ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 34 of 55
УЖМБС 2022, 7(5): 219–224
Physical Therapy and Ergotherapy

Cognitive Rehabilitation in Patients with Cerebral Pathology

Kononenko N. M., Chikitkina V. V.

The purpose of the study was to compare the effectiveness of various strategies of cognitive rehabilitation in neurosurgical pathology of the brain. Materials and methods. The dynamics of cognitive impairment was studied in 153 neurosurgical patients (95 men, 70 women, with mean age of 62.1±11.4 years) at stage II of rehabilitation. The severity of the deficiency of higher cortical functions was assessed upon admission and after 30 days in the rehabilitation department. The Roshchina test, the Mini-Mental State Examination, the Food and Behaviour Research, and the Hamilton Depression Rating Scale were used to detect depression. Results and discussion. The problem of diagnosis, treatment and prevention of cerebrovascular and neurodegenerative diseases is considered as an interdisciplinary one. The neurosurgical component of emergency care for patients who have undergone cerebrovascular accidents, in the event of complications, remains the only hope for their survival and reduction of disability. At the same time, in the treatment of these patients, medical rehabilitation is of great importance – a multifaceted, difficult process, the main purpose of which is to restore or compensate for the lost functions of the human body that have arisen as a result of various diseases of the central or peripheral nervous system. But in the literature data there is not enough information about the effect of drug and physiotherapy methods on higher nervous activity. When analyzing the dynamics of indicators of the scoring of higher cortical functions, it was found that in all groups of patients, cognitive rehabilitation led to positive results. The obtained data showed the effectiveness of traditional cognitive rehabilitation in neurosurgical patients by all assessment methods, which was enhanced when combined with drug therapy with memantine and citicoline. The addition of photochromotherapy to restorative treatment significantly improved higher cortical functions compared to a group of patients who received only neuropsychological correction procedures. The indicators of the Mini-Mental State Examination, the Food and Behaviour Research, and Roshchina's test when applying transcranial electromagnetic stimulation against the background of classes with a neuropsychologist were higher, although they were not significantly different from the control group. Similar results were obtained when traditional psychocorrection was replaced by computer training. Conclusion. The combination of neuropsychological, medical and physiotherapeutic methods at the stage of rehabilitation can significantly improve the results of rehabilitation treatment

Keywords: cognitive impairment, neurosurgical pathology, neuropsychological correction, memantine, citicoline, photochromotherapy, transcranial stimulation, computer training

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  1. Mishchenko MM. Natsionalni trendy zakhvoriuvanosti, invalidnosti ta smertnosti vid khvorob systemy krovoobihu ta tserebrovaskuliarnykh zakhvoriuvan [National trends in morbidity, disability and mortality from diseases of the circulatory system and cerebrovascular diseases]. Ukr Zh Med Biol Sportu. 2022;2(36):166-172. [Ukrainian].
  2. Zinchenko OM, Mishchenko TS. Stan nevrolohichnoi sluzhby v Ukraini v 2015 rotsi [The state of the neurological service in Ukraine in 2015]. Kh; 2016. 23 p. [Ukrainian]
  3. Shkolnyk VM, Naumenko LYu, Fesenko HD, Holyk VA, Koval MYe. Naslidky cherepnomozkovoi travmy yak prychyna invalidnosti: problemy ekspertyzy [Consequences of traumatic brain injury as a cause of disability: problems of expertise]. Semeinaia medytsyna. 2015;4(60):85-88. [Ukrainian]
  4. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016 Jun;131(6):803-820. PMID: 27157931.
  5. Rak v Ukraini, 2019-2020. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby [Cancer in Ukraine, 2019 – 2020. Morbidity, mortality, performance indicators of the oncology service]. Biuleten Natsionalnoho kantser-reiestru Ukrainy. 2021;22. Available from: [Ukrainian]
  6. Cappa SF, Benke T, Clarke S, Rossi B, Stemmer B, van Heugten CM. EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. Eur J Neurol. 2005;12(9) 665-680. PMID: 16128867.
  7. Bekker RA, Bіkov YuV. Memantyn: obzor prymenenyia v nevrolohyy [Memantine: a review of its use in neurology]. Psykhyatryia y psykhofarmakoterapyia. 2017;19(1):34-43. [Russian]
  8. Gareri P, Castagna A, Cotroneo AM, Putignano S, De Sarro G, Bruni AC. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives. Clin Intervent Aging. 2015;10:1421-1429. PMID: 26366063. PMCID: PMC4562749.
  9. Abramovych SH, Korovyna EO. Vyzualnaia fotokhromoterapyia u bolnykh hypertonycheskoi bolezniu pozhyloho vozrasta na polyklynycheskom эtape vosstanovytelnoho lechenyia [Visual photochromotherapy in elderly hypertensive patients at the polyclinic stage of rehabilitation treatment]. Syb Med Zh. 2008;2:29-32. [Russian]
  10. Ruban LA, Misiura VB. Fizychna terapiia postinsultnykh khvorykh v rezydualnomu periodi [Physical therapy of post-stroke patients in the residual period]. Naukovyi chasopys NPU imeni MP Drahomanova. 2021;3(133):112-116. [Ukrainian].