RU2521345C1 - Diagnostic technique for cerebral functional state according to health level - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: cognitive endogenous responses in the frontal central brain to audio stimulation are recorded. Two types of tone flips of the intensity of 50 to 100 dB - essential and non-essential ones with the frequency of 1,000 Hz are supplied. Besides, a person being tested performs a speaking test in the form of counting the essential tone flips aloud. A latency and amplitude of the first, second and third negative peaks, as well as of the first, second and third positive peaks are recorded in both hemispheres. That is followed by processing the derived data at the analysis stage of 750-1,000 ms. An interhemispheric latency of a perception complex $$(L_{\left(P1-N1-P2\right)}^{IH}),$$

an interhemispheric amplitude of an endogenous wave P300 $$(A_{P300}^{IH})$$

and an interhemispheric amplitude of a cognitive complex $$(L_{\left(N2-N3\right)}^{IH})$$

are determined. When $$L_{\left(P1-N1-P2\right)}^{IH}<130ms,$$

$$A_{P300}^{IH}>10mcV$$

and $$L_{\left(N2-N3\right)}^{IH}>200ms,$$

the cerebral functional state is diagnosed as good and the health level I; $$130ms\le L_{\left(P1-N1-P2\right)}^{IH}<190ms,$$

$$8mcV\le A_{P300}^{IH}\le 10mcV$$

and $$160ms\le L_{\left(N2-N3\right)}^{IH}\le 200ms$$

show the satisfactory cerebral state and the health level II; $$190ms\le L_{\left(P1-N1-P2\right)}^{IH}\le 320ms,$$

$$5\le A_{P300}^{IH}<8mcV$$

and $$140\le L_{\left(N2-N3\right)}^{IH}<160ms$$

show the moderate cerebral disorder and the health level III; with $$L_{\left(P1-N1-P2\right)}^{IH}>320ms,$$

$$A_{P300}^{IH}<5mcV$$

and $$L_{\left(N2-N3\right)}^{IH}<140ms,$$

a considerable disorder of the cerebral functional state and the health level IV.

EFFECT: method provides more reliable diagnosis that is ensured by studying the cognitive induced potentials and mathematical analysis of the derived data.

2 cl, 5 dwg, 7 tbl, 2 ex

Description

The invention relates to medicine, in particular to the field of psychophysiology, and can be used to diagnose the functional state of the brain of patients aged 20-40 years at various levels of health.

Health according to the charter of the World Health Organization (WHO) is a state of complete physical, mental and social well-being, and not just the absence of diseases and physical defects (WHO definition, 1968). The functional state of the body in the interval between norm and pathology determines the risk of the onset and development of the disease. In recent decades, ideas about a gradual change in a person’s health status, about the quality and quantity of his health have become increasingly used. This approach to assessing health corresponds to the classification of body conditions adopted today, which includes:

- conditions with sufficient functional (adaptive) reserve;

- prenosological conditions in which adverse changes in the body's work are compensated by a higher than normal tension of regulatory systems;

- premorbid conditions characterized by a decrease in the functional reserves of the body;

- the state of failure of adaptation, decompensation, and the development of diseases (Kaznacheev V.P., Baevsky P.M., Berseneva A.P. Donosological diagnosis in the practice of mass screening of the population. - L. - 1980. - 260 p.).

The timely detected state of “tension” of regulatory systems allows you to recognize the causes of dysfunctions, create conditions for the body to compensate for the effects of traumatic effects, increase reserve capabilities.

It has now been proven that the entire spectrum of the state of health, illness, as well as the conditions between health and illness, is associated with the periodic system of adaptive reactions, and the general adaptation syndrome refers to the entire set of adaptive reactions, and not just a stress reaction. And the whole spectrum of health conditions, diseases, and intermediate states between them is connected with two systems: a system of adaptive reactions and a system of areactivity states that ensure the maintenance of homeostasis and nonspecific resistance of the body.

The essence of any adaptable system is the ability to adjust its reactions according to changes in the stimulus based on existing experience, as well as to accumulate and store new information. That is why adaptation is possible only on condition that the memory mechanisms are preserved and work clearly. The central nervous system (CNS) is the main link in the chain of formation of general non-specific adaptive reactions, each of which corresponds to its own level of functional activity of the body. The formation of intercentral connections of the cerebral cortex with subcortical structures creates a stable morphological and functional basis for optimizing the adaptive reactions of the body, thus indicating the relationship between the functional state of the brain and the type of adaptive reaction (Korobeynikova E.P. Changes in the human alpha rhythm in general non-specific adaptive reactions caused by an alternating magnetic field. // The use of lasers and magnets in biology and medicine. - Rostov-n / D., 1983. - P.64-65).

It was found that the processes of self-organization in the body depend on the type of adaptive reaction, the level of reactivity at which they develop, or the state of areactivity; and the body's resistance largely determines the incidence and severity of the disease (Garkavi L.Kh., Kvakina EB, Kuzmenko TS Antistress reactions and activation therapy. Activation reaction as a way to health through self-organization processes. - M .: Imedis , 1998. - p. 540-656).

From literary sources it is known that the optimal functioning of the organism as a whole and its health depend on the functional state of the brain. The functional state of the body in the interval between norm and pathology determines the risk of the onset and development of the disease. In this regard, the level of health can be defined as the body's ability to withstand disease. Therefore, the higher the level of health, the lower the risk of developing diseases. The problem of assessing the current level of individual health and monitoring its changes is becoming increasingly important.

For an objective characterization of a person’s functional state in norm and pathology, indicators of brain bioelectric activity are widely used. Its most studied form is the electroencephalogram (EEG). Many methods have been developed for analyzing brain biorhythms recorded using EEG (Rusinov BC, Grindel OM, Boldyreva GN, Vakar EM Biopotentials of the human brain (mathematical analysis). - M .: Medicine, 1987. P. 67-254 and others.).

There is a method of psychophysiological research (see USSR author's certificate No. 1454389, IPC A 61 B 5/16), which includes exposure of the subject to light stimuli during EEG recording, with the summation of the reactions obtained and the allocation of “visual evoked potentials”. The method consists in the fact that the subject is presented with a single stimulus - a flash of light and an EEG is recorded. As a result of synchronous spatial averaging of reactions, the response to a single stimulus is isolated in the form of visual evoked potentials and, on this basis, the safety of brain reactions is judged.

The disadvantages of the technical solution include the low reliability of the method, since it does not fully reflect the higher cortical functions, since light stimulation gives variability in the responses generated against the background of spontaneous bioelectric brain activity; the zone of registration of responses to light stimuli is localized in the caudal regions, mainly in the occipital region, where the projection zone of the visual cortex (the projection area of the primary information processing is the 17th field in the spur groove, and the projection area of the secondary information processing is the 18th and 19th field) in the frontal and prefrontal regions responsible for the processes of differentiation, memory and attention.

A known method of recording a level shift of the constant electric potential of the brain when assessing the stability of a functional state (see patent RU No. 2007116, IPC AB 5/04, publication date 02/15/1994), in which a pair of recording electrodes are mounted on the subject’s head over a given area of the brain, the electrodes are connected to an electric voltage amplifier, the output of which is read at the beginning and at the end of the shear caused by external influence, the values of the constant electric potential and compare them with each other.

The disadvantages of this method are the increased complexity of the registration process and the limited scope, the lack of differential diagnosis of activated brain regions, as well as low information content and low accuracy of the results due to the instability of the electrode resistance.

A known method for diagnosing the degree of psychophysiological maladaptation (see application RU No. 98108840, IPC АВВ 5/0476, publication date 02/10/2000), including recording the brain’s biopotentials at rest, followed by a quantitative analysis of the frequency-amplitude characteristics of the electroencephalogram, in particular, in the range alpha activity with an estimate of the spectral power of alpha activity, with an absolute power of alpha activity of less than 10 μV2 or a value of the absolute power of alpha activity of more than 80 μV2 and / or relative power of alpha-active More than 50% diagnose a significant degree of psychophysiological maladaptation.

