THE EFFECTIVENESS OF COGNITIVE TRAINING WITH THE USE OF A COMBINATION OF SIMPLE VISION-MOTOR AND A SET OF ARITHMETIC AND VERBAL TASKS IN EARLY PREVENTION IN PATIENTS AFTER CORONARY ARTERY BYPASS SURGERY

Highlights

The effectiveness of cognitive rehabilitation in reducing the incidence of early postoperative cognitive dysfunction in patients who have undergone coronary artery bypass grafting has been demonstrated for the first time by optimizing neurodynamics and memory parameters.

Abstract

Aim. To study the effectiveness of cognitive training (CT) using a combination of simple visual-motor reactions with a set of arithmetic and verbal tasks to reduce the frequency of early postoperative cognitive dysfunction (POCD) in patients who underwent coronary artery bypass grafting (CABG), and to evaluate the dynamics of the neurovascular unit markers (NVU).

Methods. The prospective randomized study included 81 patients: group with CT (n = 43) and the comparison group without CT (n = 38). All patients underwent general clinical, laboratory and instrumental examinations as well as extended neuropsychological examination and determination of concentrations in the plasma of peripheral blood of NVU markers.

Results. Patients who underwent CT with a combination of vision-motor task and cognitive components in the early post-operative period of CABG showed better psychomotor and executive functions (faster reaction time, a smaller number of errors and missed signals), as well as attention (more processed symbols in the 4th minute of Burdon’s test) compared to patients without training. The patients with CT also had a decrease in the concentration of S100β protein in peripheral blood at 11–12 days after CABG and a tendency towards higher the concentration of BDNF. The comparison group had an increase in the concentration of S100β protein at 1^st day after surgery and maintained an elevated level until 11–12 days after CABG.

Conclusion. Thus, the cognitive rehabilitation as the combinations of simple visual-motor reactions with a set of arithmetic and verbal tasks in the early postoperative period of CABG contributed to a decrease in the incidence of early POCD and the maintenance of the cognitive status of patients to a greater extent due to the optimization of the activity of the neurodynamic and short-term memory domains. The decrease in the concentration of S100β protein in the peripheral blood at 11–12 days after CABG and the tendency towards higher concentration of BDNF, observed in patients with CT in comparison to patients without CT, may indicate NVU reorganization.

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