Neurophysiological diagnosis and cerebroprotection in the case of brain injuries of medium severity in the remote period in soldiers of the joint forces operation (JFO)

Abstract

Introduction. The problem of brain injury is important in the structure of general disability and mortality. Currently, highly effective methods of its treatment have been developed, the basis of which is aimed at reducing hypoxia of the brain structures, stimulating redox processes, and strengthening the utilization of oxygen and glucose. Since the severity of brain injuries is accompanied by cognitive and mental disorders, therefore, drugs to restore these functions in victims are of crucial importance. One of these neuroprotectors is citicoline, which is used in the case of lesions of the central nervous system of traumatic and vascular origin. The aim of the study. On the basis of observation of soldiers of the JFO, using modern methods of neurophysiological diagnostics, to study the peculiarities of changes in the electrical activity of the brain and to evaluate the type of reaction of the central nervous system to the effect of the drug citicoline in the case of a battle of medium severity in the remote period. Methodology and Methods. An analysis of the results of an electroencephalographic study of 31 soldiers of the JFO between the ages of 20 and 55 years with a brain injury of medium severity in the remote period. Using the method of integral quantitative analysis of the entire EEG pattern, coefficients were determined that reflected the ratio of spectral powers of all EEG bands, and changes in the coherence of EEG activity in all areas of both hemispheres of the brain were evaluated. Brain reactivity was assessed by changes in spectral power, integral coefficients in response to the administration of citicoline, the adequacy of its dose and the need for its correction. Results and Discussion. In soldiers of the JFO with a brain injury of medium severity in the remote period, the asymmetry of EEG activity was combined with changes in interhemispheric coherence indicators. Desynchronization of EEG activity was more pronounced in the central areas of the cortex. In response to the administration of citicoline, we received the following variants of brain reactivity: strengthening of the disorganization of EEG patterns, a conditionally favorable reaction of brain reactivity, a hyporeactive reaction, which was characterized by a decrease in disorganization of EEG patterns, and a favorable reaction of brain reactivity with the activation of normal EEG pattern rhythms. Conclusions. Choosing the right dose of a neuroprotector is a crucial moment for restoring the function of neurons and normalizing cortical-subcortical connections in the case of craniocerebral trauma of medium severity (cerebral contusions). For the normalization of EEG rhythms and cortical-subcortical connections, a daily dose of 1000 mg of citicoline was found to be the most optimal.