However, the alpha rhythm analyzed in the method is the dominant rhythm of passive wakefulness at rest with closed eyes, recorded in the caudal regions of the brain, in the projection of the visual cortex, which cannot objectively reflect the functional adaptation and maladaptation of the brain, without analysis of evoked potentials and without sample from mental load there are no objective criteria that analyze the adaptation processes and the nature of functional activity.

As the closest analogue, a method for studying the functional state of the brain was adopted (see patent RU No. 2130753, IPC AB 5/00, publication date 05/27/1999), which includes sound stimulation in the form of a series of clicks supplied to the patient’s headphones with subsequent registration of characteristics of the functional state of the brain and their analysis.

However, the analysis of sound images for a time interval characterizing the processes of excitability and the state of the whole brain as a whole is based only on a subjective assessment of the subject; there is no exact data in which area of the brain during sound stimulation signals are recorded; no mathematical analysis of the recorded signals. In the closest analogue, serial sound stimuli were presented with increasing interaural delay (T) between paired pulses from 1000 μs until two separately audible sound images appeared (“the moment of sound splitting”). However, a time delay is necessary only to eliminate (“cut off") the stimulus artifact that distorts the beginning of the curve. A change in the delay value of the amplifier only affects the appearance of the initial portion of the curve, but does not affect the latent periods of the recorded waves. In the closest analogue, the “Latrometer” device is used, intended only for hearing research, and not for analysis of brain activity, and studies of the functional state of the brain were carried out only in a group of children aged 10-15 years (prepubertal (10-12 years) and puberty (13-15 years)) (from literature it is known that at puberty the regulation of cortical-subcortical connections changes with the activation of subcortical structures, which affects the results and cannot be used for other age groups).

The authors proposed a method in which the cognitive evoked potentials method is used to determine functional hemisphere asymmetry, which allows obtaining information on the state of peripheral and central links of various sensory systems using evoked sensory responses to the presented stimulus and is an objective and non-invasive method for testing the central nervous system functions.

The essence of the method “Cognitive evoked potentials (hereinafter referred to as VP)” is that they isolate not just reactions to a particular stimulus associated with the arrival of afferentation, but analyze endogenous events (responses) that occur in the brain and are associated with recognition and storage stimulus, as well as the thought processes associated with decision making.

The processes of recognizing and storing information, as well as making responsible decisions, are accompanied by more or less regular neurodynamic changes that can be objectively recorded. The selection of endogenous responses occurs due to the multiple supply of stimuli and the summation of each subsequent response with the previous one. The induced endogenous responses are lower than the spontaneous bioelectric activity recorded by EEG, and the ratio between the signal of evoked and spontaneous activity for stem components is less than 1/100 (Gnezditsky V.V. Isolation of evoked potentials into single stimuli is a method of spatial synchronous averaging. // Physiology person. - 1990. - T.16 - No. 3.- S.119-126).

In response to a command to differentially determine a significant stimulus from an insignificant and remember it in the brain, a cognitive complex is recorded that includes perception (in the form of the first positive peak P1 with latency in the region of 75 ms), recognition and differentiation (in the form of a negative peak N2 with latency in the region of 170 ms) and decision making with memorization (in the form of an endogenous positive wave of P300 latency in the region of 300-354 ms).

According to various scientific sources, it was found that the main structures responsible for the generation of the endogenous P300 wave are the hippocampus, frontal lobe, parietal region, and thalamus (Polich JMCortex. - 1980. - V.16. - No. 1. - P.39- fifty). The most significant impact of the biological parameters is exerted by age, cognitive abilities and the level of wakefulness (drowsiness, sleep).

The technical task of the invention is the development of a method for diagnosing the functional state of the brain at different levels of health with high reliability and objectivity.

The technical result achieved in solving the problem is expressed in expanding the field of application of the method “Cognitive evoked potentials” with its new purpose, as well as increasing the reliability and objectivity of the method by obtaining cognitive endogenous responses from projection motor-speech zones of the brain with an estimate right and left hemisphere in a complex and separately.

The problem is solved in that in the method for diagnosing the functional state of the brain according to the level of health, including sound stimulation in the form of a series of clicks supplied to the head headphones of the subject, recording the characteristics of the functional state of the cerebral hemispheres and their mathematical processing, as characteristics of the functional state of the cerebral hemispheres cognitive endogenous responses are recorded in the frontal-central parts of the brain of the subject through e electrodes mounted on the surface of the head in the fronto-central parts of the right (F8, F4, C4) and left (F7, F3, C3) hemispheres according to the international system "10-20", and with sound stimulation the subject is in a state of active wakefulness in position sitting with your eyes closed, at the same time, two types of tone clicks with an intensity of 50 to 100 dB (significant for diagnostics with a frequency of 2000 Hz and insignificant with a frequency of 1000 Hz) are randomly delivered to the headphone biaurally in the headphone, and the intensity of significant tone clicks is less than that of insignificant ones not m less than 20 dB and their share is 30% of the total number of tone clicks, in addition, the subject performs a speech test in the form of counting out loud tone clicks, while in both hemispheres the latency (L) and amplitude (A) of the first (N1 ), the second (N2) and third (N3) negative peaks, as well as the first (P1), second (P2) and third (P3) positive peaks, after which the data are processed during the analysis era of 750-1000 ms and subsequent analysis, in this case, the interhemispheric latency of the perception complex is determined by the formulas:

$$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}=\left(\frac{L_{P\mathrm{one}}^{PP}+L_{P\mathrm{one}}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}+\frac{L_{N\mathrm{one}}^{PP}+L_{N\mathrm{one}}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}+\frac{L_{P2}^{PP}+L_{P2}^{LP}}{2}\right)/n$$

Where

- межполушарная латентность комплекса восприятия, мс; $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}$$

- interhemispheric latency of the perceptual complex, ms;

(P1-N1-P2) - a perception complex consisting of the first positive (P1), first negative (N1) and second positive (P2) peaks;

, $$L_{P1}^{ЛП}$$

- латентность первого позитивного пика P1 для правого и левого полушария соответственно, мс; $$L_{P\mathrm{one}}^{PP}$$

, $$L_{P\mathrm{one}}^{LP}$$

- latency of the first positive peak P1 for the right and left hemisphere, respectively, ms;

, $$L_{N1}^{ЛП}$$

- латентность первого негативного пика N1 для правого и левого полушария соответственно, мс; $$L_{N\mathrm{one}}^{PP}$$

, $$L_{N\mathrm{one}}^{LP}$$

- latency of the first negative peak N1 for the right and left hemisphere, respectively, ms;

, $$L_{P2}^{ЛП}$$

- латентность второго позитивного пика P2 для правого и левого полушария соответственно, мс; $$L_{P2}^{PP}$$

, $$L_{P2}^{LP}$$

- latency of the second positive peak P2 for the right and left hemisphere, respectively, ms;

n is the number of recorded peaks from the perception complex; the hemispheric amplitude of the endogenous wave P300 is determined by the formula:

$$A_{P300}^{MP}=\frac{A_{P300}^{PP}+A_{P300}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}$$

Where

- межполушарная амплитуда эндогенной волны P300, мкВ; $$A_{P300}^{MP}$$

- interhemispheric amplitude of the endogenous wave P300, μV;

, $$A_{P300}^{ЛП}$$

- амплитуда эндогенной волны P300 для правого и левого полушария соответственно, мкВ, которую определяют по формулам: $$A_{P300}^{PP}$$

, $$A_{P300}^{LP}$$

- the amplitude of the endogenous wave P300 for the right and left hemisphere, respectively, μV, which is determined by the formulas:

$$A_{P300}^{PP}=\frac{A_{N2}^{PP}}{A_{P3}^{PP}},A_{P300}^{LP}=\frac{A_{N2}^{LP}}{A_{P3}^{LP}}$$

