Dynamic electric neurostimulation in the cognitive rehabilitation of patients in the early recovery period of ischemic stroke

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Abstract

BACKGROUND: Post-stroke cognitive impairments negatively affect the results of rehabilitation, worsening the outcomes of motor functions recovery, daily activity, and also increase the likelihood of recurrent stroke and premature death. Therapeutic physical factors contribute to the activation of the body's reserve capabilities and aim at correcting metabolic and vascular disorders, improving the functional status of the nervous system, which allows them to be used in a complex of rehabilitation measures.

AIM: to substantiate the use of dynamic electric neurostimulation in the correction of cognitive impairment in patients in the early recovery period of ischemic stroke.

MATERIALS AND METHODS: A prospective cohort study of 60 patients in the early recovery period of ischemic stroke, with mild and moderate cognitive impairment, at an average age of 62.4±4.5 years, divided by random sampling into 3 groups: group 1 (n=25), in addition to the basic rehabilitation complex, which included medication, sessions with a neuropsychologist, massage and physical exercise therapy, received a 15-day course of dynamic electric neurostimulation from the "Neurodance-PCM" device; group 2 (n=20) received the basic rehabilitation complex and procedures from the placebo device similar to procedures on "Neurodance-PCM"; group 3 (n=15) received only the basic rehabilitation treatment. All patients underwent an assessment of cognitive status using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB) and the study of psychophysiological status on the psycho-physiological tester "NS-Psychotest", using the following tests: tapping test, the Schulte–Platonov tables with red-black cells, test of simple visual-motor reaction, reaction to a moving object test.

RESULTS: Over the two-week rehabilitation, it was found that the inclusion of dynamic electrical stimulation, in addition to the standard therapy of cognitive impairment in patients in the early recovery period of ischemic stroke, improves attention, memory, speech fluency, generalization functions, complicated choice reaction, increases the functions of visual attention and the speed of sensorimotor response, which was not noted in the comparison groups.

CONCLUSIONS: The inclusion of dynamic electric neurostimulation in the rehabilitation complex of patients in the early recovery period of ischemic stroke with mild and moderate cognitive impairment may affect cognitive functions by stimulating the third block of the brain according to A.R. Luria and improving the neurodynamic support of higher mental functions.

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About the authors

Viktor A. Drobyshev

Novosibirsk State Medical University

Author for correspondence.
Email: Doctorvik@yandex.ru
ORCID iD: 0000-0002-7093-3071
SPIN-code: 6953-8702

MD, Dr. Sci. (Med.), Professor

Russian Federation, Novosibirsk

Lubov A. Shpagina

Novosibirsk State Medical University

Email: lashpagina@gmail.com
ORCID iD: 0000-0003-0871-7551
SPIN-code: 5773-6649

MD, Dr. Sci. (Med.), Professor

Russian Federation, Novosibirsk

Stanislav G. Abramovich

Irkutsk State Medical Academy of Postgraduate Education ― Russian Medical Academy of Continuing Postgraduate Education

Email: prof.abramovich@yandex.ru
ORCID iD: 0000-0002-4280-9217
SPIN-code: 2407-4146

MD, Dr. Sci. (Med.), Professor

Russian Federation, Irkutsk

Alexandra V. Mashanskaya

Irkutsk State Medical Academy of Postgraduate Education ― Russian Medical Academy of Continuing Postgraduate Education

Email: ale-Mashanskaya@yandex.ru
ORCID iD: 0000-0003-1792-6822
SPIN-code: 7189-3905

MD, Cand. Sci. (Med.)

Russian Federation, Irkutsk

References

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Supplementary files

Supplementary Files
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1. Fig. 1. Indicators of the Montreal Cognitive Assessment in the compared groups before and after rehabilitation.Note: Here and in Fig. 2–4: * Criterion for the reliability of intra-group differences; ^ criterion for the reliability of intergroup differences (p <0.05).

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2. Fig. 2. Indicators of Frontal Assessment Battery in the compared groups before and after rehabilitation.

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3. Fig. 3. The dynamics of "fatigue-performance" indicators by the frequency of taps in the tapping test (Hz) in the compared groups of patients before and after rehabilitation.

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4. Fig. 4. Dynamics of visual attention indicators according to the Schulte–Platonov tables in the compared groups of patients before and after rehabilitation.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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