and early cerebral microangiopathy.

A prospective randomized, double-blind placebo-controlled study to evaluate the effectiveness of neuroprotective therapy using functional brain MRI in patients with post-covid chronic fatigue syndrome.

BACKGROUND AND PURPOSE: to assess executive network using resting-state fMRI and patterns of brain activation using task fMRI with a cognitive paradigm, against the background of taking the drug in comparison with placebo in patients with post-COVID asthenic syndrome. METHODS: The study employed a prospective, randomized, double-blind, placebo-controlled trial approach to assess the efficacy of utilizing functional MRI of the brain as a neuroprotective therapy for treating patients with chronic fatigue syndrome following COVID-19. The study included 30 patients matched by sex and age with post-COVID asthenic syndrome. All patients were examined with MFI-20, MoCA, FAS-10 scales, MRI using a Siemens MAGNETOM Prisma 3 T scanner before and after a course of therapy with coordination complex with succinate acid anion (CCSA) or placebo (15 patients each) using resting state fMRI and with cognitive paradigm. RESULTS: The changes obtained as a result of the treatment of post-Covid asthenic syndrome demonstrated clinical superiority in the reduction of asthenic symptoms for the group of patients treated with CCSA (MFI-20 scores: -20·0 points in the CCSA group compared to -12 points in the placebo group, p = 0·043). The data obtained also correlate with the analysis of task fMRI and resting state fMRI may indicate an increase in the functional cognitive status after a course of therapy with CCSA. Clinically, this correlates with a statistically significant improvement in the MoCA score (2 points in the CCSA group compared to 1 point in the placebo group, p < 0·05). CONCLUSIONS: the study demonstrates the potential effectiveness of CCSA therapy in relation to a wide range of symptoms (chronic fatigue syndrome/ asthenic syndrome and cognitive impairment) in patients with post-COVID syndrome. The first time demonstrated the effectiveness of neuroprotective therapy after post-COVID asthenic syndrome with the use of high-tech neuroimaging techniques.

[Capacity of vibroacoustic therapy for correction of respiratory manifestations of post COVID-19 syndrome]. / Vozmozhnosti vibroakusticheskoi terapii v korrektsii respiratornykh proyavlenii postkovidnogo sindroma.

The search for therapeutic strategies for the correction of post COVID-19 syndrome is an urgent task of medicine. One of the frequent manifestations of post COVID-19 syndrome is the prolonged persistence of respiratory syndromes - dyspnea and cough. Vibroacoustic therapy is promising methods in the complex effect on broncho-pulmonary symptoms of COVID-19. OBJECTIVE: To study the effect of vibroacoustic pulmonary therapy implemented through the BARK VibroLUNG apparatus on the clinical and instrumental parameters of patients undergoing COVID-19 with residual respiratory symptoms. MATHERIAL AND METHODS: The effect of vibroacoustic therapy (5-day course of 2 sessions) on dyspnea and cough and respiratory function in 60 patients aged 18 to 75 years who underwent COVID-19 of varying severity for more than 12 weeks before the start of the study, with the presence of distant respiratory symptoms, was investigated. Patients were divided into two equal and age-matched groups - without (1st) and with (2nd) chronic bronchopulmonary pathology. RESULTS: Analysis of comorbidity of patients with respiratory phenotype of post COVID-19 syndrome showed frequent presence of concomitant cardiovascular pathology (76.7%). The predominant patient complaint was dyspnea (93.3% in both groups): 29 patients (96.7%) in the non-lung group, and 27 patients (90%) in the chronic lung group. The mean mMRC dyspnea score for all patients was 1.1±0.49 points (1.2±0.5 points in the first group and 1.0±0.45 points in the second group). Cough was observed less often - in 18 patients of both groups (30%), mainly in the second group. During the course of vibroacoustic therapy in the 1st group, the number of patients with dyspnea decreased from 96.7 to 30%, in the 2nd group - from 90 to 10%, the total mean mMRC dyspnea score decreased to 0.2±0.4 (Δ 82%), and a complete regression of cough syndrome was achieved in both groups. Also, an increase in forced expiratory volume in 1st second and peak expiratory flow indicators was revealed both in the general group of patients and in the group of patients without chronic lung pathology. CONCLUSION: The results obtained during the study of the use of vibroacoustic therapy in patients with respiratory manifestations of post-COVID syndrome, including the presence of chronic bronchopulmonary pathology, allow us to conclude on the effective correction of dyspnea and cough during treatment. Vibroacoustic therapy is a promising non-drug method of exposure to bronchopulmonary manifestations of post-COVID syndrome in patients during rehabilitation.

