Library

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2023; 15 (2): 19–26

Summary:
chronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. The correct timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are also important for slowing down the progression of cognitive deficiency.

The purpose of the study is to study the effectiveness and safety of the use of Mexidol, prescribed intravenously (500 mg 1 time per day) within 14 days, with the subsequent oral administration of the drug Mexidol Forte 250 in a dose of 250 mg 3 times a day for 60 days in middle patients with medium -sized patients with chronic ischemia of the brain (HIGM) against the background of arterial hypertension and atherosclerosis.

Material and methods. The open observation program included 60 patients aged 45 to 59 years with HIGM confirmed by the results of neuropsychological and neuroimaging examination, who received Mexidol in the beginning of intravenously (14 days), and then in the form of a tablet form - Mexidol Forte 250 (60 days) . Patients conducted neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger-Khanin scale), the nature of vegetative support (the scale of the Vegetative reactions of A.M. Wein in the modification of V.L. Golubev), the severity of general, mental and physical asthenia (MFI- questionnaire 20) and qualities of life (questionnaire MOS SF-36).

Results. The results of the treatment made it possible to establish the relief of asthenic syndrome and autonomic disorders against the background of the use of Mexidol. The differences were statistically significant in nature both in comparison with the initial level, and when comparing with the control group (p <0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The totality of positive effects has led to an increase in indicators characterizing the state of quality of life (p <0.05). Treatment was characterized by good tolerance.

Conclusion. Patients with HIGM have significant emotional, vegetative and asthenic disorders. The use of Mexidol allows you to reduce the severity of these disorders, which gives reason to recommend it to treat such patients.

Keywords: chronic brain ischemia; arterial hypertension; atherosclerosis; cognitive disorders; vegetative disorders; asthenia; Mexidol; Mexol Forte 250.

¹FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;

²FSBI "Federal Center for Brain and Neurotechnology" of the Federal Medical and Biological Agency of Russia, Moscow, Russia;

³FSBI “Scientific Center for Expertise of Medical Application” of the Ministry of Health of Russia, Moscow, Russia;

⁴FGAOU in "First Moscow State Medical University named after THEM. Sechenov ”of the Ministry of Health of Russia (Sechenov University), Moscow, Russia;

⁵FGBNU "Federal Scientific Center-the All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Scriabin and Ya.R. Kovalenko of the Russian Academy of Sciences ”, Moscow, Russia;

⁶GBU "Research Institute of Health and Medical Management" of the Department of Health of Moscow, Moscow, Russia;

⁷GBUZ "City Clinical Hospital named after M.P. Konchalovsky "Department of Health of Moscow, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 1

Summary:
the value of oxidative stress (OS) in the pathogenesis of ischemic (AI) and hemorrhagic (gi) stroke is considered. The role of OS in the development of programmable cell death, an increase in the permeability of the hematoencephalic barrier, the activation of astro- and microglia, and local inflammation is shown. The issues of neuro and cytoprotheiation and their broadcasting into clinical practice are considered. Examples of experimental and clinical studies show the effectiveness of the continued administration of a multimodal neurocytoprotector with an antioxidant effect - ethylmethydlhydroxypyridine of succinate (Mexidol) in the acute and early recovery periods of AI and GI.

Keywords: stroke, reperfusion, oxidative stress, programmable cell death, apoptosis, ferroptosis, hemoglobin, neuroprotection, ethylmethylhydroxypirinate, mexidol.

