The wavelet analysis of rhythm parameters of central hemodynamics in patients with multiple sclerosis (MS) and compromised cognitive status is of great interest for better understanding formation of neurogenic disorders of regulation of blood pressure (BP) associated with organic lesions of brain and higher nervous system at large. Aim. To study circadian hemodynamic parameters in patients with MS depending on cognitive status. Materials and methods. 55 patients with verified diagnosis of disseminated sclerosis (DS) underwent standard neurological examination. A BPLab portable system (Russia) was employed during 24 hours for analysis of diurnal hemodynamic parameters using the BPLab v.2.1 software in combination with the original wavelet analysis for determining the rhythmic structure of individual characteristics and evaluating synchronization and coherence of the described parameters. Results. The observed disturbances of temporal organization of the rhythms of central hemodynamic parameters due to climatic and geographical features of the Northern region in patients with DS manifested themselves as ultradian desynchronosis. In the group of DS patients with cognitive impairment, disintegration of the time structure was characterized by bursts of rhythmic activity in the form of intercalated rhythms with periods of 12, 8 and 6 hours and non-uniform distribution during the diurnal cycle. No increase of the average BP values in the presence of a large number of risk factors for the development of hypertension in the form of non-modifiable and modifiable complications of pathogenetic therapy was documented. Conclusion. The established rigidity of the mechanisms regulating BP in patients with DS may be due to an organic lesion of the autonomic nervous system at the cerebral, spinal or peripheral levels, and even more so to the disturbed higher nervous activity concomitant with impaired cognitive functions. This clinical study may suggest the inverse model of comorbidity (dystrophy) with the abnormal relationship between pressor and depressor mechanisms of BP regulation and leveling the influence of risk factors on the development of arterial hypertension.

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The mechanism of development of neuropsychological disorders and the assessment of predictors of their development in patients with multiple sclerosis (MS) are insufficiently studied. Prediction of comorbid depression in this category of patients is of great interest and is aimed at personalized medical care for patients with optimal personal and environmental adaptation of the patient with MS. Objective. To study the predictors of the development of depressive syndrome and to develop a mathematical model for predicting comorbid depression in patients with multiple sclerosis living in the northern region. Material and methods. A standard neurological examination was conducted in 149 patients with reliable MS who lived in the northern region, including an assessment of the severity of MS disability on the EDSS scale. All patients underwent neuroimaging (magnetic resonance imaging — MRI) of the brain and spinal cord. The Beck Depression Scale was used to identify depressive disorders. Results. The prevalence of depressive disorders in patients with MS in the studied population of patients in the northern region was 35%. In terms of severity, the identified comorbid depression ranged from subdepression to moderate depression. According to the results of the study, it can be stated that the predictors of the development of comorbid depressive disorders in MS are signs of brain atrophy; chronic intoxication (tobacco smoking and alcohol abuse); foci of demyelination (the semi-oval center, corpus callosum); neurological symptoms in the form of paresis, paralysis, cerebellar symptoms (nystagmus); presence of frontal dysfunction (phonetic associations, selection reactions simple and complicated). Conclusion. Comorbid depressive manifestations in MS patients living in the northern region occur in 35% of patients and are a multidisciplinary problem. In order to reduce the effect of depressive manifestations on the main symptoms of the disease, adherence to therapy and improve the quality of life indicators in patients with MS, it is necessary to influence neurological symptoms and psychological state, paying special attention to the prevention of depression in these patients.

Multiple sclerosis is the most frequent disease of the central nervous system. An increase in multiple sclerosis frequency was registered in several countries including Russia. This may be associated with better multiple sclerosis diagnosis and treatment, better data collection and real increase in multiple sclerosis incidence. Early disability and its rapid progression emphasize the medico-social importance of multiple sclerosis. Neuropsychological disturbances are often observed in multiple sclerosis, being one of the important components in the formation of clinical disease. 43 patients living in the North region with definite multiple sclerosis and mild or moderate disability were tested with expended neuropsychological, neurological and study of quality of life. The purpose of the study was to analyze the role of cognitive, emotional and personal peculiarities at multiple sclerosis on quality of life. To assess quality of life the authors used SF-36. The results of this study of quality of life revealed significant differences in the physical, role and social components depending on the cognitive peculiarities.

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