Characteristics of Cognitive Impairments in Alcoholic and Dyscirculatory Encephalopathies
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Characteristics of Cognitive Impairments in Alcoholic and Dyscirculatory Encephalopathies O. I. Shevchenko, O. L. Lakhman, and E. V. Katamanova
Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 120, No. 5, Iss. 1, pp. 16–23, May, 2020. Original article submitted August 26, 2019. Accepted September 9, 2019. Objective. To identify the features of cognitive impairments (CI) in patients with alcoholic (AE) and dyscirculatory (DE) encephalopathies. Materials and methods. The study included 32 patients with DE and 30 with AE. Along with clinical observations, patients underwent computerized electroencephalography (EEG), recording of cognitive event-related potentials, and neuropsychological testing. Results and conclusions. The pathologies studied here showed both common and distinct signs in the clinical picture, in the emotional-personality domain, and impairments to cognitive processes. Common features of encephalopathies of different etiologies were CI and asthenic syndrome; AE was characterized by hyposthenic and DE by mixed (hyper- and hyposthenic) syndromes. The EEG showed that changes in bioelectrical activity in DE were predominantly located in the occipital-parietal areas of the cortex, while in AE they were located in the temporal and occipital-parietal areas. CI in DE and AE consisted of disorders to categorial thinking, long-term memory, reciprocal coordination, and digital gnosis, pointing to dysfunction of the frontal and parietal lobes of the left hemisphere, hippocampus, and corpus callosum. The indexes of the δ, β1, and β2 rhythms were discriminating features of CI in AE and DE. Keywords: cognitive impairments, alcoholic encephalopathy, dyscirculatory encephalopathy, differential diagnosis.
neurotransmitter impairments. These impairments can be separated into disorders associated with pathology to large and small vessels [4]. Common symptoms of DE include CI, motor abnormalities, and changes in behavior [5, 6]. Damage to the deep parts of the white matter results in dysfunction of the anterior areas of the brain. Vascular CI is characterized by emotional and behavioral impairments at onset, apparent as lability, decreased motivation and initiative, reduced insight, with inappropriate behavior, and with subsequent formation of memory defects degrading the clinical picture of DE [8, 9]. Alcoholic encephalopathy (AE) is due to chronic ethanol intoxication. It is apparent as crude functional impairments and organic changes in a variety of brain structures. Prolonged ethanol abuse causes nerve cells to undergo dystrophic changes and die, to be replaced by glial elements. The white matter of the brain is also damaged, and this is apparent as demyelination plaques and cysts at necrosis sites. Along with the concept of AE, the neurodegenerative stage of chronic alcohol intoxication is termed “toxic en-
Increasing interest in the problem of retaining adequate cognitive functioning is linked with the socially important fact of an aging population and the corresponding increases in th
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