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Authors:

AI Fedin

Translated from Zhurnal Nevrologi I Psikhiatrii Imeni SS Korsakova, Vol. 124, no. 10, pp. 35–40, October,
2024. Original Article Submitted September 9, 2024. Accepted September 16, 2024.

Place of publication:
Neuroscience and Behavioral Physiology, Vol. 55, no. 3, march, 2025

Summary: This Report Presents New Data on the Development of Oxidate Stress (OS) In Chronic Headache (HA). The Main Biochemical Characteristics of OS Are Pressented. Changes in Mri Spectroscopy and Biochemical
Marcers Confi Rmsing the Development of OS in Migraine Ar Described. The Absence of Signifi Cant Differences in Measures of OS in Migraine with and Without Aura Is Emphasized. Pathophysiological Differences Between Migraine and Chronic Tension Headache, In Which OS is not Detected, Are Demonstrate. Possible Activation of Trpa1 Ion Channels and Calcitonin Gene-Reled Peptide in OS, Which Provokes Migraine Attacks, IS Discussed. Directions for Drug Correction of OS in Chronic Headache Are Consedered.

Place of publication: a journal of neurology and psychiatry named after S.S. Korsakova / vol. 124, No. 12, issue. 2, 2024

Summary of
acute cerebral circulation disorders (ONMK) occupy the second place among the causes of deaths and are the third most important cause of disability. In the structure of the ONMK, ischemic stroke (AI) takes first place. Damage to the substance of the brain during AI is a complex cascade of pathophysiological reactions, including neo -driving, oxidative stress, exaytotoxicity and apoptosis. One of the most actively developing areas of treatment of patients with AI is reperfusion therapy (RT). The use of neuroimagingalization-CT perfusion and MRI has significantly expanded the indications for the RT. One of the possible directions for expanding the capabilities of the Republic of Tatarstan is its joint use with neurocytoprotective therapy, which would increase the efficiency and safety of the RT. The review is devoted to research on the effectiveness of a combination of neurocytoprotheiation and TLT under AI.

Keywords: ischemic stroke, reperfusion therapy, thrombolytic therapy, mechanical thromboembolectomy, reperfusion damage, neuroprotection, cytoprotection, neurocytoprotheiation.
Information about the authors:
Schukin I.A. - https://orcid.org/0000-0002-6308–9706
I. Koltsov - https://orcid.org/0000-0002–9900-4073
Fidler M.S. - https://orcid.org/0000-0001-6464-521X
Glukhareva A.P. - https://orcid.org/0009-0004-4867–2102
Author responsible for correspondence: I. Schukin -E-mail: ivashchukin@gmail.com
how to quote:
Schukin I.A., Koltsov I.A., Fidler M.S., Glukhareva A.P. The possibilities of neurocytoprotext during reperfusion
therapy. Journal of neurology and psychiatry named after S.S. Korsakova. 2024; 124 (12 Issue 2): 75–88. https://doi.org/10.17116/jnevro202412412275

Place of publication: physical and rehabilitation medicine, medical rehabilitation / vol. 6, No. 4, 2024

Autonomous non -profit organization "Clinical Institute of the Brain", Berezovsky, Russia

Annotation
justification. The study of the use of pharmacotherapy as an adjuvant component of rehabilitation of patients with acute cerebral failure is of scientific and practical interest.

The purpose of the study is to study the effectiveness and safety of consistent therapy with the drugs of the group for the treatment of diseases of the nervous system in a comprehensive rehabilitation program for patients with acute cerebral failure in the aspect of the impact on the severity of emotional and cognitive disorders, mobility, the severity of the syndrome of the consequences of intensive care and the implementation of their rehabilitation potential.

