Russian Military Medical Academy Reports


“Russian Military Medical Academy Reports” is a scientific and practical journal founded in 1900 by professor Viktor V. Pashutin, a world-famous physiologist and pathologist, one of the founders of pathological physiology in Russia, professor (1874), honorary member of the Royal Society of London.

In 2016, the Russian Military Medical Academy resumes publication, informing about the most significant achievements, new technologies, projects in educational and scientific work of the Academy in the form of original articles, as well as providing the results of scientific and clinical research. The editorial board of the journal includes honored doctors of the Russian Federation, honored scientists, professors and doctors of science.

The journal is intended for a wide range of medical and scientific responsibility


Professor Aleksandr Y. Fisun, MD, PhD

The journal publishes:

  • basic-research and clinical practice research articles, scientific reviews also with information-analytical and methodological articles aimed for developing advanced medical technologies and uncovering the latest scientific achievements in various fields of medicine, materials describing clinical cases, information of biographical and historical-medical nature.


The journal is indexing in the following international databases and directory editions:

Current Issue

Vol 41, No 4 (2022)

Original articles

Microstructural changes in the brain in persons with mild COVID-19
Lukina L.V., Ananieva N.I., Safonova N.Y., Ershov Y.А.

BACKGROUND: The purpose of which was to investigate, using voxel-based MR morphometry, changes in the volume of brain structures in persons who had undergone a new coronavirus disease.

MATERIALS AND METHODS: 34 patients with mild COVID-19 between 4 months and one year were examined. All study participants were scanned at two time points: before COVID-19 infection and re-imaging after infection. The comparison group consisted of 30 healthy volunteers who did not have COVID-19 and were comparable in terms of sex, age, timing and MRI protocol.

RESULTS: In the main and control groups a significant increase in the volume of individual segments of the large hemisphere cortex, subcortical gray matter, and white matter of the brain was detected. Signs of atrophic process were registered in the cerebellar cortex and left frontal lobe. In the main group there was an increase of cortical volume practically in all cerebral lobes with some emphasis on the posterior parts of the right hemisphere. When analyzing changes of subcortical gray matter in the main group, there was reliable (p ≤ 0.05) increase of its total volume due to left caudate nucleus, pale ball, right amygdala body and ventral diencephalon. Increased volume of white matter of the brain in COVID-19 patients was detected in the left isthmus and rostral part of the right cingulate gyrus, left paracentral lobe, and right precuneus.

CONCLUSION: the cerebellum is affected quite early by SARS-CoV-2, as we recorded atrophic changes in its cortex at 4–12 months. In COVID-19, the microstructural integrity, predominantly of gray matter and other brain segments, is impaired. Increased volume of these structures indicates the duration of the inflammatory process. An increase in the volume of these structures may indicate the duration of the inflammatory process.

Russian Military Medical Academy Reports. 2022;41(4):355-363
pages 355-363 views
The preoperative assessment of the stroke risk in oncosurgery
Tsygan N.V., Yakovleva V.A., Fufaev E.E., Ismail R. Eleskhanov I.R., Sapozhnikov K.V., Nechiporuk V.M., Ilya I. Dzidzava I.I., Litvinenko I.V.

AIM: of the research was to develop a mathematical model for the preoperative assessing of the stroke risk in surgical operations for malignant neoplasms of the chest and abdomen for the early identification of high-risk patients optimization of diagnostics and enhancing the efficacy of personalized preventive measures.

MATERIALS AND METHODS: 47 cases of perioperative stroke according to archived case histories patients with malignant neoplasms of various localization — retrospective analysis anamnesis of life and underlying disease, analysis of clinical and laboratory examination data, analysis of parameters associated with surgery and anesthetic aid, analysis of the clinical and neuroimaging picture of perioperative stroke; 102 patients who underwent elective surgery for the malignant neoplasm of the chest or abdomen — perioperative dynamic neurological support collection of anamnesis of life and disease, analysis of clinical and laboratory examination data, neurological examination with NIHSS and mRankin scores, neuropsychological testing using MoCA and FAB.

RESULTS: Risk factors for perioperative stroke in oncosurgical patients, as well as cerebroprotective factors have been established. The valid mathematical model was developed for assessing of the likelihood of perioperative stroke in the surgical treatment of malignant neoplasms of the chest and abdomen with a predictive power of 85.4%, sensitivity of 77%, and specificity of 87%.

CONCLUSION: The proposed mathematical model allows preoperatively assess the risk of perioperative stroke in percentage (according to the anamnesis and medical records data) and identify the group of high-risk patients.

