Dynamics of the cognitive sphere indicators and neurotrophic factors in the course of balneotherapy of dyscirculatory encephalopathy

Abstract

The natural factors of therapeutic significance play an important role in the rehabilitation of the patients suffering from chronic disorders of cerebral circulation since they are known to promote the development of the compensatory and adaptive processes. However, there is virtually no information in the relevant literature publications about the influence of balneotherapy on the dynamics of the cognitive sphere indicators and neurotrophic factors. The objective of the present study was to evaluate the effectiveness of balneotherapy as a component of the combined treatment of the patients presenting with discirculatory encephalopathy based on the investigations into dynamics of the neuropsychological status and the quantitative content of the neurotrophic factors in the peripheral blood, with special reference to the brain-derived neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF), in the patients receiving the balneotherapeutic treatment based at they at the 'Kluchi' health resort. A total of 72 patients presenting with the 1st and 2nd stages of chronic cerebral ischemia were examined (including 9 men and 63 women at the mean age of 62.2±2.1 years). They were given the health resort -based treatment during 14 days while staying at the 'Kluchi' resort located in the Perm region. The examination of all the patients included the psychometric testing and the determination of blood serum neurotrophic factors (BDNF and CNTF). The patients were allocated to three groups depending on the character of the prescribed treatment. The first group consisted of 29 subjects, who were given the conventional therapy (the alternation of hydrogen sulphide muds and baths number 7, daily massage of the neck-collar region in the combination with exercise therapy). The second group was comprised of 32 persons who received the standard course of chloride-sodium bromine baths number 7. The third group was composed of 11 persons suffering from chronic cerebral ischemia who received no balneo- or peloid therapy whatever. The study has revealed the different stages of cognitive and emotional disorders combined with the initially reduced level of BDNF in the blood serum of the examined patients. The level of BDNF in the peripheral blood of the patients comprising the first group increased from 3.68±2.15 to 5.02±2.88 ng/ml after the course of balneotherapy. These values were significantly higher than before the treatment (p=0.000). In the patients of the second group, the level of situational and personal anxiety estimated with the use of the Spielberger-Khanin test decreased in association with the improvement in the cognitive sphere after they received the standard course of balneotherapy including the usual chloride-sodium bromine baths. Simultaneously, the level of BDNF in the peripheral blood of these patents increased from 4.00±2.3 to 5.39±2.44 ng/ml (p=0.02). The patients of the third group, who were given no treatment whatever displayed no statistically significant changes of the studied parameters. The health resort-based treatment including the course of chloride-sodium bromine baths has a direct beneficial influence on the neuroreparative and neuroprotective functions in the patients presenting with chronic cerebral ischemia owing to the increase in the level of neurotrophic factors in the blood.