Violation of cognitive functions( memory, speech, perception) - Causes, symptoms and treatment. MF.

Cognitive functions of the brain are the ability to understand, learn, study, understand, perceive and process( remember, transmit, use) external information. This function of the central nervous system is the highest nervous activity, without which the person's personality is lost.

Gnosis is the perception of information and its processing, the mnestic functions are memory, praxis and speech are the transmission of information. With the decrease of these mnestico - intellectual functions( taking into account the initial level), they speak of cognitive impairment, cognitive deficiency.

Reduction of cognitive functions is possible with neurodegenerative diseases, vascular diseases, neuroinfections, severe craniocerebral trauma. In the mechanism of development, the main role is played by mechanisms that separate the connections between the cerebral cortex and the subcortical structures.

The main risk factor is hypertension, which triggers the mechanisms of vascular trophic disorders, atherosclerosis. Episodes of acute circulatory disorders( strokes, transient ischemic attacks, cerebral crises) contribute to the development of cognitive disorders.

There is a violation of neurotransmitter systems: the degeneration of dopaminergic neurons with a decrease in the content of dopamine and its metabolites, the activity of noradrenergic neurons decreases, the process of excitotoxicity, that is, the death of neurons as a result of the violation of neurotransmitter interrelations, is launched. The magnitude of damage and localization of the pathological process is important.

Thus, with the defeat of the left hemisphere, it is possible to develop apraxia, aphasia, agraphy( inability to write), akalkuli( inability to read), alexia( inability to read), alphabetic agnosia( not recognition of letters), logic and analysis, mathematical abilities are violated,activity.

The defeat of the right hemisphere is manifested visually - spatial violations, the inability to consider the situation as a whole, the body scheme, orientation in space, emotional coloring of events, the ability to fantasize, dream, compose is violated.

Frontal lobes of the brain play an important role in almost all cognitive processes - memory, attention, will, expressiveness of speech, abstract thinking, planning.

Temporal lobes provide perception and processing of sounds, smells, visual images, integration of data from all sensory analyzers, memorization, experience, emotional perception of the world.

Damage to the parietal lobes of the brain gives a variety of options for cognitive impairment - disorientation of spatial orientation, alexia, apraxia( inability to perform purposeful actions), agraphy, acalculia, disregard of orientation - left-right.

Occipital lobes are a visual analyzer. Its functions are visual fields, color perception and recognition of faces, images, colors and the interrelation of objects with the color scale.

Cerebellar disease causes cerebellar cognitive affective syndrome with dulling of the emotional sphere, disinhibited inadequate behavior, speech impairment - reduced fluency of speech, the occurrence of grammatical errors.

Priests of cognitive impairment

Cognitive impairments can be temporary, after traumatic brain injury, poisoning and recovering in the time interval from days to years, and may have a progressive course - in Alzheimer's, Parkinson's, vascular diseases.

Vascular diseases of the brain are the most common cause of cognitive disorders of varying severity from minimal disorders to vascular dementia. The first place in the development of cognitive disorders is arterial hypertension, further occlusive atherosclerotic lesions of the main vessels, their combination, aggravated by acute circulatory disturbances - strokes, transient attacks, systemic circulatory disorders - arrhythmias, vascular malformations, angiopathies, rheological blood disorders.

Metabolic disorders in hypothyroidism, diabetes mellitus, renal and hepatic insufficiency, vitamin B12 deficiency, folic acid, alcoholism and drug addiction, abuse of antidepressants, neuroleptics, tranquilizers can cause the development of dysmetabolic cognitive disorders. With timely detection and treatment, they can be reversible.

Therefore, if you yourself have noticed some mental disorders that have appeared, contact your doctor. Not always the patient himself can realize that something is wrong with him. Man gradually loses the ability to think clearly, remember current events and at the same time clearly remembers the old, the intellect decreases, the orientation in space, the character changes to irritable, mental disturbances are possible, self-service is violated. Relatives can be the first to pay attention to violations of everyday behavior. In this case - bring the patient to a survey.

Cognitive impairment examination

To determine the presence of cognitive dysfunction, the baseline level is taken into account. The patient and relatives are questioned. There are cases of dementia in the genus, head trauma, alcohol use, episodes of depression, medications taken.

