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Target. The study of the features of biochemical and morphometric indicators in patients with diabetes (diabetes) of type 2 and cognitive disorders (KN).

Material and methods. The main group was 72 patients suffering from type 2 diabetes, 20 people were included in the control group without cognitive violations from type 2 diabetes. Used: Montreal cognitive scale, level 1.5-anglyucitol, continuous monitoring of glucose levels, magnetic resonance imaging of the brain.

Results. As a result of data processing, it was revealed that in patients with type 2 diabetes and KN, a high level of glycated hemoglobin was recorded, however, there was no statistically significant difference in the level of 1.5 anhydroglucitol between the presented groups. Patients with KN have registered a decrease in the surface area of ​​gray and white matter, as well as subcortical structures - hippocampus, a adjacent nucleus and shells on both sides, amygdaly and a pale ball on the right. The severity of KN correlated with the degree of polyneuropathy. In patients with a proliferative stage of retinopathy, a decrease in the volume of the tail nucleus, pale ball, shells and adjacent core is a decrease.

Conclusion. As a result of the study, it was revealed that patients with type 2 diabetes have the worst parameters of carbohydrate metabolism; They also found a decrease in cortical and subcortical structures of the brain. Key words: diabetes, cognitive disorders, variability, morphometry.

One of the most common diseases associated with cognitive disorders in elderly patients is chronic heart failure, leading to a cognitive decrease in 25-80% of cases. The review discusses the role of vascular lesions of various calibers and general mechanisms of impaired microcirculation in the development of both cardiac and chronic cerebrovascular insufficiency. It is believed that their understanding can help in the development of more effective approaches in the treatment of cardiovascular and cerebrovascular pathology. Keywords: cognitive disorders, vascular dementia, heart failure, microcirculation disorders, endothelial dysfunction.

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.

Cardiovascular diseases (CCZ) remain the most common among chronic non-infectious diseases. In 2020, approximately 19.1 million deaths around the world were associated with the SVD, and their prevalence with the amendment to age amounted to 7354.1 cases per 100 thousand people. Given the increasing life expectancy and, accordingly, the share of elderly people in the structure of the population, an increase in the prevalence of the CVD is further expected. The functions of the brain and cardiovascular system (CCC) are closely interconnected. So, it is well known that diseases of the brain, such as a stroke, can lead to damage to the myocardium. On the other hand, cognitive functions directly depend on the state of CCC. Therefore, quite often to describe the pathology of the brain in patients with SVD, the term “cerebrovascular diseases” (CVP) is used. CVP combines a group of diseases due to pathological changes in cerebral vessels. The CVP is a manifestation and complication of various SVDs, such as dyslipidemia, arterial hypertension (hypertension), diabetes (diabetes), etc., leading to acute or chronic disturbances in cerebral circulation. Clinically the CVP can manifest by acute cerebrovascular accident in the form of a stroke or transient ischemic attack or have a chronic course, leading to the development of vascular cognitive impairment (KN).

The purpose of the study is to study the effectiveness and safety of the early use of Mexidol in the acute period of severe ischemic stroke (AI). Material and methods. The study included 112 patients aged 35–85 years with severe AI. Patients were divided into two groups comparable by gender and age. The main group (n = 59) received Mexidol at a dose of 400 mg per day intravenously for 10 days and basic therapy. The comparison group (n = 53) received only basic therapy. Results and discussion. In the main group, the share of favorable outcomes in severe AI in both early and delayed treatment (on the Rankin scale) was higher than in the comparison group, and mortality is significantly lower. The results of the study showed that the use of Mexidol increases the effectiveness of therapy. The drug can be recommended for the treatment of patients with severe carotid AI.

Key words: heavy ischemic stroke, Mexidol, treatment.

The purpose of the study is to study the emotional status (including Alexitimia, anxiety and depression) in patients with a brain infarction in the basin of the middle cerebral artery on the left in the late recovery period and the development of the method of correcting identified disorders.

Material and methods. The study was attended by 30 patients with a brain infarction in the basin of the middle cerebral artery on the left, the comparison group was 10 patients with chronic brain ischemia.

Results and conclusion. The data obtained demonstrate the dependence of the level of Alexitimia on the neurological deficit, gender, level of anxiety and depression. It was established that the development of brain infarction affects the level of Alexitimia. The presence of Alexitimia in patients with a brain infarction leads to a violation of adequate self -esteem of the physical and mental state, which can complicate the rehabilitation of such patients and requires correction - a combination of pharmacotherapy and psychotherapeutic effects.

Keywords: Alexitimia, brain heart attack, anxiety, depression.

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.

Chronic cerebrovascular failure (KHNMK) is the result of cerebral micriangiopathy, most often due to uncontrolled arterial hypertension. At the same time, the brain suffers due to repeated “dumb” heart attacks and/or micro -power without clinical manifestations of stroke and chronic brain ischemia. The main manifestation of a chronic progressive non -navigable vascular brain damage is progressive cognitive disorders with a predominance of insufficient concentration of attention, a decrease in the cognitive activity, a violation of planning and control with the relative preservation of memory.
As a rule, these disorders are combined with changes in the emotional sphere in the form of affective lability and depression. A description of the characteristic clinical case of KHNMK is given, the mechanisms of the formation of neurological symptoms are understood, modern approaches to the management of such patients are stated.

