COMPREHENSIVE TREATMENT OF PATIENTS WITH CHRONIC BRAIN ISCHEMIA. PURPOSEFUL CORRECTION OF COGNITIVE IMPAIRMENT AND RECOVERY OF MOTOR FUNCTIONS AFTER A STROKE

• Published in: Klinichna ta profilaktychna medyt͡s︡yna no. 4; pp. 33 - 43
• Main Authors: Cherniy, T.V., Fokina, D.A., Cherniy, V.I.
• Format: Journal Article
• Language: English
• Published: State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department 20.12.2020
• Subjects: chronic brain ischemia, complex treatment, programmatic stimulation of muscles
• ISSN: 2616-4868; 2616-4868
• DOI: 10.31612/2616-4868.4(14).2020.02

Background. Vascular cerebral pathology, caused by a slowly progressing diffuse insufficiency of blood supply to brain tissue, leads to a progressive impairment of brain function, is a predictor of stroke, shaping the development of immune failure of brain tissue. Perspective direction of protection of the brain from chronic ischemia – direct influence on the systems of neurotransmitters and neuromodulators of the brain, normalization of the ratio of the processes of excitatory and inhibitory neurotransmission, individual approach to the restoration of impaired functions, activation of additional reserves of the brain, based on different treatments. Aim: to develop a method of complex treatment of patients with chronic brain ischemia (CВI), stroke, which includes targeted correction of cognitive impairment and restoration of motor functions. Material and methods. In the period from 2016 to 2019, a total of 118 people aged 51 to 78 years with chronic cerebral ischemia without concomitant hypertension, with a history of hypertension, with CBI and a stroke with a history without movement disorders, and with disorders of arbitrary disorders were comprehensively examined, with the formation of persistent neurological deficit. Among the examined patients were 40 men and 78 women. The diagnosis was confirmed by the data of general clinical, neurological, laboratory, instrumental examination, neuropsychological testing (MMSE, DASS-21). In addition to the protocol, patients with CBI received a complex of drugs aimed at the correction of neurotransmitter metabolism: ipidacrine hydrochloride monohydrate, choline alphoscerate, citicolin for 14 days. In patients with impaired arbitrary movements additionally used the hardware-software complex «Trenar-01» in the program «Donor». Results. Supplementation of the protocol of treatment of patients with CBI in all study groups with a complex of drugs aimed at eliminating cholinergic insufficiency led to the correction of cognitive disorders in chronic brain ischemia. The use of the hardware-software complex «Trenar-01» in the course of treatment repeatedly increases the strength and function of stimulated muscles, which allows normalizing static and motor disorders faster. Conclusion. The complex of drugs aimed at eliminating cholinergic insufficiency, the use of the apparatus for electrical stimulation with biocontrol «Trenar-01» leads to the correction of cognitive impairment and the restoration of arbitrary movements in patients with CBI who have suffered a stroke with motor disorders.