COGNITIVE STATUS OF PATIENTS WITH DIFFERENT PATHOGENETIC TYPES OF ISCHEMIC STROKE: CHRONOBIOLOGICAL APPROACH


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Abstract

Aim. To study the peculiarities of cognitive affective status, quality of sleep, melatonin secretion and chronotype of patients with atherothrombotic (ATS), cardioembolic (CES) and lacunar stroke (LS). Materials and methods. 155 patients (aged 30-82) with acute ischemic stroke who were diagnosed ATS, CES and LS according to TOAST classification were examined. Complex neuropsychological investigation, Pittsburg sleep quality index (PSQI), emotional status investigation (geriatric depression scale, Spilberger-Khanin scale, apathy test) and chronobiological indices (MCTQ) were used. Nocturnal melatonin secretion was determined at the weeks 2-4 of stroke in 96 patients; 6-sulfatoxymelatonin (6-COMT) content was assessed in 96 patients. Results. Differences between ATS, CES and LS patients were obtained as a result of cognitive tests, hypotimia and apathy levels as well as subjective sleep quality estimation. Differences between the groups in relation to chronotype, sleep duration and 6-COMT concentration were also detected. Conclusions. In context of the postinsult cognitive, emotional and somnologic disorders, CES is the most unfavorable variant of IS, whereas in case of LS these spheres remain practically intact. At the same time, CES is developing against the background of relatively preserved circadian rhythms, whereas LS and, especially, ATS are characterized by significant desynchronization.

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