 Subjects -> PSYCHOLOGY (Total: 983 journals)
| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z | | The end of the list has been reached or no journals were found for your choice. |
|
|
- The place of virtual reality in the rehabilitation of patients with
multiple sclerosis
Authors: Korzhova I.E; Fuks A.A, Klochkov A.S, Khizhnikova A.E, Suponeva N.A, Zakharova M.N.
Abstract: Multiple sclerosis (MS) is a chronic autoimmune disease that limits the ability to work and lead an active lifestyle, mostly in young adults. Physical activity, along with drug therapy, is an essential part of the life of a person with MS. In the last decades, rehabilitation of MS patients has made great progress. However, the problem of compliance is still relevant. Virtual reality (VR) based rehabilitation can not only improve the quality of the training process but also increase patient compliance.
Objective: to study the literature data on the effectiveness of the techniques of VR in reducing the severity of symptoms of MS and improving the quality of life.
Materials and methods. A thorough literature search of the MEDLINE (Pubmed), eLibrary, and Google Schcolar databases was performed. Papers that met two criteria were included in the study: study population – patients with MS; presence of at least one comparison group (standard therapy or no therapy).
Results. Based on the results of the analysis, 44 articles were selected. The efficacy of VR in reducing symptoms of MS such as fatigue, balance disturbances, risk factors for falls, mobility, apraxia, impaired hand function was described, as well as the impact on overall quality of life and its components.
Conclusions. The VR rehabilitation can have its own place in the general system of physical rehabilitation and also become an effective tool to increase motivation and quality of life at all stages of rehabilitation.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Contribution of B-lymphocytes to the production of Interleukin-17 in
multiple sclerosis
Authors: Sursyakova N.V; Kuklina E.M, Baidina T.V, Nekrasova I.V, Trushnikova T.N.
Abstract: The study of pathogenic systems involved in multiple sclerosis (MS) is essential for the development of new therapies.
Objective: to determine the contribution of B-lymphocytes to the production of IL-17 in MS with an assessment of the ability of B-cells to induce the differentiation of Th17 and the own production of IL-17 by B-lymphocytes in this pathology.
Material and methods. A total of 81 subjects were examined, 68 of whom were patients diagnosed with MS, 13 were healthy individuals. The concentrations of IL-17A, IL-10, BAFF and total IgG were analyzed in blood serum by ELISA. The additional study included 13 MS patients and 11 healthy donors. Mononuclear cells were isolated from the blood, from which B-lymphocytes and CD4+T-lymphocytes were obtained. B-lymphocytes were incubated with tetanus toxoid or with myelin-oligodendrocyte glycoprotein (MOG), after which they were washed from unbounded antigen and cultured together with autologous CD4+T-lymphocytes or with peripheral blood mononuclear cells, then the content of Th17 cells in the sample was evaluated. Flow cytometry ex vivo assessed the expression of RORγt by B-lymphocytes and CD4+T-lymphocytes. The level of IL-17 in blood serum and cell culture supernatants was determined by ELISA.
Results. High IL-17 serum levels in MS patients are associated with elevated BAFF concentrations, and in patients with high IgG levels, IL-17 concentrations were also twice as high. A statistically significant higher level of IL-17-positive B-lymphocytes was detected in MS.
Conclusion. B-lymphocytes may contribute to the production of IL-17 in MS in two ways – by inducing the differentiation of T-lymphocytes producing this cytokine and by their own synthesis of IL-17.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Features of multiple sclerosis in childhood in the Republic of Tatarstan
Authors: Khaibullina A.R; Khabirov F.A, Khaibullin T.I.
Abstract: Multiple sclerosis (MS) in children and adolescents is a genuine concern of pediatric neurology that specialists in all countries are dealing with. To date, neither the causes of onset nor the individual components of the pathogenesis of the disease have been reliably clarified, and the modern, changing picture of the clinical manifestation of the disease sometimes complicates timely diagnosis even in adult patients. There are more such questions in pediatric MS.