[Application of new technologies in postgraduate education of otorhinolaryngologists]. / Primenenie novykh tekhnologii v poslediplomnom obrazovanii vrachei-otorinolaringologov.

The article is devoted to one of the urgent problems of modern medical education - postgraduate education, further development of skills and deepening of knowledge among otorhinolaryngologists after training in clinical residency. The long-term experience of training in advanced training cycles for both otorhinolaryngologists beginning their professional path and doctors with a long, decades-long work experience in the specialty is analyzed. The trajectory of professional development is presented, which allows structuring the acquired knowledge, distributing the stages of training over time, taking into account the priorities of students and combining training with the exchange of experience and personal communication with colleagues. The problems and the most promising directions of the development of postgraduate education of otorhinolaryngologists are considered.

[The study of the effect of mono- and polymalt extracts on the psycho-physiological functions of outbred rats in an experiment with course consumption].

The search for natural ingredients that have a certain nutritional value and contribute to the preservation of human health is a very urgent task. The goal of this research was to study the effect of three viscous extracts - two polymalt and one malt extract, on the psychophysiological functions of animals in an experiment with prolonged consumption. Material and methods. The study was conducted on white mongrel male rats weighing 110-130 g, divided into 4 groups of 13 individuals. The 1st group (control) received standard granulated feed without extracts, the 2nd group - the feed with a polymalt grain extract from barley, hulless oats and wheat, the 3rd group - the feed with a polymalt grain extract from barley, hulless oats and rye, the 4th group - the feed with a malt extract from barley grain, in a dose of 2.1 g/kg of body weight. The consumption of the studied extracts in all groups of animals lasted 21 days. The animals were weighed before and after the consumption period and tested using the "Open field" test (research and motor activity were recorded), the «Rotating Rod¼ test (study of locomotor reactions), «Forced Swimming¼ (study of induced depression). Results. The addition of malt and polymalt extracts to the diet of the experimental animals had a beneficial effect on them: the duration of fading as an indicator of depression during swimming test in all experimental rats decreased by 31.4-37.8% with varying degrees of statistical significance. At the same time, a monomalt extract from barley grain and a polymalt extract from grain of barley, naked oats, and rye had a more positive effect on the condition of the animals in the experiment: in the "Rotating Rod" test, the retention time of animals as an indicator of endurance increased by 26.0-27.1%; in the «Open Field¼ test, motor and exploratory activity increased and the time of passive behavior decreased by 35.0-37.4%. Conclusion. The development, production and research of malt extracts is a promising direction that requires the selection of initial grain components taking into account their chemical composition. It is possible to create general restorative supplements on the basis of extracts, as well as to introduce them into alcoholic beverages in order to reduce the toxicity of ethyl alcohol and preserve a number of physiological functions in the human body during alcohol consumption.

[Clinical significance of radiological methods for diagnosing endolymphatic hydrops in Ménière's disease]. / Klinicheskaya znachimost' luchevykh metodov diagnostiki endolimfaticheskogo gidropsa pri bolezni Men'era.

Ménière's disease is a chronic disorder of the inner ear, a permanent sing of which is endolymphatic hydrops. For the diagnosis of Ménière's disease in clinical practice, criteria that are primarily based on the clinical picture. However, instrumental methods for diagnosing Ménière's disease, aimed at identifying endolymphatic hydrops, continue to be developed and improved. Radiation diagnostics contribute significant contribution and aimed at identifying the characteristic signs of Ménière's disease. Recently, it has become possible to visualize endolymphatic hydrops using MRI of the temporal bones. This publication presents an analysis of the current state of this topical aspect of the problem of diagnosing Ménière's disease. The purpose of this review is to conduct a comparative analysis of radiation methods for diagnosing Ménière's disease. MATERIAL AND METHODS: The study included publications in English and Russian found in the PubMed, eLibrary database related to the diagnosis of Meniere's disease. RESULTS: A comparative analysis of computed tomography of the temporal bones, magnetic resonance imaging of the temporal bones and diagnostic possibilities for detecting signs characteristic of Ménière's disease are presented. The most diagnostically significant method of studying Ménière's disease is identified. CONCLUSION: MRI of the temporal bones with contrast enhancement is a promising method that can be used to develop an effective treatment algorithm.

