A clinical and paraclinical study of the effectiveness and safety of using a non-pharmacological method of intermittent fasting (IF, also known by synonyms as periodic, short-term, therapeutic nutrition, "intermittent fasting") in 185 patients aged 25 to 75 years (average age – 48,6 ±1,33 years) with arterial hypertension (AH) and headache was carried out. In the process of voluntary use of intermittent fasting, 43 patients discontinued participation in the study, 31 of them - in the 24-hour and 12 - in the 16-hour scheme of IF. Thus, 142 patients with an average age of 49,26 ±1,33 years remained in the study group, of which 69 were men and 73 were women. Arterial hypertension was considered as the most likely factor of cerebral hemodynamic disorders and likely associated cephalalgia. Patients voluntarily maintained a regimen of short-term food restriction for 16 or 24 hours once every 7 days for 4 weeks. The impact on cephalgia was assessed using a valid visual pain assessment scale, and changes were considered positive when the visual analog scale (VAS) scores decreased by 2 or more points and/or a significant reduction in the duration and frequency of headache episodes or periods. Doppler ultrasound (US) of the main arteries of the head (MAH) and intracranial vessels was performed with a LOGIQ P5 scanner (General Electric, USA), equipped with a 3S linear sensor with a frequency of 5 MHz and a phased sensor of 2 MHz. At the extracranial level, the common carotid artery (CCA), internal carotid artery (ICA), vertebral artery (XA) in segments (V1) and (V2), OA, and internal jugular veins were examined. Blood flow was assessed transcranially along the a1-a2 segments of the middle cerebral artery of the SMA using a transtemporal approach and segments of the XA using a transoccipital approach. Spatial, qualitative and quantitative characteristics of vessels were studied. The thickness of the intima-media (IM) was measured by hardware and software complexes 1 cm closer to the bifurcation of the carotid artery. The research used the method and technique of electroencephalography (EEG) and the method of visual evoked potentials (EVP) for a flash.
When analyzing the results of the study, the impact of IF on neurophysiological parameters and headache according to pain level was assessed. It was established that signs of disordered brain activity in patients with arterial hypertension and periodic headache were detected in 71.2% (according to the assessment of the preservation of the pattern of alpha activity of the brain), while the indicators of the development time of the cortical components of the evoked activity per flash (latent a period of 292,7 ms in patients with arterial hypertension and cephalgia and 260,5 ms in controls for a negative 3rd cortical component; p<0,05). A decrease in the percentage ratio of pathological EEG types to types with preserved alpha activity (p<0,05) compared to the control was revealed in the case of using the described method of IF. Intermittent fasting with a break in food intake for 24 hours once a week did not reveal deterioration of neurophysiological indicators of the brain and significant clinical negative effects in the studied group of patients.
The obtained data and their analysis allow us to characterize the IF method as effective and safe, provided that contraindications are observed, with an efficiency of up to 75% in cephalgias caused by cerebral dyscirculation in patients with arterial hypertension. The main links of the influence of IF on cephalgia in hypertension have been established, it is a complex of factors: cerebral hemodynamics, neurodynamics and microcirculation. Thus, in the completed dissertation, on the basis of complex clinical-neurological, neuropsychological, instrumental studies, the theoretical and practical justification of the clinical-paraclinical characteristics of interval nutrition in patients with arterial hypertension and headache is provided, data are given on the purpose of using and the importance of some paraclinical methods research, thanks to which the possibility and effectiveness and safety of using the method of non-invasive intervention, namely - correcting the eating pattern or intermsttent fasting in patients with headache and hypertension, are substantiated
