Кафедра неврології, психіатрії та фізичної реабілітації

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COGNITIVE FUNCTIONS IN MULTIPLE SCLEROSIS PATIENTS DEPENDING ON THE DIFFERENT RISK FACTORS PRESENCE
(ALUNA, 2021-10) Kopchak Oksana; Odintsova Tetiana; Pulyk Oleksandr
The aim: To clarify the influence of different risk factors on cognitive impairment (CI) in general and in separate domains and their association with MRI findings in patients with relapsing-remitting (RRMS) and progressive forms of multiple sclerosis (SPMS and PPMS). Materials and methods: One hundred and thirty-seven participants with MS (102 females and 35 males) aged from 22 to 69 years were enrolled into this study. All patients completed the Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A) and undergone MRI. Results: According to MS phenotypes all participants were divided into two groups: patients with RRMS (n= 106) and with progressive phenotypes (n= 31). A significant positive correlation was present between MoCA and BDI scores in all participants (p= 0,0015). Presence of anxiety did not demonstrate any valid influence on cognitive performance, although severe anxiety was significantly more often found in subjects with progressive phenotypes in presence of brain atrophy (p= 0,0028). Patients with higher education had no CI more frequently compare to those without it (p= 0,0019), whereas, participants smoking cigarettes had higher prevalence of severe CI than non-smokers (p= 0,0061). Conclusions: Among cognitive domains memory, visual-spatial and executive functions, abstract thinking were impaired the most in MS patients, though abstract thinking was more often affected in progressive forms. The results demonstrated that physical disability, depression and smoking negatively impacted cognitive performance, meanwhile presence of higher education demonstrated a favorable influence on cognition in MS patients.
FEATURES OF GUT MICROBIOTA IN PATIENTS WITH MIGRAINE AND HEALTHY INDIVIDUALS
(Tbilisi State Medical University, 2022) Kopchak O.; Hrytsenko O.
The gut – brain axis plays a significant role in the pathophysiology of migraine. This interaction can be influenced by multiple factors, such as gut microbiota profiles. Background/Objectives: The aim of the study was to analyze the gut microbiome state in patients with migraine and healthy individuals, to assess possible correlations between the detected changes in patients with migraine and the frequency, intensity of headaches, their psycho-emotional state, and quality of life. Subjects/Methods: In total, 112 patients-16.3% of men and 83.7% of women. Subjects were divided into 2 groups depending on the presence of migraine: the main - patients with chronic and episodic forms of migraine, the control - healthy individuals. The study of the intestinal microbiome was performed by chromato-mass spectrometry. The following scales were used: Visual Analogue Scale/VAS, Migraine Disability Assessment/ MIDAS, Back Depression Inventory/BDI. Results: In patients with migraine compared with healthy individuals, significant changes were noted in the quantitative composition of certain resident microorganisms including Alcaligenes spp (p=0.0061), Clostridium coccoides (p=0.0021), Clostridium propionicum (p=0.0287), Eggerthella lenta (p=0.0138), Pseudonocardia spp (p=0.0210), and Rhodococcus spp (p=0.0164). The number of microscopic fungi such as Candida spp (p=0.0079), Micromycetes spp (p=0.0011) and Micromycetes spp (p=0.0010) were increased in patients with migraine compared to the control group. In the main group, a negative correlation was found between the level of Alcaligenes spp and the score on the BDI score, HARS score (respectively: r= -0.6226, p= 0.007; r= -0.509, p=0.03), the frequency of attacks (r=-0.4879, p=0.046) and the VAS score (r=-0.487, p=0.046). Significant negative correlation was found between elevated level of Clostridium coccoides and MIDAS score (r=-0.5123, p=0.03), BDI score (r=-0.54, p=0.025) in the patients with migraine. At the same time, in the main group a positive correlation was detected between Eggerthella lenta level of and VAS score (r=0.4830, p=0.049). In the main group negative correlations were found between slightly increased content of endotoxin in the main group, the BDI score, HARS score (respectively: r=-0.697, p=0.001; r=-0.557, p=0.02) the frequency of attacks (r=-0.547, p=0.023), on the VAS score (r=-0.531, p=0.028), as well as MIDAS score (r =-0.556, p=0.02). Conclusion: The revealed peculiarities of gut microbiome changes in patients with migraines need further clarification in order to identify the possible role of the gut microbiome in the pathogenesis, clinical picture, and therapy of migraine, and is a promising area of further scientific research.
