Comparison of the brain metabolism state, cognitive functions and life quality in patients with chronic brain ischemia

Background: chronic cerebral ischemia is a common vascular pathology, the main etiopathogenetic mechanism of which is a progressive decrease in cerebral perfusion, leading to hypoxia of the nervous tissue and neuronal death. Chronic insufficiency of cerebral blood flow leads to the development of a number of symptoms that significantly reduce the quality of life of patients and gradually lead to disability. At the same time, along with the defeat of a number of areas of the brain, there is a destruction of prefrontal-subcortical connections that take part in the genesis of vascular cognitive impairment, the degree of which ranges from mild deficiency to dementia. The priority direction in assessing the severity of cognitive disorders in patients with chronic cerebral ischemia is to identify the initial forms of cognitive decline for the prevention of dementia. Positron emission computed tomography with fluorine-18-labeled glucose - 2(18F)-fluoro-2-deoxy-D-glucose, may be a promising method for detecting intellectual-mnestic disorders at the preclinical stage, allowing to evaluate metabolic and functional disorders of various structural parts of the central nervous system.
Design and methods: the sample consisted of 36 patients with chronic cerebral ischemia, who underwent a neurological examination, an assessment using the mini-mental state assessment scales, MOCA, and SF-36. Positron emission tomography with 18-fluorodeoxyglucose was also performed. All patients with chronic cerebral ischemia had cognitive impairment and reduced quality of life.
Results: according to positron emission tomography data, areas with hypoperfusion (prefrontal cortex, parietal and temporal lobes) were identified and correlated with manifestations of cognitive dysfunction. A correlation was also found between the severity of apractognostic disorders, mnestic disorders, and a decrease in perfusion in the anteroposterior parts of the parietal lobes and the left temporal lobe. Also found the relationship between the severity of intellectual dysfunction and the amount of damage to the nervous tissue.

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