A study of the brain using magnetic resonance morphometry and diffusion tensor imaging in patients with chronic orofacial pain syndrome associated with temporomandibular joint pain dysfunction syndrome revealed changes in regional gray matter volume, namely a decrease in the volume of the primary somatosensory cortex, an increase in gray matter volume in the thalamus, and an increase in both volume and microstructural alterations in the brainstem (in the dorsal horn of the midbrain) accompanied by changes in diffusion properties, specifically an increase in mean diffusivity; in the projection of structures of the descending pain modulation system, including the periaqueductal gray matter of the midbrain and the nucleus raphe magnus, as well as in the integrity of ascending pain pathways (a reduction of fractional anisotropy in the trigeminal root entry zone, the spinal trigeminal tract, and the ventral trigemino-thalamic tract); as well as bilateral increases in the gray matter volume of the pons corresponding to the principal sensory nucleus of the trigeminal nerve.

The aim of this study is to analyze current data concerning MRI neuroimaging methods of the central nervous system in patients with chronic orofacial pain syndrome in temporomandibular joint pain dysfunction syndrome comorbid with anxiety and depression. We analyzed more than 60 articles in English devoted to neuroimaging studies using voxel-based morphometry of the central nervous system in patients with chronic orofacial pain syndrome in temporomandibular joint pain dysfunction syndrome comorbid with anxiety and depression. The rapid development of imaging in recent decades has led to an increase in the number of identified causes of dysfunction in the trigeminal nerve system, which are amenable to specific treatment and functional recovery. A clinically oriented segmental approach to trigeminal nerve pathology is important for conducting specialized high-resolution imaging studies, which are a powerful tool in the examination of patients with trigeminal nerve dysfunction.

The digitalization of contemporary life exerts a profound influence on mental health, creating both new challenges and opportunities for psychiatric practice. This article examines the phenomenon of digital psychopathology as a component of individual digital well-being. Particular attention is devoted to the methodology of Ecological Momentary Assessment (EMA), which enables the real-time recording of psychological states and behaviors. The advantages of EMA for the diagnosis and monitoring of mental disorders are outlined, as are its methodological and practical limitations.

Prediction and prevention of cardiotoxic adverse reactions in neurological diseases is a pressing issue due to necessity for long-term use of antidepressant drugs. The aim of the study was to examine the quantity of antidepressant prescriptions, observation of adverse events (especially cardiovascular ones) and the caution in prescribing by practicing neurologists compared with physicians of other specialties. Materials and methods: 97 physicians of various specialties participated in the survey. After excluding physicians who did not use antidepressants in their practice, the participants were divided into two groups: neurologists and physicians of other specialties. Differences in responses between the two groups were assessed with the Pearson chi-square test (χ2) and the Kruskal-Wallis test. Results. The analysis of a survey of physicians using antidepressants in their clinical practice revealed the statistically significant differences between neurologists and physicians of other specialties who participated in the study. Neurologists tend to underestimate the cardiotoxicity of antidepressant medications (particularly SSRIs), which can lead to a potentially fatal complication—ventricular tachycardia (Torsade de Pointes). A statistically significant difference in awareness of the diagnostic criteria for long QT syndrome was found in medical practice of neurologists and physicians in other specialties. Conclusion. As a result of the analysis the obtained results, the following ways of improving the dispensary observation of patients on antidepressants were: increasing awareness and alertness of practicing physicians about the long QT syndrome; ECG monitoring before and during taking antidepressants; collection of family history and life history in patients before prescribing antidepressants. Presence of tachycardia, syncope, or anoxic seizures in a patient taking antidepressants can arise suspicion for TdP, a potentially fatal complication of QT syndrome; it requires immediate discontinuation of the drug, replacement with a less cardiotoxic one, 24-hour Holter ECG monitoring, and pharmacogenetic testing.

Tic hyperkinesis is one of the most common forms of extrapyramidal pathology in childhood. Recently, interest in non-motor manifestations of tic hyperkinesis in children has increased, as they include ADHD, OCD and anxiety disorder. It is assumed that all these neuropsychiatric diseases have a single pathophysiological basis. However, the question of effective therapy of these comorbid disorders accompanying tic hyperkinesis in children still remains. Aim: to im-prove the quality of inpatient medical care in military hospitals and increase patient satisfaction with medical services. Materials and methods: the study involved 167 patients (193 boys and 74 girls) with tic hyperkinesis aged 6 to 12 years (mean age 8.2 ± 2.3 years). All patients were divided into four groups depending on the clinical course of the disease: Group I: 32 patients with transient tics; Group II: 120 patients with chronic tics. Group III: 15 patients with Gilles de la Tourette syndrome. Motor symptoms were assessed using the YGTSS scale, and non-motor symptoms were assessed using standardized scales: Y-BOCS, SNAP-IV and STAI. The severity of symptoms was assessed before and after treatment. Results: combination neuropharmacotherapy was effective in reducing the severity of tics, ADHD, OCD, and anxiety disorder symptoms in all clinical forms of tic hyperkinesis in children. In addition, combination therapy statistically significantly reduced the severity of tics in patients with Gilles de la Tourette syndrome, ADHD symptoms in patients with transient tics and Gilles de la Tourette syndrome, and OCD symptoms in patients with Gilles de la Tourette syndrome compared to monotherapy. Conclusion: the results of this study showed that combination therapy with hopantenic acid in combination with the main line of therapy in children with tic hyperkinesis is effective in treating both tics themselves and symptoms of ADHD, OCD, and anxiety disorder.

Intervertebral disk degeneration (IVDD) is a dystrophic multifactorial, chronic, recurrent disease, its associated pain and neurological syndromes are among the most important problems in modern medicine. The etiology of IVDD includes both endogenous and exogenous risk factors. Genetic studies conducted to date have not identified a single gene responsible for the development of IVDD. A pilot study examined the allele and genotypic frequencies of single-nucleotide variants in the genome that play a role in the development of IVDD, depending on the pathophysiological mechanisms underlying its development. The study examined genes encoding fibrillar collagens, which are associated with cartilage mechanical stability, as well as genotypes of proinflammatory mediators, which influence IVD damage and increase the risk of herniation. The study involved 80 patients (40 men and 40 women) with chronic pain in the lower back and the presence of signs of degeneration of intervertebral discs at the lumbar level according to MRI aged 18 to 75 years (mean age 52.2 ± 2.3 years). Real-time polymerase chain reaction was used to detect single nucleotide variants (SNVs): rs1107946 of the COL1A1 gene, rs1799983 and rs2070744 of the NOS3 gene, rs1800795 of the IL6 gene. Genotyping of patients with a traumatic-extrusion phenotype of IVDD was performed in comparison with a degenerative-protrusive phenotype as a control. A pilot study led to the hypothesis that the studied variants of the NOS3 gene (rs1799983, rs2070744) and the IL6 gene (rs1800795), encoding inflammatory mediators, may be associated with an increased risk of traumatic-extrusion phenotype of IVDD, as well as the studied variant of the COL1A1 gene (rs1107946). Genetic testing of patients with various phenotypes of IVDD to identify the carriage of risk alleles of these genetic variants, and the study of their association with the rate of progression of IVDD is promising for the development of a personalized strategy for the diagnosis and dispensary observation of the patients.