Autoimmune and immune-mediated diseases of the central nervous system are relatively rare, but potentially severe and disabling complications of the novel coronavirus infection (COVID-19). Despite the lack of exact prevalence of this group among other complications of COVID-19, its study lately receives increasing attention. Big variety of mechanisms could be involved into pathogenesis of autoimmune and immune-mediated disorders of the central nervous system, including the aberrant immune response to direct viral invasion, neuroinflammation and activation of T- and B-lymphocytes, formation of autoantibodies as a result of cross-reactivity or due to molecular mimicry, etc. This review discusses recent data on the pathogenetic mechanisms as well as clinical features of the most common complications of COVID-19: myelitis, MOG-associated diseases, spectrum of neuromyelitis optica disorders. Multiple potential biomarkers detected in post-COVID-19 patients and their diagnostic and clinical value are discussed. Given the increased number of patients having COVID-19, the study of such diseases, their connection with infection, and possible mechanisms seems to be an extremely relevant area of modern neuroimmunology.

Spinal cord affection, according to various sources, is a common complication of a new coronavirus infection. The article describes various variants of spinal cord pathology in COVID-19, their potential mechanisms of development, approaches to treatment and outcomes of the disease. Three patients who were observed at the Research Center of Neurology and represent the most interesting cases of classic transverse myelitis, myelitis with predominant involvement of the lateral and posterior cords, and longitudinal widespread myelitis associated with antibodies to myelin oligodendrocyte glycoprotein (MOG) are considered in detail. These clinical observations demonstrate the importance of early diagnosis and selection of adequate therapy for a favorable outcome of the disease.

No abstract

Introduction. High prevalence of migraine and its impact on quality of life requires the development of original agents. In 2020, fremanezumab, a new calcitonin gene-related peptide monoclonal antibody was authorized in Russia. Objective: to evaluate safety and effectiveness of fremanezumab in patients with high-frequency episodic migraine (HF EM) and chronic migraine (CM). Materials and methods. We assessed 60 patients at the age of 35.5 8.96 years (85%, females) with HFEM and CM with and without aura who were either receiving preventive treatment or not. Fremanezumab was administered subcutaneously at a single dose of 675 mg. The study participants were followed-up for efficacy in 3 months. The investigators assessed change in the number of days with headache per month as well as headache intensity, its impact on the daily activities, anxiety, and depression. Results. By the end of month 3 post dosing, the number of days with headache decreased by 50% in 76.7% of participants where 77.8% of individuals suffered from HF EM and 72.7% of individuals had CM while headache intensity decreased in all the patients equally. No response (decrease in the number of days with headache by 30%) was reported in 15% of participants including 14.8% of individuals with HF EM and 15.2% of individuals with CM. By the end of study month 3, 81% of participants demonstrated no anxiety symptoms and 79% of participants showed no depression with significant MIDAS and HIT-6 score decline in both groups. Only 3 (5%) patients noted adverse events (redness, itching at the administration site). Conclusion. We documented higher fremanezumab safety and effectiveness in patients with EM and CM in real-world practice as compared to fremanezumab safety and efficacy in randomized clinical trials. A single dose of fremanezumab (675 mg) resulted in effective migraine prevention, decline in comorbid anxiety and depression, and improved quality of life during 3-month follow-up.