Search

To investigate the opinions of physicians about brain surgery for drug-resistant epilepsy worldwide.Practicing neurologists, psychiatrists, and neurosurgeons from around the world were invited to participate in an online survey. The survey anonymously collected data about demographics, years in clinical practice, discipline, nation, work setting, and answers to the questions about beliefs and attitudes about brain surgery for drug-resistant epilepsy.In total, 1410 physicians from 20 countries and different world regions participated. The propensity to discuss brain surgery with patients, who have drug-resistant seizures, was higher among men (versus women) [Odds Ratio (OR) 1.67, 95% CI 1.20-2.31; p = 0.002]. In comparison to neurologists, psychiatrists were less likely (OR 0.28, 95% CI 0.17-0.47; p 0.001) and neurosurgeons were more likely (OR 2.00, 95% CI 1.08-3.72; p = 0.028) to discuss about it. Survey participants working in Africa, Asia, the Middle East, and the Former Union of Soviet Socialist Republics showed a lower propensity to discuss epilepsy surgery with patients.This study showed that on an international level, there is still a knowledge gap concerning epilepsy surgery and much needs to be done to identify and overcome barriers to epilepsy surgery for patients with drug-resistant seizures worldwide.

The study aimed to investigate factors associated with non-binary gender identity in Russian female psychiatric inpatients with suicidal ideation. This case-control study included 38 female inpatients with non-binary gender identity and a control group-76 cisgender women matched for age (age range 19-35 years, M age, 21.5 years); both groups were psychiatric inpatients with suicidal thoughts. All patients underwent the Self-Injurious Thoughts and Behaviors Interview and completed the brief Reasons for Living Inventory. We also used the WHO Quality of Life Questionnaire (WHOQOL-100) and the Life Style Index (LSI). Non-binary gender identity in inpatients with suicidal ideation was associated with lower educational level, higher unemployment rate, being more socially reticent in preschool, and lifetime sexual experience with both male and female partners. In addition, they were younger at the time of the first suicidal ideation, suicide plan development, and attempt. Non-binary inpatients had lower scores in freedom, physical safety, and security facets of WHOQOL-100 and a higher level of intellectualization on LSI. People with non-binary gender identity face educational, employment, and communication issues. They also have distinct suicidal thoughts and behavioral profiles. These issues and differences mean unique approaches to suicide prevention for a population of inpatients with non-binary gender identity are needed.

Background Delayed-onset of headache seems a specific feature of cerebrovascular events after COVID-19 vaccines. Methods All consecutive events reported to the United States Vaccine Adverse Reporting System following COVID-19 vaccines (1 January to 24 June 2021), were assessed. The timing of headache onset post-vaccination in subjects with and without concomitant cerebrovascular events, including cerebral venous thrombosis, ischemic stroke, and intracranial haemorrhage was analysed. The diagnostic accuracy in predicting concurrent cerebrovascular events of the guideline- proposed threshold of three-days from vaccination to headache onset was evaluated. Results There were 314,610 events following 306,907,697 COVID-19 vaccine doses, including 41,700 headaches, and 178/41,700 (0.4%) cerebrovascular events. The median time between the vaccination and the headache onset was shorter in isolated headache (1 day vs. 4 (in cerebral venous thrombosis), 3 (in ischemic stroke), or 10 (in intracranial hemorrhage) days, all P < 0.001). Delayed onset of headache had an area under the curve of 0.83 (95% CI: 0.75–0.97) for cerebral venous thrombosis, 0.70 (95% CI: 0.63–76) for ischemic stroke and 0.76 (95% CI: 0.67–84) for intracranial hemorrhage, and >99% negative predictive value. Conclusion Headache following COVID-19 vaccination occurs within 1 day and is rarely associated with cerebrovascular events. Delayed onset of headache 3 days post-vaccination was an accurate diagnostic biomarker for the occurrence of a concomitant cerebrovascular events.

