Neurophysiological Evaluation of Central Nervous System Reactivity in Response to Pharmacological Effect in Acute Cerebral Insufficiency of Various Genesis

Abstract

One of the objectives of modern clinical neurophysiology is the identification and quantification of the electroencephalography (EEG) changes during the external influences. This is necessary in order to approach an understanding of the mechanisms of formation of responses of the brain during the neuroprotective pharmacotherapy for acute cerebral insufficiency (ACI). The aim of this study was the quantitative assessment of EEG changes during the stimulation (pharmacological action) that are not available by visual analysis, to identify the neurophysiological mechanisms of formation of responses of the brain. Materials and methods. The study included 86 patients, 46 patients with ischemic stroke (IS) and 40 patients with severe traumatic brain injury (STBI), who were treated in the neurosurgical centre of the Donetsk regional clinical territorial medical Association (DRCTMA) in the period of 2005-2011. We conducted computer tomography and magnetic resonance imaging of the brain, transcranial ultrasonographic doppler, EEG. The studies were conducted before the introduction and after the maximum concentration of the drug Tiocetam in plasma (in 30 minutes) in a daily dose of 15, 20 and 30 ml for 7 days. Results. We developed the classification of the brain reactivity - three (13 subgroups) reactions of central nervous system the pharmacological effects of the introduction of various nootropic drugs. Type I is the lack of significant changes in indicators of absolute spectral power and integral coefficients is prognostically unfavorable. Reaction of type II reflect changes in cortical-subcortical interactions in response to pharmacological influence. Reaction of the III type reflected changes in interactions at the level of the cortex. Factors, which affected the efficiency of intensive therapy by Tiocetam are the functional preservation of cerebral structures, neurotransmitter and metabolic mechanisms involved in the functional response and the dose Tiocetam. Conclusion. Using the classification of types of the reactions of CNS in response to the introduction of any neurotropic drug, it is possible to assess the adequacy of the applied dose of the drug and the need for it future correction.