Differentiation of Cognitive Status in Patients with Coronary Artery Disease Using EEG Clusterization by Discrete Optimization with a Minimax Criterion

Cognitive status and EEG in the theta, alpha, and beta ranges were studied using cluster analysis by discrete optimization in patients with cardiovascular disease in the preoperative period of coronary artery bypass grafting. The cognitive status was measured by Mini-Mental State Examination (MMSE) scale, and an integral indicator of cognitive status (IICS) formed on the basis of complex testing the indices of visual-motor responses, attention, and memory. The new method of clustering the EEG power and the cognitive status made it possible to distinguish groups of patients differenced by cognitive reserves. The IICS better differentiates groups than MMSE. The factors of age and education were decisive only in specific groups. The clusters characterized by the most represented cognitive reserves according to the higher both MMSE and IICS indicators included less pronounced activation of the cortex according to more power of the theta, alpha, and less beta rhythm. Patients with supposedly minimal reserves are differed by a low level of cognitive status, as well as education level together with higher activation state of the cortex. The third type of clusters was distinguished by an unstable composition due to the variability of EEG indicators in it, mostly cortical activity at the alpha1 frequencies. The EEG neurophysiological approach, together with cognitive screening and proposed clustering analysis, could be helpful in understanding mechanisms of cognitive reserves and identify the risk factors of postoperative cognitive dysfunction in patients with brain cardiovascular damage.