The aim of this document is to provide evidence- based recommendations for the medical treatment of depression in adults with epilepsy. The working group consisted of members of an ad hoc Task Force of the International League Against Epilepsy (ILAE) Commission on Psychiatry, ILAE Executive and the International Bureau for Epilepsy (IBE) representatives. The development of these recommendations is based on a systematic review of studies on the treatment of depression in adults with epilepsy, and a formal adaptation process of existing guidelines and recommendations of treatment of depression outside epilepsy using the ADAPTE process. The systematic review identified 11 studies on drug treatments (788 participants, class of evidence III and IV) ; 13 studies on psychological treatments (998 participants, class of evidence II, III and IV) ; and 2 studies comparing sertraline with cognitive behavioral therapy (CBT ; 155 participants, class of evidence I and IV). The ADAPTE process identified the World Federation of Societies of Biological Psychiatry guidelines for the biological treatment of unipolar depression as the starting point for the adaptation process. This document focuses on first-line drug treatment, inadequate response to first-line antidepressant treatment, and duration of such treatment and augmentation strategies within the broader context of electroconvulsive therapy, psychological, and other treatments. For mild depressive episodes, psychological interventions are first-line treatments, and where medication is used, selective serotonin reuptake inhibitors (SSRIs) are first-choice medications (Level B). SSRIs remain the first-choice medications (Level B) for moderate to severe depressive episodes ; however, in patients who are partially or non-responding to first-line treatment, switching to venlafaxine appears legitimate (Level C). Antidepressant treatment should be maintained for at least 6 months following remission from a first depressive episode but it should be prolonged to 9 months in patients with a history of previous episodes and should continue even longer in severe depression or in cases of residual symptomatology until such symptoms have subsided.

aims: To investigate the level of anxiety as well as attitude toward disease and mitigation strategies in people with non-psychotic mental disorders and healthy controls. background: The new coronavirus disease (COVID-19) pandemic resulted in an unprecedented morbidity and mortality and economic consequences worldwide. Response to pandemic required an urgent and radical change in the medical care delivery with a focus on infectious disease, which is uncommon for most developed countries. Implemented changes led to reduced psychiatric (especially inpatient) care utilization. objective: To investigate the level of anxiety as well as attitude toward disease and mitigation strategies in people with non-psychotic mental disorders and healthy controls. method: A case-control study (1:4) was conducted during a self-isolation regimen in Moscow. Cases were adult patients with NPMD consequently admitted to the Moscow Research and Clinical Center for Neuropsychiatry. Sex and age-matched controls (individuals who have never sought psychiatric help) were selected from a cohort of 7498 Moscow residents who participated in a largecross-sectional survey delivered via social networks and popular Russian web platforms. result: The level of the trait but not state anxiety was higher in people with NPMD. People with mental disorders were significantly more often concerned about the negative impact of the COVID-19 pandemic on their lives, were more likely to be confident that they would contract the coronavirus and their disease would be severe, showed suboptimal adherence to mitigation strategies, were dissatisfied with the amount of information they received about the COVID-19 and were more concerned about becoming a victim of domestic violence. conclusion: People with NPMD have higher level of trait anxiety and are prompted to develop the constellation of maladaptive beliefs toward a pandemic. These beliefs along with the lack of reliable information on coronavirus infection can lead to misunderstanding and disregard of sanitary and self-isolation recommendations. Educational programs and vaccination campaigns should be sensitive to these features of people with NPMD. other: No

