PSYCHO-EMOTIONAL AND MOTOR DYSFUNCTION AFTER HEMISPHERIC ISCHEMIC STROKE

Abstract

Purpose: to evaluate the effect of cognitive deficits and emotional dysfunction in patients after stroke on the restoration of their motor functions.
Materials and methods. The study was conducted during 2015-2016 at the Department of Vascular Neurology of Uzhhorod Central City Clinical Hospital. The study involved 132 patients with hemispheric ischemic stroke. All patients underwent general clinical examination, neuroimaging examination, neuropsychological examination using a battery of tests for the assessment of cognitive function, hospital anxiety and depression scale, functional examination using the NIHSS, Ashworth's modified spasticity scale, Muscle strength scale (Peak аnd Braddom). Statistical processing of materials
was performed using the standard statistical package “Microsoft Exel 2010”.
Results. The study involved 132 patients, residents of Uzhhorod, have suffered hemispheric ischemic stroke. The mean age of the patients was 57.0±7.0 years. By random selection, patients were divided into 3 groups. The mean age of the patients in the groups is comparative: in the first group it was 58.0±7.9 years, in the patients of the second group – 58.7±7.7 years, and in the patients of the third control group – 54.5±5.6 years. In 66 patients (50.0%), ischemic stroke was registered in the area of blood supply of left MCA, and also in the 66 patients of right MCA. 50 patients were selected in the first and second groups, and 32 patients in the third group. In the first group of patients, the treatment was performed according to the protocol of treatment of ischemic stroke with the addition of the magnetotherapy procedure, the patients of the second group also underwent treatment according to the protocol, and at the same time they underwent the magnetotherapy procedures and mirror therapy. The control group consisted of 32 individuals – these patients were treated according to the ischemic stroke treatment protocol. Low mood and high anxiety have been found to slow down the recovery of motor activity and cognitive function.
Conclusions. A depressed mood slows the recovery of motor function using the NIHSS scale. High anxiety revealed a correlation with poorer hand restoration dynamics on a 6-point muscle strength scale. Anxiety was associated with the slower recovery of cognitive functions assessed by the Schulte
tables. Improvements in the cognitive performance assessed by the Schulte tables after hemispheric stroke have the effect of reducing the spasticity of the arm and leg by the Ashworth scale.