Objective: to study the prevalence and clinical features of MS in children in the Republic of Tatarstan.
Material and methods. We conducted a survey and data analysis of 128 children and adolescents aged 0 to 18 years inclusive. The examination of patients included neurological examination according to the classical scheme, neuroimaging examination, neurophysiological examination and cerebrospinal fluid examination. The diagnosis was based on the current (as of the time of diagnosis) criteria of McDonald and the International Pediatrics MS Study Group criteria. The severity of the patients' clinical condition was assessed using the Expanded Disability Status Scale (EDSS).
Results. MS was diagnosed in 99 cases (77.3%), clinically isolated syndrome – in 10 (7.8%), acute disseminated encephalomyelitis – in 5 (3.9%), bilateral optic neuritis – in two patients (1.6%), disseminated encephalomyelitis – in one case (0.8%); other central nervous system diseases were diagnosed in 11 (8.6%) patients. After a detailed examination, the group “other diseases of the central nervous system” included such conditions as cerebral angiopathy, neurofibromatosis, brain mass, structural focal epilepsy, sequelae of viral encephalitis, and hereditary leukodystrophy. Among the patients, girls aged 15–17 years predominated. Monofocal manifestations were more frequently observed at debut. Moreover, the absolute predominance of the remitting type of course was also noted.
Conclusion. The data obtained suggest a predominance of the predominantly remitting course type of MS with a monofocal onset, which is consistent with data from other studies of MS in pediatric practice.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Distinctive parameters of gait in patients with multiple sclerosis,
depending on the profile of its dysfunction
Authors: Ryabov S.A; Boyko A.N.
Abstract: Objective: to identify characteristic gait parameters by video analysis in patients with multiple sclerosis (MS) that allow the most reliable discrimination of the dominant profile in functional systems.
Material and methods. We examined 45 patients (37 women, 8 men) with relapsing-remitting (n=38) and secondary progressive MS before and after a course of medical rehabilitation. Gait parameters were recorded with the Physiomed Smart video analysis system Physiomed Smart («Physiomed», Germany, Davis protocol).
Results. Only one indicator allowed reliable differentiation between ataxic and spastic-paretic gait patterns in MS in the EDSS range up to 5.5 points – the step width, the value of which is greater in patients with ataxia dominance. A significant difference in gait pattern asymmetry was also found in the mild disability group, namely, a greater value in the spastic-paretic pattern.
Conclusion. Comprehensive profiling of gait impairment, primarily through objective analysis of locomotor patterns, may be helpful in monitoring therapy and may reveal sensitive end points for further study in MS.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Delayed diagnosis of the neuromyelitis optica spectrum disorder
Authors: Dzhukkaeva S.A; Ermilova E.V, Nabiev S.R, Voskresenskaya O.N.
Abstract: Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune inflammatory demyelinating diseases of the central nervous system. In 2015, International Expert Panel established diagnostic criteria for NMOSD. The majority of patients with NMOSD have aquaporin-4 autoantibody (AQP4-IgG). This case describes a 43-year-old woman who presented with weakness in her limbs followed by intractable vomiting. One year and 3 months later, she experienced acute visual impairment, which recurred several times. MRI of the spinal cord revealed a T2-hyperintense signal lesion at the cervical level extending over 4 vertebral segments. MRI of the brain showed involvement of the brainstem. AQP4-IgG was detected in her blood serum. It took 30 months from the onset of symptoms to establish the correct diagnosis. During this time, several incorrect diagnoses were made, including ischemic stroke, functional movement disorder and vertebrobasilar insufficiency. As a result of delayed diagnosis and treatment, the patient developed severe irreversible visual impairment. This case underscores the importance of early diagnosis and early treatment of NMOSD.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Clinical course features of atypical demyelinating optic neuritis: case
series
Authors: Sheremet N.L; Eliseeva D.D, Bryukhov V.V, Andreeva N.A, Zhorzholadze N.V, Murakhovskaya Y.K, Kalashnikova A.K, Zakharova M.N.
