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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.

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, 2022, T. 122, No. 11, Issue. 2

Summary:
Purpose of the study. To evaluate the effectiveness of consistent therapy with Mexidol and Mexidol Fort 250 compared to placebo in patients with chronic brain ischemia (chemical) of different age -related subgroups.

Material and methods. Subanalis of data of an international multicenter randomized double-centered placebo-controlled study of Memo, in which 318 patients (25% of men) aged 40 to 90 (median 60) years participated. The effectiveness of treatment was estimated in three age groups: 40-60 (n = 163), 61–75 (n = 141) and 76–90 (n = 13) years. As the primary final point of effectiveness, an increase in the dynamics of the amount of points on the MOCA scale in the form of an absolute difference between the amount of points before the start of treatment and on the 75th day of therapy was considered. As a secondary endpoint of efficiency, the speaker was considered the sum of the points on the following questionnaires and scales: a test for the replacement of digital characters, a questionnaire for the quality of life of the SF-36, the scale of the subjective assessment of asthenia MFI-20, the Vein’s autonomic questionnaire, the Bek anxiety scale, and the scale of motor activity of Tinetti .

Results. The positive dynamics of the severity of cognitive, emotional and motor disorders in groups 40-60 and 61–75 years after 75 days of therapy were detected in patients who received both Mexidol and placebo, however, in patients who received Mexidol, these changes were more pronounced, on What indicate the higher values ​​of the median of the absolute difference between the amount of points of the studied indicators.

Conclusion. The results of the study have shown that in patients with Khim, a significant improvement in cognitive and motor functions, improving the quality of life, a decrease in the severity of autonomic disorders, asthenia and anxiety after 75 days of therapy were observed against the background of the use of Mexido compared to placebo. The results indicate the appropriateness of the use of Mexidol for the treatment of patients of different ages with chemicals.

Keywords: cognitive disorders, chronic brain ischemia, Mexidol, Mexidol Fort 250, ethylmethylhydroxypyridine succinate, examination of memo.

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.

¹ FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
² FGAOU VO "First Moscow Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
³ FGBNU "Scientific Center for Neurology", Moscow, Russia;
⁴ Tashkent Pediatric Medical Institute of the Ministry of Health of the Republic of Uzbekistan, Tashkent, the Republic of Uzbekistan;
⁵ FSBEI in Novosibirsk State Medical University of the Ministry of Health of Russia, Novosibirsk, Russia;
⁶ FGBNU "Federal Research Center for Fundamental and Transalized Medicine", Novosibirsk, Russia;
⁷ FSBEA DPO “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 11

Summary:
Purpose of the study. To evaluate the effectiveness and safety of consistent therapy with the drug Mexidol intravenously and Mexidol Forte 250 orally in patients with chronic brain ischemia. Material and methods. In the international multicenteric randomized double-blind-controlled study, 318 patients with a chemical place from 40 to 90 years are included in 15 clinical centers, located in the territory of the Russian Federation and the Republic of Uzbekistan. Patients were randomized in 2 groups, patients of the 1st group received Mexidol intravenously 500 mg once a day for 14 days, then Mexidol Forte 250 was prescribed orally 250 mg 3 times a day for the next 60 days; Patients of the 2nd groups received placebo in a similar mode. As the primary criterion for effectiveness, the average value of the change in the point on the MOCA scale was chosen at the stage of completion of the study by the patient compared to the initial level. Results. Upon completion of the study between the 1st and 2nd groups, reliable differences were identified by the result of the MOCA scale (p <0.000001). The lower boundary of 95% of the trust interval for the difference in the average indicators of the main criterion for the effectiveness between the 1st and 2nd groups was 1.51, which allows us to state higher efficiency of the use of Mexidol. According to the secondary endpoints, a statistically significant advantage over the placebo at the final visit was achieved by the following parameters: a test of digital symbol replacements, an asthenia assessment scale, a Bek anxiety scale, a tineta questionnaire, a Tinetti scale, a SF-36 questionnaire (psychological component of health), and a psychological component of health). CGI scale (a general clinical impression scale). The comparable nature of the safety profile of Mexidol and placebo is established. Conclusion. The validity and expediency of the consistent use of Mexidol and Mexidol Forte 250 in the treatment of patients with chemicals are demonstrated. Keywords: chronic brain ischemia, cognitive disorders, neuropsychological testing, ethylmethylhydroxypyrididine succinate, Mexidol, Mexidol Forte 250, treatment of chemicals, examination of memes.

