[Treatment of cognitive and non-cognitive symptoms in cerebrovascular disease].

OBJECTIVE: To study the therapeutic efficacy and safety of Ginkgo special extract EGb 761 in the treatment of cognitive and non-cognitive symptoms (anxiety, depression, sleep disorders, activity) in patients with discirculatory encephalopathy (DE) and cognitive impairment. MATERIAL AND METHODS: The study enrolled 45 patients with DE (mean age 60,8±5,9 years). Patients were randomized to treatment with EGb 761 (30 patients) or other drugs (15 patients). Patients underwent neurological examinations, along with cognitive and neuropsychological testing (FAB, MMSE, HADS and other tests). EGb 761 was used in dose 240 mg per day during 24 weeks. RESULTS: By the end of the study, the levels of anxiety and depression decreased (p<0,05) to the 12th and 24th week, respectively. CONCLUSION: The results indicate the efficacy and good tolerability of EGb 761 in the treatment of mental disorders in DE patients with cognitive impairment. The best effect was observed in relation to anxiety.

[Recovery of consciousness as manifestation of neuroplasticity].

Prolonged impairment of consciousness is one of the most fearsome syndromes during diseases and traumas of nervous system. Traumatic brain injury (TBI) is the cause of coma with outcome in vegetative state in approximately half of cases which allows considering this etiopathogenetic form of consciousness impairment as one of the models for studying its morphofunctional nature because the pathogenesis of TBI is mostly understood. Particularly, it has been showed that in the basis of clinical picture of TBI lie, on the one hand, morphological (diffuse axonal injury of subcortical white matter, necrotic changes in cortex, thalamus) and functional (diaschisis) disturbances and on the other--processes of sanogenesis occurring within the borders of neuroplasticity. The aim of our research was to investigate clinical and neurophysiological markers of consciousness recovery in patients with vegetative state (VS) after severe TBI by comparison of clinical changes dynamics and brain bioelectrical activity. In all patients we have evaluated neurological status, Glasgow coma scale, performed registration and spectral-coherent analysis of electroencephalography and also registration and analysis of somatosensory potentials, studied motor thresholds, amplitude-time characteristics of evoked motor potentials during transcranial magnetic stimulation, repeatedly conducted MRI or CT. The electroencephalography in most of the patients revealed theta- and delta-rhythm sometimes with signs of paroxysmal activity and interhemispheric asymmetry or low-amplitude EEG. It is estimated that reliable positive changes in amplitude-time characteristics of multimodal evoked potentials, reliable decrease of motor thresholds mostly in left hemisphere and increase of motor evoked potentials amplitude are in 5-7 preceded by clinical improvement in patients with TBI.

[Therapeutic correction of mild cognitive impairment in patients with chronic cerebral ischemia].

Neurodegenerative and cerebrovascular diseases are the most significant among the main reasons leading to the cognitive impairment of the elderly. Vascular cognitive impairment is not limited to only dementia, representing a heterogeneous group both in pathogenic and clinical terms. The article dwells upon new principles of vascular cognitive impairment's classification and the review of their possible therapeutic correction that was conducted. The article includes the results of the 12-week open therapeutic (randomized with the control group) study of efficiency and safety of vitrum memory for patients with mild vascular cognitive impairment. It is shown that the therapy significantly improved the state of neurodynamic and regulatory functions of the patients with I--II stage dyscirculatory encephalopathy.

[Efficacy of cytoflavin in patients in the acute ischemic stroke].

We present the results of a multicenter study on efficacy of cytoflavin in the treatment of patients with acute ischemic stroke. Seventy patients (41 of the main group and 29 of the control group) were enrolled in the study. All patients received basic therapy aimed at improving systemic hemodynamics, rheological blood properties and at the prevention of stroke complications. Patients of the main group were treated with cytoflavin as follows: days 1-10 - 20 ml (in 400 ml of the 0,9% NaCl solution) twice a day intravenously in drops; days 11-35 - 850 mg twice a day. We assessed the dynamics of restoration of lost functions (NIHSS, the Rankin scale, the Barthel index) and volumes of ischemic lesion (MRI T1-, T2-, diffusion-weighted images). Results of the study on patients of the control group were supplemented with literature data about 306 patients studied using clinical scales and 40 patients studied with MRI. We revealed a trend towards an effect of cytoflavin on the preservation of brain matter in the acute phase of stroke. Cytoflavin reduced the neurological deficit and improved activities of daily living in patients that may be explained by the less brain damage.

[Tanakan (EGb 761) in the therapy of mild cognitive impairment].

Mild Cognitive Impairment (MCI) means cognitive deterioration not yet causing disability or dementia. Aged patients with MCI constitute a group of high risk for Alzheimer disease and other types of dementia. Currently, there is no generally adopted approach to MCI management but medications with neuroprotective properties are presumed to be the most perspective. Presented are the results of a multicentral open-label clinical trial of vascular and neuroprotective drug tanakan (EGb 761). The study has shown the decrease of cognitive impairment, which was both clinically and statistically significant, in patients at early stages of vascular and neurodegenerative pathological process. Probable efficacy of long-term tanakan treatment in prevention of dementia is discussed.

[Radionuclide study of the thymus gland in myasthenia patients]. / Radionuklidnoe issledovanie vilochkovoi zhelezy u bol'nykh miasteniei.

Using 75Se methionine the authors performed a scintigraphic examination of the thymus in 65 patients, 15 of whom were suffering from myasthenia and 48 (control) from various neoplastic pathologies of the thyroid and the larynx. The examination has made it possible to discover parts of the thymus active tissue including those remaining after thymectomy. The method enables one to control the results of radiation and surgical treatment of myasthenic patients.