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Place of publication:
neurology, neuropsychiatry, psychosomatics. 2018, No. 10

Summary:
The purpose of the study is to assess the effectiveness of the inclusion of Mexidol in complex drug therapy in patients in the acute period of ischemic (AI) and hemorrhagic stroke. Patients and methods. 60 patients aged 60–74 years with a first -aimed stroke were examined: 34 of them were diagnosed with AI, in 26 - intra -core hemorrhage (Navy). The main group was 31 patients who received, in addition to therapy in accordance with the standards adopted in the Russian Federation, Mexidol. The comparison group included 29 patients who were prescribed only standard therapy. Before and against the background of intravenous drip administration of Mexidol, 500 mg for 10 days, indicators were assessed by the stroke scale of the American National Institute of Health (National Institutes of Health Stroke Scale, NiHSS), the Rivermide mobility index and the Rankin scale and the Bartel index. The percentage absorption of lipid phospholipid complexes in the infrared spectrum of blood serum was also investigated. The control group amounted to 20 practically healthy persons. Results and discussion. It was found that the dynamics of lipid phospholipid complexes of the blood serum correlate with the type of stroke. The inclusion of Mexidol in complex drug therapy in elderly patients in the acute period of AI and Navy contributed to the regression of focal neurological deficiency, improving daily activity and functional independence. Mexidol's reception had a positive effect on the level of phospholipids of neuronal membranes. Conclusion. Mexidol’s positive effect on the level of blood serum phospholipids was noted. The conclusion was made about the effectiveness of its inclusion in the complex therapy of the acute period of AI and hemorrhagic stroke, especially in the elderly. Key words: ischemic stroke; intracassium hemorrhage; therapy; Mexidol; phospholipids.

Place of publication:
“Journal of Neurology and Psychiatry”, 10, 2018

Summary:
antihypoxic, antioxidant and nootropic effects of Mexidol contribute to improving the condition of patients with cerebrovascular pathology. The results of clinical studies show that the sequential scheme for the use of the drug (first intravenously or intramuscularly, then orally) is effective in the complex therapy of ischemic diseases of the brain, vascular surgery, therapy and rehabilitation of patients with degenerative-dystrophic changes in the spine, with neurodegenerative pathology, infectious neuropathies, a and Also in therapy of neuropsychological and autonomic disorders.

Place of publication:
a journal of neurology and psychiatry, 9, 2018; Ext. 2

Summary:
Purpose of the study. To study the clinical efficiency, metabolic and membraneproprothetic effects of Mexidol with transient ischemic attacks (TIA) in the vertebral-baslar system (VBS) in elderly patients with chronic brain ischemia (HIGM). Material and methods. 53 patients aged 60 to 74 years with the first episode of TIA in the WBS against the background of HIGM were examined. The main group included 33 patients who received Mexidol in addition to standard therapy (500 mg for 10 days). The comparison group consisted of 20 patients who received only standard therapy. They studied the dynamics of clinical manifestations of TIA, indicators of the state of oxidant and antioxidant systems, as well as the percentage absorption of lipid phospholipid blood serum complexes in the infrared spectrum. The control group amounted to 20 practically healthy patients. Results and conclusion. The use of Mexidol is associated with faster regression of focal neurological deficiency. The drug reliably reduced the intensity of lipid peroxidation and had a positive effect on the level of phospholipids of neuronal membranes. The identified metabolic and membraneproprothetic effects of Mexidol, as well as the positive effect of the drug on the regression of the focal neurological deficiency substantiate its inclusion in the complex therapy of the TIA in the WBS against the background of HIGM, especially in elderly patients. Key words: transient ischemic attack, vertebral-baslar system, chronic brain ischemia, mexidol, lipid oxidation, phospholipids.

