Theoretical Study of Microgel Functional Groups' Mobility.

Polymer microgels, micrometer-sized cross-linked polymer particles, are considered to be a promising type of advanced materials for a wide range of applications. To enhance the microgels' applicability, it is essential to incorporate various functional groups into a microparticle polymer network. Yet, the availability of functional groups for the interaction with surroundings depends strongly on the properties of the polymer network and has a great impact on further effective usage. In this theoretical study, we address this question and, with the help of coarse-grained molecular dynamics computer simulations, assess the segmental mobility and accessibility of functional groups bound to polymer network depending on microgel architecture and solvent quality. Additionally, we evaluate the minimum number of functional groups needed to facilitate the hopping mechanism between the functional groups (i.e., charge transfer). As an example of practical implementation of the obtained results, we estimate the optimal network topology for redox-active microgels to provide the maximum charge capacity for the dispersion electrolyte in redox-flow batteries.

[Interaction of DNA Methyltransferase Dnmt3a with Phosphorus Analogs of S-Adenosylmethionine and S-Adenosylhomocysteine].

Enzymatic methyltransferase reactions are of crucial importance for cell metabolism. S-Adenosyl-L-methionine (AdoMet) is a main donor of the methyl group. DNA, RNA, proteins, and low-molecular-weight compounds are substrates of methyltransferases. In mammals, DNA methyltransferase Dnmt3a de novo methylates the C5 position of cytosine residues in CpG sequences in DNA. The methylation pattern is one of the factors that determine the epigenetic regulation of gene expression. Here, interactions with the catalytic domain of Dnmt3a was for the first time studied for phosphonous and phosphonic analogs of AdoMet and S-adenosyl-L-homocysteine (AdoHcy), in which the carboxyl group was substituted for respective phosphorus-containing group. These AdoMet analogs were shown to be substrates of Dnmt3a, and the methylation efficiency was only halved as compared with that of natural AdoMet. Both phosphorus-containing analogs of AdoHcy, which is a natural methyltransferase inhibitor, showed similar inhibitory activities toward Dnmt3a and were approximately four times less active than AdoHcy. The finding that the phosphonous and phosphonic analogs are similar in activity was quite unexpected because the geometry and charge of their phosphorus-containing groups differ substantially. The phosphorus-containing analogs of AdoMet and AdoHcy are discussed as promising tools for investigation of methyltransferases.

[Cognitive disorders in burnout syndrome]. / Kognitivnye narusheniya pri sindrome emotsional'nogo vygoraniya.

OBJECTIVE: To study the impairment of cognitive functions in patients with different stages of the burnout syndrome (BS). MATERIAL AND METHODS: 78 patients aged 25-45 years (average age 36.9±9.5 years) were examined, which at the BS stage were divided into two subgroups: Residence (51.3%, n=40) and Exhaustion (48.7%, n=38). The control group consisted of 106 practically healthy (average age 36.3±7.2 years) The following methods were used: Russian-language version of the MBI questionnaire, questionnaire to diagnose the level of emotional burnout by V.V. Boyko, questionnaire CFQ, method «Learning 10 words¼ by A.R. Luria, registration of cognitive evoked potentials (EP) in the psychophysiological visual test VCPT. RESULTS: Subjective symptoms of memory loss were in 47 patients (60.3% of the total number of patients with EBS): 17 patients (42.5%) from the subgroup Resistance and 30 patients (78.9%) from the subgroup Exhaustion. The quantitative evaluation of the subjective symptoms in the CFQ test showed a reliable increase in all patient groups (p<0.05) and especially in the subgroup Exhaustion. There was statistically reliable decrease of the P200 component in subgroup Resistence and control group in the alloys Cz (p<0.001) and Fz (p<0.001), as well as statistically reliable reduction of the P300 component in the indicated leads (Cz (p<0.001) and Pz (p<0.001)) in patients in the subgroup Resistance. Most BS patients had cognitive complaints that were more common at the Exhaustion stage. At the same time, objective cognitive impairments were detected only in patients at the stage of Exhaustion. Only the long-term memory is affected. Psychophysiological research has shown a decrease in the level of attention in both subgroups, which demonstrated an increased impairment of mental processes. CONCLUSION: Cognitive impairment in patients with BS manifests in various forms of attention, memory impairment, and performance degradation in the resistance and exhaustion phases, and can result from high asthenization.

