Vol. 5, Issue 6 (2016)

Author(s):
Nasonova TI

Abstract:
The objective of the research was to study the post-stroke pathological fatigue and anxiety and depressive disorders and to identify strategic brain areas of psycho-emotional disorders according to MRI in patients with ischemic stroke on the background of MS. Materials and methods. The main group consisted of 30 patients (16 women and 14 men) at the age of 44 to 81 (the average age was 66+4.2 years) being in the early rehabilitation period of ischemic stroke on the background of MS (atherothrombotic stroke – 13 patients, lacunar stroke – 15 patients, cardioembolic stroke – 2 patients). The control group consisted of 16 patients in the early rehabilitation period of ischemic stroke (atherothrombotic stroke – 6 patients, lacunar stroke – 10 patients) at the age of 54 to 76 (the average age was 63+3.8 years) without MS. Volumetric investigation was performed on MRI scanner ToshibaVantageTitan 1.5. Workstation for images post processing: Vitrea. Total volume of cerebral hemispheres, volume of white matter and gray (cortex) matter separately as well as corpus callosum area in cm² was determined. Neurological patients’ condition was determined according to National Institute of Health Stroke Scale (NIHSS). HADS,FAS questionnaires were completed. Results and discussion. According to FAS questionnaire median of fatigue severity constituted Ме=32.2(Q1=16.5; Q3=51.5) in the main group and Ме =26.25(Q1=14.5; Q3=48.5) in the control group before the treatment. The distribution of depression in the main and control groups was about the same. According to FAS pathological fatigue was diagnosed in the vast majority of patients of the main group (90%), and depression according to HADS was detected only in 21%. This indicates that depression and pathological fatigue have different pathogenetic substrate. According to NIHSS, positive dynamics was observed in the main and control groups after the treatment. Significant correlation dependence of pathological fatigue severity according to FAS and stroke severity according to NIHSS was not defined. The significant difference of volumes of white matter and cortex (P <0.05) between the indices of the main and control groups was determined decreasing in the main group. A significant decrease (Ñ€<0.05) in the corpus callosum area was observed in patients with cerebrovascular diseases on the background of MS in comparison with the patients without MS. Conclusions. MS probably contributes to the development of atrophic processes in patients with cerebrovascular pathology. The combination of hypertension, insulin resistance, dyslipidemia, and so on, accelerates atrophic processes more than each of these components separately, which were determined in patients without MS.