This paper discusses the promising areas of research into machine learning applications for the prevention and correction of neurodegenerative and depressive disorders. These two groups of disorders are among the leading causes of decline in the quality of life in the world when estimated using disability-adjusted years. Despite decades of research, the development of new approaches for the assessment (especially pre-clinical) and correction of neurodegenerative diseases and depressive disorders remains among the priority areas of research in neurophysiology, psychology, genetics, and interdisciplinary medicine. Contemporary machine learning technologies and medical data infrastructure create new research opportunities. However, reaching a consensus on the application of new machine learning methods and their integration with the existing standards of care and assessment is still a challenge to overcome before the innovations could be widely introduced to clinics. The research on the development of clinical predictions and classification algorithms contributes towards creating a unified approach to the use of growing clinical data. This unified approach should integrate the requirements of medical professionals, researchers, and governmental regulators. In the current paper, the current state of research into neurodegenerative and depressive disorders is presented.

Objective. The purpose of this study was to assess the annual socio-economic burden of stroke in the Russian Federation from the position of the state. Material and methods. Based on official statistics on morbidity and mortality due to stroke (2019), the results of a survey of patients or caregivers (680 respondents) and cost indicators of 2022, the social and economic burden of stroke during the 1st year after the acute period is modeled. All cost estimates are made from the position of the state. Results. In 2019 435.2 thousand cases of stroke have been registered in the Russian Federation, 30% of those patients died during the year after the acute episode, thus annually up to 1.7 million years of life are lost. According to our study, stroke accounted for 2% of all days of disability paid by Social Insurance Fund in 2019 and 9% of cases of primary receiving of disability. More than 139 thousand working people assisted their relatives who suffered a stroke, 59.2 thousand of them were forced to change jobs, 18 thousand people left work due to the need to care for a relative. The economic burden of stroke amounted to more than 490 billion rubles. or 0.3% of GDP. The average costs per 1 registered case of hemorrhagic stroke amounted to 0.93 million rubles, ischemic — 1.2 million rubles, of which about 10% are medical costs, 5% are non-medical costs and 85% are costs associated with loss of productivity. Conclusion. Stroke causes a significant socio-economic burden for the state in the Russian Federation, the economic losses within 1 year is equal to the 0.3% of the country’s annual GDP. The main contribution to the stroke economic and social burden is not only mortality, but also disability, leading to incapacitation of patients who have suffered a stroke, as well as to a reduction in the contribution to the economy of their relatives who help and care for them.

After discharge from the Intensive Care Unit (ICU), more than 50 % of patients experience pathological symptoms that are not related to the primary emergency but reduce the quality of life and require rehabilitation. Post Intensive Care Syndrome (PIСS) include only those conditions that do not have a direct causal relationship with the emergency condition that gave rise to hospitalization in the ICU. The pathophysiological basis of the PICS is the phenomenon of “learned non-use”: a state of artificial limitation of the patient’s motor and cognitive activity as a result of the use of analgosedation, bed rest and immobilization. The clinical picture of PICS is determined by the severity of its individual components, detailed using a package of clinimetric scales. Based on the results of dynamic testing, the PICS severity index is calculated. The sum of the scores in the range from 0 to 10 reflects the severity and effectiveness of rehabilitation measures. For the prevention of PICS, the Union of Rehabilitologists of Russia together with the Federation of Anesthesiologists and Resuscitators of Russia has developed the rehabilitation complex “ReabICU”. In the English-language literature, such a complex is called “Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility” bundle. ReabICU is a complex of technologically therapeutic and diagnostic modules “positioning and mobilization”, “prevention of dysphagia and nutritional deficiency”, “prevention of emotional and cognitive impairment and delirium”, “prevention of loss of self-care skills”. The basis of the multidisciplinary rehabilitation team, which includes a doctor for medical rehabilitation, 2 specialists in physical rehabilitation, a specialist in occupation therapy, a medical psychologist, a medical speech therapist, a nurse for medical rehabilitation. The activity of multidisciplinary rehabilitation team is evaluated on the basis of quality criteria and the achievement of the main goal of ReabICU — the preservation of the premorbid status of the patient’s socialization.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить эффективность и безопасность Проспекты в терапии умеренных когнитивных расстройств у больных в раннем восстановительном периоде ишемического инсульта. МАТЕРИАЛ И МЕТОДЫ В исследование были включены 275 пациентов (средний возраст 64,0±8,1 года), перенесших ишемический инсульт давностью от 3 до 6 мес, с умеренными когнитивными расстройствами и умеренной активностью в повседневной жизни. На этапе скрининга оценивали выраженность когнитивных нарушений по краткой шкале оценки психического статуса, Монреальской шкале оценки когнитивных функций (MoCA); уровень активности в повседневной жизни по шкале Бартел; качество жизни по шкале оценки качества жизни, связанной с инсультом (SS-QOL). Пациенты принимали Проспекту или плацебо по 2 таблетки 2 раза в день 24 нед. Период последующего наблюдения составил 4 нед. Для оценки эффективности конечной точкой исследования была принята доля пациентов с улучшением когнитивных функций (+1 и более баллов по MoCA) через 24 нед лечения. Для оценки безопасности анализировали наличие и характер нежелательных явлений, их степень тяжести, связь с приемом препарата, исход, динамику жизненно важных показателей, долю пациентов с клинически значимыми отклонениями лабораторных показателей. РЕЗУЛЬТАТЫ Положительный терапевтический ответ в виде клинически значимого улучшения когнитивных функций получен у 91,9% пациентов группы Проспекта по сравнению 82,1% группы плацебо (p=0,02). Выявлено 57 нежелательных явлений у 37 (27,4%) пациентов группы Проспекта, 53 нежелательных явления у 39 (27,9%) участников группы плацебо (p=1,0). Ни одно нежелательное явление не было достоверно связано с приемом Проспекты. Клинически значимых изменений жизненно важных показателей, отклонений лабораторных показателей в процессе исследования выявлено не было. ЗАКЛЮЧЕНИЕ Проспекта — эффективный и безопасный препарат для лечения умеренных когнитивных расстройств у пациентов в раннем восстановительном периоде ишемического инсульта.