Effect of Sol-Gel Alumina Biocomposite on the Viability and Morphology of Dermal Human Fibroblast Cells.

This paper is the continuation of our previous work on the ability of biocomposites based on sol-gel alumina (boehmite) to promote skin recovery from burns and atrophic scars. The present study describes the increasing of the cytoplasma volume and the number of filopodias of HDF cells, which for the first time indicates their proliferation on the alumina itself and on alumina-based biocomposite. Studies in vivo confirm the efficiency of the composite in the treatment of atrophic scars.

['School of Excellence' in the structure of teaching otorhinolaryngology at the department of diseases of the ear, nose and throat of Sechenov University: experience and perspective]. / Shkola masterstva v strukture prepodavaniia otorinolaringologii na kafedre boleznei ukha, gorla i nosa Sechenovskogo Universiteta: opyt i perspektiva.

We describe our experience of teaching practical skills in Otorhinolaryngology in the Department of Ear, Larynx and Nose diseases of the Sechenov First Moscow State Medical University (Sechenov University) as a part of the rector's project 'School of Mastery' Training is held under the program, specially designed at the department. This program takes into account all the aspects of ENT doctor's practice. During their training in the school students actively participate in the work of the ENT department - they visit the dressing room, operating theater, take part in professors' rounds, and oversee the patients with various ENT conditions. Seminars are held weekly to consolidate learned practical skills. Training sessions are also held in departments of Children's Otorhinolaryngology and emergency ENT department. Results of the 'School of Mastery' were analyzed at the Department of Ear, Larynx and Nose diseases. Future perspectives are also stated.

[Executive functions: fMRI of healthy volunteers during Stroop test and the serial count test]. / Upravliaiushchie funktsii mozga: funktsional'naia magnitno-rezonansnaia tomografiia s ispol'zovaniem testa Strupa i testa seriinogo scheta pro sebia u zdorovykh.

AIM: To assess executive function in healthy adults using fMRI. MATERIAL AND METHODS: An analysis of fMRI activation and functional connectivity during a serial count task (as a shifting function test) and color-word Stroop test (classical inhibition function test) was made for 12 healthy adults. RESULTS AND CONCLUSION: The executive control network and salience network activation was comparable in both tasks. Nevertheless, there were differences between two tests in functional connectivity of the dorsolateral prefrontal cortex (DLPFC) and the supplementary motor area (SMA) with other brain regions, that can be explained by the differences in the regulatory mechanisms of task performance. Stroop test assumes its automatic performance, and control of program realization is performed mainly by executive-control network. The connectivity between the two DLPFCs with the lower parietal lobules and with each other and inhibition by SMA connectivity with only the right hemisphere regions support this notion. Serial count task excludes the process of monotonous learning, that was confirmed by widespread SMA connections in the absence of connectivity of the DLPFC with executive control network regions. This connectivity pattern allows assuming the leading role of SMA in certain brain regions choice and switching their activity for providing attention and executive control of cognitive operations shift during task performance. These findings allow us to consider the serial count task as the relevant fMRI test for executive functions with the special focus on set shifting, also in patients with executive function deficits. Furthermore, SMA region mapping with the serial count test paradigm could be considered as a potential target for navigated transcranial magnetic stimulation (nTMS) in these patients.

[The experience with the education based at the clinical residency of the Department of Ear, Throat and Nose Diseases, I.M. Sechenov First Moscow State Medical University (on the occasion of the 260th anniversary of the Sechenovsky University)]. / Opyt obucheniia v klinicheskoi ordinature na kafedre boleznei ukha, gorla i nosa Pervogo MGMU im. I.M. Sechenova (k 260-letiiu osnovaniia Sechenovskogo universiteta).

This publication was designed to report the experience gained by the Department of ear, nose and throat diseases at I.M. Sechenov First Moscow State Medical University in the matters concerning professional medical education in the framework of the clinical residency. The main factors that contribute to the adequate shaping of the future ENT-doctor are considered. These include the continuity of generations and conservation of the traditions in the combination with the development of the leading areas of scientific, clinical and educational work.

[A current view on the MRI diagnosis of multiple sclerosis: an update of 2016 revised MRI criteria]. / Sovremennyi vzgliad na MRT-diagnostiku rasseiannogo skleroza: obnovlennye MRT-kriterii 2016 g.

