RESUMEN
OBJECTIVE: The dependence of result of cognitive training in patients who have suffered an ischemic stroke (IS) on the timing of their onset continues to be discussed. The aim was to study the results of cognitive rehabilitation of patients after IS during various periods after it. MATERIAL AND METHODS: 140 patients were examined during complex rehabilitation in terms up to 1, 2-3, 4-6 and 7-12 months after IS, 78 of them received drug support (DS) of rehabilitation with intravenous injections of ampasse. The Montreal Cognitive Assessment (MoCA) and Hospital Anxiety and Depression Scale (HADS) were used to monitor the effectiveness of rehabilitation. RESULTS: In all subgroups, there was a statistically significant increase in the MoCA score after the course, but number of people with an increase in the score by 1 or more points was highest among those who started the course 3 or more months after the development of IS (p=0.015). Among those who received DS, an increase in the MoCA was noted in 87.2%, in those who did not receive it - 38.7% (p<0.001). There was no statistically significant increase in the severity of anxiety and depression after the course of treatment in any of the subgroups. CONCLUSION: The used approach of a combination of cognitive, physical rehabilitation and DS proved to be justified for achieving results during a two-week course of inpatient rehabilitation of patients both in the early and late recovery period after IS.
Asunto(s)
Accidente Cerebrovascular Isquémico , Humanos , Entrenamiento Cognitivo , Ansiedad/etiología , Trastornos de Ansiedad , Inyecciones IntravenosasRESUMEN
OBJECTIVE: To develop a method for assessing neurodynamic disorders in the acute period of stroke. MATERIAL AND METHODS: Sixty-three right-handed patients in the acute period of ischemic stroke (IS) were examined, including 28 patients with IS in the basin of the left middle cerebral artery (LMCA) (group 1), 19 patients with IS in the basin of the right middle cerebral artery (group 2) and 16 patients with IS in the vertebrobasilar system (group 3). The control group consisted of 37 healthy individuals. The «Tapping Test¼ technique developed by E.P. Ilyin was used to assess the strength of nervous processes. The mobility of nervous processes was determined by a complex sensorimotor reaction of discrimination. To assess the balance of the processes of excitation and inhibition, a complex sensorimotor reaction to a moving object was used. RESULTS: There was a significant decrease in the strength of nervous processes in the patients compared to the control group (p<0.0001), more pronounced in IS in LMCA. When checking the mobility of nervous processes in patients of groups 1 and 2, the number of errors was statistically significantly higher than in the control group (inertness of nervous processes). These indicators were the highest in patients with IS in LMCA while in patients of group 3 the lowest values, approaching the data of healthy individuals, were noted. When checking the balance of nervous processes, torpidity of reactions was noted in patients of group 1, torpidity when performing the test with a paretic hand was noted in group 2. In group 3 these indicators approach the data of healthy individuals, which reflected the approximate balance of the processes of excitation and inhibition. CONCLUSION: In the study of neurodynamic processes in patients in the acute period of IS, there was a decrease in strength, inertness, and torpidity of the mobility of nervous processes, more pronounced in the damage of the dominant hemisphere. It can be assumed that in the origin of these shifts in patients in the acute period of IS, a diaschisis plays an important role, and with left-sided localization of IS, not only the focal, but also its connective, transcallosal form.
Asunto(s)
Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular/complicaciones , ManoRESUMEN
In recent years, brain-computer interfaces have been widely used in neurorehabilitation, and an extensive database of results from clinical studies conducted around the world has been accumulated, demonstrating their effectiveness in restoring motor function after a stroke. Currently, their use in post-stroke cognitive impairment is expanding. This article discusses the potential and prospects for using brain-computer interfaces for the treatment of cognitive disorders, reviews the experience of using it, presents the results of clinical studies in stroke patients, evaluates the possibilities of using this technology, describes the prospects, new directions of work on studying its effects.