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:
New therapeutic journal Non Nocera, June/July 2021

Summary:
neurological complications of the coronavirus infection Covid-19 caused by the SARS-COV-2 virus are extremely diverse and are found in more than 30% of patients. So, with COVID -19, ischemic and hemorrhagic strokes, encephalopathy, meningitis, autoimmune diseases, for example, Guinen - Barre, violations of smell and taste, can develop. However, the fight against the Sarscov -2 virus does not end with screening and treatment of acute conditions. The delayed consequences for the health of people who have experienced Covid -19 are currently being actively studied.

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.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 3

Summary:
Purpose of the study. Studying the effectiveness and safety of the effect of complex therapy of ethylmethylhydroxypyridine with succinate (Mexidol Forte 250) and venotonic drugs of Lizinate and diosmine of hesperidine in patients with chronic cerebral venous insufficiency (CCVN). Material and methods. 120 patients with CCVN have clinical and ultrasonic signs of cerebral venous discirculation were examined. Patients are divided into 3 subgroups depending on the type of therapy. The first group (n = 40) was prescribed orally Mexidol Fort 250 and diosmine of hesperidine within 74 days in combination with the appointment of 2 courses of intravenous administration of lysinate escin (L-lysine of the escinate) on the 1st and 30th day from the beginning of treatment; The 2nd group (n = 40) was prescribed orally Mexidol Fort 250 and diosmine hesperidine for 74 days; The 3rd group (n = 40) orally prescribed the drug Diosmin Hesperidine for 74 days. Results and conclusion. The effectiveness and safety of the complex therapy of patients with CCVN venotonic drugs with the inclusion of the antioxidant drug Mexidol Forte 250 by 750 mg/day for 74 days is shown. The study demonstrates the reliable positive effect of Mexidol Forte 250 on the dynamics of complaints and indicators of the neurological and psychoemotional status of patients. Monotherapy with a venotonic drug with a diosmine of hesperidine showed its insufficient effectiveness. Keywords: chronic cerebral venous deficiency, antioxidants, Mexidol forte 250, venotonic drugs, lesinate escine, diosmine gesperidine.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 3, Issue. 2

Summary:
Purpose of the study. Studying the possibility of increasing the effectiveness of treatment of patients with chronic brain ischemia (HIGM) against the background of COVID-19 using the drug Mexidol. Material and methods. 304 patients with HIGM and Covid-19 were observed; The 1st group (n = 152) was compiled by patients who received basic therapy and Mexidol, the 2nd group (n = 152)-received only basic therapy. For 14 days, Mexidol was prescribed intravenously with a drop of 500 mg (10 ml) per 400 ml of physiological solution, then Mexol Forte 250 was prescribed 250 mg 3 times a day for 2 months. They evaluated the state of cognitive functions (Mosa scale), sleep (Spiegel questionnaire), asthenia (MFI-20 scale), quality of life (SIP questionnaire). The examination was carried out before the start of treatment, 30 and 75 days after its beginning. Results. Patients of the 1st group took place: a more complete and early restoration of the state of cognitive functions (an increase in indicators on the Mosa scale, p <0.01), astress regression (p <0.05), normalization of sleep (p <0.01) . Among patients of the 1st group, the end of the study turned out to be reliably more patients with complete or significant restoration of all indicators of the quality of life. Conclusion. Long-term sequential therapy with Mexidol with the drug provides a more complete restoration of impaired functions in patients with HIGM and Covid-19. Key words: Covid-19, SARS-COV-2 virus, chronic brain ischemia, asthenia, cognitive disorders, dementia, quality of life, Mexidol.