RU2308885C1 - Method for treating cognitive disorders in bronchial asthma patients suffering from chronic encephalopathy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves carrying out electroencephalographic examination for detecting zonal α-rhythm distribution disorders and applying audiovisual treatment. The α-rhythm index and θ-rhythm index and relative power are additionally estimated. The α-rhythm index being fallen below 60%, zonal α-rhythm distribution disorder taking place, θ-rhythm index increasing from 15 to 50% and/or θ-rhythm relative power in occipital and temporal leads growing above 15%, audiovisual treatment is carried out with Vojager Galaxy instrument produced by Tetha Technologies, USA in treatment mode, beginning from audiovisual signals of 12 Hz with following frequency reduction during 8 min to 7.83 Hz that is to be kept unchanged to the session end. The total treatment course is 10 sessions long with each session being 30 min long.

EFFECT: enhanced effectiveness of treatment; excluded application of unfavorable frequency bandwidth.

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Description

The invention relates to medicine, namely to methods for treating cognitive impairment in chronic encephalopathy in patients with bronchial asthma, and can be used in therapy and neurology.

E.I. Gusev et al. (Gusev E.I. Neurological symptoms, syndromes, symptom complexes and diseases / E.I. Gusev, V.E. Grechko, G.S.Burd. - M :. Medicine, 1988. - 324 p.) Consider that how hypercapnia and hypoxemia in lung diseases can lead to encephalopathy. V.A. Kutin (Kutin V.A. Neurological and electrophysiological disorders in children with bronchial asthma / V.A. Kutin // Journal of Neuropathology and Psychiatry named after S.S. Korsakov. - 1988. - T.LXXXVIII. - Issue 3. - S.48-50.) In 70% of patients with AD, intellectual disorders were found.

Existing drug methods of treatment do not directly affect the central mechanisms of the pathological process and are often accompanied by side effects. (Smetankin A.A. Prospects for the use of the biological feedback method for electroencephalogram in clinical practice / A.A.Smetankin, I.M. Gabibov // Biological feedback. - 2000. - No. 1. - S.3-5). In addition, internationally recognized experts in the field of asthma Peter Bames, Simmon Godfrey (Burns P. Bronchial asthma: transl. From English / P. Burns, S. Godfrey. - M.: BINOM-Press, 2003. - 128 p. .) believe that a patient with moderate to severe AD should take the minimum amount of drugs to control the disease and stop taking additional funds. The fewer drugs, the greater the likelihood that the patient is taking them correctly, and the more effective the control of the disease. In addition, polypharmacy leads to adverse effects of pharmacodynamic and pharmacokinetic interactions.

It is possible to purposefully change the functional state of the central nervous system and the whole organism by acting through the sensory organs and causing a modification of psychophysiological processes (Kuchinov A.I. Use of light and color in psychotherapy / A.I. Kuchinov, E.V. Beznosyuk, O.V. Yurtov / / Russian Medical Journal. - 2001. - No. 3. - P.39-40). For more than 30 years, for the treatment of a number of diseases that have a neurological basis, the method of biological feedback by EEG and the associated methods of changing the course of diseases have been used. Any signal entering the brain has its own characteristics (energy, frequency, space-time) and the central nervous system constantly brings the internal environment (function of internal organs, metabolic processes, etc.) in accordance with these signals, i.e. in accordance with the external environment, providing homeostasis. Intermittent phono- and photostimulation contributes to a change in metabolic processes, regional cerebral blood flow. The neurophysiological effects of rhythmic light and sound vibrations make it possible to use them for therapeutic purposes as sensory afferent stimulation.