Materials and methods . The randomized intervention prospective study of 60 patients with acute cerebral failure, divided into 2 groups, included five visits. Patients of the main group received standard therapy and the drug ethyl hydroxypyridine serpentine (intravenously 500 mg/day, 10 days),
then ethylmethylhydroxypirinate of the forte 250 (1 tablet 3 times/day, 8 weeks); Patients of the control group during the same period received only standard therapy.
Results. Both groups noted a comparable improvement in cognitive functions on the Mosa scale (p <0.001). The statistically significant superiority in reducing the level of anxiety on the HADS scale is shown on visit 4 in the main group compared to the control: 2 [1; 4] and 5 [2.25; 7] points, respectively (p <0.01). A significant increase in the Rivermide index in both groups at all stages of the study (p <0.001) was determined in excess of the value of the median in the main group by 3 points compared to the control for visit 5 (p <0.001). The tendency to the superiority of the main group over the control in terms of the life of the rehabilitation routing scale (SRM; p = 0.053) was combined with statistically significantly smaller number of disabled patients (≥3 points for scraps) than in the control group, to visits 5 (χ2 Yates = 4; P = 0.045). In patients of both groups, the consequences syndrome were determined by the intensive care therapy of a slight severity with a tendency to reduce the number of patients from the 3rd to the 5th visit in the main group compared to the control (χ2 Yates = 3.491; p = 0.062). At the visit 5, the relationship of indicators on the scrap scale and the Rivermide index in patients of both groups (P <0.05) and the SPRM and MOCA scales in patients of the main group (P <0.01) is established. No undesirable phenomena for the period of research were not noted.
Conclusion. The positive effect of sequential therapy of the group’s drugs for the treatment of diseases of the nervous system in the complex rehabilitation program of patients with acute cerebral deficiency on the state of their emotional-cognitive status, the degree of disability, mobility, the severity of the consequences of intensive care and rehabilitation prognosis was demonstrated. A high degree of safety of the study scheme of therapy has been proved.
Key words: acute cerebral failure; ethylmethylhydroxypyridine succinate; Hads; Moca; MRC; Rivermide index; Scrap; intensive care syndrome; Pits; Rehabilitation potential.
How to quote:
Belkin V.A., Vasilchenko I.E., Belkin A.A. The dynamics of domains of emotional-cognitive and motor disorders in the structure of PIT syndrome
in patients who have undergone acute cerebral failure //

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 11

Summary:
the article is devoted to an important problem of diagnosis and treatment of children with autonomic dysfunction syndrome (SVD). Information about the evolution of views on the pathogenesis of this state is given. The issues of pathogenesis, classification and clinical manifestations of SVD in patients in childhood and adolescence are covered in detail. The high efficiency of the use of the drug Mexidol was demonstrated in the complex correction and prevention of the manifestations of the SVD, as well as the accompanying psychoneurological disorders in children and adolescents. Key words: vegetative disorders, autonomic dysfunction syndrome, children, Mexidol.

Place of publication:
New therapeutic magazine "Non Nocera", May 2024

Summary:
Cerebrovascular diseases (CVP) retain in the modern world a leading position in the rating of the incidence and disability of the population of most countries. Metabolic disorders, being important risk factors for the development of CVP, are also widespread in populations regardless of gender and age. The frequent combination of CVP and metabolic disorders, including somatic and abdominal obesity, insulin resistance, hyperinosulinemia, hyperglycemia and dyslipidemia, is a bridgehead for the rapid development of complications. One of the early manifestations of such a comorbid union is the formation of vegetative disorders. It is known that vegetative disorders are most often secondary, that is, they arise against the background of existing somatic or mental diseases, but can also develop when exposed to psychogenic factors (stress reaction, adaptation disorders, psychosomatic diseases, anxious and depressive disorders). The most common causes of the development of autonomic dysfunction are organic diseases of the nervous system and somatic diseases, including metabolic and hormonal.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 4

