Cognitive Disorders In Patients Research Articles

Relationship of neurospecific proteins with neuroimaging and cognitive disorders in patients with obstructive sleep apnea

Relationship of neurospecific proteins with neuroimaging and cognitive disorders in patients with obstructive sleep apnea

Prognostic significance of predictors of early postoperative cognitive disorders in patients after traumatic surgeries (prospective cohort study)

Prognostic significance of predictors of early postoperative cognitive disorders in patients after traumatic surgeries (prospective cohort study)

Characteristics of neurovegetative disorders in ischemic heart disease patients after coronavirus disease 2019 (COVID-19)

The aim of the study. To examine the frequency and spectrum of cognitive, anxiety-depressive, autonomic disorders and their interrelationship in patients with coronary heart disease (CHD) after COVID-19 infection. Materials and methods. The study involved 71 patients with CHD, stable angina pectoris FC II–III (age 69.0 [64.0; 76.0] years): group 1 (main) – 31 CHD patients after COVID-19; group 2 (comparison) – 40 CHD patients without COVID-19 history. Spectral and temporal HRV parameters were assessed using 24-hour Holter ECG monitoring, anxiety-depressive disorders (ADD) – using the HADS scale, cognitive status of patients – according to the MoCa scale. Results. CHD patients after COVID-19 had a higher frequency of ADD detection and a greater anxiety level (16 [10; 24] versus 10 [9; 13] points, p < 0.05), depression (14 [8; 20] versus 11 [10; 12] points, p < 0.05) as compared to patients without previous history of COVID-19. At the same time, the predominance of the anxiety component over the depressive one in patients of both groups has been revealed. In CHD patients after COVID-19, a decrease in the total MoCa scale score has been found as compared to patients without COVID-19: 24 [22; 26] versus 28 [26; 30] points, p < 0.05. There was an association between the total level of anxiety and depression and the severity of cognitive impairment (r = -0.36, p < 0.05). CHD patients exposed to COVID-19 showed an increased sympathetic and parasympathetic tone of the central nervous system within 24 hours, an increased LF/HF ratio during the active period, activation of slow-acting humoral regulation mechanisms amid increasing stress index and centralization index. In the group of patients with CHD after COVID-19, a wide range of correlations between the rate of ADD, cognitive disorders and HRV parameters has been found. Conclusions. Patients with coronary heart disease recovered from COVID-19 have shown an increase in the incidence and degree of ADD and cognitive disorder manifestations which was accompanied by autonomic dysfunction resulting in stress on the functional and adaptive state of the cardiovascular system. The association between ADD, autonomic and cognitive disorders in patients with coronary heart disease after COVID-19 has confirmed the common pathogenetic links of the disorders found.

Effects of esketamine on postoperative negative emotions and early cognitive disorders in patients undergoing non-cardiac thoracic surgery: A randomized controlled trial

Study objectiveTo investigate whether a single dosage of esketamine injection in the anesthesia period could improve postoperative negative emotions and early cognitive function in patients undergoing non-cardiac thoracic surgery. DesignA prospective single center double blinded randomized placebo-controlled trial. SettingPerioperative period; operating room, post anesthesia care unit and hospital ward. Patients129 adult patients that underwent elective non-cardiac thoracic surgery under general anesthesia. InterventionsDuring the operation, pharmacologic prevention of postoperative negative emotion and early cognitive disorder with 0.2 mg/kg (Low esketamine group) and 0.5 mg/kg esketamine (High esketamine group) vs. placebo. MeasurementsEmotion and early cognitive performance were assessed on the day before surgery (POD-1), postoperative day 1 (POD1) and day 3 (POD3) using HADS-A, HADS-D, Pain Visual Analogue Scale (VAS), Confusion Assessment Method (CAM), Mini-Mental State Examination (MMSE), and serum biomarkers (S100β, BDNF, IL-6, acetylcholine, and norepinephrine). Main resultsThe high esketamine group showed significantly lower HADS-A and HADS-D scores than control group on POD1 and POD3. No significant differences were observed between the low esketamine group and the control group. The esketamine-treated groups showed lower pain VAS scores than the control group at 2 h and on the first day after operation. There were no significant differences among the three groups in CAM and MMSE scores. However, the high esketamine group had lower S100β and IL-6 levels, and higher BDNF levels postoperatively, while serum acetylcholine and norepinephrine were not significantly different. ConclusionsA single intraoperative injection of 0.5 mg/kg esketamine can alleviate postoperative anxiety, depression, and pain to some extent. Although cognitive function behavioral evaluation did not show obvious benefits, it can also reduce the production of pro-inflammatory and brain injury-related factors while promoting the generation of brain-derived neurotrophic factor.Registration Trial registry: http://www.chictr.org.cn/; Identifier: ChiCTR2100047067.