Background A Core Outcome Set (COS) is a standardised list of outcomes that should be reported as a minimum in all clinical trials. In epilepsy, the choice of outcomes varies widely among existing studies, particularly in clinical trials. This diminishes opportunities for informed decision-making, contributes to research waste and is a barrier to integrating findings in systematic reviews and meta-analyses. Furthermore, the outcomes currently being measured may not reflect what is important to people with epilepsy. Therefore, we aim to develop a COS specific to clinical effectiveness research for adults with epilepsy using Delphi consensus methodology. Methods The EPSET Study will comprise of three phases and follow the core methodological principles as outlined by the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Phase 1 will include two focused literature reviews to identify candidate outcomes from the qualitative literature and current outcome measurement practice in phase III and phase IV clinical trials. Phase 2 aims to achieve international consensus to define which outcomes should be measured as a minimum in future trials, using a Delphi process including an online consensus meeting involving key stakeholders. Phase 3 will involve dissemination of the ratified COS to facilitate uptake in future trials and the planning of further research to identify the most appropriate measurement instruments to use to capture the COS in research practice. Discussion Harmonising outcome measurement across future clinical trials should ensure that the outcomes measured are relevant to patients and health services, and allow for more meaningful results to be obtained. Core Outcome Set registration COMET Initiative as study 118.

Background and objectivesOne year after the onset of the coronavirus disease 2019 (COVID-19) pandemic, we aimed to summarize the frequency of neurologic manifestations reported in patients with COVID-19 and to investigate the association of these manifestations with disease severity and mortality.MethodsWe searched PubMed, Medline, Cochrane library, ClinicalTrials.gov, and EMBASE for studies from December 31, 2019, to December 15, 2020, enrolling consecutive patients with COVID-19 presenting with neurologic manifestations. Risk of bias was examined with the Joanna Briggs Institute scale. A random-effects meta-analysis was performed, and pooled prevalence and 95% confidence intervals (CIs) were calculated for neurologic manifestations. Odds ratio (ORs) and 95% CIs were calculated to determine the association of neurologic manifestations with disease severity and mortality. Presence of heterogeneity was assessed with I2, meta-regression, and subgroup analyses. Statistical analyses were conducted in R version 3.6.2.ResultsOf 2,455 citations, 350 studies were included in this review, providing data on 145,721 patients with COVID-19, 89% of whom were hospitalized. Forty-one neurologic manifestations (24 symptoms and 17 diagnoses) were identified. Pooled prevalence of the most common neurologic symptoms included fatigue (32%), myalgia (20%), taste impairment (21%), smell impairment (19%), and headache (13%). A low risk of bias was observed in 85% of studies; studies with higher risk of bias yielded higher prevalence estimates. Stroke was the most common neurologic diagnosis (pooled prevalence 2%). In patients with COVID-19 ≥60 years of age, the pooled prevalence of acute confusion/delirium was 34%, and the presence of any neurologic manifestations in this age group was associated with mortality (OR 1.80, 95% CI 1.11–2.91).DiscussionUp to one-third of patients with COVID-19 analyzed in this review experienced at least 1 neurologic manifestation. One in 50 patients experienced stroke. In those >60 years of age, more than one-third had acute confusion/delirium; the presence of neurologic manifestations in this group was associated with nearly a doubling of mortality. Results must be interpreted with the limitations of observational studies and associated bias in mind.Systematic Review RegistrationPROSPERO CRD42020181867.

