RU2624154C1 - Method for cognitive disorders treatment in children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: bitemporal 10 min exposure to a traveling magnetic field in the continuous mode, with inductance of 6-40 mT, frequency of 50 Hz in synchronism with a laser light wave length of 0.85-0.9 micron, frequency of 50 Hz, power of 3.5 mW. At the same time, an impact is provided on the palms of both hands. Then, after 2 hours, tonal acoustic effect through headphones is provided for 10-15 minutes by EEG converted into sound signals obtained at 4 head points in frontal and occipital regions, arranged symmetrically on either side of the sagittal line. The therapeutic course is 10 procedures.

EFFECT: method allows to increase treatment efficiency, which is achieved by the simultaneous impact of a traveling magnetic field and laser radiation on head and palms of the hands in combination with the acoustic tone exposure using EEG converted into sound signals.

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Description

The invention relates to medicine, namely to neurorehabilitation, neurology, pediatrics, physiotherapy, and can be used to treat children aged 3 to 13 years with a delay in psycho-speech development of various degrees, usually due to perinatal and antenatal hypoxic brain damage.

There is a method of treating cognitive disorders in children using nootropic medications that stop cerebral symptoms, but do not have a directed effect on the restoration of impaired brain function (Daminov V.D., Germanovich V.V. Use of gliatilin in the complex treatment of patients after cranio -brain injury. // Journal of Pharmateka. - 2007. - No. 15 (149). - S. 70-73).

There is a method of treating cognitive disorders in children by transcranial exposure to a bitemporal pulsed magnetic field with an inductance of 45 mT, frequency of 1-15 Hz for 10-15 minutes with a course of 10 procedures (Orekhova E.M., Konchugova T.V., Svistunov A., Raigorodsky Yu .M., Prikazchikova OA The effectiveness of dynamic magnetotherapy in the complex treatment of cognitive impairment in patients with chronic cerebrovascular insufficiency // Journal of Neurology and Psychiatry named after S. S. Korsakov. - 2009. - T. 109, N 2. - P. 59-62). However, the achieved improvement in brain metabolism and blood flow is insufficient for targeted training of speech function and memory.

A known method of treating cognitive impairment in children (Pat. RF No. 2192777, publ. 20.11.2002). EEG is recorded, EEG signals are converted into an audible range of sound frequencies separately for each lead and simultaneously for all leads. They act on the patient with sound signals by organizing biological acoustic feedback with the placement of sound sources to the left and right of the patient’s head. The duration of the procedure is 20-30 minutes, the course of treatment is 3-7 procedures. However, the method does not improve the metabolism and blood flow of the brain necessary for its maturation and development.

Closest to the claimed is a method of treating the treatment of cognitive impairment in children (Pat. RF No. 2501584, publ. 12/29/2013), adopted as a prototype. They act simultaneously bitemporally and along the spinal column at the C1-L1 level by a running magnetic field in continuous mode with an inductance of 6-40 mT, frequency 50 Hz, synchronously with laser radiation with a wavelength of 0.85-0.9 μm, frequency 50 Hz, power 3.5 MW under EEG control. The duration of exposure is 10-12 minutes, the course of treatment is 10 daily procedures.

However, the prototype is not effective enough, because it does not provide the full activation of cognitive functions of the brain, namely:

- volumetric and versatile activation of the cortical-subcortical brain structures that are important for the formation and development of memory and speech;

- directed adequate action on receptor fields that are directly related to the formation of cognitive functions, in particular speech function;

- physiological training of cognitive functions of the brain.

The invention is aimed at creating a method for the treatment of cognitive disorders in children, which provides an increase in the effectiveness of treatment due to the most complete and rapid maturation and development of cognitive functions in children with a delay in psycho-speech development.

The specified technical result in the implementation of the invention is achieved by the fact that in the known method for the treatment of cognitive impairment in children, including exposure to a traveling magnetic field in a continuous mode with an inductance of 6-40 mT, a frequency of 50 Hz synchronously with laser radiation with a wavelength of 0.85-0.9 μm , with a frequency of 50 Hz, with a power of 3.5 mW, bitemporal for 10 minutes, the peculiarity is that they act additionally simultaneously with bitemporal impact on the palms of both hands, then after 2 hours they are acoustically The tonal tonal effect through the headphones for 10-15 minutes converted into sound EEG signals taken from 4 points of the head in the frontal and occipital regions located symmetrically on both sides of the sagittal line, the treatment course is 10 procedures.