Neuropsychological assessment of the morphofunctional organization of humour perception processes

A review of studies analysing the process of humour perception under normal conditions and its disturbances in brain damage is presented. The perception of humour is considered to be a multicomponent mental activity that occurs through a series of cognitive and affective processes characterized by a specific brain organization. The results of studies on the perception of humour in healthy people and in patients with brain damage are largely inconsistent: neuroimaging studies confirm the important role of structures of both hemispheres of the brain, while clinical data indicate a significant contribution of structures of the right hemisphere to the perception of humour. Studies on humour perception in healthy individuals and clinical studies have found no differences between the neuronal correlates of verbal and non-verbal humour perception. A neuropsychological approach to the study of the structure of the process of humour perception may be important for diagnosis of affective and cognitive disorders in patients with brain damage, as difficulties in the perception of humour may reflect disturbances of the most subtle aspects of the functioning and interaction of cognitive and emotional-personal processes.

Efficacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis

IntroductionCognitive impairments present challenges for patients, impacting memory, attention, and problem-solving abilities. Virtual reality (VR) offers innovative ways to enhance cognitive function and well-being. This study explores the effects of VR-based training programs and games on improving cognitive disorders.MethodsPubMed, Scopus, and Web of Science were systematically searched until May 20, 2023. Two researchers selected and extracted data based on inclusion and exclusion criteria, resolving disagreements through consultation with two other authors. Inclusion criteria required studies of individuals with any cognitive disorder engaged in at least one VR-based training session, reporting cognitive impairment data via scales like the MMSE. Only English-published RCTs were considered, while exclusion criteria included materials not primarily focused on the intersection of VR and cognitive disorders. The risk of bias in the included studies was assessed using the MMAT tool. Publication bias was assessed using funnel plots and Egger’s test. The collected data were utilized to calculate the standardized mean differences (Hedges’s g) between the treatment and control groups. The heterogeneity variance was estimated using the Q test and I2 statistic. The analysis was conducted using Stata version 17.0.ResultsTen studies were included in the analysis out of a total of 3,157 retrieved articles. VR had a statistically significant improvement in cognitive impairments among patients (Hedges’s g = 0.42, 95% CI: 0.15, 0.68; p_value = 0.05). games (Hedges’s g = 0.61, 95% CI: 0.30, 0.39; p_value = 0.20) had a more significant impact on cognitive impairment improvement compared to cognitive training programs (Hedges’s g = 0.29, 95% CI: -0.11, 0.69; p_value = 0.24). The type of VR intervention was a significant moderator of the heterogeneity between studies.ConclusionVR-based interventions have demonstrated promise in enhancing cognitive function and addressing cognitive impairment, highlighting their potential as valuable tools in improving care for individuals with cognitive disorders. The findings underscore the relevance of incorporating virtual reality into therapeutic approaches for cognitive disorders.

Chronic traumatic encephalopathy: predictors of the development of cognitive disorders and functional disability

