Myeloproliferative neoplasms (MPN) are clonal diseases that arise at the hematopoietic stem cell level, characterized by the proliferation of one or more myelopoietic cell lines in the bone marrow with features of preserved terminal differentiation. According to the fifth edition of the World Health Organization (WHO) classification (2022), Ph-negative MPNs include polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF), chronic neut23rophilic leukemia, chronic eosinophilic leukemia, juvenile myelomonocytic leukemia, and myeloproliferative neoplasm, unclassified (MPN-U). ET, PV, PMF, and MPN-U have similar genetic characteristics and account for 98 % of all Ph-negative MPNs. This article describes three clinical cases of patients with ischemic stroke (IS) and a verified diagnosis of Ph-negative myeloproliferative neoplasm (one clinical cases of IS against the background of polycythemia vera, two against the background of essential thrombocythemia), admitted to the Regional Vascular Center, Republic Hospital No. 2 – Center for Emergency Medical Aid. A literature review is presented, risk factors and possible pathways for the development of venous and arterial thrombosis in MPN are considered, as well as the role of the JAK2 V617F mutation in the development of cerebrovascular complications. It is shown that, despite their rarity, MPNs are a significant cause of stroke, with IS often the first manifestation of MPN. Heterogeneity of vascular lesions in IS against the background of MPN, as well as a high probability of developing recurrent cerebral infarctions, are demonstrated. The issue of the need for timely diagnosis of MPN, cytoreductive therapy along with antithrombotic therapy for the prevention of thrombotic complications is considered separately.

Chronic discogenic back pain and comorbid sleep disorders (insomnia) are a pressing and difficult-to-treat condition in the practice of neurologist. The development of this comorbidity is thought to involve common pathogenetic pathways, but the definitive connecting “bridges” have not been fully established. A growing number of recent studies focus on the phenomenon of low-grade inflammation (LGI), which underlies both the progression of intervertebral disc degeneration and insomnia. Since there are no validated, specific, and sensitive methods for assessing LGI in clinical neurology, the development of promising diagnostic panels is necessary. Signatures of small non-coding ribonucleic acids (microRNAs) represent one such promising panel, as preclinical studies have demonstrated their involvement in the epigenetic control of LGI. The influence of microRNAs on sustaining LGI, neuroplasticity, and circadian dysfunction has been established. The aim of this review is to update neurologists’ knowledge on the role of microRNAs (via the connecting “bridge” of LGI) in the pathogenesis of chronic pain syndrome associated with insomnia in patients with intervertebral disc degeneration (IVDD), and to assess their diagnostic potential. A search for publications was conducted in the PubMed, Springer, Research Gate, Google Scholar, Cochrane, and e-Library databases for the period 2016–2026 using the keywords: inflammation, lowgrade inflammation, intervertebral disc degeneration, discogenic pain syndrome, neuropathic pain syndrome, comorbidity, insomnia, diagnosis, epigenetics, microRNAs. The analysis includes original preclinical and clinical studies, as well as systematic reviews. The review summarizes data on more than 40 microRNAs involved in the regulation of key inflammatory pathways (NF-κB, NLRP3 inflammasome, etc.) and circadian genes (PER, BMAL1, CLOCK, etc.) in intervertebral disc (IVD) cells and the central nervous system. A signature of the most promising candidates (miR-29a, miR-132, miR-155, miR-34a-5p, and the let-7 family), which are simultaneously involved in the regulation of LGI, pain signaling, and circadian rhythms, has been identified. The expression levels of certain microRNAs (miR-340-5p, miR-494) have been shown to correlate with the severity of IVDD on MRI and may serve as sensitive epigenetic biomarkers. MicroRNAs are promising epigenetic biomarkers and therapeutic targets for personalized therapy of discogenic back pain and insomnia in IVDD. Further translational and validation clinical studies are required to introduce the microRNA signature into neurological practice.

