Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis
Author:
GRIBACHEVA I.A., POPOVA T.F., PETROVA E.V., ZVONKOVA A.V.
Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk
Summary:
Chronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. Correct and timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are important, among other things, for slowing down the progression of cognitive deficits. Objective: to study the efficacy and safety of Mexidol administered intravenously by drip infusion (500 mg 1 time per day) for 14 days, followed by oral administration of the drug Mexidol FORTE 250 at a dose of 250 mg 3 times a day for 60 days in middle-aged patients with chronic cerebral ischemia (CCI) on the background of arterial hypertension and atherosclerosis. Material and methods. The open observational program included 60 patients aged 45 to 59 years with CCI, confirmed by the results of a neuropsychological and neuroimaging examination. Patients received Mexidol first intravenously (14 days), and then orally in pills – Mexidol FORTE 250 (60 days). Patients underwent neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger–Khanin scale), of vegetative disfunction (A.M. Wayne's autonomic response scale modified by V.L. Golubev), of the severity of general, mental and physical asthenia (MFI-20) and quality of life (MOS SF-36 questionnaire). Results. The results of the treatment made it possible to establish relief of asthenic syndrome and vegetative dysfunction on the background of Mexidol use. The differences were statistically significant both when comparing with the baseline and with the comparison group (p<0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The combination of positive effects led to an increase in indicators of quality of life (p<0.05). The treatment was well tolerated. Conclusion. Patients with CCI have significant emotional, vegetative and asthenic disorders. The use of Mexidol can reduce the severity of these disorders, which gives reason to recommend it for the treatment of such patients. Keywords: chronic cerebral ischemia; arterial hypertension; atherosclerosis; cognitive impairment; vegetative disorders; asthenia; Mexidol; Mexidol FORTE 250.
Efficacy of Mexidol in the correction of postcovid syndrome in patients with chronic cerebrovascular diseases
Author:
E.B. KUZNETSOVA, E.A. SALINA, N.S. KUZNETSOV
Razumovsky Saratov State Medical University, Saratov, Russia
Summary:
Objective. To evaluate the effectiveness of sequential therapy with Mexidol and Mexidol FORTE 250 in the correction of postcovoid syndrome (PKS) in patients with chronic cerebrovascular diseases (CVD). Material and methods. The analysis of the results of examination and treatment of 110 patients with CVD who underwent COVID-19 was carried out. Patients of the main group (OH, n=55) received Mexidol (5 ml IV drip for 14 days, followed by the transition to the tablet form of Mexidol FORTE 250 1 table 3 times/day for 2 months); 55 patients of the comparison group (GS) did not receive antioxidants. All patients included in the study were conducted MRI examination and extensive neuropsychological testing. Results. There was a significant improvement in the state of cognitive functions, regression of symptoms of asthenia, improvement of night sleep in patients with OG. The differences were statistically significant both in comparison with the baseline level and the HS. Conclusion. The administration of the drug does not require age-related dose adjustment and is well combined with basic therapy. The recommended regimen for the use of Mexidol: 14 days of 5 ml i/v or i/m, then taking the drug Mexidol FORTE 250 at a dose of 1 table 3 times/day for 2 months. Keywords: chronic cerebrovascular diseases, postcovid syndrome, Mexidol, treatment.
Clinico-psychological profile and life quality of patients with post-COVID syndrome
Author:
L.V. CHICHANOVSKAYA, T.A. SLYUSAR, YU.V. ABRAMENKO, T.M. NEKRASOVA, I.N. SLYUSAR
Tver State Medical University, Tver, Russia
Summary:
Objective. To study clinico-psychological profile and life quality of patients with post-COVID syndrome. Material and methods. We examined 162 patients aged 24-60 years with confirmed SARS-CoV‑2 infection which having symptoms that served as the basis for the diagnosis of post-COVID syndrome. Patients underwent general neurological and somatic examination with allocation of the corresponding neurological syndromes. The intensity and quality of pain were assessed using the McGill Pain questionnaire. The level of psychosocial stress was determined by the Holmes-Ray questionnaire, the identification and severity of asthenia — by the MFI-20 asthenia scale. The level of reactive and personal anxiety was studied according to the Spielberger—Khanin questionnaire, depression — according to the Beck scale. The assessment of life quality was carried out using the Russian version of SF-36 questionnaire. To correct the identified disorders, Mexidol was used according to the scheme: 500 mg once daily intravenously for 14 days, followed by Mexidol FORTE 250 750 mg per day orally (250 mg 3 times a day) for 2 months. Results. The course of treatment with Mexidol in patients with post-COVID syndrome led to decrease in the severity of subjective and objective symptoms, asthenic, anxiety and depressive disorders, and improved the life quality of patients. Conclusion. The high efficacy and safety of sequential therapy with Mexidol (injections followed by tablets of Mexidol FORTE 250) has been shown. Keywords: post-COVID syndrome, SARS-CoV‑2 infection, emotional disorders, anxiety, depression, life quality, Mexidol.