Background. Predicting the individual risk of developing cognitive impairment and functional disability in everyday life among patients with chronic traumatic encephalopathy (CTE) will allow timely and adequate treatment to prevent dementia. Therefore, the study aimed to develop a mathematical model for predicting the risk of cognitive disorders and functional disability in patients with CTE based on the analysis of polymorphic variants of the ACE, AT2R1, eNOS, ePON1, IL-1β, IL-10, TNF-α genes, as well as cofactors (gender, age group, follow-up, presence/absence of somatic comorbidity). Materials and methods. We examined 145 individuals with CTE who were undergoing inpatient treatment in the Communal Non-Profit Enterprise “Ternopil Regional Clinical Psychoneurological Hospital” in 2021–2022 and were included in the retrospective analysis. The molecular and genetic testing was performed for 26 patients. The molecular and genetic differentiation of the studied polymorphic variants of genes was carried out in the molecular and genetic laboratory of the State Institution “Reference Centre for Molecular Diagnostics of the Ministry of Health of Ukraine” in Kyiv. Cognitive functions were studied using the Montreal Cognitive Assessment (MoCA), activities of daily living — with the Barthel index. Statistical analysis was done using Microsoft Excel and Statistica 13.0 computer software. A logistic regression analysis was performed to determine the likelihood of cognitive impairment and functional disability in patients with CTE. Results. When analyzing polymorphic variants of the ACE, AT2R1, eNOS, ePON1, IL-1β, IL-10, TNF-α genes, as well as such cofactors as gender, age group, follow-up, presence/absence of somatic comorbidity in the context of the development of cognitive disorders in patients with CTE, it has been found that the I/D polymorphism of the ACE gene has the most significant prognostic value (in the presence of the D/D genotype, the probability of cognitive impairment is 83.33 %). At the same time, patients with CTE who were carriers of the D allele of the ACE gene had a significant decrease in the MoCA score compared to the group of those who didn’t carry this allele. Regarding the development of functional disability in patients with CTE, the C108T polymorphism of the PON1 gene has the most significant prognostic value (in the presence of the T/T genotype, the risk of functional disability is 41.49 %, with significantly lower Barthel index compared to the C/C homozygotes). Conclusions. It was found that the I/D polymorphism of the ACE gene and the C108T polymorphism of the PON1 gene are likely associated with the development of cognitive impairment and functional disability in patients with CTE that indicates the feasibility of further studies involving a larger sample of patients.

Sensorimotor Rehabilitation and Psychotherapeutic Techniques Effect on the Psychoemotional State in the Stroke Recovery Period

INTRODUCTION. Stroke is the leading cause of disability of the population. In addition to motor disorders, cognitive and affective disorders contribute to the development of disability. The development of effective neurorehabilitation programs aimed not only at reducing the severity of motor deficits, but also at timely correction of psychoemotional disorders in stroke patients is very relevant for restorative medicine. In view of the proven positive therapeutic effect of physical exercises on anxiety and depression, their protective effect on cognitive functions, it is of interest to study the effect of motor rehabilitation on psychoemotional disorders in stroke patients.
 AIM. To study the effect of sensorimotor rehabilitation on affective and cognitive disorders in patients in the recovery period of stroke in comparison with a complex psychotherapeutic technique.
 MATERIALS AND METHODS. The study examined 2 groups of patients in the recovery period of ischemic stroke (up to 2 years) with the presence of anxiety and/or depressive disorders, comparable in gender, age, duration and focus of stroke localization, severity of neurological deficit. The 1st group — 24 patients — received a course of sensorimotor rehabilitation without targeted impact on affective disorders; the 2nd group — 25 patients — a course of complex medical and psychological adaptation lasting 18 days. The effectiveness of rehabilitation was assessed using validated scales and questionnaires (Rivermead Mobility Index, 6-point muscle strength assessment scale, modified Ashfort spasticity scale; Berg balance scales, Beck depression, Spielberger-Khanin anxiety, MMSE, MoCA; Schulte Table Methodology, SS-QOL Stroke Quality of Life Assessment Scale). Statistical analysis was carried out using the StatTech v. 2.8.8 program (developed by Stattech LLC, Russia).
 RESULTS AND DISCUSSION. The preliminary assessment carried out in both groups showed a twofold predominance of anxiety states over depressive ones, concomitant cognitive impairments were detected in 88 % of patients, among whom attention disorders were most often recorded (there was no intergroup difference in these indicators). After completing the course of both sensorimotor and medico-psychological rehabilitation, both groups showed a significant decrease in the level of situational and personal anxiety on the Spielberger-Khanin scale, positive dynamics on the MoСа scale, the SS-QOL questionnaire, while a significant decrease in the level of depression on the Beck scale was registered only in patients of the 2nd group on against the background of the use of specialized psychotherapeutic techniques.
 CONCLUSION. Motor rehabilitation is positively comparable with complex medical and psychological adaptation, it affects anxiety and cognitive functions in patients with ischemic stroke, it can be considered as one of the effective ways to correct anxiety states and prevent cognitive impairment in these patients, while in the treatment of depression the priority is should be given to specialized medical and psychological intervention.