A known method of influencing cognitive processes using audiovisual stimulation (ABC) for the treatment of attention deficit disorder and hyperreactivity. (Lubar J.F. Neocortical dynamics: explanation of the effect of neurobiological feedback and related techniques on increasing attention // Applied Psychophysiology and Biofeedback, 1997, Vol. 22, No. 2, P.111-126). To increase cerebral activity, ABC is used at a frequency of 20-21 Hz. ABC leads to an increase in beta activity on the EEG, a decrease in activity at low frequencies, and as a result leads to long-term improvements in academic performance. However, in AD, an increase in the high-frequency spectrum on the EEG is undesirable, because an increase in beta activity indicates parabiotic stress and is observed during an exacerbation of AD (Karashurov S.A. Features of cerebral circulation and bioelectric brain activity in patients with bronchial asthma / S.A. Karashurov // Klin. Medicine. - 1996. - No. 1. - S. 34-35).

In addition to influencing cognitive processes, sound and light effects on the corresponding analyzers with a frequency of 1-13 Hz stimulate the T-link of immunity. (Peculiarities of the immunological response of healthy individuals to audiovisual stimulation / E.I. Masterova, V.N. Vasiliev, T.I. Nevidimova, M.A. Medvedev // Bulletin of Experimental Biology and Medicine. - 1999 - V.128. - No. 8. - S.204-206). Within 7 days, subjects were presented with ABC for a duration of 24 minutes. During the session, the frequencies of light and sound exposure changed from the range of alpha-EEG waves of 9-13 Hz to the range of delta-EEG waves of 1-3 Hz.

The disadvantage of this method is that ABC is carried out without assessing the neurophysiological, neuropsychological dynamics, neurological status.

There is a method of treating disorders of the central nervous system in AD through biofeedback with feedback on EEG parameters (Lovitsky S.V. Diagnostics, pathogenetic value and therapy of central nervous regulation disorders in patients with bronchial asthma // Abstract of dissertation ... Dr. med. Science. - St. Petersburg, 1997 - 24 p.). The patient's EEG was recorded and, using an analog-to-digital converter in real time, one of the EEG parameters was distinguished - the duration of alpha-wave generation. The patient received information about the current change in the biorhythm of his brain and could arbitrarily change it, causing a state of relaxation. The duration of 1 session was 30 minutes, 7-10 sessions were carried out, which were carried out daily.

However, the author, noting that the correction of pathological changes in the central nervous system facilitates the course of asthma, does not conduct a comprehensive analysis of the dynamics of the central nervous system, limiting itself to an analysis of the bioelectric activity of the brain. The author notes the effectiveness of the treatment (effect on the course of asthma with prolonged remission of asthma, a decrease in the level of reactive anxiety, a decrease in the severity of autonomic imbalance) only in patients with normal EEG or in the "diencephalic" version of the EEG. One can only guess about the influence of this method on cognitive processes, the course of chronic encephalopathy in patients with AD.

Closest to the claimed is a method for the treatment of dyscirculatory atherosclerotic encephalopathy, including cognitive impairment associated with this disease, developed at the Federal State Pedagogical University of Health and Safety and the Novokuznetsk State Institute for the Advancement of Physicians Cl. 7 A61N 2/00, BIMP No. 22, 08/10/2002.). The method includes audiovisual stimulation alternating with pulsed magnetic therapy. To conduct ABC, all patients preliminarily undergo EEG mapping to study the state of bioelectric activity of the brain. Based on the EEG data, the exposure mode is selected. If there is a predominance of slow activity and disturbances in the zonal distribution of the alpha rhythm, a mode for restoring alpha activity is proposed: the frequency of audiovisual signals starts at 8 Hz and gradually rises to a frequency of beta activity of 15 Hz, the duration of the session is 15 minutes.

The disadvantage of the prototype is that high frequencies are used at which the session ends, which is not desirable for BA, since an increase in the relative power of beta activity is typical for exacerbation of BA.

The objective of the present invention is to increase the effectiveness of the treatment of cognitive impairment in chronic encephalopathy in patients with bronchial asthma by using afferent stimulation due to the use of a regime that excludes exposure in an unfavorable frequency range.

