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© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Objectives. The amplitude and latency of the P300 wave are regarded as basic neurophysiological correlates in studies of cognitive functions. The characteristics of the event-related θ rhythm recorded in the same time period as the P300 wave are less well studied. The aim of the present work was to carry out a complex assessment of the neurophysiological parameters of cognitive processes in health and various degrees of cognitive dysfunction in patients with personality disorders, schizotypal disorders, and schizophrenia. Materials and methods. A total of 124 subjects were studied: 44 healthy subjects (normal), 40 patients with schizophrenia, 22 patients with personality disorder, and 18 with schizotypal disorder. Studies used a probabilistic presentation of significant and non-significant auditory signals. P300 amplitude and latency were determined for each subject, along with power and paired coherence in the event-related θ rhythm, on presentation of significant stimuli. Results and conclusions. All patients, as compared with healthy subjects, were found to have a tendency to decreases in P300 amplitude and increases in latency, with reductions in the power and coherence of the event-related θ rhythm. In schizophrenia, this trend was spatially generalized, while changes in personality disorder and schizotypal disorders were mostly localized and did not reach statistical significance on between-group comparisons. These data may be evidence of gradual weakening of cognitive functions going from normal through schizotypal disorder and personality disorder to schizophrenia, which may correspond to decreases in insight and the ability to foresee the consequences of actions.

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Objectives. The amplitude and latency of the P300 wave are regarded as basic neurophysiological correlates in studies of cognitive functions. The characteristics of the event-related θ rhythm recorded in the same time period as the P300 wave are less well studied. The aim of the present work was to carry out a complex assessment of the neurophysiological parameters of cognitive processes in health and various degrees of cognitive dysfunction in patients with personality disorders, schizotypal disorders, and schizophrenia. Materials and methods. A total of 124 subjects were studied: 44 healthy subjects (normal), 40 patients with schizophrenia, 22 patients with personality disorder, and 18 with schizotypal disorder. Studies used a probabilistic presentation of significant and non-significant auditory signals. P300 amplitude and latency were determined for each subject, along with power and paired coherence in the event-related θ rhythm, on presentation of significant stimuli. Results and conclusions. All patients, as compared with healthy subjects, were found to have a tendency to decreases in P300 amplitude and increases in latency, with reductions in the power and coherence of the event-related θ rhythm. In schizophrenia, this trend was spatially generalized, while changes in personality disorder and schizotypal disorders were mostly localized and did not reach statistical significance on between-group comparisons. These data may be evidence of gradual weakening of cognitive functions going from normal through schizotypal disorder and personality disorder to schizophrenia, which may correspond to decreases in insight and the ability to foresee the consequences of actions.

© 2018, Media Sphera Publishing Group. All rights reserved. Essential arterial hypertension (AH) is one of the main risk factors for the development of cognitive impairment and dementia. Cognitive decline is an early sign of brain damage as a target organ of hypertension, it occurs even in patients with uncomplicated hypertension with minimal duration of disease. Cognitive impairment progresses with increasing age and hypertension duration, as well as in non-controlled AH. In patients with hypertension, the prevalence of emotional disorders — anxiety and depression is also high. In addition to antihypertensive therapy, hypertensive patients need correction of concomitant cognitive and emotional disorders. Rat-gopantenic acid simultaneously corrects both emotional and cognitive impairment, and has a good tolerability profile as well. An analysis of the evidence base of rac-gopantenic acid showed its high efficacy in the treatment of mental disorders and good tolerability along with a positive effect on somatic disorders and results of antihypertensive therapy. Taken together, they enhance adherence to treatment and, consequently, reduce the cardiovascular risk.

© 2018 Radboud University Medical Center Attention-deficit/hyperactivity disorder (ADHD) is highly heritable and the most common neurodevelopmental disorder in childhood. In recent decades, it has been appreciated that in a substantial number of cases the disorder does not remit in puberty, but persists into adulthood. Both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use, depression, anxiety, and accidents. However, course and symptoms of the disorder and the comorbidities may fluctuate and change over time, and even age of onset in childhood has recently been questioned. Available evidence to date is poor and largely inconsistent with regard to the predictors of persistence versus remittance. Likewise, the development of comorbid disorders cannot be foreseen early on, hampering preventive measures. These facts call for a lifespan perspective on ADHD from childhood to old age. In this selective review, we summarise current knowledge of the long-term course of ADHD, with an emphasis on clinical symptom and cognitive trajectories, treatment effects over the lifespan, and the development of comorbidities. Also, we summarise current knowledge and important unresolved issues on biological factors underlying different ADHD trajectories. We conclude that a severe lack of knowledge on lifespan aspects in ADHD still exists for nearly every aspect reviewed. We encourage large-scale research efforts to overcome those knowledge gaps through appropriately granular longitudinal studies.

