Alexithymia in patients with left-hemispheric cerebral infarction in the late recovery period
Author:
N.A. ANTONOVA, E.B. KUZNETSOVA, I.I. SHOLOMOV
Razumovsky Saratov State Medical University, Saratov
Summary:
Objective. To study emotional status, including alexithymia, anxiety and depression, in patients with cerebral infarction in the area of the middle cerebral artery (on the left side) in the late recovery period and to develop a method for correction of the damage. Material and methods. The study included 30 patients with cerebral infarction in the area of the middle cerebral artery (on the left side). A comparison group consisted of 10 patients with chronic brain ischemia. Results and conclusion. The results have demonstrated the correlation between the level of alexithymia and the severity of neurological deficit, sex-related level of anxiety and depression. The cerebral infarction impacts on the level of alexithymia. Alexithymia in patients with cerebral infarction affects the adequate self-esteem of physical and mental condition that may complicate the rehabilitation of these patients and demands correction as a combination of pharmacotherapy and psychotherapeutic intervention.
Keywords: alexithymia, cerebral infarction, anxiety, depression.
Modern methods of rehabilitation for poststroke patients
Author:
I.V. SIDYAKINA, M.V. VORONOVA, P.S. SNOPKOV, T.V. SHAPOVALENKO, K.V. LYADOV
Medical Rehabilotation Center, Moscow
Summary:
The article reviews the problem of complex post stroke rehabilitation. Special attention is drawn to neurorehabilitation aspect of patient’s state, restorative treatment in the acute stage of stroke, peculiarities of working up individualized rehabilitation programs, innovations and medicament support of rehabilitation process.
Keywords: stroke, rehabilitation, technical means of rehabilitation, medication support of rehabilitation process.
Side effects of psychopharmacotherapy in patients with the syndrome of dementia and the ways of its correction
Author:
S.N. DUMA
Summary:
The purpose of the study. Analysis of side effects of treatment with neuroleptics in patients with the syndrome of dementia of Alzheimer’s type. Evaluation of the effectiveness of the correction of side effects of treatment with neuroleptics with the additional use in the treatment of ethylmethylhydroxypiridine succinate (Mexidol®). Materials and methods. The study included 150 patients with Alzheimer’s disease with behavioral and psychotic disorders. The average duration of disease was 4.8 years. The average age of patients was 79,8±3,2 years. All patients received basic anti-dementia therapy for 2,6±1,4 years. Additionally patients were getting neuroleptic therapy within 4,2 ±1,2. The analysis of the character and intensity of the newly appeared side effects was based on the complaints of the relatives who were taking care e of patients and results of neurological examination. The comparative analysis of effectiveness of dose=reduction correction of side effects of neuroleptics was performed in two groups of patients. In the main group (n=76) the therapy included of Mexidol® 5,0–10,0 ml (250–500 mg), by parenteral route, No. 10–15. In the control group (n=74) the medicine was not administered. Evaluation of the effectiveness of treatment was based on a scale of Global Clinical Impression (CGI-I) after treatment. The results and conclusion. Side effects associated with neuroleptic therapy included the following most frequent and early appearing: reversible extrapyramidal disturbances such as akathisia and parkinsonism. They disappeared with a dose reduction of the antipsychotic medicine. While choosing pharmacotherapy it’s necessary to give preference to low doses of atypical neuroleptics. Additional parenteral therapy with ethylmethylhydroxypiridine succinate (Mexidol®) 5,0–10,0 ml (250–500 mg) No. 10–15 effectively (p<0,05) provides a more rapid reduction of side effects from neuroleptic therapy.
Keywords: Alzheimer’s Disease, dementia, psychotic symptoms, antipsychotics, Mexidol®.
