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Increased aging of the population makes problems of the diagnosis and treatment of neurodegenerative diseases socially more significant. The ability to use the retina as a "window" to the central nervous system has attracted great attention in recent years. Optical coherence tomography (OCT) is a non-invasive method for in vivo studies of various conditions to generate high-resolution images of the tissue cross sections under study. Retinal OCT parameters are considered to be potential surrogate biomarkers of early-stage neurodegenerative disorders, and have already been included in the guidelines for diagnosing neuromyelitis optica. This review summarizes and analyzes the current information on retinal changes according to OCT data in neurodegeneration in vitro and in vivo in Alzheimer's and Parkinson's diseases. The application of ultra-high resolution OCT for the diagnosis of the early stages of neurodegeneration is also considered. Morphological and functional links and possible mechanisms for the retinal lesions in Alzheimer's and Parkinson's diseases, and their similarities in glaucoma are discussed. The efficacy of using this method in the diagnosis of neurodegenerative processes at an early stage is likely to be increased by the development of instrumentation and improvements in the design study for carrying out investigations in different groups of patients, including those having hereditary diseases of the nervous system.

Background and purpose Rare diseases affect up to 29 million people in the European Union, and almost 50% of them affect the nervous system or muscles. Delays in diagnosis and treatment onset and insufficient treatment choices are common. Clinical practice guidelines (CPGs) may improve the diagnosis and treatment of patients and optimize care pathways, delivering the best scientific evidence to all clinicians treating these patients. Recommendations are set for developing and reporting high‐quality CPGs on rare neurological diseases (RNDs) within the European Academy of Neurology (EAN), through a consensus procedure. Methods A group of 27 experts generated an initial list of items that were evaluated through a two‐step Delphi consensus procedure and a face‐to‐face meeting. The final list of items was reviewed by an external review group of 58 members. Results The consensus procedure yielded 63 final items. Items are listed according to the domains of the AGREE instruments and concern scope and purpose, stakeholder involvement, rigour of development, and applicability. Additional items consider reporting and ethical issues. Recommendations are supported by practical examples derived from published guidelines and are presented in two tables: (1) items specific to RND CPGs, and general guideline items of special importance for RNDs, or often neglected; (2) items for guideline development within the EAN. Conclusions This guidance aims to provide solutions to the issues specific to RNDs. This consensus document, produced by many experts in various fields, is considered to serve as a starting point for further harmonization and for increasing the quality of CPGs in the field of RNDs.

Целиакия -хроническое аутоиммунное генетиче-ское заболевание, которое характеризуется иммунным от-ветом на потребляемый в пищу глютен, содержащийся в зернах пшеницы, ржи, ячменя, в результате чего развива-ются воспаление, атрофия ворсинок и гиперплазия крипт в тонком кишечнике [1]. Частыми проявлениями класси-ческой формы целиакии являются диарея, боль в животе, потеря массы тела, общая слабость. Только у 30% взрос-лых встречается классическая форма целиакии, у осталь-ных 70% наблюдается атипичная форма, для которой ха-рактерны разнообразные экстраинтестинальные проявле-ния. Раньше целиакию считали исключительно глютено-вой энтеропатией, однако сейчас имеется все больше данных о мультисистемном характере заболевания. Не-врологическими проявлениями целиакии являются атак-сия, полинейропатия, деменция, миопатия, эпилепсия и мигрень [2,3]. Цель исследования -изучение распространенности мигрени среди больных целиакией, клинических особенностей синдрома «глютеновая мигрень» и оценка эффективности аглютеновой диеты в ее лечении. Материал и методы. Основную группу составили 200 пациентов с целиакией, группу сравнения -100 больных с рефлюкс-эзофагитом без целиакии. Пациенты заполняли дневник головной боли в течение 3 мес до постановки диагноза мигрени и 6 мес аглютеновой диеты. Результаты. В основной группе синдром мигрени встречался в 4 раза чаще, чем в группе сравнения (48,5%; p<0,001), мигренозные приступы отличались большей частотой (в 2,5 раза выше, р=0,004), но были менее продолжительными (в среднем 8 ч), приступы были менее интенсивными по визуальной аналоговой шкале в процентах (в среднем 55) и с более поздним дебютом, чаще встречались у больных старше 50 лет (р<0,05). На фоне аглютеновой диеты у 1 / 4 пациентов основной группы наблюдалось исчезновение приступов мигрени, у 38% -уменьшение интенсивности и/или их частоты. Установлена четкая ассоциация мигрени и целиакии и показана высокая эффективность аглютеновой диеты в лечении симптомов мигрени. Ключевые слова: мигрень, целиакия, аглютеновая диета.Objective -to study the prevalence of migraine among patients with celiac disease (CD) and clinical features of «gluten migraine» syndrome and to assess the efficacy of gluten diet in its treatment. Material and methods. Authors examined 200 CD patients (main group) and 100 patients with reflux esophagitis and without CD (control group). All patients fulfilled the headache diary during three months before the diagnosis of migraine was made and six months during gluten diet. Results and conclusion. CD group had migraine syndrome four times more often than the control group (48.5%; p<0.001). In CD group migraine attacks were 2.5 times more frequent than in the control group (р=0.004), but the duration of the attacks was less long, 8 hours in average. The migraine attacks measured by the Visual Analog Scale were less intensive, 55% in average, and had a later onset. The attacks were more frequent in CD patients who were older than 50 years old (р<0.05). The attacks disappeared in 25% of patients with migraine syndrome wh...

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