Interdisciplinary consensus on the use of Cereton in the treatment of central nervous system diseases with cognitive impairment of congenital and acquired genesis in children. Resolution of the interdisciplinary council of expertsXXIII All-Russian Forum "Zdravnitsa-2024".

The article is devoted to an urgent problem of modern neurology - early diagnosis and complex restorative treatment of cerebral palsy (cerebral palsy). Etiological factors and pathogenetic aspects of the formation of various forms of cerebral palsy are considered in detail, as well as modern possibilities of differential diagnosis in children of the first years of life of cerebral palsy and a wide range of pathological conditions (somatic, endocrine, hereditary-conditioned, including hereditary-metabolic and neuromuscular diseases). The leading directions of complex rehabilitation of cerebral palsy are widely presented, taking into account modern standards and clinical recommendations. The high efficacy of the drug Cortexin has been shown, due to its positive multimodal action (stimulation of the processes of neuropreparation, neuroprotection, neuroplasticity) in the treatment of motor, cognitive and autonomic disorders in children with perinatal lesions of the central nervous system and cerebral palsy.

The review analyzes the current possibilities of using hopanthenic acid (Pantocalcin) in the treatment of diseases of the nervous system in children (perinatal CNS lesions, developmental delays, cerebral palsy, ADHD, tics, enuresis, cognitive and neurotic disorders), taking into account modern standards and clinical recommendations. The results of numerous studies demonstrate that Pantocalcin is a highly effective and safe drug in the treatment of diseases of the nervous system in children with complex neurometabolic, neuroprotective, neurotrophic properties.

It has now been established that neurological and neuropsychiatric disorders persist for prolonged periods in a significant proportion of adult patients who have had COVID-19, though there is much less information about the manifestations of post-COVID syndrome (PCS) in children and adolescents. This review presents data on the features of the course of PCS in young patients, and considers the options for treating these patients. The results of studies on the use of Cortexin for correcting cognitive and emotional disorders are analyzed.

The article details modern approaches to the comprehensive diagnosis and treatment of cognitive dysfunctions in children with cerebral palsy. It is shown that cognitive disorders in cerebral palsy are diverse and are represented by disorders of perception, memory, attention, visual-motor coordination, intelligence and speech. Diagnosis of cognitive dysfunctions in patients with cerebral palsy is a difficult task, due to their diverse combination with motor, speech and sensory pathology, which requires an integrated approach. The article highlights in detail the modern directions of complex rehabilitation (including medical, social, psychological and pedagogical correction) of cognitive dysfunctions in children with cerebral palsy, in accordance with modern clinical recommendations and treatment standards.

The article is devoted to an important problem of modern pediatric neurology and rehabilitation, - the issues of diagnosis and comprehensive restorative treatment of the consequences of traumatic brain injury (TBI) in children and adolescents. It is known that TBI is characterized by a high frequency of disability, while asthenic, vegetative, cognitive, emotional, motor and postural disorders are leading in the clinical picture. It is shown that the factors influencing the severity of the consequences of TBI in children are not only the severity of the injury itself, but also the age at which the injury occurred, as well as the localization of the lesion. The article describes modern methods of complex diagnosis and rehabilitation of the consequences of TBI in children, as well as pathogenetically justified approaches to drug therapy, while showing the high effectiveness of the drug choline alfoscerate (Cereton) in restoring cognitive functions and improving the clinical condition in children with the consequences of TBI, according to the results of a double-blind placebo-controlled multicenter randomized trial.