Summary:
Purpose of the study. Assessment of the effect of the pharmacological modulation of the rehabilitation process with Mexidol with a rehabilitation component of the rehabilitation treatment of cognitive-emotional disorders in patients who have undergone acute cerebral deficiency (scenario) due to acute cerebrovascular impairment or cranial-brain injury. Material and methods. A randomized intervention prospective study was carried out, which consisted of 5 visits. Patients are divided into main groups (OG, N = 30, received standard therapy and Mexidol in/B 500 mg/day 10 days with the subsequent prescription of the drug Mexidol Forter 250, orally, 1 tablet 3 times a day 8 weeks) and comparison (GS, N = 30, received only standard therapy for 66 days). Results. The OG has a comparable to the HS improvement of cognitive functions (p <0.001) (in both groups, improving the results of the Schulte test according to the criteria “Effectiveness of Work” and “The total execution time”, on the Moca scale (for visit 5 - 23.8 ± 2, 6 and 22.9 ± 3.0 points, p = 0.227)). The significant superiority of the OG over the GS is shown in terms of such indicators as a decrease in the severity of anxiety (HADS scale), a visit 4 - 2.6 ± 2.4 versus 4.4 ± 2.4 points (p = 0.004), and depression (Beka scale) , visit 3 - 7.5 ± 4.5 versus 11.4 ± 5.6 points (p = 0.005). The tendency of the superiority of the OG according to muscle power (MRC scale), a visit 4 - 3.3 ± 5.1 versus 2.1 ± 2.2 points (p = 0.051) and the level of vital activity (according to RM), a visit 5 - 2, 9 ± 0.7 versus 3.3 ± 0.6 points (p = 0.053). The statistically significant increase in the mobility of the patients of the OG compared to the GS (the difference in the values ​​of the Rivermid index is 5 - 10.3 ± 2.8 and 8.0 ± 2.8 points, p = 0.006), the average increase in the Rivermide index for visits 5 - 5.4 ± 2.1 versus 3.4 ± 1.6 points (p <0.001). The decrease in the points of the consequences of intensive care (Pets) in both groups was revealed, the statistically significant decrease in the severity of Pits in relation to the previous visit was revealed only in OG (p <0.001). The OG also determined the best, compared to control, indicators of the dynamics of systolic velocity of cerebral blood flow and overshoot coefficient. The study did not record undesirable phenomena (nya). Conclusion. A positive modulating effect of Mexidol was demonstrated with respect to accelerating the restoration of tolerance to cognitive loads, improving the psycho -emotional background by reducing symptoms of anxiety and depression and secondary improvement of motor rehabilitation results in the early recovery period in patients who suffered the scenes, including with Pets manifestations. During the study, Nyu and significant differences in vital functions are not registered, which indicates the comparable safety of therapy in OG and HS. Keywords: acute cerebral failure, Mexidol, ethylmethylhydroxypyridine succinate, Bek scale, modulating effect, Mexidolneuro2023.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 3, Issue. 2

Summary:
ischemic stroke (AI) is an acute life -burning state, its outcome is determined by the degree of damage to brain tissue, the quality and rate of medical care in the first minutes and hours of the disease. An important mechanism for damage to brain tissue both with ischemia and reperfusion is oxidative stress. The review considers the adverse effect of oxidative stress with ischemia and brain reperfusion of AI. The results of preclinical studies are presented that demonstrate the ability of Mexidol to eliminate the effect of free radicals, to activate antioxidant protection. The data of clinical studies of the use of Mexidol in combination with thrombolytic therapy in patients with AI are considered. Key words: ischemic stroke, revascularization, oxidative stress, Mexidol.