© 2018 Ima-Press Publishing House. All Rights Reserved. The brain is a natural target organ in hypertension and, as shown by some clinical observations, it is affected earlier than other organs and systems. Due to the specific features of the anatomy of cerebral circulation, hypertensive microangiopathy leads primarily to damage to the sub-cortical basal ganglia and deep white matter. Clinically, this is manifested by a concuirence of predominantly subcortical cognitive impairment and emotional and behavioral disorders as depression, emotional lability, and apathy. Some features of depression, such as the prevalence of anhedonia and fatigue and the significant severity of cognitive and somatic symptoms in an elderly person with vascular disease, suggest its organic nature (vascular depression).

© 2018, Media Sphera Publishing Group. All rights reserved. The authors describe manifestations of chronic cerebral ischemia (CCI) and present the cases of a combination of primary headache and CCI. Management of patients with CCI and headache and the use of vazobral and its efficacy in treatment of such patients are discussed.

© 2018, Media Sphera Publishing Group. All rights reserved. The main groups of neuroprotectors, which are active in preventing the processes of the death of the nerve cells of vascular, traumatic, toxic and other etiologies and can decrease the severity of cognitive impairment, include phosphatidylcholine, phosphatidylserine, preparations based on ginkgo biloba, group B vitamins, folic acid. Preparations based on ginkgo biloba have the same effect as synthetic nootropics. The antioxidant and membrane-stabilizing effects of neuroprotectors are highlighted. In view of practical applications, attention is given to the advantages of the combinations of different neuroprotectors. Cerebrovin as one of these drugs can be recommended for treatment of cognitive impairment in the elderly.

© 2018, Media Sphera Publishing Group. All rights reserved. Alzheimer’s disease and vascular dementia are two most common causes of dementia in late life. The combination of Alzheimer’s type dementia and vascular dementia is the third most common form of dementia, especially in the elderly. Most clinical forms of dementia are characterized by the presence of «overlap» symptoms of both neurodegenerative and vascular pathology, which makes it expedient to consider mixed dementia as a separate entity characterized by clinical presentations, course and the rate of progression of cognitive decline. Despite the lack of clinical guidelines for management of patients with mixed dementia, it seems appropriate to use strategies that have shown their effectiveness in various types of cognitive impairment.

© 2018 by the authors; licensee Modestum Ltd., UK. Objective: Cognitive impairments (CIs) appear to be commonly encountered in patients with arterial hypertension (AH). Hence, our study was aimed at examining the frequency of cognitive impairments (CIs) in the physician’s outpatient practice, as well as at determining clinical and instrumental peculiarities of the course of AH in patients with and without CIs. Method: We carried out comprehensive examination of three hundred and fifty 50-to-80-year-old hypertensive patients followed up in the setting of a polyclinic and tested by means of neuropsychological scales (MMSE, Mini-Cog test, Montreal Cognitive Assessment Scale, Hospital Anxiety and Depression Scale), duplex scanning of extracranial vessels, and magnetic resonance tomography (MRT) of the brain. Results: The findings of neuropsychological testing demonstrated the presence of CIs in 83.5% of hypertensive patients, with CIs reaching the level of dementia in 16.9% and being combined with depressive symptoms in 40.3%. Hypertensive patients with CIs as compared with those without CIs were found to have more pronounced lesions to white matter of the brain: periventricular (71.1%) and/or subcortical (15.8%) leukoaraiosis. Subcortical leukoaraiosis of the frontal lobes of the brain was associated with an elevated level of systolic arterial pressure (SAP). It was confirmed that impaired circadian rhythm of AP with stable persistence of nocturnal hypertension resulted in the most pronounced structural and morphological damage of the brain. Conclusion: High incidence of CIs in hypertensive patients has been confirmed. Structural and morphological impairments of strategically important regions of the brain (subcortical leukoaraiosis of the frontal lobes) in hypertensive patients with CIs were associated with elevated SAP.