Russian Military Medical Academy Reports. 2022;41(4):365-370
pages 365-370 views
Study of the effectiveness of training using the “NeuroChat” brain–computer interface at a later age
Zakharova I.A., Karunin I.V., Sharashkina N.V., Runikhina N.K., Lysenkov S.N.

BACKGROUND: This article examines the effectiveness of training using the increasingly popular brain–computer interface “NeuroChat” on a sample of older people.

AIM: The purpose of this study is to determine the effectiveness and characteristics of training using the “NeuroChat” device.

MATERIALS AND METHODS: The study involved 41 patients — 6 men and 35 women aged 55 to 89 years with various comorbid conditions, undergoing planned treatment at the Russian Gerontology Research and Clinical Centre of the N.I. Pirogov Russian national research medical University. As research methods, a set of diagnostic tests was used: Montreal Cognitive Assessment (MoCA-test), Bourdon’s test (correction test), 10-word auditory-speech memory test, visual memory test, thinking test “4-th superfluous” (4 subtests were used), The Hospital Anxiety and Depression Rating Scale (HADS), as well as the neurotraining using the “NeuroChat” brain–computer interface.

RESULTS: By comparing the control test data with the test data conducted at the beginning of the study, the following results were obtained. Significant changes were found between groups in the 10-word memory test. It is also possible to note an improvement in the indicator of cognitive functioning in general (MoCA screening test), however, this indicator significantly improved in the control group. There was no correlation between the effectiveness of neurotraining with the use of the “NeuroChat” device and the number of sessions conducted. Changes in the psycho-emotional component of the life of the subjects were not found.

CONCLUSION: The use of trainings using the “NeuroChat” device has a positive effect on the cognitive characteristics of older people without affecting the psycho-emotional sphere. The improvement in the characteristics of the cognitive sphere is confirmed by the results of diagnostic tests and occurs after the first use of the “NeuroChat” brain–computer interface. The authors consider it necessary to study the relationship between training using the “NeuroChat” device and improving the cognitive characteristics of people of different age groups, especially the improvement of auditory-speech memory.

Russian Military Medical Academy Reports. 2022;41(4):371-377
pages 371-377 views
Current aspects of neuropsychological evaluation of efficiency complex treatment chronic-type tension headache
Lepekhina А.S., Pospelova M.L., Efimtcev A.Y., Trufanov G.E., Piskovatskov D.V., Alekseeva T.M.

BACKGROUND: Tension-type headache is one of the widespread pathologies (80%) in the structure of headaches, occurring in the practice of both neurologists and general practitioners and therapists. The group of chronic cephalalgias occupies about 4% in the general population, but significantly affects the neuropsychological characteristics of patients, including their quality of life, level of working capacity, emotional state and anxiety level, which can be defined as comorbid conditions that contribute to the long-term chronic course of the disease. Currently, the pathogenetic aspects of chronicity include the development of peripheral and central sensitization, the reorganization of the pain and analgesic systems, which leads to the appearance of pain behavior.

AIM: was to perform a neuropsychological analysis of the efficiency of osteopathic and non-drug treatment in patients suffering from chronic tension headaches.

MATERIALS AND METHODS: reflect the data of neuropsychological evaluation using standardized neurological scales: visual analog scale — VAS, Spielberg–Khanin; The Short Form-36 (SF-36), short questionnaire WHO, Headache Impact Test (HIT-6) and clinical assessment of osteopathy in combination with drug treatment in 34 patients suffering from chronic tension headache. Statistical data processing was shortchanged in the Statistica 10 software package.

RESULTS: demonstrated an improvement in neuropsychological parameters against the background of the use of a combined treatment method and the ability to influence the pathobiomechanical levels of chronic cephalgia. The data obtained from the results of the study: positive dynamics was revealed, manifested in a decrease in the number of cases of cephalalgia attacks, a decrease in the severity of pain syndrome, a decrease of influence on daily activity, and improvement of life quality. During the study, the deterioration of the condition of patients and adverse reactions against the back-ground of complex therapy in patients were not detected.

CONCLUSION: The combination of non-pharmacological therapies with a standard protocol is an effective method of choice for improving neuropsychological outcomes in patients with chronic-type headaches.

Russian Military Medical Academy Reports. 2022;41(4):379-384
pages 379-384 views
Effects of human lactoferrin under conditions of neurotoxic exposure: experimental research
Kopaeva M.Y., Cherepov A.B., Zarayskaya I.Y.

BACKGROUND: Translational research using laboratory animals aimed at revealing the features of the pathogenesis of Parkinson’s disease serve as a tool for finding new therapeutic strategies.

