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- "The number of people with addictions has increased significantly over the past few years"
"The number of people with addictions has increased significantly over the past few years"
Scientists at the N.P. Bekhtereva Institute of the Human Brain have mastered the method of ridding patients with Parkinson's disease of tremor without surgery, and have made significant progress in the diagnosis and treatment of oncological brain pathologies. This was facilitated by the institute's technical re—equipment program - the renovation of the instrument base and the construction of a new building. This was stated in an interview with Izvestia by the director of the Institute, Doctor of Medical Sciences Mikhail Didur. The organization, which celebrates its 35th anniversary on March 12, is also looking for an opportunity to produce implantable electrodes in Russia, developed by academician Natalia Bekhtereva, and more recently launched a new positron emission tomograph, which has no analogues in the country.
"The waiting list in our department of psychiatry has increased three to four times"
— Mikhail Dmitrievich, psychologists are already calling the habit of playing computer games at night and sleeping in class, copying even what they have just learned from the phone, a feature of the younger generation. How do you see this problem from your side?
— Gaming addictions, various forms of addiction to gadgets have become a reality of medicine today. There are many mental, physical, and chemical addictions — a very wide range, and humanity cannot defeat them yet. The number of people with addictions has increased significantly over the past few years. As a manager, I can state that the need for psychiatric, psychological, and psychotherapeutic care for people with addictions has increased not by a certain number of percent, but by several times, compared with the indicators before the COVID-19 pandemic. The waiting list in our department of psychiatry has increased three to four times, this applies to both adults and children. There are hundreds of millions of such addicted people on the planet today, and if we take into account the spread of this technique, then perhaps billions.
— How can you help them? Do you use certain areas of the brain in such cases?
— The difficulty lies in the fact that addiction-related pathologies are not available for accurate prediction in terms of the course, because we do not know how the child, family, his environment at school, and in the external environment will behave in the future. This is more of a social problem than a medical one.
Previously, studies were conducted on the effects on certain areas of the brain of patients with drug addiction, including at our institute. Certain results were obtained, both positive and negative, but these works were curtailed.
— Do you have any plans to resume these studies?
- no. We are developing neurosurgical methods in other fields, such as oncology, which significantly affects the life expectancy of a large number of people. The second huge group of pathologies is neurodegenerative diseases, which includes Parkinson's disease, multiple sclerosis, Alzheimer's disease — everything that is united by a single term: neurodegeneration. It has an active, almost explosive growth. Even 10 years ago, neither adolescents nor children with multiple sclerosis were described. Now we sometimes have several of them in the department. This severe disabling disease has rejuvenated. A wave, an avalanche rolls in and places a heavy burden on the social services of the state, and medicine is ringing the bells, trying to figure out how to influence these processes.
"A person can go home right on the day of the procedure"
— Are there any impressive achievements here?
- yes. For example, the tremor effect in Parkinson's disease is eliminated immediately, and noninvasively, without surgery. And this is something that usually greatly hinders a person, invalidates him.
— The institute is actively updating its material and technical base. Has a new method of dealing with tremor become possible due to an upgrade in equipment?
— Yes, and this device is called an ultrasound ablator. The procedure looks something like taking an encephalogram. The patient puts on a special cap, which has built-in ultrasound emitters. They produce approximately 1,200 directional radiated ultrasound signals that can affect the deep tissues of the human brain. The main area of impact is 5 cm from the median line of the brain, which allows you to affect foci associated with Parkinson's disease, and especially with motor disorders, epilepsy and a number of other related dysfunctions.
Previously, these centers were affected with a gamma knife, but gamma rays are completely unsafe for the human body, and it must also be borne in mind that everything related to the opening of the human skull is quite traumatic. No autopsies are needed here. Therefore, an ultrasound ablator was supplied to our institute to replace the gamma knife. Today there are only three such devices in the country — one in Moscow, one in Ufa and one in our country.
— So the tremor can be removed without surgery?
"Exactly. A person can go home right on the day of the procedure. If some other pathological focus is destroyed by the same method, the person is observed during the day.
"Import substitution is already improving in the field of pacemaker production"
— What other unique devices did you manage to obtain as part of the technical re-equipment?
— Our institute has been an absolute leader in the use of positron emission tomography in our country. The first such device in the USSR was brought to the country by Natalia Bekhtereva. And exactly two weeks ago, we launched a new positron emission tomograph of the latest generation, the only one in terms of equipment in our country and one of the most modern devices of this class in the world.
New magnetic resonance imaging
— What is its fundamental difference from other PET systems?
— He has five special research rings. There are three-ring systems in Russia. The more rings there are, the higher the diagnostic accuracy and the quality of visualization of the studied area of the brain.
In addition, we will soon launch the third X-ray operating room, a new building with 60 beds, and as a result we will have 175 beds in total, which is a lot for a research institute. Natalia Bekhtereva said that there is no fundamental science without the clinic, and it was she who created the combination of fundamental science and clinical practice at our institute. That is why we are now actively developing the clinical area. Today, we receive everything we need — funding for science and medical activities, and this allows us to work clearly and systematically to do the work that the state expects of us.
— What is the situation with the import substitution of implantable electrodes that Natalia Bekhtereva developed, but the institute named after her is now forced to purchase abroad?
— At one time, the institute was the country's leader in the field of neurosurgical treatment methods, including stereotactic neurosurgery, and many employees received state awards for this. Now, electrode implantation operations have become routine, although there are still only five or six institutions in the camp that perform such operations.
As for restoring the production of the electrodes themselves, the first studies are underway, but today this is only the beginning of a long journey. First, we need to reach the level of the product that is already on the market. The production of electrodes was launched in the USA by one of the employees of Natalia Bekhtereva's laboratory, who left our country. Import substitution is already underway in the field of pacemaker production, as for implanted electrodes, it is still a long way off, but sooner or later we will solve this problem.
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