Neurometabolic therapy of moderate cognitive disorders in patients with chronic brain ischemia

Authors:
E.A. ANTIPENKO¹, A.V. SHULYNDIN², K.M. BELYAKOV³

¹Federal State Budgetary Educational Institution of Higher Education, Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia;
²Vectorpharm LLC, Moscow, Russia;
³Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko, Nizhny Novgorod, Russia

Place of publication:
S.S. KORSAKOV JOURNAL OF NEUROLOGY AND PSYCHIATRY, 2024, Vol. 124, No. 3

Abstract:
Objective of the study. To evaluate the effect of sequential therapy with Mexidol (500 mg intravenous drip injections for 14 days) and Mexidol FORTE 250 (250 mg tablets 3 times a day for 60 days) on higher cortical functions in patients with mild cognitive impairment (MCI) associated with chronic cerebral ischemia (CCI). Material and methods.The comparative prospective study included 63 patients with CCI and MCI. All patients received basic therapy aimed at reducing risk factors (antihypertensive, antithrombotic drugs). Patients in the main group (MG, n=30, 12 men, 18 women) received Mexidol intravenously at 500 mg in 100 ml of 0.9% NaCl solution once a day for 14 days, then Mexidol FORTE 250 at 250 mg 3 times a day for the next 60 days. The comparison group (CG) consisted of 33 patients (14 men, 19 women) who received only basic therapy. Cognitive status (MoCA scale, frontal dysfunction battery, 10-word memory test), severity of asthenia (MFI-20 scale), anxiety and depression (HADS scale), patient assessment of the dynamics of the condition (CGI improvement scale) were examined at 1, 14, and 74±5 days. On days 1 and 74±5 of observation, patients underwent examination using transcranial magnetic stimulation (TMS) to study the neuronal activity of the cerebral cortex. Results. In the MG, at the end of treatment, a pronounced regression of MCI was noted (an increase in the MoCA scale of 3 points, a difference with the CG of 1 point, p Conclusion. The results of the study of therapy with Mexidol 500 mg intravenously by drip once a day for 14 days followed by oral administration of Mexidol FORTE 250 1 tablet 3 times a day for 60 days indicate its clinical efficacy and safety in patients with chronic cerebral ischemia and MCI, and confirm its importance for the prevention of disease progression. Key words: chronic cerebral ischemia, mild cognitive impairment, Mexidol, MoCA scale, frontal dysfunction, transcranial magnetic stimulation.