Neuropsychological criteria for diagnosing cognitive impairment in patients with occupational diseases caused by physical factors

Abstract

The aim. To identify neuropsychological signs of a decrease in higher mental functions associated with professional exposure to physical factors.Materials and methods. The study involved 40 patients with vibration disease caused by local vibration (Group 1), 50 patients with vibration disease caused by combined exposure to local and general vibration (Group 2), 71 civil aviation pilots with an established diagnosis of occupational sensorineural hearing loss (Group 3), and 38 healthy men (Group 4, control group). Methods of neuropsychological testing were used.Results. In Groups 1–3 the state of functioning of the cognitive sphere is represented by a mildly pronounced nature of impairments. The results of MMSE and FAB tests in patients of Groups 1–2, when compared with Group 4, determine a decrease in the functional activity of the frontal lobes and subcortical structures (25 (24–27), 25 (22–26), 15 (14–16) and 15 (13–16) points respectively). The most informative feature associated with the fact of occupational exposure to local vibration is the indicator of long-term memory (F = 9.41; р = 0.003); with combined impact of local and general vibration – short-term memory (F = 11.0; р = 0.001); with aircraft noise – objective gnosis (F = 8.48; р = 0.001). The obtained features make it possible to track with a high degree of accuracy the development of a decrease in cognitive functions in this contingent (86.1 %, 84.8 % and 72.1 % respectively).Conclusion. Common signs of changes in the cognitive sphere and lesions of the brain structures in patients with vibration disease are a decrease in praxis, impressive speech, for occupational sensorineural hearing loss – the lack of analytical-synthetic and conceptual thinking, object and finger gnosis, characterizing the inferiority of the functioning of the frontal and parietal regions of the left hemisphere.