[Clinical and psychological features in patients with incident and recurrent cases of benign paroxysmal positional vertigo]. / Kliniko-psikhologicheskie osobennosti patsientov pri vpervye voznikshikh i retsidiviruyushchikh pristupakh dobrokachestvennogo paroksizmal'nogo pozitsionnogo golovokruzheniya.

OBJECTIVE: To assess the clinical and psychological features in patients with incident and recurrent posterior canal BPPV. PATIENTS AND METHODS: The study included 47 patients (mean age 49.1±10.9 years; 12.8% of men and 87.2% of women) with idiopathic BPPV, posterior canal. According to the anamnesis, the patients were divided into two groups: 27 (57.4%) patients with incident BPPV (iBPPV) and 20 (42.6%) patients with recurrent BPPV (rBPPV). All patients were treated with repositioning Epley and/or Semont maneuvers until resolution of canalolithiasis. After that, clinical and psychological testing was immediately carried out, including short version of Vertigo Symptom Scale (VSS), Dizziness Handicap Inventory (DHI), Visual analogue scale (VAS) for fear of vertigo spells, Depersonalization-Derealization Inventory (DDI), Social Readjustment Rating Scale (SRRS) of Holmes and Rahe, Anxiety Sensitivity Index (ASI), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ). RESULTS: Patients with rBPPV compared with iBPPV had more severe symptoms of dizziness according to DHI (p=0.02) due to a functional and emotional subscales, as well as a more pronounced feeling of fear according to VAS (p=0.01). The data obtained on the remaining scales and questionnaires did not show statistically significant differences between the groups. The revealed results may indicate a greater predisposition of patients with rBPPV to the development of a special kind of mental disorders - functional dizziness or persistent postural-perceptual dizziness, which requires additional study and development of preventive measures.

[Motor activity in psychogenic arm palsy confirmed by polysomnography (clinical case)]. / Dvigatel'naia aktivnost' pri psikhogennom paraliche, zaregistrirovannaia pri polisomnografii (klinicheskii sluchai).

According to current criteria, the diagnosis of psychogenic motor defect is based on the tests which allow recording of movements in the pseudo-paralyzed extremity. Using polysomnography, electromyography and videomonitoring of motor activities during sleep, movements in the pseudo-paralyzed left arm were recorded in a patient with Munchhausen syndrome and psychogenic plegia in the left arm. A reduced motor activity in the left side of the body, in particular in the pseudo-paralyzed arm was observed as well. Possibilities of using movement monitoring during sleep for the diagnosis of psychogenic motor defect are discussed.

[The agonist of dopamine receptors piribedil in treatment of Parkinson's disease]. / Agonist dofaminovykh retseptorov piribedil v terapii bolezni Parkinsona.

In this paper, the authors review the current foreign and domestic literature on a role of the agonist of dopamine receptors piribedil in the treatment of Parkinson's disease. The results of the main studies of the efficacy and safety of piribedil, mechanisms of actions and a comparative characteristics with other dopamine receptors agonist are reviewed.

[Functional (psychogenic) vertigo]. / Funktsional'noe (psikhogennoe) golovokruzhenie.

Psychogenic (functional) vertigo is in second place by frequency after benign positional paroxysmal vertigo. It is often difficult to make the diagnosis, diagnostic program is expensive and traditional treatment often is not effective. This literature review covers current concepts on the terminology, clinical signs, pathogenesis and treatment approaches with regard to functional vertigo. Special attention is given to cerebral mechanisms of the pathogenesis including cognitive aspects.

[Functional disorders: pathogenesis and systematic of clinical presentation]. / Funktsional'nye rasstroistva: sistematika klinicheskikh proiavlenii i patogenez.

Functional disorders hold a prominent place in the clinical practice of physicians of different specialties. The difficulties in the diagnosis of functional disorders need expensive examinations, and standard treatment is, as a rule, is not effective. Currently, the pathogenesis of these disorders is considered in the frames of the biopsychosocial model. In this literature review, the authors present modern concepts of terminology, classification, main features and general trends of the course of functional disorders. Special attention is drawn to comorbidity, a role of psychogenic factors and cerebral mechanisms of the pathogenesis including cognitive aspects.

[The use of P300 event-related potentials in the evaluation of the effectiveness of therapy of episodic exertional headaches].

