Possibilities of antioxidant therapy for asthenia and cognitive deficit in elderly patients with chronic brain ischemia

Author:
S.N. DUMA.
Research Institute of Therapy, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk.

Summary:
Aim. To evaluate the effect of the antioxidant mexidol on the oxidant-antioxidant potential of low-density lipoprotein (LDL), asthenic and anxious symptoms, and cognitive function of neurodynamic type in elderly patients with chronic brain ischemia (CBI). Subjects and methods. Thirty women (mean age 66.7 years) with grade 1-2 dyscirculatory encephalopathy (DE) were examined. Trends for asthenic, anxious, and cognitive symptoms of neurodynamic type were estimated using the standard tests (MFI-20, Hamilton Anxiety Rating Scale, Schulte Tables, Wechsler test) on days 1, 15, and 60 of mexidol treatment (for 60 days). LDLs were isolated from blood by heparin precipitation. The baseline level of lipid peroxidation products was determined and the concentrations of fat-soluble antioxidants (α-tocopherol, retinol, β-carotene, and xanthins) were examined in the isolated LDLs on days 1 and 5 of the study. Results. A 60-day mexidol therapy cycle statistically significantly caused a reduction in asthenic and anxious symptoms in elderly patients with CBI and induced positive changes in the symptoms of cognitive neurodynamics. Assessing the specific features of the pharmacodynamics of the antioxidant mexidol used in the elderly patients for 15 days revealed a statistically significant positive effect on the oxidative potential of LDLs as a decreased predisposition to their antioxidative processes in vivo. The drug’s effect in elevating the levels of α-tocopherol and β-carotene was altered insignificantly (without statistically significant changes), which reflects the pharmacodynamic features of the drug in the elderly patients. Conclusion. The 60-day cycle of therapy with the antioxidant mexidol has a positive impact on asthenic and neurotic symptoms in the elderly patients with CBI. Mexidol is well tolerated and safe when used long.

Keywords: asthenia, anxiety, cognitive defect, chronic brain ischemia, elderly age, specific features of antioxidant therapy, mexidol.


Chronic cerebrovascular diseases associated with metabolic syndrome: new treatment approaches

Author:
M.M. TANASHYAN, O.V LAGODA, K.V. ANTONOVA.
Nevrology Research Center Russian Academy of Medical Sciences, Moscow.

Summary:
Metabolic syndrome is a risk factor for acute and chronic cerebrovascular diseases. The development of oxidative stress promotes the progression of cerebral ischemia and treatment of the biochemical disturbances is needed. Use of antioxidants in patients with cerebrovascular diseases and metabolic syndrome reduce such symptoms as insulin resistance, hyperglyceridemia, hyperglycemia. The authors present results of a clinical study of mexidol in 40 patients, aged from 50 to 70 years, with chronic cerebrovascular pathology. Perspectives of using this group of drugs as universal neuroprotectors are discussed.

Keywords: ischemic cerebrovascular diseases, antioxidant treatment, metabolic syndrome, mexidol.


Adaptogenic effects of mexidol in chronic cerebral ischemia

Author:
E.A. ANTIPENKO.

Summary:
The data on the effect of the succinate-containing antioxidant mexidol on the adaptation abilities of patients with chronic brain ischemia are presented. We studied 98 patients with discirculatory encephalopathy of I, II and III stages. A set of indices for psychoemotional status, functional state of the brain, autonomic status, nonspecific stability to hypoxia, adaptive reactions of the blood system and status of antioxidant defense have been used to evaluate adaptive abilities of the body. It has been shown that the introduction of the antioxidant in the treatment set strengthens the effects of basic treatment by increasing adaptive reserves of the body in stages I and II of disease that is related with the realization of reactions of urgent adaptation. The introduction of mexidol in the treatment set increases the frequency of favorable outcomes after one year of follow-up.

Keywords: brain ischemia, discirculatory encephalopathy, adaptation, adaptogenic effect, stress.


The assessment of the clinical efficacy, vasoactive and metabolic effects of mexidol in elderly patients with discirculatory encephalopathy

Author:
YU.V. ABRAMENKO.

Summary:
Forty patients, aged from 55 to 74 years, with chronic cerebral ischemia — discirculatory encephalopathy, stages I—II, against the background of arterial hypertension and atherosclerosis were studied. Patients were randomized into 2 equal groups. Patients of the main group received the antioxidant mexidol intramuscular in dose 100 mg during the first 10 days and then perorally in dose 125 mg three times a day during 20 days in the combination with the regular treatment (diroton in dose 5-20 mg daily, cardiomagnyl in dose 75 mg daily). Patients of the control group received regular treatment during 30 days. The efficacy was evaluated at baseline, on the 10th and 30th days after the treatment using clinical scales (the number of complaints, neurological deficit, cognitive and emotional disorders), parameters of cerebral hemodynamics measured with transcranial duplex scanning, laboratory indices of the state of oxidant and antioxidant systems (the content of malonic dialdehyde and superoxide dismutase in the blood plasma as well as the plasma total antioxidant activity). The statistically significant (p<0.05-0.01) reduction in the severity of asthenic and anxiety disorders, the improvement of static-locomotor and cognitive functions as well as of parameters of cerebral hemodynamics due to the decrease in the peripheral vascular resistance and the normalization of venous outflow from the cavity of scull was seen in patients treated with mexidol compared to the baseline and the control group. Mexidol significantly reduced the intensity of lipid peroxidation and increase the total antioxidant activity of the blood. The results obtained in the study allow to consider mexidol as the effective drug in the complex treatment of discirculatory encephalopathy in elderly patients.

Keywords: chronic cerebral ischemia, discirculatory encephalopathy, antioxidants, neuroprotectors, mexidol.