Clinical efficacy and safety of nicergoline combined with oxiracetam in the treatment of vascular cognitive impairment.

As a α1-adrenergic receptor antagonist, nicergoline can induce vasodilation and increase arterial blood flow. Its clinical application can effectively prevent and treat cognitive impairment and reduce cognitive decline and comprehensively improve patients' daily living ability and social function. The clinical efficacy of nicergoline combined with oxiracetam in the treatment of vascular cognitive impairment after stroke was analyzed. 120 patients with cognitive impairment after stroke were randomly divided into nicergoline group and Experience group. They were treated with nicergoline and nicergoline combined with oxiracetam respectively. Both groups were treated for one month. Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of the two groups before and after treatment, and the clinical efficacy was compared. The results showed that the average score of MoCA in the combined group was (5.97±2.06), higher than that in the nicergoline group (3.53±1.44). The change of MoCA score was the most significant. There was significant difference between the nicergoline group and the combined group (t=4.21, P<0.01). The combined group had the highest effective rate and the total effective rate was 93.3%. Conclusion: Nicergoline and oxiracetam are effective drugs in the treatment of vascular cognitive impairment (VCI). The combined use of nicergoline and oxiracetam is better than that of nicergoline alone. The combined use of nicergoline and oxiracetam can significantly improve the severity of symptoms and quality of life in patients with vascular cognitive impairment after stroke. The clinical effect is definite.

[Influence of arterial hypertension on the clinical course of Parkinson's disease (PD) among middle-aged patients].

Ultrasound Doppler investigation was conducted among 164 patients with PD having 1.5-3 score (Hoehm-Yahr), disease duration from 2 to 8 years. Age feature connected with hypertension effects on clinical manifestation of PD was studied. The authors suggest a possibility for correction of cerebral hemodynamis of PD patients using different alpha-adreno-blockers (Nicergolin) in a complex pathogenetic therapy scheme.

A unique and promising combination of medications for the treatment of Alzheimer's disease.

At present there is no therapy for Alzheimer's Disease which completely stops the progressive dementia effecting late onset Alzheimer's Disease (AD) patients. It is felt that the main reason for this failure is that AD appears to be a disease caused by four major pathological processes. To date, efforts to develop treatments have addressed only one or another of these four etiologies. However, even a partially effective therapy against one cause allows the others, untreated, to continue their inexorable destruction of the neurons of the brain. It is suggested that a therapy is required which inhibits all four causes of the disease. Just such a therapy is proposed here with four specific drugs and a vitomer together in a combination treatment. The four major pathologic processes causing AD are: I. vascular hypoperfusion of the brain with associated mitochondrial dysfunction. II. destructive protein occlusions. III. uncontrolled oxidate stress and IV: pro-inflammatory immune processes secondary to microglial and astrocytic dysfunction in the brain. A detailed literature search has provided four drugs and a B6 vitomer which together provide an ideal combination to treat the four etiologies of AD. All four drugs are used clinically for various indications and would be used "off label" in combination to treat AD. The drugs have been used in preliminary studies to treat dementia with favorable indications in all of them inhibiting dementia with only modest side effects. In in vitro studies all five of the combination have been shown effective in inhibiting one or more of the four disease etiologies and together they are effective against all four. The four drugs are Trental, Nicergoline, Nilotinib, and Methylene blue. The vitamer is B6 pyridoxamine. The cumulative benefits of this combination should provide an effective treatment to completely stop the progressive dementia of AD, measured in 12-18months. The use of an endpoint of complete cessation of progressive dementia rather than the standard of a statistical determination of the slowing of progressive dementia allows the study to be conducted with a cohort of only 15 patients (no statistics and no placebo patients) as every AD patient would otherwise show progressive dementia without the effective treatment.

Nicergoline facilitates vestibular compensation in aged male rats with unilateral labyrinthectomy.

The ergoline derivatives, nicergoline (NIC) or dihydroergocristine (DHE) were administered at various doses (0.1, 0.5 and 1 mg/kg) to aged male rats subjected to labyrinth unilateral lesion (LBX). The nystagmus rate appeared to be lower in animals treated with DHE or NIC 1mg/kg than in saline-injected rats, when observed on day 1 and 2 after operation. The number of falls in the rotorod test of LBX animals was decreased by NIC 0.5 or 1 mg/kg at all observation times. This parameter was affected by DHE only at the higher dose. These results suggest that NIC facilitates vestibular compensation of LBX rats. DHE appeared to be less potent in this respect. Since both drugs act on central dopaminergic neurotransmission, it is possible that this neurotransmission may be involved in their mechanism of action.

