Chronic Cerebral Insufficiency Research Articles

Metabolic cardiocytoprotectors (trimetazidine and trimethylhydrazine) in geriatrics. Short review

The review presents the clinical studies results of the effectiveness of cardiocytoprotectors, fatty acids synthesis inhibitors, trimetazidine (preductal), and trimethylhydrazine (meldonium, mildronate) in the treatment of cardiovascular disease (angina pectoris, chronic heart failure) and the central nervous system disease (dyscirculatory encephalopathy, chronic cerebral insufficiency, stroke) various ages patients. These data indicate the prospects of using these drugs in the complex therapy of cardiovascular and cerebrovascular diseases in the geriatric clinic. Keywords: metabolic cardiocytoprotectors, cardiovascular and cerebrovascular pathology, trimethylhydrazine, elderly

Cerebralcare Granule® combined with nimodipine improves cognitive impairment in bilateral carotid artery occlusion rats by reducing lipocalin-2

AimsClinically, Cerebralcare Granule® (CG) has been widely utilized to treat various types of headache, chronic cerebral insufficiency and other diseases, and the effect is significant. Clinical studies have shown that CG can significantly relieve vascular dementia (VaD), however, the molecular mechanisms haven't been established. To clear the therapeutic mechanisms of CG against VaD, a hypothesis was proposed that CG could treat neurovascular injury by inhibiting the production of lipocalin-2 (LCN 2). Main methods90 dementia rats were selected by water maze test and randomly divided into 6 groups, including nimodipine (NM), CG L (low dose) (0.314 g kg−1), CG H (high dose) (0.628 g kg−1), and combined group (CG + NM). And in vitro neuronal cell OGD modeling to evaluate the effect of CG on JAK2/STAT3. Key findingsCG could significantly shorten the escape latency of two-vessel occlusion (2-VO) rats, increase their exploratory behavior, alleviate the symptoms of VaD and improve the ultrastructural pathological damage of neurovascular unit and accelerate the recovery of cerebral blood perfusion. CG combined with NM is better than NM alone. It was further showed that CG could inhibit the pathogenicity of LCN 2 through JAK2/STAT3 pathway and suppress the production of inflammatory cytokines. It plays a role in the protection of cerebral microvasculature and BBB in 2-VO rats. SignificanceTaken together, there data has supported notion that CG can protect the integrity of cerebral blood vessels and BBB and improve cognitive impairment through mainly inhibiting LCN 2, which provides scientific evidence for clinical application.

Clinical Effect Analysis of Shunaoxin Dropping Pills on Chronic Cerebral Insufficiency of Blood Deficiency and Blood Stasis

Clinical Effect Analysis of Shunaoxin Dropping Pills on Chronic Cerebral Insufficiency of Blood Deficiency and Blood Stasis

Efficacy and Efficient Evaluation of Yangxueqingnao Granules Combined with Aspirin in Treatment of Chronic Cerebral Insufficiency

Efficacy and Efficient Evaluation of Yangxueqingnao Granules Combined with Aspirin in Treatment of Chronic Cerebral Insufficiency

Long-term results of surgical brain revascularization in patients with chronic cerebral insufficiency

The study objective is to evaluate long-term effectiveness of extracranial-intracranial (EC-IC) bypass in patients with symptomatic occlusion of the internal carotid artery (ICA).Materials and methods. From 2013 to 2015, 129 patients (aged 41 to 78, average age – 60 years) were applied EC-IC bypass on the side of ICA symptomatic occlusion at the Department of Neurosurgery of N.V. Sklifosovsky Research Institute for Emergency Medicine. We revealed right ICA occlusion in 54 patients, left ICA occlusion – in 67, bilateral occlusion – in 8. Symptomatic ICA occlusion was 5 times more often in men. We assessed neurological status in 1, 2, and 3 years using modified Rankin Scale, National Institutes of Health Stroke Scale, and Rivermead Mobility Index. Computed tomography (CT) angiography of extracranial and intracranial arteries, ultrasound of the anastomosis zone, single-photon emission computed tomography (SPECT) were performed.Results. In the early postoperative period, according to CT angiography and ultrasound, the anastomosis functioned in 125 (97 %) patients; improvement of regional cerebral perfusion according to SPECT was observed in all examined patients (n = 62). We examined 31 patients in the remote postoperative period. According to CT angiography and ultrasound, anastomosis functioned in 30 (97 %) patients, 30 (97 %) patients demonstrated positive dynamics of neurological status and brain perfusion. There were no repeated ischemic-type cerebral circulatory disorders and repeated transient ischemic attacks in the long-term postoperative period.Conclusion. Positive dynamics after EC-IC bypass was revealed both in early and in distant periods (within 1–3 years). During the surgery, it is necessary to take into account cases of ischemic strokes or transient ischemic attack, ICA occlusion according to CT angiography, a decrease in cerebrovascular reserve (<10 %) according to brain SPECT when tested with acetazolamide. To prevent complications, EC-IC bypass should not be used in patients with severe neurological impairments and concomitant pathology. Properly selected patients and postoperative drug therapy helps prevent repeated ischemic cerebral circulatory disorders.Conflict of interest. The authors declare no conflict of interest.Informed consent. All patients gave written informed consent to participate in the study.