Summary:
arterial hypertension (AG) is a leading risk factor for the development of cardiovascular diseases, including with the development of cerebrovascular complications. The lesion of the brain as an agricultural organ is manifested by a stroke and/or vascular cognitive impairment (SKN) of varying degrees of severity. In order to identify and assess the severity of SKN, patients with AH need to conduct a neuropsychological examination, and to verify the vascular nature of disorders - neuroimaging. For the prevention and treatment of KN, along with antihypertensive therapy, the use of neuroprotectors plays an important role, among which ethylmethydlhydroxypirinate is a serious evidence base (reference drug - Mexol). Keywords: arterial hypertension, cognitive disorders, cerebrovascular disease, neuroprotection, ethyl -methylhydroxypyridine succinate, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 3

Summary:
Purpose of the study. Assessment of the effect of consecutive therapy with Mexidol preparations (injections of 500 mg intravenously for 14 days) and Mexidol Forte 250 (tablets 250 mg 3 times a day for 60 days) for higher cortical functions in patients with moderate cognitive disorders (Ukrainian) in chronic ischemia brain (chem). Material and methods. In a comparative prospective study, 63 patients with Khim with Ukrainian are included. All patients received basic therapy aimed at reducing risk factors (antihypertensive, antitrobotic drugs). Patients of the main group (OG, N = 30, 12 men, 18 women) received Mexidol intravenously 500 mg per 100 ml of a 0.9% solution of NACL once a day for 14 days, then Mexidol Forte 250 to 250 mg 3 times a day for the next 60 days. The comparison group (GS) compiled 33 patients (14 men, 19 women) who received only basic therapy. Investigated the cognitive status (the MOCA scale, the frontal dysfunction battery, the memorization test of 10 words), the severity of asthenia (the MFI-20 scale), anxiety and depression (HADS scale), the patient’s assessment of state dynamics (CGI-Maintenance scale) at 1, 14 and 74 -y ± 5 days. Patients in the 1st and 74th ± 5 days of observation were examined by transcranial magnetic stimulation (TKMS) in order to study the neuronal activity of the cerebral cortex. Results. At the time of completion of treatment, a pronounced regression of UKR was noted (growth on the Moca 3 score scale, the difference with GS 1 point, p <0.0001; the tests of the frontal dysfunction batteries - 4 points, the difference with GS 2 points, p <0.001; the memorization test test 10 words - 2 points, the difference with GS 1 point, p <0.05), emotional (Hadss Alarm scale - 8 points, difference with GS 3 points, p <0.001, hads depression - 3.5 points, difference with GS 1 , 5 points, p <0.01), asthenic (scale MFI-20-30 points, difference with GS 15.5 points, p <0.01), improving the well-being of patients (CGI-speed scale-2 points, difference with GS 1 point, p <0.0001). According to the TKMS, a statistically significant decrease in the central motor time at the level of both motor motor neurons is bilaterally from the moment therapy (p <0.01) is determined. The reverse correlation of the time of the central motor conduct and the results of the tests of the frontal dysfunction battery for left -sided localization of the first motor neuron (p <0.01) was revealed. Conclusion. The results of the study of therapy with Mexidol drugs at 500 mg iv 1 time per day for 14 days, followed by the oral administration of Mexidol Fort 250, 1 tablet 3 times a day for 60 days indicate its clinical efficiency and safety in patients with Khim with UKR , and also confirm its significance for the prevention of the progression of the disease. Key words: chronic brain ischemia, moderate cognitive disorders, Mexidol, MOCA scale, frontal dysfunction, transcranial magnetic stimulation.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 2

Summary:
Purpose of the study. To evaluate the clinical efficiency and safety of the drug Mexidol in patients in the acute period of ischemic stroke in the vertebral-baslar system (IIVBS).

Material and methods. The open randomized comparative study was attended by 52 patients, of which 32 were received by Mexidol (main group, OG) and 20 - standard therapy without the use of neuroprotective drugs (comparison group). Assessment of the severity of the clinical manifestations of IIVBS was carried out using the Hoffenberth scale, the severity of the stroke was estimated on the NiHSS scale, the degree of disability of patients after the stroke used the Rankin scale, a neuropsychological study of patients was carried out using the Montreal scales for evaluating cognitive functions (MOCA), a hospital of anxiety and depression scale (depression ( HADS), asthenication scales (MFI-20), assessment of the quality of life of patients was carried out using the EQ-5D questionnaire.

