Prevention and treatment of cognitive impairment from the standpoint of effectiveness and safety

Authors

  • M.M. Seliuk Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • M.M. Kozachok Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine
  • O.V. Seliuk Ukrainian Military Medical Academy, Kyiv, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2224-0713.17.2.2021.229897

Keywords:

cardiovascular diseases, cerebrovascular pathology, cerebral circulation, insufficiency, cognitive functions, cognitive imbalance, prevention, treatment, safety, efficacy

Abstract

Cardiovascular diseases rank first among non-infectious diseases in Ukraine. One of the threatening conditions is cerebrovascular complications. According to official statistics, cerebrovascular diseases are the second most common cause of death in Ukraine. The most common cause of cerebral vascular lesions is arterial hypertension. Impaired cerebral circulation is a result of high blood pressure and the progression of atherosclerosis. The Framingham Study found that increased blood pressure was associated with poorer cognitive performance such as attention and memory. Cognitive impairment in older people is one of the most pressing problems of modern medicine. Severe cognitive impairment, primarily vascular dementia, leads to complete or partial loss of self-management and independence of the patient, causing professional, social and domestic maladjustment. Early detection of cognitive imbalance and timely initiation of therapy is the key to effective patient care. Given the multifactorial mechanism of disorders leading to cognitive impairment, it is worth choosing drugs that have dual mechanisms of action. Cavinton is such an agent. It improves the blood supply to the brain (vasoactive effect and a positive influence on the rheological properties of the blood) and stimulates cerebral metabolism. Clinical studies and many years of experience in the use of Cavinton have confirmed its high efficacy and safety in the treatment of cognitive disorders. The most significant clinical effects were found with early administration of Cavinton. Thus, it is advisable to prescribe Cavinton to patients immediately, when the risk of cardiovascular and cerebrovascular diseases is detected, in order to prevent the development of cognitive impairment.

References

STEPS. Поширеність факторів ризику неінфекційних захворювань. Україна 2019 / World Health Organization.

Центр громадського здоров’я МОЗ України. Всесвітній день боротьби з інсультом. 29.10.2020. https://phc.org.ua/news/29-zhovtnya-vsesvitniy-den-borotbi-z-insultom.

Верещагин Н.В., Моргунов В.А., Гулевский Т.С. Патология головного мозга при атеросклерозе и артериальной гипертензии. М.: Медицина, 1997. 288 с.

Бокарев И.Н. Атеросклероз — проблема современности. Тромбоз, гемостаз и реология. 2000. № 1. С. 6-7.

Elias P.K., D’Agostino R.B., Elias M.F., Wolf P.A. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp. Aging Res. 1995. 21. 393-417.

Launer L.J., Ross G.W., Petrovitch H., Masaki K., Foley D., White L.R., Havlik R.J. Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol. Aging. Jan-Feb 2000. 21(1). 49-55. doi: 10.1016/s0197-4580(00)00096-8.

Singh-Manoux A., Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. J. Clin. Epidemiol. 2005. 58. 1308-15.

Захаров В.В., Вознесенская Т.Г. Нервно-психические нарушения: диагностические тесты. М.: МЕДпреcс-информ, 2014. 320 с.

Nasreddine Z., Phillips N., Bédirian V. et al. Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J. Am. Geriatr. Soc. 2005. 53. 695-9.

Стулин И.Д., Левченко О.В. Кавинтон: успехи в лечении сосудистых заболеваний головного мозга (обзор литературы). Мистецтво лікування. 2005. 4(20).

Gulyas B., Haldin C., Karlsson P. Brain uptake and plasma metabolism of (11C) vinpocetine: a prеilimanary PET study in a cynomolgus monkey. J. Neuroimaging. 1999. Vol. 9. № 4. Р. 217-222.

Виленский Б.С. Инсульт: профилактика, диагностика и лечение. СПб.: Фолиант, 2002.

Solti E., Iskum M., Czako E. Effect of ethyl apovincaminate on cerebral circulation. Studies in patients with obliterative cerebral arterial disease. Arzneim-Forschung. 1976. Vol. 26. P. 1945-1947.

Hayakawa M. Effect on vinpocetine on red blood cell deformability in stroke patients. Arzneim. Forsch. 1992. Vol. 42. № 4. Р. 425-427.

Гусев Е.И., Скворцова В.И. Ишемия головного мозга. М.: Медицина, 2001. С. 248.

Erdo S.L., Molnar P., Lakics V. et al. Vincamine and vincanol are potent blockers of voltage-gated Nа+ channels. Eur. J. Pharmacol. 1996. Vol. 314. № 1–2. Р. 69-73.

Хорват Ш. Кавинтон в терапии хронической недостаточности мозгового кровообращения. Orvosi Hetilap. 2001. № 8. С. 383-389.

Diogo N. et al. The safety and lack of efficacy of vinpocetine in Alzheimer’s disease. J. Am. Geriat. Soc. 1989. Vol. 37. № 6. Р. 515-520.

Blaha L., Erzigkeit H., Adamczyk К. et al. Clinical evidense of the effectiveness of vinpocetine in the treatment of organic psychosyndrome. Human Psych. 1989. № 4. Р. 103-111.

Lаkics V., Sebestyen M.G., Erdo S.L. Vinpocetine is a highly potent neuro-protectant against veratridin-induced cell death in primary cultures of rat cerebral cortex. Neirosci Lett. 1995. Vol. 185. № 2. Р. 127-130.

Miyazaki M. The effect of a cerebral vasodilatator vinpocetine on cerebral vascular resistance evaluated by the Doppler ultrasonic technique in patients with cerebrovascular diseases. Angiology. 1995. Vol. 46. № 1. Р. 53-58.

Wade D.T. Measurement in neurological rehabilitation. Oxford university press, 1992.

Суслина З.А. Ишемические нарушения мозгового крово-обращения и система простаноидов (клинико-биохимическое исследование): Дис… д-ра мед. наук. М., 1990. 339 с.

Hindmarch L., Fuchs H., Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int. Clin. Psychiat. 1991. Vol. 6. Р. 31-43.

Ebi O. Open-labeled phase III clinical trials with vinpocetine in Japan. Ther. Hung. 1985. Vol. 33(1). P. 41-49.

Farsang C., Kertesz G., Banki M.C. et al. Effect of two years’ Cavinton treatment on the ECG. Ther. Hung. 1987. Vol. 35(3). P. 125-128.

Nagy Z., Vargha R., Kovacs L. et al. Meta-analysis of cavinton. Praxis. 1998. Vol. 7. P. 63-68.

Published

2021-05-19

Issue

Section

To practicing Neurologist