Abstract: Optic neuritis (ON) can often occur at the onset of a demyelinating autoimmune CNS disease or as one of its clinical manifestations. The introduction of novel laboratory techniques, technical advances in magnetic resonance imaging (MRI), electrophysiologic studies, and ocular imaging have significantly expanded the spectrum of autoimmune optic neuropathies. Identification of different forms of ON based on clinical and instrumental data can lead to early diagnosis of the underlying neurologic disorder. According to current guidelines, one can distinguish between typical ON, which are mainly associated with multiple sclerosis (MS), and atypical ON, which are the main clinical manifestation of neuromyelitis optica spectrum disorders (NMOSD) and diseases associated with myelin oligodendrocyte glycoprotein antibodies (MOGAD). In this paper, we present four clinical cases of atypical ON at the onset of NMOSD and MOGAD and illustrate the high diagnostic value of a multidisciplinary approach.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Prolonged observation after the use of cladribine in multiple sclerosis:
efficacy and safety
Authors: Kukushkina A.D; Boyko A.N.
Abstract: Multiple sclerosis (MS) is a chronic disease whose pathogenesis is based on autoimmune neuroinflammatory and neurodegenerative components. The goal of therapy of MS is to reduce the risk of exacerbations and progression of the disease. In recent years, treatment options have expanded significantly with the advent of a greater number of highly effective drugs that alter the course of MS (disease-modyfyung therapies, DMTs) and in the context of the development of a new direction – immune reconstitution therapy (IRT). IRT has a number of advantages, including short treatment courses with long-term effects on immune mechanisms. Cladribine tablets are a selective, highly effective oral form of IRT for MS patients with exacerbations that targets lymphocytes while preserving innate immune cells. Given the increasing number of patients receiving cladribine therapy, questions are increasingly being raised about further tactics for managing these patients, particularly in cases of persistent disease activity despite ongoing pathogenetic therapy. In this review, we publish the results of the consensus opinion of international experts on the analysis of long-term experience with cladribine.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Neuromyelitis optic spectrum disorders (NMOSD): from pathogenesis to
targeted therapy
Authors: Zaitseva P.A; Boyko A.N.
Abstract: In the review, we present the main pathogenetic mechanisms of the development of neuromyelitis optic spectrum disorders (NMOSD) associated with the appearance of anti-aquaporin-4 (APQ4-IgG) autoantibodies: damage to astrocytes, including complement-dependent and complement-independent cytotoxicity, with subsequent damage to oligodentrocytes, axons, and demyelination. Based on these data, the main directions of pathogenetic treatment of NMOSD are discussed, which has two main directions: treatment of exacerbations and prevention of relapses. In recent years, the second direction has been actively developing, and two drugs of monoclonal antibodies have been approved in Russia, which have as their main indication the treatment of patients with NMOSD and antibodies to APQ4-IgG: e eculizumab and satralizumab. The remaining drugs are still prescribed in necessary cases by decision of medical commissions.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- The evolution of interferon therapy in multiple sclerosis
Authors: Boyko O.V; Smirnova N.F, Boyko A.N.
Abstract: The article reviews the evolution of interferon-β (IFN-β) in the treatment of multiple sclerosis (MS) from the first high-dose interferons to the most recent pegylated forms. The results of pivotal trials are presented and discussed. The main problems of the first IFN-β were: 1) moderate efficacy in the presence of neutralizing antibodies (NAB, in 20% of treated patients), leading to a decrease in efficacy, 2) poor tolerability due to frequent injections (every other day), 3) severe local reactions and flu-like syndrome. Pegillation made it possible to extend the duration of administration to one injection every 14 days and to reduce the probability of NAB to less than 1% of all treated patients. The first drug administered subcutaneously had a pronounced flu-like syndrome; the domestic drug SamPEG-IFN-β1a administered intramuscularly was better tolerated with similar efficacy.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Prospects for the use of curcumin as an additional treatment for multiple
sclerosis
Authors: Rogovskii V.S; Kukushkina A.D, Boyko A.N.
