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To search for electroencephalographic markers of alexithymia in patients with moderate depression.Sixty-four right-handed inpatients (20 men and 44 women, mean age 29.3+10.7 years), were studied. The level of alexithymia was assessed by the Russian version of the Toronto Alexithymia Scale (TAS-20-R). Patients were stratified into 4 groups by TAS-20-R scores. Two main groups of 22 patients each included people with high (60 scores) and low (20-51 scores) levels of alexithymia. Control groups included 10 patients with 60-85 scores and 10 patients with 52-54 scores. Current methods of electroencephalographic analysis were used.Alexithymia in patients with moderate depression is characterized by a restructuring of the integrative activity of the brain detected by electroencephalography at rest. Patients with high alexithymia differ from those with low alexithymia by (1) lower values of the real part of the coherence between the frontal and anterior temporal leads of the left hemisphere in the band 28-30 Hz; (2) lower values of the imaginary part of coherence in the band 11-12 Hz between the posterior temporal and parietal as well as the posterior temporal and occipital cortical zones of the right hemisphere; (3) higher rates of the real part of the coherence between the right frontal and central leads in the frequency ranges 12-14 and 6-7 Hz; (4) large values of the imaginary part of the coherence between the left parietal and right posterior temporal cortex in the band 24-26 Hz; (5) higher values of the square of the coherence modulus between the left frontal and anterior temporal cortical zones in the band 17-18 Hz.Large cortical representations with involvement of theta, alpha, beta-1 and beta-2 rhythms can contribute to the pathogenesis of alexithymia.Поиск возможных электроэнцефалографических маркеров алекситимии (АЛ) у больных с умеренно выраженными депрессиями.Были обследованы 64 стационарных больных (все правши), 20 мужчин и 44 женщины, средний возраст которых 29,3+10,7 года. Уровень АЛ у них оценивался при помощи русскоязычной версии Торонтской алекситимической шкалы — TAS-20-R. В соответствии с ее показателями были сформированы 4 группы обследованных. Две основные (обучающие) группы по 22 человека составили пациенты с высокой (60 баллов по TAS-20-R) и низкой (20—51 балл) АЛ. В две контрольные (экзаменующие) группы по 10 человек вошли пациенты с пограничными высокому (60—58 баллов) и низкому (52—54 балла) уровнями АЛ. Основным методом исследования была электроэнцефалография с применением различных современных методов анализа ЭЭГ.Установлено, что АЛ у больных депрессиями характеризуется перестройкой интегративной деятельности головного мозга, выявляемой электроэнцефалографически в состоянии покоя. Больные с высоким уровнем АЛ отличаются от пациентов с ее низким уровнем: 1) меньшими значениями действительной части когерентности между лобными и передними височными отведениями левого полушария в полосе 28—30 Гц; 2) более низкими значениями мнимой части когерентности в полосе 11—12 Гц между задними височными и теменными, а также задними височными и затылочными корковыми зонами правого полушария; 3) более высокими показателями действительной части когерентности между правыми лобными и центральными отведениями в частотных диапазонах 12—14 и 6—7 Гц; 4) большими значениями мнимой части когерентности между левой теменной и правой задней височной корой в полосе 24—26 Гц; 5) более высокими значениями квадрата модуля когерентности между левыми лобной и передней височной корковыми зонами в полосе 17—18 Гц. Таким образом, было показано участие в патогенезе АЛ многих корковых структур с вовлечением тета, альфа, бета-1 и бета-2-ритмов.

Based on the complex study of 150 patients with different forms of epilepsy in the remission phase, we singled out a group of 68 (45.3%) patients with depressive disorders. Variants of depressive disorders and their EEG-characteristics were described. Depressive disorders were stratified by the causes, course and response to pharmacotherapy into following variants: depressive disorders caused by the epileptic process per se; organic depressive disorder and disorder of adaptation with depression and anxiety-depressive disorders. Functional neuroimaging methods suggest the involvement of both the limbic system and cortical structures, with the elevated activity of the left hemisphere, in the development of depression.

We studied 35 patients with organic brain lesions caused by secondary brain harmful factors (group 1) and 33 patients with organic brain diseases of vascular genesis (group 2). Mean age of patients was 45.5±2.3 years. Asthenic, cerebroasthenic, psychoorganic syndromes in the combination with dissomnic, psychoautonomous, depressive, hypochondriac disorders predominated in the clinical picture of patients. Pantoham was prescribed in dose 1.0 g 3 times daily during 45 days. The effect of the drug on cognitive and mental disorders was found. The drug was most effective in patients of group 1. Pantoham was well-tolerated.