The efficacy of mexidol in carotid endarterectomy procedure in patients with cerebral atherosclerotic stenosis
Author:
V.I. GOLOVKIN, A.V. SVETLIKOV, A.S. SHAPOVALOV, L.O. POPOVA
North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg
Summary:
Objective - to determine the antihypoxic efficacy of mexidol in carotid endarterectomy (CE) procedure in patients with cerebral atherosclerotic stenosis using cerebral oximetry. Material and methods. Clinical/psycho/neurological monitoring was performed in 109 patients with internal carotid artery stenosis of 69±7.0% and neurological symptoms of cerebral ischemia, 2-3 degree, in pre- and postoperative periods. Cerebral oximetry was carried out perioperatively. Fifty-four patients were treated with mexidol in a dose of 1000 mg/day for 14-15 days and 55 patients did not received mexidol. Results and conclusion. The difference in initial brain oxygenation (rSO2) between the main and comparison groups was shown (60.8±5.0 and 47.29±5.5%, respectively). During operation, the degree of blood oxygenation in these groups decreased by 57% and 41%, respectively. On day 7, significant differences in the Schulte test in two groups of patients with similar neurological status were found considering efficiency of work and mental stability before and after operation. No differences were found in the comparison group. Mexidol used for antihypoxic brain protection in carotid endarterectomy of patients with cerebral atherosclerotic stenosis significantly reduces the degree of cerebral hypoxia, decreases the duration of surgery, improves neurological status of patients and performance of psychological tests in postoperative period.
Keywords: cerebral stenosis, cerebral ischemia, carotid endarterectomy, cerebral oximetry, mexidol.
Efficiency mexidol in patients with endocrine polyneuropathy
Author:
E.B. KUZNETSOVA, I.I. SHOLOMOV, S.V. GERASIMOV, E.A. SALINA
Razumovsky Saratov State Medical University, Saratov; Clinical Hospital, Saratov
Summary:
Objective. To evaluate the efficacy of mexidol and necessity of using it in patients with endocrine polyneuropathies caused by primary hypothyroidism (PPHT). Materials and methods. We have examined 51 patients with confirmed diagnosis of PPHT and assessed their neurological status and indicators of metabolic homeostasis before and after treatment. Electroneuromyography (ENMG) was performed to assess the status of the peripheral nervous system. Results. The results indicate the presence of endocrine disorders of obligate metabolic homeostasis in patients with polyneuropathies. Antioxidants, in particular, mexidol, in a complex with other drugs can be used in the treatment of these disorders. Worsening of ENMG-parameters, demonstrating a trend towards the normalization in response to treatment antioxidants, are characteristics of this pathology. Conclusion. The efficacy of mexidol in patients with PPHT has been confirmed.
Keywords: endocrine polyneuropathies, metabolic homeostasis, mexidol, electroneuromyography.
Diagnosis and treatment of asthenic syndrome in elderly people after acute respiratory viral infection
Author:
I.E. POVERENNOVA, I.A. ZOLOTOVSKAYA, E.V. BEZGINA
Samara State Medical University, Samara; Samara City Policlinic, Samara; Medical X-Ray Center, Samara
Summary:
Objective: To study the characteristics of asthenic syndrome in elderly people after acute respiratory viral infection. Material and methods: We examined 87 patients with chronic cerebral ischemia and other comorbid disorders, aged from 63 to 78 years. Patients were randomized to two groups. Patients of the main group received mexidol (1 tablet (125 mg) 3 times a day during 3 weeks) along with standard treatment. Patients of the control group received standard treatment only. All patients underwent neuropsychological testing for the assessment of symptoms of asthenic syndrome. Results and Conclusion: A comparative analysis of the patient’s condition in both groups has demonstrated a reduction in symptoms of asthenia, autonomic lability and cognitive deficit in patients treated with mexidol.
Keywords: old age, asthenic syndrome, acute respiratory viral infection, treatment, mexidol.
Role of antioxidants in treatment and prevention of patients with high risk of cardiovascular complications
Author:
L.A. SHCHEPANKEVICH, M.M. TANASHYAN, YU.A. NIKOLAEV, V.YA. POLYAKOV, M.A. PERVUNINSKAYA, K.V. ANTONOVA
Research Institute of Experimental and Clinical Medicine, Novosibirsk, Russia; Neurology Research Center, Mosсow, Russia
Summary:
Aim — to estimate effect of Mexidol on blood lipids in patients with high cardiovascular risk and diabetes mellitus type 2 (DM2). Material and methods. Two groups of patients with DM2 as the main risk factor of vascular complications were prospectively followed-up within 3 months. Achievement of target blood lipid was compared in standard therapy with statins (group 1) and addition of Mexidol to basic therapy (group 2). Enzymatic colorimetric method was used to determine blood lipids level (Boehringer Mannheim, Germany). Results. There was a positive effect of Mexidol at the initial stage of statins therapy that was expressed by normalized lipids level in DM2 patients with high and very high cardiovascular risk.