AIM: Was to investigate the effects of human lactoferrin (a multifunctional globular glycoprotein) on behavior the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated mice as the model of dopaminergic neurons loss.

MATERIALS AND METHODS: Nigrostriatal dopaminergic injury was induced by single administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (40 mg/kg) to five-month-old C57Bl/6 mice. Behavioral functions were assessed in the open field and rotarod tests and by the stride length analysis.

RESULTS: Preliminary administration of lactoferrin resulted in a significant reduction in the severity of nervous system lesions induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The positive effect of lactoferrin on the exploratory behavior of animals disturbed by neurotoxin, depending on the time of administration, was revealed. Exogenous protein with double preliminary administration had a protective effect on the change in body weight of mice after acute 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine exposure. This suggests a reduction in systemic toxic effects against the background of lactoferrin therapy.

CONCLUSION: The results obtained indicate the possibility of the potential use of lactoferrin as a promising therapeutic agent in the treatment of neurodegenerative diseases.

Russian Military Medical Academy Reports. 2022;41(4):385-392
pages 385-392 views
Alterations in internetwork functional connectivity in patients with post COVID-19 syndrome within the boundaries of the Triple Network Model
Trufanov A.G., Efimtsev A.Y., Litvinenko I.V.

AIM: Was to assess the changes in the connections between the three main neural networks using resting-state fMRI in patients with post COVID-19 syndrome with cerebral neurological symptoms, within the boundaries of the triple net-work model.

MATERIALS AND METHODS: We examined a total of 15 patients (mean age 36.4 ± 8.3 years; M : W = 10 : 5) with post COVID-19 syndrome who presented with neurological complaints, primarily decreased memory and attention, general weakness, low performance and sleep disturbance. The control group consisted of healthy 15 subjects (mean age, 32.2 ± 6.9 years; M : W = 11 : 4) who had not previously been exposed to COVID-19. All members of the control group were vaccinated with the Sputnik-V vaccine. Magnetic resonance examination was performed on a Siemens Espree magnetic resonance imaging machine with a magnetic field strength of 1.5T. To exclude structural brain lesions, a standard magnetic resonance examination was performed with pulsed T1-WI, T2-WI, and Flair sequences. For postprocessing, T1 gradient echo and resting state echo-planar imaging protocols were performed. Postprocessing was performed using the software package CONN toolbox 20a to obtain clusters of functional connectivity of the studied neural networks using the seed-to-voxel processing protocol.

RESULTS: Disruption of connectivity of the standard resting neural network with lingvalis ingual, fusiform, and middle frontal gyrus was detected. The salient resting neural network had a worse ability to form connections in patients with post COVID-19 syndrome with lateral occipital cortex, angular gyrus, superior parietal lobule and supramarginal gyrus in one cluster and frontal cortex, and paracingular gyrus in the second cluster. The resting frontoparietal neural network interacted significantly better in the control group with the cerebellar structures, the middle frontal gyrus, and the cuneus and precuneus.

CONCLUSION: Patients with COVID-19 and the presence of post COVID-19 syndrome have reduced functional connectivity of all three basic neural networks with the big number of anatomo-physiological brain structures.

Russian Military Medical Academy Reports. 2022;41(4):393-398
pages 393-398 views
Comparison of the state of brain metabolism and psycho emotional disorders in patients with postmastectomy syndrome
Makhanova A.M., Pospelova M.L., Ryzhkova D.V., Alexeeva T.M., Fionik O.V., Krasnikova V.V., Tonyan S.N., Nikolaeva A.E., Bukkieva T.A., Mokin E.A., Voynov M.S., Laptev M.I., Vyalykh E.E.

BACKGROUND: The most common consequence of radical treatment of breast cancer is postmastectomy syndrome — a complex of changes in the lymphocirculatory system, central and peripheral nervous system, skeletal and muscular apparatus, that significantly reduce the quality of life and working capacity of women. In recent years, special attention has been paid to the study of psycho emotional disorders in this group of patients. A promising method for preclinical diagnosis of anxiety and depressive disorders in patients with postmastectomy syndrome may be positron emission computed tomography with fluorine-18 labeled glucose — 2(18F)-fluoro-2-deoxy-D-glucose, which makes it possible to deduce typical patterns of changes in glucose metabolism in cerebral structures in various depressive and anxiety states.

AIM: The purpose of this study is to study the relationship between brain metabolism and psycho emotional status in patients with postmastectomy syndrome.