CHRONIC ALCOHOL-INDUCED ENCEPHALOPATHY: PREDICTORS OF COGNITIVE IMPAIRMENT AND FUNCTIONAL DISABILITY

Introduction: Predicting the risk of cognitive dysfunction and disability in everyday life among chronic alcohol-induced encephalopathy (CAIE) patients allows timely treatment to prevent dementia.
 The aim: to develop a mathematical model for predicting the risk of developing cognitive disorders and functional disability in patients with CAIE based on the analysis of polymorphic variants of the genes ACE, AT2R1, eNOS, PON1, IL-1β, IL-10, TNF-α, as well as cofactors (gender, age group, the disease duration, and presence/absence of somatic comorbidity).
 Materials and methods: We examined the 102 patients with CAIE who were undergoing inpatient treatment in the communal non-profit enterprise «Ternopil Regional Clinical Psychoneurological Hospital» during 2021-2022 and were included in the retrospective analysis. The molecular-genetic testing was performed for 26 patients of the general group. The molecular-genetic differentiation of the studied polymorphic variants of genes was carried out in the molecular-genetic laboratory of the state institution «Reference Centre for Molecular Diagnostics of the Ministry of Health of Ukraine», Kyiv. Cognitive functions were assessed using the Montreal Cognitive Test (MoCA); activities of daily living were assessed using the Barthel index. A logistic regression analysis was performed to determine the risk of cognitive impairment and functional disability developing in patients with CAIE.
 Results: Analyzing polymorphic variants of the ACE, AT2R1, eNOS, PON1, IL-1β, IL-10, TNF-α genes, as well as such cofactors as gender, age group, history and presence/absence of somatic comorbidity in the context of the development of cognitive disorders in patients with CAIE it has been established that the C108T polymorphism of the PON1 gene has the most significant prognostic value (in the presence of the T/T genotype, the probability of cognitive impairment is 39.84 %). At the same time, carriage of both the T allele and the C allele of the PON1 gene is associated with a significant decrease in the MoCA score. Regarding the development of functional disability in patients with CAIE, the C108T polymorphism of the PON1 gene also has the most significant prognostic value (in the presence of the T/T genotype, the probability of functional disability is 48.08 %, respectively, C/C – 30.96 % and CT – 39.22 %, however, no statistically significant differences in the Barthel index values were found in carriers of the above genotypes).
 Conclusions: It was established that the C108T polymorphism of the PON1 gene is significantly associated with the development of cognitive impairment and functional disability in patients with CAIE, which indicates the feasibility of further studies involving a larger sample of patients.

Effect of oxidative stress on moderate cognitive disorders in patients with vascular risks

Effect of oxidative stress on moderate cognitive disorders in patients with vascular risks

Cognitive disorders in patients with chronic kidney disease(CKD) and its relationship with the concentration in the blood of the biomarker of kidney damage cystatin C

Cognitive disorders in patients with chronic kidney disease(CKD) and its relationship with the concentration in the blood of the biomarker of kidney damage cystatin C

Impact of rehabilitation measures on patients, who have undergone COVID-19, in post-acute period

COVID-19 infection is associated with many different complications. The consequences of COVID-19 infection affect the quality of life and cause emotional distress. Rehabilitation activities for various groups of patients who have undergone COVID-19 are of great importance from several aspects. Each patient must be fully evaluated by the rehabilitation team. Together with the patient, the team should develop rehabilitation goals, taking into account the wishes of the patient. The direct impact of COVID-19, its consequences and comorbidities determine the medical rehabilitation plan. It is necessary to assess the state of physical, cognitive, emotional disorders.The purpose of the study. To determine the dynamics of anxiety-depressive and cognitive disorders in patients who have undergone COVID-19, using individual rehabilitation programs.Research methods. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety-depressive disorders, and the Mini-Mental State Examination (MMSE) was used to identify cognitive impairment. A special rehabilitation scale for patient routing was used to assess the patient's condition, determine management and routing tactics.Conclusions. Individually tailored post-acute multidisciplinary rehabilitation is associated with clinical and functional improvements in patients who have experienced varying degrees of severity of COVID-19.

