r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2025-30-3-32-39r-n-j-711Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSПредикторы развития и прогрессирования постинсультных когнитивных нарушенийPredictors of post-stroke cognitive impairments development and progressionhttps://orcid.org/0000-0003-1743-4713ТынтероваА. М.TynterovaA. M.

Калининград

Kaliningrad

antynterova@mail.ruhttps://orcid.org/0009-0001-7444-1736ГорбачеваА. В.GorbachevaA. V.

Калининград

Kaliningrad

Vps-anna@mail.ruhttps://orcid.org/0000-0002-8848-6134ШушаринаН. Н.ShusharinaN. N.

Калининград

Kaliningrad

nnshusharina@gmail.comhttps://orcid.org/0000-0001-8056-2019ХоймовМ. С.KhoimovM. S.

Калининград

Kaliningrad

matthewkhoimov@gmail.comhttps://orcid.org/0009-0005-4320-2635СмирноваД. А.SmirnovaD. A.

 Калининград

Kaliningrad

dasmirnova@kantiana.ruБалтийский федеральный университет имени Иммануила КантаРоссияImmanuel Kant Baltic Federal UniversityRussian FederationБалтийский федеральный университет имени Иммануила Канта; Городская больница №2РоссияImmanuel Kant Baltic Federal University; State budget health care organisation City Hospital No. 2Russian Federation2025080920253033239Copyright © Тынтерова А.М., Горбачева А.В., Шушарина Н.Н., Хоймов М.С., Смирнова Д.А., 20252025Тынтерова А.М., Горбачева А.В., Шушарина Н.Н., Хоймов М.С., Смирнова Д.А.Tynterova A.M., Gorbacheva A.V., Shusharina N.N., Khoimov M.S., Smirnova D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/711Цель исследования

Цель исследования: на основании дискриминантного анализа верифицировать предикторы развития и прогрессирования когнитивных нарушений (КН) у пациентов в восстановительном периоде ишемического инсульта (ИИ).

Материал и методы

Материал и методы. Обследовано 192 пациента, перенесших ИИ. Для оценки КН на 14-е сутки и через 6 месяцев после развития ИИ применялась клиническая рейтинговая шкала деменции (КРШД) (англ. CDR). Проанализирована взаимосвязь КРШД (коэффициент корреляции, r), предиктивной способностью (машинное обучение (МО)), приростом информации (п.и.) в отношении 28-ми параметров: демографические характеристики, данные о коморбидности, клинические, иммунологические и инструментальные показатели.

 Результаты

 Результаты. Ухудшение когнитивной функции было выявлено в 34,5% (развитие — 15,2%, прогрессирование — в 19,3%). Значимые корреляции (p < 0,05) с КРШД и предиктивной способностью (p < 0,001) были выявлены в отношении коморбидности (r = 0,620; п.и. = 0,431), возраста (r = 0,320; п.и. = 0,204), концентраций CXCL10 (r = 0,322; п.и. = 0,341), CXCL1 (r = 0,333; п.и. = 0,304) и CCL2 (r = 0,440; п.и. = 0,124).

Заключение

Заключение. Наибольшая значимость в отношении развития и прогрессирования КН в восстановительном периоде ИИ была выявлена для показателя полиморбидности, возраста, уровня цитокинов CXCL10, CXCL1 и CCL2. Для более глубокого понимания структуры и динамики постинсультных КН необходимо проведение крупномасштабных исследований с оценкой данных расширенного нейропсихологического тестирования и аспектов медикаментозной терапии, соответствующей текущим рекомендациям по лечению когнитивных нарушений.

The purpose of this study was to verify predictors of the cognitive impairment (CI) development and progression in patients in recovery period after ischemic stroke (IS) using discriminant analysis.

 Material and methods

 Material and methods. 192 patients underwent IS were examined. To assess the degree of CI on the 14th day and in 6 months after the IS development CDR scale was applied. The relationship with CDR (correlation coefficient, r) and predictive ability (ML, information gain, p.g.) was analyzed in relation to 28 parameters: demographic characteristics, comorbidity, clinical, immunological and instrumental indicators.

 Results

 Results. Deterioration of cognitive function was found in 34.5% of cases (development in 15.2%, progression in 19.3%). Significant correlations (p < 0.05) with CDR and predictive ability (p < 0.001) were found for comorbidity ( r = 0.620; p.g. = 0.431), age (r = 0.320; p.g. = 0.204), CXCL10 (r = 0.322; p.g. = 0.341), CXCL1 (r = 0.333; p.g. = 0.304) and CCL2 (r = 0.440; p.g. = 0.124) concentrations.

 Conclusion

 Conclusion. Polymorbidity, age, and levels of cytokines CXCL10, CXCL1, and CCL2 were found to be most relevant to the development and progression of CI in the recovery period of IS. For better understanding of the structure and dynamics of post-stroke CI large-scale researches assessing data from extended neuropsychological testing and aspects of drug therapy consistent with current recommendations for the cognitive impairment treatment are required.

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The authors declare that there are no conflicts of interest present.