Asthenia. Modern concept
https://doi.org/10.51793/OS.2023.26.10.003
Abstract
Background. This article provides contemporary data on the epidemiology, pathogenesis, classification and treatment of asthenic syndrome. The pathogenesis of asthenic syndrome and the physiological substrate of asthenic symptom complex are analyzed in detail: persistent feeling of fatigue, malaise, loss of energy, lack of resources for work and any activity, muscle weakness, sleep disorders, hyperesthesia, affective disorders, etc. The central nature of asthenic manifestations is emphasized, which is often unrelated to the nature and severity of somatic disorder – the provocateur of asthenic syndrome.
Objective. The modern concept of the pathogenetic mechanism of asthenia development is considered, which is confirmed by neuroimaging data, the phenomenon of central hypothalamic sensitization and its clinical significance, influence on the course of asthenic disorder are analyzed. An integrated classification of asthenic disorders, convenient for use in real clinical practice, is given, possible ways of coding asthenia according to the current classification of diseases of the 10th revision are listed, separately for asthenic disorders associated with COVID-19.
Results. The necessity of differential diagnosis of asthenia and chronic fatigue syndrome (myalgic encephalomyelitis) with the introduction of revised diagnostic criteria of the latter is indicated. Examples of the clinical significance of asthenic syndrome are given, some diseases accompanied by the development of asthenization in patients are listed, including rare clinical situations are described. The vector of treatment of asthenia with the use of non-drug methods and drug therapy is indicated. The current data on pathogenetically justified drug treatment are selected, the results of modern research are presented.
Conclusion. Attention is focused on the mechanism of action and clinical data on the use of a nootropic drug with a dopaminergic effect, its antiasthenic activity, and safety.
About the Authors
E. G. Demianovskaya
State Budgetary Healthcare Institution Infectious Clinical Hospital No. 1 of the Moscow Department of Healthcare; Federal State Budgetary Institution of Additional Professional Education Central State Medical Academy of the Presidential Administration of the Russian Federation
Russian Federation
Russian Federation
Ekaterina G. Demianovskaya, Cand. of Sci. (Med.), Neurologist; Associate Professor of the Department of Neurology
63 Volokolamskoe Shosse, Moscow, 125310
19 b. 1A Marshala Timoshenko str., Moscow, 121359
A. S. Vasilev
Federal State Budgetary Institution of Additional Professional Education Central State Medical Academy of the Presidential Administration of the Russian Federation
Russian Federation
Russian Federation
Aleksey S. Vasilev, Cand. of Sci. (Med.), Head of Education, Associate Professor of the Department of Neurology
19 b. 1A Marshala Timoshenko str., Moscow, 121359
V. I. Shmyrev
Federal State Budgetary Institution of Additional Professional Education Central State Medical Academy of the Presidential Administration of the Russian Federation
Russian Federation
Russian Federation
Vladimir I. Shmyrev, Dr. of Sci. (Med.), Professor, Head of the Department of Neurology
19 b. 1A Marshala Timoshenko str., Moscow, 121359
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Review
For citations:
Demianovskaya E.G., Vasilev A.S., Shmyrev V.I. Asthenia. Modern concept. Lechaschi Vrach. 2023;(10):18-23. (In Russ.) https://doi.org/10.51793/OS.2023.26.10.003
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