A neurologist on examination can detect a major disease with the corresponding neurological symptoms. An analysis of the mental state is carried out according to various tests by an approximately neurologist and in depth by a psychiatrist. Care, reproduction, memory, mood, execution of instructions, imagery of thinking, writing, counting, reading are studied.

The MMSE( Mini-mental State Examination) is used extensively-30 questions for an approximate assessment of the state of cognitive functions-orientation in time, place, perception, memory, speech, execution of a three-stage task, reading, and drawing. MMSE is used to assess the dynamics of cognitive functions, the adequacy and effectiveness of therapy.

Easy reduction of cognitive functions - 21 - 25 points, heavy 0-10 points.30 - 26 points is considered the norm, but the initial level of education should be taken into account.

A more accurate clinical dementia rating scale( CDR) is based on a study of violations of orientation, memory, interactions with others, behavior at home and at work, self-service. On this scale, 0 points - this is the norm, 1 point - mild dementia, 2 points - moderate dementia, 3 - severe dementia.

Scale - The frontal dysfunction battery is used for screening dementias with predominant lesions of frontal lobes or subcortical cerebral structures. This is a more complex technique and defines violations of thinking, analysis, generalization, choice, fluency, praxis, attention reaction.0 points - severe dementia.18 points - the highest cognitive abilities.

The test of drawing a clock is a simple test when a patient is asked to draw a clock - a dial with numbers and arrows indicating a certain time can be used for differential diagnosis of dementia of the frontal type and for the defeat of subcortical structures from Alzheimer's.

For a patient with acquired cognitive deficits, a laboratory examination is necessary: ​​blood test, lipidogram, thyroid-stimulating hormone, vitamin B 12, blood electrolytes, liver tests, creatinine, nitrogen, urea, blood sugar.

For neuroimaging the brain lesions use computer and magnetic resonance imaging, dopplerography of the main vessels, electroencephalography.

Method of electroencephalography .

The patient is examined for the presence of somatic diseases - hypertensive disease, chronic lung diseases, heart.

A differential diagnosis of vascular dementia and Alzheimer's disease is carried out. Alzheimer's disease is characterized by a more gradual onset, gradual slow progression, minimal neurologic disorders, late memory impairment and executive functions, cortical type of dementia, absence of walking disorders, atrophy in the hypocampal region and temporo-parietal cortex of the brain.

Alzheimer's disease .

Treatment of violations

Mandatory treatment of the underlying disease!

For the treatment of dementia apply donepezil, galantamine, rivastigmine, memantine( abixa, meme), nicergoline. Dosages, duration of administration and schedules are selected individually.

For the improvement of cognitive functions, drugs of different pharmacological groups with neuroprotective properties are used: glycine, cerebrolysin, Semax, somazine, ceraxone, nootropil, piracetam, praistar, memoplant, sermion, cavinton, mexidol, mildronate, solcoseryl, cortexin.
Mandatory treatment of hypercholesterolemia. This helps reduce the risk of developing cognitive dysfunction. This compliance with a diet with low cholesterol - vegetables, fruits, seafood, low-fat dairy products;vitamins of group B;statins - lipprimar, atorvastatin, simvatin, torvacard. Avoid smoking, alcohol abuse.

Consultation of a neurologist on the topic of cognitive impairment

Question: Is it useful to solve crossword puzzles?
Answer: Yes, this is a kind of "gymnastics" for the brain. It is necessary to force the brain to work - read, retell, remember, write, draw. ..

Question: Is it possible to develop cognitive disorders in multiple sclerosis?
Answer: Yes, the structure of deficiency of cognitive functions in multiple sclerosis is the violation of the speed of information processing, miscalculation( short-term memory), violation of attention and thinking, visual and spatial violations.

Question: what is "caused cognitive potential"?
Answer: The electrical reaction of the brain to the performance of a mental( cognitive) task. The neurophysiological method of induced cognitive potentials is the recording of bioelectric reactions of the brain in response to the performance of a mental task with the help of electroencephalography.

Question: what medications can I take on my own for easy distraction, attention and memory disorders after emotional overload?
Answer: glycine for 2 tablets dissolve under the tongue or preparations ginkgo biloba( memo, ginkofar) 1 tablet 3 times a day, B vitamins( neurovitan, milgamma) up to 1 month or nootropil - but the dosage will be prescribed by the doctor depending onage and disease. And it's better to see a doctor right away - you can underestimate the problem.

Neurologist doctor Kobzeva S.V.