Method of assessment eeg reactivity in asthma and chronic obstructive bronchitis

 

The invention relates to medicine, namely to neurophysiology and pulmonology. Conduct EEG research before and after salbutamol samples. Determine the reactivity indices spectral power in Delta and theta rhythms, and when they increase more than 20% after the sample compared with the background to determine the increase in EEG reactivity in the brain, which is the basis for the additional purpose of psychotropic drugs. The method allows to increase the reliability of the assessment of the Central nervous system in bronchial asthma and chronic obstructive bronchitis and promptly appoint psychotropic drugs. table 1.

The invention relates to medicine, in particular to neurophysiology and pulmonology.

There is a method of conducting acute tests with beta2-adrainostimulatoram inhalation of salbutamol at a dose of 200 mcg for detecting the degree of reversibility of bronchial obstruction in diseases of the respiratory tract accompanied bronchoobstructive syndrome (Chuchalin A., Chronic obstructive pulmonary disease. Nevsky dialect" Saint-Petersburg, 1998, 130-143, 160-167).

This test can not objectively assess while their role in the pathogenesis of these diseases recognized.

There is a method of assessing the functional state of the CNS in patients with BA and COB by recording and analyzing EEG patterns (Lowicki S. C. Diagnosis, pathogenesis and therapy of disorders of the Central nervous regulation in patients with bronchial asthma. 1997, 28-45, 94-106, 181-190).

The disadvantages of this method are the great polymorphism of the background EEG patterns; lack of specific changes in patients with BA and COB; the inability to individually evaluate electrical reactivity in BA and COB, which is important for the timely appointment of adequate therapy.

Solutions assessment objectives EEG reactivity in BA and COB we have not identified.

The technical result of the proposed solution is to eliminate the above disadvantages, creating a new way to objectively determine the improvements EEG-reactivity, which is the basis for the assignment of psychotropic drugs.

This result is achieved in that conduct EEG research before and after salbutamol samples with the definition of reactivity indices spectral power in Delta and theta rhythms, and when they increase more than 20% after the sample compared with the background determined by the Oia psychotropic drugs.

Does not follow from the prior art is the fact that the change of reactivity indices average spectral power in Delta and theta rhythms more than 20% after salbutamol samples compared to the background can serve as a diagnostic criterion EEG reactivity in BA and COB.

The method is as follows.

Patient BA or COB conduct EEG research. Recording EEG perform monopolar from symmetric zones: F3, F4, C3, C4, P3, P4, O1, O2, F7, F8, T3, T4, T5, T6 (scheme 10-20%). The frequency-amplitude characteristics and topographic distribution of EEG rhythms was determined by spectral analysis of the EEG method fast Fourier transform averaged not less than 30 ages of 2 with subsequent mapping system "BRAINSYS" (Russia).

Then the patient spends inhalation of 200 g salbutamol by metered-dose aerosol inhaler, after 10 minutes, repeat the recording of the EEG. The data obtained after inhalation of salbutamol compared with the background EEG recording. To do this, calculate the sum of the average Delta - and theta-indices of the right and left hemispheres before and after samples. Determine the difference between the amounts and calculate the percent of this figure from the background value is increased EEG reactivity brain what is the basis for the assignment of psychotropic drugs in patients with bronchial asthma and chronic obstructive bronchitis.

Example 1 Patient So history 2806), 56. Diagnosis: bronchial asthma, endogenous form of heavy flow. Chronic obstructive bronchitis, emphysema, respiratory failure II. The patient complained of irritability, tearfulness, headaches, decreased mood. Conducted therapy COB-bronchospasmolytic (berodual for 3 doses 4 times a day), mukolitikami. But was detected resistance to therapy. Recording and spectral analysis of the EEG before and after acute test with salbutamol showed the dynamics of the average (averaged over all derivations) metric of spectral power in Delta and theta ranges below (L - left hemisphere, P - the right hemisphere, in MKV) (see table).

The sum of the spectral power in Delta and theta rhythms to sample equal 6.9+6.7+5.5+5.1= 24.2, and after samples: 10.5+10.4+7.3+7.4=35.6. A measure of reactivity equal to the difference 35.6-24.2=11.4. This accounts for 47.1% of the background values.

Therefore, EEG reactivity exceeded 20% in comparison with the background. Given EEG data in the combined therapy were included antiproxy is the mental condition of the patient improved, has changed in regard to his condition stabilized mood, decreased irritability.

This method is used by us 60 patients of bronchial asthma and chronic obstructive bronchitis. In 28 patients (46.6%) of the marked increase in the reactivity of the spectral power in Delta and theta rhythms more than 20% after salbutamol samples compared with the background. These data were taken into account when conducting therapy with bronchial asthma and chronic obstructive bronchitis with administration of psychotropic medicines.

Thus, for the first time developed a way to determine the improvements EEG reactivity in BA and COB, which is the basis for further inclusion in the complex of therapeutic measures psychotropic drugs, improving the efficiency of the treatment of the above diseases.

Claims

Method of assessment EEG reactivity in asthma and chronic obstructive bronchitis, characterized by carrying out EEG studies before and after salbutamol samples with indices of reactivity power of Delta and theta rhythms, and when they increase more than 20% after the sample compared with the background driving electroencephalography

 

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FIELD: medicine, neurology, psychopathology, neurosurgery, neurophysiology, experimental neurobiology.

SUBSTANCE: one should simultaneously register electroencephalogram (EEG) to detect the level of constant potential (LCP). At LCP negativization and increased EEG power one should detect depolarizational activation of neurons and enhanced metabolism. At LCP negativization and decreased EEG power - depolarized inhibition of neurons and metabolism suppression. At LCP positivation and increased EEG power - either repolarized or hyperpolarized activation of neurons and enhanced metabolism. At LCP positivation and decreased EEG power - hyperpolarized suppression of neurons and decreased metabolism of nervous tissue. The method enables to correctly detect therapeutic tactics due to simultaneous LCP and EEG registration that enables to differentiate transition from one functional and metabolic state into another.

EFFECT: higher accuracy of diagnostics.

5 dwg, 1 ex, 1 tbl

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