Magnetic resonance imaging (MRI) is the primary method for confirming the clinical diagnosis of multiple sclerosis (MS). The article presents the current data on using MRI of the brain and spinal cord for diagnosis in suspected MS. Special attention is paid to the MRI criteria of McDonald and MAGNIMS for relapsing-remitting MS (RRMS) and primary-progressive MS (PPMS) in the latest revisions of 2010 and 2016. The information provided can help radiologists and neurologists to optimize the use of MRI in clinical practice for diagnosis of MS.

[The role of the vomeronasal system in the formation of the human sexual behaviour]. / Rol' vomeronazal'noi sistemy v formirovanii seksual'nogo povedeniia cheloveka.

This review deals with the structure and function of the vomeronasal system and evaluation of its influence on the sexual sphere of humans and animals. Special attention is given to the role of pheromones in the regulation of the sexual behaviour. The data concerning the function of the vomeronasal organ following surgical interventions in the nasal cavity are discussed.

[The peripheral vestibular disorders encountered in the routine out-patient practical work]. / Perifericheskie vestibuliarnye rasstroistva v ambulatornoi praktike.

The objective of the present study was to elucidate the frequency of causes underlying the development of dizziness and vertigo in the patients seeking advice and care at an outpatient healthcare facility. A total of 590 patients with complaints of dizziness and vertigo were examined. It was found out that the peripheral disorders of the vestibular analyzer were the most frequent causes of dizziness and vertigo in the majority of the examined patients. These conditions were documented to occur in more than 65% of the patients. The most common forms of peripheral vestibular disorders were benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuronitis. The central vestibular disorders occurred considerably less frequently than peripheral ones and were diagnosed only in 10.9% of the patients. The results of the study provided a basis for the development of the algorithm forthe bedside examination of the patients presenting with vertigo and dizziness associated with peripheral vestibular disorders. It is emphasized that such examination should include, besides the standard neurological studies, the neuro-otological tests making it possible to detect the most common forms of peripheral vestibular disorders.

[The peculiar features of the psychosomatic status in the patients presenting with the spondylogenic and cochleovestibular disorders]. / Osobennosti psikhosomaticheskogo statusa u bol'nykh s vertebrogennymi kokhleovestibuliarnymi narusheniiami.

The objective of the present study was to elucidate the peculiar features of the psychosomatic status in the patients with chronic vertebrogenic and cochleovestibular disorders The psychosomatic status was evaluated in 117 patients at the age from 21 to 65 years presenting with these conditions using the psychometric tests based on the STAI questionnaire (the state-trait anxiety inventory) adapted for the determination of the level of reactive and personal anxiety. It was shown that the vestibular disorders, tympanophonia, and hearing impairment have a negative influence on the psychogenic status of the patients suffering from cochleovestibulopathy. As many as 92.3% of the patients were characterized by the high or moderately high level of reactive and personal anxiety. The depressive conditions of various severity were diagnosed in 29.1% of the patients. The correction of postural muscular disbalance made it possible to achieve the well apparent reduction of the manifestations of reactive anxiety without prescription of the pharmacotherapeutic treatment and thereby to increase the effectiveness of the management of the patients presenting with the vertebrogenic and cochleovestibular disorders.

[The role of the students' research groups in the formation of the system of values as a personality trait of the future doctor]. / Rol' studencheskogo nauchnogo kruzhka v formirovanii tsennostnykh orientatsii lichnosti budushchego vracha.

This publication was designed to report the experience gained by the Department of Ear, Throat and Nose Diseases at I.M. Sechenov First Moscow State Medical University in the matters concerning the education of the students involved in the activities of research groups. The main causes for which the senior students should be attracted to doing research work in the framework of the university-based scientific societies are considered. Special emphasis is laid on the role of the students' research groups in the formation of the system of values as a personality trait of the future doctor. The experience gained during the recent years with the organization of inter-institutional students' competitions (otorhinolaryngological olympiads) is discussed.

[Seven principles in the treatment of vestibular vertigo and results of the study of VIRTUOSO]. / Sem' printsipov lecheniia vestibuliarnogo golovokruzheniia i rezul'taty issledovaniia.