[Therapy of organic brain syndrome with nicergoline given once a day]. / Therapie des hirnorganischen Psychosyndroms mit Nicergolin in täglicher Einmalgabe.

In a double-blind, active-controlled study 30 patients with mild to moderate multiinfarct dementia diagnosed according to DSM III definition were treated by either 20 mg nicergoline or 4.5 mg co-dergocrine mesilate once daily during eight weeks. Therapeutic effects on symptoms of the organic brain syndrome were quantitatively measured by standardized psychological and psychometric methods evaluating cognitive and thymopsychic functions. Main criteria, which were tested by inferential analysis, were SCAG total score (Sandoz Clinical Assessment Geriatric Scale), SCAG overall impression and the AD Test (alphabetischer Durchstreichtest). Other results were assessed by descriptive statistics. Both treatments resulted in a statistically significant improvement in most of the tested functions. The effects of 4.5 mg co-dergocrine mesilate s.i.d. were in accordance with published results. Although differing slightly with respect to individual results 20 mg of nicergoline once daily showed the same efficacy on the whole.

[Nicergoline in the treatment of patients after a mild ischemic stroke]. / Nicergolina w leczeniu chorych po lekkim udarze niedokrwiennym mózgu.

25 patients with neurological and neuropsychological deficits after a mild ischaemic stroke were treated with nicergoline (Adavin 60 mg/d) versus placebo in a double blind cross-over trial (3 and 3 months). The patients were examined repeatedly by a neurologist and a neuropsychologist using a battery of tests (PPL, AVLT, Benton and Bourdon tests, number-repetition test). On completion of the trial the improvement of neurological signs (mainly cerebellar deficits) and neuropsychological impairments (in particular of attention and manual manipulation difficulties) was found to be more marked after the period of nicergoline treatment than after placebo. No drug-dependent side effects--including the influence on blood pressure--were observed in the whole group treated.

[Current strategies of pathogenetic therapy of Alzheimer's disease]. / Sovremennye strategii patogeneticheskoi terapii bolezni Al'tsgeimera.

This is a review of the data available in the literature and the authors' own findings on pathogenetical rationale for the use and clinical study of current treatments for Alzheimer's disease (AD) (synonym: Alzheimer-type dementia). In the past decade many attempts have been made at targeting different links of the pathogenesis of a neurodegenerative process that underlie AD. Several areas of pathogenetical therapy for AD have been developed on the basis of experimental studies and pilot clinical tests. The most developed areas are as follows: various compensatory (replacement) treatments aimed at overcoming neurotransmitter deficit in different neuronal systems that are damaged in AD to a greater or lesser extent; neuroprotective therapy promoting increased viability (survival) of neurons and their plasticity, and vasoactive therapy. Rather new directions of AD pathogenetic therapy, such as antiinflammatory and hormonal therapy along with antiamyloid therapeutic strategies are still under study.

[Nicergoline-induced Prinzmetal angina. "Heartache" instead of headache]. / Nicergoline által indukált Prinzmetal-angina. Fejfájás helyett "szívfájás".

A 56 year old woman was admitted to our hospital with crescendo chest pain in the last ten days. Her past history included hypertension treated by 100 mg metoprolol for more than ten years and right carotid endarterectomy. She complained headache and a treatment of 20 mg nicergoline (ergoline derivate) daily was started. Her chest pains started always one hour after the nicergoline intake. The chest pain was accompanied by breathing difficulties and sweating of 5 min duration at first but the next days it lasted longer and longer. Next morning following her admission, one hour after the nicergoline administration she had severe chest pain again. The ECG showed ST-segment elevation in inferior leads resolved after nitroglycerin administration. The angiogram revealed normal coronary artery. Nicergoline was stopped. The patient was treated with felodipine and remains free of symptoms. Nicergoline was good for head but worse for heart in this case.

[The vertebral artery syndrome and patient management tactics].

The data of literature on vertebral artery syndrome, its clinical presentations, etiology and pathogenesis are summarized. Based on the own studies, the author considers possibilities for a pathogenetic treatment of this syndrome with sermion (nicergoline). Twenty-two patients, aged 21-71 years (a half of them were outpatients and another half were inpatients), were treated with sermion. Treatment duration ranged from 2 to 6 months. The positive effect of sermion on the most frequent clinical symptoms of the vertebral artery syndrome, including headache, vertigo and persistent or sudden increase in the blood pressure, was noted. The long-term treatment with sermion revealed a significant improvement in patient's quality of life measured with SF-36. The treatment was effective in any variant of vertebral artery syndrome regardless of its causes.