The task is achieved by the fact that in the proposed method for the treatment of cognitive disorders in chronic encephalopathy in patients with bronchial asthma, drug treatment is carried out, EEG is recorded and the prevalence of slow-wave activity and disturbances in the zonal distribution of alpha rhythm is revealed to select an audiovisual stimulation program. Perform audiovisual stimulation. Additionally, the index and relative power of the alpha rhythm and theta rhythm are evaluated, and with a decrease in the alpha rhythm index below 60%, a violation of the zonal distribution of the alpha rhythm, an increase in the theta rhythm index from 15% to 50% and / or an increase in the relative power of the theta rhythm in the temporal or occipital leads above 15% carry out the audiovisual effect in the following mode: start from the frequency of the audiovisual signals 12 Hz and gradually reduce their frequency for 8 minutes to a frequency of 7.83 Hz, which is maintained until the end of the session, a course of treatment of 10 sessions 30 minutes.

The novelty of the method:

- Additionally, an assessment is made of the index and relative power of the alpha rhythm and theta rhythm.

- If the alpha rhythm index decreases below 60%, the zonal distribution of the alpha rhythm is violated, the theta rhythm index increases from 15% to 50% and / or the relative theta rhythm power in the temporal or occipital leads exceeds 15%, an audiovisual effect the following mode: start with a frequency of audiovisual signals of 12 Hz and smoothly reduce their frequency over 8 minutes to a frequency of 7.83 Hz, which is maintained until the end of the session.

- The course of treatment consists of 10 sessions of 30 minutes.

The proposed method allows to increase the effectiveness of the treatment of cognitive disorders in chronic encephalopathy in patients with bronchial asthma by using afferent stimulation due to the use of a regime that excludes exposure in an unfavorable frequency range.

The use of frequencies in the alpha-rhythm range for ABC is explained by the fact that recent studies by Angelakisa Efthymios et al. (Efthymios A. Electroencephalographic peac alfa frequency correlates of cognitive traits / A.Efthymios, L.Joes, S.Stamatina / Neuroscience Letters. - 2004 . - Vol.371. - Iss.1. - P.60-63.) Indicate the connection of successes in cognitive activity with the characteristics of the alpha rhythm: the frequency of the maximum peak, the largest width of the alpha range, and the stability of the alpha spindle. The use of audiovisual stimulation is based on the fact that the occipital region of the brain is the projection zone of the visual analyzer and is characterized by a dominant role in the mechanisms of alpha rhythm generation, as a result of which light stimuli cause the most pronounced changes in its electrical activity and metabolic rate. Visual and auditory analyzers provide the entry into the human brain of more than three quarters of information. Rhythmic photostimulation with a smoothly changing flash frequency provokes, according to the resonance mechanism, the activity of a number of fine-tuned brain oscillators at characteristic frequencies specific for different areas of the brain (Galochkin Yu.G. Dynamics of time parameters and the effectiveness of targeted motor actions on a conditional light signal / Yu.G. Galochkin / / Journal of Higher Nervous Activity. - 1993. - Issue 2. - P.147-150; Mukhamedrakhimov R.Zh. Assessment of preferences and autonomic reactions in the perception of sound intensity / R.Zh. Mukhamedrakhi mov // Human Physiology. - 1993. - T. 19. - No. 2. - S.45-52 .; Fedotchev A.I. EEG - human reactions to intermittent light effects of different frequencies / A.I. Fedotchev, A. T. Bondar // Uspekhi Fiziologicheskikh Nauk - 1990. - T. 21. - No. 1. - S.97-109). It is proved that resonance phenomena in the frequency range corresponding to the basic EEG rhythms are carried out at the level of membranes, organs and systems in which oscillatory processes are carried out (Markevich N.I., Mathematical model of resonant amplification of external effects on membranes / N.I. Markevich, EE Selkov // Biophysics. - 1986. - T.31. - No. 4. - S.662-666; Ohnyanskaya, L.G. On the role of vibrational-wave processes in human life / L.G. Okhnyanskaya, N.A. Nikiforova, A.N. Nikolayeva // Abstracts of the 15th Congress of the All-Union Physiological Society named after I.P. vlova, Chisinau, 1987. - Chisinau, 1987. - S.25-26). Any restructuring of the rhythm of nerve cells is accompanied by a corresponding shift in metabolism, a change in regional cerebral blood flow in different areas of the brain (Livanov, MN Rhythms of electroencephalograms and their functional significance / MN Livanov // Journal of higher nervous activity. - 1984. - T .34. - No. 4. - S.613-626). Therefore, it is advisable to use for medical purposes these neurophysiological effects of rhythmic light and sound vibrations, used as sensory afferent stimulation.