Cognitive disorders in patients with atrial fibrillation

Atrial fibrillation (AF) is one of the most common arrhythmias, and its prevalence increases with age. Cognitive impairment (CI) is a frequent concomitant disorder in AF and is an additional factor in reducing the quality of life and adherence to treatment in such patients. AF is associated with an increased risk of dementia in patients with and without history of stroke. It is well known that AF and CI share common risk factors such as age, hypertension, diabetes, dyslipidemia, obstructive sleep apnea, coronary heart disease, heart failure, chronic kidney disease, obesity, etc. The available data show that AF and CI have common pathophysiological factors, which, in addition to stroke, include hypoperfusion, microhemorrhages, brain atrophy, systemic atherosclerotic vascular damage, endothelial dysfunction, and inflammation. Screening neuropsychological scales might be used to assess the state of cognitive functions in patients with AF, and contemporary neuroimaging methods allow detecting structural changes in the brain. Specific methods of treatment of CI in AF have not yet been developed. Optimal antithrombotic therapy is the main means of prevention of cerebrovascular events, and therefore CI in AF.

Cognitive Disorders in Patients with Hypertension: Are There Gender Differences?

Background: Given the profound differences between women and men, there is a need to study gender as a vital variable and factor in blood pressure regulation, control, and treatment. The level of anxiety and depression, which significantly affect the psychological characteristics and patients' quality of life, and the status of the autonomic nervous system represent a rather significant layer of hypertension problems due to its specificity, accumulating its medical, social, gender, and humanitarian aspects, which are related to sexual characteristics.
 Material and Methods: The study results are based on the data of a comprehensive examination of 185 working patients with controlled hypertension (H) stage II. According to the neuro-psychological testing on MMSE, МоСА and Life Quality scales, 157 people with various severity cognitive disorders (CD) were found. There were 87 (55.4 %) women and 70 (44.6 %) men among them, and the average age [M(SD)] was 52.3 (8.2) years; the average duration of H was 10 (8-12 years). The comparison and control groups were adequate for the purpose. The standard methods of parametric and non-parametric statistics processed the obtained data. 
 Results: As a result of the study, significant differences were found in patients with hypertension and CD of both sexes compared with healthy individuals and patients with hypertension without cognitive impairment in relation to the daily blood pressure profile (VAR SBP, VAR DBP) both during the day and at night. The females, even middle-aged, with controlled hypertension but high systolic blood pressure variability, have a substantial risk of developing CD. Male patients with hypertension, even in the absence of CD, are more prone to depression, according to the HADS scale. In the presence of hypertension with CD, they are characterized by significantly worse personal-role physical and emotional functioning compared to female patients on the life quality scale. The often irresponsible attitude of men to the doctor's advice and regular antihypertensive treatment probably plays a significant role in the formation of gender differences in the quality of life of patients with hypertension and CD.
 Conclusion: It is necessary to ensure early diagnosis and monitoring of CD as a marker of brain damage due to hypertension and determine the level of anxiety and depression, which significantly affect the psychological characteristics and quality of life even of patients with controlled hypertension, regardless of gender. However, middle-aged women, even with controlled hypertension but high SBP variability, have a priority risk of CD development.

Cognitive disorders in patients with atrial fibrillation: A review

Cognitive disorders (CD) represent one of the leading causes of disability among the elderly. Atrial fibrillation (AF) is an independent and corrected risk factor for CD and dementia. The development of CD with AF is associated with the occurrence of cerebral infarcts, silent infarcts, cerebral micro and macro hemorrhages, a cerebral small vessels disease, cerebral hypoperfusion, and comorbid neurodegenerative disease. The prevention of the first and recurrent ischemic stroke (IS) is the leading importance in preventing the development and progression of the CD in AF, which include the use of the vitamin K antagonists (VKA) and new oral anticoagulants (the NOACs apixaban, dabigatran, rivaroxaban, edoxaban), control of arterial pressure and other methods of prevention. The use of the NOACs is more effective than using VKA, reduces the risk of CD and dementia. The use of individual NOACs, various methods for the prevention of CD and Alzheimer's disease in patients with AF are discussed.

Cognitive disorders in patients with chronic kidney disease: Approaches to prevention and treatment.

