Acute meningitis in children is a common cause of complications and leads to developmental disabilities. That is the reason why it is important to look for possible markers that indicate nerve tissue damage for early diagnosis, their prevention and prognosis of CNS complications.Objective. To examine neuron specific enolase (NSE) and its diagnostic significance as an indicator of neuronal damage in children with acute meningitis. Materials and methods.Blood samples of 40 children with acute meningitis and 30 of healthy children between the ages of 1 month to 18 years old were studied. The measurement of NSE was made from a blood serum during the first 24 hours after hospitalization by the enzyme-linked immunosorbent assay test performing. The degree of impaired consciousness was determined by the Glasgow Coma Scale. The results were processed with the Student's t-test, correlation and regression analysis methods with constructing confidence intervals.Results. NSE levels in children with acute meningitis was 7.6 times higher than the results of healthy children, which was 22.56 ± 1.14 and 2.95 ± 0.16 ng/ml, respectively, (P < 0.0001) (95 % CI; 19.19 to 20.03). CNS complications of the disease in patients were detected in 22 (55 %). Patients with complications had significantly higher level of NSE than patients without complications and it was 25.35 ± 1.61 and 18.60 ± 1.49 ng/ml, respectively, (P < 0.01) (95 % CI; 5.74 to 7.75). Impaired consciousness was observed in 21 (52.5 %) patients. The content of NSE in patients with impaired consciousness was within 20.72 ± 7.33 ng/ml and it was higher than NSE content in patients with normal consciousness that was within 16.56 ± 4.69 ng/ml (P < 0.05) (95 % CI; 0.17 to 8.14). Reliable inverse and strong correlation was detected between the NSE level and the level of consciousness by the Glasgow Coma Scale, where the coefficient of determination R 2 = 0.624 and coefficient of correlation r -0.785 (P < 0.001) (95 % CI; -1.08 to -0.48).Conclusions. Thus, the data indicates that acute meningitis occurs with the brain matter damage. The blood NSE content in acute meningitis can be used as a biochemical marker for the neuronal damage severity and as a prognostic marker for the CNS complications development.Нейрон-специфічна енолаза як можливий показник нейронального пошкодження при гострих менінгітах у дітей Л. В. Пипа, Р. В. Свістільнік, Г. С. Московко, Ю. М. Лисиця, М. М. МургінаГострий менінгіт у дітей -часта причина виникнення ускладнень і розвитку інвалідизації. Тому важливим є пошук можливих маркерів пошкодження нервової тканини для ранньої діагностики та прогнозу ускладнень із боку ЦНС і їх запобігання.Мета роботи -вивчити вміст нейрон-специфічної енолази у крові та її діагностичне значення як показника нейронального пошкодження в дітей із гострими менінгітами.Матеріали та методи. Виконали дослідження зразків крові 40 дітей із гострими менінгітами, 30 здорових дітей віком від 1 місяця до 18 років. Нейрон-специфічну енолазу (НСЕ) визначали в сироватці крові в першу добу пі...

Human walking is considered as a complex cognitive act. The research purpose is an analysis of age-related features of spatio-temporal parameters of human walking and directions of their changes at walking with dual (cognitive) tasks. The walking spatio-temporal indexes were studied in 608 individuals of both sexes aged 12-43 years by GAITRite® (CIR Systems Inc.,Clifton, NJ) under normal walking at individually comfortable velocity and under additional cognitive tasks: 1) sequentially pronounce aloud any known animals; 2) starting from a number 100, subtract 7 and pronounce the result aloud. The statistical processing of the got results was carried out in the licensed software “STATISTICA 5.5”. At performing the first, simpler, task, the spatial parameters had no significant changes in all age groups. Most of the temporal parameters changed: cycle time, swing time, single support time, and double support time increased. Therefore, equilibrium maintaining at walking with naming animals is realized with a longer overall support period, reducing the walking cadence and velocity. The constant width of the support base and the angle of the feet turn indicate that the magnitudes of the functional support base and angle of the feet turn at normal walking is sufficient to maintain posture and balance at walking with simultaneous performance of the cognitive task, as well as more rigid mechanisms of regulation of these two parameters. The walking temporal parameters are more labile than spatial parameters. With age, the percentage of the integral index of walking quality (FAP) decreases especially in females: in girls by 15.3 %, in young women by 14.4 %, in middle-aged women by 7.4 %. At performing the second, more complex, arithmetic task, in young men and young girls support base, toe-in-out, step length difference had no significant changes only. The mean velocity, cadence, step length, stride length, step extremity ratio decreased. The count of steps, all temporal parameters, and stance percentage increased. FAP declined critically by 30.4 % in young men and 33.4 % in young women, indicating a decrease in balance and body stability under walking with cognitive task and increasing the risk of falls. Therefore, a significant reduction in FAP can be used as a diagnostic criterion in neurological practice.