Where

, $$A_{N2}^{ЛП}$$

- амплитуда второго негативного пика N2 для правого и левого полушария соответственно, мкВ; $$A_{N2}^{PP}$$

, $$A_{N2}^{LP}$$

- the amplitude of the second negative peak N2 for the right and left hemisphere, respectively, μV;

, $$A_{P3}^{ЛП}$$

- амплитуда третьего позитивного пика P3 для правого и левого полушария соответственно, мкВ; $$A_{P3}^{PP}$$

, $$A_{P3}^{LP}$$

- the amplitude of the third positive peak P3 for the right and left hemisphere, respectively, μV;

further determine the interhemispheric latency of the cognitive complex according to the formula:

$$L_{\left(N2-N3\right)}^{MP}=\frac{L_{N3}^{PP}+L_{N3}^{LP}}{2}-\frac{L_{N2}^{PP}+L_{N2}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}$$

Where

- межполушарная латентность когнитивного комплекса, мс; $$L_{\left(N2-N3\right)}^{MP}$$

- interhemispheric latency of the cognitive complex, ms;

(N2-N3) - a cognitive complex consisting of the second (N2) and third (N3) negative peaks;

, $$L_{N2}^{ЛП}$$

- латентность второго негативного пика N2 для правого и левого полушария соответственно, мс; $$L_{N2}^{PP}$$

, $$L_{N2}^{LP}$$

- latency of the second negative peak N2 for the right and left hemisphere, respectively, ms;

, $$L_{N3}^{ЛП}$$

- латентность третьего негативного пика N3 для правого и левого полушария соответственно, мс; причем в случаях, когда $$L_{\left(P1-N1-P2\right)}^{МП}<130мс$$

, $$A_{P300}^{МП}>10мкВ$$

и $$L_{\left(N2-N3\right)}^{МП}>200мс$$

, функциональное состояние головного мозга соответствует I уровню здоровья (хорошее функциональное состояние мозга); при $$130мс\le L_{\left(P1-N1-P2\right)}^{МП}<190мс$$

, $$8мкВ\le A_{P300}^{МП}\le 10мкВ$$

и $$160мс\le L_{\left(N2-N3\right)}^{МП}\le 200мс$$

соответствует II уровню здоровья (удовлетворительное функциональное состояние мозга); при $$190мс\le L_{\left(P1-N1-P2\right)}^{МП}\le 320мс$$

, $$5\le A_{P300}^{МП}<8мкВ$$

и $$140\le L_{\left(N2-N3\right)}^{МП}<160мс$$

соответствует III уровню здоровья (умеренное нарушение функционального состояния мозга); при $$L_{\left(P1-N1-P2\right)}^{МП}>320мс$$

, $$A_{P300}^{МП}<5мкВ$$

и $$L_{\left(N2-N3\right)}^{МП}<140мс$$

соответствует IV уровню здоровья (значительное нарушение функционального состояния мозга). Кроме того, в способе подают значимые тоновые щелчки интенсивностью 60 дБ и незначимые тоновые щелчки интенсивностью 80 дБ. $$L_{N3}^{PP}$$

, $$L_{N3}^{LP}$$

- latency of the third negative peak N3 for the right and left hemisphere, respectively, ms; and in cases where $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<130m\mathrm{from}$$

, $$A_{P300}^{MP}>10m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}>200m\mathrm{from}$$

, the functional state of the brain corresponds to the first level of health (good functional state of the brain); at $$130m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<190m\mathrm{from}$$

, $$8m\mathrm{to}\mathrm{AT}\le A_{P300}^{MP}\le 10m\mathrm{to}\mathrm{AT}$$

and $$160m\mathrm{from}\le L_{\left(N2-N3\right)}^{MP}\le 200m\mathrm{from}$$

corresponds to the II level of health (satisfactory functional state of the brain); at $$190m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}\le 320m\mathrm{from}$$

, $$5\le A_{P300}^{MP}<8m\mathrm{to}\mathrm{AT}$$

and $$140\le L_{\left(N2-N3\right)}^{MP}<160m\mathrm{from}$$

corresponds to the III level of health (moderate impairment of the functional state of the brain); at $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}>320m\mathrm{from}$$

, $$A_{P300}^{MP}<5m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}<140m\mathrm{from}$$

corresponds to the IV level of health (a significant violation of the functional state of the brain). In addition, the method provides significant tone clicks with an intensity of 60 dB and non-significant tone clicks with an intensity of 80 dB.

A comparative analysis of the essential features of the proposed technical solution with the essential features of analogues indicates its compliance with the criterion of "novelty."

In this case, the distinguishing features of the claims solve the following functional tasks.

The sign “as characteristics of the functional state of the cerebral hemispheres, cognitive endogenous responses are recorded in the fronto-central parts of the brain of the subject using electrodes mounted on the surface of the head in the fronto-central parts of the right (F8, F4, C4) and left (F7, F3, C3 ) the hemisphere according to the international system "10-20" allows you to identify objective criteria for the diagnosis of the functional state of the brain, as well as to improve the accuracy and reliability of the data, because it is when the sound ovyh signals as tone clicks occurs most actively evaluation and signal processing with subsequent transfer of information in the frontal lobes of the cortex, where the differentiation and storing information.

The sign “during sound stimulation the subject is in a state of active wakefulness” provides a high level of perception of the task, since with passive relaxed wakefulness the concentration of attention decreases, absent-mindedness and distraction increase.

The sign “[the subject is] in a sitting position” also provides a high level of perception of the task, since lying the subject can go into a nap, which will reduce attention and concentration on the examination, may fall asleep, which will reduce reliability, and may disrupt the position of the sensors during movement, increase interference from the side of the recording electrodes, can change their position on the surface of the head.

The sign “[examinee] ... with eyes closed” increases the focus on the examination, since the examinee is not distracted by external stimuli, perceives better sound stimulation of different intensities, makes fewer errors, more accurately calculates significant tone clicks.

The sign “two types of tone clicks with an intensity of 50 to 100 dB are randomly fed into the headset biaurally - significant for diagnosis with a frequency of 2000 Hz and insignificant with a frequency of 1000 Hz” and “the proportion of [significant tone clicks] is 30% of the total number of tone clicks” allows with higher reliability to isolate endogenous responses to significant tone clicks with an endogenous P300 wave, and the response to insignificant tone clicks is a response to sound stimulation without recognition.

The sign “the intensity of significant tone clicks is less than that of insignificant ones by no less than 20 dB” improves the recognition of significant tone clicks among insignificant ones.

The sign "the subject performs a speech test in the form of aloud counting of significant tone clicks" allows you to increase the intensity of endogenous responses to significant tone clicks with the expansion of the registration area in the hemispheres; during the identification of significant tone clicks using a speech sample, activation of the medial and lateral zones of the frontal cortex is observed.

The sign “in both hemispheres record latency (L) and amplitude (A) of the first (N1), second (N2) and third (N3) negative peaks, as well as the first (P1), second (P2) and third (P3) positive peaks "Allows with high probability and reliability to record the characteristics of endogenous responses to significant tone clicks.

The sign “perform processing of the obtained data” improves the diagnostic efficiency by obtaining reliable and stable data by filtering “noise”, automatically accumulating, averaging, and plotting endogenous responses to significant tone clicks for the left and right hemispheres.

The sign “[processing of the obtained data] during the analysis era in the range of 750-1000 ms” allows with high probability and reliability to fix the appearance of the endogenous P300 wave during the calculation of significant tone clicks.