The aim of the study was to investigate the clinical and neuroimaging characteristics of cerebral venous thrombosis (CVT) in young women in the Sakha Republic (Yakutia) for the period 2014–2025. A retrospective and prospective cohort study was conducted using a continuous method. 41 female patients aged 18–44 years with a verified diagnosis of CVT according to the data of the vascular centers of the Sakha Republic (Yakutia) from 2014 to 2025 were included. An analysis of complaints and anamnesis, assessment of neurological status according to the Glasgow Coma Scale and NIHSS, analysis of magnetic resonance imaging data with time-offlight venography were performed. The main risk factors were the use of combined oral contraceptives (41.5 %), pregnancy and the postpartum period (24.4 %), and iron deficiency anemia (24.4 %). The clinical picture was dominated by cephalgic syndrome (70.6). Epileptic seizures at onset or during the acute period were recorded in 51.2 % of patients, which significantly exceeds the data of large international registries (25-34 %). According to neuroimaging data, combined lesions of the sinuses and veins of the brain were detected in 53.2 % of patients, with the transverse sinus most frequently involved (70.7 %). Parenchymal changes of various nature (cerebral infarction, hemorrhagic transformation, intracerebral hematoma) were detected in 75.6 % of patients. Cerebral venous thrombosis in young women in Yakutia is characterized by a high frequency of epileptic seizures in the acute period (51.2 %) and a significant proportion of hemorrhagic parenchymal changes (over 40 %). The presence of headaches and epileptic seizures in young women, combined with hemorrhagic lesions based on neuroimaging data, requires the primary consideration of cerebral venous thrombosis. These findings support the need to develop regional clinical guidelines tailored to the ethnic characteristics of the Yakut population.

Over the past decade, a significant increase in the prevalence and incidence of neuromyelitis optica spectrum disorder (NMOSD) has been observed worldwide, including in the Russian population, as exemplified by the Sakha Republic (Yakutia). These changes are particularly pronounced when analyzing the Yakut ethnic group, which constitutes the overwhelming majority of the republic’s population. Neuromyelitis optica spectrum disorder manifests as isolated or combined involvement of unilateral or bilateral optic neuritis, longitudinally extensive transverse myelitis, and signs of brainstem and other brain region involvement, most commonly following a relapsing course. The disorder exhibits distinct gender and age characteristics, with a marked female predominance and onset typically occurring in young adulthood during the prime working years. NMOSD is highly disabling, and each relapse carries a high risk of permanent disability, which has substantial socio-economic implications.

Paroxysmal conditions are found in 8-26 % of children who have traumatic brain injury (TBI). The occurrence of early epileptic seizures after TBI makes the prognosis of the disease less favorable. Purpose was to evaluate the possibility of occurrence in the acute period of post-traumatic epilepsy in children, to study the duration of posttraumatic effects in the longterm, and to substantiate treatment methods and prognosis based on data on the type of TBI, clinical and instrumental examinations. Materials. 81 children with TBI aged from 2 months to18 years were examined. Results. According to diagnostics results was determined the severity of TBI in children: mild was found in 58 % of the cases, moderate – in 19.8 % and severe TBI – in 22.2 %. EEG recording was performed in 39(65 %) boys and 21(35 %) girls with TBI in acute period. The representation of epileptiform activity on the EEG correlated with the severity of the injury. Post-traumatic epilepsy was found in 41.2 % of the cases, and in 23.5 % of the cases there was a risk of its formation. In 34.6 % of the cases, children with TBI were treated with antiepileptic drugs (AEDs). As a result of treatment, seizures stopped in 23 (82.1 %) children with post-traumatic epilepsy, and they continued in 5(17.9 %) children. Main conclusions. Diagnosis, prognosis and treatment of the consequences of TBI of different severity in children should be carried out taking into account the anamnesis, frequency and structure of post-traumatic seizures, EEG, CT and MRI data. It is advisable to identify convulsive syndromes in children after TBI with a low probability of the occurrence of post-traumatic epilepsy; convulsive syndromes in which post-traumatic epilepsy is more likely to occur; epilepsy.