The treatment method is as follows. A preliminary clinical and paraclinical examination of a patient with bronchial asthma is carried out, a diagnosis of chronic encephalopathy is established. Neuropsychological testing is also preliminarily conducted, aimed at identifying cognitive impairments - Schulte test, Bourdon test, test for speech activity, memorization of 10 words, kinetic test. In the study of cognitive evoked potentials P300, the obtained values of P300 are compared with the standard values pre-set for the corresponding age group using average values and standard deviations.

The patient is placed in a chair in a sitting position. Put on him a "helmet" of rubber bands. EEG registration is carried out by the bipolar method using cup electrodes, which are attached using a "helmet" made of rubber bands according to the international "10-20" pattern. The EEG study is carried out in the daytime (10-13 hours).

To implement the method using the apparatus "Vojager Galaxy, by Tetha Texnologies, USA" allowing to conduct ABC in an individually selected mode, and a 32-channel electroencephalograph "DG Compact 32", Medelek, England. A visual assessment of the EEG and automated quantitative frequency analysis of the EEG is carried out, the index, the power of the spectrum by frequency ranges in percent for the alpha (α) -, theta (θ) rhythms of the temporal, occipital zones of the left and right hemispheres are evaluated. The frequency ranges are set in the following limits: δ 0.1-3.9 Hz, θ 4-7.9 Hz, α 8-12.9 Hz, β1 13-19.9 Hz, β2 20-32.0 Hz. The helmet is removed.

Then the patient is comfortable in the chair, puts on glasses and headphones, closes his eyes. After that, on the Vojager Galaxy, by Tetha Texnologies, USA, a program with the necessary mode is selected. With a decrease in the alpha rhythm index below 60%, a violation of the zonal distribution of the alpha rhythm, an increase in the theta index from 15% to 50% and / or an increase in the relative power of the theta rhythm in the temporal or occipital leads above 15%, an audiovisual effect is performed in the following mode : start with a frequency of audiovisual signals of 12 Hz and smoothly reduce their frequency over 8 minutes to a frequency of 7.83 Hz, which is maintained until the end of the session, the total duration of which is 30 minutes The course of treatment consists of 10 daily sessions.

Under our supervision, there were 30 patients with chronic encephalopathy on the background of moderate allergic bronchial asthma. The diagnosis of chronic encephalopathy was made by a neuropathologist on the basis of clinical data, the results of neuropsychological testing, and instrumental examination data (EEG mapping, the study of cognitive evoked potentials P300). Also examined were 20 healthy people aged 20-50. The indicators of healthy electroencephalograms did not differ from the norm: EEGs contained an alpha rhythm with an index of 70% - 80%, an amplitude of waves not exceeding 100 μV, beta waves with an amplitude not exceeding 15 μV in the frontal and central leads, single theta and delta waves did not higher than the main rhythm, without the nature of bilateral synchronous outbreaks or regular local changes, the index of which did not exceed 15% (Zenkov L.R. Clinical electroencephalography with elements of epileptology / L.R. Zenkov. - Taganrog: Publishing house TRTU, 1996. - 358 from.). In 89.6% of patients with allergic bronchial asthma with cognitive impairment amid chronic encephalopathy, abnormalities were detected by EEG. The following changes in the bioelectric activity of the brain were recorded: a decrease in the alpha activity index below 60%, a violation of the zonal distribution of alpha activity, registration of beta activity with an amplitude above 15 μV, an increase in the theta index over 15% to 50%, the presence of pathological activity on the EEG in the form of local registration of theta waves in the temporal and (or) occipital regions during visual analysis and an increase in the relative power of theta activity during spectral analysis in the occipital and temporal branches niyah above 15%.

