[The effectiveness of tele-rehabilitation for patients with multiple sclerosis during the COVID-19 pandemic in 2020-2021 was evaluated in this study]. / Effektivnost' telereabilitatsii patsientov s rasseyannym sklerozom v usloviyakh pandemii koronavirusnoi infektsii v 2020­2021 gg.

OBJECTIVE: To evaluate the effectiveness of telerehabilitation (TELEREBT) of patients with multiple sclerosis (MS) in the context of the coronavirus pandemic 2020-2021. MATERIAL AND METHODS: The study included 37 patients with MS who underwent a course of teleRBT. The course included 10 classes of 60 minutes for 10 days with a two-day break. Various questionnaires and scales were used to assess the effectiveness, as well as an assessment of the neurological status. RESULTS: 19 patients refused to participate in the program. The level of disability on the EDSS scale decreased from 4.86±1.19 at the initial level to 4.73±1.12 after the course of teleRBT, while no statistically significant changes were found. CONCLUSION: TeleRPT in patients can be an effective way to correct existing disorders. Further research is required to establish the effectiveness of teleRBT.

[Dance therapy in the rehabilitation of neurological diseases]. / Tantseval'no-dvigatel'naya terapiya v reabilitatsii nevrologicheskikh zabolevanii.

A literature review of clinical trials on the effectiveness of the use of dance movement therapy in patients with neurological diseases is presented. A systematic review and meta-analysis of the effectiveness of dance movement therapy on non-motor manifestations of Parkinson's disease is presented. Dance movement therapy was found to have a significant positive effect on cognitive impairment, but no effect on depression, fatigue, and apathy. The effectiveness of dance movement therapy in post-stroke rehabilitation is shown. The data of a systematic review are presented, which found that dance movement therapy is effective not only in the rehabilitation of Parkinson's disease and stroke, but also in the rehabilitation of patients with multiple sclerosis, Huntington's disease and the consequences of spinal cord injury.

Vaccination and Multiple Sclerosis - Current Situation.

Active immunization of patients with autoimmune diseases is a current challenge. Vaccination of patients with multiple sclerosis (MS) has been shown not to be associated with increased risk of exacerbation. A personalized approach to immunization of this group of patients is required, taking account of ongoing therapy and the nature of the course of illness. MS is not an absolute contraindication for vaccination against the new coronavirus infection. Vaccination can be with any of the currently authorized immunoformulations.

[Ofatumumab - a new drug for the treatment of multiple sclerosis]. / Ofatumumab ­ novyi preparat dlya lecheniya rasseyannogo skleroza.

Recently anti-B-cell therapy has been increasingly integrated into the treatment of multiple sclerosis (MS). This review is devoted to ofatumumab, a new drug of this line. Ofatumumab, an all-human monoclonal antibody used to treat chronic leukemia, binds to a different region than the binding site of other CD20 antibodies, including both a small and large loop in the CD20 receptor structure. This monoclonal antibody provides favorable results for MS by reducing the frequency of exacerbations and the risk of disability progression, significantly more pronounced when compared with teriflunomide. The drug can be used in patients with active relapsing MS and SPMS with exacerbations, with the ineffectiveness of first-line drugs as one of the options for second-line therapy, in patients with highly active MS, especially with a high risk of PML (transfer from natalizumab), as well as if there are difficulties in organizing intravenous courses in day hospitals (produced as outpatient injections).

[Vaccination and multiple sclerosis at the present stage]. / Vaktsinatsiya i rasseyannyi skleroz na sovremennom etape.

Immunization of the patients with autoimmune diseases is rising a lot of concerns. It was previously demonstrated that vaccination in MS patients was not associated with an increased risk of exacerbations. A personalized approach is needed to define the immunization schedule. A decision should be made based on the course of the disease and the treatment used. Multiple sclerosis is not an absolute contraindication to vaccination. Any authorized vaccine can be used in MS patients.

[Possibilities of art therapy and color therapy in the rehabilitation of multiple sclerosis]. / Vozmozhnosti art-terapii i tsvetoterapii v reabilitatsii pri rasseyannom skleroze.