MATERIALS AND METHODS: In our work, the sample consisted of 28 patients who underwent radical treatment for breast cancer, who underwent an assessment of the psycho-emotional state using the State-Trait Anxiety Inventory and Zung scales for self-assessment of depression. Positron emission tomography was also performed with 18-fluorodeoxyglucose.

RESULTS: The study revealed that 71% of patients showed an increased level of anxiety, 64% showed signs of depression. Positron emission tomography data revealed the following areas of hypometabolism in patients with anxiety-depressive disorders: parietal cortex, inferior parietal lobule, precuneus, superior temporal gyrus, prefrontal cortex, posterior cingulate cortex.

CONCLUSION: Thus, typical zones of changes in glucose metabolism in patients with psycho emotional disorders have been identified, which makes it possible to improve the accuracy of diagnosing these conditions, as well as to develop the most effective ways to prevent and treat them.

Russian Military Medical Academy Reports. 2022;41(4):399-406
pages 399-406 views

Case report

Acute symptomatic epileptic seizures and epilepsy after stroke
Prokudin M.Y., Tikhomirova O.V., Bazilevich S.N., Dyskin  D.E., Tsygan  N.V., Moiseeva A.M., Prokudina S.S.

Acute symptomatic epileptic seizures occur within 7 days after the stroke onset. Acute symptomatic epileptic seizures occur in 6.3% of stroke cases: ischemic stroke — 4.2%, cerebral infarction with hemorrhagic transformation — 12.5%, intracerebral hemorrhage — 16.2%. Cumulative risk of subsequent unprovoked epileptic seizure after the first acute symptomatic seizure at follow-up for 10 years is 18.7 %. In acute symptomatic epileptic seizure secondary prevention with antiepileptic drugs usually is not indicated. If antiepileptic drug treatment is initiated after a single acute symptomatic seizure, it should be discontinued after the acute period of the disease. The 10-years risk of subsequent unprovoked epileptic seizures after the single unprovoked epileptic seizure in stroke patients is 71.5%. In this situation the epilepsy diagnosis is reasonable and antiepileptic drug treatment should be initiated. The incidence of epilepsy after acute ischemic or hemorrhagic stroke is identical — 10–12%. The choice of the group of antiepileptic drugs should be based on clinical guidelines for patients with focal forms of epilepsy. Pharmacokinetic interactions between antiepileptic drugs and oral anticoagulants, antiplatelet agents, antihypertensive drugs, and other xenobiotics should be minimized. Thus antiepileptic drugs that induce or inhibit microsomal liver enzymes should also be avoided.

Russian Military Medical Academy Reports. 2022;41(4):407-413
pages 407-413 views


Multysensory disorders in neurodegenerative diseases related to aging
Litvinenko I.V., Naumov K.M.

Disorders of the sensory systems (vision, hearing, etc.) in the elderly are often considered as a natural process of body changes over time (presbyopia, age-related hearing loss, presbiataxia, etc.) and remain untreated. However, nowadays reliable data show the connection of sensory system disorders with the onset of cognitive impairment. On the other hand there is the evidence that complaints about the functioning of individual sensory systems may be the first symptoms of the developing neurodegenerative disease ahead of its manifestation by several years. This suggests that early detection and development of measures for compensation and treatment of processes and diseases that cause disturbances in the work of sensory systems will both improve the quality of early diagnosis of neurodegenerative diseases and delay the clinical manifestation of neurodegenerative diseases. The data show the necessity of an integrated approach to diagnosis in patients with complaints of visual, hearing, balance and walking disorders in order to develop the set of measures for the correction and treatment of the identified disorders and diseases.

Russian Military Medical Academy Reports. 2022;41(4):415-420
pages 415-420 views
Graphene as the basis of biological sensors for the diagnosis of neurodegenerative dementia
Vorobev S.V., Ternovykh I.K., Lebedev A.A., Smirnov A.N., Usikov A.S., Lebedev S.P.