¹ FSBI “Scientific Center for Expertise of Medical Application” of the Ministry of Health of Russia, Moscow, Russia;
² FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
³ FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
⁴ FGBNU "Federal Scientific Center-All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Scriabin and Ya.R. Kovalenko of the Russian Academy of Sciences ”, Moscow, Russia;
⁵ GBU "Research Institute for the Organization of Health and Medical Management" of the Moscow Department of Health, Moscow, Russia;
⁶ GBUZ "City Clinical Hospital named after M.P. Konchalovsky "Department of Health of Moscow, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 11

Summary:
chronic brain ischemia (Khim) - a common syndrome, which in the absence of adequate therapy is characterized by a progressive course, an increase in cognitive, emotional, motor and other disorders, which ultimately lead to persistent disability of the patient. In the treatment of patients with chemicals, the use of drugs with a multimodal neuroprotective effect is indicated. The results of an analysis of a series of clinical studies of Mexidol and Mexidol Forte in patients with chemicals are given. The effects of the drug are considered in relation to cognitive, emotional, asthenic, vegetative and other manifestations of chemical. The conclusion is drawn about the appropriateness of the consistent use of Mexidol and Mexidol Forte in such patients.

Key words: chronic brain ischemia, cognitive disorders, emotional disorders, mexidol, treatment.

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2022

Summary:
To reduce the risk of developing unwanted phenomena and increasing the adherence of elderly patients, it is recommended to limit the total number of drugs prescribed by him as much as possible, using one drug to treat two or more pathologies if possible. LS, which meets the criteria for the use of elderly patients and/or patients with comorbidity, includes the original Russian drug Mexidol ^® (ethylmethylhydroxypyridine succinate), which has multimodal mechanism of action and has multiple pharmacological effects. In order to study the safety of Mexidol in comparison with placebo in patients with chronic brain ischemia of different age groups, an aposteric analysis of the international multicenter randomized double -centered clamped placebo -controlled memo with adaptive design on evaluating the effectiveness and safety of sequential therapy Mexidol ^® solution for intravenous and intramuscular administration, 50 MG/ml (NPK LLC Pharmasoft, Russia) and Mexidol ^® Fort 250 tablets covered with a film shell, 250 mg (NPK LLC Pharmasoft, Russia) in patients with chronic brain ischemia) with the participation of 318 patients aged 40 to 90 years old. The comparable safety and tolerance of Mexidol with middle and elderly persons with chronic brain ischemia, including patients older than 75 years, has been demonstrated. Key words: adult patients of different age groups; elderly; Memo study; Mexidol ^® ; Mexidol ^® Fort 250; ethylmethylhydroxypyridine succinate; safety.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2022, T. 122, No. 8

Summary:
Cerebrovascular diseases (CVP) are one of the most common causes of the development of cognitive impairment. The occurrence of CVP is associated with the main factors of cardiovascular risk, leading to the development of hypoxia, oxidative stress, mitochondrial and endothelial dysfunction and, ultimately, apoptosis, the formation of degenerative changes in the brain. The most important mechanisms for the development of CVP are hypoxia and oxidative stress, which indicates the need to use agents with antihyplance and antioxidant activity. Such drugs include Mexidol (ethylmethylhydroxypyridine succinate). Mexol directly affects the pathogenetic factors of the formation of ischemic-hypoxic brain damage, and has high clinical efficiency in the treatment of various forms of CVP.

Key words: chronic cerebrovascular failure, hypoxia, oxidative stress, vascular cognitive disorders, endothelial dysfunction, Mexidol.

Place of publication:
New therapeutic journal "Non Nocera", April/May 2022

Summary:
Diagnostics of cognitive disorders (KR) - an integral part of the work of primary doctors working with older persons. KR - an extremely heterogeneous group of conditions not only in gravity, but also by etiology. According to gravity, dementia (severe KR) and non -seal disorders, which are often the prodromal stage of dementia, are distinguished. According to etiology, the most frequent causes of the Kyrgyz Republic in the elderly are neurodegenerative (Alzheimer's disease, a disease of diffuse Taurus Levy) and vascular diseases of the brain, as well as their combination.

¹ FGOU VO "Stavropol State Medical University" of the Ministry of Health of Russia, Stavropol, Russia;
² MBUZ "City Clinical Hospital No. 3", Stavropol, Russia;
³ Institute "Medical Academy named after S.I. Georgievsky "FGAOU in" Crimean Federal University named after V.I. Vernadsky ", Simferopol, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 3, Issue. 2

Summary:
Purpose of the study. To evaluate the effectiveness of the use of Mexidol to restore cognitive functions in patients after an ischemic stroke (AI).

