Babenkov N.V.
Federal State University “Educational and Scientific Medical Center”
Office of the President of the Russian Federation, Moscow
INTRODUCTION In the treatment of patients of older age groups, it is especially important to use non-drug therapies that have both targeted and complex beneficial effects on the aging body. Disorders of the central regulation of vascular tone in the elderly are essential in the pathogenesis of dyscirculation in various forms of vascular pathology of the brain. Therefore, special attention should be paid to the normalization of the activity of the vasomotor centers, the autonomic nervous system.
Transcranial electrical stimulation (TES therapy) provides activation of the protective mechanisms of the brain due to the analgesic, anti-shock, anti-stress effects of the endorphin mechanisms of the analgesic system. Materials and methods. A study of the effectiveness of TES therapy of opioid systems of the brain in the complex treatment of dyscirculatory encephalopathy (DE) I-III art. in 86 patients.
Dyscirculatory encephalopathy developed against the background of cerebral atherosclerosis in 13 patients, arterial hypertension – in 22 and their combination – in 51 patients. There were 37 men and 49 women; the age of patients was 65-86 years. The course of treatment consisted of 5-15 procedures lasting 25-45 minutes, carried out by the Transair-02 device. The front-mastoidal electrodes were operated with a pulse current of 1-2 mA, an hour of 77 Hz, a pulse duration of 35 ms, taking into account individual tolerability. Taking into account the main contraindications, the method was not used in patients with atrial fibrillation and on the background of hypertensive crisis.
RESULTS. Neurological complaints in patients were quite diverse and characteristic of CHILDREN. Thus, headache and heaviness in the head were noted by all patients, noise in the head and ears – 48, dizziness – 64, increased irritability – 67, sleep disorders – 57, general weakness – 62, increased sweating – 29, itching – 7, pain and paresthesia in the extremities – 50, fluctuations in arterial pressure pressure – 63.
In the clinical picture of all patients, along with the scattered focal symptoms characteristic of DE, intellectual and mnestic disorders, a significant place was occupied by disorders from the psychoemotional sphere, manifested in the form of asthenic and asthenoipochondriac syndromes.
The combination of lesions of the autonomic nervous system with mental disorders indicated a violation of the mechanisms of psychovegetative integration in these patients. The analysis of the background EEG suggested the presence of a violation of the functional state of mainly non-specific brain stem structures. After the course of TES therapy, there was a distinct positive dynamics of the patients’ condition: reduction of headaches, dizziness, tinnitus, improvement of sleep, memory, mood, sleep disorders, reduction of fatigue, anxiety and general weakness.
The assessment of complaints and symptoms was carried out on a quantitative 4-point scale (0 – no violations, 1 – mild, 2 – moderate, 3 – severe), which made it possible to visually analyze the dynamics of individual signs of the disease in the examined group.
In 12 patients, the first procedures caused increased headaches, and therefore the intensity of the electrical effect was reduced to subthreshold. We did not observe any other side effects. Conjunctival biomicroscopy showed normalization of microvascular tone with an increase in the number of functioning capillaries, a decrease in vascular permeability and perivascular edema, aggregation of erythrocytes.
Changes in the electroencephalogram indicated an improvement in the functional state of the brain. Positive changes were noted on the EEG in the form of a decrease in the dominance of beta activity and desynchronization of biopotentials, an improvement in the severity of the alpha rhythm, and the appearance of zonal differences in the main rhythms. This indicates the stabilization of the central mechanisms of vascular regulation due to the action of endorphins on the work of the vasomotor center of the brain, stimulation of reparative processes, including neurotrophic, in trophic disorders of the vascular wall.
FINDINGS. TES therapy with course application can be successfully used in the complex treatment of patients with dyscirculatory encephalopathy in older age groups. TES therapy has a calming effect in the absence of an undesirable daytime hypnotic effect, relieves tension and anxiety, improves mood, stabilizes the activity of the autonomic nervous system, normalizes natural sleep.
