PECULIARITIES OF STRUCTURAL CHANGES IN BRAIN OF PATIENTS WITH HYPERTENSION, HYPOTHYROIDISM AND DURING THE COMORBID COURSE OF THESE TWO DISEASES

Abstract

This article presents the investigation of structural parameters of the brain in 67 patients aged 47.23 ± 2.64 years, whose duration of the disease was 13.27 ± 0.75 (from 2 to 19) years. The control group included 18 healthy individuals of the same age (47.84 ± 0.36 years), whose selection was carried out based on the anamnesis and the absence of hypothyroidism and hypertension. According to the data we discussed in our previous publications, during neuropsychological testing we registered memory deterioration in patients with hypertension assessed by the test for learning 10 words according to the method proposed by A.R. Luria (p <0.05), as well as serial counting by the Matisse scale (p <0.05).
 The patients with hypothyroidism were found as demonstrating attention deficiency (p <0.05) by applying the method of "Selectivity of attention" (G. Munsterberg test). For more detailed assessment, we used Schulte tables, the result of which demonstrates the state of the domain of the patient's executive functions and proves the instability of attention. The analysis of the results showed that taking into account the interaction between hypertension and hypothyroidism, the most affected cognitive domains were memory and attention, respectively (p <0.05). To diagnose cognitive and mnestic disorders of all groups, we used MR imaging, measured the transverse dimensions of the medial, lateral (temporal horn) and vertical perihippocampal spaces, and evaluated the volume of gray matter (cortex) of the frontal lobe of the brain in 3 zones. The measurements were performed in the right and left hemispheres.
 There was a significant increase in the indices of the medial and upper perihippocampal right and left in the patients in group III compared with the groups I and II. The lateral perihypocampal index did not differ significantly in the three groups (p> 0.05). Thus, taking into account the interaction of factors (hypertension and hypothyroidism), the patients were found to have an increase in perihippocampal indices (p> 0.05). Based on the data in table 2, in the patients of group I the average value of the frontal lobe was 634.06 ± 10.92. In the patients of group II, the average value of the frontal lobe was 638.6 ± 7.82, and in the patients of group III, the average value of the frontal lobe was 601.3 ± 3,325. There was no statistically significant difference between groups I and II (p = 0.05). But groups I and III demonstrated statistically significant difference between the indicators (p <0.05). We also found a statistically significant difference between groups II and III (p <0.05). Thus, in patients with hypertension, hypothyroidism and hypertension with concomitant hypothyroidism, an increase in perihippocampal indices, a decrease in the volume of gray matter (cortex) of the frontal lobe of the brain (right and left), significantly exceeded possible (involutional or otherwise). Thus, the results of the study indicate that in cases of isolated hypertension, hypothyroidism, and in the comorbidity of hypertension and hypothyroidism, there has been detected a significant acceleration of atrophic processes.