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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">polenovjournal</journal-id><journal-title-group><journal-title xml:lang="ru">Российский нейрохирургический журнал имени профессора А. Л. Поленова</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Neurosurgical Journal named after Professor A. L. Polenov</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2071-2693</issn><publisher><publisher-name>Семинары, Конференции и Форумы</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.56618/2071-2693_2025_17_4_114</article-id><article-id custom-type="edn" pub-id-type="custom">NEFNNF</article-id><article-id custom-type="elpub" pub-id-type="custom">polenovjournal-715</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ И КЛИНИЧЕСКИЕ СЛУЧАИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS OF LITERATURE AND CLINICAL CASES</subject></subj-group></article-categories><title-group><article-title>Механизмы воздействия физической нагрузки при эпилепсии</article-title><trans-title-group xml:lang="en"><trans-title>Mechanisms of physical activity in epilepsy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-2164-1610</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лебедева</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Lebedeva</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елизавета Никитична Лебедева – лаборант Научно-исследовательской лаборатории эпилептологии; ординатор-невролог кафедры неврологии им. акад. C. Н. Давиденкова</p><p>ул. Маяковского, д. 12, Санкт-Петербург, 191025</p></bio><bio xml:lang="en"><p>Elizaveta N. Lebedeva – Laboratory Technician at the Epileptology Research Laboratory</p><p>12 Mayakovskogo street, St. Petersburg, 191025</p></bio><email xlink:type="simple">isa1210leb@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2790-0191</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иванова</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanova</surname><given-names>N. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наталия Евгеньевна Иванова – доктор медицинских наук, профессор, заслуженный врач Российской Федерации, член-корреспондент Российской академии естественных наук, академик Академии медико-технических наук, действительный член Петровской академии наук и искусств, член Правления Ассоциации нейрохирургов России, член Правления Ассоциации нейрохирургов им. И. C. Бабчина, член Географического общества России, врач функциональной и ультразвуковой диагностики, зав. научным отделом; профессор кафедры неврологии и психиатрии</p><p>ул. Маяковского, д. 12, Санкт-Петербург, 191025</p></bio><bio xml:lang="en"><p>Natalya E. Ivanova – Dr. of Sci. (Med.), Full Professor, Distinguished Doctor of the Russian Federation, Corresponding Member of the Russian Academy of Medical and Technical Sciences, Academician of the Academy of Medical and Technical Sciences, Full Member of the Petrovskaya Academy of Sciences and Arts, Member of the Board of the Association of Neurosurgeons of Russia, Member of the Board of the Babchin Association of Neurosurgeons, Member of the Geographical Society of Russia, Doctor of Functional and Ultrasound Diagnostics, Head at the Scientific Department of Russian Neurosurgical Institute, Head at the Scientific Department</p><p>12 Mayakovskogo street, St. Petersburg, 191025</p></bio><email xlink:type="simple">ivamel@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6350-4060</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шалыгин</surname><given-names>Д. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Shalygin</surname><given-names>D. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитрий Юрьевич Шалыгин – аспирант, врач-невролог, старший лаборант кафедры неврологии с клиникой</p><p>ул. Маяковского, д. 12, Санкт-Петербург, 191025</p></bio><bio xml:lang="en"><p>Dmitrii Yu. Shalygin – Postgraduate Student, Neurologist, Senior Laboratory Assistant at the Department of Neurology with Clinic</p><p>12 Mayakovskogo street, St. Petersburg, 191025</p></bio><email xlink:type="simple">shalygin_dyu@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1290-3659</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абрамов</surname><given-names>К. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Abramov</surname><given-names>K. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Константин Борисович Абрамов – кандидат медицинских наук, заместитель главного врача по нейрохирургии, врач-нейрохирург высшей категории Нейрохирургического отделения № 2</p><p>ул. Маяковского, д. 12, Санкт-Петербург, 191025</p></bio><bio xml:lang="en"><p>Konstantin B. Abramov – Cand. of Sci. (Med.), Deputy Chief Physician for Neurosurgery, Neurosurgeon at the Department of Neurosurgery No. 2</p><p>12 Mayakovskogo street, St. Petersburg, 191025</p></bio><email xlink:type="simple">abramov_kb@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2667-7717</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Деньгина</surname><given-names>Н. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Dengina</surname><given-names>N. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Нина Олеговна Деньгина – кандидат педагогических наук, доцент, лаборант-исследователь Научно-исследовательской лаборатории эпилептологии</p><p>ул. Маяковского, д. 12, Санкт-Петербург, 191025</p></bio><bio xml:lang="en"><p>Nina O. Dengina – Cand. of Sci. (Ped.), Associate Professor, Research Assistant at the Epilepsy Research Laboratory</p><p>12 Mayakovskogo street, St. Petersburg, 191025</p></bio><email xlink:type="simple">dengina_no@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7186-0054</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Одинцова</surname><given-names>Г. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Odintsova</surname><given-names>G. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Галина Вячеславовна Одинцова – кандидат медицинских наук, старший научный сотрудник, руководитель Научно-исследовательской лаборатории эпилептологии</p><p>ул. Маяковского, д. 12, Санкт-Петербург, 191025</p></bio><bio xml:lang="en"><p>Galina V. Odintsova – Cand. of Sci. (Med.), Senior Researcher, Head at the Epileptology Research Laboratory</p><p>12 Mayakovskogo street, St. Petersburg, 191025</p></bio><email xlink:type="simple">odintsova_gv@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский научно-исследовательский нейрохирургический институт имени профессора А. Л. Поленова – филиал Федерального государственного бюджетного учреждения «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>02</day><month>02</month><year>2026</year></pub-date><volume>17</volume><issue>4</issue><fpage>114</fpage><lpage>122</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лебедева Е.Н., Иванова Н.Е., Шалыгин Д.Ю., Абрамов К.Б., Деньгина Н.О., Одинцова Г.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Лебедева Е.Н., Иванова Н.Е., Шалыгин Д.Ю., Абрамов К.Б., Деньгина Н.О., Одинцова Г.В.</copyright-holder><copyright-holder xml:lang="en">Lebedeva E.N., Ivanova N.E., Shalygin D.Y., Abramov K.B., Dengina N.O., Odintsova G.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://polenovjournal.elpub.ru/jour/article/view/715">https://polenovjournal.elpub.ru/jour/article/view/715</self-uri><abstract><p>ВВЕДЕНИЕ. Физическая активность играет важную роль в жизни пациентов с эпилепсией и положительно влияет как на физическое, так и на психическое здоровье. Современные исследования показывают, что умеренные физические нагрузки способствуют лучшему контролю приступов.ЦЕЛЬ. Уточнить механизмы воздействия и полярность влияния физической нагрузки на эпилептическую активность и приступы при эпилепсии (по данным литературного обзора).МАТЕРИАЛЫ И МЕТОДЫ. Предметом исследования являлись научные работы, посвященные изучению влияния физической нагрузки на эпилептогенез. Осуществлен поиск литературы в международных и отечественных базах данных по ключевым словам.РЕЗУЛЬТАТЫ. Выделены основные протекторные (ацидоз, повышение гамма-аминомасляной кислоты (ГАМК), β-эндорфинов и др.) и провоцирующие (гипервентиляция, ишемия и др.) механизмы влияния физической нагрузки на течение эпилепсии. Исследования подтверждают пользу физической активности для качества жизни, эмоционального состояния пациентов с эпилепсией, однако доказательные протоколы нагрузок отсутствуют, необходима разработка эффективных рекомендаций.ЗАКЛЮЧЕНИЕ. Физическая активность – перспективный нефармакологический метод лечения и реабилитации при эпилепсии. Однако необходимы дальнейшие исследования для уточнения механизмов ее действия и разработки научно обоснованных рекомендаций.</p></abstract><trans-abstract xml:lang="en"><p>INTRODUCTION. Physical activity plays an important role in the lives of people with epilepsy and has a positive effect on both physical and mental health. Current research suggests that moderate exercise contributes to better seizure control.AIM. To clarify the mechanisms of influence and polarity of the effect of physical activity on epileptic activity and seizures in epilepsy (following a literature review).MATERIALS AND METHODS. The subject of the study was a scientific work dealing with the study of the effect of physical activity on epileptogenesis. The literature was searched in international and national keyword databases. However, there are no evidence-based exercise protocols. A systematic analysis of data on the effects of physical activity is needed to develop effective recommendations.RESULTS. The main protective (acidosis, increased gamma-aminobutyric acid (GABA), β-endorphins, etc.) and provoking (hyperventilation, ischemia, etc.) mechanisms of the influence of physical activity on the course of epilepsy are identified. Studies confirm the benefits of physical activity on the quality of life and emotional state of patients with epilepsy, but evidencebased exercise protocols are lacking; effective recommendations need to be developed.CONCLUSIONS. Physical activity is a promising non-pharmacological method for the treatment and rehabilitation of epilepsy. However, further studies are needed to clarify the mechanisms of action and to develop evidence-based recommendations.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>эпилепсия</kwd><kwd>физическая нагрузка</kwd><kwd>механизмы</kwd><kwd>реабилитация</kwd></kwd-group><kwd-group xml:lang="en"><kwd>epilepsy</kwd><kwd>physical activity</kwd><kwd>mechanisms</kwd><kwd>rehabilitation</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена в рамках государственного задания № 123021000127-7 «Разработка новой технологии нейрореабилитации пациентов после хирургического лечения фармакорезистентной эпилепсии».</funding-statement><funding-statement xml:lang="en">The work was carried out within the framework of the State assignment No. 123021000127-7 “Development of new technology neurorehabilitation of patients after surgery treatment of drug-resistant epilepsy”.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Odinstova G., Dengina N. 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