[Clinical and psychological manifestations of emotional burnout in mothers of children with neuropsychiatric diseases (on a model of ADHD)]. / Kliniko-psikhologicheskie proyavleniya emotsional'nogo vygoraniya u materei detei s psikhonevrologicheskimi zabolevaniyami (na modeli SDVG).

OBJECTIVE: To evaluate the therapeutic efficacy of Pantogam aktiv in the treatment of clinical manifestations of burnout in mothers of children with ADHD. MATERIAL AND METHODS: Under observation were 108 mothers of children with attention deficit hyperactivity disorder (ADHD) aged 25 to 50 years, who had symptoms of burnout in the clinical picture during the initial visit. The following research methods were used in the work: clinical history taking, neurological examination, S. Maslach questionnaire for assessing the burnout manifestations, subjective asthenia rating scale (MFI-20) with five subscales, digital fatigue rating scale (10-point variant), quantitative assessment of autonomic changes (questionnaire A.M. Wein), Spielberger-Khanin Scale for assessing emotional disorders, psychophysiological study of cognitive functions: test of attention variables TOVA (the Test of Variables of Attention). For the treatment of patients, the drug Pantogam Active was used in capsules of 300 mg, at a daily dose of 900 mg (2 capsules in the morning and 1 capsule in the afternoon) for 8 weeks. RESULTS: A re-examination after a course of treatment showed improvement in 68.5% of patients. After treatment, there was a significant decrease in the severity of such indicators of burnout as emotional exhaustion and depersonalization, a significant decrease in the average values according to the A.M. Wayne, a decrease in reactive anxiety, a statistically significant improvement in attention and a decrease in impulsivity (p<0.05). CONCLUSION: Thus, the results of the study indicate that the use of Pantogam active in the treatment of clinical manifestations of parental burnout is characterized by high efficiency. After treatment, there is a significant decrease in fatigue, asthenia, anxiety, and total indicators characterizing burnout. The data obtained make it possible to recommend the use of Pantogam aktiv in the treatment of clinical manifestations of parents burnout in children with neurological diseases.

[Emotional and behavioral dysregulation in children with attention deficit hyperactivity disorder]. / Narusheniya emotsional'noi i povedencheskoi regulyatsii u detei s sindromom defitsita vnimaniya s giperaktivnost'yu.

OBJECTIVE: To study disorders of emotional regulation in different types of attention deficit hyperactivity disorder (ADHD) in children. MATERIAL AND METHODS: 58 children suffering from ADHD, aged 12 to 15 years were divided into 2 subgroups (38 children with a combined form of ADHD and 20 children with ADHD with a predominance of inattention). The control group consisted of 30 children without manifestations of neuropsychiatric disorders. The following research methods were used in the work: the SNAP-IY scale to assess the severity of the disease; the Strengths and Difficulties Questionnaire (SCT), a form for parents to assess emotional and behavioral impairments; Spielberger's self-assessment test in the processing of Khanin to assess the level of anxiety; spectral analysis of the EEG with the construction of graphical power spectra and registration of evoked potentials (EP) with the performance of an attention test in the Go/No-Go paradigm. RESULTS: The results of the study showed the presence of emotional and behavioral disorders in children with ADHD, more pronounced in the combined form of the disease. Complaints of emotional lability, tearfulness, irritability were noted in 53 children with ADHD in the study group (61.6%). At the same time, these complaints were registered in 39 children from the first group (72.2%) and 14 children from the second group (43.8%). The level of inattention was approximately the same (3.21±0.64 and 3.43±0.56, respectively), while the level of hyperactivity and impulsivity in adolescents from the first group was significantly higher (3.18±0.54, p<0.01). Indicators of the SCT scale, as a total indicator (3.4±1.6, p<0.01), and on the scales of «behavior problems¼ (7.4±1.6, p<0.01), «emotional problems¼ (8.0±1.6, p<0.01), «problems with peers¼ (7.6±1.3, p<0.01), «prosocial behavior¼ (3.4±1.6, p<0.01) were significantly higher in the subgroup of children from the first group. The performed statistical analysis of the test data for attention in the Go/No-Go paradigm revealed significant differences (p<0.01) in the number of omissions of significant pairs of stimuli between healthy children and a subgroup with ADHD with a predominance of inattention, between healthy children and a subgroup with combined form ADHD. When comparing evoked EEG synchronization in the theta range under Go conditions, we found a significant decrease in this parameter in the range of 200-400 ms in the subgroup of children with ADHD with a predominance of inattention and in the subgroup of ADHD with a combined form; under No-Go conditions, a significant decrease in the magnitude of evoked EEG synchronization was revealed in a subgroup of children with combined form ADHD. CONCLUSION: In general, the results of this study allow us to conclude that impaired cognitive control has a large impact on the development of emotional disorders in children with ADHD.

