Possibilities of multimodal neuroprotection in patients with chronic cerebral ischemia on the background of arterial hypertension and atherosclerosis


Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk

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.