Dysphagia and progressive swallowing problems due to motoneuron death is one of amyotrophic lateral sclerosis (ALS) symptoms. Malnutrition and body weight loss result in immunological disturbances, fatigability and increase risk of secondary complications in ALS patients, percutaneous endoscopic gastrostomy tube (PEG) placement representing a well-recognized method for malnutrition correction and potentially increasing life expectancy. However, despite nutritional correction, occasional rapid neurological deterioration may develop after PEG placement. We have hypothesized that this decline can be a result of exteroceptive stress during PEG placement and promote neurodegeneration in ALS patients. Intravenous sedation may decrease stress during invasive procedures and it is safe during PEG placement in ALS patients. The aim of the study was comparing different PEG placement protocols of anesthesia (local anesthesia or local anesthesia plus intravenous sedation) in ALS from perspectives of stress load and neurological deterioration profile. During 1.5 years 94 ALS patients were admitted; gastrostomy was performed in 79 patients. After screening according to inclusion and exclusion criteria, 30 patients were included in the prospective consecutive study. All patients were divided in two groups, with local anesthesia and with combination of local anesthesia and intravenous sedation. Routine biochemical indices, neurodegeneration and stress markers were measured. The age of ALS patients was 61 ± 10 years; 20 patients were included at stage 4A and 10 at stage 4B (King’s College staging). PEG was placed at average14 months after the diagnosis and 2.2 years after first symptoms. Mean ALS Functional Rating Scale-Revised was 27.8, mean forced vital capacity of lung 46.3% (19—91%). After one year of observation only 8 patients survived. Mean life duration after PEG was 5 months (5 days—20 months). Comparison of two PEG placement protocols did not reveal differences in survival time, stress load and inflammation level. Higher saliva cortisol levels, serum cortisol, glucose, C-reactive protein and interleukin-6 were detected after PEG placement, confirming considerable stress response. PEG is a stressful factor for ALS patients, PEG placement representing a natural model of exteroceptive stress. Stress response was detected as increased cortisol, C-reactive protein, interleukin-6, and glucose levels. Intravenous sedation did not increase the risk of PEG placement procedure, however, sedation protocol did not affect stress load.

There are as yet no data pointing to any increase in the incidence of the novel coronavirus infection (COVID-19) or a more severe course of illness in patients with epilepsy. However, considering the high prevalence of epilepsy in patients over 60 years of age, the high comorbidity of epilepsy and a whole series of somatic diseases, and the need to maintain the opportunity for constant access to antiepileptic medications and follow-up of epilepsy patients, we can expect a whole set of difficulties in the management of these patients in the conditions imposed by the COVID-19 pandemic. This article addresses the main principles of the management of epilepsy patients in the conditions of the COVID-19 pandemic: the need to follow regimes; preservation of regular and continuous taking of antiepileptic drugs, including consideration of interdrug interactions; and switching patients to i.v. forms of antiepileptic drugs where necessary.

The coronavirus disease 2019 (COVID‐19) pandemic has affected the care of all patients around the world. The International League Against Epilepsy (ILAE) COVID‐19 and Telemedicine Task Forces examined, through surveys to people with epilepsy (PWE), caregivers, and health care professionals, how the pandemic has affected the well‐being, care, and services for PWE. The ILAE included a link on their website whereby PWE and/or their caregivers could fill out a survey (in 11 languages) about the impact of the COVID‐19 pandemic, including access to health services and impact on mental health, including the 6‐item Kessler Psychological Distress Scale. An anonymous link was also provided whereby health care providers could report cases of new‐onset seizures or an exacerbation of seizures in the context of COVID‐19. Finally, a separate questionnaire aimed at exploring the utilization of telehealth by health care professionals since the pandemic began was available on the ILAE website and also disseminated to its members. Seventeen case reports were received; data were limited and therefore no firm conclusions could be drawn. Of 590 respondents to the well‐being survey (422 PWE, 166 caregivers), 22.8% PWE and 27.5% caregivers reported an increase in seizure frequency, with difficulty in accessing medication and health care professionals reported as barriers to care. Of all respondents, 57.1% PWE and 21.5% caregivers had severe psychological distress (k score >13), which was significantly higher among PWE than caregivers (p

Depression is characterized by extremely high clinical heterogeneity. Only a few of the many symptoms of depression may overlap in different people with major depressive disorder. The search for molecular genetic markers of depression often yields conflicting results, which may be due to the heterogeneity of the samples. The aim of this work was to identify genetic risk factors for three diseases characterized by severe depressive symptoms. All participants were of East Slavic origin from Moscow and the regions of Central Russia. The polymorphisms of the genes of the dopamine transporter (SLC6A3/DAT1), dopamine receptors (DRD4 and DRD2), and the enzyme catechol-O-methyltransferase (COMT) were studied in patients with three diagnoses: depressive episode, recurrent depression, and mixed anxiety and depressive disorder. We observed statistically significant differences in the distribution of alleles for the SLC6A3 (DAT1) 40 bp VNTR locus in patients with mixed anxiety and depressive disorder. The short allele (8R and 9R) was more common in patients than in the control group (p = 0.005); significant differences were also observed in the distribution of genotypes of this locus (p = 0.025). No associations were found between the loci of the dopaminergic system and the risk of depressive episode and recurrent depression.