PECULIARITIES OF THE GUT MICROBIOTA IN PATIENTS WITH MIGRAINE COMPARING TO HEALTHY INDIVIDUALS
(Aluna Publishing, 2022-09) Kopchak Oksana; Hrytsenko Olena; Pulyk Oleksandr
The aim: Analyze the gut microbiome state in patients with migraine (M) and healthy individuals, to assess possible correlations between the detected changes in patients with migraine and the frequency, intensity of headaches, psycho-emotional state of the patients, and their quality of life. Materials and methods: 100 objects were enrolled, divided into 2 groups: main – patients with M and control – healthy volunteers. Investigation of the intestinal microbiome was performed by chromato-mass spectrometry. For M patients the following scales were used: Visual Analogue Scale (VAS), Migraine Disability Assessment (MIDAS), Back Depression Inventory (BDI). Results: In main group increased amount of Alcaligenes spp (p = 0.0061), Clostridium coccoides (p = 0.0021), Clostridium propionicum (p = 0.0287), Eggerthella lenta (p = 0.0138), Pseudonocardiaspp (p = 0.0210),Rhodococcus spp (p = 0.0164), Candidaspp (p = 0.0079), Micromycetes spp(campesterol) (p = 0.0011) were found. Patients with M had a raised amount of Herpes simplex (p = 0.0305) and endotoxin level (p = 0.0459). Differences in gut microorganisms in both groups were significant. In patients with M negative correlations were observed between Alcaligenes spp ammount and BDI score (r = -0.6226, p =0.007), VAS score (r = -0.489, p = 0.046), headache frequency (r = -0.487, p = 0.046); between the levels of Clostridium coccoides and MIDAS score (r =-0.51, p = 0.035), BDI score (r = -0.54, p = 0.025) and positive correlation between Eggerthellalenta level and VAS score (r =0.4830, p=0.049). Conclusions: Correlations between changes of gut microbiome and M are promising for further research.
Predicting cognitive impairment and psycho-emotional disorders in Multiple Sclerosis patients according to MRI findings
(AMPH, 2022-12-30) Odintsova Tetiana; Kopchak Oksana
Objectives. The aim of our study was to assess the probability of cognitive impairment (CI) in general and in separate domains, depression, anxiety and sleep disorders onset depending on their association with MRI findings in patients with multiple sclerosis (MS). Materials and methods. 137 patients with MS were enrolled into the study. All participants were divided into two groups: group A included study subjects with relapsing remitting multiple sclerosis (RRMS) and B consisted of patients with secondary progressive multiple sclerosis (SPMS). Results. Participants with progressive forms of MS had a higher risk of CI development compare to the patients with RRMS (p=0,0361). Memory decline onset depended on the presence of the brain atrophy in combination with lesions of the parietal lobe (OR=2.74 (0.85-8.77), p <0.0001) in RRMS cases, furthermore, on presence of combined demyelination in temporal lobe with corpus callosum (OR=17.33 (2.92-103.02), p=0.0006) and parietal lobe separately (OR=7.5 (1.14-49.26), p=0.0239) in patients with SPMS. Conclusions. CI and psycho-emotional disorders can be predicted by means of MRI findings and potentially prevented.
