CEREBROVASCULAR DISORDERS IN PATIENTS WITH COVID-19 CONSEQUENCES PATHOGENETICALLY DETERMINED DIAGNOSIS AND METHODS OF CORRECTION

Authors:

Abstract:

The purpose of the study was to investigate and to correct the state of the autonomic system, cognitive functions, vestibular apparatus and cerebral blood circulation autoregulation in patients with cerebrovascular pathology formed as the result of COVID-19 consequences. Patients with chronic cerebral inschemia in the compensated and subcompensated stages together with 46 patients with ischemic stroke were examined. The Mini-Mental State Examination and Frontal Assessment Batter ctiteria were used together with 10-word recall test. Vegetative characteristics were investigated in patients: tone, reactivity and vegetative activity ensuring, together with brain arteries reactivity in triplex mode using an ultrasound scanner. Cognitive, psychoemotional, vestibular, and autonomic disorders have been found to be key and comorbidities of cerebrovascular insufficiency in people who have experienced COVID-19 and are correlated with the degree of brain damage. Their progression is facilitated by the transferred coronavirus infection with subsequent decompensation of ischemia, especially as a result of direct damage to the CNS vascular system. The use of β-phenyl-GABA restores cognitive functions, affects vestibular structures, improves their vascularization, has a harmonizing vegetotropic, antidepressant effect, and also normalizes cerebrovascular reactivity.

Keywords:

cerebrovascular pathology coronavirus infection vegetative system cognitive and vestibular disorders nervous system damage β-phenyl-GABA

References:

1. Vinichuk SM, Fartushna OE. Epidemiolohiya tranzytornykh ishemichnykh atak u strukturi hostrykh porushen mozkovoho krovoobihu v Ukrayini ta inshykh krayinakh. Mizhnarodnyy nevrolohichnyy zhurnal. 2017; 5(91): 105–111. doi: 10.22141/2224-0713.5.91.2017. 110863 [In Ukrainian].
2. Lesiv МІ. Kohnityvni funktsiyi u khvorykh na hipertonichnu khvorobu ta hipotyreoz z retrospektyvnoyu otsinkoyu kontrolyu kompensatsiyi zakhvoryuvannya. Ukrayinsʹkyy nevrolohichnyy zhurnal. 2019; (2-3), 40–44. doi: 10.30978/UNJ2019-2-40 [In Ukrainian].
3. Svyrydova NK, Cherednichenko TV. Diahnostyka ta likuvannya kohnityvnykh rozladiv u komorbidnykh patsiyentiv iz khronichnoyu ishemiyeyu holovnoho mozku. Liky Ukrayiny. 2020; 8(244): 50–53. doi: 10.37987/1997-9894.2020.8(244).215487 [In Ukrainian].
4. Trinus KF, Claussen KF. Mizhnarodnyy klinichnyy protokol z prysinkovykh porushen (zapamorochen) Skhidno-yevropeyskyy nevrolohichnyy zhurnal. 2015;4: 4–47 [In Ukrainian].
5. Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T et al. The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample. Neurol Sci. 2022; 43(2): 979–984. doi: 10.1007/s10072-021-05392-y.
6. Barpanda S. Pathophysiology and Epidemiology of Cerebrovascular Disease International Journal of Collaborative Research on Internal Medicine & Public Health. 2021; 13(7): 1–2.
7. Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A. et al. Neurological associations of COVID-19. Lancet Neurol. 2020; 19(9): 767–783. doi: 10.1016/S1474-4422(20)30221-0
8. Fifi JT, Mocco J. COVID-19 related stroke in young individuals. Lancet Neurol. 2020; 19(9): 713–715. doi: 10.1016/S1474-4422(20)30272-6
9. Kellar D, Lockhart SN, Aisen P, Raman R, Rissman RA, BrewerJ, Craft S. Intranasal Insulin Reduces White Matter Hyperintensity Progression in Association with Improvements in Cognition and CSF Biomarker Profiles in Mild Cognitive Impairment and Alzheimer’s Disease. J Prev Alz Dis. 2021; 8(3): 240–248. doi: 10.14283/jpad.2021.14
10. Obaid M, Flach C, Marshall I, Wolfe CDA, Douiri A. Long-Term Outcomes in Stroke Patients with Cognitive Impairment: A Population-Based Study. Geriatrics (Basel). 2020; 5(2): 32. doi: 10.3390/geriatrics5020032.
11. Rajeev V, Fann DY, Dinh QN, Kim HA, De Silva TM, Lai MKP. et al. Pathophysiology of blood brain barrier dysfunction during chronic cerebral hypoperfusion in vascular cognitive impairment. Theranostics. 2022; 12(4): 1639–1658. doi: 10.7150/thno.68304
12. Stoyanov AN, Kalashnikov VI, Vastyanov RS, Pulyk AR, Son AS, Kolesnik OO. State of autonomic regulation and cerebrovascular reactivity in patients with headache with arterial hypertension. Wiadomości Lekarskie. 2022; 75(9 p2): 2233–2237. doi: 10.36740/WLek202209210
13. Su Y, Dong J, Sun J, Zhang Y, Ma S, Li M. et al. Cognitive function assessed by Mini-mental state examination and risk of all-cause mortality: a community-based prospective cohort study. BMC Geriatr.2021; 21: 524. doi: 10.1186/s12877-021-02471-9
14. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS. et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020; 395(10234): 1417–1418. doi: 10.1016/S0140-6736(20)30937-5
15. Zhitao Li, Zhen Z, Zhuoya Z, Zhiyong W, Hao Li. Cognitive impairment after long COVID-19: current evidence and perspectives. Front Neurol. 2023; 14: 1239182. doi: 10.3389/fneur.2023.1239182

Publication:

«World of Medicine and Biology» Vol. 20 No. 88 (2024) , с. 146-151
УДК 616.89-008.434.5-06:616.831-005.4-085.21

DOI:

https://doi.org/10.26724/2079-8334-2024-2-88-146-151