Due to direct transcranial exposure to a traveling magnetic field, neuronal excitability and axonal conductivity of the cortical and subcortical-stem structures of the brain are activated, which accelerates the formation of centers responsible for cognitive functions. A running magnetic field improves cerebral blood flow, especially its weak link-venous blood flow. Low-intensity laser radiation primarily activates brain metabolism in the pool of external carotid arteries and reflexively in the pool of internal carotid arteries and the brain as a whole.

The combined diffuse magnetolaser action on the brain activates and develops the functions of the whole brain, especially cognitive ones, the provision of which is distributed over the cortical-subcortical structures of the brain. Laser stimulation of the glial structures of the brain provides the activation of memory, the carrier of which are neuroglial populations of the brain.

Optimization of the genetically determined neuroregeneration program by physical factors ensures the development of nerve growth factors in the glial structures of the brain and Schwann cells of the terminal receptor fields of denervated organs (palms).

The impact on the palms is significant, since their cortical innervation is intimately connected with the area of motor innervation of Brock's speech. The palms are directly related to the stages of the formation and development of cognitive functions (fine motor skills, design, drawing, writing, gesturing during speech).

The acoustic tonal effect through headphones converted to sound EEG signals taken from 4 points of the head in the frontal and occipital regions located symmetrically on both sides of the sagittal line additionally activates the regenerative and reparative processes of the brain. The tonal effect on the auditory analyzer causes a response in the brain: nonspecific activation of the cortical-subcortical structures of the brain and centers associated with the implementation of cognitive functions. Acoustic effects activate the integral function of the brain, creating optimal opportunities for the localization of specific centers.

A significant effect of several therapeutic physical factors (traveling magnetic field, low-intensity infrared laser radiation, acoustic tonal effects) on the child's psycho-emotional state restores the emotional sphere, creating favorable conditions for the maturation of cognitive functions. This is important because in children, emotions prevail over specific brain functions.

The method is as follows.

Immediately before the start of treatment, clinical, neurological, neuropsychological, speech therapy and EEG studies are performed. In addition to the traditional EEG, the presence and speed of evoked cognitive potentials (auditory or visual) are determined. Perform an MRI of the brain.

First, perform the procedure of laser laser therapy. The child is laid on a couch on his back. They act simultaneously bitemporally and on the area of the palms of the arms extended along the torso with a running magnetic field in a continuous mode with a frequency of 50 Hz, an inductance of 6-40 mT and laser radiation with a wavelength of 0.85-0.9 μm, a pulse duration of 100 ± 50 ns, a frequency of 50 Hz (carrier frequency 1500-2500 Hz) and a power of 3.5 mW (in a pulse of 15-20 V) in synchronous mode. Duration of exposure 10 min.

Then for 2 hours the child is in a relaxed atmosphere, resting in the room, can walk. After 2 hours, the child is placed in a soundproofed room, 4 cutaneous electrodes are applied in the frontal and occipital regions located on the surface of the head symmetrically on both sides of the sagittal midline. Remove EEG signals under each electrode. Then, separately for each lead and simultaneously for all leads, EEG signals are modified, converting them as biological feedback into an audible range of tonal acoustic signals. These signals are fed to the headphones, the mixer sets a comfortable power. Sound exposure lasts 10-15 minutes. Then the patient rests for 1-2 hours, often falls asleep. The course of treatment is 10 daily procedures.

At the end of the course of treatment in the nearest history (1-4 months), a clinical and control EEG study is carried out with a determination of the speed of cognitive potentials in response to the presentation of a different tone of auditory or various visual stimuli.

In the presence of positive clinical and EEG signs, the treatment is repeated after 6-12 months. In the absence of positive dynamics or the manifestation of markers of a negative reaction, which reflects the depletion of the resources of the protective reactions of the brain, the courses are not repeated.