Objective The aim of the study was to study the effect of the drug recognan (citicoline) on the neurodynamic characteristics of mental activity in patients with mild cognitive impairment. Material and methods A survey of 58 subjects (17 of them male and 41 female) aged 18-45 years (average age 27.2±12.5 years) was conducted. Clinical diagnosis according to ICD-10 «Mild cognitive impairment» (F06.7). The main subgroup included29 people received oral recognan therapy (in solution, 100 mg in 1 ml) for 30 days, with a daily dosage of 500 mg (5 ml of solution). In the control group (29 people) drug therapy was not performed. Tests were used: «Graphic sample», the sample on the reciprocal coordination of the hands (Ozeretsky test), test for the compression of fingers, the test «number series». The follow-up period was 30 days. All subjects were examined three times (initially, in the middle of the study - on day 15, at the end of the study - on day 30). Results and conclusion The results obtained showed that the use of the drug recognan (citicoline) has a positive effect on the indicators of visual-motor coordination and spatial representations, neurodynamic characteristics of movement, and cognitive functions. After a 2-week treatment with recognan improved graphical sample, 84% of patients, with reliable improvement according to the Wilcoxon (p=0.0002), the sample in the compression of the fingers 60%, as well as coordination 60%, the accounting functions in 44%. After a month (30 day) treatment course recomanem there was an increase in indices of samples for the compression of fingers in 71.4% of patients, with significant improvement (p=0.0499) and run the graphical samples of 71.4%, coordination at 46.4%, counting functions - 48% patients.

OBJECTIVE The aim of the observational program was to study the effect of the use of the drug recognan (citicoline) on the state of higher mental functions (memory, attention, visual-motor coordination, dynamic praxis,verbal thinking and imagination) in patients with mild cognitive impairment. MATERIAL AND METHODS A survey of 54 subjects (16 of them male and 38 female) aged 18-50 years (average age 28.5±10.5 years) was conducted with a diagnosis of «Mild cognitive impairment» («F06.7»). The group was randomized into 2 subgroups: the main subgroup (26 people) received oral therapy with the drug Recognan, for 30 days, with the daily dosage of the drug being 500 mg. In the control group (28 people), nootropic drug therapy was not performed. Standard psychometric techniques were used to study higher mental functions. All subjects were examined three times (initially, in the middle of the study - on day 15, at the end of the study - on day 30). RESULTS AND CONCLUSION After 2 weeks of treatment with recognan, there was an improvement in concentration in 81.9%, memory in 50% (p=0.008), verbal imagination productivity in 68.2% (p=0.015), counting functions in 60% (p=0.015), visual-motor coordination and dynamic praxis - in 86.4% (p=0.003), increased speed and efficiency of mental work (p=0.001). After a 30-day course of treatment with recognan, there was an improvement in memory in 58.3% of patients (p=0.007), an increase in concentration in 64%, an improvement in counting functions in 64.3% (p=0.011), verbal imagination productivity in 63.3%, visual-motor coordination and dynamic praxis in 86.4% (p=0.007), speed and efficiency of mental work (p=0.006), which indicates a complex positive effect of recognan on higher mental functions in patients with mild cognitive impairment cognitive impairment.

AIM:To assess the formation of positive personality phenomena in patients with mild cognitive impairment and asthenic syndrome during the treatment with recognan (citicoline).MATERIAL AND METHODS:Thirty-eight patients (17 men and 21 women), aged 18 to 45 years (mean age 27.8±12.1 years), with asthenic syndrome with mild cognitive impairment (ICD-10 F06.7) were examined. Patients were divided into two groups: 20 people in the main group and 18 people in the comparison group. The main group received recognan (orally, in solution, 100 mg in 1 ml) for 30 days, the daily dosage of the drug was 0.5 g (5 ml solution). The comparison group did not receive any medications. Adapted methods of positive personality psychology were used: the Fordyce Emotions Questionnaire, the Subjective Happiness Scale (SHS), the Adult Hope Scale (AHS), the Satisfaction with Life Scale (SWLS), M. Atkinson's Scale of Emotional Maturity, the projective technique 'Map of experiences'. The follow-up period was 30 days. All subjects were examined three times (at baseline, 15 and 30 days after treatment).RESULTS AND CONCLUSION:After a month of treatment with recognan, there was an improvement of positive personality traits and a significant decrease in negative experiences, indicating the positive impact of the drug on the formation of positive personality manifestations and compensation for emotional disorders in patients with mild cognitive impairment and asthenic syndrome.