© 2018 Media Sphera Publishing Group.All right reserved. Objective. This study aimed to assess the cognitive functions and cerebral blood flow measured with arterial spin labeling (ASL) and their possible correlations with vascular age in untreated middle-aged patients with grade 1-2 essential arterial hypertension (EAH). Methods. We examined 73 subjects aged 40-59 years (33 with EAH and 40 healthy volunteers [controls]). Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Trail Making test (part A and part B), Stroop Color and Word Test, verbal fluency test (phonemic verbal fluency and semantic verbal fluency), 10-item word list learning task. All subjects underwent brain MRI. MRI protocol included ASL. Vascular age was calculated by two techniques-using Framingham Heart Study risk tables and SCORE project scales. Results. Patients with EAH had lower performance on phonemic verbal fluency test and lower mean MoCA score (29.2±1.4 vs. 28.1±1.7 points) compared to controls (13.4±3.2, p=0.002; 29.2±1.4, p=0.001, respectively). White matter hyperintensities (WMH) were present in 7.5 % controls and in 51.5 % EAH patients (p=0.0002). Cerebral blood flow (CBF) in EAH patients was lower in both right (39.1±5.6 vs. 45.8±3.2 ml/100 g/min) and left frontal lobes of the brain (39.2±6.2 45.2±3.6 ml/100 g/min, respectively) compared to controls (p<0.001). EAH patients without WMH had lower CBF compared to controls (right frontal lobe: 39.5±5.1 ml/100 g/min, p=0.0002; left frontal lobe: 38.9±4.3 ml/100 g/min, p=0.00002). In EAH patients vascular age (57.7±7.4 and 64.6±11.0 years as measured by SCORE project scales and Framingham Heart Study risk tables, respectively) was significantly (p<0.001) greater than chronological one (50.2±6.2 years) and was significantly (p<0.001) higher than the corresponding values in the control group. Correlation analysis revealed negative significant associations between vascular age and MoCA score, phonemic verbal fluency test score and CBF. Conclusions. Treatment-naive middle-aged patients with uncomplicated grade 1-2 EAH compared to normotensive controls have lower mean scores in phonemic fluency test and MoCA, lower CBF, even in the absence of WMH, which correlates with vascular age, particularly with the value calculated by Framingham Heart Study risk tables. Early vascular ageing is important factor of brain impairment in hypertension in middle-aged patients even at early stages of EAH.

© 2018 Ima-Press Publishing House. All Rights Reserved. Objective: to investigate the effectiveness of cognitive and motor training as an additional method to basic therapy in patients with Alzheimer's disease (AD) and vascular cognitive impairment (VCI). Patients and methods: The investigation enrolled 41 patients (15 women and 26 men; mean age. 73.59±6.3 years), including 32 patients with AD (mean age 74.94±5.15 years) and 9 patients with VCI (mean age, 72.31±4.98 years). Cognitive impairment (CI) corresponded to mild dementia in 15 patients (5 women and 10 men; mean age 74.6±2.8 years) and to moderate dementia in 29 (10 women and 19 men; mean age 72.1±3.2 years). The patients were randomly assigned to individual, group, and mixed (individual and then group) cognitive training groups. Quantitative scales were used to assess changes in CI and emotional and behavioral disorders after 1.5, 3, and 6 months of therapy. Results and discussion: During cognitive and motor training, all the groups showed a significant decrease in the severity of CI (p < 0.05), depression, anxiety, and apathy. The effectiveness of the training was further influenced by the severity of concomitant cardiovascular disease, the degree of apathy, adherence to the training, and the early initiation of basic symptomatic therapy. The greatest positive changes in anxiety and depressive disorders were noted in the patients receiving group cognitive and motor training. Conclusion: The results of the investigation allow group cognitive and motor training to be recommended as a mainstay in the therapy of patients with CI concurrent with emotional disorders.

