Синдром дефицита внимания с гиперактивностью (СДВГ) — одна из частых причин социальной дезадаптации школьников [2, 4, 7]. Несмотря на имеющиеся публикации, посвященные СДВГ, остаются мало изученными дисфункции интегративных систем мозга, в структуре которых особое место занимают нарушения сна и бодрствования. Кроме того, изучение сна у детей нередко ограничивается клинической оценкой жалоб без объективной регистрации структуры сна с помощью полисомнографического исследования. Открытыми остаются вопросы взаимовлияния бодрствования, фаз медленного сна (ФМС), быстрого сна (ФБС) при развитии СДВГ. Являются ли нарушения сна при этом первичными, вторичными или коморбидными? Напомним, что существуют три фундаментальных состояния мозга, характеризующиеся совокупностью нейрофизиологических параметров и психической деятельности: бодрствование, ФБС (пародоксальный, REM-сон) и ФМС (ортодоксальный, NON REM-сон) сон [1, 6]. ФБС обеспечивает биологические механизмы психологической защиты, выбор коппинг-стратегий и закрепление путей решения поисковой задачи, осуществляет адаптацию к значимой информации. ФМС сопряжена с концентрацией соматотропного гормона, анаболическими процессами, функциональным созреванием нейронов, консолидацией следов памяти, что лежит в основе усвоения информации, оптимизации деятельности внутренних органов. Цель настоящего исследования — изучение клинических особенностей и структуры сна по данным полисомнографии у детей с СДВГ.

80 children of preschool age were observed after concussion of the brain. In follow-up from 6 months 3 years clinical-anamnestic and neuropsychologic methods were used. The functions of autonomic nervous system were evaluated according to the results of estimation of initial autonomic tonus, autonomic reactivity, autonomic maintenance of the activity and the data of cardiointervalography. The state of nonspecific systems of the brain was studied with day time polygraphic research with a visual EEG evaluation, construction of histogramms by Fora method, estimation of speed and order of the fading of the components of a rough response. Psychovegetative stress was the ground for neurologic disorders in posttraumatic period. The disorders of adaptive regulation were manifested in exhausting of ergotropic systems with compensatory overstrain of trophotropic mechanisms, resulted in predominance of inhibiting influences with an inadequate response of synchronization on EEG during functional loads. Severity of clinical manifestations and disorders of adaptive regulation were more pronounced in children 1-3 year-old and with hypoxic-traumatic damages of the brain in anamnesis. Disintegration of cerebral activity correlated with the remote period. In the first 6-12 months after the concussion of the brain changes of vegetative reactivity prevailed, after 18 months the alterations in vegetative maintenance progressed.

Peculiarities of infringement of the vegetative status in children, suffered concussion of brain are revealed. Disintegration of activity of vegetative systems was displayed by suppression of ergotropic link, causing insufficient vegetative reaction and inadequate vegetative provision of activity. Interrelation of character of vegetative reaction with terms of remote period was observed. Influence of age of the children, character of medical history, degree of clinical compensation was shown.

The clinico-epidemiological analysis and comparison of the data of a comprehensive study of suprasegmental vegetative regulation revealed an appreciable tension of the adaptation mechanisms in the acute period in 55 children with the meningeal form of tick-borne encephalitis (TE). Alterations in vegetative regulation in children suffering from TE were found to be coupled with impairment of the stem-hemispheric interrelations, reduction in the level of nonspecific activation, rise of convulsive preparedness of the brain. A correlation was established between alterations in the main parameters of variational cardiointervalography, character of brain bioelectric activity and the disease gravity. The data obtained can be employed as criteria for predicting the disease outcome and assessment of TE treatment in children.

Based on a clinico-anamnestic analysis and comparison of the data of comprehensive studies of vegetative nervous system functions it was discovered that in 85 children aged 4 to 14 years suffering from neurogenous syncopes, vegetovascular maintenance of the processes of activation and adaptation turned out insufficient. It is shown that in early childhood, the formation of vegetative dysregulation occurs under the influence of numerous factors, of which the most significant are hereditary predisposition to paroxysms, perinatal pathology, and psychogenic effects. It is established that there are two possible variants of the combination of pathophysiological alterations predetermining the clinical picture and phenomenology of neurogenous syncopes in children.