Signs of “analysis, while determining interhemispheric latency of the perception complex according to the formulas:

$$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}=\left(\frac{L_{P\mathrm{one}}^{PP}+L_{P\mathrm{one}}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}+\frac{L_{N\mathrm{one}}^{PP}+L_{N\mathrm{one}}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}+\frac{L_{P2}^{PP}+L_{P2}^{LP}}{2}\right)/n$$

Where

- межполушарная латентность комплекса восприятия, мс; $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

- interhemispheric latency of the perceptual complex, ms;

(P1-N1-P2) - a perception complex consisting of the first positive (P1), first negative (N1) and second positive (P2) peaks;

, $$L_{P1}^{ЛП}$$

- латентность первого позитивного пика P1 для правого и левого полушария соответственно, мс; $$L_{P\mathrm{one}}^{PP}$$

, $$L_{P\mathrm{one}}^{LP}$$

- latency of the first positive peak P1 for the right and left hemisphere, respectively, ms;

, $$L_{N1}^{ЛП}$$

- латентность первого негативного пика N1 для правого и левого полушария соответственно, мс; $$L_{N\mathrm{one}}^{PP}$$

, $$L_{N\mathrm{one}}^{LP}$$

- latency of the first negative peak N1 for the right and left hemisphere, respectively, ms;

, $$L_{P2}^{ЛП}$$

- латентность второго позитивного пика P2 для правого и левого полушария соответственно, мс; $$L_{P2}^{PP}$$

, $$L_{P2}^{LP}$$

- latency of the second positive peak P2 for the right and left hemisphere, respectively, ms;

n is the number of recorded peaks from the perception complex; the hemispheric amplitude of the endogenous wave P300 is determined by the formula:

$$A_{P300}^{MP}=\frac{A_{P300}^{PP}+A_{P300}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}$$

Where

- межполушарная амплитуда эндогенной волны P300, мкВ; $$A_{P300}^{MP}$$

- interhemispheric amplitude of the endogenous wave P300, μV;

, $$A_{P300}^{ЛП}$$

- амплитуда эндогенной волны P300 для правого и левого полушария соответственно, мкВ, которую определяют по формулам: $$A_{P300}^{PP}$$

, $$A_{P300}^{LP}$$

- the amplitude of the endogenous wave P300 for the right and left hemisphere, respectively, μV, which is determined by the formulas:

, $$A_{P300}^{ЛП}=\frac{A_{N2}^{ЛП}}{A_{P3}^{ЛП}}$$

$$A_{P300}^{PP}=\frac{A_{N2}^{PP}}{A_{P3}^{PP}}$$

, $$A_{P300}^{LP}=\frac{A_{N2}^{LP}}{A_{P3}^{LP}}$$

Where

, $$A_{N2}^{ЛП}$$

- амплитуда второго негативного пика N2 для правого и левого полушария соответственно, мкВ; $$A_{N2}^{PP}$$

, $$A_{N2}^{LP}$$

- the amplitude of the second negative peak N2 for the right and left hemisphere, respectively, μV;

, $$A_{P3}^{ЛП}$$

- амплитуда третьего позитивного пика P3 для правого и левого полушария соответственно, мкВ; $$A_{P3}^{PP}$$

, $$A_{P3}^{LP}$$

- the amplitude of the third positive peak P3 for the right and left hemisphere, respectively, μV;

further determine the interhemispheric latency of the cognitive complex according to the formula:

$$L_{\left(N2-N3\right)}^{MP}=\frac{L_{N3}^{PP}+L_{N3}^{LP}}{2}-\frac{L_{N2}^{PP}+L_{N2}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}$$

- межполушарная латентность когнитивного комплекса, мс; $$L_{\left(N2-N3\right)}^{MP}$$

- interhemispheric latency of the cognitive complex, ms;

(N2-N3) - a cognitive complex consisting of the second (N2) and third (N3) negative peaks;

, $$L_{N2}^{ЛП}$$

- латентность второго негативного пика N2 для правого и левого полушария соответственно, мс; $$L_{N2}^{PP}$$

, $$L_{N2}^{LP}$$

- latency of the second negative peak N2 for the right and left hemisphere, respectively, ms;

, $$L_{N3}^{ЛП}$$

- латентность третьего негативного пика N3 для правого и левого полушария соответственно, мс» позволяют определить количественное значение качественных критериев диагностирования функционального состояния головного мозга. $$L_{N3}^{PP}$$

, $$L_{N3}^{LP}$$

- latency of the third negative peak N3 for the right and left hemisphere, respectively, ms "allow us to determine the quantitative value of the qualitative criteria for diagnosing the functional state of the brain.

, $$A_{P300}^{МП}>10мкВ$$

и $$L_{\left(N2-N3\right)}^{МП}>200мс$$

, функциональное состояние головного мозга соответствует I уровню здоровья (хорошее функциональное состояние мозга); $$130мс\le L_{\left(P1-N1-P2\right)}^{МП}<190мс$$

, $$8мкВ\le A_{P300}^{МП}\le 10мкВ$$

и $$160мс\le L_{\left(N2-N3\right)}^{МП}\le 200мс$$

соответствует II уровню здоровья (удовлетворительное функциональное состояние мозга); при $$190мс\le L_{\left(P1-N1-P2\right)}^{МП}\le 320мс$$

, $$5\le A_{P300}^{МП}<8мкВ$$

и $$140\le L_{\left(N2-N3\right)}^{МП}<160мс$$

соответствует III уровню здоровья (умеренное нарушение функционального состояния мозга); при $$L_{\left(P1-N1-P2\right)}^{МП}>320мс$$

, $$A_{P300}^{МП}<5мкВ$$

и $$L_{\left(N2-N3\right)}^{МП}<140мс$$

соответствует IV уровню здоровья (значительное нарушение функционального состояния мозга)» позволяют определить уровень здоровья обследуемого.Signs “in cases where $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<130m\mathrm{from}$$

, $$A_{P300}^{MP}>10m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}>200m\mathrm{from}$$

, the functional state of the brain corresponds to the first level of health (good functional state of the brain); $$130m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<190m\mathrm{from}$$

, $$8m\mathrm{to}\mathrm{AT}\le A_{P300}^{MP}\le 10m\mathrm{to}\mathrm{AT}$$

and $$160m\mathrm{from}\le L_{\left(N2-N3\right)}^{MP}\le 200m\mathrm{from}$$

corresponds to II level of health (satisfactory functional state of the brain); at $$190m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}\le 320m\mathrm{from}$$

, $$5\le A_{P300}^{MP}<8m\mathrm{to}\mathrm{AT}$$

and $$140\le L_{\left(N2-N3\right)}^{MP}<160m\mathrm{from}$$

corresponds to the III level of health (moderate impairment of the functional state of the brain); at $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}>320m\mathrm{from}$$

, $$A_{P300}^{MP}<5m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}<140m\mathrm{from}$$

corresponds to the IV level of health (a significant violation of the functional state of the brain) ”allows you to determine the level of health of the subject.

Figure 1 shows the registration scheme of endogenous responses to significant tone clicks when applying sound stimulation through the headphone.

Figure 2 schematically shows a graph of the endogenous response to significant tone clicks with amplitude-latent analysis of positive and negative peaks.

Figure 3 shows the start page of the computer program "AntiStress".

Figure 4 shows graphs of endogenous responses to significant tone clicks of the subject K. (33 years old) according to example 1.

Figure 5 shows graphs of endogenous responses to significant tone clicks in subject I. (38 years old) according to example 2.

The figures show the head headphones 1 of the subject, recording the reference 2 and active electrodes 3, as well as the ground electrode 4 mounted on the surface of the head 5 of the subject using a silicone mesh cap (not shown in the drawings), as well as graphs of endogenous responses to significant 6 tone clicks.

The headphone 1 of the subject of known design is made by known technology.

Reference electrodes 2 are installed on the surface of the head according to the International System "10-20": from the central frontal region (Fz), indent 20 cm to the right side - the right frontal region (F4) and 20 cm to the left side - the left frontal region (F3 ), from the left frontal frontal region (Fpl) 20 cm to the left side - the left hind frontal region (F7), from the right front frontal region (Fp2) 20 cm to the right side - the right hind frontal region (F8), from the central region (Cz), indent 20 cm to the right side - the right central region (C4) and 20 cm to the left side - the left center Ordering area (C3).