Clinical study on the treatment of chronic cerebral insufficiency with Rongnao-Tongluo-Yizhi decoction combined with flunarizine hydrochloride capsules

Objective To observe the Rongnao-Tongluo-Yizhi decoction combined with flunarizine hydrochloride capsules for chronic cerebral circulation insufficiency (CCCI) patients with the cognitive dysfunction. Methods A total of 90 patients with CCCI in our hospital from October 2015 to December 2017 were enrolled in this study. The subjects were randomly divided into the control group (n=45) and the treatment group (n=45). The control group were given conventional western medicine treatment, oral Fluorine Hydro chloride Capsules. The observation group received Rongnao-Tongluo-Yizhi decoction combined with notifying kidney and essence method treatment on the basic treatment of control group. The clinical effect rates of two groups were compared. Results The total effective rate of the treatment group was 93.3%, and the control group was 71.1%. There was significant difference between groups (χ2=6.157, P=0.013). After treatment, the serum TNF-α (0.71 ± 0.13 ng/ml vs. 1.02 ± 0.15 ng/ml, t=3.652), IL-8 (1.94 ± 0.12 ng/ml vs. 4.51 ± 0.54 ng/ml, t=3.367), hs-CRP (1.01 ± 0.14 mg/L vs. 2.15 ± 0.29 mg/L, t=3.701) of the observation group were significantly lower than the control group (P<0.05). The average blood flow velocity of basal artery (47.51 ± 3.63 cm/s vs. 42.21 ± 4.21 cm/s, t=7.385), the left side of the vertebral artery (42.12 ± 7.36 cm/s vs. 35.23 ± 2.23 cm/s, t=6.940), the right side of the vertebral artery (43.21 ± 6.18 cm/s vs. 38.46 ± 7.16 cm/s, t=3.890) in the treatment group were significantly higher than the control group (P<0.01). The treatment group total score (28.1 ± 6.3 vs. 25.0 ± 6.4, t=2.315) was higher than the control group (P<0.01). Conclusions The Rongnao-Tongluo-Yizhi decoction combined therapy could improve the symptoms, cognitive level, and quality of life of patients. Key words: Brain ischemia; Rongnao-Tongluo-Yizhi decoction; flunarizine hydrochloride capsules; Cognitive dysfunction; Blood flow velocity; Clinical study

The dynamics of markers of apoptosis in the acute period of ischemic stroke

To study the dynamics of markers of apoptosis (Bcl-2, p53) in serum in the acute period of ischemic stroke (IS) in comparison to the severity of the neurological condition and the volume of infarct. Fifty-one patients (mean age 60.5±2.2 years) with the first ever carotid IS were examined within the first 24 hours. The comparison group consisted of 20 patients (mean age 58.7±2.1 years) with chronic cerebral insufficiency. Clinical and neurological dynamic examinations with assessment of neurological deficit using (NIHSS), CT/MRI of the brain; ELISA immunoassay of p53 and Bcl-2 in blood serum were carried out. Significantly higher levels of p53 and of Bcl-2 were shown on the 3rd and 10th days in patients with IS compared to the control group (p<0.05). An increase in the content of p53 was positively correlated with the severity of neurological deficit (NIHSS≥10) on the first and third days of acute IS and with larger amounts of damage to the brain parenchyma according to the MRI study from the first day of IS and all subsequent days. High levels of Bcl-2 were positively correlated with the large volume of brain damage only on the 10th day of IS (p<0.045). The results confirm the active involvement of pro- and antiapoptotic processes in the formation of delayed neuronal death in the brain, which are important components of damaged brain tissue in IS.

