COVID-19 infection is a significant and poorly understood problem of modern world medicine. As the virus spreads, data on the clinical picture of the disease and damage to the nervous system are accumulating. Symptoms such as fatigue, anxiety, depression, sleep disturbances and many other neurological and somatic symptoms are often recorded, persist for a long time even after the acute infectious stage of the disease has been stopped, and make it difficult for the patient to fully recover. These symptoms occur even with a mild disease and persist for many months. One of the most common and disabling symptoms of post-COVID syndrome is cognitive impairment, in the formation of which, in addition to the direct ability of the virus to penetrate the nervous system and pathology of the microvasculature, various pathological mechanisms are involved, including dysregulation of cholinergic transmission. A comprehensive approach is important in the treatment of cognitive impairment; it is advisable to use both medication and non-medication methods. The main approaches to the treatment of secondary cognitive disorders are based on the hypothesis of replenishing the defect in mediator systems, including those associated with the death of cholinergic neurons. With these abnormalities, it is advisable to replenish acetylcholine. Among the precursors of choline, choline alfoscerate occupies a special place due to its proven efficacy in the treatment of neurodegenerative diseases, as well as due to data on its multifactorial action. The article presents the actual literature data on the mechanisms of development and features of the clinical manifestations of post-COVID cognitive impairment, as well as materials of experimental and clinical studies of the drug choline alfoscerate (Gliatilin).

The aim of the study was to study the personality characteristics and psychological state of patients with tremulous hyperkinesis in Parkinson’s disease. We studied men and women aged 49 to 75 years with an established diagnosis of «Parkinson’s disease» of a tremulous (main group) and akinetic-rigid form (control group), stages 1-2 according to Hyun and Yar. To study the psychological state of patients, the Giessen personality questionnaire was used, which made it possible to take into account personal, intrapsychic and socio-psychological variables, as well as to investigate their corresponding characteristics; to establish relationships between intra- and interpersonal variables; to correlate personality traits with interpersonal interaction, social behavior, social attitudes and reactions of the individual. To study the level of social adaptation of patients, a questionnaire of social maladaptation associated with tremor was selected, which made it possible to assess the social consequences of existing disorders, as well as the real severity of tremor. Psychological factors play a significant role in the formation and course of Parkinson’s disease (PD). The study of social adaptation in patients with tremor in PD was first conducted. The study of the personality characteristics of patients with PD showed that, regardless of the form of the disease, all patients with PD are characterized by a decrease in the perception of their social reputation, attractiveness, popularity, respect for others, and the ability to achieve their goals; lack of long-term attachments, lack of sociability, poor ability to surrender, poor fantasy. Only patients with an akinetic-rigid form are characterized by humility, obedience, complaisance, patience, distrust, distancing from other people. Patients with combined tremor are more prone to anxiety than patients with isolated tremor. Shivering hyperkinesis causes social disadaptation and self-stigmatization of patients.

One of the important areas of modern neurology is movement disorders, due to their negative impact on the daily activity and quality of life of patients. Dystonia is the third most common extrapyramidal disease. Often, dystonia is accompanied by trembling hyperkinesis, however, known data on dystonic tremor are scattered and not systematized, and its fixation causes difficulties due to the lack of clear tremorographic characteristics. Many issues of prevalence, pathophysiology, differential diagnosis with other types of tremor, as well as the effectiveness of therapy also remain insufficiently studied. This review focuses on the literature on dystonic tremor.

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