This work aims to evaluate the prognostic value of the demographical and clinical data on long-term outcomes (up to 12 months) in patients with severe acquired brain injury with vegetative state/unresponsive wakefulness syndrome (VS/UWS/UWS) or a minimally conscious state (MCS). Patients (n = 211) with VS/UWS/UWS (n = 123) and MCS (n = 88) were admitted to the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology after anoxic brain injury (n = 53), vascular lesions (n = 59), traumatic brain injury (n = 93), and other causes (n = 6). At the beginning of the 12-month study, younger age and a higher score by the Coma Recovery Scale-Revised (CRS-R) predicted a survival. However, no reliable markers of significant positive dynamics of consciousness were found. Based on the etiology, anoxic brain injury has the most unfavorable prognosis. For patients with vascular lesions, the first three months after injury have the most important prognostic value. No correlations were found between survival, increased consciousness, and gender. The demographic and clinical characteristics of patients with chronic DOC can be used to predict long-term mortality in patients with chronic disorders of consciousness. Further research should be devoted to finding reliable predictors of recovery of consciousness.

The review focuses on the neuroprotective mechanisms of therapeutic hypothermia from the standpoint of metabolic depression and genomic reprogramming of neurons that develop when brain temperature decreases.The concept of hypothermic pre-conditioning based on the development of typical nonspecific reactions for the formation of the cytoprotective phenotype of neurons due to potentially dangerous stimuli, such as ischemia, reperfusion, and hypothermia, was used to explain the effects of low temperatures. The data confirming the role of therapeutic cerebral hypothermia as a technique of selective brain exposure to mild cold for the neuroprotection and correction of temperature balance disorders are shown.The approach to therapeutic hypothermia as a hypothermic pre-conditioning allows to significantly expand the scope of its use in various procedural variants.

The prevalence of stroke-induced cognitive impairment is high. Effective approaches to the treatment of these cognitive impairments after stroke remain a serious and perhaps underestimated challenge. A BCI-based task-focused training that results in repetitive recruitment of the normal motor or cognitive circuits may strengthen stroke-affected neuronal connectivity, leading to functional improvements. In the present controlled study, we attempted to evaluate the modulation of neuronal circuits under the influence of 10 days of training in a P3-based BCI speller in subacute ischemic stroke patients.

Analysis of sleep patterns in patients with chronic disorders of consciousness attracts attention from the perspective of the diagnosis and prognosis of the disease as well as the treatment. Yet, the very existence of normal sleep in patients in a vegetative or minimally conscious state is still a matter of debate. This paper presents a retrospective analysis of overnight polysomnographic records of 40 patients with chronic disorders of consciousness aimed at the possibility of establishing the connection between the degree of impaired consciousness and the presence and organization of polysomnographic graphical elements, associated with stages of sleep in normal individuals. Specialized software based on expert system artificial intelligence was developed to calculate indices and parameters that characterize sleep. It was shown that a remarkably low percentage of patients have a rhythmic change in sleep patterns, what indicates the prevalence of violations of the Sleep–Wake cycle in a vegetative state and minimally conscious state. Sleep spindles were not found in records, however, the absence can originate from the limitations of polysomnographic method applied to patients with severe brain damage. A positive correlation between the rhythmic change of sleep patterns, better outcome and CRS-R scores was confirmed.

Information and communication technologies penetrate into all areas of everyday life of modern society, learning, helping and replacing human labor. Without information technologies, it is already impossible to imagine the field of medical science: at present and in the near future, they will improve the continuity of health monitoring, take over the prediction of the risks of complications, the adjustment of drug therapy during life and many other processes. The article is devoted to the problems and prospects of information technologies in healthcare in Russia. The general model of information technologies, problems and ways of solving the restrictions from Western campaigns are highlighted. In view of the digitalization of the healthcare system in our country, the article talks about the need to ensure the continuity and independence from external influence of information technology systems in its full cycle: from client terminals, communication systems, to data storage and processing servers. The most important factor that allows us to speak with confidence about the development of specialized information technologies solutions in the healthcare system of the Russian Federation is an effective state policy in ensuring the digitalization of the economy: national projects, government programs, changes in legislation, roadmaps for achieving key indicators.

Original Article Two-year outcomes of patients with prolonged disorders of consciousness: a prospective cohort study in Russian Federation Julia Nekrasova, Mikhail Kanarskii, Ilya Borisov, Pranil Pradhan, Stanislav Roshka, David Musatov, Ivan Redkin, Marina V. Petrova