The cognitive changes in patients with lacunar infarction after antery-intervention therapy

Objective To explore the characteristics of the cognitive changes in patients with lacunar infarction(LI) after carotid artery stenting(CAS). Methods Neuropsychological tests were conducted in 43 patients with LI and carotid stenosis before and 1 month, 6 months, 12 months after CAS and the scores were compared with those of 41 healthy cases. Results Compared with control group, MMSE scores (26.33±1.94), memory and executive function in therapy group lowered obviously. There was statistical difference (P<0.05 or P<0.01). Compared with before CAS, MMSE scores of 1 month (27.17±2.15), 6 months (27.17±2.15), 12 months (28.15±1.98) after CAS, memory and executive function in therapy group were all better obviously.There was statistical difference (P<0.05 or P<0.01). Conclusion In acute stage of patients with LI (with in 1 week), most cognitive impairment was severe. Most cognition disorders was improved to normal level 12 months after CAS.The mechanism may be associated with the improvement of chronic cerebral insufficiency. Key words: Lacunar infarction; Carotid stenosis; Antery-intervention therapy; Cognition disorders

The Effects of Ginkgo biloba Extracts on the Memory and Motor Functions of Rats with Chronic Cerebral Insufficiency

The main goal of the curren study was to investigate the effects of two Ginkgo leaf extracts, EGb 761 and an extract of local Ginkgo leaf (LGb), on the memory and motor functions of rats with chronic cerebral insufficiency (produced by bilateral common carotid artery ligation). After the operation, spatial memory and motor functions were tested for over 80 days. Tests included (1) radial-arm maze test for testing spatial memory and locomotor activity and (2) muscle force and hind limbs for escape. The results indicate that both EGb 761 and LGb improved spatial memory from the second week after operation, but only EGb 761 delayed deterioration of motor functions from the fifth week after operation.

Evaluation of the therapeutic effect of duxil in chronic cerebral insufficiency. Analysis of 4636 patients at cerebrovascular risk

Les troubles de la mémoire ou de l'attention, le ralentissement intellectuel et les troubles neurosensorielssont très fréquemment rencontrés lors du vieillissement. Cette étude multicentrique regroupant plus de 4 000 dossiers a pour but d'évaluer l'activité de Duxil, médicament qui favorise l'oxygénation du tissu cérébral et augmente son métabolisme énergétique, dans cette pathologie liée au déclin cérébral dans une population encore jeune. Les patients, d'âge moyen 65 ans, présentent tous au moins un signe clinique d'insuffisance cérébralechronique tel que céphalées, troubles de la mémoire, acouphènes ou bien vertiges. A ces symptômes sont associés un ou plusieurs facteurs de risque cérébro-vasculaire (tabagisme, hypertension, surcharge pondérale). La majorité des patients, traités en ambulatoire pendant 2 mois, reçoit 2 comprimés ou 80 gouttes de Duxil par jour. Tous les signes cliniques d'inclusion (céphalées, troubles de la mémoire, acouphènes, vertiges) sont évalués en intensité et en fréquence, de même. que les troubles de la vigilance et de la concentration éventuellement associés. Les résultats montrent une amélioration significative des céphalées, des vertiges et des acouphènes dès le I er mois, qui se confirme le 2 e mois. Les troubles de la mémoire, de la concentration et de la vigilance sont améliorés chez 70 p. 100 des patients après 2 mois de traitement. L'évaluation globale conclut dans 4 cas sur 5 à une amélioration des symptômes. Du point de vue physiologique, il est admis que la baisse de l'efficience intellectuelle et les troubles psycho-comportementaux liés à l'âge traduisent une altération des capacités fonctionnelles du neurone, étroitement dépendantes d'une altération des capacités métaboliques, tout particulièrement oxydatives. La démarche thérapeutique logique de l'insuffisance cérébrale chronique doit donc viser à corriger cette faillite des mécanismes oxydatifs par une augmentation de la quantité d'oxygène disponible. Dès les premiers signes d'insuffisance cérébrale, Duxil en enrichissant le sang artériel en oxygène, autorisele bénéfice de cet apport supplémentaire d'oxygène au niveau du tissu cérébral et neuro-sensoriel.