All patients with bronchial asthma underwent a course of treatment, including medications. Pharmacotherapy of AD patients was carried out by a stepwise method (Bronchial asthma. Global strategy // Pulmonology. - 1996. Appendix; National Heart, Lung, and Blood Institute. Highlights of the Expert Panel Repot 2: Guidelines for the diagnosis and management of asthma. Bethesda, MD : department of Health and human services, 1997. NIH publication No.97-4051A), in which the level of therapy increased with increasing severity of asthma. In case of mild persistent asthma, short-acting bronchodilators were prescribed to stop the attack - inhalation of agonists (32-adrenergic receptors: salbutamol, terbutaline (no more than 3-4 times a day) .If necessary, inhaled glucocorticosteroids were prescribed for 2 stages of treatment - 200-500 mcg per day - fluticasone propionate, beclomethasone dipropionate, budesonide, as well as cromoglycate sodium, nedocromil, short-acting bronchodilators as needed. At 3 steps, standard doses of inhaled glucocorticosteroids were used. in combination with long-acting β2-adrenoreceptor agonists or prolonged theophylline preparations; inhalation of short-acting β2-adrenoreceptor agonists as needed.

Additionally, audiovisual stimulation was performed. Audiovisual stimulation was performed for those patients with chronic encephalopathy on the background of bronchial asthma, in which deviations from the norm of EEG indices were detected. The course of treatment was 10 daily sessions of 30 minutes.

After a course of treatment in 67.8% of cases, a repeated EEG study revealed an increase in the alpha activity index to 70% -80%, normalization of the zonal distribution of biopotentials on the convexital surface of the cortex, a decrease in the index of relative theta rhythm power, approximation of neuropsychological testing results, indicators of cognitive evoked potentials to the age norm, which was combined with clinical improvement: the disappearance of dissomnia, complaints of headaches, the restoration of mental work a reduction in diffuse microorganic neurological symptoms. In 32.2% of cases, EEG indices did not change, which was combined with the lack of clinical improvement: manifestations of cephalgic, asthenoneurotic, dissominal, dysmnestic syndromes persisted. A repeat course of treatment was recommended for these patients.

Thus, audiovisual stimulation helps to reduce dissomnia, improve psychomotor functions, memory, which indicates the normalization of the state of non-specific brain systems, is confirmed by changes in the electroencephalogram, P300 and improves the treatment of patients with chronic encephalopathy against bronchial asthma by reducing or eliminating cognitive defect.

An example of the use of audiovisual stimulation in a patient with chronic encephalopathy on the background of bronchial asthma with characteristic neuropsychological changes, changes in the EEG, P300.

Patient P., 36 years old, was treated in the pulmonology department of the Federal State Medical and Prophylactic Institution "Scientific and Clinical Center for Miners' Health" with a diagnosis of allergic bronchial asthma, moderate severity; atopic sensitization to household, plant, epidermal allergens; chronic encephalopathy, decompensation in the form of cephalgic, astheno-neurotic syndromes. He was admitted with complaints of asthma attacks up to 2 times a day, cough after exposure to pungent odors, shortness of breath during physical exertion, headaches, irritability, general weakness, decreased mental performance. Considers himself ill for 8 years. Every year he received medical treatment courses, after which the condition improved. He constantly takes Aldecin 600 mcg per day. The real deterioration during the month is associated with hypothermia.

Objective: Free breathing. Respiratory rate 19 per minute. Above the lungs percussion pulmonary sound all over. Wheezes are dry, single.

Pulse 82 beats / min satisfactory voltage and filling. Borders of the heart: left on SCR, upper - 3 intercostal space, right - right edge of the sternum. Heart sounds of normal sonority, rhythmic. I tone at the top is not changed. II tone is not changed. Heart murmurs are not detected. HELL 120/80 mm Hg, right and left.

