Dynamics of Anxiety, Depression, Physical and Cognitive Functioning in Subacute Stroke: a Clinical and Morphometric Study and the Possibility of Using Virtual Reality

Recovery of cognitive and affective disorders after stroke is possible to varying degrees in cerebral stroke-survivors. It is hypothesized that these functions and the effectiveness of rehabilitation may depend on the size of the prefrontal dorsolateral cortex (DLC) and the thalamus. Purpose is to correlate the sizes of the DLC and thalamus measured analyzing the data from computed tomography data various functioning indicators in sub-acute ischemic stroke (IS) patients and their dynamics during rehabilitation. Material and methods. The study group included 102 patients of late working age (68% men) undergoing a course of rehabilitation in sub-acute phase of IS using a clinical assessment of affective, physical and cognitive impairments and voxel morphometry of the DLC and thalamus based on the results of cerebral computed tomography performed in the acute period of IS. All subjects gave informed consent to participate in the study, the study design was approved by the Local Ethics Committee of the Bashkir State Medical University. Results. The absence of a correlation between the sizes of the examined cerebral structures and the recovery of mental health was shown. The dynamics of anxiety, depression and the rehabilitation routing scale index showed a negative correlation with the transverse sizes of both thalami. Conclusion. The rehabilitation potential for cognitive impairment does not depend on the morphometric parameters of the prefrontal dorsolateral cortex and thalami. The transverse sizes of the thalami, measured according to X-ray computed tomography in the acute period of cerebral ischemic stroke may be significant for predicting the limitations of life activity and functioning (both physical and psychological (as shown by the data on anxiety and depression). A promising field for the rehabilitation planning for such patients includes methods using elements of virtual reality in the treatment.