International multicenter randomized double-blind placebo-controlled study assessing the efficacy and safety of sequential therapy with Mexidol® and Mexidol® forte 250 in patients with chronic brain ischemia (MEMO): subanalysis in patients with arterial hypertension
Author:
ZAKHAROV V.V.1, OSTROUMOVA O.D.1,2, KOCHETKOV A.1,2, KLEPIKOVA M.V.2, FEDIN A.1,3
1I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)
2Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia, Moscow
3N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
Summary:
Abstract. Chronic brain ischemia (CBI) is one of the most common neurological disorders in clinical practice. Objective: to evaluate the efficacy and safety of sequential therapy with Mexidol® solution intravenously and Mexidol® FORTE 250 film-coated tablets, 250 mg orally in patients with and without arterial hypertension (AH) in terms of the drug effect on cognitive functioning, as well as the severity of asthenic, anxiety, vegetative and motor disorders, and quality of life in CBI. Material and methods. In a subanalysis patients with CBI were divided into four subgroups: 1st – AH patients receiving Mexidol® and Mexidol® FORTE 250 (n=144); 2nd – AH patients receiving placebo (n=146); 3rd – patients without AH receiving Mexidol® and Mexidol® FORTE 250 (n=15); 4th – patients without AH receiving placebo (n=12). Results. At the end of the follow-up, significant differences were found in the dynamics of the MoCA scores between the patients receiving Mexidol® and placebo (p=0,000), which allows to state a superior efficacy of Mexidol in the subgroup of patients with AH. Also in the long-term sequential therapy with Mexidol®, in contrast to the placebo, the median value of the MoCA score at the end of the follow-up reached normal levels in patients with and without AH. When assessing secondary efficacy endpoints, a significant advantage of Mexidol® over placebo in the population of patients with AH at the end of follow-up was achieved on the following parameters: The Digit Symbol Substitution Test, MFI-20, the Beck Anxiety Inventory, Tinetti Performance-Oriented Mobility Assessment, psychological component of health according to SF-36 questionnaire. A comparable character of the safety profile of Mexidol® and placebo was established. Conclusion. The obtained results allow to recommend the use of long-term sequential therapy with Mexidol in the complex therapy of patients with AH and CBI as a tool for the brain protection as a AH target organ and as a tool of pathogenetically substantiated therapy of cognitive, emotional, asthenic, vegetative and motor disorders. Key words: chronic brain ischemia, arterial hypertension, cognitive impairment, ethylmethyhydroxypyridine succinate, Mexidol®, Mexidol® FORTE 250.
Improving the effectiveness of pharmacotherapy in comorbid patients with chronic cerebral ischemia on an outpatient basis
Author:
T.L. VIZILO1, E.G. AREFIEVA2
1Kemerovo State Medical University, Kemerovo, Russia;
2Barbarash Kuzbass Clinical Cardiological Dispensary , Kemerovo, Russia
Summary:
Objective. To study the efficacy and safety of sequential therapy with Mexidol (500 mg 1 time/day for 14 days intravenously) and Mexidol FORTE 250 (Mexidol FORTE 250 for 250 mg 3 times/day, 60 days) in patients with chronic cerebral ischemia (CCI) on an outpatient basis. Material and methods. The open comparative study included 56 patients aged 46—74 years, age — 60.5+7.9 years. In all patients, the diagnosis of CCI was confirmed by clinical and neuroimaging methods. Patients of group 1 (n=28) received basic therapy and Mexidol, group 2 (n=28) received only basic therapy. Results. Against the background of therapy in patients of group 1, there was a statistically significant improvement in the state of cognitive functions, a decrease in the severity of symptoms of depression and anxiety, manifestations of asthenia. The treatment was characterized by good tolerability, absence of adverse events and cases of drug interactions. Conclusion. Sequential therapy with Mexidol and Mexidol FORTE 250 drugs provides relief of the main clinical manifestations of CCI, is characterized by good tolerability and safety. Keywords: chronic cerebral ischemia, arterial hypertension, ethylmethylhydroxypyridine succinate, Mexidol, Mexidol FORTE 250.
Features of treatment and rehabilitation of COVID-19 patients with ischemic stroke
Author:
G.S. RAKHIMBAYEVA, SH.R. GAZIEVA, M.K. ATANIYAZOV, F.H. MURATOV, D.S. TOLIPOV, U.D. SHODIEV
Tashkent Medical Academy, Tashkent, Republic of Uzbekistan
Summary:
The development of COVID-19 is associated with damage to various organs and organ systems, including the development of acute ischemic stroke (AI). The article examines modern ideas about the pathogenesis of AI in COVID-19. The data on the choice of optimal therapy for patients with acute AI and COVID-19, as well as on the possibility of improving the effectiveness of rehabilitation measures, are analyzed. Information is provided on the efficacy of the drug Mexidol in patients with AI and COVID-19. Keywords: ischemic stroke, COVID-19, treatment, rehabilitation, Mexidol.