[Clinical features of asthenia in the context of adjustment disorders]. / Klinicheskie osobennosti astenii v ramkakh rasstroistv adaptatsii.

OBJECTIVE: To study asthenic symptoms in patients with adjustment disorders and to assess the efficacy of cytoflavin in their treatment. MATERIAL AND METHODS: The study included 100 patients, aged 20 to 43 years, with a diagnosis of adjustment disorder. Clinical, neurophysiological and parametric methods were used. An asthenic state scale, the Multidimensional Fatigue Inventory (MFI-20), a digital rating scale (a 10-point variant) and the Headache Impact Test (HIT-6), the Psychological Stress Measure (PSM-25), the Cognitive Emotion Regulation Questionnaire, the Test of Variables of Attention (TOVA) were administered. Cytoflavin was used in a dose of 2 tab. 2 times a day for 25 days for the treatment of patients from the study group. RESULTS: In the study group, 48.0% of patients had a pronounced degree of asthenia, and 52% had a moderate one. The clinical improvement was achieved in 73.0%. In the subgroup with moderate asthenia, the improvement was recorded in 88.5% of cases, in the subgroup of patients with severe asthenia in 56.3% of patients. There was a significant decrease in the severity of indicators on the scales of general asthenia, decreased activity and mental asthenia; a significant decrease in the integral indicator of mental tension, a significant improvement in the indicator of attention, a decrease in the frequency and intensity of headache. The improvement in the functional state of the brain in the form of a decrease in the power of the alpha rhythm in the anterior cerebral cortex was shown. CONCLUSION: The results of the study allow us to conclude that the use of cytoflavin is effective in the treatment of adjustment disorders.

[Long-term results of radical surgery treatment of patients with bladder cancer].

PURPOSE: To investigate long-term results after radical cystectomy in patients with bladder cancer. MATERIALS AND METHODS: Since 1997 to 2020 yy. we have performed 404 radical cystectomy with different methods of derivation for patients with bladder cancer in our clinic. There were 342 (86,4%) men and 62 (13,6%) women. Laboratory study, ultrasound, X-ray, CT. MRI investigations were performed in all patients. RESULTS: Mortality rate was 2,9%. Early and late postoperative complications have occurred in 136 (33,6%) and 98 (41,8%) cases, respectively. Local recurrence has occurred in 33 (8,5%) patients. 10-years overall and cancer-specific survival were 43,4% and 47,2%, respectively. In lymph-negative patients 2-years and 5-years overall survival were 81,2% and 67,2%, respectively. In lymph positive patients 2-years and 5-years overall survival were 46,9% and 13,9%, respectively. In lymph-negative patients 2-years and 5-years cancer-specific survival were 83,6% and 70,7%, respectively. In lymph positive patients 2-years and 5-years cancer-specific survival were 51,0% and 15,1%, respectively. Overall and cancer -specific survival decreased according to increasing pT-stage and histopathologic grade. CONCLUSIONS: pT-stage (pT), lymp nodes status (pN), histopathologic grade ( pG) have a significant independent influence on overall and cancer-specific survival of bladder cancer patients after radical cystectomy.

[Non-invasive neurostimulation in migraine]. / Neinvazivnaya neirostimulyatsiya pri migreni.

Migraine is the most common chronic neurological disease. Migraine is in the top 5 causes that reduce the quality of life. In recent years, neuromodulation techniques are successfully used with primary headaches. Several variants of non-invasive neuromodulation have been shown to be effective in various forms of migraine. This review analyzes clinical trials and case reports of the effectiveness and safety of non-invasive stimulation of the first branch of the trigeminal nerve in migraine.

[Disturbances of executive functions in children with emotional and behavioral dysregulation]. / Narusheniya upravlyayushchikh funktsii u detei s emotsional'noi i povedencheskoi disregulyatsiei.