AIM:To study the efficacy of recognan (citicoline) in the treatment of cognitive, emotional, autonomic, asthenic disorders in patients with asthenic syndrome.MATERIAL AND METHODS:Thirty-eight subjects (17 men and 41 women), mean age 27.75±12.05 years, with asthenic syndrome (ICD-10 F48.0 - Neurasthenia) were studied. The sample was randomized into 2 subgroups: the main group (n=20) received oral therapy with recognan (100 mg in 1 ml) for 30 days, while the daily dosage was 500 mg (5 ml). In the control group (n=18), no drug therapy was performed. Patient's state was assessed with a large battery of psychological tests and psychometric scales. The follow-up period was 30 days. All participants were examined three times (initially, in the middle of the study (day 15), in the end of the study (day 30)).RESULTS AND CONCLUSION:Asthenic syndrome was detected in 100% of the patients (total asthenia was noted in 70%, decreased activity in 70%, decreased motivation in 40%, physical asthenia in 45%, mental asthenia in 50%). Recognan (citicoline), used for 2 weeks or one month, has a positive effect on the compensation of autonomic, asthenic cognitive and emotional disorders and increases stress resilience of the patients.

Article is devoted to topical issues of complex diagnosis and treatment of the consequences of traumatic brain injury (TBI) in children, adolescents and adults. Craniocerebral trauma is one of the most important problems of modern neurology, due to the high frequency and severity of disability. In recent years, there has been a steady increase in effects of TBI, a significant part of which are asthenic, autonomic, cognitive, emotional and motor disorders. Factors affecting the severity of the consequences of TBI are: the severity of the injury, the age, at which the injury occurred, the time elapsed since the injury, the localization of the lesion. After mild TBI, the structure of cognitive impairment is dominated by memory and attention disorders (75%), visual-motor coordination, as well as asthenic disorders (88%), chronic headaches (95%). After moderate and severe TBI, there are more pronounced impairment of cognitive and motor functions accompanied by pathological neurological symptoms in 94-100% of children, which leads to difficulties in learning, self-service and has a negative impact on social adaptation. The article describes in detail the modern methods of complex diagnosis, as well as pathogenetically justified methods of drug therapy of cognitive disorders in patients with the consequences of TBI. The high efficacy of the modern cytoprotective drug Cytoflavin in the treatment of the effects of TBI is shown.

This lecture presents general information about children cerebral palsy concerning current views on its causes and pathogenesis as well as the data on different classifications of speech disorders (localization of lesions, clinical presentations) and their prevalence, which are important for general practitioners. Special attention is drawn to the principles and tasks of diagnostics of speech disorders, organization of treatment-correction measures considering all possible approaches to the care of patients.

AIM:To study the efficacy of recognan (citicoline) in treatment of cognitive, emotional, autonomic, asthenic disorders in university students and teachers.MATERIAL AND METHODS:Fifty-eight subjects (17 men and 41 women), mean age 27.75±12.05 years, including who 42 students and 16 teachers were studied. The sample was randomized into 2 groups (29 each): the main sub-group received oral therapy with recognan for 30 days, while the daily dosage was 500 mg (5 ml). In the control group, no drug therapy was performed. Patient's state was assessed with a large battery of psychological tests and psychometric scales. The follow-up period was 30 days. All participants were examined three times (initially, in the middle of the study (day 15), in the end of the study (day 30)).RESULTS AND CONCLUSION:Asthenic state was detected in 69%, autonomic dysfunction in 82.7%, sleep disorders in 75.8% of subjects. A high level of state anxiety was revealed in 22.2%, trait anxiety in 29.8%, a high level of stress was determined in 6,9%. It is shown that the use of recognan (citicoline) has a positive effect on compensation of autonomic and asthenic disorders, improves cognitive status, corrects psycho-emotional disorders, when used as a short (2 week) and month course.

The article covers the problems of diagnosis and treatment of mental impairment in children with cerebral palsy. Mental disorders in cerebral palsy include cognitive impairment (disorders of perception, memory, attention, motor-visual coordination, intelligence and speech), border disorders (cerebral/asthenic, neurosis-like, psychopathic-like syndromes) and personality disorders (accentuation of character, mental infantilism). Diagnosis of mental disorders in patients with cerebral palsy is a challenging task, due to various combinations of them with physical, speech and sensory disorders, which requires a differentiated approach. Current trends in comprehensive system of rehabilitation, including medical and social, and psychological-pedagogical correction of cognitive, emotional and behavioral disorders, in cerebral palsy are reviewed. Experience of using cortexin, which compensates for cognitive impairment and improves social adaptation, is discussed.