Place of publication:
Journal of Neurology and Psychiatry, 8, 2018

Summary:
Purpose of the study. Assess the effect of mono- and combined therapy with Mexidol with young patients with cerebral angiodistonia. Material and methods. 90 patients (38 men and 52 women aged 25 to 44 years) were examined with vegetative dysfunction syndrome in the form of asthenovegetative and cephalgic syndromes taking Mexidol (1st group, 30 patients), Vinpocetin (2nd group, 30) and 30) and 30) and 30) and 30) and 30) Their combination (3rd group, 30). The condition of cerebral hemodynamics was evaluated using an algorithm for complex ultrasound examination, the state of autonomic regulation - by analyzing the variability of the heart rhythm, the functional state of microcirculation - by conducting a laser Doppler flower before and 10 days after the course of use of drugs. Results and conclusion. Mexidol in both mono and complex treatment of patients with cerebral angiodistonia possessed a vegetostabilizing, cerebrooprotective effect. An improvement in cerebral hemodynamics and microhemocirculation was revealed. As part of combined therapy (Mexidol and Vinpocetin), the effect of each drug was enhanced, and the adaptation of cerebral blood flow took place much faster than when using only winepocetine. Thus, the use of combined therapy (Mexidol and Vinpocetin) in patients with cerebrovascular pathology helps to minimize the negative prognosis of the development of the disease and may impede the development of acute cerebrovascular disorders. Keywords: Mexidol, Vinpocetin, microcirculatory disorders, autonomic dystonia, laser Doppler floometry, Cerebral angiodistonia.

Place of publication:
Journal of Neurology and Psychiatry, 4, 2018

Summary:
Purpose of the study. Assessment of the effectiveness and tolerance of the drug Mexidol as a corrector of cognitive disorders in patients with arterial hypertension and clinical manifestations of chronic cerebrovascular accident. Material and methods. 42 patients with clinical manifestations of chronic brain ischemia (chemical) and cognitive disorders were examined. Patients of the 1st group (n = 21) received traditional antihypertensive therapy, patients of the 2nd group (n = 21)-antihypertensive drugs and Mexidol. To evaluate the neuropsychological status, MMSE, Mosa, Mosa, Watch Drawing West were used. To control the adherence to therapy, a survey was carried out using the Morisk -Grine test. Results and conclusion. After the course of treatment with Mexidol, the number of patients with a lack of complaints increased by 3 times, headache regression was noted in 90% of patients, improving memory, concentration of attention, and the disappearance of anxiety in 50, 55, 67%, respectively. In patients of the 2nd group (Mexidol), more significant changes have occurred for the watch drawing test compared to the 1st group (0.95 and 0.54 points, And Mosa, which indicates the effective effect of the drug on cognitive symptoms of neurodynamic type and well -being in patients with chemical genesis. The drug Mexidol is recommended for the use of patients in this group as part of the complex therapy of the underlying disease. Key words: Mexidol, cognitive impairment, commitment.

Place of publication:
Journal of Neurology and Psychiatry, 2, 2018

Summary:
Purpose of the study. Track the dynamics of biochemical markers of inflammation and indicators of damage to the brain tissue in the acute period of ischemic stroke (AI) in the background of taking submaximal doses of the drug Mexidol. Material and methods. The study included 60 patients received in the first 6 hours from the onset of the disease, with verified AI on the Aspects scale 7–9 points. Patients of the main group (n = 30) received submaximal doses of Mexidol - 750 mg of the drug diluted in 250.0 ml of physiological solution, 2 times a day intravenously for 6 days. Patients of the control group (n = 30) were prescribed standard therapy. All patients were determined by biomarkers, an assessment of the neurological status within 60 minutes from the moment of receipt to the hospital and on the 7th day. Results and conclusion. In both groups, the indicators of the C-reactive protein, Interleukin-6 and fibrinogen changed slightly and did not have reliable significance in assessing the effectiveness of Mexidol. The indicators of biomarkers such as brainwater peptide and pretein plasma-A protein-A, as well as the average indicators in the NIHSS and MFI-20 scales in a group of patients receiving Mexidol, have significantly decreased compared to the control group. The results indicate a decrease in oxidant stress and signs of inflammation in the acute period of AI against the background of submaximal doses of the drug Mexidol, a decrease in the severity of neurological deficiency, and an increase in physical activity of patients. Given the time of activation of the damaged antioxidant system of the body, the recommended period of drug support is 3 months. Key words: antioxidant stress, inflammation, acute period, ischemic stroke, Mexidol.

