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P.1.j. Basic and clinical neuroscience − Cognitive neuroscience
encephalopathy is caused by ineffective metabolic control and develops in 80.7% of patients with Diabetes Mellitus type 1. Objective: Comparative analysis of the development of emotional–affective and cognitive disorders as manifestations of diabetic encephalopathy in patients with diabetes mellitus type 1 receiving Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Insulin Injections (MDI). Materials and Methods: The study included 34 patients aged 29±11 years with the duration of the disease 14.25±9.25 years, the level of glycated hemoglobin of 9.5±1.5%. Exclusionary criteria were: psychiatric disorders, congenital cognitive deficits, exogenous intoxications, somatic diseases leading to encephalopathy. The first group (N = 16) consisted of patients who were on therapy with Continuous Subcutaneous Insulin Infusion over 4.5±1.5 years. All patients of the first group were on insulin therapy by means of Multiple Daily Insulin Injections for the period of 11.3±5.4 years before the change of the treatment method to Continuous Subcutaneous Insulin Infusion. The second group (N = 18) composed of patients treated with insulin by means of Multiple Daily Insulin Injections in the course of 12.7±7.7 years. The assessment of cognitive functions and emotional conditions of the patients of both groups was performed using standardized scales: Hospital Anxiety and Depression Scale (HADS), Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA). Statistical analysis was performed in the software SAS for Windows 9.3. The results were evaluated by Student’s t-test (f = 32, t = 2.037, p < 0.05). Results: The MMSE scale has not revealed the differences in the level of cognitive functions between the patients of two groups. All the patients had the MMSE score corresponding to normal cognitive function without any significant difference between aforementioned groups. MoCa scale has demonstrated that the patients on CSII had a higher score in comparison with the patients on MDI: 29.3 and 27.6, respectively (p < 0.05). The presence as well as severity of emotional disorders was assessed by HADS scale. The mean value of patients on CSII was 4.12, which corresponded to normal emotional condition, the mean value of patients on MDI rised to 8.44, which corresponded to subclinical anxiety or depression (p < 0.05). Conclusion: The comparative analysis of the development of emotional–affective and cognitive disorders as manifestations of encephalopathy in patients with diabetes mellitus type 1 using different methods of insulin therapy has revealed significant differences in the presence and severity of cognitive and emotional– affective disorders, which indicate the advantages of Continuous Subcutaneous Insulin Infusion as compared with Multiple Daily Insulin Injections in terms of the development of diabetic encephalopathy.
P.1.j.028 Electrophysiological markers of neurocognitive deficits in paranoid schizophrenia M. Petrov1 ° , B. Ershov2 , N. Daeva3 , A. Berezina1 , A. Gvozdetsky4 1 Saint-Petersburg State University, Department of Medical Psychology and Psychophysiology, Saint-Petersburg, Russia; 2 North-Western State Medical University named after I.I. Mechnikov, Department of Psychology and Pedagogy, SaintPetersburg, Russia; 3 Herzen University, Department of Medical Psychology and Psychophysiology, Saint-Petersburg, Russia;
4 Saint-Petersburg State University, Department of Psychiatry and Narcology, Saint-Petersburg, Russia
Introduction: In the recent few years number of research analyzing neurobiological factors of diseases severity, cognitive functioning increases. It is necessary both for theoretical comprehension of mechanisms resulting in psychopathological schizophrenia syndromes and for identifying treatment’s and rehabilitation’s targets. Components of event related potentials (ERP) are considered to be representative for cognitive deficits investigation. Evaluation of ERP components allow to keep optimal relationship between different aspects of information processing, decision making and their electrophysiological reflection. Objectives: We investigated cognitive deficits and ERP components in solving verbal logical task in participants with schizophrenia, with recurrent depressive disorder and conditionally healthy participants. According to (our) recent research we hypothesized that: 1. subjects with schizophrenia compare to subjects with recurrent depression and conditionally healthy participants would show impairment in auditory system (verbal learning, auditory working memory and verbal fluency) and decline of processing speed; 2. in patients with schizophrenia late ERP components would be reduced in the temporal lobes region and 3. these components would be correlated with cognitive impairment in auditory system. Methods: The sample includes 19 patients with schizophrenia (SZ), 12 patients with recurrent depressive disorder (RD) and 33 healthy controls (HC). The clinical status was determined by using of the following scale: Montgomery-Asberg Depression Rating Scale (MADRS) and the Positive and Negative Syndrome Scale (PANSS). All participants completed a cognitive battery (The Brief Assessment of Cognition in Schizophrenia (BACS)), which was used to evaluate participants cognitive status. The procedure of electrophysiological experiment includes presentation of words pairs. The participants task was to define a type of logical words connection. There were three answers type: the first word is the part of second, the last one is the part of the first one and the absence of any connection. Responses were given through pressing keyboards 1, 2 or 3. Electrophysiological components were registrated during solution of experimental task. Results: Using bootstrap random forest for identifying predictors distinguishing SZ group from RD and HC group. Four variables were extracted. They include two cognitive components: processing speed (p = 0.048), verbal fluency (p = 0.044); and interaction of two electrophysiological components: the power of ERP amplitudes at right (T4) temporal site in a time window between 440 and 480 ms and at left temporal site (T5) in a time window between 360 and 400 ms (p = 0.02). Using previous analysis a regression model was calculated (pseudo-R2 = 0.38, bootstrap corrected area under ROC curve is 0.72). SZ group was marked by decreasing in cognitive domains and reduction of late ERP components. Conclusion: The results suggest that late ERP components are reduced, these components are correlated with impairment in auditory system. Thus current data concerning functional weaknesses of temporal lobes in processing of verbal task solution contribute to development of multifactor schizophrenia model. Also current study could be used for calculating mathematical models allowing to reveal the specificity of relation between cognitive and electrophysiological parameters in subjects with paranoid schizophrenia.