OBJECTIVE: To study a role of executive functions in the development of organic emotionally labile (asthenic) disorder (OELD) and oppositional defiant disorder (ODD). MATERIAL AND METHODS: The study included 66 patients, aged 6 to 8 years, including 36 children with OELD and 30 children with ODD. Fatigue was assessed by parents on a 10-point digital rating scale. SNAP-IV questionnaire for evaluation of severity of behavioral disorders, the "Strengths and Difficulties Questionnaire" for assessment of emotional and behavioral disorders, the anxiety test of P. Temple, M. Dorkey and V. Amen, A.R. Luria test for auditory-speech memory and the Test of Variables of Attention (TOVA) were used. RESULTS AND CONCLUSION: A significantly greater severity of cognitive and emotional impairment in the group of children with OELD is identified. The data suggest that if the insufficiency of functions regulating the activation of behavior and impaired cognitive control of behavior is important in the pathogenesis of OELD, then behavioral self-regulation disorders associated with emotional reinforcement play a leading role in children with ODD.

[The intraoperative prophylaxis of local ischemical brain damage in neurosurgical patients with cerebral aneurysm]. / Intraoperatsionnaia profilaktika lokal'nogo ishemicheskogo povrezhdeniia golovnogo mozga u neirokhirurgicheskikh patsientov s tserebral'noi anevrizmoi.

AIM: To study the effectiveness of intraoperative administration of Cytoflavine for the prevention of ischemic brain injury during cerebral aneurysm (CA) clipping with temporary occlusion of the leading artery under general anesthesia. MATERIAL AND METHODS: The prospective cohort single-center study included 40 patients with CA ( the main group - 27 patients with intraoperative administration of cytoflavine; the comparison group -13 patients without use of cytoflavine), who underwent aneurism clipping with temporary occlusion of the afferent artery. We assesed the intraoperative state of the brain, the time of awakening and extubation of patients after surgery, neurological deficit and local ischemic changes in the area of surgery according to the CT of the brain in the early postoperative period, resuscitation bed-day and the relationship of these indicators with the duration of temporary occlusion of the afferent artery in the selected groups of patients. RESULTS: In intergroup comparison, patients of the main group treated with intraoperative cytoflavin showed a reduction in the time of awakening (p=0.013) and the time of extubation (p=0.01) both with temporary occlusion of the afferent artery and in patients without temporary occlusion (p<0.05). The duration of resuscitation bed-day decreased in the main group of patients receiving intraoperatively cytoflavine (p=0.01), as well as in patients in the comparison group without temporary occlusion (p<0.05). CONCLUSION: Temporary occlusion of the afferent artery with short intervals of vessel occlusion in combination with intraoperative intravenous administration of cytoflavine expands the tolerability to artery occlusion in patients operated in the 'cold' period, reduces the possibility of neurological deficit, reduces the recovery period and resuscitation bed-day after surgical clipping CA.

The Effect of Antitumor Antibiotic Olivomycin A and Its New Semi-synthetic Derivative Olivamide on the Activity of Murine DNA Methyltransferase Dnmt3a.

Olivomycin A is a highly active antitumor drug that belongs to the family of aureolic acid antibiotics. The antitumor effect of olivomycin A is related to its ability to bind to the DNA minor groove in GC-rich regions as Mg2+-coordinated complexes. Characterization of cellular targets of olivomycin A and its mechanism of action is crucial for the successful application of this antibiotic in clinical practice and development of semi-synthetic derivatives with improved pharmacological properties. Previously, we have shown that minor groove ligands are able to disrupt the key epigenetic process of DNA methylation. In this paper, we have studied the impact of olivomycin A and its improved semi-synthetic analogue N,N-dimethylaminoethylamide of 1'-des-(2,3-dihydroxy-n-butyroyl)-1'-carboxy-olivomycin A (olivamide) on the functioning of de novo DNA methyltransferase Dnmt3a (enzyme that carries out methylation of cytosine residues in the DNA CG-sites in eukaryotic cells) using an in vitro system consisting of the murine Dnmt3a catalytic domain and a 30-mer DNA duplex containing four consecutive GC pairs. We have shown that olivomycin A and olivamide inhibit Dnmt3a with IC50 of 6 ± 1 and 7.1 ± 0.7 µM, respectively. Neither olivomycin A nor olivamide interfered with the formation of the specific enzyme-substrate complex; however, olivomycin A prevented formation of the covalent DNA-Dnmt3a intermediate that is necessary for the methylation reaction to proceed. The inhibitory effects of olivomycin A and olivamide can be explained by the disruption of the enzyme catalytic loop movement through the DNA minor groove (the reaction stage that precedes the covalent bond formation between DNA and the enzyme). The results of this work indicate the epigenetic contribution to the antitumor effect of aureolic acid group antibiotics.