Results. The use of Mexidol in the form of prolonged sequential therapy in patients of the OG led to a decrease in the severity of the clinical manifestations of IIVBS by 53.3%, a neurological deficit on the NIHSS scale by 59.5%. By the end of the course of therapy by Mexidol, 96.9% of patients coped with their own affairs without outside help, which was accompanied by the regression of emotional disorders and an increase in the quality of life of patients.

Conclusion. The early appointment of Mexidol in therapy of patients with IIVBS can be considered the most justified, since it contributes to an earlier and significant decrease in neurological deficiency and improve the quality of life of patients.

Keywords: cerebrovascular diseases, ischemic stroke in the vertebral-baslar system, vertebral-baslar failure, neuroprotective therapy, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 1

Summary:
Purpose of the study. Conduct a meta -analysis of the effectiveness of Mexidol therapy in patients with chronic ischemia of the brain (chemical) and mild (moderate) cognitive disorders (KR).

Material and methods. This meta -analysis includes the results of research on the effectiveness of Mexidol with the Kyrgyz Republic, the severity of which was evaluated on the MOCA scale. The assessment of the combined effect included all publications based on the results of independent clinical studies, in which data assessments were presented at the Moca scale at a level sufficient for further statistical analysis. The main result of the meta -analysis was obtained for the final values ​​of the effectiveness indicator in groups of patients receiving Mexidol, in comparison with groups of basic therapy.

Results. The meta -analysis includes the results of 10 prospective clinical studies of the effectiveness of Mexidol against the background of basic therapy in patients with chemical and mild (moderate) cr. The main group was 482 patients, the comparison group was 455. When using the statistical model of random effects, the size of the effect was 2.06 points, 95% of the CI for the difference in efficiency in two groups - [0.98; 3.14 points] (p = 0.0002).

Conclusion. The statistically significant improvement in the cognitive functions of patients with chemicals against the background of the use of Mexidol was demonstrated.

Keywords: chronic brain ischemia, cognitive disorders, ethylmethylhydroxypyridine succinate, mexidol, treatment.

¹ FSBEI in "First St. Petersburg State Medical University named after I.P. Pavlova "of the Ministry of Health of Russia, St. Petersburg, Russia;
² Baltic Center for Neurotechnology and Artificial Intelligence FGAOU in Baltic Federal University named after Immanuel Kant ”, Kaliningrad, Russia;
³ FSBVOU in the "Military Medical Academy named after CM. Kirova »Ministry of Defense of Russia, St. Petersburg, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 12, Issue. 2

Summary:
Purpose of the study. A systematic assessment of information published in the reviewed publications on the effect of therapy with Mexidol with the course and outcome of ischemic stroke (AI) in adult patients.

Material and methods. The meta-analysis includes 11 studies published in Russian (2-randomized controlled, 9-incomeized unraveling cohort studies).

Results. Data was obtained indicating the positive effect of Mexol's drug on the course of AI in adult patients: statistically significant, when comparing with the comparison group, a decrease in the NIHSS scale on the 7-10s and 21-24 days and the values ​​of the modified Rankin scale by 5- 7th and 10-14th day. The accumulative effect of the drug is shown: the difference in values ​​on the NIHSS scale grows as the observation duration increases. The effect of Mexidol’s influence on the indicators on the NIHSS scale is all the more significant, the greater the initial severity of the neurological deficit.

Conclusion. The heterogeneity of the design and characteristics of patients led to significant statistical heterogeneity, and therefore the evidence presented at the time of writing the review require further study, taking into account the emergence of new data.