© Ima-Press Publishing House. All rights reserved. Cognitive impairment (CI) is common in patients with migraine; its causes and pathogenesis continue to be discussed. Some authors consider that migraine proper does not lead to decreased cognitive functions, neuroimaging changes in the brain white matter are asymptomatic in migraine; and CI in patients with this condition is caused by comorbidities (depression, anxiety disorder) and/or concurrent cerebrovascular and neurodegenerative diseases. Other authors report the pathogenetic role of migraine in the development of CI and the importance of the frequency of headache attacks and neuroimaging changes in the brain matter in migraine. The paper reviews clinical trials dealing with the prevalence, causes, and pathogenesis of CI in patients with migraine. It sets forth the current principles of prevention and treatment of CI in patients with this condition.

© 2018 Ima-Press Publishing House. All rights reservbed. The socially significant problems in patients with prior stroke include post-stroke cognitive impairment (PCI), the prevalence of which is high (from 24 to 70%). The causes of disability in these patients are that the role of cognitive impairment is often underestimated and attention is paid only to motor defects. The pathogenesis of PCI may include not only vascular, but also neurodegenerative (due to Alzheimer's disease) mechanisms of brain damage. The diagnosis of early PCI is of great practical importance, as it is most effective to treat mild PCI. The paper considers current approaches to preventing and treating PCI. The authors give their own experience in treating a patient with moderate PCI.

© 2018 Ima-Press Publishing House. All rights reserved. Prior stroke plays an important role in the development of cognitive impairment (CI), the prevention of which requires detailed study. Patients and methods. A total of 350 patients (mean age, 65±17.7 years; 49% men) who had experienced a stroke with a small degree of neurological deficit were followed up. Cognitive functions were evaluated using the Mini-Mental State Examination (MMSE), Mattis dementia rating scale, the clock drawing test, the test on memorizing 12 words, and the Schulte table. During 5 years of follow-up, 61 (17.4%) patients died, including 45 (12.8%) from recurrent stroke; 89 recurrent strokes developed. Results. The first examination did not reveal CI in 59 (17%) patients; 73 (21%) were found to have marked CI (mild or moderate dementia). After 1, 3, and 5years of follow-up, the proportion of patients with marked CI increased up to 23.2, 29.5, and 34.5%, respectively. Within 5 years, there was an average decline of 2 MMSE scores. The maximum decrease in cognitive functions was seen in patients who had experienced a recurrent stroke, but this also occurred in the absence of a stroke. Cognitive functions were substantially better in a group of patients with blood pressure (BP) normalization. Conclusion. The 5-year follow-up has shown that post-stroke CI gradually progresses, which is associated with the progression of both vascular disease and a concomitant neurodegenerative process. BP normalization during antihypertensive therapy contributes to the prevention of progressive post-stroke CI.

© 2018 ABV-Press Publishing House. All rights reserved. Background. Patients with the chronic migraine frequently present with memory and attention complaints. However, the prevalence and phenotype of such impairment in chronic migraine have not been studied. Objective-to evaluate the prevalence of the objective cognitive deficit in patients with chronic migraine and factors underlying its etiology. Materials and methods. We recruited 62 subjects with chronic migraine and 36 gender-and age-matched controls with low-frequency episodic migraine (not more, then 4 headache days per month) aged 18-59. All patients filled in the Hospital Anxiety and Depres sion Scale (HADS) and Sheehan Disability Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20). Results. In this study 58 % of patients with chronic migraine complained of memory loss. Cognitive impairment was also found with PDQ-20. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rate. In 40 % of subjects with chronic migraine scored lower than 26 points on MoCA. Patients with chronic migraine more frequently had lower DSST rates as compared to episodic migraine (odds ratio 5.07 (95 % confidence interval-1.59-16.17); p = 0.003). Depression and anxiety did not correlate with performance on cognitive tests. Chronic migraine (frequent headache) and longer headache history, but not depression, anxiety or medication overuse were independent predictors of cognitive impairment. Conclusion. Subjective and objective cognitive deficits are prevalent in the chronic migraine population. Most often memory and attention are impaired. Longer headache history and presence of chronic migraine are independent risk factors for cognitive impairment in patients with chronic migraine.