THE PURPOSE OF THE STUDY: To study the effectiveness of non-drug methods of prevention and rehabilitation of patients with various variants of multiple sclerosis (MS) in outpatient settings. MATERIAL AND METHODS: In a group of 35 patients with limited mobility with various variants of the course of MS, continuous art therapy was performed (art lectures, work with various art materials - markers, pastels, etc.). The average duration of the training cycle in the group was 6 months. Classes were held on an outpatient basis, and if it was impossible to attend classes - remotely. RESULTS: Positive results were obtained in double psychological testing. 68% of patients had decreased levels of depression and anxiety on the HADS scale, 34% of patients refused to take antidepressants. However, positive psychotherapeutic dynamics against the background of art therapy is not a reason to cancel the main basic treatment. CONCLUSION: Art therapy-art therapy and, as its division, color therapy (diagnosis of the condition and treatment of color) is a synthesis of medicine, art and psychology. In MS patients, the following color combinations are recommended when working with art materials:stimulating (red, orange, coral, yellow); soothing (green, blue, blue, purple). Negative colors are excluded - black, gray, dirty shades with a mixture of black or gray.

[Preliminary results of rehabilitation intervention for the correction of cognitive impairment in patients with multiple sclerosis]. / Predvaritel'nye rezul'taty reabilitatsionnoi interventsii dlya korrektsii kognitivnykh narushenii u bol'nykh rasseyannym sklerozom.

One of the leading symptoms in patients with multiple sclerosis (MS) is cognitive impairment. It often affects aspects of cognition such as learning ability, memory, processing speed, and attention. It has been proven that patients often complain of difficulties in multitasking and choosing the right words. These problems are often underestimated. Various studies show that regular physical activity, mainly aerobic exercise, can potentially improve cognitive function. Positive effects on concentration, memory, and multitasking were described. In March 2019, the Tyumen regional center of MS, together with the clinical Institute of the brain (Yekaterinburg), launched a clinical study of methods for rehabilitation of cognitive disorders in patients with MS. There was a statistically significant improvement in MOCA-test scores, according to SDMT and PASSAT data in the main group of MS patients. Despite a significant improvement in cognitive function, the self-assessment of mental function according to the MSQOL54-MN test in this group of patients did not change. Our preliminary results suggest that a comprehensive and well-controlled training program can improve cognitive abilities in MS patients even after a short course of treatment.

[The use of music therapy in the treatment of adverse effects in patients with multiple sclerosis treated with alemtuzumab]. / Primenenie muzykal'noi terapii dlya korrektsii nezhelatel'nykh yavlenii pri terapii alemtuzumabom u bol'nykh rasseyannym sklerozom.

Alemtuzumab (Lemtrada) is a recombinant humanized IgG1 kappa monoclonal antibody against cell surface glycoprotein CD 52. It is authorized in more than 65 countries worldwide including the Russian Federation. This is one of the most effective drugs for the treatment of the aggressive form of multiple sclerosis. Its safety profile includes different infusion reactions. Current publication demonstrates our experience of using music therapy during alemtuzumab infusion and its role in the adverse reactions management.

[Clinical cases of multiple sclerosis in children with cerebral palsy]. / Klinicheskie sluchai rasseiannogo skleroza u detei s detskim tserebral'nym paralichom.

The careful differential diagnosis is very important in pediatric cases of multiple sclerosis (MS). It has special difficulties, if MS started in patients with residual neurological pathology. Two cases of development of MS in children with cerebral palsy (CP) are presented. The clinical features and diagnostic difficulties in such comorbid situations are discussed .

[The risk of ischemic stroke in patients with multiple sclerosis]. / Risk razvitiia ishemicheskogo insul'ta u bol'nykh rasseiannym sklerozom.

A brief literature review on risk factors of ischemic stroke in patients with multiple sclerosis (MS) is presented. A case of ischemic stroke in a MS patient was demonstrated, and risk factors were identified.

