Computer cognitive training for prevention of postoperative cognitive dysfunction after simultaneous coronary artery bypass grafting and carotid artery surgery: a pilot study

Objective. To assess the effect of computer cognitive training (CCT) on the incidence of early postoperative cognitive dysfunction (POCD) in patients with multifocal atherosclerosis after simultaneous heart and brain revascularization. Material and methods. Cognitive functions were assessed in 51 men before and after simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA). Patients were randomized into 2 groups: the first group (even numbers) included patients without CCT, the second group (odd numbers) included patients with CCT. We analyzed cognitive functions 1—2 days before surgery and after 5—7 postoperative days (after the last session of cognitive training) using Status-PF complex. We used tests developed by employees of the Novosibirsk State Technical University under the guidance of Professor of the Department of Psychology and Pedagogy O.M. Razumnikova. Statistical analysis was performed using Statistica 10.0 software. Results. In early postoperative period, patients without CCT decreased visual-motor reaction rate (p=0.03), increased the number of errors in this test (p=0.04) and time to complete the task (p=0.01). Patients with CCT increased time to complete the task in nervous functional mobility test (p=0.01) and the number of memorized numbers in the test of the same name (p=0.02). The incidence of early POCD in patients without CCT was 77.4% (24 patients), in patients with CCT — 50.0% (10 patients) (p<0.05). The odds ratio showed that patients without CCT were 3.4 times more likely to develop early POCD (CI 1.017—11.560, p<0.05). Conclusion. CCT reduces the incidence of early POCD after simultaneous interventions and may be recommended after simultaneous CABG and unilateral CEA to prevent early POCD.