Abstract Funding Acknowledgements Type of funding sources: None. The reduction of the risk of stroke in patients with AF is achieved with the help of continuous administration of oral anticoagulants (OAC). The presence of cognitive impairment in a patient may be a significant risk factor for low adherence to antithrombotic therapy, therefore, the medico-social significance of impaired cognitive functions in patients with AF is high. At the same time, it is still unclear which neurophysiological mechanisms and areas of the brain are responsible for the development of cognitive disorders in this pathology. Thus, further studies are needed to assess the state of higher cortical functions in patients with AF. Materials and methods The study included 50 patients with nonvalvular AF and a high risk of hemorrhagic and ischemic events, with a risk of thromboembolic complications on the CHA2DS2-VASc scale of at least 2 points and a risk of bleeding on the HAS-BLED scale of at least 3 points. The control group consisted of 17 relatively healthy individuals. Research results The analysis of indicators of extended neuropsychological testing made it possible to establish that, compared with healthy individuals of the same age, patients with AF perform worse on tests of neurodynamics, attention and short-term memory, Table. Patients with AF have a lower rate of complex sensorimotor reactions, a greater number of errors, especially in tests with biofeedback (brain performance test). Also, patients with AF have worse performance indicators and higher focused attention depletion (characterized by the number of characters processed in the 1st and 4th minutes of the proofreading test, respectively). As for the indicators of short-term memory, healthy subjects were superior to patients with AF in memorizing meaningless syllables and words, but not numbers. The power indicators of the theta EEG rhythms at rest with eyes closed were taken. The factors were identified - GROUP (2 levels: patients with AF; healthy individuals), AREA (5 levels: (frontal, central, temporal, parietal, occipital) and LATERALITY (2 levels: left, right hemisphere). In patients with cardiac arrhythmias, the increase in the power of the theta-2 rhythm biopotentials in the direction from the anterior to the posterior cortex is significantly pronounced (p = 0.000001), while in healthy individuals the gradient curve is flatter (p = 0.009). Conclusions It was found that about half of the examined AF patients have syndrome mild cognitive impairment (MCI). The most significant cognitive decline in these patients compared with relatively healthy individuals was noted for the speed of sensorimotor response, performance control indicators, and short-term memory, while decreased cognitive test scores were associated with a greater representation of slow waves in the resting EEG, mainly in the posterior regions of the cerebral cortex.
Read full abstract