Dmitry S. Petelin’s research while affiliated with Moscow State University of Medicine and Dentistry and other places

Background. Chronic neck and low back pain is characterized by high comorbidity with anxiety and depressive disorders, which can exacerbate pain. The usefulness of psychiatrist involvement in the management of patients with chronic non-specific neck and low back pain has been poorly studied. Aim. To study the effect of anxiety and depressive disorder on pain intensity, physical activity, and quality of life in patients with nonspecific neck and low back pain, as well as the feasibility of involving a psychiatrist in the examination of patients. Materials and methods. The study included 43 patients (11 men and 32 women, average age 56.2±13.3 years) with chronic nonspecific neck and low back pain, who were diagnosed with increased anxiety or depression using the Spielberg test and/or the Beck depression questionnaire. All patients were consulted by a psychiatrist. A numerical rating scale was used to assess pain intensity, an international questionnaire on physical activity was used to analyze the level of physical activity, a central sensitization questionnaire was used to diagnose central sensitization, and the Spielberger test with an assessment of reactive (RA) and personal anxiety, and the Beck depression questionnaire were used to assess anxiety and depressive disorders. The SF-12 questionnaire was used to assess the quality of life, taking into account the division of this questionnaire into consolidated scales of physical and mental health. Results. Based on an in-person consultation with a psychiatrist, the following diagnoses were established according to ICD-10: F32 "Depressive episode" in 11 patients, F33 "Recurrent depressive disorder" in 14 patients, F41.1 "Generalized anxiety disorder" in 11 patients, F41.0 "Panic disorder" in 1 patient, F41.2 "Mixed anxiety and depressive disorder" in 4 patients, F41.9 "Anxiety disorder, unspecified" in 1 patient, F40.0 "Agoraphobia" in 1 patient. A negative impact of anxiety and depression on both the intensity of pain and the quality of life of patients was found. A relationship was found between pain intensity and the severity of depression (β=0.048; p=0.008; 95% CI 0.013–0.084) and RA (β=0.052; p=0.007; 95% CI 0.015–0.089). A negative impact of depression (β=-0.424; p=0.004; 95% CI -0.702–-0.144) and RA (β=-0.365; p=0.020; 95% CI -0.688–-0.061) on physical activity was shown. A negative impact on the mental component of quality of life was found for depression (β=-0.414; p=0.005; 95% CI -0.698–-0.129), RA (β=-0.437; p=0.005; 95% CI -0.735–-0.138) and personal anxiety (β=-0.364; p=0.007; 95% CI -0.625–-0.103). Conclusion. Anxiety and depressive disorders increase the intensity of pain syndrome, reduce physical activity and quality of life in patients with chronic nonspecific neck and low back pain. A psychiatric consultation allows you to diagnose a specific mental disorder.

Bipolar disorder (BD) involves altered reward processing and decision-making, with inconsistencies across studies. Here, we integrated hierarchical Bayesian modelling with magnetoencephalography (MEG) to characterise maladaptive belief updating in this condition. First, we determined if previously reported increased learning rates in BD stem from a heightened expectation of environmental changes. Additionally, we examined if this increased expectation speeds up belief updating in decision-making, associated with modulation of rhythmic neural activity within the prefrontal, orbitofrontal, and anterior cingulate cortex (PFC, OFC, ACC). Twenty-two euthymic BD and 27 healthy control (HC) participants completed a reward-based motor decision-making task in a volatile setting. Hierarchical Bayesian modelling revealed BD participants anticipated greater environmental volatility, resulting in a more stochastic mapping from beliefs to actions and paralleled by lower win rates and a reduced tendency to repeat rewarded actions than HC. Despite this, BD individuals adjusted their expectations of action-outcome contingencies more slowly, but both groups invigorated their actions similarly. On a neural level, while healthy individuals exhibited an alpha-beta suppression and gamma increase during belief updating, BD participants showed dampened effects, extending across the PFC, OFC, and ACC regions. This was accompanied by an abnormally increased beta-band directed information flow in BD. Overall, the results suggest euthymic BD individuals anticipate environmental change without adequately learning from it, contributing to maladaptive belief updating. Alterations in frequency-domain amplitude and functional connectivity within the PFC, OFC, and ACC during belief updating underlie the computational effects and could serve as potential indicators for predicting relapse in future research.

