RESUMO
OBJECTIVE: To evaluate the effect of vinpocetine therapy on clinical manifestations of chronic cerebral ischemia (CCI) and the blood concentrations of neuroinflammation markers (S100B, IL-1ß). MATERIAL AND METHODS: The study included 30 patients (mean age 61.6 [56.9; 67.9] years) with CCI that received vinpocetine (30 mg/day) for 3 months. Brain changes according to magnetic resonance imaging data were assessed using the STRIVE protocol. We analyzed the dynamics of changes in the clinical questionnaires: Montreal Cognitive Assessment Scale (MoCA), Hospital Anxiety and Depression Scale (HADS), Asthenic State Scale (ASS), Epworth Sleepiness Scale (ESS), general impressions of treatment (Global Rating of Change Scale, GRC). RESULTS: In 3 months after vinpocetine therapy there was a significant improvement in cognitive status (MoCA: 25.1±2.1 vs 26.6±1.4 p<0.05), emotional state (HADS: 8.4±1.4 vs 7.1±1.8 (p<0.05)), daytime sleep parameters (ESS 8.4±2.1 vs 6.2±2.3 p<0.05) and reduction in asthenia (ASS: 72.2±18.1 vs 52.3±9.3, p<0.05). A significantly larger proportion of patients assessed the improvement from therapy as «moderate¼ and «pronounced¼ (GRC, n=22, 73.3%). Concentrations of S100B and IL-1ß decreased significantly by the time therapy was completed. The overall severity of cerebrovascular changes according to MRI was significantly associated with blood levels of S100ß, but not IL-1ß: ß=0.504, p=0.026, 95% CI 0.149-0.901, mainly due to periventricular changes in white matter (ß=0.562, p=0.035, 95% CI (-0.024-0.820). Blood levels of S100ß correlated with MoCA test results (r=0.6795), and IL-1ß correlated with ESS scores (r=0. 6657). CONCLUSIONS: The use of vinpocetine can significantly reduce the severity of cognitive and affective disorders, asthenia, normalize the circadian rhythm of sleep, suppress the expression S100ß and IL-1ß in patients with CCI. One of the vinpocetine's mechanisms of action may be the inhibition of neuroinflammation.
