Постковидный синдром: от биологии к нейропсихологии
Аннотация
Актуальность. Постковидный синдром, или длительный COVID (Long COVID), — новый синдром во врачебной практике, введенный ВОЗ после пандемии COVID-19, выявляется у многих перенесших COVID-19 пациентов.
Цель. Рассмотреть вызываемые COVID-19 когнитивные нарушения с точки зрения нейропсихологии и патофизиологии.
Выборка. В ходе поиска литературы в базах данных Pubmed, Google.scholar и Scopus были отобраны 63 источника. Ключевые слова при отборе литературы «neuropsychiatry/neuropsychology», «pathophysiology», «COVID-19», «SARS-CoV-2».
Методы. Обзор и анализ исследований COVID-19 и его связи с появлением когнитивных дефицитов у пациентов.
Результаты. Вирус SARS-CoV-2 проникает в организм человека и поражает структуры головного мозга. Сохранение симптомов усталости, одышки, проблем с концентрацией внимания и памятью, потери или изменения вкуса и обоняния, боли в мышцах и в суставах и расстройства сна могут объясняться особенностью взаимодействия вируса с ЦНС. Нейропсихологический анализ нарушений с позиции теории трех функциональных блоков мозга А.Р. Лурия позволяет выявить пораженные звенья функциональных систем высших психических функций (ВПФ) и в сочетании с анализом клинических данных дает возможность выстроить программу реабилитации, в том числе когнитивные тренинги и психологическую помощь, а также подобрать адекватную медикаментозную терапию, позволяющую редуцировать или компенсировать психические нарушения.
Выводы. SARS-CoV-2 вызывает поражение таких структур головного мозга, как ствол, лимбическая система, префронтальная кора и обонятельный тракт, что служит объяснением наблюдаемых симптомов. Нейропсихологическая диагностика позволяет выявить нарушенные звенья ВПФ у пациентов с постковидным синдромом, выстроить адекватную реабилитационную программу, а также подобрать медикаментозную терапию.
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Поступила: 24.01.2023
Принята к публикации: 08.02.2024
Дата публикации в журнале: 21.03.2024
Ключевые слова: постковидный синдром; нейропсихология; нейропсихиатрия; высшие психические функции
DOI: 10.11621/LPJ-24-02
Доступно в on-line версии с: 21.03.2024
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