Background. Today it is well known that the structure of sleep disorders and frequency of complaints about sleep disorders depend on the diseases profile. Emotional and behavioral features of patients with different disease profile are important factors affecting the development of sleep disorders. Aim. To estimate difference of sleep disorders according to the profile of the disease and to assess the emotional and psychological factors that may influence sleep disorders. Materials and methods. A total of 300 patients participated in the study: 100 from every department (neurological, psychiatric and pulmonological). To assess the quality of sleep Pittsburgh Sleep Quality Index was used; data from the Spielberger anxiety scale, a 5-factor personality questionnaire, and a questionnaire for evaluating coping strategies (coping strategies) were used to assess personal and emotional factors. Results. Patients from the psychotherapeutic group appeared to be more likely to complain of sleep disorders in general. They also had an average Pittsburgh Sleep Quality Index score higher than patients from neurological and somatic hospitals. In the group of patients with a neurological profile loud snoring is more often reason for sleep disturbing. Awakenings due to difficulties in breathing were more often detected in the group of somatic profile. Situational and personal anxiety influenced the structure of sleep disorders regardless of the disease profile. Conclusion. The use of various coping strategies has the greatest impact on the presence of sleep disorders in the group of patients with a somatic profile, to a lesser extent – in the group of neurological profile.

The mirror neuron system is a fundamental brain system of the brain that provides the ability to understand the actions of others and plays a key role in motor learning and empathy. In this review, we have thoroughly examined the internal and external factors that influence the functioning of the mirror neuron system. Issues such as difficulties in interpreting the mu rhythm and its relationship to theory of mind, which are particularly salient when analysing the mirror neuron system in the context of mental illness, have been identified. The role of the mirror neuron system in the formation of various mental disorders and neurological diseases has been considered. Additionally, a promising direction for future research is highlighted — the study of the mirror neuron system in the context of Parkinson's disease, focusing on the peculiarities of the functioning of the dopaminergic system of the mirror neuron system under normal conditions and in the presence of pathology. Prospective directions for further research are suggested, including the analysis of the mu-rhythm, the role of mentalization, studying the mirror neuron system in mental and neurological diseases.

Objective Atypical depression (AD) is a clinical subtype of depression characterised by mood reactivity and at least two of the following features: significant weight gain/increased appetite, hypersomnia, leaden paralysis, and/or interpersonal rejection sensitivity. The role of genetics in the development of depression remains a considerable level of interest among individuals. Due to the large number of breakthrough studies in genetics, there is currently a wealth of heterogeneous data on the existence of genetic markers for depression, including AD. However, it appears that there is a gap in the literature, as we were unable to identify any systematic reviews or meta-analyses that comprehensively describe these data. Therefore, our research aims to provide high-quality, solid evidence for further studies in this area. Method Electronic bibliographic databases (Scopus, MEDLINE) were systematically searched from inception to September 2023. We searched for any specific genetic markers that could be retrieved associated with AD. The quality of studies has been assessed by means of the Q-genie tool. Results Nine studies meeting the inclusion criteria were selected, which appeared to link genetic polymorphisms to atypical depression. Four studies examined genetic polymorphisms associated with the serotonin transporter gene (5-HTT), three studies examined genetic polymorphisms associated with endocrine regulation, two studies considered genetic polymorphisms associated with immune and/or cellular regulation, specifically the melanin-concentrating hormone receptor 2 (MCHR2), mineralocorticoid receptor (MR), and fat mass and obesity-associated protein (FTO) genes involved in the regulation of energy balance. Conclusions The extracted data confirm that the atypical type of major depressive disorder is heritable to a certain extent. Individual risk markers for developing this type of depression may be identified in the future.

Chronic pain is one of the main problems of modern clinical medicine. It is associated with its high prevalence, negative impact on the level of development and the life quality of patients, as well as difficulties in selecting effective drug therapy. According to various data, the population prevalence of chronic pain during life varies from 11% to 40%. Modern publications have proven the connection of various pain syndromes with unpredictable psychopathological conditions, including affective disorders, anxiety disorders, addiction to psychoactive substances, and personality disorders. Currently, a large number of methods that reduce the severity of chronic pain are available. Due to the emphasis of this article on the consequences associated with painful disorders, only methods used in psychiatric practice are discussed. This includes psychopharmacotherapy, psychotherapy and non-drug biological methods of therapy. In order to illustrate the main provisions presented in the review literature, the article offers a clinical observation.

Functional neurological disorders are widely represented in clinical practice, but their etiology, pathogenesis, as well as approaches to diagnosis and therapy have not been sufficiently studied. This article provides an overview of the taxonomy and clinical manifestations of functional neurological disorders. Modern data on the diagnosis of the discussed group of disorders are also presented, with an emphasis on instrumental methods – electroencephalography, transcranial magnetic stimulation, functional magnetic resonance imaging. The available data on evidence-based approaches to the treatment of functional neurological disorders are summarized. The main points of the literature review are illustrated by clinical observation.