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Interfaces Cerebro-Computador , Disfunción Cognitiva , Rehabilitación Neurológica , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Humanos , Rehabilitación de Accidente Cerebrovascular/métodos , Disfunción Cognitiva/etiologíaRESUMEN
OBJECTIVE: To study the effectiveness of brain-computer interfaces (BCI) and cognitive training using computer technologies in restoring cognitive functions in poststroke patients. MATERIAL AND METHODS: Thirty-four stroke patients (mean age 59.3±10.8 years) with stroke duration of 5.1±4.7 months, were included. To assess the effectiveness of treatment, patients before and after treatment were tested using memorization of words according to the method of Luria A.R. «10 words¼, the Montreal Cognitive Assessment Scale (MoCA), the Clock Drawing Test (CDT). All patients received standard rehabilitation therapy (exercise therapy, physiotherapy, sessions with a speech therapist-neuropsychologist). Patients of the first group additionally received training on the «Neurochat¼ complex, patients of the second group - on the «Exokist-2¼ complex, patients of the third group - cognitive training according to standard programs using computer technology and visual material. RESULTS: Patients of the three groups showed a significant improvement in the total MoCA score: in the 1st and 2nd groups - p<0.01, in the 3rd group - p<0.05. According to CDT, there was a significant change in the 2nd group (p=0.018). The Luria method «10 words¼ revealed an improvement in memory in all groups (p<0.01, p<0.05), being more pronounced in the 1st and 2nd groups. CONCLUSION: The effectiveness of BCI in restoring cognitive functions in patients after a stroke in comparison with cognitive training without BCI has been demonstrated. However, there are reasons to believe that various BCIs have a specific effect on cognitive functions and have their own target group.
Asunto(s)
Interfaces Cerebro-Computador , Entrenamiento Cognitivo , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Anciano , Humanos , Persona de Mediana Edad , Cognición , Computadores , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular/métodosRESUMEN
OBJECTIVE: Study of the effectiveness of the use of the drug Ampasse in the process of complex rehabilitation in patients in the early recovery period of ischemic stroke at the second (stationary) stage. MATERIAL AND METHODS: The study included 60 patients, 28 women and 32 men, aged 43 to 76 years (mean - 58.4±9.1 years), in the recovery period after suffering a stroke in the period from 1 to 12 months (on average - 4.7±3.5 months). All patients received complex rehabilitation, patients of the 1st group received additional intravenous injections of the drug Ampasse 25 mg (5.0 ml), 15 injections. Patients of the 2nd group (n 0) did not receive Ampasse. To assess cognitive functions, the following tests were used: the Montreal Cognitive Assessment Scale (MoCA), Stroop's test, subtest 9 of the Wechsler test, Koos cubes (CC), the severity of anxiety and depression was assessed, and motor recovery was assessed by the hand motor activity test (ARAT). The assessment was carried out before the start of treatment and on the 21st day. RESULTS: There was a statistically significant increase in the score on the MoCA scale, in patients of the 1st group by an average of 2 points, in the 2nd group there was no significant dynamics, a statistically significant difference was found in the proportion of patients who had an increase in the MoCA index after the course of treatment in the 1st group. compared with the 2nd (χ2 - 22.528, p<0.001). Decreased the level of rigidity according to the Stroop test in patients of the 1st group compared with the 2nd (χ2 - 8.297, p=0.004). The number of patients who showed positive dynamics in the Koos cubes test in the 1st group was statistically significantly higher (χ2- 4.344, p=0.038). A statistically significant decrease in the level of depression was revealed in patients of the 1st group. The number of patients with improved motor function of the hand was greater in the 1st group of MG (χ2 - 4.286, p<0.039). CONCLUSION: In patients in complex therapy receiving intravenous administration of the drug Ampasse at a dose of 25 mg (5.0 ml) 15 administrations, a statistically significant improvement in cognitive functions was revealed according to MoCA tests, Stroop test, Koos Cubes, when compared with the comparison group. The use of Ampasse increased the effectiveness of cognitive and motor rehabilitation in patients with post-stroke disorders.