Neurological status. Weakened convergence, fine horizontal nystagmus. There are no motor and sensory disturbances. There are no pathological hand and stop signs. In a pose of Romberg sways.

Survey conducted:

General analysis of blood, general analysis of urine without pathology.

Biochemical analysis of blood - cholesterol 4.58 mmol / L, lipoproteins 51.24 cu, triglycerides 1.97 mmol / L.

ECG: Moderate changes in the myocardium of a metabolic nature.

Echocardiography - without pathology.

Fundus examination - without pathology.

Ig E 359 ng / ml

FVD: FVC 73%, OVF1 41%, POS 34%, FV1 / FVC 56%, SOS 25-75 18%, MOS 25 - 20%, MOS 50-19%, MOS 75 - 19%.

EEG: Alpha rhythm is combined with diffuse registration of theta waves. Alpha rhythm index reduced to 50%, theta rhythm index - 50%. Zonal differences in alpha rhythm are smoothed. In spectral analysis, the relative spectral power of the theta rhythm in the temporal leads on the left is 15% -18%. Conclusion: moderate diffuse changes in the bioelectric activity of the brain.

The method was carried out as follows. The patient was comfortable in a chair and put on glasses and headphones, closed his eyes. Audiovisual stimulation was performed using the apparatus Vojager Galaxy, by Tetha Texnologies, USA with the aim of afferent stimulation of the cerebral cortex. The exposure was carried out in the following mode: they started from the frequency of audiovisual signals of 12 Hz and gradually reduced their frequency over 8 minutes to a frequency of 7.83 Hz, which was maintained until the end of the session. The duration of the session is 30 minutes. The course of treatment amounted to 10 daily sessions.

Before treatment, neuropsychological tests were performed and the following changes were identified (Tables 1 and 2).

Table 1 Tests Healthy (n = 19) (M ± m) Patient P. Schulte test (sec) 36.6 ± 1.61 45 Bourdon test:
1. Number of lines
23.1 ± 0.91
22.5 2. The percentage of errors 0.9 ± 0.24 1.7 Associations: naming of verbs: number of words (per 1 min) 23.9 ± 1.52 17 Associations: naming plants:
1. number of words (in 1 min)
26.2 ± 1.54
22 2. number of semantic fields 6.5 ± 0.35 four 10 words memory test:
1. First play
7.3 ± 0.23
6 2. Last play 10.0 ± 0.02 9 3. Delayed playback 9.8 ± 0.13 9 table 2 Activity Test Results Tests Healthy (n = 19) (M ± m) Patient P. Brush compression (amount per 10 sec):
1. right hand
24.9 ± 0.82
21 2. Left hand 24.8 ± 1.13 21 Finger searches: (time 3 lane, sec):
1. right hand
6.4 ± 0.25
8 2. Left handed 6.7 ± 0.25 8 Reciprocal coordination (number of pairs in 20 s) 35.9 ± 1.24 thirty

An analysis of the cognitive processes of the brain using the method P300.

Table 3 Indicators of peak amplitude and latency P300 of a patient with asthma and healthy subjects Age Group of examined Amplitude Latent period 36 years Patient P. 8.9 365 30-40 years (n = 8) Healthy (M ± m) 12.4 ± 2.39 313.5 ± 5.11

Patient P. compared with healthy subjects had an increase in latent periods and a decrease in the amplitude of P300.

A treatment course was carried out, including drug treatment: inhaled glucocorticosteroids - 200-500 mcg per day, inhalation of β2-adrenoreceptor agonists as needed, but not more than 3-4 times a day, prolonged theophylline drugs, anti-inflammatory drugs.

Conducted 10 sessions of audiovisual stimulation of 30 minutes. After a course of treatment, the patient noted the disappearance of headaches, a decrease in irritability, dissomnia, and restoration of mental performance.