Fifteen healthy individuals and 17 patients with episodic exertional headaches were examined before and after treatment with citalopram using P300 event-related potentials. Unlike healthy controls, patients with headaches before treatment displayed an increase in P300 amplitude and the loss of its habituation, which correlated with a decrease in cognitive functions. The treatment lowered the degree of pain and vegetative syndromes, normalized P300 parameters, and improved cognitive functions. The use of P300 method may be an additional criterion of the effectiveness of therapy in patients with exertional headaches.

[Bioelectric brain activity in patients with neurotic disorders].

Seventy-three patients with neurotic disorders, aged 14-35 years, and 33 healthy controls have been examined using electroencephalographic method with spectral analysis of EEG, which has been conducted on the Brain Surfing system by the algorithm of direct Fourier transformation. The patients had changes of brain electric activity manifesting as insufficiency of thalamo-cortical synchronizing systems that caused an excessive activating effect of reticular formation on the cortex realized through extrathalamic reticular cortical and septo-hippocampal activation paths. Determinative in electrophysiological brain organization was the theta-rhythm, a marker of excessive emotional and autonomic activation, which directly correlated with an extent of personality accentuation and severity of neurotic state.

[The spectral analysis of the variability of frequency and amplitude characteristics of tremor in patients with essential tremor and tremulous form of Parkinson's disease].

A clinical and electrophysiological analysis of tremor in patients with essential tremor and tremulous form of Parkinson's disease as well as healthy subjects has been conducted. The method of accelerometry was used for assessing the variability of frequency and amplitude tremor. A comparison of the time-domain characteristics and spectral components of tremor was made between the two groups of patients that allowed to find the series of typical characteristics, which were important for understanding of its pathogenesis and differential diagnosis of this disease.

[An electrophysiological study of the rehabilitation of cognitive functions during the treatment of patients with panic disorders].

To investigate psychophysiological features of panic disorder (PD) before and after treatment with citalopram, P300 auditory event-related potentials (ERPs) were recorded in 31 patients who met the DSM-IV criteria of PD and 24 age- and sex-matched normal controls. The ERPs were recorded during a standard two-tone discrimination task (oddball task). The treatment was conducted as a monotherapy during 6 weeks, with citalopram dosage of 20 mg/day. Compared to controls, patients differed significantly by the reduced P300 amplitude and the alteration of its habituation. These patients also demonstrated more pronounced anxiety, depression, autonomic dysfunction, alexithymia and attention insufficiency. High efficacy of the medication was detected in 80,7% of patients. The data obtained demonstrate disturbances of cognitive function in PD patients as well as qualitative psychoneurophysiologic differences of patients before and after the treatment which were most striking for the wave amplitude and for the alteration of its habituation. It is concluded that P300 evaluation may be used as a diagnostic tool and should be taken into account in the choice of effective therapy for PD patients.

[Paradoxical kinesis phenomenon in focal hand dystonia--writer's cramp].

Paradoxical kinesis (PK) phenomenon and its variants, exerting a beneficial influence on dystonia dynamics, are described using self clinical examination of 57 writer's cramp patients. PK was found in all the patients independently of writer's cramp variant, duration and severity. The most frequent writing maneuvers were as follows: hand printed (100%), proximal arm muscles writing (82.5%), individually selected writing instrument (67.5-80%), unusual means (67.5-75%), writing imitation with unlike-pen object (70%), marked papers (52.5%). The beneficial influence of PK phenomenon on dystonia expression may be considered as one of the directions of writer's cramp rehabilitation.

[An impact of pronoran on cognitive and affective disorders in Parkinson's disease].

Sixty patients with different types of Parkinson's disease (PD), the disease stage 2.3 +/- 0.08 according to Hoehn&Yahr scale, were treated with Pronoran. Impact of the drug on movement, cognitive and affective disorders assessed by corresponding scales and psychological tests has been studied. Pronoran exerted a positive effect on all the disorders. It improved cognitive function, i.e. reasoning, memory and attention. A more pronounced influence on cognitive function was detected in earlier stages of the disease and for less severity cases of rigid-tremor PD type. A moderate antidepressive effect of Pronoran was found, being more pronounced in the severe PD stages. Emotional disorders were better treated, when Pronoran was used in combination with madopar, and cognitive dysfunction--in case of monotherapy.