Chronic disorders of consciousness (DOC) represent severe central nervous system damage resulting in long-term disability and a significant burden to healthcare institutions and patientsʼ families. DOC develop in patients after coma and are characterized by the presence of wakefulness with complete or almost complete absence of signs of awareness. DOC include vegetative state (VS) and minimally conscious state (MCS). The term prolonged disorders of consciousness (pDOC) is also used in the Russian literature to describe the initial stages of chronic DOC. Another clinical entity, exit from MCS, is used to characterize the stage of recovery of cognitive functions. Diagnosis of DOC is based on repeated structured clinical examination using specific scales, provided that reversible causes of impaired consciousness are excluded. Treatment of DOC patients includes maintenance of vital functions and optimal nutrition and control of typical complications and concomitant conditions (pressure sores, spasticity, pain, paroxysmal sympathetic hyperactivity, etc.). Rehabilitation of DOC patients should involve a multidisciplinary rehabilitation team, the extent of which is determined by the individual problems and capabilities of the patient. Rehabilitation is most effective if started early. To date, there is no robust evidence on the effectiveness of specific methods for restoring consciousness, while a number of pharmacological and non-pharmacological interventions are being studied; however, they should be applied provided that the maximum possible level of correction of the patientʼs somatic problems is achieved. The family plays a key role in rehabilitation. They need practical information about their loved oneʼs condition, guidance in rehabilitation, and psychological support. Хронические нарушения сознания (ХНС) представляют собой синдромы тяжелого поражения центральной нервной системы, приводящие к длительной грубой инвалидизации и требующие значительных усилий по лечению и реабилитации, которые ложатся на медицинские учреждения и на плечи близких пациентов. ХНС развиваются у пациентов после комы и характеризуются наличием бодрствования при полном или практически полном отсутствии признаков осознанного поведения. К ХНС относятся вегетативное состояние (ВС) и состояние минимального сознания (СМС). Также для описания начальных стадий этих состояний используется термин «продленное нарушение сознания» (ПНС). Отдельно выделяют выход из СМС — состояние, которое формируется по мере восстановления когнитивных функций. Диагностика ХНС основывается на многократном структурированном клиническом осмотре с применением специализированных шкал при условии исключения обратимых причин нарушения сознания. Лечение пациентов с ХНС включает в себя поддержание жизненно важных функций, обеспечение оптимального питания и борьбу с типичными осложнениями и сопутствующими состояниями (пролежни, спастичность, боль, пароксизмальная симпатическая гиперактивность и др.). У пациентов с ХНС должна проводиться реабилитация с участием мультидисциплинарной реабилитационной команды в объеме, который определяется проблемами и возможностями конкретного пациента. Наиболее эффективной реабилитация является при условии ее раннего начала. На данный момент однозначных доказательств эффективности каких-либо специфических методов, направленных на восстановление сознания, не получено; изучается ряд соответствующих фармакологических и нефармакологических вмешательств, обязательным условием применения которых является максимально возможная коррекция соматических проблем пациента. Важную роль в ведении пациентов с ХНС играет вовлечение близких пациента, которые, в свою очередь, нуждаются в получении объективной практической информации о состоянии своего родственника и о направлениях реабилитации, а также в психологической помощи.

Introduction. Ischemic stroke (IS) remains a serious medical and social issue due to its high prevalence, mortality, and resulting disability. Reperfusion therapy is an effective method of treating patients with IS. Objective. The aim of this study was to examine the results of implementation of reperfusion technologies for the treatment of IS in the Russian Federation. Material and methods. The analysis was based on nationwide data collected from 2015 through the first quarter of 2025. The following indicators were assessed: the proportion of IS patients admitted to stroke units within the first 4.5 hours after symptom onset; the frequency of intravenous thrombolytic therapy (IVT), including the use of telemedicine technologies for IVT administration; the rate of thrombectomy; and the hospital mortality rate from IS. The implementation of telemedicine technologies was evaluated based on the presence of teleconsulted primary stroke units (tele-PSUs) in each region and the proportion of IS patients who received IVT in tele-PSUs. Results. Over the study period, an increase was observed in the proportion of IS patients admitted within 4.5 hours of symptom onset — from 23% in 2015 to 31% in 2024. The frequency of IVT and thrombectomy procedures increased from 2% and 0.1% in 2015 to 10.2% and 2.8% in the first quarter of 2025, respectively. The rate of IVT performed in tele-PSUs in 2024 was 13.6% of IS patients admitted to tele-PSUs. The ischemic stroke mortality rate decreased from 16.8% in 2015 to 12.6% in the first quarter of 2025. Conclusions. Reperfusion therapy technologies for IS are being actively implemented across the country, significantly improving clinical approaches to stroke management. Increasing the number of reperfusion procedures will contribute to improved patient outcomes, reduced mortality, and increase the number of individuals achieving favorable recovery of neurological functions.