Features of treatment and rehabilitation of COVID-19 patients with ischemic stroke
Author:
G.S. RAKHIMBAYEVA, SH.R. GAZIEVA, M.K. ATANIYAZOV, F.H. MURATOV, D.S. TOLIPOV, U.D. SHODIEV
Tashkent Medical Academy, Tashkent, Republic of Uzbekistan
Summary:
The development of COVID-19 is associated with damage to various organs and organ systems, including the development of acute ischemic stroke (AI). The article examines modern ideas about the pathogenesis of AI in COVID-19. The data on the choice of optimal therapy for patients with acute AI and COVID-19, as well as on the possibility of improving the effectiveness of rehabilitation measures, are analyzed. Information is provided on the efficacy of the drug Mexidol in patients with AI and COVID-19. Keywords: ischemic stroke, COVID-19, treatment, rehabilitation, Mexidol.
Oxidative stress in the pathogenesis of stroke and its correction
Author:
M.YU. MARTYNOV1,2, M.V. ZHURAVLEVA3,4, N.S. VASYUKOVA5, E.V. KUZNETSOVA6, T.R. KAMENEVA7
1Pirogov Russian National Research Medical University, Moscow, Russia;
2Federal Center of Brain Research and Neurotechnologies, Moscow, Russia;
3Research Center for Examination of Medical Devices, Moscow, Russia;
4Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
5Skriabin and Kovalenko Institute of Experimental Veterinary Medicine, Moscow, Russia;
6Research Institute for Healthcare and Medical Management, Moscow, Russia;
7Konchalovsky City Clinical Hospital, Moscow, Russia
Summary:
We reviewed the role of oxidative stress (OS) in the pathogenesis of ischemic (IS) and hemorrhagic stroke (HS). OS plays a major role in programmed cell death, increased permeability of the blood-brain barrier, astroglial and microglial activation, and local inflammatory response. We also reviewed the current state of neuro- and cytoprotection studies and their translation in clinical practice. With respect to experimental and clinical data the efficacy of long term administration of multimodal cytoprotective drug with antioxidant effect — ethylmethylhydroxypyridine succinate (Mexidol) is discussed during the acute and early recovery period after stroke. Keywords: stroke, reperfusion, oxidative stress, programmed cell death, apoptosis, ferroptosis, hemoglobin, neuroprotection, ethylmethylhydroxypyridine succinate, Mexidol.
Cognitive disorders of vascular genesis in the practice of a therapist
Author:
P.R. KAMCHATNOV1, R.A. CHEREMIN2, L.A. SKIPETROVA2, A.V. CHUGUNOV1
1N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
2Center of Speech Pathology and Neurorehabilitation of the Moscow Healthcare Department
Summary:
Cognitive impairment (CI) is a widespread clinical syndrome, with which specialists of various profiles often meet in outpatient settings. Diagnosis of CI is a responsible task, the correct solution of which requires a comprehensive analysis of anamnestic information, the nature of the clinical picture, the results of laboratory and instrumental examination. Cerebrovascular diseases are a common cause of CI. The article discusses the issues of management of patients with coronary artery disease, in particular, the main aspects of correction of cardiovascular risk factors, the choice of optimal drug therapy are considered. Information is provided on the possibility of using the drug Mexidol for the treatment of this contingent of patients. The results of studies devoted to the study of the possibility of using Mexidol in patients with chronic disorders of cerebral circulation with CI are analyzed. Key words: chronic cerebral ischemia, chronic cerebrovascular diseases, small cerebral artery disease, cognitive impairment, Mexidol.
Results of clinical studies of the efficacy and safety of the use of ethylmethylhydroxypyridine succinate in patients with chronic cerebral ischemia
Author:
M.V. ZHURAVLEVA1,2, P.R. KAMCHATNOV3, N.S. VASYUKOVA4, V.V. ARKHIPOV1, E.V. KUZNETSOVA5, T.R. KAMENEVA6, S.YU. SEREBROVA1,2
1Research Center for Examination of Medical Devices, Moscow, Russia;
2Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
3Pirogov Russian National Research Medical University, Moscow, Russia;
4Skriabin and Kovalenko Institute of Experimental Veterinary Medicine, Moscow, Russia;
5Research Institute for Healthcare and Medical Management, Moscow, Russia;
6Konchalovsky City Clinical Hospital, Moscow, Russia
Summary:
Chronic cerebral ischemia (CCI) is a common syndrome that, in the absence of adequate therapy, is characterized by a progressive course, an increase in cognitive, emotional, motor and other disorders, eventually leading to persistent disability of the patient. In the treatment of patients with CCI, the use of drugs with a multimodal neuroprotective effect is indicated. The results of the analysis of a series of clinical trials of the drugs Mexidol and Mexidol FORTE in patients with CCI are presented. The effects in relation to cognitive, emotional, asthenic, vegetative and other manifestations of CCI are considered. It is concluded that it is advisable to consistently use the drugs Mexidol and Mexidol FORTE in such patients. Keywords: chronic cerebral ischemia, cognitive impairment, Mexidol, emotional disorders, treatment.