Angioreconstructive interventions are generally known to be of prophylactic value for cerebrovascular diseases (CVD). At the same time, their prognosis in comorbid patients, particularly in those with type 2 diabetes (T2D), have been insufficiently covered.Objective: to study the impact of T2D on cognitive functions after carotid angioplasty with stenting (CAS)Patients and methods. CAS was performed in 99 patients with chronic CVD. Group 1 consisted of 51 patients (median age, 64.5 years) without carbohydrate metabolism disorders. Group 2 included 48 patients (median age, 64 years) with T2D. Over time, all the patients underwent clinical, neurological, and neuropsychological examinations, general clinical and biochemical blood tests, duplex scanning of the brachiocephalic arteries, and magnetic resonance imaging (MRI) of the brain. Blood flow in the middle cerebral artery was monitored to assess the embolic and hemodynamic situation during a CAS procedure.Results and discussion. The baseline frequency of neurocognitive impairment was almost the same (75%) in both groups; however, the impairment was more obvious in patients with T2D. Re-examination in Group 1 patients immediately after intervention revealed slight positive cognitive changes, while the patients with T2D showed a decrease in the indicators of mental functions. The improved ability to abstract and increase the level of generalization of functions appeared in T2D patients only 2 months after intervention. Post-CAS MRI revealed ipsilateral acute ischemic foci (AIF) in the brain substance in 11 (22%) patients of Group 1 and in 24 (50%) with concomitant T2D. Comparison of neuroimaging data with cognitive function assessments for the entire group of the examinees established deterioration in the cognitive status in patients with new ischemic brain changes detected after intervention.Conclusion. CVD concurrent with T2D usually contributes to deterioration in the cognitive status. Angioreconstructive interventions, in particular CAS, are frequently accompanied by the identification of AIF (including «silent» ones) that can cause a transient deterioration in cognitive functions. When planning angioreconstructive interventions in patients with T2D, the question arises of predicting such risks and possible neuroprotective methods.

Background. The significance of this study becomes more relevant due to the higher incidence and complication of dysphagia in patients with severe brain damage as a result of stroke, traumatic brain injury, and other diseases and injuries. Purpose The study aimed to assess the effectiveness of the new stimulating method - "passive-active logopedic cryomassage" for restoring impaired swallowing function (dysphagia) in patients with severe brain injury, used in the system of speech therapy measures at the early stage of rehabilitation in the neurointensive care unit. Methods. The study involved 96 patients with dysphagia caused by severe brain damage, who received speech therapy assistance aimed at restoring the impaired swallowing function in a system of early rehabilitation measures carried out in a neurorehabilitation department. The severity of dysphagia was evaluated using an integrative assessment of swallowing function scale. Results. The practice of using the new method developed in combination with thermal and tactile stimulation: "passive-active logopedic cryomassage" indicated its higher efficiency in comparison with the traditionally used methods of speech therapy stimulation. In the course of this study, there were three categories of patients: patients with a rapid positive effect, patients with a delayed effect, and patients with no apparent positive effects. There was an analysis of all possible causes of different therapeutic effects. Conclusion. This new method of combined thermal and tactile stimulation - "passive-active logopedic cryomassage" can be recommended with all its indications and contraindications for widespread use in the clinical practice assisting speech therapists in the restoration of impaired swallowing function in patients with severe brain injury

BACKGROUND: Rehabilitation of patients with post-stroke aphasia is an important medical and social goal. The use of traditional methods of rehabilitation is often not effective enough, which forces us to look for new methods aimed at restoring lost functions. AIM: The aim of this study is to determine the effectiveness of non-invasive brain stimulation using transcranial direct electric current stimulation (tDCS) in patients with post-stroke aphasia. MATERIALS AND METHODS: 28 patients with motor post-stroke aphasia were examined according to the method of L.S. Tsvetkova with co-authors. All patients received a traditional rehabilitation complex: psychological and correctional classes with a speech therapist-aphasiologist; neurometabolic therapy. 14 patients (Group I) additionally had transcranial direct electric current stimulation; 14 patients had placebo transcranial direct electric current stimulation. RESULTS: All patients with post-stroke aphasia showed an improvement in expressive and impressive speech, however, in patients who had true transcranial direct electric current stimulation, the improvement in expressive and impressive speech was higher than in patients who had placebo transcranial direct electric current stimulation. There were no complications from the use of transcranial direct electric current stimulation. CONCLUSION: Based on the results of the study, it can be concluded that it is expedient to include the non-invasive transcranial direct electric current stimulation method in the rehabilitation of patients with post-stroke aphasia.