Place of publication:
journal neurology, neuropsychiatry, psychosomatics, 1, 2018

Summary:
in elderly patients, dizziness can be caused by various causes, the possibilities of drug therapy are limited, the most commonly used are the betagistine of digidloride. The purpose of the study is to study the effectiveness and safety of complex therapy with Mexidol ^® and betagistin in patients with dizziness according to the global evaluation of the effectiveness of treatment. Patients and methods. The study includes 89 elderly patients (average age - 73.7 years) with chronic cerebrovascular pathology and dizziness complaints. In all patients, neurological, otoneurological (orthostatic samples, with forced hyperventilation, dix - medalpike, tinetti, visual analogue of dizziness), somatic, cognitive and emotional status. Patients were randomized into two groups. The main group included patients who received a betagistin of 48 mg/day, Mexidol ^® 5.0 ml intravenously for 10 days, then 375 mg/day tablets; In the comparison group - patients who used only 48 mg/day betagistine for 60 days. Assessment of the effectiveness of treatment was carried out on a global scale on the 60th day of therapy in both groups, taking into account the opinion of the doctor and the patient. Results. In elderly patients, dizziness in most cases (75%) was caused by several causes. In a group of combined treatment (betagistin + Mexidol ^® ), a more significant (more than doubled) decrease in dizziness symptoms are noted than in the comparison group. Conclusion. In elderly patients with chronic cerebrovascular disease and dizziness, combined therapy with Mexidol ^® and betagistin with neuroprotective properties improves treatment results.

Place of publication:
a journal of neurology and psychiatry, 3, 2017; Ext. 2

Summary:
Purpose of the study. To evaluate the effectiveness and safety of prolonged sequential therapy with Mexidol with patients with hemispherical ischemic stroke (AI) in acute and early recovery periods. Material and methods. In a randomized double-centered placebo-controlled in parallel groups, the study included 151 patients (62 men and 89 women), 150 patients (62 men and 88 women) aged 40 to 79 years were randomized. Patients by simple randomization were distributed to 2 groups: patients of the 1st group received therapy with Mexidol of 500 mg/day intravenously for 10 days, followed by 1 tablet (125 mg) 3 times a day for 8 weeks. Patients of the 2nd group received a placebo according to a similar scheme. The duration of participation in the study was from 67 to 71 days. Results. At the time of the end of the therapy, the average score on the modified scale of Rankin (MSHR) was lower in the 1st group than in the 2nd (p = 0.04). The dynamics of reducing the average score according to MSHR (1-5th visit) was more pronounced in the 1st group (p = 0.023). The proportion of patients who have reached the recovery corresponding to 0-2 points in MSHR (5th visit) was significantly higher in the 1st group (p = 0.039). When testing on a stroke scale of the National Institute for Health to the 5th visit, the average value was lower in the 1st group (p = 0.035). A decrease in the score on the stroke scale of the National Institute for Health at the time of the end of the course of therapy regarding the initial level in patients with diabetes was more pronounced in the 1st group (p = 0.038). In the 1st group in the general population of patients and subpopulation of patients with diabetes, the dynamics of improving the quality of life was more pronounced and was observed from the 2nd visit. The proportion of patients with the lack of problems in space was significantly higher in the 1st group (p = 0.022). There were no reliable differences in the frequency of unwanted phenomena in patients of both groups. Conclusion. It is recommended that the use of Mexidol in the acute and early recovery periods of AI is recommended.