Seventy-four patients with paroxysmal mental disorders in the debut of epilepsy have been examined. To study an age-related aspect of these disorders, all patients have been stratified by age at debut of epilepsy into 3 subgroups (children, adolescence and adult age). Based on a key psychopathological syndrome, three types of simple and complex partial "psychiatric" seizures have been singled out. The higher is the age of debut, the higher are the variability of clinical presentations of psychopathological disorders and more complex clinical presentations of complex partial (psychomotor) attacks in the structure of simple partial seizures. In children aged 7-14 years and people older than 18 years, the simple partial "psychiatric" seizures as well as first manifestations of disease were seen more often than in adolescents. This type of debut was not observed in children younger than 7 years. The age curve of debut of epilepsy with complex partial seizures has two distinct peaks, at the children (up to 7 years) and adult ages. In the group older than 18 years, frequencies of psychomotor seizures and first disease manifestations are inversely correlated with age.

Magne-B6 was used, together with anticonvulsive therapy, in the treatment of 25 patients with different forms of epilepsy. In all cases, psychiatric status of patients featured by depression, anxiety and some psychotic sighs. The drug was prescribed in the mean therapeutic dose during 28 days. Along with psychopathologic examination, a psychometric method, using self-rating scales for Zung anxiety and depression scale, SCL-90 and Global clinical impression (CGI) scale, was administered. Magne-B6 exerted a positive non-specific influence on patient's mental state, especially with regard to affective disorders. The positive effect of the drug emerged on 14th day of the treatment and achieved a statistically significant level to 28th day. The medication was more effective in asthenic and subdepressive syndromes, in encephalopathic syndrome the efficacy was lower. The drug was well tolerated and did not cause any side effects.

Thirty patients diagnosed with partial epilepsy (PE): 17 cases with cryptogenic PE, 11--with symptomatic PE and 2--with symptomatic generalized PE, have been switched to topamax monotherapy, in dosage 50-200 mg daily, for 3 months. A type of seizures--simple partial, complex partial and secondary generalized, was taken into account, when considering topamax efficacy. A complete elimination of seizures was achieved after 3 months treatment in 80% of the cases, the mostly pronounced effect being demonstrated for secondary generalized seizures. A decrease of seizures frequency was shown for all types, but in simple partial and secondary generalized seizures the effect emerged earlier (after 1 month of the treatment) comparing to complex partial seizures. Good tolerability of topamax was observed.

Twenty-five epileptic patients, mean age 25.7 years, have been studied. Twenty-two of them were diagnosed with symptomatic partial epilepsy, 1--with criptogenic partial epilepsy and 2--with idiopathic partial epilepsy. Illness duration was estimated as follows: above 5 years--5 patients, above 10 years--10, above 20 years--4 and less than 5 years--6. Polymorphic seizures were detected in 56% of the cases and monomorphic ones, resistant to the previous traditional anticonvulsant therapy,--in 44%. Topamax was used as an add-on therapy to the previously prescribed anticonvulsants in initial dose of 25 mg daily, with a following continuous dose increase. The mean therapeutic dosage was 100 mg daily. Therapeutic efficacy was assessed during 3 months. Since 1 month of topamax adjunction to a treatment schedule, a mean frequency of all types of seizures was reduced. The best effect was found in the case of combination of simple partial and secondary generalized seizures. The medication was effective in 60-80% of the patients with strong resistance to traditional anticonvulsants. Topamax is concluded to be a highly effective antiepileptic medication, which gives new possibilities for a treatment of patients with partial epilepsy resistant to traditional drugs.

On the basis of neurological, encephalographic and clinico-anamnestic examinations of 106 children with a family history of epilepsy the authors have specified a group of children (n = 38) suffering from different neurotic disorders which included neurotic ticks, sleep disturbances, affective-shock reactions and signs of asthenization. The role of familial factors in the formation of neurotic states of children is emphasized. The authors consider the time during which the child was exposed to psychotraumatic circumstances and the relationship between the severity of epileptic process in parents and the development of neurotic disorders in their progeny. A conclusion has been made that the disease of the parents can exert both direct and indirect influence on the nervous system of the child, this leading to the development of different neurotic states. The prophylaxis of neurotic disturbances in children should include the creation of healthy psychic atmosphere in families where one of the parents suffers from epilepsy.

Using clinical electro-encephalic and experimental psychological methods, 75 children born to epileptic parents were examined. The clinical picture of epilepsy in children was found to correlate with the severity and duration of the disease in the parents. In the majority of children the onset of the disease was characterized by non-convulsive paroxysms. The main course of disadaptation of the children to the environment, which hindered their learning in school was mental change expressed in the form of intellectual, emotional and characterological disorders.

Studied were 150 children born to epileptic parents. Clinical investigation and long-lasting follow-up resulted in singling out the groups of children with psychoneurological disorders, normals and a group at risk of epilepsy. The latter was analysed in detail and the neurologist's tactics with respect to every group was elaborated.

Clinical and biochemical investigation was performed in 49 patients with epilepsy of different etiology and clinical course, 10 patients with nonepileptic forms of neurologic and psychic disorders and 50 normal subjects. An additional blood serum protein fraction was found in epileptic patients as compared with the normals using the electrophoretic investigation on the acetate-cellulose plates and devices produced by Hélène France company. Additional biochemical study is suggested as a diagnostic tool in epilepsy.