THE CHANGES IN NEUROPHYSIOLOGICAL PARAMETERS AND NEUROVASCULAR UNIT MARKERS IN CARDIAC SURGERY PATIENTS UNDER THE INFLUENCE OF MULTITASK TRAINING IN A THREE-DIMENSIONAL ENVIRONMENT

Highlights For the first time it was demonstrated that changes in the neurophysiological parameters and markers of the neurovascular unit in cardiac surgery patients under the influence of multitask training in a three-dimensional environment result in optimization of the attention and short-term memory domains, the absence of significant dynamics of low-frequency theta activity and a pronounced activation of BDNF synthesis in contrast to patients without training. Abstract Aim . To study the changes in a complex index of cognitive status in the neurodynamic, attention and short-term memory domains, electroencephalogram (EEG) indices and neurovascular unit (NVU) markers in cardiac surgery patients under the influence of multitask training in a three-dimensional environment. Methods. The prospective randomized study included 100 patients who were divided into two groups using the envelope method: 47 patients underwent a course of multitask training in a three-dimensional environment and 53 patients received no training. In addition to a standard clinical examination, all patients underwent an extended study of cognitive status, EEG parameters, and NVU markers in peripheral blood. Results. The complex indicators of attention and short-term memory improved at 11–12 days after CABG compared to preoperative values, but only in patients who underwent training. There were no significant changes in complex indicators of cognitive domains in patients without training. Analysis of the EEG total power revealed that theta 1 rhythm indicators did not statistically differ from preoperative values in patients who underwent training. In the group without training, the increase in theta activity (theta1 and theta2) was significant, as was beta 1–2 activity. The dynamics of changes in the BDNF indicator demonstrated that in patients with training, who had an increase in BDNF concentrations in the peripheral blood on the 1 st day after CABG, there was no development of early POCD at 11–12 days after cardiac surgery. Conclusion. The multitask trainings in a three-dimensional environment contributed to a decrease in the incidence of POCD at the end of the in-hospital stage of CABG due to optimization of the activity of the attention and short-term memory domains. The positive effect of the training was the absence of significant dynamics of low-frequency theta activity and a more pronounced activation of BDNF compared to patients without training, which may indicate a reorganization of brain activity and NVU, but this effect requires confirmation in further studies.