To date, there are two complementary directions in the management of patients with ischemic stroke: the maximum early blood flow restoration (reperfusion) and the protection of brain tissue from ischemic lesion (neuroprotection). The main goal of neuroprotection is to intervene in the events of the ischemic cascade, block the links of the pathological process, prevent the death of nerve cells in the ischemic partial shade zone and expand the “therapeutic window” for reperfusion therapy. The use of drugs with neurotrophic, antioxidant and neuroregenerative effects is pathogenetically substantiated at all stages of rehabilitation treatment after a stroke. Ethylmethylhydroxypyridine is succinate (Mexidol) is a derivative of amber acid. The drug has antihypoxic, membrane, nootropic, anticonvulsant, anxiolytic effects. When studying the neuroprotective drug, Mexidol in patients with strokes, the absolute majority of researchers, a positive effect was noted in the form of a pronounced regression of neurological deficiency, wider possibilities for subsequent early rehabilitation. In 2017, the results of a multicenter prospective double blind placebo-controlled study of the effectiveness and safety of Mexidol with prolonged consistent therapy in patients in the acute and early restoration periods of the hem-step-mesh stroke (Epica) were published. The results of the study demonstrated the best positive dynamics of the restoration of impaired neurological functions in the early prescription of Mexidol and the continuation of therapy up to 2 months. During the study, the safety of prolonged use of Mexidol was proved.

Keywords: stroke, acute period, neuroprotection, succinate, therapy efficiency, therapy safety.

The purpose of the study.

Studying the structure of an alarming symptom complex in patients of late age with amnestic, disregional and polymodal types of moderate cognitive disorder (UKR) and determining the clinical efficiency of ethylmethylhydroxypyridine (Mexol).

Material and methods.

The selective study included 32 patients with both sexes over 55 years old from UKR (F06.7 according to ICD-10), who applied for medical help for anxiety. The inclusion criteria were compensation for concomitant somatic pathology, the lack of
significant stress events during the year, the lack of depression. They used clinical-psychopathological and psychometric methods: Hamilton's scale for evaluating anxiety (HAM-A), a geriatric depression questionnaire (GDS), a brief scale for evaluating mental status (MMSE), a scale of a general clinical impression (CGI-S, CGI-I), a scale for evaluating stress events. The main criterion for the effectiveness of 4-week therapy with Mexidol (375 mg per day) was the reduction of a common score on the scale of us-a. Results and conclusion. At the time of inclusion in the study,
the average points on the HAM-A and MMSE scales amounted to 39.9 ± 3.18 and 25.7 ± 0.6, respectively. When studying the structure of an alarming state in people with amnestic, dysregulatory and polymodal types of UKR, it was found that the phenomenology of an alarming symptom complex with these types of UKR is different. A re-assessment of anxiety on the HAM-A scale was carried out after 1, 2 and 4 weeks of therapy with Mexidol. Improving the mental state was noted with all types of UKR, but the proportion of people with a significant improvement was higher with amnestic and dysregulatory types compared
to polymodal. The development rate of the anti -aircraft effect was noted more with the dysregulatory type of UKR. In all patients, the use of Mexidol contributed to an increase in the stability of the function of attention and correction of autonomic dysfunction.

Key words: anxiety, moderate cognitive disorder (UKR), neuropsychological types of UKR, Mexidol.

The problem of cognitive deficiency affects almost every person on the planet, huge socio-economic, ethical and moral losses that society carries are associated with it. In the world, according to WHO, about 47 million people suffering from dementia live. The annual number of new cases of the disease is almost 10 million. The most complex functions of the brain should be understood by the cognitive functions by which the process of rational cognition of the world is carried out. It is the cognitive status that determines the success of a person in society in the profession, in the family. A decrease in cognitive functions is always perceived painfully and significantly worsens the quality of human life.

The results of a series of domestic clinical trials are given to study the effectiveness and safety of the drug Mexidol in patients with cerebrovascular disorders, in particular with ischemic stroke (AI). It is emphasized that the use of Mexidol is associated with a more complete and rapid regression of focal neurological deficiency. Good tolerance of treatment with Mexidol and the absence of significant undesirable side effects are noted. It is recommended to use the drug in forms for enteric and parenteral use in patients with AI.
Key words: ischemic stroke, treatment, Mexidol.