Cognitive impairment is common in patients with chronic kidney disease (CKD), and early intervention may prevent the progression of this condition. Here, we review interventions for the complications of CKD (anemia, secondary hyperparathyroidism, metabolic acidosis, harmful effects of dialysis, the accumulation of uremic toxins) and for prevention of vascular events, interventions that may potentially be protective against cognitive impairment. Furthermore, we discuss non-pharmacological and pharmacological methods to prevent cognitive impairment and/or minimize the latter's impact on CKD patients' daily lives.

Cognitive impairment in the acute period of cardioembolic stroke

Background. Acute disorders of cerebral circulation are one of the most urgent problems of modern clinical neurology. Its significance is due to both the high frequency of occurrence and a large number of unsatisfactory outcomes, as well as the significant impact on the quality of life. Cognitive disorders are one of the main syndromes that manifest in post-stroke period and are associated with the rehabilitation potential, as well as opportunities for social and household adaptation. Our objective was to study the profile of cognitive impairment in a continuous sample of patients with cardioembolic stroke in the acute period of stroke, as well as to determine the correlations between their occurrence and the factors determining the course of the disease. Design and methods. The study involved 46 patients of both sexes in the acute stage of ischemic stroke (average age was 69 ± 11 years). The selection of patients was carried out in accordance with the diagnostic criteria of the International Association of Vascular Behavioral and Cognitive Disorders VASCOG. The results of the Hachinski scale were also considered. All patients underwent interview for history, complaints, as well as the assessment of the neurological status. Risk factors for stroke were evaluated. We also assessed the results of computer and magnetic resonance imaging, standard “stroke” scales and performed a neuropsychological examination aimed at a comprehensive study of cognitive functions. All studies were conducted at the end of 10-14 days from the development of focal neurological symptoms. Results. Cognitive disorders in patients with cardioembolic ischemic stroke turned out to be quite heterogeneous. Their severity in the majority of our patients was considered as mild cognitive impairment. Changes at dementia level were much less common and were characteristic of patients with extensive lesions or in the case of disorders in the field of cognitively significant “strategic” foci. Neurodynamic disorders predominated in the profile of disorders of higher cortical functions. Memory impairment was expressed slightly and was of a secondary nature. With the aggravation of cognitive disorders, mnestic disorders progressed. In addition, regulatory disorders began to be detected. The most significant correlations were found between the results of neurocognitive tests on the one hand and the assessment on the Bartel scales, the assessment of changes in white matter, as well as the volume of the necrosis focus, the presence of heart failure and dyscirculatory encephalopathy in the anamnesis. Conclusions. Cognitive impairment is a significant component of the clinical picture of cardioembolic stroke. Their severity is largely determined by the volume and topical localization of the ischemic focus, as well as the presence and severity of previous chronic cerebrovascular pathology. This determines the need to develop methods to assess the state of cognitive functions before the development of stroke.

Possibilities of personalized pharmacotherapy and medical rehabilitation of patients with long COVID from the perspective of clinical metabolomics

Introduction. The material presents the results of the study of the effectiveness of the drug Ethylmethylhydroxypyridine malate in patients with long COVID, based on the dynamics of clinical manifestations and metabolomic parameters responsible for the level of oxidative stress. Aim. Evaluation of efficacy and registration of adverse reactions of ethylmethylhydroxypyridine malate administration to decrease oxidative stress level and reduce symptoms of asthenia and cognitive disorders in patients with long COVID. Materials and methods. 24 patients diagnosed with U09.9 “Condition after COVID-19 unspecified” were included in a non-randomized controlled prospective study, Patients were divided into 2 groups of 12 each. The experimental group received Ethylmethylhydroxypyridine malate tablets chewable 100 mg in a dosage of 400 mg/day. Clinical assessment by scales (mMRC dyspnea scale; 6-minute walk test (6MWT); MFI-20 subjective asthenia assessment scale; Montreal Cognitive Assessment Scale (MoCA); Barthel Baseline Functional Activity Rating Scale), and determination of metabolomic parameters were performed on days 1 and 14–18 of the study. Results. Use of the drug ethylmethylhydroxypyridine malate in patients with long COVID, led to a decrease in the level of oxidative stress, and normalization of mitochondrial function, as well as more pronounced improvements of the clinical picture. According to the scale of evaluation of asthenia (MFI-20) in the group of patients who received ethylmethylhydroxypyridine malate improvement of 21% was noted, in the control group improvement of 13% was noted. According to cognitive impairment assessment scale (MoCA), the drug group showed 20% improvement, while the control group showed 12,5% improvement. Conclusion. The drug ethylmethylhydroxypyridine malate tablets chewable 100 mg in a dosage of 400 mg/day demonstrates clinical efficacy characterized by, among other things, a decrease in oxidative stress, as well as clinical safety due to the absence of development of adverse reactions in patients with long COVID.