Key words: chronic brain ischemia, discirculatory encephalopathy, vascular cognitive impairment.

The purpose of the study.

To clarify the mechanisms of the anti -stress effect of the antioxidant drug (Mexidol) in patients with chronic brain ischemia (Khim). Material and methods. 67 patients with chemicals, 48 ​​women and 19 men, the average age 48.2 years observed. To assess the state of a multi -level stress system, they studied: the level of anxiety and depression, the degree of vegetative imbalance, adaptive blood reactions and the functional properties of red blood cell membranes, the level of medium mass molecules in the blood plasma. Therapeutic complexes included standard therapy and Mexidol of 500 mg (10 ml) intravenously by a drop of 200 ml of physiological solution 1 time per day for 10 days with the subsequent transition to the oral intake of 1 tablet (125 mg) 3 times a day for 3 months. Results and conclusion. In the group of patients receiving Mexidol, a more pronounced and prolonged positive effect on the clinical symptoms of chemicals was noted. These patients had a persistent decrease in anxiety, a decrease in vegetative imbalance. The dynamics of adaptive blood reactions indicated the activation of the function of the adrenal cortex. There was a decrease in the content of the level of medium mass molecules and the restoration of the sorption capacity of ER Itrocytes. The results indicate a multicomponent multi -level stressful effect of Mexidol in patients with chronic brain ischemia.

Key words: Mexidol, chronic brain ischemia, treatment, stress.

Metabolic syndrome (MS) is a factor in the risk of acute and chronic vascular diseases of the brain. Oxidizing stress developing under these conditions contributes to the progression of atherosclerotic lesions of the brachiocephalous arteries, which makes it necessary to correct the identified pathobiochemical disorders. The use of antioxidant drugs in patients with cerebrovascular diseases and MS helps to reduce such manifestations of the latter as insulin resistance, hyperthyglyceridemia, hyperglycemia. The article presents the results of studies of Mexidol in patients with chronic cerebrovascular diseases against the background of atherosclerosis and MS, demonstrating good prospects for the use of drug compounds of this group with the aim of comprehensive correction of various links in the pathogenesis of developing pathology.

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 purpose of the study . Assessment of the dynamics of the functional activity of the structures of the brain that provide cognitive functions in patients with encephalopathy in acute poisoning with neurotoxic substances at the rehabilitation stage.

Material and methods. 56 patients were examined. The main group was 40 patients, for the treatment of which the intravenous drip administration of Mexidol was used - 10 patients, a combination of Mexidol with non -drug methods of treatment in the form of mesodyeencephalic modulation (MDM) - 10 patients, hyperbaric oxygenation (HBO) - 10 patients and combinations of MDM and HBO - 10 patients. The comparison group was 16 people. All patients were recorded by EEGs caused by auditory (associated event) potentials (SSP) and carried out neuropsychological testing. Results and conclusion. EEG changes noted in all their severity examined with their great severity, and the dominance of signs of violation of the functional activity of the formations of
the diencephalic or mesodyeencephalous level was noted. After the treatment in the main group, positive dynamics was detected in 60% of cases. In 80% of cases, positive dynamics was noted when using a combination of Mexidol, MDM and HBO. Negative dynamics in the main group was noted in 5 (12.5%) cases, while it was more often detected when only Mexidol was used in the treatment process. The results of the primary neuropsychological study showed that in the main group in 97.5% of cases and in 100% of patients of the comparison group, violations of cognitive activity of varying degrees of severity were detected. After the treatment in patients of the main group, 62.5% improved indicators for neuropsychological tests, there was a reduction in the latent period of components N200, P300, an increase in the amplitude of the caused potentials. Thus, the use of patients with encephalopathy in acute poisoning with various neurotoxicants at the stage of rehabilitation of Mexidol, HBO and MDM leads to an improvement in the indicators that reflect the functional state of the brain as a whole and the state of cognitive functions.

Keywords: encephalopathy, acute neurotoxicant poisoning, electroencephalography, auditory -related potential (P300), psychophysiological testing, mexidol, mesodyeencephalmic modulation, hyperbaric oxygenation.

A high level of glucose in the blood with a hypoxic-ischemic state is one of the main factors that determine the degree of brain damage. The consequence of a hyperglycemic-ischemic state is an increase in the formation of active forms of oxygen and impaired functioning of the endogenous antioxidant system. To compensate for the forming cerebrovascular disorders against the background of a combination of ischemia and diabetes, drug treatment must be used. The most effective tools are antioxidants from the group of
2-ethyl-6-methyl-3-oxypyrididine derivatives.
Key words: brain ischemia, phospholipids, phosphatidylcholine, diabetes mellitus, neuropathy, free radicals.

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.