Material and methods. 70 patients with acute AI were examined, who were randomized in two groups by random sample; The 1st group amounted to 40 patients (28 men, 12 women), who, against the background of the main standard therapy for 14 days, received Mexidol in/in a drop of 500 mg/day with a further oral administration of Mexidol Forte 750 mg/day for 60 days . The 2nd group included 30 patients (21 men, 9 women), who were carried out only standard therapy.

Results. The initial indicators in the MOCA and MMSE scales did not differ in two groups. Repeated testing showed that the improvement on these scales was statistically more significant in the 1st group. An analysis of the indicators of the caused P300 potential confirmed a more pronounced positive dynamics in the 1st group (p <0.01).

Conclusion. The use of consistent therapy with Mexidol is accompanied by a more complete restoration of cognitive functions in patients who have suffered AI.

Keywords: stroke, acute cerebrovascular disorders, cognitive disorders, Mexidol, Mexidol Fort 250.

Summary:
The Covid-19 Pandemic Has Had Signifi Cantl Uences on the Incidence of Acute Cerebrovascular and the Structure of Mortaly. SARS-COV-2 Increases The Risks of Developing Both Ischemic and Hemorrhagic Stroke. The Key Pathogenetic Eleement Underlying the Development of Cerebral Stroke in Covid-19 Consists of Impairments to the Operation of Angotensin 2 Receeptors, Which Are Accompaned Accumulation of Excess Quantities of Angiotensin 2, Endothelial Dysfunction, Hypercoagulation, Overproduction of Proin Flamatory Cytokines, and An an An an An an An an An an An an An an An an An an An an An an An an An an An an An an An an An An An An An Ana Oxidive Storm. In Patients with Stroke and Covid-19, Lesion Severity is Associated with Dual Mechanisms of Ischemia-Systemic and Cerebral. The Possibilites of Medication-Based Correction of Systemic Impairments Associated with Coronavirus Infection and Local Imparamic TO ISCHEMIC Ain Damage, Are Limited. Substances with Antioxidant Activity May Potentially Be Effective in Patients with Stroke and Covid-19. Data from a Number of Clinical Rials Indicate that Mexidol Signifi Cantly Imprings Functional Outcomes in Ischemic Stroke. Use of Mexidol in Patients with Stroke and Covid-19 is Advised . Keywords: Ischemic Stroke, Coronavirus Infection, Angiotensin Receptors, Cytokine Storm, Oxidate Stress, Mexidol.

The existing methods of pharmacotherapy in the recovery period of a stroke used to correct motor, affective and cognitive disorders were carried out. Data on the conditions for the use and effectiveness of botulinum toxin, oral muscle relaxants, selective reversal inhibitors of serotonin, acetylcholinestin inhibitors and a glutamatergic transmission in post -stroke neurorebilitation, recommendations for their rational and safe use are given.
The clinical effectiveness of Mexidol, which has a multimodal effect on a wide range of post -stroke disorders, especially with prolonged consistent therapy, was discussed The integrated use of post -industry rehabilitation agents with the determination of individual tactics on the basis of the clinical picture of the patient and the established rehabilitation goals has been recommended. To solve problems associated with improving motor, cognitive and affective functions, as well as self -care and quality of life, the inclusion of Mexidol in the complex therapy of patients with the consequences of a stroke looks promising. A continuation of high -quality clinical studies is required to assess the effectiveness of pharmacological agents regarding post -industry disorders.

Key words: stroke, hemiparesis, spasticity, depression, dementia, neurorebilitation, pharmacotherapy.

The clinical expression of chronic brain ischemia (Khim) is the occurrence of not isolated syndrome (rarely found), but a complex of neurological and neuropsychological disorders. Some of them are subclinically and are detected only when using special tests and samples. To clarify the nature of the headache, it is necessary to find out whether it is provoked by overwork after physical and emotional load and whether after a short -term rest decreases. The vascular type of headache is associated with different options for craniocerebral arteriovenous dystonia, which very often do not correlate with the main indicators of systemic hemodynamics.

