[Alzheimer disease and epilepsy]. / Bolezn' Al'tsgeimera i epilepsiya.

Alzheimer Disease (AD) is a progressive neurodegenerative disorder characterized by loss of memory, difficulty in thinking, changes in behavior and personality disorders. The risk of developing epileptic seizures (ES) in patients with AD increases significantly. Animal and human studies have shown a close relationship between the pathogenesis of ES and AD. The exact prevalence of ES in AD remains unclear due to methodological difficulties, in particular, detection of ES in patients with cognitive impairment. EP types differ in sporadic and hereditary forms of AD. Antiepileptic therapy in AD has its own characteristics. Certain antiepileptic drugs can have a positive effect on cognitive function.

[Case-report of neuroacanthocytosis associated with a compound mutation in the VPS13A gene]. / Sluchai neiroakantotsitoza, svyazannyi s mutatsiei VPS13A.

Neuroacanthocytosis is a group of neurodegenerative diseases manifested by a combition of neurological symptoms (most often choreic hyperkinesis) and the presence of an increased number of acanthocytes (erythrocytes with horns) in the peripheral blood. This group includes chorea-acanthocytosis, MacLeod's syndrome, pantothenate kinase-associated neurodegeneration, Huntington-like disease type 2, and some other very rare diseases. This article presents a genetically confirmed clinical case of chorea-acanthocytosis associated with a compound mutation in the VPS13A gene, discusses in detail the stages of a diagnostic search, presents an algorithm for examining patients with chorea.

[Validation of the Russian version of the modified Addenbrooke's cognitive examination for Alzheimer's disease diagnosis]. / Validizatsiia russkoiazychnoi versii modifitsirovannoi Addenbrukskoi kognitivnoi shkaly dlia diagnostiki bolezni Al'tsgeimera.

AIM: To evaluate the validity of the Russian version of the modified Addenbrooke's cognitive examination (ACE-m) for Alzheimer's disease (AD) diagnosis. MATERIAL AND METHODS: ACE-m and MMSE, as a comparison scale, were administered to 78 patients including 49 patients with AD and 29 healthy people. RESULTS AND CONCLUSION: ACE-m demonstrated the high validity in the diagnosis of dementia in AD. Cronbach's alpha was 0.89. ACE-m is a brief and simple in use test that measures a wide spectrum of cognitive functions, gives a general impression about cognitive deficit and diagnoses dementia in AD with the greater validity compared to MMSE. This scale is useful not only in diagnosis of AD but also in differentiation with other causes of dementia.

[The use of biperiden (akineton) in patients with ephedrone encephalopathy].

An open comparative cross-over trial of the selective central M1 cholinoreceptors blocker - biperiden (akineton) was carried out in 35 patients with efedron encephalopathy (EEP) with mean illness duration 6,9 years. Patients received biperiden in individually adjusted dose, maximally up to 10 mg daily. Seventeen patients initially were treated with trihexyphenidyl in dosage 10 mg daily with switching to biperiden after 3 months. The total duration of treatment was 6 months. There was a significant decrease on the Fahn-Marsden scale and a clinical EEP scale, along with the moderate improvement quality of life assessed with the EQ-5D and the increase of the Barthel index. The decrease on the Fahn-Marsden scale by more than 30% was found in 40% patients treated with biperiden during 6 months and in 29% patients treated with trihexyphenidyl. Among patients switched to biperiden, 36% preferred to continue with the drug and only 12% preferred trihexyphenidyl.

[The use of melatonin in the treatment of chronic fatigue syndrome and circadian rhythm disorders in Parkinson's disease].

Chronic fatigue syndrome (CFS), a specific asthenic condition, is identified in a half of patients with Parkinson's disease (PD). An aim of the study was to evaluate an effect of melatonin (melaxen) on the severity of CFS, affective disorders, quality of life and sleep disorders in 30 patients with early and late stages of PD. After treatment, there was a decrease by 21% (p<0,05) on the Parkinson fatigue scale. At the same time, the improvement of sleep, assessed by the PDSS, decrease in the state anxiety on the Spilberger's scale and improvement of quality of life on the PDQ-39 (p<0,05) were found. No significant differences in motor, cognitive autonomic disorders and depression level were noted compared to baseline. Therefore, melatonin, together with optimized antiparkinsonian treatment, can treat CFS, improve sleep and quality of life of PD patients.

[The optimization of using levodopa in patients with Parkinson's disease: results of the OPTIMA study].

The objective of this multicenter observational study "Optimization levodopa therapy for patients with Parkinson's disease" (OPTIMA) was to evaluate the current practice of prescribing levodopa to patients with Parkinson's disease (PD) by general practitioners and specialists in the treatment of extrapyramidal disorders in Russia. The study included 763 patients with PD, stages from I to V according to Hoehn and Yahr staging of PD. Patients were randomized into three groups. Group I included 230 patients not previously treated with levodopa who needed treatment with this drug due to the motor deficit progression. Group 2 consisted of 262 patients treated with levodopa/carbidopa (nakom) who needed higher doses or the dose redistribution. Group 3 included 271 patients treated earlier with other levodopa preparations and currently needed treatment with levodopa/carbidopa (nakom). Primary symptoms of parkinsonism, motor deficit (motor fluctuations, dyskinesia) and non-motor symptoms (depression) were reduced after the beginning of treatment as well as after the increase in doses. The results revealed that the addition of levodopa/carbidopa can improve daily activities with the low risk of side-effects.