Active electrodes 3 are located in the region of the left (M1) and right (M2) mastoids (the back-temporal region of the left and right hemispheres) - in the area of the projection of the auditory cortex of the left and right hemispheres.

The ground electrode 4 is located in the central frontal region along the sagittal line (Fpz).

Two types of tonal clicks, significant and insignificant, are randomly fed into the headphone 1 biaurally in random order.

The graphs of endogenous responses to significant 6 tone clicks are depicted in accordance with the generally accepted image rule of the Cognitive Evoked Potentials method.

The inventive method is as follows.

Preliminarily, on the surface of the head 5 of the subject, which is located in a darkened noise-insulating room, a recording reference 2 and active electrodes 3, as well as a grounding electrode 4 are installed using a silicone mesh cap (not shown in the drawings).

Then, two types of tone clicks are fed into the headphone 1 biaurally, in random order - significant for diagnosis with a frequency of 2000 Hz and an intensity of 60 dB and insignificant with a frequency of 1000 Hz and an intensity of 80 dB, and the proportion of significant tone clicks is 30% of the total number of tone clicks .

At the same time, the subject is in a state of active wakefulness in a sitting position with his eyes closed and performs a speech test in the form of counting out loudly significant tone clicks.

The apparatus for implementing the inventive method can be used different in the form of a multifunctional computer apparatus with the study program "Cognitive evoked potentials".

The authors conducted studies using the multifunctional computer complex "Neuro-MVP" (Ivanovo, Russia) with the technical characteristics presented in table 1.

Table 1 Registration parameters on the Neuro-MVP device Tone clicks frequency Hz Probability% Intensity, dB significant 2000 thirty 60 insignificant 1000 70 80 Frequency band from 0.01-0.5 to 30 Hz Analysis Age 750-1000 ms Artifact Suppression Over 100 μV Number of averages 100 The number of incentives is 100, of which 30 are significant

During sound stimulation, latency (L) and amplitude (A) of the first (N1), second (N2) and third (N3) negative peaks, as well as the first (P1), second (P2) and third (P3) are recorded in both hemispheres positive peaks, during the analysis era of 750-1000 ms, the obtained data is filtered out from “noise”, automatically accumulate, average and plot endogenous responses 6 to significant tone clicks for the left and right hemispheres.

After that, the endogenous responses to significant tone clicks are analyzed separately in the hemispheres by calculation, while the hemisphere latency of the perception complex is determined by the formulas:

$$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}=\left(\frac{L_{P\mathrm{one}}^{PP}+L_{P\mathrm{one}}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}+\frac{L_{N\mathrm{one}}^{PP}+L_{N\mathrm{one}}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}+\frac{L_{P2}^{PP}+L_{P2}^{LP}}{2}\right)/n$$

Where

- межполушарная латентность комплекса восприятия, мс; $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

- interhemispheric latency of the perceptual complex, ms;

(P1-N1-P2) - a perception complex consisting of the first positive (P1), first negative (N1) and second positive (P2) peaks;

, $$L_{P1}^{ЛП}$$

- латентность первого позитивного пика P1 для правого и левого полушария соответственно, мс; $$L_{P\mathrm{one}}^{PP}$$

, $$L_{P\mathrm{one}}^{LP}$$

- latency of the first positive peak P1 for the right and left hemisphere, respectively, ms;

, $$L_{N1}^{ЛП}$$

- латентность первого негативного пика N1 для правого и левого полушария соответственно, мс; $$L_{N\mathrm{one}}^{PP}$$

, $$L_{N\mathrm{one}}^{LP}$$

- latency of the first negative peak N1 for the right and left hemisphere, respectively, ms;

, $$L_{P2}^{ЛП}$$

- латентность второго позитивного пика P2 для правого и левого полушария соответственно, мс; $$L_{P2}^{PP}$$

, $$L_{P2}^{LP}$$

- latency of the second positive peak P2 for the right and left hemisphere, respectively, ms;

n is the number of recorded peaks from the perception complex; the hemispheric amplitude of the endogenous wave P300 is determined by the formula:

$$A_{P300}^{MP}=\frac{A_{P300}^{PP}+A_{P300}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}$$

Where

- межполушарная амплитуда эндогенной волны P300, мкВ; $$A_{P300}^{MP}$$

- interhemispheric amplitude of the endogenous wave P300, μV;

, $$A_{P300}^{ЛП}$$

- амплитуда эндогенной волны P300 для правого и левого полушария соответственно, мкВ, которую определяют по формулам: $$A_{P300}^{PP}$$

, $$A_{P300}^{LP}$$

- the amplitude of the endogenous wave P300 for the right and left hemisphere, respectively, μV, which is determined by the formulas:

, $$A_{P300}^{ЛП}=\frac{A_{N2}^{ЛП}}{A_{P3}^{ЛП}}$$

$$A_{P300}^{PP}=\frac{A_{N2}^{PP}}{A_{P3}^{PP}}$$

, $$A_{P300}^{LP}=\frac{A_{N2}^{LP}}{A_{P3}^{LP}}$$

Where

, $$A_{N2}^{ЛП}$$

- амплитуда второго негативного пика N2 для правого и левого полушария соответственно, мкВ; $$A_{N2}^{PP}$$

, $$A_{N2}^{LP}$$

- the amplitude of the second negative peak N2 for the right and left hemisphere, respectively, μV;

, $$A_{P3}^{ЛП}$$

- амплитуда третьего позитивного пика P3 для правого и левого полушария соответственно, мкВ; далее определяют межполушарную латентность когнитивного комплекса по формуле: $$A_{P3}^{PP}$$

, $$A_{P3}^{LP}$$

- the amplitude of the third positive peak P3 for the right and left hemisphere, respectively, μV; further determine the interhemispheric latency of the cognitive complex according to the formula:

$$L_{\left(N2-N3\right)}^{MP}=\frac{L_{N3}^{PP}+L_{N3}^{LP}}{2}-\frac{L_{N2}^{PP}+L_{N2}^{\mathrm{<figure-callout\; id="2"\; label="L\; P"\; filenames="00000116.png"\; state="\{\{state\}\}">L\; </figure-callout>}P}}{2}$$

Where

- межполушарная латентность когнитивного комплекса, мс; $$L_{\left(N2-N3\right)}^{MP}$$

- interhemispheric latency of the cognitive complex, ms;

(N2-N3) - a cognitive complex consisting of the second (N2) and third (N3) negative peaks;

, $$L_{N2}^{ЛП}$$

- латентность второго негативного пика N2 для правого и левого полушария соответственно, мс; $$L_{N2}^{PP}$$

, $$L_{N2}^{LP}$$

- latency of the second negative peak N2 for the right and left hemisphere, respectively, ms;

, $$L_{N3}^{ЛП}$$

- латентность третьего негативного пика N3 для правого и левого полушария соответственно, мс. $$L_{N3}^{PP}$$

, $$L_{N3}^{LP}$$

- latency of the third negative peak N3 for the right and left hemisphere, respectively, ms.