Abstract: Multiple sclerosis (MS) is a chronic demyelinating autoimmune disease. MS therapy does not always allow slowing of disease progression and also has significant side effects, such as immunosuppressive effects (especially when second-line disease-modifying therapies (DMT) are used). In this context, it is important to explore novel approaches to MS therapy that may improve the therapeutic potential of first line DMTs and reduce the likelihood of switching to switch to second line DMTs. Curcumin is one of the promising candidates for such application. Several anti-inflammatory and neuroprotective effects of curcumin have been reported in the literature, which could be considered for such applications. The favorable safety profile of this compound is also important. Over the past decade, encouraging clinical data have been obtained on the use of curcumin as part of adjunctive therapy for MS. However, to date, there are inadequate clinical studies on the use of curcumin in the therapy of MS. This may be due to the fact that curcumin, like other polyphenols, has low bioavailability, which limits its therapeutic potential. Recently, new highly bioavailable forms of curcumin have been developed (e.g., nanoemulsions). In this regard, it is promising to conduct new clinical trials of curcumin as an adjunctive therapy in MS, especially using its forms with increased bioavailability.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- Diagnostic criteria and treatment of neuromyelitis optica spectrum
disorders (NMOSD)
Authors: Simaniv T.O; Bakhtiyarova K.Z, Belova A.N, Goncharova Z.A, Sivertseva S.A, Spirin N.N, Totolyan N.A, Trushnikova T.N, Turova E.L, Khaibullin T.I, Sherman M.A, Boyko A.N.
Abstract: Neuromyelitis optic spectrum disorders (NMOSD) are rare, severely disabling diseases of the central nervous system. They are characterized by periodic, unpredictable exacerbations that lead to an accumulation of irreversible neurologic damage. Despite existing possibilities for diagnosing NMOSD, it can be difficult to make the correct diagnosis in clinical practice. Current treatment options for NMOSD include drugs that affect the pathogenesis of the disease, including complement C5 inhibitors, with which experience is still limited, but published data from clinical trials demonstrate high efficacy of these drugs with an acceptable safety profile. The article reviews the main current approaches to the diagnosis and treatment of NMOSD.
PubDate: Mon, 21 Aug 2023 00:00:00 +030
- MicroRNAs as biomarkers of multiple sclerosis progression
Authors: Baulina N.M; Kiselev I.S, Kulakova O.G, Popova E.V, Favorova O.O, Boyko A.N.
Abstract: Multiple sclerosis (MS) is an autoimmune inflammatory neurodegenerative disease of the central nervous system. The disease is characterized by a heterogeneous clinical course, which is reflected in the fact that there are various types, such as relapsing-remitting MS (RRMS), primary and secondary progressive MS (PPMS and SPMS, respectively). Currently, there is an active search for MS biomarkers capable of predicting and assessing disease progression with high sensitivity and specificity, which would be of great benefit in determining treatment tactics and evaluating their efficacy. MicroRNAs (miRNAs) are short (21–25 nucleotides) non-coding RNA molecules that are primarily involved in post-transcriptional regulation of gene expression. miRNAs play an essential role in tissue development, homeostasis, immune system regulation, and immune cell maturation; they are also involved in the pathophysiology of MS. In addition, high hopes are pinned on miRNAs as disease biomarkers, mainly due to their stability and ability to be released from cells into the extracellular space and circulate there for a long time. The review considers published data on miRNAs in different types of MS. In the future, changes in their levels may be used to create a panel of prognostic markers for disease progression. Studies of miRNAs levels in both circulating fluids (plasma, serum, cerebrospinal fluid) and brain tissue of MS patients were reviewed. Based on the aggregated data from the studies reviewed, it can be confirmed that the accumulated data are quite sufficient to recognize that regulatory miRNAs molecules are involved in the pathophysiological mechanisms of MS progression. However, there is still a long way to go to establish a panel of circulating miRNAs that predict the rate of progression of MS.
PubDate: Sun, 20 Aug 2023 00:00:00 +030
|
Open Access journal
