State Institution "Institute of Neurosurgery named after acad. A. P. Romodanov of the National Academy of Medical Sciences of Ukraine", Kyiv
Introduction. Occupational desadaptation of mental workers is a subject of research for many years. Occupational "burnout" and related to it manifestations of occupational desadaptation are among disorders of social and occupational functioning. Purpose. To develop a comprehensive diagnostics of cognitive disorders and occupational desadaptation in mental workers with chronic brain ischemia.
Materials and methods. There have been examined 48 patients with chronic brain ischemia. Clinical and neurological examination, a combination of neuropsychological testing, based on the use of rating scales: the Hospital Anxiety and Depression Scale (HADS), the Montreal Cognitive Assessment Scale (MoSA), evaluation of occupational adaptation (degree of desadaptation), a scale on burning (MBІ); ultrasound investigation of blood vessels on head and neck; cognitive auditory evoked potentials (ABR) P300; computer electroencephalography (cEEG) with mapping; neuroimaging examinations (MRI, CT); statistic analysis of the data obtained, have been conducted. The patients were divided into two groups: I – those with occlusive lesions of brachiocephalic arteries (up to 60 %, according to the USI) – 23 patients; II – without atherosclerotic chan ges – 25 patients.
Results. The results of neuropsychological testing, according to the grading scale HADS in patients of group I, showed a significant increase in cases of clinical anxiety – 58 %, as compared with group II (35 % cases). The signs of occupational desadaptation were found in 79,2 % of the examined patients, characterized by moderate to expressed changes. In patients with hypertensive changes in the main arteries of the head and neck, according to ultrasound investigation, there have been recorded more significant changes in amplitude-hourly parameters of P300. A relation between cognitive disorders and occupational desadaptation and the general state of the cerebral blood flow has been revealed.
Conclusion. A comprehensive method of neurophysiological and neuropsychological testing has been developed, available for practical use in many health care institutions of Ukraine, in order to detect cognitive disorders in patients with chronic brain ischemia, for monitoring the effectiveness of recovery in the process of treatment, which is important for medical, social and occupational rehabilitation.
Keywords: cognitive disorders, occupational desadaptation, acoustic potentials, chronic brain ischemia