The method has undergone clinical trials in the clinic of the Institute of Physics and Mathematics of the Russian Academy of Sciences in the treatment of 30 children aged 3 to 13 years with a delay in psycho-speech development of various degrees of varying degrees, usually due to perinatal and antenatal hypoxic brain damage. Treatment was received by 22 boys and 8 girls.

Moderate selective violations of higher mental functions in the form of speech underdevelopment, memory loss and behavioral reactions were detected in 3 children who studied in a regular school, although their study was not successful.

The average degree of delay in psycho-speech development was found in 14 children. They had significant speech and memory impairments, poor sleep with terrifying dreams, and difficult socialization.

A pronounced degree of delay in psycho-speech development is dianostic in 13 children. In the clinic of these patients, alalia, mental retardation, lack of skills, learning ability, untidiness dominated.

In addition, exhaustion, poor learning ability, emotional instability, passivity or hyperactivity, decreased or lack of self-care skills, and vegetative dystonia were observed in all children of the study group of varying degrees.

An EEG study found a violation of bioelectric activity with disorganization, polyfocal and polymorphic changes of the organic type. In children with moderate or moderate degree of damage, a significant decrease in the speed of cognitive evoked potentials was noted with the presentation of various auditory or various visual stimuli. With a pronounced degree of damage, cognitive potentials were not determined.

All children underwent a course of combined magnetic laser therapy and acoustic exposure according to the proposed method. The dimensions of the solenoids (2 "headband" and 2 prismatic) within 163 × 53 × 64 mm. The diameter of the apertures for laser radiation is 12 mm. The distance between the axes of the apertures is 37-39 mm. A pair of headband emitter with concave internal surfaces was reinforced with bitemporal soft holders. A pair of prismatic emitters were placed in the palm of your hand. Influenced simultaneously transcranially and in the palm of a running magnetic field and infrared low-intensity laser radiation in synchronous mode. We used a physiotherapeutic apparatus for magneto-and LED infrared laser therapy "TRANSCRANIO" (Saratov). For acoustic impact as a biofeedback, the Synchro-S hardware complex was used.

All children underwent the procedure well, no headaches, insomnia or convulsive manifestations were observed.

The result immediately after the end of the course of treatment and in the nearest follow-up (1-6 months).

In 3 children with a moderate degree of delay in psycho-speech development, a steady leveling of the mood background, a significant improvement in the formation of school skills and a more successful perception of the school curriculum were noted.

In 14 children with an average degree of delay in psycho-speech development, an increase in tolerance to educational loads was noted, therefore, patient learning accelerated and became more effective. Sleep improved, it became longer, calmer, without frequent awakenings and terrifying dreams. The sound pronunciation has improved, the vocabulary has expanded, the construction of phrases has become more clear and understandable. The improvement in memory was manifested in the memorization of a longer series of words or numbers (by 2-3), the drawing function appeared.

In 13 children with a severe degree of delay in psycho-speech development, initially the neatness skill was partially manifested and gradually restored. Their orientation in the place of residence has improved.

Parents no longer needed to “keep their eyes on the child”, give him some everyday independence (get to the toilet, turn on the light). A speech function showed up - the children began to utter simple words, short sentences and understand speech at the household level. Children began to follow simple instructions that they did not understand before treatment.

In the EEG, the disorganization of the biorhythm of the brain significantly decreased, the polyfocal and polymorphism decreased or were stopped. In some cases, the EEG approached normal. The speed of cognitive potentials with the presentation of auditory and visual stimuli increased by 10-15% with a moderate degree.

With an average degree in 5 children, an increase in the speed of cognitive potentials by 15-20% was recorded with recognition of auditory stimuli.

In severe cases, a more organized bioelectric activity of the brain was observed according to EEG data, in some cases it was possible to identify low-intensity cognitive potentials, sometimes epileptiform activity, which indicated the tension of the regenerative systems of the brain.

We give examples - extracts from medical records.

Example 1. Child K., 10 years old, was in the clinic of the PMI RAS from 09.24.2014 to 10.10.2014. Diagnosis: Moderate delay in psycho-speech development due to perinatal hypoxia. The child attended a regular school. But he could not learn lessons without the help of adults, had a difficult relationship with peers, studied poorly (average score 3-). On admission, severe cerebral asthenia, tearfulness, impairment of dynamic praxis, residual dysarthria, lack of shape, counting, memory, and other cognitive functions. In the EEG, diffuse changes in bioelectric activity with the disorganization of brain biorhythms, a marked decrease in the speed of cognitive potentials upon presentation of auditory stimuli.

