Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Cognitive, emotional and motor disorders and their impact on the postoperative rehabilitation of neurosurgical patients

Full Text:


Pathological post-anesthetic changes can be determined by the type and duration of anesthesia, the somatic and neurological status of the patient in the preoperative period, age, etc.
Objective: to assess the severity of cognitive (CI), emotional and motor impairments in patients who underwent spinal surgery.
Patients and methods. The clinical study included 60 patients aged 30-74 years who underwent spinal surgery under general anesthesia. The neuropsychological, emotional, somatic, and neurological status were assessed at the baseline and one week, 3, and 6 months after the surgery. Thirty patients underwent a course of cognitive training (main group), and 30 patients were included in a comparison group.
Results and discussion. In the postoperative period, pain indicators decreased in both groups. There was an improvement in cognitive functions, emotional state, and quality of life (QoL) in the main group 3 and 6 months after surgery. The inclusion of cognitive training in the rehabilitation program for patients undergoing neurosurgical spinal surgery improved cognitive and motor functions and the QoL of patients. Evaluation and treatment of neurosurgical patients are discussed, which are helpful to improve the results of rehabilitation and QoL in the postoperative period.
Conclusion. Additional positive impact of cognitive-motor training for pain regression in patients after spinal surgery was observed.

About the Authors

D. Fantalis
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

 11, Rossolimo St., Build. 1, Moscow 119021, Russia 

I. S. Preobrazhenskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

 11, Rossolimo St., Build. 1, Moscow 119021, Russia 


1. Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998 Mar 21;351(9106):857-61. doi: 10.1016/s0140-6736(97)07382-0

2. Rasmussen LS, Johnson T, Kuipers HM, et al. Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand. 2003 Mar;47(3):260-6. doi: 10.1034/j.1399-6576.2003.00057.x

3. Bekker AY, Weeks EJ. Cognitive function after anaesthesia in the elderly. Best Pract Res Clin Anaesthesiol. 2003 Jun;17(2):259-72. doi: 10.1016/s1521-6896(03)00005-3

4. Zakharov VV. All-Russia epidemiological and therapeutic investigation concerning cognitive impairment in the elderly («Prometheus»). Nevrologicheskii zhurnal. 2006;11(2):27-32 (In Russ.).

5. Bryson GL, Wyand A. Evidence-based clinical update: General anesthesia and the risk of delirium and postoperative cognitive dysfunction. Can J Anaesth. 2006 Jul;53(7):669-77. doi: 10.1007/BF03021625

6. Cole MG. Delirium in elderly patients. Am J Geriatr Psychiatry. Jan-Feb 2004;12(1):7-21.

7. Inouye SK. Delirium in older persons. N Engl J Med. 2006 Mar 16;354(11):1157-65. doi: 10.1056/NEJMra052321

8. Hofacer RD, Deng M, Ward CG, et al. Cell age-specific vulnerability of neurons to anesthetic toxicity. Ann Neurol. 2013 Jun;73(6):695-704. doi: 10.1002/ana.23892. Epub 2013 Jun 5.

9. Shu Y, Patel SM, Pac-Soo C, et al. Xenon pretreatment attenuates anestheticinduced apoptosis in the developing brain in comparison with nitrous oxide and hypoxia. Anesthesiology. 2010 Aug;113(2):360-8. doi: 10.1097/ALN.0b013e3181d960d7

10. Yakhno NN. Cognitive impairment in neurological clinical practice. Nevrologicheskii zhurnal. 2006;11(S1):4-13 (In Russ.).

11. Yakhno NN, Zakharov VV. Mild cognitive impairment in old age. Nevrologicheskiy zhurnal. 2004;9(1):4-8 (In Russ.).

12. Stratmann G, Sall JW, May LD, et al. Beyond anesthetic properties: the effects of isoflurane on brain cell death, neurogenesis, and long-term neurocognitive function. Anesth Analg. 2010 Feb;110(2):431-7. doi: 10.1213/ANE.0b013e3181af8015

13. Baranov D, Bickler PE, Crosby GJ, et al. Consensus statement: First International Workshop on Anesthetics and Alzheimer's disease. Anesth Analg. 2009 May;108(5):1627-30. doi: 10.1213/ane.0b013e318199dc72

14. Jevtovic-Todorovic V, Hartman RE, Izumi Y, et al. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci. 2003 Feb 1;23(3):876-82. doi: 10.1523/JNEUROSCI.23-03-00876.2003

15. Wu L, Zhao H, Wang T, et al. Cellular signaling pathways and molecular mechanisms involving inhalational anesthetics-induced organoprotection. J Anesth. 2014 Oct;28(5):740-58. doi: 10.1007/s00540-014-1805-y. Epub 2014 Mar 9.

16. Bedford PD. Adverse cerebral effects of anaesthesia on old people. Lancet. 1955 Aug 6;269(6884):259-63. doi: 10.1016/s0140-6736(55)92689-1

17. Fredriksson A, Ponten E, Gordh T, Eriksson P. Neonatal exposure to a combination of N-methyl-d-aspartate and gamma-aminobutyric acid type A receptor anesthetic agents potentiates apoptotic neurodegeneration and persistent behavioral deficits. Anesthesiology. 2007 Sep;107(3):427-36. doi: 10.1097/01.anes.0000278892.62305.9c

18. Wilder RT, Flick RP, Sprung J, et al. Early exposure to anesthesia and learning disabilities in a population-based birth cohort. Anesthesiology. 2009 Apr;110(4):796-804. doi: 10.1097/01.anes.0000344728.34332.5d

19. Flick RP, Katusic SK, Colligan RC, et al. Cognitive and behavioral outcomes after early exposure to anesthesia and surgery. Pediatrics. 2011 Nov;128(5):e1053-61. doi: 10.1542/peds.2011-0351. Epub 2011 Oct 3.

20. LaMorte W. Prospective and Retrospective Cohort Studies. Boston: Boston University College of Public Health; 2013. Retrieved Nov 25, 2013.

21. Daniel WW. Kolmogorov–Smirnov one-sample test. In: Applied Nonparametric Statistics (2nd ed.). Boston: PWS-Kent; 1990. P. 319-30.

22. Shapiro SS, Wilk MB. An analysis of variance test for normality. Biometrika. 1965;52(3):591-611.

23. Mann HB, Whitney DR. On a test of whether one of two random variables is stochastically larger than the other. Ann Mathem Stat. 1947;18:50-60.

24. Wilcoxon F. Individual comparisons by ranking methods. Biometrics. 1945;(1):80-3.

25. Kruskal WH, Wallis WA. Use of ranks in one-criterion variance analysis. J Am Stat Assoc. 1952;47(260):583-621.

26. Nikulin MS. Chi-squared test for normality. In: Proceedings of the International Vilnius Conference on Probability Theory and Mathematical Statistics. 1973.

27. Fisher RA. On the interpretation of 2 from contingency tables, and the calculation of P. J Royal Stat Soc. 1922;85(1):87-94.


For citations:

Fantalis D., Preobrazhenskaya I.S. Cognitive, emotional and motor disorders and their impact on the postoperative rehabilitation of neurosurgical patients. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(6):35-40. (In Russ.)

Views: 272

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)