, $$A_{P300}^{МП}>10мкВ$$

и $$L_{\left(N2-N3\right)}^{МП}>200мс$$

, функциональное состояние головного мозга соответствует I уровню здоровья (хорошее функциональное состояние мозга); при $$130мс\le L_{\left(P1-N1-P2\right)}^{МП}<190мс$$

, $$8мкВ\le A_{P300}^{МП}\le 10мкВ$$

и $$160мс\le L_{\left(N2-N3\right)}^{МП}\le 200мс$$

соответствует II уровню здоровья (удовлетворительное функциональное состояние мозга); при $$190мс\le L_{\left(P1-N1-P2\right)}^{МП}\le 320мс$$

, $$5\le A_{P300}^{МП}<8мкВ$$

и $$140\le L_{\left(N2-N3\right)}^{МП}<160мс$$

соответствует III уровню здоровья (умеренное нарушение функционального состояния мозга); при $$L_{\left(P1-N1-P2\right)}^{МП}>320мс$$

, $$A_{P300}^{МП}<5мкВ$$

и $$L_{\left(N2-N3\right)}^{МП}<140мс$$

соответствует IV уровню здоровья (значительное нарушение функционального состояния мозга).At the final stage, determine the level of health: when $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<130m\mathrm{from}$$

, $$A_{P300}^{MP}>10m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}>200m\mathrm{from}$$

, the functional state of the brain corresponds to the first level of health (good functional state of the brain); at $$130m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<190m\mathrm{from}$$

, $$8m\mathrm{to}\mathrm{AT}\le A_{P300}^{MP}\le 10m\mathrm{to}\mathrm{AT}$$

and $$160m\mathrm{from}\le L_{\left(N2-N3\right)}^{MP}\le 200m\mathrm{from}$$

corresponds to the II level of health (satisfactory functional state of the brain); at $$190m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}\le 320m\mathrm{from}$$

, $$5\le A_{P300}^{MP}<8m\mathrm{to}\mathrm{AT}$$

and $$140\le L_{\left(N2-N3\right)}^{MP}<160m\mathrm{from}$$

corresponds to the III level of health (moderate impairment of the functional state of the brain); at $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}>320m\mathrm{from}$$

, $$A_{P300}^{MP}<5m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}<140m\mathrm{from}$$

corresponds to the IV level of health (a significant violation of the functional state of the brain).

Health levels were identified by statistical processing of data obtained using the AntiStress computer program, created on the basis of the psychophysiological questionnaire L.Kh. Garkavi (AntiStress expert system. // Medical Information Systems. Taganrog. - 1995. - Issue 5. - S.13-16) (see Fig. 4-6). According to the AntiStress program, one of 4 types of adaptive reaction was diagnosed: training reaction; activation reactions (calm activation reaction and increased activation reaction); reactivation reaction; stress response, as well as one of 4 types of reactivity level: high, medium, low, very low. Then, the obtained type of adaptive reaction and the level of reactivity were analyzed according to the table “Categories of the state of adaptive mechanisms (with a determination of the level of health) according to the types of adaptive reactions and the level of reactivity of the body” (VV Markin An individual approach to the correction of maladaptive states of students by plant adaptogens. Dis. Candidate of Medical Sciences - Vladivostok, 2004. - 678 p.) with the definition of the appropriate level of health (Table 2).

table 2 The levels of health and the general condition of the body, depending on the category of the state of adaptive mechanisms according to the types of adaptive reactions and the level of reactivity Health level Adaptation reactions General state I RT, A UR; PCA, A UR; RPA, A and B UR Great, good II RT, B UR; PCA, B UR; RPA, C UR Satisfactory III PC, A and B UR; PCA, C and D SD; RPA, D UR; RP, C UR; RT, C UR Mild or moderate impairment of health IV RT, D UR; PC, C, and D ur; RP, D UR Significant Health Impairment Note: Adaptation reactions: RT - reaction of training, RSA - reaction of calm activation, RPA - reaction of increased activation, RP - reaction of reactivation, PC - stress reaction; A - high, B - medium, C - low, D - very low, SD - reactivity level; I - the first level of health, II - the second level of health, III - the third level of health, IV - the fourth level of health.

According to table 2, persons with a reaction of training at a high level of reactivity (RT, A UR) belong to the I level of health; with a calm activation reaction at a high level of reactivity (RSA, A UR); with a reaction of increased activation at a high and medium level of reactivity (RPA, A, B UR), having excellent or good health. II level of health is observed in individuals with a training reaction and an average level of reactivity (RT, B UR); with a calm activation reaction and an average level of reactivity (SAR, B SD); with a reaction of increased activation at a low level of reactivity (RPA, C UR), with a satisfactory state of health. The III level of health is inherent in people with a stress reaction with a high and medium level of reactivity (PC, A, B SD); with a calm activation reaction at a low and very low level of reactivity (RSA, C, D SD); with a reaction of increased activation at a very low level of reactivity (RPA, D SD); with a reactivation reaction and a low level of reactivity (RP, C UR); with a training reaction and low reactivity (RT, C UR), with mild or moderate impairment of health. The IV level of health includes people with a stress reaction with a low and very low level of reactivity (PC, C, D SD); with a training reaction at a very low level of reactivity (RT, D SD); with a reactivation reaction with a very low level of reactivity (RP, D SD), with a significant impairment of health.

At the final stage, after statistical processing of the results of the analyzes of “Cognitive EPs”, a relationship was found between health levels and indicators of the functional state of the brain (Table 3).

Table 3 Indicators of the functional state of the brain depending on the level of health Health level Characteristics of endogenous responses to significant tone clicks Perception Complex (P1-N1-P2) Cognitive Complex (N2-P3)

$$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

$$A_{P300}^{MP}$$

$$L_{\left(N2-N3\right)}^{MP}$$

I determined stably (stable in component composition upon repeated stimulation), the form of responses is correct, latency (P1) <70 ms it is determined stably, the form of answers is correct $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}<130m\mathrm{from}$$

$$A_{P300}^{MP}>10m\mathrm{to}\mathrm{AT}$$

$$L_{\left(N2-N3\right)}^{MP}>200m\mathrm{from}$$

II determined stably, the form of answers is correct, latency P1 = 71-109 ms (with repeated stimulation, P1 is unstable) it is determined stably, the form of answers is correct $$130m\mathrm{from}\le L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}190m\mathrm{from}$$

$$8m\mathrm{to}\mathrm{AT}\le A_{P300}^{MP}\le 10m\mathrm{to}\mathrm{AT}$$

$$160m\mathrm{from}\le L_{\left(N2-N3\right)}^{MP}\le 200m\mathrm{from}$$

III is unstable, some of the responses in the series are deformed (up to 50%), P1 = 110-150 ms, P2 is extended (> 170 ms), there are no peaks P1 and N1 unstable, response form changed $$190m\mathrm{from}\le L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}\le 320m\mathrm{from}$$

$$5\le A_{P300}^{MP}<8m\mathrm{to}\mathrm{AT}$$

$$140\le L_{\left(N2-N3\right)}^{MP}<160m\mathrm{from}$$

IV broken in composition: P2 is unstable, peak P1> 150 ms, peak N1> 122 ms (sharply elongated in latency or absent) sharply reduced in amplitude and elongated in latency, with poor identification of components, the shape of the responses is deformed $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}>320m\mathrm{from}$$

$$A_{P300}^{MP}<5m\mathrm{to}\mathrm{AT}$$

$$L_{\left(N2-N3\right)}^{MP}<140m\mathrm{from}$$

Note: (P1-N1-P2) - a perception complex consisting of the first positive (P1), first negative (N1) and second positive (P2) peaks; (N2-N3) - a cognitive complex consisting of the second (N2) and third (N3) negative peaks; $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

- interhemispheric latency of the perceptual complex; $$A_{P300}^{MP}$$

- interhemispheric amplitude of the endogenous wave P300; $$L_{\left(N2-N3\right)}^{MP}$$

- Interhemispheric latency of the cognitive complex.

The studies were carried out in the city of Vladivostok at the Department of Normal Physiology, SBEI HPE VSMU and at the NEURON Medical Center. For the survey, volunteers were selected in the amount of 127 people of both sexes (59 men and 68 women) aged 20-40 years. The age category of 20–40 years was selected for the survey, since this age group belongs to the young age group according to WHO with more stable age-related neurophysiological indices according to the component composition of “Cognitive EPs” without gross violations in the state of health. Dynamic testing was carried out in the morning (from 10 to 14 hours).