An objective examination: HELL 120/80 mm Hg Weakened convergence, no nystagmus. There are no motor and sensory disturbances. In the Romberg position is steady.

Repeated neuropsychological tests revealed a decrease in the level of cognitive impairment, which was manifested in an improvement in the results of neuropsychological tests: the average Schulte test time decreased; increased speech activity according to the results of each of the three subtests of the sample (the number of words increased during the test for free associations, for naming verbs and for naming plants). The positive dynamics of the memory indicators was observed according to the results of the first direct reproduction. The kinetic test indicators significantly improved: the speed of movements in both hands increased, which was observed both in the samples for compression of the hand and finger-searching, and in the sample for reciprocal coordination.

An increase in accuracy was noted during the Bourdon test, which resulted in a decrease in the number of errors made. The number of lines processed by the patient has not changed significantly.

Indicators of neuropsychological tests before and after treatment are presented in tables 4, 5.

Table 4 Results of performing neuropsychological tests by patient P. on the background of drug treatment with the inclusion of the ABC course Tests Before treatment After treatment Schulte test (sec) 45 40 Bourdon test:
1. Number of lines
22.5
23 2. Percentage of errors 1.7 1.4 Associations: naming of verbs:
number of words (in 1 min) 17 twenty Associations: naming plants:
1. number of words (in 1 min)
22
23 2. number of semantic fields four 5 10 words memory test: 2. First play 6 7 2. Last play 9 9 3. Delayed playback 9 10

Table 5 Activity Test Results Tests Before treatment After treatment Brush compression (amount per 10 sec):
1. right hand
21
23 2. Left handed 21 23 Finger searches: (time 3 lane, sec):
1. right hand
8
7 2. Left handed 8 7 Reciprocal coordination (number of pairs per 20 sec) thirty 33

The results of neuropsychological testing show the beneficial effect of drug treatment with the inclusion of an ABC course on the cognitive functions of a patient with AD. After treatment, increased mental performance. An increase in the activity of mental processes was also manifested in the speech sphere. The volume of memorization increased both by the results of the first direct reproduction and by delayed memorization. In addition, the execution time of the mnestic tasks was reduced, which indicates a positive effect on the dynamic aspects of the mnestic function. The level of involuntary attention, that is, the readiness of the brain to solve cognitive problems, has increased.

When re-recording the EEG, an increase in the alpha rhythm index up to 75%, restoration of the zonal distribution of the alpha rhythm was revealed.

After treatment, P300 changed as follows: an increase in amplitude to 11 μV and a decrease in latency to 349 ms were noted.

The given clinical example indicates that the performed therapeutic effects contributed to the restoration of the functions of the central nervous system, which was reflected in the clinical improvement of the patient's condition, a decrease in cognitive impairment, and improvement of neuropsychological and neurophysiological parameters.

The advantage of the proposed method is that it allows you to:

1) to influence the manifestations of chronic encephalopathy, namely the cognitive processes in chronic encephalopathy in patients with bronchial asthma;

2) allows you to individualize the therapeutic effect;

3) easy to perform and does not require invasive intervention.

Claims (1)

A method for the treatment of cognitive disorders in chronic encephlopathy in patients with bronchial asthma, including drug treatment, conducting an electroencephalographic (EEG) study, identifying violations of the zonal distribution of the alpha rhythm and audiovisual effect, characterized in that it further evaluates the alpha rhythm index, as well as the index and the relative power of the theta rhythm and with a decrease in the alpha rhythm index below 60%, a violation of the zonal distribution of the alpha rhythm, an increase in the theta rhythm index from 15 to 5 0% and / or an increase in the relative power of the theta rhythm in the temporal and occipital leads above 15%, audiovisual stimulation is performed using the Vojager Galaxy, by Tetha Texnologies, USA instrument in the exposure mode, starting from the frequency of audiovisual signals 12 Hz followed by a smooth reducing the frequency for 8 minutes to 7.83 Hz, which is maintained until the end of the session, the course of treatment is 10 sessions of 30 minutes.