[Comorbid cognitive impairments in children with nocturnal enuresis and their treatment]. / Komorbidnye kognitivnye narusheniia u detei s nochnym énurezom i ikh lechenie.

AIM: To study comorbid cognitive impairments in children with enuresis and assess the efficacy and safety of cerebrolysin in treatment of comorbid pathology. MATERIAL AND METHODS: Seventy patients, aged from 7 to 10 years, with the primary monosymtomatic form of enuresis were examined. Enuresis was assessed by the mean number of 'wet' nights per week. Neuropsychological tests were administered to measure short-term auditory-verbal and visual memory as well as SNAP-1V inattention and TOVA impulsivity. Electroencephalography was used as well. RESULTS AND CONCLUSION: Children with enuresis performed lower on auditory-verbal and visual memory and attention tests compared to the patients of the control group. Electroencephalography showed activation deficit and synchronized effects of thalamic structures. The high efficacy of cerebrolysin (the improvement was seen in 80% of the patients) was demonstrated.

[Ways of optimizing the management of patients with migraine in Russia (resolution of the council of experts)]. / Puti optimizatsii vedeniia patsientov s migren'iu v Rossii (rezoliutsiia soveta ékspertov).

Migraine is the third most common disease in the world. The overall prevalence of migraine in the Russian Federation is estimated at 20% with an estimated global prevalence of 14.7%. Migraine affects mostly people of working age and has a significant negative impact on the quality of life, the level of adaptation, ability to work, social functioning. Migraine represents a significant social and economic burden for patients and society as a whole. A team of national experts on migraine offers a program to prioritize quality of management of patients with headache.

[Consequences of specific language impairment in children]. / Posledstviia spetsificheskikh rasstroistv rechevogo razvitiia u detei.

AIM: To assess cognitive and emotional disorders in children of primary school age who have a history of specific language impairment (SLI). MATERIAL AND METHODS: Eighty-six children, aged 7-9 years, who were previously studied at age of 3-6 years with a diagnosis of SLI with a predominant disorder of expressive speech, were examined. Common neurological examination, psychological and psychometric testing were performed. RESULTS AND CONCLUSION: Clinical manifestations of the developmental disorder of expressive speech of moderate degree remained in 19.8% of children. In 53.4% of cases, the state of children could be regarded as an organic asthenic disorder. Clinical manifestations of Attention Deficit Hyperactivity Disorder (ADHD) were observed in 24.4% of children. Disorders of the formation of school skills were revealed in 32.5% of children. Thus, the SLI play an important role in the formation of cognitive, emotional and regulatory disorders and can serve as predictors of the development of other neuropsychiatric diseases.

[Detection of DNA Methylation by Dnmt3a Methyltransferase using Methyl-Dependent Restriction Endonucleases].

DNA methylation at cytosine residues in CpG sites by DNA methyltransferases (MTases) is associated with various cell processes. Eukaryotic MTase Dnmt3a is the key enzyme that establishes the de novo methylation pattern. A new in vitro assay for DNA methylation by murine MTase Dnmt3a was developed using methyl-dependent restriction endonucleases (MD-REs), which specifically cleave methylated DNA. The Dnmt3a catalytic domain (Dnmt3a-CD) was used together with KroI and PcsI MD-REs. The assay consists in consecutive methylation and cleavage of fluorescently labeled DNA substrates, then the reaction products are visualized in polyacrylamide gel to determine the DNA methylation efficiency. Each MD-RE was tested with various substrates, including partly methylated ones. PcsI was identified as an optimal MD-RE. PcsI recognizes two methylated CpG sites located 7 bp apart, the distance roughly corresponding to the distance between the active centers of the Dnmt3a-CD tetramer. An optimal substrate was designed to contain two methylated cytosine residues and two target cytosines in the orientation suitable for methylation by Dnmt3a-CD. The assay is reliable, simple, and inexpensive and, unlike conventional methods, does not require radioactive compounds. The assay may be used to assess the effectiveness of Dnmt3a inhibitors as potential therapeutic agents and to investigate the features of the Dnmt3a-CD function.

[Migraine 'masks': differential diagnosis of acute headache]. / 'Maski' migreni: voprosy differentsial'nogo diagnoza ostroi golovnoi boli.