Tic disorders, in particular Tourette syndrome, are a neurodevelopmental disorder common in the pediatric population. The clinical manifestations of these disorders vary greatly depending on individual characteristics, age, gender, and the presence or absence of comorbidities. The pathophysiology of these disorders is believed to involve a combination of genetic, environmental, psychological, immunological, and neurobiological factors. From a fundamental neurophysiological perspective, Tourette syndrome is associated with a neurochemical imbalance of monoamines and structural and functional changes affecting, in particular, neural networks involved in the processing and coordination of movements: the basal ganglia, thalamus, motor cortex, and cingulate cortex. To date, studies have demonstrated the involvement of many more brain areas, such as the prefrontal cortex and cerebellum. This article presents the latest research on neuroanatomical features in patients with Tourette syndrome and healthy individuals. During the analysis of the literature, a connection was found between the clinical manifestations of the disease and the morphometric characteristics of the basal ganglia, thalamus, cerebellum, cingulate gyrus and prefrontal cortex of patients.

The timely detection of cognitive impairment in pediatric epilepsy is a pressing issue in neurological practice. This study examined cognitive changes in children aged 5 to 17 years (inclusive) with temporal lobe epilepsy (26 subjects) and self-limited epilepsy with centrotemporal spikes (22 subjects). The control group consisted of 32 healthy volunteers aged 6 to 17 years (inclusive). A comparative analysis of cognitive testing results using the Wechsler cognitive assessment (child and adult versions) revealed multiple changes in verbal and nonverbal functions in patients with epilepsy compared to the control group. Patients with self-limited epilepsy with centrotemporal spikes also showed more pronounced changes in verbal IQ, with scores decreasing relative to the group of patients with temporal lobe epilepsy and the control group. A correlation was also noted between a right-sided focus of epileptiform activity and statistically significantly lower scores on the nonverbal IQ subtests. Similarities in cognitive profile changes were also observed in patients with genetic and structural focal epilepsy. However, the diffuse changes revealed by the test results were consistent with normal IQ scores. The findings demonstrate the widespread influence of epileptogenic processes on the development of cognitive functions, as well as the high compensatory capacity of children. Thus, neuropsychological examination of children with epilepsy already at the early stages of the disease can reveal deviations in the development of cognitive status, which can significantly affect the further development and socialization of pediatric patients and necessitates the organization of neuropsychological screening for this pathology.

Sleep disturbances and affective disorders are among the most common and clinically significant non-motor manifestations of Parkinson’s disease. Despite their high prevalence, the relative contribution of anxiety and depression to the development of sleep disturbances in this patient population remains insufficiently studied. The aim of the study was to investigate the relationship between affective disorders and sleep disturbances in patients with Parkinson’s disease, as well as to assess the associations of these parameters with the main clinical and demographic characteristics of the disease. A retrospective analytical study was performed using a database of 134 patients with Parkinson’s disease. The analysis included sex, age, age at disease onset, disease duration, Hoehn and Yahr stage, cognitive status assessed by the MoCA scale, disease severity assessed by the UPDRS, as well as the severity of anxiety and depression according to the HADS. Sleep quality was assessed using the Spiegel Sleep Questionnaire. Worsening sleep was associated with greater severity of both anxiety and depressive symptoms: the median HADS-A score increased from 6.0 [5.0; 7.0] to 8.0 [5.5; 10.0] points (p = 0.026), whereas the median HADS-D score increased from 6.5 [4.0; 8.8] to 9.0 [6.0; 11.0] points (p = 0.045). Categorical analysis revealed a statistically significant association between anxiety and the frequency of sleep disturbances (χ² = 10.541; p = 0.032). In logistic regression analysis, a 1-point increase in HADS-A was associated with a higher probability of clinically significant sleep disturbance (OR 1.155; 95 % CI 1.014–1.316; p = 0.030), while a 1-point increase in HADS-D increased this probability by 20.2 % (OR 1.202; 95 % CI 1.047–1.380; p = 0.009). When anxiety and depression were entered into the model simultaneously, only depression retained an independent association with sleep disturbance (OR 1.160; 95 % CI 1.003–1.341; p = 0.045). Additionally, depressive symptoms were associated with lower MoCA scores (ρ = -0.203; p = 0.018), whereas both anxiety and depression correlated with longer disease duration and greater disease severity. Sleep disturbances in patients with Parkinson’s disease are highly prevalent and closely associated with affective symptomatology. Notably, unlike anxiety, depression retained an independent association with clinically significant sleep disturbance after adjustment for major clinical factors. These findings highlight the need for routine screening for affective disorders, especially depression, in patients with Parkinson’s disease who complain of poor sleep.

