The Structure of Early Post-Stroke Cognitive Impairment in Patients. with Damage to the Right and Left Hemispheres of the Brain: Cohort Study

AIM. To identify the most informative indicators of functional-cognitive status, allowing for a differentiated approach to the diagnosis of cognitive impairment in patients with damage to the right and left hemispheres in the acute period of ischemic stroke. MATERIAL AND METHODS. 240 patients diagnosed with ischemic stroke in the carotid region were examined. Depending on the location, the patients were divided into two groups: Group 1 — 122 patients with damage to the left hemisphere of the brain;Group 2 — 118 patients with damage to the right hemisphere. The following scales were used to assess parameters of cognitivefunctional status: Montreal Cognitive Assessment Scale (MoCA), National Institutes of Health Scale (NIHSS), Barthel Index (BI), Questionnaire for Cognitive Decline in the Elderly (IQCODE), additional scales for assessing praxis, semantic aphasia, perceptual and executive function, Hospital Anxiety and Depression Scale (HADS), MFI-20 and Apathy Scale (AES). The latency and amplitude of acoustic endogenous evoked potential, P300, was used as neurophysiological markers. Statistical analysis was performed using the SPSS 23 software package. RESULTS AND DISSCUSION. The main relevant indicators of cognitive dysfunction in both groups were declines in the areas of memory, perception and executive function, which prevailed in patients of the 1st group. The disorder of visual perception, understanding of complex grammatical structures, a predominance of decreased motivation and mental fatigue were identified in patients of the 1st group; impaired recognition of emotions and understanding of idioms, the presence of general fatigue and depression — in patients of the 2nd group. Statistically significant neurophysiological indicators were an increase in P300 latency in the frontal and central leads in patients of the 2nd group. CONCLUSION. The study identified relevant indicators of cognitive and psychoemotional status depending on the lateralization of the lesion in patients in the acute period of ischemic stroke. The P300 evoked potential method can be used to objectify cognitive dysfunction and evaluate the effectiveness of therapy for cognitive disorders. The results prove the feasibility of a comprehensive examination of cognitive deficits with the inclusion of additional scales and tests to assess perception, executive and mnestic functions, fatigue, affective and personality disorders. This will allow us to develop more effective individual rehabilitation programs aimed at restoring the cognitive and emotional resources of patients. KEYWORDS: ischemic stroke, cognitive function, affective disorders, fatigue, evoked potentials, Р300