© 2018 Ima-Press Publishing House. All Rights Reserved. This review provides information on prospects for using the antidepressant agomelatine in neurological practice. The drug has a unique receptor profile, being a melatonin receptor type 1 and 2 agonist and a serotonin receptor subtype 2C antagonist. Due to this and in addition to antidepressant action, the drug has a number of other effects, such as analgesic, anti-apathetic, anti-asthenic, procognitive, anxiolytic, and sleep-normalizing ones, which are of great importance in the treatment of neurological diseases. There are clinical and experimental data that prove the high efficiency and safety of agomelatin in the follow-up of patients with post-stroke depression, Parkinson's disease, Alzheimer's disease, Pick's disease, Huntington's disease, chronic fatigue syndrome, and pain syndromes.

© 2018 Russian Association of Endocrinologists. All rights reserved. In recent years, a large amount of data has been accumulated on the relationship between cognitive impairment, dementia and diabetes mellitus. This article presents an overview of modern literature, including the definition of cognitive functions, the modern classification of cognitive impairment, pathogenetic mechanisms of diabetes mellitus influence on the development of cognitive impairment and dementia (neurogenesis, integrity of the blood-brain barrier, systemic inflammatory reactions, hyper- And hypoglycemia, insulin resistance, vascular dysfunction of the microvasculature and increase in glucocorticosteroids). The influence of anti-diabetic medications on cognitive functions has been examined in detail: insulin preparations, oral hypoglycemic agents of the biguanide group (metformin), thiazolidinediones (rosiglitazone and pioglitazone), sulfonylurea derivatives (glycazide, glipizide), a-glucosidase (acarbose) inhibitors, incretin-directed therapy (receptor agonists glucan-like peptide (exenatide and liraglutide) and inhibitors of dipeptidylpeptidase type 4 (sitagliptin, vildagliptin and alogliptin)), sodium glucose inhibitors cotransporter type 2. The data demonstrating a multidirectional effect on the cognitive functions of various antidiabetic drugs is presented, the possible influence on the rate of progression of cognitive impairment and the risk of dementia of intensive control of plasma glucose level in comparison with the standard decrease in patients with type 2 diabetes is analyzed.

© ABV-Press Publishing House. All rights reserved. Over a half of chronic pain (CP) patients present with cognitive complaints, which increase their disability and impact quality of life. The paper reviews objective impairments in memory, attention, processing speed and executive function demonstrated in the CP population. The paper also reviews common pathology underlying cognitive impairment and CP: neuroplasticity in the shared brain areas, neurotransmitter and other molecular mechanisms. Common mechanisms in CP and depression precipitating cognitive impairment are also discussed. The paper also compares the potential of different antidepressants to improve cognitive functions in depression and CP.

© Ima-Press Publishing House. All rights reserved. Post-stroke cognitive impairment (PSCI) is often characterized by a complex prognosis of neurorehabilitation, insufficient restoration of the functional status of patients, and a high risk of recurrent strokes and disability, which determines considerable health care costs. Objective: to carry out a comparative pharmacoeconomic analysis of the use of actovegin (Takeda Pharmaceuticals, Switzerland) in Russian patients with PSCI. Patients and methods. The investigation was conducted using a modeling method to determine the cost-effectiveness of competing treatment strategies: standard patient management; standard patient management and use of actovegin. Data from the ARTEMIDA clinical trial were used. Results and discussion. The use of actovegin was economically justified, which was expressed in more preferable cost-effectiveness indicators. Also, the use of actovegin in patients significantly reduced the risk of post-stroke dementia and, accordingly, the cost of treatment in future periods. Conclusion. The findings data indicate the clinical and economic feasibility of using actovegin in patients with PSCI.

© 2018, Media Sphera Publishing Group. All rights reserved. Non-motor disturbances represented by sensory, affective, obsessive-compulsive disorders, cognitive dysfunction, sleep disturbances are often found in patients with dystonia and have a negative impact on their quality of life. The prevalence of sensory and affective disorders and sleep disturbances is above 50% in patients with cervical dystonia and is 25% in patients with blepharospasm, writing spasm; cognitive dysfunction is found in more than 25% of patients with focal dystonia. The relationship of nonmotor, in particular psychiatric disorders, with the impairment of social and everyday life and worsening of quality of life in whole was shown. Common pathophysiological mechanisms of non-motor disorders as well as approaches to treatment of these disorders are discussed. The authors present the results on the positive effect of botulinum toxin therapy that reduces cognitive dysfunction, sensory disorders and depressive syndrome. Non-medication treatment of non-motor disorders in patients with dystonia is considered.