The COVID‐19 pandemic has changed the face of many practices throughout the world. Through necessity to minimize spread and provide clinical care to those with severe disease, focus has been on limiting face‐to‐face contact. Research in many areas has been put on hold. We sought to determine the impact of the COVID‐19 pandemic on epilepsy research from international basic science and clinical researchers. Responses to five questions were solicited through a convenience sample by direct email and through postings on the ILAE social media accounts and an ILAE online platform (utilizing Slack). Information was collected from 15 respondents in 11 countries by email or via Zoom interviews between May 19, 2020, and June 4, 2020. Several themes emerged including a move to virtual working, project delays with laboratory work halted and clinical work reduced, funding concerns, a worry about false data with regard to COVID research and concern about research time lost. However, a number of positive outcomes were highlighted, not least the efficiency of online working and other adaptations that could be sustained in the future.

Objective. To determine the frequency of nonconvulsive status epilepticus (NCSE), epileptiform activity, and rhythmic and periodic patterns in patients with acute cerebrovascular accidents (aCVA). Materials and methods. The informativeness of the EEG was studied in 86 patients hospitalized in the neurology section of the Department of Resuscitation and Intensive Therapy of a level 3 medical center with diagnoses of aCVA. The criterion for starting recordings was an epileptic seizure or clinical suspicion of NCSE. The content of biomarkers of the ictal-interictal continuum and the diagnostic value of the EEG were evaluated in relation to prognoses for survival and recovery of consciousness. Results. Pathological changes in the EEG were seen in 84% of patients. Most patients lacked a dominant occipital rhythm (DOR) (66% of patients) and many showed hemispheric slowing (42%). Slowing of the background rhythm to below the θ range was seen in 41% of patients. EEG reactivity was absent in 20% of patients. Individual epileptiform graphical elements were recorded in 36% of patients, while rhythmic and periodic patterns were recorded in 26%. Significant predictors of unfavorable outcomes were the absence of DOR, areactivity, and decreases in the amplitude and generalized slowing of the background EEG to below the θ range. Our data did not find any link between recording of epileptiform graphic elements or their rhythmic and periodic patterns on the one hand and an increased probability of death on the other. Conclusions. The most informative EEG indicators for prognosticating survival and recovery of consciousness were the amplitude, the dominant frequency of the background recording, and reactivity in response to external stimulation. Recording of sporadic epileptiform graphic elements and rhythmic and periodic patterns in patients with aCVA was not always linked with unfavorable prognoses.

Health consequences that persist beyond the acute infection phase of COVID-19, termed post-COVID-19 condition (also commonly known as long COVID), vary widely and represent a growing global health challenge. Research on post-COVID-19 condition is expanding but, at present, no agreement exists on the health outcomes that should be measured in people living with the condition. To address this gap, we conducted an international consensus study, which included a comprehensive literature review and classification of outcomes for post-COVID-19 condition that informed a two-round online modified Delphi process followed by an online consensus meeting to finalise the core outcome set (COS). 1535 participants from 71 countries were involved, with 1148 individuals participating in both Delphi rounds. Eleven outcomes achieved consensus for inclusion in the final COS: fatigue; pain; post-exertion symptoms; work or occupational and study changes; survival; and functioning, symptoms, and conditions for each of cardiovascular, respiratory, nervous system, cognitive, mental health, and physical outcomes. Recovery was included a priori because it was a relevant outcome that was part of a previously published COS on COVID-19. The next step in this COS development exercise will be to establish the instruments that are most appropriate to measure these core outcomes. This international consensus-based COS should provide a framework for standardised assessment of adults with post-COVID-19 condition, aimed at facilitating clinical care and research worldwide.

