Background: Significant (>70%) extracranial stenosis of the internal carotid artery (ICA) is a known risk factor for brain damage in patients with coronary heart disease (CHD) undergoing coronary artery bypass grafting (CABG). There is no clear evidence of the low and moderate ICA stenoses influence on the neurophysiologic status of patients after CABG. This work was aimed at studying the influence ICA stenoses (<50%) on the dynamics of neurophysiologic status in patients undergone CABG. Methods: We examined neurophysiologic functions and electroencephalograph in CHD patients (N = 45) aged from 45 to 70 years. All patients were divided into two groups: with ICA stenosis (n = 20) and without one (n = 25). Results: It was established that the group ICA stenosis had a negative dynamics of neurophysiologic status 6 months follow-up after CABG compared with patients without stenosis. Conclusion: Our results suggest that the presence of low and moderate ICA stenosis is one of the factors affecting the neurophysiologic status of CHD patients. It has been assumed that the patients with ≤50% ICA stenoses constitute a high-risk group for cerebral complications after on-pump CABG.

Background: Mild cognitive impairment (MCI) may contribute to the development of postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG). Objective: The aim of this study was to investigate the incidence of early and l

СТРУКТУРА КОГНИТИВНЫХ НАРУШЕНИЙ И ДИНАМИКА БИОЭЛЕКТРИЧЕСКОЙ АКТИВНОСТИ МОЗГА У ПАЦИЕНТОВ ПОСЛЕ ПРЯМОЙ РЕВАСКУЛЯРИЗАЦИИ МИОКАРДА

Aim. To evaluate the effectiveness of dual-task computerized cognitive training (CCT) in the prevention of postoperative cognitive dysfunction in patients after on-pump coronary artery bypass grafting (CABG).Material and methods. This cohort prospective study included 68 patients (median age, 64 years [54; 69]) admitted for elective on-pump CABG. In addition to the standard preoperative examination, all patients underwent advanced neuropsychological and neurophysiological examination. Starting from 3-4 days of the postoperative period, all patients underwent dual-task CCT.Results. After 8-10 days, early postoperative cognitive dysfunction was observed in 37 (54,4%) patients from CCT group, while in patients without training in 69,3% of cases (n=79). The best results of cognitive functioning were achieved in neurodynamics and short-term memory. In addition, in patients who completed the training course, a postoperative increase in the frontooccipital gradient of theta rhythm was observed.Conclusion. Neuropsychological and neurophysiological assessment have demonstrated the limited effectiveness of a short-term dual task CCT using in the prevention of early postoperative cognitive dysfunction in patients after on-pump CABG. The dual task method can be an additional preventive intervention in the development of a personalized approach to cognitive rehabilitation therapy in cardiac surgery patients.

Aim of the study was to analyze the event-related synchronization/desynchronization of brain electrical activity during visual selection task in patients underwent on-pump coronary artery bypass grafting (CABG) with and without postoperative cognitive dysfunction (POCD). Material and methods. The study included 32 men who underwent on-pump CABG, mean age 57.2 ± 6.08 years. All patients carried out extended neuropsychological testing, a multi-channel computer electroencephalography (EEG) 3-5 days before CABG and on the 7-10th day after the surgery. The POCD was determined according to the criterion: 20 % decrease in the cognitive indicator compared to that at baseline on 20 % of the tests included in the neuropsychological battery. Monopolar EEGs were recorded in 62 sites of 10-20 system with NEUVO encephalograph (Compumedics, USA) during cognitive task performing in patients wi h and without POCD. Statistical processing was performed using the STATISTICA 10.0. Results. It was found that the POCD patients had less pronounced theta desynchronization in the left frontal-central regions during the stage of 200-400 ms at the 7-10 days after CABG in comparison to patients without cognitive decline. Moreover, in the left parietal leads POCD patients had decreased theta desynchronization during the stage of 200-400 ms even before the surgery. At the 7-10 days after CABG, only the patients without POCD had a decrease of event-related theta activity in the left parietal leads compared with baseline. During the stage of 600-800 ms, the POCD patients had a lower degree of theta-desynchronization of both frontal-central and parietal regions of right hemisphere compared to patients without cognitive decline. Conclusion. The cognitive decline in patients after CABG determined according to neuropsychological testing is accompanied by pathological changes in the event-related theta activity. An analysis of event-related synchronization/desynchronization can be used both as predictor of postoperative cognitive impairment and as objective marker of POCD.

ВЛИЯНИЕ ТРЕХНЕДЕЛЬНОГО КУРСА АЭРОБНЫХ ФИЗИЧЕСКИХ ТРЕНИРОВОК НА НЕЙРОДИНАМИЧЕСКИЕ ПОКАЗАТЕЛИ ПАЦИЕНТОВ, ПЕРЕНЕСШИХ КОРОНАРНОЕ ШУНТИРОВАНИЕ