Anxiety-depressive disorders (ADD) are among the most frequent and clinically significant complications of stroke, significantly affecting the rehabilitation process and the patients’ quality of life. The relevance of this study is driven by the high prevalence of these conditions and their role in the development of cognitive impairment (CI), as well as their influence on the course and prognosis of stroke. The aim of this work is to identify clinical predictors for the development of post-stroke anxiety and depression in patients during the acute period of ischemic stroke to improve early diagnosis and treatment strategies. Materials and Methods. The study was conducted at the Regional Vascular Center (Yakutsk). The sample included 91 patients (53 men, 38 women; mean age approx. 59 years) with ischemic stroke. Exclusion criteria: hemorrhagic stroke, severe speech and cognitive impairment, and a history of neurodegenerative diseases. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Neuropsychological testing included the Hospital Anxiety and Depression Scale (HADS), the Montreal Cognitive Assessment (MoCA), and the Mini-Mental State Examination (MMSE). Brain MRI was used to verify the localization and volume of the lesion, and stroke etiology was refined using instrumental and laboratory diagnostic methods. Results. In the acute period of ischemic stroke, anxiety was detected in 36 patients (39.6 %), and depression in 24 patients (26.4 %). A comorbid course of anxiety-depressive disorders was observed in 18.68 % of those examined. It was established that the presence of an anxiety syndrome significantly increases the risk of developing post-stroke depression (p=0.003; OR=4.8). These findings underscore the necessity of early screening for affective disorders in the post-stroke period to predict cognitive deficit and optimize rehabilitation measures.

Sleep disorders are a group of pathologies that are difficult to differentiate and diagnose due to the presence of many features. It is noted that sleep disorders have symptomatic similarities with each other and with other diseases, and are also comorbid conditions, which may lead to difficulties in clarifying the diagnosis. Thanks to genome-wide association studies (GWAS) conducted in the previous 20 years, it was found that sleep and its disorders are genetically determined, partially inherited and polygenic. Circadian rhythms are an important mechanism for regulating the sleep/wake cycle, but they are also genetically determined. Circadian rhythms are regulated by clock genes, whose expression follows the circadian rhythm. Due to the above reasons, there is an urgent need to search for biomarkers capable of providing accurate information for the subsequent diagnosis of sleep disorders. This paper provides a review of currently published scientific studies describing genes and genetic variants (SNVs) directly involved in the genetic regulation of circadian rhythms and the sleep/wake cycle, as well as aberrantly expressed genes and SNVs, potentially biomarkers of sleep disorders, which may simplify the process of diagnosing this type of disorders.

In recent years, the issue of workplace safety and first aid has become increasingly important. With rapidly advancing technology, an increasingly fast pace of life, and a growing number of industrial and domestic injuries, the need for high-quality and accessible medical care is undeniable. Situations arise daily that require emergency medical care to preserve a person’s life and health, including sudden loss of consciousness accompanied by convulsions or circulatory arrest, injuries resulting from traffic accidents, drowning, and other conditions and accidents. Having first aid skills in the immediate vicinity of such situations and potentially participating in first aid allows people to take the necessary measures to save the lives and health of victims before receiving medical attention. Providing first aid to a victim by someone present at the scene of an incident before the arrival of an ambulance or medical professional not only significantly increases the chances of survival, but also improves the effectiveness of subsequent medical care, as well as reduces the incidence of disability, the duration of temporary disability, and the financial costs of treatment and rehabilitation.