Hemorheological parameters during rehabilitation with transcranial micropolarization in patients in the early post-stroke recovery period: 616.8‐085.84

Abstract

Summary. Introduction. The underlying mechanism of ischemic stroke is progressive microcirculatory cerebral disorders. The state of microcirculation largely depends on blood rheological properties. The impact of transcranial direct current stimulation (tDCS) on these factors in patients in the early post‐stroke recovery period has yet to be fully elucidated. Aim: to evaluate the relation‐ ship between the effects of tDCS in a complex of rehabilitation measures and changes in hemorheology in patients in the early post‐stroke recovery period. Materials and Methods. A prospective controlled randomized intervention study in parallel groups was conducted. A total of 33 patients in the early post‐stroke recovery period (main group) and 40 practically healthy individuals without a history of cardiovascular diseases (control group) were examined. The patients in the main group were randomly divided into two subgroups. In subgroup 1 (n = 19; 57.6%) tDCS was used as part of the rehabilitation complex; reference subgroup 2 (n = 14; 42.4%) did not receive tDCS. At the beginning and end of the rehabilitation course, venous blood was taken to determine hemorhe‐ ological parameters, including hemoglobin, hematocrit, erythrocyte aggregation, blood viscosity, plasma viscosity and the number of desquamated endothelial cells. The following indicators were calculated: coefficient of erythrocyte cohesion, caisson viscosity, oxygen delivery efficiency index, and rigidity index. Results. In patients in the main group, there was an increase in erythrocyte aggregation, higher levels of blood viscosity, plasma, hemoglobin and hematocrit, a higher number of desquamated endothelial cells, a higher erythrocyte rigidity index and a decrease in the efficiency of oxygen delivery to tissues compared with the indicators of practically healthy individuals. Upon completion of the rehabilitation course, a statistically significant decrease was observed in hemoglobin and blood hematocrit levels in both study subgroups. Additionally, a decrease in plasma viscosity, blood viscosity at high shear rates, caisson viscosity, and rigidity index was evident in subgroup 1 patients. Conclusion. During the comprehen‐ sive rehabilitation of patients in the early recovery period, blood rheological properties were found to return to normal. This is evidenced by a decrease in hemoglobin and hematocrit levels, blood viscosity, and an increase in the efficiency of oxygen delivery to tissues. In patients undergoing complex rehabilitation with tDCS employed, a statistically significant reduction was observed in the caisson viscosity, the viscosity of whole plasma and blood at high shear rates, as well as in the erythrocyte rigidity index. These findings may be indicative of improved deforming properties of erythrocytes and blood fluidity in the great vessels.

For citation: Gasanbekova A.R., Yastrebtseva I.P., Pakhrova O.A. Hemorheological parameters during rehabilitation with transcranial micropolarization in patients in the early post‐stroke recovery period. Tromboz, gemostaz i reologiya. 2024;(3):58–66. (In Russ.).

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