[Immunological and neuroanatomic markers of the clinical dynamics of MCI and pre-MCI]. / Immunologicheskie i neiroanatomicheskie markery dinamiki dodementnykh kognitivnykh rasstroistv pri neiroreabilitatsii.

OBJECTIVE: To study the relationship of the parameters of immunity and systemic inflammation with the structural magnetic resonance imaging (MRI) parameters in patients with mild cognitive impairment (MCI) and pre-MCI undergoing neurocognitive rehabilitation to search for candidate markers of its effectiveness. MATERIAL AND METHODS: The main group included 49 patients, aged ≥60 years, with MCI and pre-MCI with memory impairment, who underwent a course of neurorehabilitation for 5 weeks. The control group included 19 volunteers of similar age with a total MoCA score of ≥25, who did not have cognitive impairment and immuno-inflammatory disorders. The parameters of cellular and humoral immunity and markers of inflammation were studied, and structural MRI was performed. RESULTS: The content of activated natural killer cells (NK-cells) was increased in MCI and pre-MCI (0.63±0.12% vs. 0.22±0.07% in the control group, p=2.2·10-7). The level of immunoglobulin G (IgG) <12.5 g/l in patients with MCI and pre-MCI with the Montreal Cognitive Assessment Scale (MoCA) score <22 was associated with a decrease in the volume of the right nucleus accumbens (376±35 mm3 in patients with IgG <12.5 g/l (p=0.0013) and 480±44 mm3 at IgG <12.5 g/l, 480±44 mm3 in the control group), as well as with a decrease of the thickness and volume of a number of other cortical zones. A logistic regression model including the level of immunoglobulin G, NK cells, CD8+ NK cells and right amygdala volume was constructed to predict the number of MoCA scores 6 months after the course of rehabilitation (R2=0.57; p<1·10-5; standard error of estimate: 2.93). CONCLUSION: As a result of this work, the perspectives of assessing the immunological parameters in combination with socio-demographic data and morphometric changes of the brain as potential prognostic markers of the dynamics of cognitive impairment in patients with MCI and pre-MCI after neurorehabilitation has been shown.

[Dynamics of cognitive functions using the rehabilitation program of cognitive training]. / Dinamika kognitivnykh funktsii pri ispol'zovanii reabilitatsionnoi programmy kognitivnogo treninga.

OBJECTIVE: To study the efficiency of the neuropsychological rehabilitation of patients with mild cognitive impairments. MATERIAL AND METHODS: The study included 103 elderly people, aged 59 to 88 years, including 90 women and 13 men with subjective complaints of memory loss (ICD-10: F06.70; F06.71; F06.78; F06.79). Participants were divided into experimental group (n=43) and comparison group (n=42). The estimated impact was the rehabilitation program «The psychosocial therapy and neurocognitive rehabilitation of elderly patients with cognitive impairments¼, within which the principle of complex stimulation of various parameters of the cognitive sphere was used in rehabilitation work with patients in the experimental group in accordance with the «Memory Clinic¼ program. The study was conducted using randomized, equalized comparison groups, and the principle of «triple-blind¼ research. Non-parametric statistics (SPSS) methods were used to assess differences. RESULTS: A significant difference between the comparison and experimental groups has been identified, primarily in relation to high-level mental processes associated with the function of the third structural-functional block according to A.R. Luria. After the training, the number of correct answers significantly increased (t(42)=-2.67, p<0.001) in the experimental group, while in the comparison group the indicator did not change (t(41)=0.50, p=0.617). The number of false alarms in the experimental group decreased significantly (t(42)=2.13, p=0.039). CONCLUSION: The results confirm the leading role of these processes in the hierarchy of mental functions, which suggests that they should primarily be targets of rehabilitation interventions.

[Dynamics of cognitive functions in elderly and old people after completing a comprehensive neurocognitive rehabilitation program]. / Dinamika kognitivnykh funktsii u lits pozhilogo i starcheskogo vozrasta po okonchanii kompleksnoi programmy neirokognitivnoi reabilitatsii.

OBJECTIVE: To analyze the differences in the dynamics of cognitive functions in the elderly and old people during a comprehensive neurocognitive rehabilitation program with- and without drug therapy. MATERIAL AND METHODS: Ninety-six patients, aged 53-88 years, with cognitive impairment of varying degrees are divided into two groups depending on the presence/absence of drug therapy during the neurocognitive rehabilitation program. Assessment of cognitive functions was carried out twice: at the beginning and at the end of the rehabilitation program using international cognitive status assessment scales (MMSE and MoCA). RESULTS: The analysis of the dynamics of cognitive functions revealed the high efficiency of the neurocognitive rehabilitation program in both groups. The results of the study demonstrate insignificant differences in the dynamics of cognitive functions in the two groups, however, a clear direct effect of drug therapy on changes in cognitive functions has not been established. An analysis of the statistical significance of the data did not reveal differences. CONCLUSIONS: The study confirmed the positive dynamics of cognitive functions in the elderly and old people who underwent the neurocognitive rehabilitation program both with the use of drug therapy and without its use. The issue of the need to use drugs in the framework of this program requires further study. The results of the study can be used in planning programs of psychological, medical and social support for the elderly and old people.

[Complex Program of Neurocognitive Rehabilitation for Elderly Patients Suffering from Mild Cognitive Impairment Syndrome in Medical Rehabilitation Department «Memory Clinic¼].

The article introduces a complex program of neurocognitive rehabilitation into the system of dementia prevention in patients with mild cognitive impairment syndrome. It took about a year to prepare and form a complex program of neurocognitive rehabilitation (the Program). The researchers have also developed clear algorithms of the specialized medical rehabilitation unit Memory Clinic. The conducted study has proved the effectiveness of cognitive functions improvement in patients with mild cognitive impairment after participation in the Program in Memory Clinic. The authors, Professor Kostyuk, and Research Institute for Healthcare Organization and Medical Management have prepared Medical Rehabilitation Guidelines for Elderly Patients with Early Signs of Cognitive Deficits (Structural and Functional Model). The guidelines serve as a tool for practice distribution and transforming them into a project Memory Clinic.

[The characteristics of epilepsy in left-handed people (a clinico-electroencephalographic study)]. / Osobennosti épilepsii u levshei (kliniko-élektroéntsefalograficheskoe issledovanie).

As many as 16 epileptic patients with the sings of sinistrality in the motor and sensory spheres were examined. The authors demonstrate the clinical characteristics of epilepsy in the left handed, that distinguish them from the right-handed; dissimilarity of each psychopathological symptom and syndrome to their analogs in the right-handed, the occurrence of unusual phenomena, impossible in the right-handed. Depict specific features of the EEG that distinguish the patients examined from healthy right- and left-handed. The data obtained are interpreted as evidence that the clinical characteristics and the EEG appearance of epilepsy are determined to a considerable measure by the profile of asymmetry of each patient as well as by the fact that the left-handed may demonstrate diverse varieties of functional brain asymmetry, differing from the type of asymmetry of cerebral hemisphere functions common to all the right-handed in the maintenance of integral neuropsychic activity.