The complex influence of the combination of the BDNF (rs6265), VDR (rs2228570), and NMDA (rs4880213) genotypes on the development of cognitive disorders in patients with autoimmune thyroiditis andhypothyroidism

Background. Numerous studies have demonstrated that thyroid conditions can affect cognitive function. Gene polymorphisms associated with pathology of the endocrine and nervous system have ethnic and population specificity, which determines the need to study them in a certain region. The purpose of the study was to investigate the combined impact of the BDNF (rs6265), VDR (rs2228570), and NMDA (rs4880213) gene polymorphisms on cognitive impairment in patients with autoimmune thyroiditis and hypothyroidism among the population of Western regions of Ukraine, and to predict the onset of cognitive disorders. Materials and methods. The study involved a total of 153 patients with autoimmune thyroiditis and hypothyroidism. Genotyping of the VDR (rs2228570), BDNF (rs6265), and NMDA (rs4880213) gene polymorphism using TaqMan probes and TaqMan Genotyping Master Mix (4371355) was performed on CFX96™ Real-Time PCR Detection System (Bio-Rad Laboratories, Inc., USA). Polymerase chain reaction for TaqMan genotyping was carried out according to the kit instructions (Applied Biosystems, USA). We detect a decline in cognitive function using the Mini-Mental State Examination. Results. Carrying a combination of CC/AG/CC genotypes significantly reduces the risk of developing cognitive impairment (odds ratio (OR)=0.1410; 95% confidence interval (CI) 0.0181–1.0965; p=0.0416). At the same time, carrying a combination of CT/AG/CT genotypes increases the risk of cognitive impairment by more than 5 times (OR=5.1915; 95% CI 1.2471–21.6107; p=0.0214) and a combination of CT/AG/TT genotypes — by 10 times (OR=10.1224; 95% CI 1.1037–92.8401; p=0.0281). Carriers of the CT/AA/CT genotype combination have a 6.4-fold increased risk of cognitive impairment (OR=6.4062; 95% CI 1.2019–34.1471; p=0.0253). Conclusions. Among patients with autoimmune thyroiditis and hypothyroidism, carriers of the CC/AG/CC genotype combination of the BDNF (rs6265), VDR (rs2228570) and NMDA (rs4880213) genes have a reduced risk of developing cognitive disorders, while carriers of the CT/AG/CT, CT/AG/TT and CT/AA/CT have an increased risk of cognitive impairment.

Methodological Problems of Psychometric Tests in Clinical Studies of Cognitive Disorders in Patients with Cerebral Vascular Lesions: a Review

AIM. To assess cognitive dysfunction in clinical practice, depending on the task being solved in the examination, different neuropsychological research methods are used. To identify the specific cause of the dysfunctions in the structure of various mental functions (neuropsychological characteristics of the defect) and in the brain functions (topical diagnosis), methods of qualitative analysis of the detected symptoms of the disorder are used. Psychometric (quantitative) methods are used to assess numerically the severity of disorders and the dynamics of changes in the state of individual mental functions, as well as for screening assessment of e possible cognitive decline level in general. Methods of cognitive dysfunctions qualitative assessment are focused on the search for a «missing link» in the structure of the examined mental functions. Psychometric tests, in most cases, describe the general state of either individual mental functions, or, in the case of screening, a set of cognitive functions. Thus, one or more aspects of mental functions are evaluated, in which several cognitive functions are involved at once. The article presents the results of a literature review with a description and analysis of preferences, methods used and corresponding techniques for neuropsychological examination of cognitive disorders in domestic clinical practice in vascular brain lesions.