To evaluate ciliary neurotrophic factor (CNTF) level in blood serum (BS) and lacrimal fluid (LF) of people with epilepsy (PWE). A case-control study of 72 consecutive patients with focal epilepsy (cases, epilepsy group) and 60 age- and gender-matched healthy volunteers (controls) was performed. Based on comorbid depression, two subgroups of PWE were formed. CNTF level was measured by an enzyme-linked immunosorbent assay (ELISA) in the BS and LF. For measurements of low CNTF levels in the BS, the methodology previously improved by the authors was applied. As compared to controls, CNTF level (pg/mL) in PWE was increased both in the BS (7.0±2.9 vs. 3.7±2.0, P

Objective Interictal dysphoric disorder (IDD) has been regarded as an affective disorder occurring only in people with epilepsy (PWE). Data showing similar characteristics and similar prevalence of IDD in patients with migraine and with psychogenic nonepileptic seizures question the epilepsy-specific nature of IDD. The aim of the study was to investigate the nature of IDD in people with prevalent epilepsy with mood disorders and people with mood disorders who are free of neurological disease. Methods This is a case-control study, with 142 patients with a confirmed diagnosis of epilepsy and major depressive disorder (MDD; cases) and 222 patients with MDD only (controls). MDD diagnosis was confirmed by a structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID-I-RV). We used the Beck Depression Inventory and the Beck Anxiety Inventory to estimate anxiety and depression levels and the Interictal Dysphoric Disorder Inventory (IDDI) to confirm the presence of IDD. Mann-Whitney U test, Pearson chi-squared, Spearman correlation, and logistic regression were used. Results No differences were found in the prevalence of IDD between PWE with MDD and people with MDD alone (88.73% vs. 85.13%, χ2 = .96, p = .32). There were no differences between the groups overall or for any IDDI subscales (all p > .05). In both groups, IDD symptoms were grouped with the same incidence and had the same duration and periodicity. IDD was not associated with epilepsy (odds ratio = .84, 95% confidence interval = .40-1.98, p = .72). No significant correlation was found between epilepsy, demographic characteristics, and all IDDI subscales (all p > .05). Notably, patients with IDD suffered from affective disorders longer (6.68 ± 6.82 years vs. 3.7 ± 3.97 years, p = .001) and also received higher scores on all psychometric scales (all p Significance This study does not confirm the specificity of IDD for epilepsy. The presence of IDD symptoms may be associated with a more severe course of MDD and significant anxiety distress.

The World Health Organization (WHO) has recognized epilepsy as a public health imperative due to its occurrence at all ages in all regions of the world, its high impact on disability-adjusted life years and psychosocial aspects, and the accompanying stigma. The International League Against Epilepsy and the International Bureau for Epilepsy have established crucial collaborations with regional and global organizations to promote epilepsy as a treatable disease, close the treatment gap in care, education, and research, and eradicate stigma. In November 2020, the efforts of these three organizations-with support from WHO member states, the World Federation of Neurology, and the European Federation of Neurological Associations-culminated in the unanimous approval of a WHO resolution to create and implement an Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders. This unique achievement is built on more than 2 decades of collaboration and effort, and heralds extraordinary opportunities to work toward a world where no person's life is limited by epilepsy.