The organization of walking and its disorders remain one of the most difficult sections of the physiology of the nervous system and neurology. The purpose of the work is to analyze the sexual features of the spatio-temporal parameters of the person walking and the directions of their changes in the conditions of performing additional cognitive tasks. Sex-related features of human walking with cognitive tasks are investigated. 608 individuals of both sexes aged 12-43 years were examined by GAITRite®. Consistent naming of animals and consistent subtraction of 7 starting at 100 were used as cognitive tasks. Statistical processing of the obtained results was performed in the license package “STATISTICA 5.5” using parametric estimation methods. At performing the first (simpler) cognitive task in all age groups of men step length, stride length, step extremity ratio, support base, toe-in-out were increased. Temporal parameters in adolescents of both genders did not differ. Girls have longer step time, cycle time, single support, swing time and a slower velocity. The integral index of walking quality (FAP) tended to decrease in all examined groups: in adolescent males by 13.3±3.9 %; in young men by 14.6±2.2 %; in adolescent women by 15.3±1.8 %; in young women by 14.4±1.1 %; in middle-aged women 7.3±4.8 %. Boys and girls performed more complex cognitive tasks with reduced spatial and temporal parameters (primarily by increasing the double support and swing time), the support base and toe-in-out were stable. The step cycle was rebuilt. The support base and toe-in-out remained unchanged both in boys and girls. The boys were moving at a faster velocity, taking more steps per minute. The step time right, cycle time for each leg, single support time and double support time in girls lasted much longer. FAP declined sharply by 30.4 % in boys and by 33.4 % in girls, indicating a major reorganization of basic mechanisms for regulating walking stability. Such a decrease in FAP leads to a decrease in the level of the balance maintaining and a decrease in body stability during movement, which means that it increases the risk of falls. A complex cognitive task led to a decrease in walking performance and a more critical decrease in the quality of walking in favor of moving forward and maintaining the balance. Thus, walking is not an automated process, but requires the use of a variety of additional CNS resources, primarily attention and cognitive resources.

In this paper, we reviewed scientific sources on multiple sclerosis, analyzed the latest data on the peculiarities of cognitive dysfunction and comorbid pain syndrome in patients with multiple sclerosis. Multiple sclerosis belongs to the group of chronic progressive demyelinating diseases with a predominant lesion of the central nervous system. It affects over 2.5 million people worldwide and is considered as one of the most disabling neurological disorders. Symptoms range from physical ones including loss of vision, spasticity, bladder and bowel dysfunction, problems with walking and balance, fatigue and pain, to mental problems such as cognitive impairment, depression, and anxiety. Comorbid conditions have a significant impact on the quality of life of patients with multiple sclerosis. This evokes considerable scientific interest, since their presence can cause a delay in diagnosis, change the progression of neurological deficits, reduce physical activity and increase the severity of symptoms of the underlying disease. One of the most common comorbid conditions associated with multiple sclerosis is pain. The prevalence of pain syndrome ranges from 29% to 86%. Patients can consider pain as one of the first symptoms of multiple sclerosis. Moreover, in the treatment and diagnosis of multiple sclerosis, in most cases, the state of cognition is missed or neglected, but it always accompanies the patients in the form of cognitive disorders of varying severity. Cognitive function is understood as the most complex mechanism by which the process of rational cognition of the environment and interaction with it is carried out. Both a series of cognitive tests for multiple sclerosis and an MRI evaluation of gray matter atrophy can help to assess the state of cognition. Also, an additional diagnostic method is transcranial magnetic stimulation, with which it is possible to create a model for mapping the cerebral cortex using evoked motor potentials. Thus, the analysis of the literature has shown that the issues of the influence of comorbidity and cognitive dysfunction on the course of multiple sclerosis, the relationship of the onset of multiple sclerosis with comorbid conditions, and the correlation of neurological deficit with the cognitive ability of patients are not studied completely yet.

No abstract