According to the proposed method, they were acted for 10 minutes at the same time bitemporally and on both palms by a laser radiation exposure by a running magnetic field synchronously with infrared laser radiation. After 2 hours, the acoustic effect of the EEG modified into tonal sounds was carried out through the headphones for 15 minutes. Conducted 10 daily procedures.

Repeated hospitalization in the clinic of the IMCh RAS after 1 g 3 months, from 12/07/2015 to 12/22/2015. When examining minor manifestations of cerebral asthenia, the symptoms of dysarthria, impaired counting operations, and construction have not been established. Drawing and dynamic praxis have improved significantly. Significantly improved communication skills. He takes lessons on his own. At school, the average mark rose to 4. With a cursory glance, pathology is almost impossible to determine. The speed of evoked cognitive potentials has increased in the EEG.

Conclusion: continuing positive dynamics. Under the influence of 2 courses of combined magnetic laser therapy and acoustic exposure according to the proposed method, a practical recovery or a condition close to it was obtained.

Example 2. Patient R., 5 years old, was in the clinic of the PMI RAS from 04/10/2015 to 04/27/2015. Diagnosis: Diagnosis: Delay in severe psycho-speech development. In the status, partial neatness skills, a gross violation of communicative skills, are not in contact with relatives and medical staff. The child has no motivation for any elementary constructive actions. Sensomotor alalia. In an EEG, diffuse changes in brain biorhythmics with immaturity, epileptiform activity, a decrease in the speed of cognitive potentials upon presentation of visual stimuli are reduced by 80%.

According to the proposed method, they were exposed for 10 min at the same time bitemporally from both sides and to both palms by a laser radiation exposure by a running magnetic field synchronously with infrared laser radiation. After 2 hours, acoustic impact of the EEG modified into tonal sounds was performed through the headphones for 10 minutes. Conducted 10 daily procedures.

Immediately after treatment, there were signs of communication. He began to approach the playing children, follow the game. He began to use a mobile phone while playing with him.

Repeated admission after 7 months. Hospitalization at the PMI RAS from 11/30/2015 to 12/15/2015

A course of combined magnetic laser therapy and acoustic exposure of 10 daily procedures according to the proposed method.

They acted for 10 min at the same time bitemporally on both sides and on both palms of the magneto-laser exposure by a running magnetic field in synchronization with infrared laser radiation. After 2 hours, acoustic impact of the EEG modified into tonal sounds was performed through the headphones for 10 minutes.

Result. Control of physiological functions was restored, but enuresis was manifested as a concomitant disease (associated with the main one). Exit from Alalia - pronounces many sounds, short phrases to follow. It is in good contact with surrounding children and adults. Plays with children. I started working with the tablet and mastered some of its functions. In EEG previous data, without deterioration. Got a bladder electrical stimulation course of 5 procedures, after which the control of urination was restored.

Conclusion: the child retains symptoms of tension of regenerative and reparative processes. Adequate treatment should be continued.

The advantage of the proposed method is to increase the effectiveness of treatment due to the most complete and rapid maturation and development of cognitive functions in children with a delay in psycho-speech development.

The effect is justified by the full activation of cortical-subcortical brain structures that are important for the formation and development of memory and speech; directed adequate action on the receptor fields of speech function; training of cognitive functions of the brain according to the type of biological acoustic feedback, normalization of the emotional background.

Claims (1)

A method for the treatment of cognitive disorders in children, including exposure to a traveling magnetic field in continuous mode with an inductance of 6-40 mT, frequency 50 Hz, synchronously with laser radiation with a wavelength of 0.85-0.9 μm, frequency 50 Hz, power 3.5 mW, bitemporal within 10 minutes, characterized in that they act additionally simultaneously with bitemporal impact on the palms of both hands, then after 2 hours an acoustic tonal effect is carried out through the headphones for 10-15 minutes converted to sound EEG signals taken from 4 points of the head in the frontal and occipital regions located symmetrically on both sides of the sagittal line, the course of treatment is 10 procedures.