This article reports the results of the international post-marketing observational program VIRTUOSO aimed at the evaluation of the efficacy of betahistine dihydrochloride at the dose of 48 mg/day for 1-2 months in patients with paroxysmal vertigo of various origins. The clinical response was rated as good, very good or excellent in 74.1% of the patients (p<0.001). Monthly vertigo attack frequency with betahistine decreased in average from 8.0 to 3.0 (p<0.001). Vertigo attack frequency further decreased during the 2-month follow-up after the end of betahistine treatment. No serious adverse effects of betahistine have been reported.

[Changes in the Functional Connectivity of Motor Zones in the Use of Multimodal Exoskeleton Complex "Regent" in the Neurorehabilitation of Post-Stroke Patients].

The article discusses the effect of a course of treatment with the use of multimodal complex exoskeleton (MCE) "Regent" on the reorganization of cortical locomotor zones in 14 patients with post-stroke hemiparesis, mainly atthe chronic stage of the disease. Before the course of treatment, we identified specific areas of activation in the primary sensorimotor and supplementary motor areas and the inferior parietal lobules in both affected and healthy hemispheres by means of functional MRI (fMRI) with the use of special passive sensorimotor paradigms. After the course of treatment with MCE, we observed an improvement of temporal characteristics of walking; it was accompanied by a decrease in the activation zones of inferior parietal lobules, especially in the healthy hemisphere, and by a significant increase in the activation zone of primary sensorimotor and supplementary motor areas. The analysis of the functional connectivity of studied zones before and after the course of treatment with MCE showed significant changes in intra- and interhemispheric interactions.

[A DTI study of the spinal cord lesion in patients with multiple sclerosis during the follow-up after relapse]. / Porazhenie spinnogo mozga u patsientov s rasseyannym sklerozom posle obostreniya po dannym diffuzionno-tenzornoi magnitno-rezonansnoi tomografii.

UNLABELLED: Spinal cord involvement is frequent in multiple sclerosis (MS) but the correlation between spinal cord damage on conventional MRI and clinical symptoms is not always obvious. Diffusion tensor imaging (DTI) is a sensitive technique for revealing tissue damage. OBJECTIVE: to investigate spinal cord DTI changes in MS patients during the relapse and in the follow-up. MATERIAL AND METHODS: Data were acquired from 25 patients with relapsing-remitting MS during the relapse characterized by unilateral light hand palsy, in three and twelve months after it. All patients underwent full neurological examination and MRI including conventional head and neck MRI and DTI of the brain and upper spinal cord in the sagittal plane. Twelve healthy subjects entered the control group. RESULTS AND CONCLUSION: Spinal cord sagittal DTI provides a reliable information about significant changes in MS patients compared tothe control group both inside demyelinating lesions and in the normal appearing spinal cord. These differences are preserved both in 3 and 12 months after the relapse and together with clinical recovery create evidence of functional compensatory mechanisms development. A tendency towards DTI parameters normalization together with faster fine motor skills recovery in patients without the asymmetrical decrease in vibration sense shows an important role that afferentation plays in recovery after the relapse.

[Standartization of MRI studies in multiple sclerosis]. / Standartizatsiya MRT- issledovanii pri rasseyannom skleroze.

The use of magnetic resonance imaging (MRI) in patients with multiple sclerosis has markedly increased in recent years. The main task of the MRI studies after the diagnosis of multiple sclerosis is to assess the dynamics of MRI for determining disease progression and monitoring the efficacy of therapy. In this regard, it is very important to obtain the most identical baseline and follow-up MRI that is possible when a single standard protocol is used. This article presents the protocol of brain MRI and spinal cord MRI and interpretation of MRI studies in patients with multiple sclerosis.

Influence of Dipole Orientation on Solution Properties of Polyzwitterions.

We have studied the influence of segmental dipole orientation on the solution properties of polyzwitterions using dynamic and static light scattering of poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), n-butyl-substituted choline phosphate polymers (PMBP), and their diblock (PMPC-b-PMBP) copolymers in solutions of different salt concentration. We find that these three structures exhibit dramatically different aggregation behaviors. For the conditions in our study, PMPC is a swollen excluded-volume chain without significant presence of dipolar correlations as evident from the lack of sensitivity to the ionic strength of the solution. In contrast, PMBP self-assembles into finite-sized structures in solution, which are stabilized by electrostatic dipole-dipole interactions. Evidence of these interactions is also present in the diblock polymer, PMPB-b-PMPC, which self-assembles into two distinct, stable aggregates in addition to unaggregated chains. These results contribute to the breadth of understanding of polyzwitterions in solution and provide a platform for future simulation and experimental explorations.