Effectiveness of transcranial magnetic stimulation of the prefrontal cortex for the correction of autonomic disorders in miners with polyneuropathy

Introduction. Polyneuropathy is the most common occupational neurological pathology. Violation of the activity of the central links of autonomic regulation due to excessive afferent impulses from the receptors of the skin and other tissues of the extremities leads to sympathetic activation and angiospasm, the progression of polyneuropathy. A decrease in the parasympathetic influence is the cause of systemic trophic disturbances. The possibility of transcranial magnetic stimulation of the prefrontal cortex opens up new therapeutic opportunities to correct the autonomic disorders in occupationally caused polyneuropathy.

The aim of the study was to evaluate the effect of transcranial magnetic stimulation of the dorsolateral zone in the prefrontal cortex of the right hemisphere for the correction of neuroautonomic disorders in miners with polyneuropathy.

Material and methods. Forty-two miners of the Kuzbass coal mines with a proven diagnosis of upper extremity polyneuropathy were examined. To identify autonomic dysregulation, the “Questionnaire for revealing the signs of autonomic changes”, spectral and nonlinear indices of cardio rhythm were used. Low-frequency (1 Hz) transcranial magnetic stimulation of the dorsolateral zone of the prefrontal cortex of the right hemisphere was performed in the course of 5 procedures according to a specially elaborated methodology.

Results. In the examined miners, a decrease in the nonlinear and spectral indices of heart rate variability was initially determined, which indicated reducing adaptive capabilities, an increase in sympathetic influence. After the magnetic stimulation course, there was an improvement in general well-being and normalization of autonomous regulation according to the questionnaire. An increase in the spectral indices of the heart rate variability, more pronounced in the range of very low frequencies, indicated the activation of suprasegmental autonomic centers and an increase in parasympathetic influence.

Conclusions. Transcranial magnetic stimulation of the prefrontal cortex effectively corrects autonomic disorders in miners with polyneuropathy and promotes an increase in adaptive capabilities due to the activation of suprasegmental autonomic centres.

Contribution:

Gidayatova M.O. — the concept and design of the study, collection and processing of material, statistical processing, writing a text;

Martynov I.D. — editing;

Yamshchikova A.V. — collection and processing of material;

Fleishman A.N. — editing.

All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Conclusion of the biomedical ethics committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases: the study was carried out by non-invasive methods and complies with the ethical standards of the bioethical committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases, developed in accordance with the Declaration of the Russian Federation “, approved by the Order of the Ministry of Health of the Russian Federation No. 266 of June 19, 2003.