Currently, there is no approved list of biomarkers for the diagnosis of vascular cognitive dysfunction. The main problem for a practitioner doctor when identifying cognitive disorders in patients is differential diagnosis of Alzheimer's disease, vascular cognitive dysfunction and other types of cognitive impairment, which are much less common. Vascular cognitive dysfunction includes post-industry dementia, cognitive dysfunction for cardiovascular and cerebrovascular diseases. Without determining the etiology of the disease, it is impossible to prescribe adequate treatment. Another problem is the identification of cognitive disorders before the development of dementia. A review of literature is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive dysfunction and the establishment of markers of moderate cognitive dysfunction. The search for articles was carried out in the databases of Web of Science and Pubmed. A list of liquor, plasma, serum and genetic biomarkers was compiled, which allowing differential diagnosis between vascular dysfunction and Alzheimer's disease, and markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the subordinate stage. Keywords: vascular dementia, moderate cognitive dysfunction, homocysteine, cerebral nodtriuretic peptide, ghrelin, protein S100β.

The article of a review nature outlines the issues of pathogenesis, clinic, diagnosis and treatment of chronic brain ischemia. The aspects of the development of "disease of small vessels", endothelial dysfunction, processes of peroxidation of lipids, apoptosis and neuroplasticity are highlighted. It was noted that the joint management of patients with chronic brain ischemia neurologists and doctors of other specialties, the appointment of individualized pathogenetic therapy. Key words: chronic brain ischemia, small vessels disease, endothelial dysfunction, apoptosis, neuroplasticity.

Key words: chronic brain ischemia, small vessels disease, endothelial dysfunction, apoptosis, neuroplasticity.

¹ FGBNU "Federal Research Center for Fundamental and Transalized Medicine", Novosibirsk, Russia;
² FSBEI "Novosibirsk State Medical University" of the Ministry of Health of Russia, Novosibirsk, Russia;
³ GBUZ but "State Novosibirsk Regional Clinical Hospital", Novosibirsk, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 10

Summary:
Purpose of the study. Studying the effectiveness and safety of consistent therapy with Mexidol, used intravenously (500 mg 1 time per day) for 14 days, followed by the oral form of Mexidol Fort 250 at a dose of 250 mg 3 times a day for 60 days in elderly patients with Chronic ischemia of the brain (chem) against the background of arterial hypertension and atherosclerosis. Material and methods. An open avenue observation study includes 60 patients with a diagnosis of chemicals confirmed by the results of neuroimaging. All patients underwent an examination with the assessment of neuropsychological status (MOCA Test), the severity of asthenia (scale of MFI-20), emotional state (an alarm and depression scale), motor functions (formalized clinical scale for assessing the motor activity of the elderly thinetti). The effectiveness of the therapy was evaluated according to the quality questionnaire (SF-36). Results. The results of the study showed high efficiency and safety of consistent therapy with Mexidol in relation to the relief of asthenic and emotional disorders, improve the state of cognitive functions, and improve the quality of life of patients. The maximum effect took place after the end of the full course of therapy. The high commitment of patients on the therapy, the low frequency of undesirable phenomena are shown. Conclusion. The consistent use of intravenous administration of Mexidol, followed by the oral administration of the drug Mexidol Forte 250, is an effective and safe way to treat patients with chemicals. Keywords: chronic brain ischemia, arterial hypertension, atherosclerosis, ethylmethylhydroxypirinatin, Mexidol, Mexidol Forte 250, cognitive disorders.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2021, T. 121, No. 9