Persons with a history of complaints of episodes of speech, movement, or episodes of hearing and vision loss were excluded from the study; subjects (observed at the NEURON Clinic) with complaints of memory loss and with organic lesions of the brain of various origins (infectious, traumatic, toxic, etc.) are also excluded. The legitimacy of the study was confirmed by the decision of the Ethics Committee of the SBEI HPE VSMU (protocol No. 4, case No. 19 dated 01/24/2011).

Previously, a test group was tested using the AntiStress program to identify types of adaptive reactions:

1 - the reaction of increased activation was diagnosed in 3% of cases with high and medium, in 12% - with low and in 1% - with a very low level of reactivity;

2 - a calm activation reaction was detected in 13% of cases with high, in 24% - with medium and in 8% - with low and very low reactivity;

3 - the training reaction was in 7% of cases at a high, in 16% - at an average and in 1% - at a very low level of reactivity;

4 - stress reaction with a high and medium level of reactivity was detected in 5% of cases, with low and very low in 4% of cases;

5. The reactivation reaction was 4% at a low and 2% at a very low level of reactivity.

Then, according to Table 2, the level of health was determined: 23% of the examined were registered with I level of health, 52% with II level of health, 18% with III level of health, and 7% with IV level of health.

The invention is illustrated by the following examples.

Example No. 1. Surveyed K., male, 33 years old.

He did not actively complain. A history of VVD (Vegetative-Vascular Dystonia). Injury and infection denied. Examined by a neurologist at the NEURON Center - without focal and conduction symptoms. Expressed white dermographism, blood pressure (blood pressure) 110/70 mm Hg

According to the results of the registration of “Cognitive EPs”, it was found that endogenous responses at the peripheral level are unstable to long-term stimulation, while at the beginning of registration the complex (P1-N1-P2) is determined stably, the form of responses is correct, with prolonged sound stimulation, the latencies of the components increased to the upper bounds norms, and (P1) is increased to 100 ms for 1 channel (left) and up to 102 ms for 2 channels (right); the cognitive complex (N2-P3) is determined stably, the form of answers is correct.

Table 4 shows the survey results indicating the average latency of endogenous responses in the fronto-central parts of the left and right hemispheres.

Table 4 Latency parameters of endogenous responses in the fronto-central parts of the left and right hemispheres to significant tone clicks in subject K. (33 g.) Type of tone click and its characteristics Component Latency (L), ms Norma, ms Channel 1 Channel 2 P1 one hundred 102 74-109

significant N1 118 122 82-122 frequency 2000 Hz P2 220 224 149-250 60 dB intensity N2 310 312 243-315 RZ 353 355 289-360 N3 475 475 440-500 Note: P1 is the first positive peak; N1 is the first negative peak; P2 is the second positive peak; N2 is the second negative peak; P3 is the third positive peak; N3 is the third negative peak; channel 1 - the left hemisphere; channel 2 - the right hemisphere.

=147,6 мс и когнитивного комплекса (N2-N3): $$L_{\left(N2-N3\right)}^{МП}$$

=164 мс.Next, the value of the interhemispheric latency of the perception complex (P1-N1-P2) was determined by calculation: $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

= 147.6 ms and cognitive complex (N2-N3): $$L_{\left(N2-N3\right)}^{MP}$$

= 164 ms.

Then, an amplitude analysis of endogenous responses to significant tone clicks was performed in the fronto-central parts of the left and right hemispheres (Table 5).

Table 5 The amplitude parameters of endogenous responses in the fronto-central parts of the left and right hemispheres to significant tone clicks in subject K. (33 g.) Type of tone click and its characteristics Component Amplitude (A), μV Channel 1 Channel 2 significant N2 42 45 frequency 2000 Hz P3 4.6 5.3 60 dB intensity Note: N2 is the second negative peak; P3 is the third positive peak; channel 1 - the left hemisphere; channel 2 - the right hemisphere.

=8,75 мкВ.Next, the interhemispheric amplitude of the endogenous wave P300 was determined by calculation: $$A_{P300}^{MP}$$

= 8.75 uV.

=147,6 мс, $$L_{\left(N2-N3\right)}^{МП}$$

=164 мс и $$A_{P300}^{МП}$$

=8,75 мкВ, функциональное состояние головного мозга по таблице 3 соответствует II (второму) уровню здоровья (общее состояние - удовлетворительное).Insofar as $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

= 147.6 ms, $$L_{\left(N2-N3\right)}^{MP}$$

= 164 ms and $$A_{P300}^{MP}$$

= 8.75 μV, the functional state of the brain according to table 3 corresponds to the II (second) level of health (general condition is satisfactory).

Example 2. Surveyed I., a man, 38 years old.

He complained of decreased performance and fatigue during work. History: TBI and infection denied, suffers from chronic gastritis for 6 years. Examined by a neurologist at the NEURON Center - without gross focal and guide symptoms. Exhibited "Cerebrosthenic syndrome."

Using the method of "Cognitive EP" revealed violations and instability of endogenous responses to significant tone clicks. The process of perception of information is reduced with a delay in the processes of recognition and differentiation of the audio signal, which occur weakly and intermittently, the process of directed attention suffers with a disruption in the operation of operational processes of memory.

Table 6 shows the survey results indicating the latency of endogenous responses.

Table 6 Latency parameters of endogenous responses in the fronto-central parts of the left and right hemispheres to significant tone clicks in subject I. (38 years old) Type of tone click and its characteristics Component Latency (L), ms Norma, ms Channel 1 Channel 2 significant P1 196 191 74-109 frequency 2000 Hz N1 360 357 82-122 60 dB intensity P2 508 483 149-250

N2 570 572 243-315 P3 642 643 289-360 N3 708 710 440-500 Note: P1 is the first positive peak; N1 is the first negative peak; P2 is the second positive peak; N2 is the second negative peak; P3 is the third positive peak; N3 is the third negative peak; channel 1 - the left hemisphere; channel 2 - the right hemisphere.

=349,16 мс и когнитивного комплекса (N2-N3): $$L_{\left(N2-N3\right)}^{МП}$$

=138 мс.Next, the value of the interhemispheric latency of the perception complex (P1-N1-P2) was determined by calculation: $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

= 349.16 ms and cognitive complex (N2-N3): $$L_{\left(N2-N3\right)}^{MP}$$

= 138 ms.

Then, an amplitude analysis of endogenous responses to significant tone clicks in the frontal-central parts of the left and right hemispheres was performed (Table 7).

Table 7 The amplitude parameters of endogenous responses in the fronto-central parts of the left and right hemispheres to significant tone clicks in subject I. (38 years old) Type of tone click and its characteristics Component Amplitude (A), μV Channel 1 Channel 2 significant N2 12 10 frequency 2000 Hz P3 four 5 60 dB intensity Note: N2 is the second negative peak; P3 - the third positive peak channel 1 - the left hemisphere; channel 2 - the right hemisphere.

=2,5 мкВ.Next, the interhemispheric amplitude of the endogenous wave P300 was determined by calculation: $$A_{P300}^{MP}$$

= 2.5 μV.

=349,16 мс, $$L_{\left(N2-N3\right)}^{МП}$$

=138 мс и $$A_{P300}^{МП}$$

=2,5 мкВ, функциональное состояние головного мозга по таблице 3 соответствует IV (четвертому) уровню здоровья (общее состояние - значительное нарушение здоровья).Insofar as $$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}$$

= 349.16 ms, $$L_{\left(N2-N3\right)}^{MP}$$

= 138 ms and $$A_{P300}^{MP}$$

= 2.5 μV, the functional state of the brain according to table 3 corresponds to the IV (fourth) level of health (general condition - a significant violation of health).

According to the results of the survey, a relationship was found between changes in the component composition of “Cognitive evoked potentials” (stable for the peripheral complex (P1-N1-P2) and the cognitive complex (N2-P3)) and the state of health.