The purpose of the study is to study the state of cerebrovascular reactivity (CVR) and structural changes in the substance of the brain in patients with moderate cognitive disorders.

Patients and methods. 385 patients aged 57 to 79 years with moderate vascular cognitive disorders (SKN) were examined. The relationship of clinical variants of SKN and depression with the volume and localization of ischemic damage to the brain substance, as well as with the state of CVR in various vascular pools at the stage of inclusion in the study and after 20 months, has been studied.

Results. The connection of the neuropsychological profile and the severity of the SKN with the features of structural damage to the substance of the brain was revealed, but to a greater extent with a decrease in the CVR in the carbon arteries (SA) system and a combined decrease in the CVR in the CA and the verteba -basial basin (VBB). The association of the frequency of development of depression with the localization of ischemic damage in the frontal lobes and a decrease in the CVR in CA on the left, as well as a combined decrease in the CVR and VBB, has been established.

Conclusion. The state of the CVR, determined in various vascular pools, can serve as an early prognostic sign of developing SKN or depression.

Key words: vascular cognitive impairment; cognitive and emotional disorders; Cerebrovascular reactivity.

Cerebrovascular diseases (CVP) are an “archive” medical and social problem of modern medicine, as they give the highest indicators for incidence, mortality and disability in almost all countries of the world, which is associated with the aging of the planet and an increase in the number of risk factors. So, for example, on average about 460–560 thousand strokes are recorded annually in Russia, of which up to 200 thousand end in death, and of the surviving patients, at least 80% remain disabled, despite the rapid development of diagnostic and therapeutic medical technologies, hundreds of publications and dissertations about the effective treatment of this pathology.

The article based on the results of multicenter clinical research and the experience of leading domestic and foreign experts sets out actual theoretical and practical aspects of therapy and prevention of acute cerebrovascular accident. The pharmacotherapy of patients with strokes is examined in detail. The importance of the use of neuroprotective drugs has been demonstrated, among which Mexidol - Antihyxant with a multimodal action mechanism occupies a special place.

Keywords: stroke, therapy, prevention, neuroprotection, antihypoxants, Mexidol.

The purpose of the study is to determine using the cerebral oximetry of the effectiveness of the antihypoxic effect of Mexidol with carotid endarctomy (CE) in patients with stenosis cerebral atherosclerosis.

Material and methods. In 109 patients with stenosis cerebral atherosclerosis with a degree of stenosis of the internal carotid artery 69 ± 7% and a clinical picture of chronic brain ischemia, clinical and psychineological monitoring was carried out in the pre- and postoperative periods of KE. Cerebral cerebral oximetry was perimetically. In 54 patients, the operation was carried out after the course of Mexidol at a dose of 1000 mg/day for 14-15 days. The other 55 people made a comparison group that did not receive Mexidol. Results and conclusion. The difference in the initial
oxygenation of the brain (RSO2) was revealed: 60.8 ± 5.0 and 47.29 ± 5.5%, respectively, in these groups. During the operation in the same groups of patients, the degree of blood saturation with oxygen decreased to 57 and 41%, respectively. On the 7th day after the KE with patients in both groups of both groups, a reliable improvement was obtained when performing the Shulti test to the group that received Mexidol, when evaluating the effectiveness of work and mental stability before and after surgery, which was not observed in patients who did not conduct antioxidant therapy. The use of Mexidol as
antihyplack of KE in patients with stenosis atherosclerosis of extracerebral arteries significantly reduces the degree of brain hypoxia, reduces the time of surgery, improves the neurological status of patients and the implementation of neuropsychological tests in the postoperative period.

Keywords: cerebral stenosis atherosclerosis, carotid endarterctomy, cerebral oximetry, Mexidol.