Summary:
The review is devoted to the analysis of the characteristics of pathogenesis, diagnosis and therapy of traumatic brain injury (CHMT) from the point of view of a neurologist. The mechanisms of development of damage to the central nervous system, including neuro -sparks and oxidative stress, are considered, in persons carrying the ChMT, the connection of clinical manifestations with the severity of the injury. Particular attention is paid to the description of such consequences of the TSMT as structural pharmacoresistant epilepsy and post -traumatic stress disorder. The data is given that rehabilitation measures at the victims of the Civil Code are difficult and less accessible in the conditions of the Covid-19 pandemic. The need to include antioxidant/antihypoxant Mexidol in the complex CMT therapy was noted. In the conditions of the Covid-19, the role of a neurologist increases in the provision of assistance to victims with the CCT, especially at the outpatient stage, during therapy, and medical rehabilitation. Key words: traumatic brain injury, oxidative stress, structural pharmacoresistant epilepsy, post-traumatic stress disorder, infection SARS-COV-2, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 8, Issue. 2

Summary:
atherotrombotic stroke is one of the most frequent subtypes of ischemic cerebrovascular accident, the cause of which is atherosclerosis of the large arteries of the brain or their branches. The results of the latest studies have shown that the atherosclerotic process is based on inflammatory changes in the vascular wall, leading to the initiation of atherosclerosis, endothelial dysfunction, oxidative stress, and redistributing various protein components in the composition of the hematoencephalic barrier. As a result, the progression of the described conditions leads to the manifestation of clinical symptoms and the formation of an acute vascular event. Understanding the molecular components underlying functional disorders and damage to cerebral vessels provides the key to modern therapy strategies, forming the foundation for adequate, pathogenetically substantiated drug correction. In such patients, it should be aimed at normalizing cerebral and central hemodynamics and taking into account neuroplasticity mechanisms. The drug Mexidol (ethylmethylhydroxypyridine succinate) can be considered as one of the pathogenetically reasonable drugs in complex drug therapy for brain ischemia. Keywords: ischemic stroke, atherosclerosis, vascular inflammation, oxidative stress, endothelial dysfunction, ethylmethylhydroxypirine succinate.

Place of publication:
Medical alphabet No. 22 /2021. Neurology and psychiatry (3)

Summary:
Purpose of the study. To study the features of response to stress, stress resistance and adaptation of elderly men and women with chronic brain ischemia (Khim), as well as the stressful effect of Mexidol. Materials and methods. 124 patients aged 60–74 years were examined: 72 men and 52 women (average age, respectively, 65.3 ± 0.4 and 64.7 ± 0.7 years) with the I - II stage against the background of arterial hypertension and its combination from Atherosclerosis of cerebral vessels. The level of psychosocial stress was determined on the scale of Holmes-Roya. Features of the response of patients to stress were studied using the techniques of “scale of psychological stress RSM -25” and S. Rosenzweig. Stress resistance was investigated using the self -esteem of the stress resistance of S. Cohehen and G. Willianson. The levels of anxiety were determined using the scale of Ch. D. Spielberger and Yu. L. Khanin, depression - the questionnaire of BEK. The type of adaptive reactions was studied in the leukocyte blood formula for the percentage of lymphocytes and segmented neutrophils, taking into account the representation of other uniform elements. Results. The level of stress in elderly women with chemicals was higher than in men. In men, the predominance of intropunetary orientation of the reaction to stress and the resolving type of response was revealed, in women - an extrapunitive orientation and a self -defensive type of response, which indicated a greater frustration of women. The level of stress resistance in women was lower than that of men, and correlated with higher indicators of situational anxiety. Adverse adaptive reactions were more often recorded in women. The course of treatment with Mexidol of elderly patients with chemicals led to a decrease in the severity of subjective and objective symptoms, anxiety disorders, increased the stress resistance and adaptive capabilities of the body, which was confirmed by an increase in the number of persons with favorable adaptive reactions. The high efficiency and safety of consistent therapy with Mexidol (injections, then the tablet form of Mexidol Forte 250) is shown. Key words: chronic brain ischemia, gender, stress, stress resistance, emotional disorders, anxiety, depression, Mexidol, adaptive reactions.