Introduction . Autism spectrum disorders and attention deficit hyperactivity disorder are among the most significant and widespread mental disorders that manifest in childhood and adolescence. Their etiology and pathogenesis have not been studied enough and most likely a complex of factors leads to their formation. Among other things, data are accumulating on the role of various hazards and diseases of the mother, which increase the risk of neuropsychiatric disorders in offspring. These include genitourinary infections, whose contribution to the development of autism spectrum disorders and attention deficit hyperactivity disorder has not yet been systematically studied. Aim . To establish the contribution of maternal genitourinary infections to the formation of autism spectrum disorders and attention deficit hyperactivity disorder in children. Materials and methods . An electronic search was conducted in the Scopus and Pubmed databases to obtain relevant literature by August 2022. The search strategy included a combination of keywords and MESH terms: urogenital infections, and autism, and autism spectrum disorders, and attention deficit hyperactivity disorder, and maternal infections. Results . On this topic 10 papers have been identified in the available literature – 6 on autism spectrum disorders and 4 on attention deficit hyperactivity disorder. In all the papers on attention deficit hyperactivity disorder included in the analysis, an association between genitourinary infections and neuropsychiatric disorders was revealed. In the case of autism spectrum disorders, the data obtained were more contradictory. The heterogeneity of the available data (different designs, different deficits and approaches to the diagnosis of genitourinary infections) did not allow for a meta-analysis. Conclusions . Genitourinary infections play a pathogenetic role in the formation of attention deficit hyperactivity disorder, while the effect of genitourinary infections on the development of autism spectrum disorders seems less unambiguous. It is necessary to continue work in this area with a more unified design to form practical recommendations for the prevention of neuropsychiatric disorders.

Chest pain of a non-cardiac nature is one of the extremely significant problems of clinical medicine, which is associated with the widespread prevalence of this condition and the high healthcare costs for diagnosing and treating such patients. Along with neurological, gastroenterological and pulmonological diseases, mental disorders make a major contribution to the formation of chest pain. Moreover, the formation of pain in the chest area can be associated not only with such well-known psychopathological conditions as depression and anxiety disorders, but also with the pathology of the somatoform circle. This review presents data on the frequency of chest pain associated with mental disorders (pain as a symptom of a mental disorder, mental disorders as a consequence of a previous episode of chest pain, etc.), the nature of the relationship between pain symptoms and mental disorders, as well as the clinical picture somatoform disorders manifesting in the form of thoracalgia. Information is summarized on approaches to diagnosing mental disorders in patients with chest pain and the possibilities for their psychopharmacotherapy and psychotherapy. When discussing psychopharmacotherapy, emphasis is placed on the possibilities of using the atypical tranquilizer tofisopam in this category of patients, and a brief description of its effectiveness and safety is given. To illustrate the main points of the review, a clinical case of a patient with chest pain of non-cardiac origin, which manifested itself after a traumatic event, which in turn provoked a myocardial infarction, is also presented. Positive dynamics with subsequent recovery during therapy with tofisopam are described.

Bipolar disorder (BD) involves altered reward processing and decision-making, with inconsistencies across studies. Here, we integrated hierarchical Bayesian modelling with magnetoencephalography (MEG) to characterise maladaptive belief updating in this condition. First, we determined if previously reported increased learning rates in BD stem from a heightened expectation of environmental changes. Additionally, we examined if this increased expectation speeds up belief updating in decision-making, associated with modulation of rhythmic neural activity within the prefrontal, orbitofrontal, and anterior cingulate cortex (PFC, OFC, ACC). Twenty-two euthymic BD and 27 healthy control (HC) participants completed a reward-based motor decision-making task in a volatile setting. Hierarchical Bayesian modelling revealed BD participants anticipated greater environmental volatility, resulting in a more stochastic mapping from beliefs to actions and paralleled by lower win rates and a reduced tendency to repeat rewarded actions than HC. Despite this, BD individuals adjusted their expectations of action-outcome contingencies more slowly, but both groups invigorated their actions similarly. On a neural level, while healthy individuals exhibited an alpha-beta suppression and gamma increase during belief updating, BD participants showed dampened effects, extending across the PFC, OFC, and ACC regions. This was accompanied by an abnormally increased beta-band directed information flow in BD. Overall, the results suggest euthymic BD individuals anticipate environmental change without adequately learning from it, contributing to maladaptive belief updating. Alterations in frequency-domain amplitude and functional connectivity within the PFC, OFC, and ACC during belief updating underlie the computational effects and could serve as potential indicators for predicting relapse in future research.