The article is devoted to the comprehensive diagnosis and treatment of perinatal lesions of the nervous system and their consequences in children. Reflects modern approaches to data classification conditions, taking into account ideas on the etiology and pathogenesis of the disease, the clinical manifestations of the main syndromes (excitation and depression, hypertensive, convulsive, movement disorders) as the neonatal period, and in the formation of long-term effects (motor and mental delay and speech development, hyperkinetic syndrome, cerebral palsy and others). Considerable attention is paid to the modern principles of diagnosis (clinical, psychometric, instrumental) and comprehensive rehabilitation (medical, social and psycho-pedagogical) the effects of perinatal lesions of the nervous system. The results of the review of research on the use of the polypeptide and nootropic neurometabolic stimulator - cortexin - in the complex rehabilitation of perinatal lesions of the nervous system and their consequences in children. It is shown that the use of cortexin in treatment of critical conditions in newborns reduced the duration of intensive care and the length of stay of patients in a intensive care unit, the average period of hospital treatment and the stage of the primary neurological rehabilitation 2.5-3 times, but also reduces the frequency of detection of syndromes movement disorders in 2 times, hypertension-hydrocephalic disorders 3 times, vegetative-visceral dysfunctions 5 times. Application cortexin in the rehabilitation of children of the first years of life with the consequences of perinatal CNS indicates a significant improvement in their motor and cognitive functions, as well as predrechevogo and speech development. Application cortexin significantly improved the forecast recovery of motor, cognitive, and neurological status in general, with full compensation by the end of 1 year of life in 90% of patients, and was accompanied by a decline in disability in extremely premature newborns from 13.6% to 4.6% compared to the standard therapy, as well as reduced length of stay in hospital for 14.7 days of hospital stay. Revealed the cumulative effect of the drug: maintained for 6 to 18 months with repeated courses of therapy, his positive influence. High efficiency of cortexin due to a combination of nootropic, neurotrophic, neuroprotective, anticonvulsant and reparative effects, as well as antioxidant, metabolic and anti-stress action, which determines the need for wide application in complex regenerative treatment of perinatal lesions of the nervous system and their consequences.

The article reviews studies dealing with the use of the polypeptide nootropic and neurometabolic stimulant cortexin in the multimodal rehabilitation of patients with central nervous system diseases. The high efficiency of using cortexin is shown to be due to a combination of nootropic, neurotrophic, neuroprotective, reparative, and anticonvulsive effects, as well as antioxidant, metabolic, and antistress activities, which determines its high therapeutic efficacy in multimodal correction.

The article reviews studies dealing with the use of the polypeptide nootropic and neurometabolic stimulant cortexin in the multimodal rehabilitation of patients with central nervous system diseases. The high efficiency of using cortexin is shown to be due to a combination of nootropic, neurotrophic, neuroprotective, reparative, and anticonvulsive effects, as well as antioxidant, metabolic, and antistress activities, which determines its high therapeutic efficacy in multimodal correction.

С.А. Немкова1, 2, О.И. Маслова1, Н.Н. Заваденко2, Т. Ли3, Н.Н. Володин4, В.А. Доровских5, Г.А. Каркашадзе1, А.М. Мамедьяров1, В.В. Алтунин1, Э.А. Абашидзе1, О.В. Кожевникова1, Ю.Е. Нестеровский2 1 Научный центр здоровья детей, Москва, Российская Федерация 2 Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава России, Москва, Российская Федерация 3 Хэйлунцзянский университет китайской традиционной медицины, Харбин, КНР 4 Лечебно-реабилитационный научный центр филиала Федерального научного центра детской гематологии, онкологии и иммунологии им. Дмитрия Рогачёва Минздрава России, Москва, Российская Федерация 5 Амурская государственная медицинская академия Минздрава России, Благовещенск, Российская Федерация