[Additional possible mechanisms of the action of ocrelizumab in multiple sclerosis on example of a case-report]. / Vozmozhnye dopolnitel'nye mekhanizmy deistviia okrelizumaba pri rasseiannom skleroze na primere klinicheskogo sluchaia.

Anti-B-cells products, including the anti-CD20 monoclonal antibody ocrelizumab, are widely coming to multiple sclerosis (MS) therapy. Its clinical-MRI efficacy in MS with relapses as well in primary progressive MS (PPMS) was proved by three phase III clinical studies. One example of the use of ocrelizumab use in aggressive MS showed the possibility of action on the leptomeningeal folliculi, seen at contract-enhancing MRI images.

[Results of a study of velaxin (venlafaxine) efficacy in patients with subacute and chronic spondylogenic dorsalgia].

An open comparative study of efficacy and tolerability of velaxin (venlafaxine with prolonged action), which has been prescribed in a single dosage of 75 mg daily during 8 weeks, included 47 patients with subacute and chronic spondylogenic dorsopathy (SD). Degree of pain chronisation and its intensity (The Visual Analogous Scale - VAS and the Verbal Pain Scale - VPS) and levels of daily activity restriction (the modified Pain Disability Questionnaire - PDQ), anxiety and depression were measured. The comparison group consisted of 32 patients with SD matched for clinical characteristics with the main group, who did not receive antidepressants and antiepileptics in the complex treatment of pain syndrome. Scores of VAS, VPS and PDQ in the main group were 69+/-2.9; 2.8+/-0.1 and 44.2+/-3.2 respectively, at baseline; 38.8+/-3.3 (p<0.01); 1.6+/-0.2 (p<0.01) and 26.2+/-2.5 (p<0.01) after 4 weeks and 15.8+/-2.5 (p<0.05); 0.6+/-0.1 (p<0.05) and 11.2+/-1.6 (p<0.01) to the end of treatment. To the 8th week, scores on VAS, VPS and PDQ were significantly low in the main group compared to the controls (p<0.5) and the intensity of pain was reduced by 50% in 40 (85%) patients. No serious side-effects were observed.

Association and linkage of juvenile MS with HLA-DR2(15) in Russians.

The aim of this study was to determine the role of the HLA-DRB1 gene [6p21] in susceptibility to juvenile MS (JMS) (age at onset < or =15 years) of children of Russian descent. Association of DR2(15) with JMS has been found by the comparison of patients with JMS with both unrelated and affected family-based healthy controls. The linkage of DR2(15) with JMS was shown by transmission disequilibrium test. There were no significant differences in the frequencies of DRB1 alleles and genotypes between 56 patients with JMS and 234 patients with MS with age at onset > or =16 years.

Clinico-immunogenetic characteristics of multiple sclerosis with optic neuritis in children.

The frequency of multiple sclerosis (MS) with clinical onset before 16 years of age in different regions of Russia fluctuates from 2 to 10% of all MS patients. One of the most frequent signs of MS manifestation and/or exacerbation at this age is optic neuritis (ON). Forty-seven children with MS were observed in Moscow. Diagnosis of MS in every case was clinically definite and proved by serial MRI. Clinico-tomographic dissociation was noticed: numerous large lesions, typical for MS on T2 images were often seen in children with mild or moderate residual neurological symptoms. All patients had relapsing/remitting MS course, mean EDSS was 2.24+/-0.26. Thirty-eight children (80%) had ON at least once, ten (21.3%) - twice or more times. In several cases ON had subclinical course or might be missed and the damage of the optic nerve with partial atrophy was found only after complex ophthalmological investigation including visual evoked potentials. Thus, the clinical course of MS and ON have some peculiarities in children and may be genetically based. Analyses of allelic polymorphisms of HLA-DR and TNF loci on chromosome 6 was performed. Data from children with MS were compared with data from their parents, healthy controls and other MS patients from the same ethnic group. Children with MS had increased frequency of DR2(15) and TNF-a11, but not TNF-a9 as adult MS patients from the same ethnic group. The presence of TNF-a7, rare in adult patients, could be proposed as a marker of early MS onset.