Differential diagnosis of migraine, can be difficult, especially of migraine with aura. On the one hand, some diseases can produce symptoms similar to migraine (cerebral aneurysm before rupture, reversible cerebral vasoconstriction syndrome). On the other hand, migraine with aura and some other disorders are conditions that have common pathophysiological mechanisms (e.g., CADASIL and MELAS syndrome, antiphospholipid syndrome). Thirdly, clinical presentations of migraine are often difficult to distinguish from features of other headache conditions (migraine with aura - transient ischemic attack, migraine with visual aura - occipital epilepsy). The author discusses the differential diagnosis of acute headache, especially thunderclap headache, and main strategies of effective treatment of migraine attacks.

[Concomitant oncopathological changes in the prostate of urinary bladder cancer patients undergoing radical cystoprostateectomy].

AIM: To determine the incidence of spreading bladder transitional cell carcinoma and primary adenocarcinoma to the prostate in patients with bladder cancer undergoing radical cystectomy. MATERIALS AND METHODS: From 1995 to 2016, 283 men underwent radical cystectomy with removal of the bladder, perivesical tissue, prostate, seminal vesicles and pelvic lymph nodes. Prostate sparing cystectomy was performed in 45 (13.7%) patients. The whole prostate and the apex of the prostate were preserved in 21 (6.4%) and 24 (7.3%) patients, respectively. RESULTS AND DISCUSSION: The spread of transitional cell cancer of the bladder to the prostate occurred in 50 (15.2%) patients. Twelve (3.6%) patients were found to have primary prostate adenocarcinoma. Clinically significant prostate cancer was diagnosed in 4 (33.3%) patients. CONCLUSION: We believe that the high oncological risk of prostate sparing cystectomy, despite some functional advantages, dictates the need for complete removal of the prostate in the surgical treatment of bladder cancer.

[Diagnosis and treatment of cognitive impairment in adults with attention deficit hyperactivity disorder]. / Diagnostika i lechenie kognitivnykh narushenii pri sindrome defitsita vnimaniia u vzroslykh.

AIM: To qualify cognitive impairment in adults with attention deficit hyperactivity disorder (ADHD) and evaluate the efficacy of memoplant in the treatment of this pathology. MATERIAL AND METHODS: The authors present the results of the clinical, psychological and electroencephalographic examination of 40 patients with ADHD, aged from 18 to 45 years. All patients received memoplant in dose of 240 mg a day for 8 weeks. RESULTS AND CONCLUSION: Adult patients with ADHD were characterized by both subjective and objective disorders of memory and attention. The results of the electroencephalographic study suggested the dysfunction of the frontal-thalamic regulatory system and the lack of non-specific activation of the reticular formation. After treatment, clinical improvement was observed in 24 patients (60.0%). Repeated psychological and neuropsychological examinations showed a reduction of inattention and improvement of memory performance.

[Diagnosis and treatment of migraine: Recommendations of the Russian experts]. / Diagnostika i lechenie migreni: rekomendatsii rossiiskikh ékspertov.

These recommendations on the diagnosis and treatment of migraine were elaborated by Russian headache experts in accordance with the evidence-based practice. Together with the latest classification, diagnostic principles and criteria of different clinical sub-forms the consensus contains basic data on migraine epidemiology, pathophysiological mechanisms, differential diagnosis and most effective and evidence based approaches to pharmacological and non-pharmacological management of migraine patients.

[Emotional impairments and their correction in patients with migraine]. / Émotsional'nye narusheniia i ikh korrektsiia u patsientov s migren'iu.

AIM: To study emotional impairments in patients with migraine and to evaluate the efficiency of Noophen therapy for this pathology. SUBJECTS AND METHODS: 63 patients aged 18 to 45 years with migraine without aura were examined. 56 patients used prophylactic antimigraine therapy: Group 1 (n = 26) received metoprolol and Group 2 took metoprolol in combination with Noophen. RESULTS: The patients with migraine had a significantly higher level of alexithymia than the controls. Concomitant anxiety disorders were found in 47 (74.6%) cases. The study provided evidence that the treatment was highly effective in Group 2 that exhibited a more pronounced decrease in pain intensity, a greater reduction in the levels of anxiety, and more vital activity. CONCLUSION: The results of this study allow a conclusion that emotional impairments are implicated in the pathogenesis and clinical presentations of migraine and that it is appropriate to use Noophen for the treatment of this pathology.