Keywords: ischemic stroke, neuroprotection, Mexidol, ethyl-methylhydroxypyridine succinate, meta-analysis, NIHSS scale, modified Rankin scale, cerebrovascular diseases.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 11

Summary:
a review of the literature on the relationship of cognitive disorders (KN) with arterial hypertension (AH) is presented. The pathogenetic mechanisms of AH are associated with the development of cerebral microangiopathy. In antihypertensive therapy (AGT), disorders of the autoregulation of cerebral blood flow should be taken into account with cerebrovascular disease and critical stenosis of large brain arteries, especially in patients over 80 years old. The importance of AGT, focused on the level of cerebral perfusion pressure, the severity of KN and the physical functioning of patients, is emphasized. Neurocytoprotective therapy is recommended for the correction of KN.

Key words: arterial hypertension, cognitive disorders, antihypertensive therapy, cerebral perfusion pressure.

¹ FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
² FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
³ Russian gerontological scientific and clinical center of the FGAOU in the Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 10

Summary:
the article discusses the possibilities of pharmacotherapy of vascular moderate cognitive disorders in various age groups. The results of a double blind randomized clinical examination of MEMO using an antioxidant and anti -hyphyxant drug Mexidol are given. Using a set of tests for evaluating cognitive functions, the high efficiency of the sequential purpose of the parenteral and oral form of Mexidol in each of the three analyzed groups is shown: 40-60, 61-75 and 76-90 years. In all age groups, Mexidol demonstrated a high security profile.

Key words: vascular moderate cognitive impairment, chronic brain ischemia, antioxidants, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 9

Summary:
the problem of pharmacotherapy of elderly and senile age is currently extremely relevant due to the aging of the population and the growth of the prevalence of cardiovascular diseases. One of the most serious problems of an elderly person is the development of a cognitive decline due to cerebrovascular pathology. However, in elderly patients, a large number of comorbid diseases are often observed, which leads to the difficulties of the diagnosis and conduct of these patients, and often to the development of polypragmasis, which can lead to a deterioration in functional status, cognitive impairment, side reactions and drug interactions. In addition, older patients may observe changes in pharmacokinetics and pharmacodynamics due to anatomical and physiological invoices. At the same time, drugs whose effectiveness and tolerance were evaluated precisely in elderly and senile patients, relatively few. In a randomized clinical examination of consistent parenteral and oral therapy, Mexidol's patients with moderate cognitive disorder of vascular genesis confirmed the positive effect of this therapy on various domains (cognitive, emotional, vegetative, motor) of chronic cerebrovascular disease, which allows us to recommend it for the use of elderly elderly elders. and senile age.

Keywords: vascular cognitive disorders, elderly patient, pharmacotherapy, ethylmethylhydroxyperidine succinate, Mexidol.

¹ FSBEI in Kemerovo State Medical University of the Ministry of Health of Russia, Kemerovo, Russia;
² GBOUZ "Kuzbass Clinical Cardiological Dispensary named after Academician L.S. Barbarash ", Kemerovo, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 3

Summary:
Purpose of the study. Studying the effectiveness and safety of consistent therapy with Mexidol preparations (500 mg 1 time per day for 14 days in/c) and Mexidol Fort 250 (Mexol Fort 250 by 250 mg 3 times a day, 60 days) in patients with chronic brain ischemia ( Chem) on an outpatient basis.

Material and methods. The open comparative study included 56 patients aged 46–74 years (average - 60.5 ± 7.9 years). In all patients, the diagnosis of Khim was confirmed by clinical and neuroizialization methods. Patients of the 1st group (n = 28) received basic therapy and Mexidol, the 2nd group (n = 28)-only basic therapy.

Results. Against the background of therapy in patients of the 1st group, there was a statistically significant improvement in the state of cognitive functions, a decrease in the severity of the symptoms of depression and anxiety, and manifestations of asthenia. The treatment was characterized by good tolerance, the absence of undesirable phenomena and cases of drug interactions.

Conclusion. Consistent therapy with Mexidol and Mexidol Forte 250 ensures the relief of the main clinical manifestations of chemicals, is characterized by good tolerance and safety.

Keywords: chronic brain ischemia, arterial hypertension, ethylmethylhydroxypyrididine Succinate, Mexidol, Mexidol Forte 250.