When the reaction of calm activation at a high level of reactivity, the reaction of training at a high level of reactivity and the reaction of increased activation at a high level of reactivity, diagnosed according to the AntiStress program and corresponding to health level according to Table 2, complexes (P1-N1-P2) and (N2 -P3) “Cognitive EPs” do not change in latency and amplitude, but are recorded within the normal range (for the age group of 20–40 years). During a calm activation reaction with an average level of reactivity and a training reaction with an average level of reactivity diagnosed by the AntiStress program, corresponding to table II health level, the composition of Cognitive EPs at the peripheral level (P1-N1-P2) is unstable, which indicates a decrease in attention processes with prolonged intellectual stress. In cases of registration of a calm activation reaction at a low and very low reactivity level and a reactivation reaction and training at a low reactivity level according to the AntiStress program corresponding to level III of health, in the Cognitive EP pattern, latencies of late responses P3 and P4 significantly increase against the background of instability peripheral components (P1-N1-P2) (the processes of recognition and differentiation occur weakly and intermittently (and there is a dependence on the stimulus), the process of directed attention and recognition of significant stimulus with impaired process memory). When the stress reaction was at a low and very low reactivity level and the reactivation reaction was at a very low reactivity level (according to the AntiStress program), which corresponds to level IV health, more pronounced violations were detected in the component composition of Cognitive EPs, with a maximum increase in the latency of the positive peak P300 . At the same time, a low and unstable amplitude of the main components, difficulties of identification with the slowdown and periodic absence of the late - cortical components of the “Cognitive EP” were revealed. Thus, at the fourth level of health, the processes of perception and differentiation of sound signals are unstable with the difficulty of determining the components for significant stimuli. The amplitude of the positive peak of the endogenous wave P300 is reduced due to a decrease in the processes of recognition of auditory stimuli and distraction during prolonged monophonic stimulation with the difficulty of identifying significant signals against the background of insignificant signals.

Thus, the diagnosis of the functional state of the brain under different health conditions using the “Cognitive Evoked Potentials” method is the key to understanding the psychophysiological mechanisms of human adaptation.

Claims (2)

1. A method for diagnosing the functional state of the brain according to the level of health, including sound stimulation in the form of a series of clicks supplied to the head headphones of the subject, recording the characteristics of the functional state of the cerebral hemispheres and their mathematical processing, characterized in that as characteristics of the functional state of the cerebral hemispheres register cognitive endogenous responses in the fronto-central parts of the brain of the subject through electrodes, it is established people on the surface of the head in the frontal-central parts of the right (F8, F4, C4) and left (F7, F3, C3) hemispheres according to the international system "10-20", and with sound stimulation the subject is in a state of active wakefulness in a sitting position with eyes closed, while in the headphone biaurally, in random order, two types of tone clicks with an intensity of 50 to 100 dB are applied - significant for diagnostics with a frequency of 2000 Hz and insignificant with a frequency of 1000 Hz, and the intensity of significant tone clicks is less than that of insignificant, not less than 20 dB and their share is 30% of the total number of tone clicks, in addition, the subject performs a speech test in the form of counting out loud tone clicks, while latency (L) and amplitude (A) of the first (N1), second (N2) are recorded in both hemispheres and the third (N3) negative peaks, as well as the first (P1), second (P2) and third (P3) positive peaks, after which the data are processed during the analysis era of 750-1000 ms and subsequent analysis, while determining the hemisphere latency of the complex perceptions by the formulas:
$$L_{(P\mathrm{one}-N\mathrm{one}-P2)}^{MP}=\left(\frac{L_{P\mathrm{one}}^{PP}+L_{P\mathrm{one}}^{LP}}{2}+\frac{L_{N\mathrm{one}}^{PP}+L_{N\mathrm{one}}^{LP}}{2}+\frac{L_{P2}^{PP}+L_{P2}^{LP}}{2}\right)/n$$

Where
$$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}$$

- interhemispheric latency of the perceptual complex, ms;
(P1-N1-P2) - a perception complex consisting of the first positive (P1), first negative (N1) and second positive (P2) peaks;
$$L_{P\mathrm{one}}^{PP}$$

, $$L_{P\mathrm{one}}^{LP}$$

- latency of the first positive peak P1 for the right and left hemisphere, respectively, ms;
$$L_{N\mathrm{one}}^{PP}$$

, $$L_{N\mathrm{one}}^{LP}$$

- latency of the first negative peak N1 for the right and left hemisphere, respectively, ms;
$$L_{P2}^{PP}$$

, $$L_{P2}^{LP}$$

- latency of the second positive peak P2 for the right and left hemisphere, respectively, ms;
n is the number of recorded peaks from the perception complex;
the hemispheric amplitude of the endogenous wave P300 is determined by the formula:
$$A_{P300}^{MP}=\frac{A_{P300}^{PP}+A_{P300}^{LP}}{2}$$

Where
$$A_{P300}^{MP}$$

- interhemispheric amplitude of the endogenous wave P300, μV;
$$A_{P300}^{PP}$$

, $$A_{P300}^{LP}$$

- the amplitude of the endogenous wave P300 for the right and left hemisphere, respectively, μV, which is determined by the formulas:
$$A_{P300}^{PP}=\frac{A_{N2}^{PP}}{A_{P3}^{PP}}$$

, $$A_{P300}^{LP}=\frac{A_{N2}^{LP}}{A_{P3}^{LP}}$$

Where
$$A_{N2}^{PP}$$

, $$A_{N2}^{LP}$$

- the amplitude of the second negative peak N2 for the right and left hemisphere, respectively, μV;
$$A_{P3}^{PP}$$

, $$A_{P3}^{LP}$$

- the amplitude of the third positive peak P3 for the right and left hemisphere, respectively, μV;
further determine the interhemispheric latency of the cognitive complex according to the formula:
$$L_{\left(N2-N3\right)}^{MP}=\frac{L_{N3}^{PP}+L_{N3}^{LP}}{2}-\frac{L_{N2}^{PP}+L_{N2}^{LP}}{2}$$

Where
$$L_{\left(N2-N3\right)}^{MP}$$

- interhemispheric latency of the cognitive complex, ms;
(N2-N3) - a cognitive complex consisting of the second (N2) and third (N3) negative peaks;
$$L_{N2}^{PP}$$

, $$L_{N2}^{LP}$$

- latency of the second negative peak N2 for the right and left hemisphere, respectively, ms;
$$L_{N3}^{PP}$$

, $$L_{N3}^{LP}$$

- latency of the third negative peak N3 for the right and left hemisphere, respectively, ms;
and in cases where $$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<130m\mathrm{from}$$

, $$A_{P300}^{MP}>10m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}>200m\mathrm{from}$$

, the functional state of the brain corresponds to the first level of health (good functional state of the brain);
$$130m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}<190m\mathrm{from}$$

, $$8m\mathrm{to}\mathrm{AT}\le A_{P300}^{MP}\le 10m\mathrm{to}\mathrm{AT}$$

and $$160m\mathrm{from}\le L_{\left(N2-N3\right)}^{MP}\le 200m\mathrm{from}$$

corresponds to the II level of health (satisfactory functional state of the brain);
$$190m\mathrm{from}\le L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}\le 320m\mathrm{from}$$

, $$5\le A_{P300}^{MP}<8m\mathrm{to}\mathrm{AT}$$

and $$140\le L_{\left(N2-N3\right)}^{MP}<160m\mathrm{from}$$

corresponds to the III level of health (moderate impairment of the functional state of the brain);
$$L_{\left(P\mathrm{one}-N\mathrm{one}-P2\right)}^{MP}>320m\mathrm{from}$$

, $$A_{P300}^{MP}<5m\mathrm{to}\mathrm{AT}$$

and $$L_{\left(N2-N3\right)}^{MP}<140m\mathrm{from}$$

corresponds to the IV level of health (a significant violation of the functional state of the brain). 2. A method for diagnosing the functional state of the brain according to the health level according to claim 1, in which significant tone clicks with an intensity of 60 dB and non-significant tone clicks with an intensity of 80 dB are supplied.

Images