Objectives. To identify the pattern of functional connectivity (FC) between areas and networks in the brain in patients with frontal and temporal foci of epileptic activity. Materials and methods. A total of 43 patients aged 18–50 years with focal epilepsy – 32 with temporal epilepsy (TE) and 11 with frontal epilepsy (FE) – were studied. The control group consisted of 32 healthy subjects. The main method used in the study was brain MRI scans run using the epilepsy protocol and additionally including high-resolution structural images of the brain, along with resting-state fMRI. Results and conclusions. The most marked fMRI feature in patients with TE as compared with healthy subjects was a decrease in the FC of the insular cortex and the temporal opercula (the part of the temporal gyrus of each hemisphere overhanging the insula). In left-sided FE, the decrease on the left was significant. Increased FC in the dorsal part of the attention network on the left with the temporal and parietal areas of the cerebral cortex was specific for right-sided TE. TE also produced a decrease in FC between the anterior part of the cingulate gyrus and the basal ganglia. All significant results were linked with increases in FC in patients with FE as compared with healthy subjects, maximally in areas of the temporal cortex. Thus, the localization and lateralization of the focus of epileptic activity determine the pattern of FC in these areas and neural networks of the brain in patients with focal epilepsy.

Objectives: To estimate the incidence of amyotrophic lateral sclerosis (ALS) in Moscow by investigating multiple sources of cases. Incidence rates from previous Russian studies ranged from 0.3 to 0...

To identify the rates of neurological events following administration of mRNA (Pfizer, Moderna) or adenovirus vector (Janssen) vaccines in the U.S..We utilized publicly available data from the U.S. Vaccine Adverse Event Reporting System (VAERS) collected between January 1, 2021-June 14, 2021. All free text symptoms that were reported within 42 days of vaccine administration were manually reviewed and grouped into 36 individual neurological diagnostic categories. Post-vaccination neurological event rates were compared between vaccine types and to age-matched baseline incidence rates in the U.S. and rates of neurological events following COVID.Of 306,907,697 COVID vaccine doses administered during the study timeframe, 314,610 (0.1%) people reported any adverse event and 105,214 (0.03%) reported neurological adverse events in a median of 1 day (IQR0-3) from inoculation. Guillain-Barre Syndrome (GBS), and cerebral venous thrombosis (CVT) occurred in fewer than 1 per 1,000,000 doses. Significantly more neurological adverse events were reported following Janssen (Ad26.COV2.S) vaccination compared to either Pfizer-BioNtech (BNT162b2) or Moderna (mRNA-1273; 0.15% versus 0.03% versus 0.03% of doses, respectively,P0.0001). The observed-to-expected ratios for GBS, CVT and seizure following Janssen vaccination were ≥1.5-fold higher than background rates. However, the rate of neurological events after acute SARS-CoV-2 infection was up to 617-fold higher than after COVID vaccination.Reports of serious neurological events following COVID vaccination are rare. GBS, CVT and seizure may occur at higher than background rates following Janssen vaccination. Despite this, rates of neurological complications following acute SARS-CoV-2 infection are up to 617-fold higher than after COVID vaccination. This article is protected by copyright. All rights reserved.

Background A substantial portion of people with COVID-19 subsequently experience lasting symptoms including fatigue, shortness of breath, and neurological complaints such as cognitive dysfunction many months after acute infection. Emerging evidence suggests that this condition, commonly referred to as long COVID but also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post-COVID-19 condition, could become a significant global health burden. Main text While the number of studies investigating the post-COVID-19 condition is increasing, there is no agreement on how this new disease should be defined and diagnosed in clinical practice and what relevant outcomes to measure. There is an urgent need to optimise and standardise outcome measures for this important patient group both for clinical services and for research and to allow comparing and pooling of data. Conclusions A Core Outcome Set for post-COVID-19 condition should be developed in the shortest time frame possible, for improvement in data quality, harmonisation, and comparability between different geographical locations. We call for a global initiative, involving all relevant partners, including, but not limited to, healthcare professionals, researchers, methodologists, patients, and caregivers. We urge coordinated actions aiming to develop a Core Outcome Set (COS) for post-COVID-19 condition in both the adult and paediatric populations.

