Psychopathological peculiarities of vascular dementia with different localization of pathological focuses

Abstract

Relevance. Vascular dementia, caused by various organic lesions, volume and location of organic damage to brain tissue, manifests itself in a wide range of concomitant neuropsychiatric symptoms. However, despite the obvious link between the location of vascular lesions and the patient's psychopathological symptoms, the effects of the physical characteristics of the brain damage that caused the vascular dementia and the corresponding neuropsychiatric symptoms remain poorly understood. The aim of the study was to investigate psychopathological features of cognitive impairment in patients with vascular dementia depending on the location of the lesion. Contingents and methods. 157 people with a diagnosis of vascular dementia were examined, divided into five groups: group 1 — 22 people with localization of the pathological process in the frontal lobe; group 2 — 18 patients with temporal lobe lesions; group 3 — 17 patients with parietal lobe lesions; group 4 — 15 patients with occipital lobe lesions and group 5 — 68 people with total lesions. Results: It was found that the lesion of the frontal lobes is characterized by a high frequency of euphoria and hallucinatory phenomena, as well as minor manifestations of apathy and anxiety; lesion of the temporal lobe — the highest frequency and severity of apathy; parietal lesions — low frequency of anxiety combined with its high intensity; occipital lesions — intense depressive experiences (in cases where they occurred), total brain damage — the lowest prevalence and intensity of delusional feelings, irritability and agitation. Conclusions. A comprehensive study of patients with vascular dementia identified specific to each localization of brain lesions spectra of neuropsychiatric symptoms, which creates the necessary conditions for early application of differentiated therapeutic and rehabilitation measures and, accordingly, to improve the quality of patients life in this category.