Prevalence of sexual disorders in relapsing-remitting multiple sclerosis patients depending on various risk factors
(AMPH, 2024) ODINTSOVA Tetiana; KOPCHAK Oksana
Objective. Multiple sclerosis is a perilous, disabling, physically as well as mentally, demyelinating disease of the central nervous system. This work aims to evaluate prevalence of sexual dysfunctions and their correspondence with non- and disease related risk factors, as well as with MRI findings in patients with relapsing-remitting multiple sclerosis. Results. Based on conducted multifactorial analysis, the most prominent risk factor associated with presence of sexual dysfunctions in in patients with relapsing-remitting multiple sclerosis was depression. Sexual dysfunctions are tied to cognitive deficit, in general and in separate domains, particularly in memory, executive functions and language. Considering disease-related agents, sensory and motor deficits are linked to the development of sexual dysfunctions in case of relapsing-remitting multiple sclerosis. Among nondisease-related factors, unemployment, marital status, level of education and tobacco smoking are affecting sexual dysfunctions’ severity. According to the MRI, frontal lobe and corpus callosum and periventricular area were affected more often comparing to other brain regions in case of sexual dysfunctions. Conclusions. Patients suffering from relapsing-remitting multiple sclerosis encounter secondary and tertiary sexual dysfunctions. Knowing all struggles of MS, patients should be offered more nuanced management options that will improve their quality of life on a deeper level.
Psychological well-being of Ukrainian students three months after the emerge of full-scale war
(Polish Psychiatric Association Editorial/Publishing Commitee, 2024) Pinchuk Irina; Solonskyi Andrii; Yachnik Yuliia; Kopchak Oksana; Klasa Katarzyna; Sobański Jerzy; Odintsova Tetiana
Aim. To depict overall psychological well-being of a large group of students of different universities in Ukraine three months after the emerge of the full-scale war. Material and methods. A total of 1,142 participants were asked to measure their psychological well-being on a 0–10 scale before and after the onset of full-scale war. Mental health symptoms were measured with questionnaires targeting depression (PHQ-9), anxiety (GAD-7), sleep problems (ISI), eating disorders (SCOFF), alcohol abuse (CAGE), and PTSD symptoms (PC-PTSD-5). To evaluate the connection between variables a χ2 was conducted. Phi and Cramer’s V coefficient were stated to demonstrate the power of the relationships. Additionally, machine learning (the XGBoost regression model) was used to build a predictive model for depressive symptoms. Results. Of all respondents, 66% screened positive for PTSD symptoms, 45% – moderate and severe anxiety symptoms, 47% – moderate and severe depressive symptoms. Regarding sleep, alcohol use and eating behavior, 19% of surveyed students had signs of moderate and severe insomnia, 15% reported alcohol abuse and 31% disordered eating. The severity of the aforementioned disorders varied depending on gender, year of study, social status, etc. According to the predictive model, lower initial psychological well-being, female gender, younger age, first years of study and any traumatic experience, including multiple trauma, predicted increases in depression score. Return to home after relocation was a protective factor. Conclusions. The study demonstrated the high prevalence of mental health symptoms among university students in Ukraine during the first months of the full-scale war. The psychological well-being pre-war was the strongest predictor of depressive symptoms in the model.
