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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