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Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Isquemia Encefálica/complicaciones , Isquemia Encefálica/tratamiento farmacológico , Cognición , Femenino , Humanos , Masculino , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Cerebral stroke is one of the leading causes of disability in the modern world. Despite the high efficacy of high-tech treatment methods, the issue of rehabilitation is extremely relevant for post-stroke patients. Much attention is paid to non-pharmacological approaches; their use in the treatment process seems to be very promising. The review presents therapeutic approaches aimed at increasing the plasticity of the brain, including rhythmic transcranial magnetic stimulation, direct current stimulation, training with a speech therapist-neuropsychologist, computerized cognitive training, biofeedback techniques for support response, electroencephalogram, high-tech approaches using virtual reality, interfaces brain-computer, art therapy, music therapy, various complexes of physical exercises.
Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Encéfalo , Cognición , Humanos , Accidente Cerebrovascular/terapia , Estimulación Magnética TranscranealRESUMEN
Experiments on isolated neurons of Lymnaea stagnalis and Planorbis corneus using the intracellular dialysis and fixed membrane potential techniques showed that strophanthin G in a concentration range from 10(-11) to 10(-6) M produce dolse-dependent reversible suppression of the ion currents in potassium, calcium, and sodium channels. At the maximum concentration (10(-6) M), the maximum suppression (up to 55% of that in the control) was observed for the calcium ion current. At the minimum concentration (10(-12) M), the drug did not influence the sodium ion current, but slightly (approximately by 5%) increased the calcium and potassium ion currents. In addition, strophanthin accelerated the inactivation of slow potassium ion currents.
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Cardiotónicos/farmacología , Gastrópodos/fisiología , Neuronas/fisiología , Estrofantinas/farmacología , Animales , Calcio/fisiología , Gastrópodos/efectos de los fármacos , Técnicas In Vitro , Activación del Canal Iónico , Canales Iónicos/fisiología , Lymnaea/efectos de los fármacos , Lymnaea/fisiología , Potenciales de la Membrana , Neuronas/efectos de los fármacos , Potasio/fisiología , Sodio/fisiologíaAsunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Servicios Médicos de Urgencia/métodos , Hipertensión/tratamiento farmacológico , Antihipertensivos/administración & dosificación , Gasto Cardíaco/efectos de los fármacos , Humanos , Hipertensión/complicaciones , Hipertensión/etiología , Resultado del Tratamiento , Resistencia Vascular/efectos de los fármacosRESUMEN
Aquatic-phenol trichloroacetic and salt extracts of Pseudomonas aeruginosa have been studied for their effect on hypersensitivity of the delayed type to guinea pig antigen in mice. It is found that salt extracts of wild strains contain thermostable immunosuppressive factors which are of the lipid nature, have high molecular weight and can be inactivated by trichloroacetic acid and phenol. The salt extracts of museum strains as well as aquatic-phenol and trichloroacetic extracts obtained from wild and museum strains had no immunosuppressive activity.
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Factores Biológicos/farmacología , Tolerancia Inmunológica/efectos de los fármacos , Pseudomonas aeruginosa/patogenicidad , Animales , Antígenos Bacterianos/inmunología , Factores Biológicos/aislamiento & purificación , Cobayas , Humanos , Hipersensibilidad Tardía/etiología , Hipersensibilidad Tardía/inmunología , Tolerancia Inmunológica/inmunología , Inmunidad Celular/efectos de los fármacos , Inmunidad Celular/inmunología , Macrófagos/inmunología , Ratones , Ratones Endogámicos CBA , Pseudomonas aeruginosa/inmunología , Pseudomonas aeruginosa/aislamiento & purificación , Bazo/inmunologíaRESUMEN
Experiments in mice showed influenza virus and adenovirus to inhibit the secondary and the primary immune response to thymus-dependent antigens and not to influence production of antibodies to thymus-independent antigens.