Issue №1-89, 2019

Structurally functional approach to the choice of medicamentous therapy of post-coma unconscious states (description of a clinical case)

¹ Shpichko A.I., ¹ Shpichko N.P., ¹ Zinchenko D.V., ¹ Borodin M.M.

¹ «Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology», Moscow, Russia

ABSTRACT

Article presents novel ideas about impairment formation mechanisms of consciousness, shows importance of objectivedata containing dominant clinical syndrome depending on the level of brain damage at each stage of the rehabilitationprocess for choosing the method of medicamentous correction. Post coma consciousness recovery is analyzed as a responseto gradual prescription of neuromodulators. Damaged brain function recovery is surveyed on the basis of the clinical scalesmethod, neurovisualisational and neurophysiological data.

KEYWORDS: uncosciousness states, monitoring of consciousness, neurotransmitters, restoration of consciousness.

References:

1. Chen Y, Shohami E, Constantini S, Weinstock M. Rivastigmine, a brainselective acetylcholinesterase inhibitor, ameliorates cognitive and motor deficits induced by closed-head injury in the mouse. J Neurotrauma. 1998;15(4):231-237. doi: 10.1089/neu.1998.15.231
2. Noble JM, Hauser WA, Silver JM. Effects of rivastigmine on cognitive function in patients with traumatic brain injury. J Correspondence Neurology. 2007;68:1749-1750. doi: 10.1212/01.wnl.0000266745.86958.ce
3. Tenovuo O. Central acetylcholinesterase inhibitors in the treatment of chronic traumatic brain injury-clinical experience in 111 patients. Prog Neuropsy-chopharmacol Biol Psychiat. 2005;29:61-67. doi: 10.1016/j.pnpbp.2004.10.006,
4. Siegel M. Why we sleep. Sci Am 2003;291:92-7.
5. Clauss RP, Nel HW. Drug induced arousal from permanent vegetative state. Neuro Rehabil 2006;21:23-8.
6. Bales JW, Wagner AK, Kline AE, Dixon CE. Persistent cognitive dysfunction after traumatic brain injury: A dopamine hypothesis. J Neuroscience and Biobe-havioral Reviews. 2009;33:981-1003/ doi: 10.1016/j.neubiorev.2009.03.011
7. Volkow N.D. et al. Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals // Am. J. Psychiatry. - 1998. - V.155. - P.344-349.
8. Alexadrova E.V., Zaitsev O.S., Potapov A.A. [Neurotransmitter basis of consciousness and uncosciousness states] Problems of neurosurgery named after N.N. Burdenko, 2014; 78; 1: 26-32
9. Zeman A. Consciousness. Brain 2001; 7: 1263-1289.
10. Alexadrova E.V., Tenedieva V.D., Potapov A.A. [Post-traumatic unconscious states: fundamental and clinical aspects] Moscow, Geotar-Media, 2015, 106
11. Alexadrova E.V., Tenedieva V.D., Potapov A.A. [Post-traumatic unconscious states: fundamental and clinical aspects] Moscow, Geotar-Media, 2015, 210-211
12. Zaitsev O.S., Grinenko O.A., Shaginyan G.G. [Early seizures and posttraumatic epilepsy] Neurosurgery and neurology of Kazakhstan, 2010, 4(21), 20-24
13. Zaitsev O.S., Tsarenko S.V., Chelyapina M.V., Sharova E.V., Alexandrova E.V., Potapov A.A. [Issues of the accounting of a weak neurotransmitter component in the pharmacotherapy of postcomatose states] Neurology, Neuropsychiatry, Psychosomatics. 2016;8;4:87-90
14. Zaitsev O.S., Tsarenko S.V. [Neuroreanimatology. Coma recovery (therapy of post-coma states)]Moscow, Litass, 2014, p.53
15. Rodriguez A, Whitson J, Granger R. Derivation and analysis of basic computational operations of thalamocortical circuits. J Cogn Neurosci 2004;16(5):856-77.
16. Showalter PE, Kimmel DN. Stimulating consciousness and cognition following severe brain injury: a new potential clinical use for lamotrigine. Brain Inj. 2000; 14(11):997-1001.
17. Stefan H, Feuerstein TJ. Novel anticonvulsant drugs. Pharmacol Ther. 2007;113(165-8):3.

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Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.