Objective. To analyze severity of psychological maladjustment in military personnel with consequences of combat trauma and effectiveness of innovative rehabilitation technologies with neurofeedback based on acoustic stimulation for its correction. Material and methods. The study involved 100 military personnel with consequences of combat trauma. All patients received basic therapy (BT), including psychotropic medications, psychological counseling and physical exercises. All ones were randomized into 4 groups. The control group received BT alone. In the second group (comparison group 1), patients received a course of bioacoustic correction (BAC) in addition to BT. In the third group (comparison group 2), BT was supplemented with a course of binaural therapy. In the main group, patients received BAC and binaural stimulation in addition to BT. We assessed effectiveness of rehabilitation measures considering psychometric tests, heart rate variability and integral level of functional reserves. Results. BAC therapy was the most effective for chronic pain syndrome. The mechanism is based on modulation of pathological neural activity through EEG-dependent feedback. Binaural therapy demonstrated the greatest results in correcting the manifestations of post-traumatic stress reactions (according to the Mississippi scale), asthenic syndrome (reduced fatigue according to the MFI-20), and anxiety with autonomic dysfunction (lower PARS index). Its action is aimed at synchronizing brain rhythms, increasing parasympathetic tone, and restoring energy resources. Combined therapy (BAC+binaural stimulation) demonstrated the highest efficacy for complex anxiety-depressive disorders and comprehensive rehabilitation of posttraumatic stress disorders due to synergistic effect. Our results allowed for development and validation of methodology for a differentiated approach to selecting medical and psychological rehabilitation strategies based on strict principle of pathogenetic and symptomatic correspondence. According to this approach, maximum clinical and psychophysiological effectiveness is achieved when dominant mechanism of therapeutic factor precisely matches the leading pathogenetic component of certain clinical syndrome. Conclusion. We formulated and empirically substantiated methodology for differentiated use of neuroacoustic technologies in rehabilitation of military personnel with consequences of combat mental trauma. This methodology is based on a strict correspondence between the mechanism of action of physical factor and the leading pathogenetic component of syndrome. The proposed syndrome-oriented algorithm facilitates transition from universal protocols to personalized and diagnosis-guided rehabilitation.
Yudin et al. (Thu,) studied this question.