With an increasing number of individuals recovering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there is an urgent need to study the medium- and long-term consequences of the disease. Growing evidence suggests that some patients exhibit symptoms such as fatigue, “brain fog,” or cognitive complaints after the acute infection stage, commonly referred to as “Long COVID.”1 A 6-month study using multidimensional data from the medical records of 73,435 coronavirus disease 2019 (COVID-19) patients showed that, after the first 30 days of illness, individuals have an increased risk of death, higher health resource utilization, and an increased burden from neurocognitive disorders.1 Indeed, evidence from previous epidemics shows that subsequent neurological and, particularly, cognitive complications can occur, such as in the severe influenza epidemic from 1918 to 1921 (also known as the Spanish flu).2 More recently, cases of encephalitis, sensory impairment, coma, and severe neurological damage were reported during the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in 20123 and vascular or inflammatory damage of the brain and central nervous system in people affected by the severe acute respiratory syndrome coronavirus (SARS-CoV) outbreak in 2003.4 Cognitive dysfunction has a significant impact on functionality and quality of life.5 Given the high incidence of COVID-19 and the associated economic, health, and social burden of the epidemic, studying its occurrence and underlying mechanisms is crucial. In the current systematic review, we assess whether there is an increased occurrence of cognitive deficits in adult patients with COVID-19 who previously had no cognitive impairment.

Objective. To study the neurophysiological features of cognitive activity in patients with anxiety-depressive and hypochondriasis disorders. Materials and methods. A total of 65 subjects were studied: 16 with hypochondriasis disorder, 23 with mixed anxiety and depressive disorder, and 26 healthy subjects. Heart rate variability and electroencephalography methods were used. Results and conclusions. The EEG showed a decrease in the β1 range after performance of a cognitive task in patients with anxiety-depressive disorder. Patients with hypochondriasis disorder showed a decrease in the duration of the R–R interval and an increase in the frequency of the resting β1 range, an increase in the dominant frequency of β2 activity during performance of the cognitive task, and an increase in the spread of θ frequencies after cognitive tests.

This review is devoted to the place of anxiety disorders in the spectrum of psychiatric comorbidity in patients with epilepsy. The authors present general characteristics of anxiety manifestations and current views on the classification and qualification of anxiety disorders in such patients. Recent data show the relationship of anxiety with different forms of epilepsy, demographic and gender characteristics, localization of epileptic focus. The problem of bidirectional relationship of anxiety and epilepsy as well as the temporal relationship between anxiety and epileptic states are considered.Обзор посвящен месту тревожных расстройств в спектре психиатрической коморбидности у пациентов с эпилепсией. Представлена общая характеристика тревожных проявлений, отображены современные взгляды на классификацию и квалификацию тревожных расстройств у таких пациентов. Приведены современные данные о связи тревоги с разными формами эпилепсии, демографическими и гендерными характеристиками, локализацией эпилептического очага. Рассмотрены вопросы двунаправленности отношений тревоги и эпилепсии, а также временна`я связь тревожных и эпилептических состояний.

The review provides epidemiological data and discuss the associated burden of non-epileptic seizures (PNES). Data on the prevalence, socio-demographic and clinical risk factors for the development of PNES are presented. The hypotheses of the PNES origin, including the contribution of psychological trauma, are considered. We also describe contemporary methods for differential diagnosis of epileptic seizures and PNES, including biomarkers and the use of diagnostic questionnaires. Special attention is given to the issues of the psychiatric comorbidity of PNES.В обзоре приводятся данные о распространенности психогенных неэпилептических приступов (ПНЭП) и связанном с этим расстройством бремени. Представлены данные о социодемографических, психологических и клинических факторах риска развития ПНЭП. Рассмотрены гипотезы формирования ПНЭП, в том числе вклад психологической травмы. Освещены методы дифференциальной диагностики эпилептических приступов и ПНЭП, включая биомаркеры и применение диагностических опросников. Отдельное внимание уделено вопросам психиатрической коморбидности ПНЭП.