Cognitive disorders are currently being considered within the framework of the most pressing problems of modern clinical neurology in particular and medicine in general. Their significance is due to both the significant negative impact on the health and quality of life of patients, as well as the condition of their immediate relatives and society as a whole. In addition, widespread violations of higher cortical functions significantly affect the financial and economic indicators of individual groups of individuals and the state. These provisions determine the need to search for new highly effective ways of managing patients. The solution of this problem is impossible without the introduction of effective diagnostic methods that allow rapid and qualitative verification of the pathological process, especially at its early stages. Given the fact that Alzheimer’s disease plays a major role in the development of dementia in old age, the development of its diagnostic methods is the interest area for the researchers. Currently used diagnostic algorithms, which include, in addition to neuropsychological examination, such methods as the study of the content of β-amyloid and τ-protein in the cerebrospinal fluid, positron emission tomography, a number of others are either invasive or require expensive specialized equipment and have a high financial cost. This leads to a significant limitation of their use in everyday clinical practice. At the same time, certain successes have been achieved recently in the field of the introduction of nanotechnology products into medical science. This is the direction for the further prospects for the development of diagnostic and therapeutic strategies. One of the materials obtained in this direction is graphene, which is a two-dimensional allotropic modification of carbon with a number of specific physical properties. Currently biological sensors based on graphene are being developed, which have high sensitivity and specificity to the biomarkers under study and allow them to be determined in extremely low concentrations. The research in this direction may lead to the creation of a new diagnostic method that allows for the effective diagnosis of Alzheimer’s disease in the early stages, including at the outpatient level.

Russian Military Medical Academy Reports. 2022;41(4):421-428
pages 421-428 views
The place of myofascial syndrome in the genesis of headaches and facial pains
Tardov M.V., Boldin A.V., Sturov N.V., Kobylyanu G.N., Thiago F.D.

The article discusses the patterns of development and the main features of myofascial syndrome. Emphasis is placed on the myofascial syndrome involving head and face muscles with characterization of “masks” of the syndrome: irradiation zones of trigger point pain in the skeletal muscles of the cervical region are described (important role of the sternocleidomastoid muscle is emphasized), in the facial muscles and masticatory muscles. Trigger point properties are covered in detail, including painful and non-painful manifestations, such as tinnitus and congestion in the ear, dizziness, vertigo and hearing loss; as well as local vegetative symptoms. When diagnosing myofascial syndrome, it is necessary to specify in detail the anamnestic data (the time and conditions for the onset of the first manifestations), as well as to specify as many characteristics of pain as possible (the circumstances of its provocation and relief, the duration of the attack, the pain modality). The most important role belongs to palpation of the muscles with the definition of trigger points and muscle cords. The basic principles of therapy for myofascial syndrome are given: anesthesia, relaxation and stretching. Further, specific methods of drug, physiotherapeutic and manual procedures on the affected muscles are analyzed in detail. Two clinical cases from our own practice are presented, demonstrating the features of the myofascial syndrome clinical picture formation in the face area and the possibility of interrupting the pain phenomenon and non-painful manifestations by inactivating muscle triggers. The importance of joint supervision of a patient with myofascial syndrome by a multidisciplinary medical team, including, if necessary, not only neurologist and osteopath, but also an ENT doctor and a dentist, is emphasized. In conclusion, it was concluded that it is necessary to develop recommendations at the federal level for the diagnosis and treatment of myofascial syndrome.

Russian Military Medical Academy Reports. 2022;41(4):429-437
pages 429-437 views
Role of short-chain fatty acids in the pathogenesis of Parkinson’s disease
Krasakov I.V., Litvinenko I.V., Rodionov G.G., Davydova N.I., Aleksanin S.S.

Parkinson’s disease is tightly related to enteric nervous system dysfunction and gut microbiota dysbiosis. Short-chain fatty acids are the main metabolites produced by the gut bacteria fermentation of dietary fiber and are suggested to play a key role in gut–brain cross-talk. The article presents a review of the literature on the contribution of short-chain fatty acids to the pathogenesis of Parkinson’s disease. Patients with Parkinson’s disease have higher plasma concentrations of acetate, propionate, and butyrate than controls. These changes correlate with the severity of the clinical picture of Parkinson’s disease, levels of pro-inflammatory gut bacteria and pro-inflammatory cytokines. The cause of these changes may be an over-population of the gut of Parkinson’s disease patients with bacteria such as clostridia and ruminococci, leading to regulatory immune reactions, intestinal inflammation, increased permeability of the intestinal barrier, excessive intake primarily of propionate in the central nervous system, and activation of neuroinflammation. The importance of further study of the relationship between changes in gut metabiotic, its metabolome, and the immune system T-cell in patients with Parkinson’s disease is demonstrated. Justified the study of blood plasma from patients with Parkinson’s disease using gas chromatography–mass spectrometry for the accurate, clinically relevant, assessment of the gut–brain crosstalk.

Russian Military Medical Academy Reports. 2022;41(4):439-444
pages 439-444 views
Immune-mediated and autoimmune disorders of central nervous system after new coronavirus disease
Kozlova A.О., Zabirova A.K., Baydina E.V., Zakharova M.N.

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.

Russian Military Medical Academy Reports. 2022;41(4):445-453
pages 445-453 views

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