SLEEP DISORDERS IN RELAPSING-REMITTING MULTIPLE SCLEROSIS PATIENTS
(Aluna Publishing, 2021) Kopchak Oksana; Odintsova Tetiana
The aim: Our study aimed at evaluating the relationships between sleep disorders (SD), cognitive impairment (CI), anxiety and depression in patients with relapsing-remitting multiple sclerosis (RRMS). Materials and methods: One hundred and five patients with RRMS (80 females and 25 males) aged from 22 to 67 years (mean age: 41,8±10,7; EDSS:3,5±1,6; disease duration (DD): 10,3±8,5 years) were enrolled into the study. All participants completed questionnaires on sleep (the Pittsburgh Sleep Quality Index /PSQI), cognitive functions (The Montreal Cognitive Assessment /MoCA), anxiety (Hamilton Anxiety Rating Scale /HAM-A), depression (Beck Depression Inventory/ BDI). Results: According to PSQI score the patients were divided into two groups: with (n=42) and without SD (n=63). The patients with SD were older (45,36±1,66 vs 39,41±1,27, p=0.005), had higher EDSS score (3,98±0,26 vs 3,14±0,19, p=0,008), BDI (13,79±1,14 vs 8,96±0,86, p=0,0009) and HAM-A (24,52±1,42 vs 16,56±0,99, p<0,0001) scales compared with patients without SD. The frequency of anxiety (p=0,0034) and depression (p=0,038) was significantly higher in RRMS patients with compared to those without SD. No significant difference was found in gender, DD and MoCA score. In patients with SD significant negative correlation between MoCA and BDI score (r = -0,42, p<0,005) was found. In the group of patients without SD significant negative correlation between MoCA and EDSS (r = -0,27, p=0,03), MoCA and BDI (r = -0,26, p=0,043),) MoCA and HAM-A (r = -0,25, p=0,041) score was detected. Conclusions: Insomnia type SD in RRMS patients were associated with older age, higher EDSS score and presence of anxiety and depression.
ПСИХОПАТОЛОГІЧНИЙ ТА АДИКТИВНИЙ СТАТУС ОСІБ, ЩО СТРАЖДАЮТЬ НА СИНДРОМ ЗАЛЕЖНОСТІ ВІД АЛКОГОЛЮ, ПІСЛЯ ПЕРЕНЕСЕНОЇ КОРОНАВІРУСНОЇ ХВОРОБИ COVID – 19
(«Центр учбової літератури», 2021-03-18) Тасенко Михайло Володимирович; Пострелко В. М.
У статті наведено дані щодо психопатологічного стану та адиктивного статусу осіб, які страждають на синдром залежності від алкоголю та перехворіли на коронавірусну хворобу COVID - 19. Встановлено, що у осіб з синдромом залежності від алкоголю, які перехворіли на коронавірусну хворобу COVID - 19, переважають середній ступінь тяжкості та тяжка форма тривожного розладу та виражений депресивний розлад. Для самополегшення психопатологічних симптомів пацієнти збільшують дозу алкоголю,що не тільки підвищує ризик розвитку важкої алкогольної залежності, але й гальмує процеси відновлення організму після коронавірусної інфекції. Слід очікувати збільшення кількості епізодів алкогольного абстинентного синдрому, оскільки незавершені соматичні захворювання змушують пацієнтів на деякий час відмовитися від алкоголю.
СИНДРОМ ЗАЛЕЖНОСТІ ВІД АЛКОГОЛЮ В УЧАСНИКІВ ЛІКВІДАЦІЇ НАСЛІДКІВ АВАРІЇ НА ЧОРНОБИЛЬСЬКІЙ АЕС ЧЕРЕЗ 35 РОКІВ
(«Центр учбової літератури», 2021-04-07) Тасенко Михайло Володимирович; Пострелко В. М.
У статті представлено порівняльну характеристику особливостей перебігу синдрому залежності від алкоголю в учасників ліквідації наслідків аварії на Чорнобильській АЕС та їхніх нащадків, які перехворіли на COVID - 19. Дослідження виявило, що люди, які брали участь у ліквідації наслідків аварії на ЧАЕС, порівняно з людьми, які були дітьми на момент аварії, або народилися у людей, які брали участь у ліквідації наслідків аварії на ЧАЕС, мали більш тяжкий перебіг коронавірусної хвороби та виражені тривожні та депресивні розлади, нічні жахи, тяжкі когнітивні порушення. Характерною особливістю всіх груп було різке збільшення дози вживаного алкоголю, або вихід з ремісії. Після дослідження спостерігалося покращення загального стану пацієнтів та якісна ремісія.

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