Features of psychoneurological and functional disorders in patients with major cognitive impairment of various etiologies

Cognitive impairment in patients with major cognitive impairment is often accompanied by behavioral and mental violations (BMV). BMV is common in both patients with major neurodegenerative cognitive impairment due to Alzheimer’s disease (MNDCI) and patients with major vascular cognitive impairment (MVCI). As cognitive impairment progresses, there is a gradual loss of basic activities in daily life such as feeding, dressing, bathing and movement, which are necessary for independent functioning. The article considers behavioral and psychoneurological symptoms and evaluates the functional activity in everyday life in patients with major cognitive impairment of various etiologies. To make a comparative characterization of the prevalence of behavioral and psychoneurologicall symptoms and to assess the functional activity in everyday life in patients with major cognitive impairment of various etiologies. Psychoneurological symptoms in patients with major cognitive impairment were quite heterogeneous and differed in structure and frequency of manifestations. Behavioral disorders in the vast majority of cases were significantly more common in patients MVCI (73.3 %) than MNDCI (36.7 %), p = 0.0040. Affective disorders (depressive) were also observed more often in patients with MVCI (67.8 %) than with MNDCI (38.2 %), p = 0.0370. When assessing the prevalence of psychoneurological symptoms on the NPI scale in patients with MVCI with the same severity, more pronounced depression/dysphoria (p = 0.0281), apathy/indifference (p = 0.0412) were noted. In patients with MNDCI, sleep and nocturnal behavioral disorders (p = 0.0389), irritability/mood lability (p = 0.0480). When assessing activity in daily life on the BADLS scale, no significant differences were observed in the total number of points in patients with MNDCI and MVCI (14,6 ± 3,35), (19,0 ± 4,06), р = 0,3961. However, an important feature of the comparative characteristics of the functional status in MNDCI and MVCI in mild disease severity were the presence of more significant and probable differences in subtests: «ability to shop» (p = 0.0047), «time orientation» (p = 0.0242), «cooking» p = 0.0335), «use of transport» (p = 0.0439). In patients with MVCI moderate degree by subtests: «dressing» (p = 0.0035), «time orientation» (p = 0.0421), «walking» (p = 0.0473). Thus, according to the results of the study, patients with MVCI had more serious behavioral, psychoneurological symptoms and functional disorders than patients with MNDCI.

Systematic Review of the Kynurenine Pathway and Psychoneurological Symptoms Among Adult Cancer Survivors

The co-occurrence of multiple psychoneurological symptoms, including pain, sleep disturbance, fatigue, depression, anxiety, and cognitive disturbance among adult cancer survivors led us to question which common biological mechanisms are shared among these conditions. Variances in tryptophan (Trp) levels and downstream metabolites of the kynurenine (Kyn) metabolic pathway are known to affect immune response and psychoneurological symptoms. The objective of this systematic review was to help us (a) better understand the role of the Kyn pathway in psychoneurological symptoms among adult cancer survivors and (b) identify common significant biomarkers across psychoneurological symptoms as a guide for future research. Some evidence has shown that decreased Trp levels and increased Kyn, Trp/Kyn ratio, and kynurenic acid/Trp ratio in parallel with immune activation are correlated with some psychoneurological symptoms among people undergoing cancer treatment, although discrepancies exist between studies. Kyn pathway activation could also be associated with psychoneurological symptoms among adult cancer survivors, but further research is needed to confirm its exact etiological role with respect to psychoneurological symptoms.

PREMENSTRUAL SYNDROME: CLINICAL PATTERN, DIAGNOSTICS AND THERAPEUTIC APPROACHES

Premenstrual syndrome (PMS) is a complex, cyclical, polyethiological, multifactorial combination of physical and mental disorders that occur in some women of reproductive age in the second - luteal - phase of the menstrual cycle and negatively affect the woman’s usual lifestyle.Premenstrual dysphoric disorder (PMDD) is a severe form of PMS in which psychoneurological symptoms prevail. For the diagnosis of PMDD, the specific DSM-5 criteria were developed by the American Psychiatric Association according to which the the diagnosis is confirmed by the presence of five or more symptoms in women during the week prior to menstruation and their disappearance a few days after the onset of menstruation. These symptoms are observed for at least two cycles.Treatment of women with PMS/PMDD, first of all, should start with the lifestyle adjustment, inclusion of regular mode rate physical activity into daily activities. The effectiveness of vitamins B6, E and calcium has not been confirmed in studies. First-line drug therapy includes SSRIs or combined oral contraceptives containing drospirenone are prescribed first, then agonists of gonadotropin-releasing hormone.

Identifying Molecular Features Associated with Psychoneurological Symptoms in Women with Breast Cancer Using Multivariate Mixed Models

Breast cancer (BC) is the second most common cancer among women. Research shows many women with BC experience anxiety, depression, and stress (ADS). Epigenetics has recently emerged as a potential mechanism for the development of depression. 1 Although there are growing numbers of research studies indicating that epigenetic changes are associated with ADS, there is currently no evidence that this association is present in women with BC. The goal of this study was to identify high-throughput methylation sites (CpG sites) that are associated with three psychoneurological symptoms (ADS) in women with BC. Traditionally, univariate models have been used to examine the relationship between methylation sites and each psychoneurological symptom; nevertheless, ADS can be treated as a cluster of related symptoms and included together in a multivariate linear model. Hence, an overarching goal of this study is to compare and contrast univariate and multivariate models when identifying methylation sites associated with ADS in women with BC. When fitting separate linear regression models for each ADS scale, 3 among 285,173 CpG sites tested were significantly associated with depression. Two significant CpG sites are located on their respective genes FAM101A and FOXJ1, and the third site cannot be mapped to any known gene at this time. In contrast, the multivariate models identified 8,535 ADS-related CpG sites. In conclusion, when analyzing correlated psychoneurological symptom outcomes, multivariate models are more powerful and thus are recommended.