Keywords: cardiovascular complications, diabetes mellitus type 2, dyslipidemia, prevention, Mexidol.
An effect of mexidol on the expression of the transcription factor Nrf2 in cerebral cortex in ischemia
Author:
E.N. YAKUSHEVA, P.YU. MYLNIKOV, I.V. CHERNYKH, A.V. SHCHULKIN.
Ryazan State Medical University, Ryazan, Russia.
Summary:
Objective. To study an effect of the antioxidant and antihypoxant mexidol (ethylmethylhydroxypyridine succinate) on the transcription factor Nrf2 expression in neuronal nucleis of frontal cortex cells autor the common carotid artery unilateral occlusion. Material and methods. The study was performed on 64 male Wistar rats. The Nrf2 expression was determined immunohistochemically. Results. Single intraperitoneal mexidol (120 mg/kg b.w.) infusion and oral (100 mg/kg p.w. thrice a day for 14 days) administration of mexidol did not affect Nrf2 expression. Unilateral common carotid artery occlusion led to the increase in Nrf2 expression 4 h and 5 days after occlusion. Oral administration of mexidol in dose of 100 mg/kg b.w. thrice a day for 14 days before and after ischemia increased Nrf2 expression on the 4th h and on the 12th day in comparison with intact animals. Nrf2 expression was higher after 4 h and 12 days in comparison with the control occlusion group. Conclusion. Mexidol increases Nrf2 expression in the frontal cortex of rats not under normal conditions but in common carotid artery unilateral occlusion.
Keywords: mexidol, Nrf2, ethylmethylhydroxypyridine succinate, ischemia, occlusion, common carotid artery.
The study of the neuroprotective effect of mexidol on the cellular model of glutamate stress
Author:
O.A. GROMOVA, I.YU. TORSHIN, E.V. STELMASHUK, O.P. ALEXANDROVA, A.V. PRONIN, I.V. GOGOLEVA, L.G. HASPEKOV
Federal Research Center «Informatics and Cybernetics», RAS, Moscow, Russia; Scientific Center of Neurology, Moscow, Russia; Ivanovo State Medical Academy of the Ministry of Health of Russia, Ivanovo, Russia
Summary:
Purpose of the study. Study of neuroprotective properties of mexidol on a cellular model of glutamate stress. Material and methods. Cytological studies were carried out under the conditions of the model of glutamate stress in the culture of granular neurons of the cerebellum. Results. The addition of mexidol to the cultural medium increased the survival of neurons by 8-10% after the addition of glutamate (p<.05). The effect of mexidol was more pronounced when applied at the stage of growing the culture of neurons (5 days), when the survival of the cells in conditions of glutamate stress increased by an average of 20%. The conclusion. The results of the study confirm the direct neuroprotective effect of mexidol in the culture of neurons under the conditions of the glutamate stress.
Keywords: cellular stress, excitotoxicity, glutamate, mexidol.
Comparative chemoreactome analysis of mexidol
Author:
I.YU. TORSHIN, O.A. GROMOVA, I.S. SARDARYAN, L.E. FEDOTOVA
Moscow Institute of Physics and Technology, Dolgoprudny. Russia; Ivanovo State Medical Academy of the RF Ministry of Health, Ivanovo, Russia
Summary:
Objective. To compare mexidol with control molecules (choline alfoscerate, piracetam, glycine, semax) using chemoreactome analysis. Material and methods. The chemical structure of mexidol was compared to molecule metabolites extracted from the Human Metabolome Database (HMDB) and a drug database. More than 40 000 of metabolites from HMDB were used as a model of human metabolome. Results and conclusion. The chemoreactome analysis showed that mexidol may be (1) an agonist of acetylcholine and GABA-A receptors; (2) an anti-inflammatory agent, the effects of which are carried out by inhibiting the synthesis of pro-inflammatory prostaglandins; (3) a neurotrophic agent with neuroprotective properties; (4) a coagulation inhibitor; (5) a diabetes medication and (6) a hypolipidemic agent. Compared to «control» molecules, mexidol has a more pronounced safety profile (a lower impact on serotonin, dopamine and adrenergic receptors, a lesser degree of interaction with the potassium channels of the heart, MAO and P450 cytochromes). The results of modeling allow to specify the mechanisms of action of mexidol at the molecular level.
Keywords: mexidol, neuroprotection, chemoreactome analysis, chemoinformatics, forecasting.