Management of patients with post-stroke dementia
Abstract
Dementia occurs in 10-20% of cases and substantially hampers the rehabilitation of patients who have had stroke. Management of patients with post-stroke dementia is based on the prevention of recurrent stroke, cognitive stimulation, and the use of drugs improving cognitive functions. The paper gives the data available in the literature on the results of randomized placebo-controlled trials evaluating the efficacy of central acetylcholinesterase inhibitors and the NMDA receptor antagonist akatinol memantine in vascular dementia, as well as the author’s positive experience with akatinol memantine used in 20 patients.
About the Author
Svetlana Viktorovna VerbitskayaRussian Federation
References
1. <div><p>Вахнина НВ, Никитина ЛЮ, Парфенов ВА, Яхно НН. Постинсультные когнитивные нарушения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2008;108(S22):16–21. [Vakhnina NV, Nikitina LYu, Parfyonov VA, Yakhno NN. Post-stroke cognitive disturbances.</p><p>Neuroscience and Behavioral Physiology. 2008;108(S22):16–21.]</p><p>Дамулин ИВ, Парфенов ВА, Скоромец АА, Яхно НН. Нарушения кровообращения в головном и спинном мозге. В кн.: Болезни нервной системы. Руководство для врачей. Т. 1. Под ред. НН Яхно. Москва: Медицина; 2005. С. 232–303. [Damulin IV, Parfenov VA, Skoromets AA, Yakhno NN. Narusheniya krovoobrashcheniya v golovnom i spinnom mozge. V kn.: Bolezni nervnoy sistemy. Rukovodstvo dlya vrachey. T. 1. Pod red. NN Yakhno. Moscow: Meditsina; 2005. P. 232–303.]</p><p>Парфенов ВА, Хасанова ДР. Ишемический инсульт. Москва: МИА; 2012. 288 с. [Parfenov VA, Khasanova DR. Ishemicheskiy insul't. Moskva: MIA; 2012. 288 p.]</p><p>Яхно НН. Когнитивные расстройства в неврологической практике. Неврологический журнал. 2006;11(S1):4–12. [Yakhno NN. Cognitive impairment in neurological clinical practice. Nevrologicheskiy zhurnal. 2006;11(S1):4–12.]</p><p>O’Brien J, Ames D, Gustafson L еt al., editors. Cerebrovascular disease, cognitive impairment and dementia. Second edition of Cerebrovascular disease and dementia. Martin Dunitz; 2004.</p><p>Gorelick PB, Scuteri A, Black SE et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association. Stroke. 2011;42(9):2672–713. DOI: 10.1161/STR.0b013e3182299496. Epub 2011 Jul 21.</p><p>Henon H, Pasquie F, Leys D. Poststroke Dementia. Cerebrovasc Dis. 2006;22(1):61–70. DOI: 10.1212%2FWNL.57.7.1216. Epub 2006 Apr 26.</p><p>European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis. 2008;25(5):457–507. DOI: 10.1159/000131083. Epub 2008 May 6.</p><p>Вербицкая СВ, Парфенов ВА. Клинический опыт применения меманитина при постинсультной деменции. Неврологический журнал. 2008;13(4):45–7. [Verbitskaya SV, Parfenov VA. Clinical experience of memantine administration in patients with post-stroke dementia. Nevrologicheskiy zhurnal. 2008;13(4):45–7.]</p><p>Black S, Roma’n GC, Geldmacher DS et al.; Donepezil 307 Vascular Dementia Study Group. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke. 2003;34(10):2323–30. DOI: 10.1161%2F01.STR.0000091396.95360.E1. Epub 2003 Sep 11.</p><p>Roma’n GC, Salloway S, Black SE et al. Randomized, placebo controlled, clinical trial of donepezil in vascular dementia: differential effects by hippocampal size. Stroke. 2010;41(6):1213–21. DOI: 10.1161/STROKEAHA.109.570077. Epub 2010 Apr 15.</p><p>Erkinjuntti T, Kurz A, Gauthier S et al. Efficacy of galantamine in probable vascular dementia and Alzheimer’s disease combined with cerebrovascular disease: a randomized trial. Lancet. 2002;359(9314):1283–90.</p><p>Auchus AP, Brashear HR, Salloway S et al.; GAL-INT-26 Study Group. Galantamine treatment of vascular dementia: a randomized trial. Neurology. 2007;69(5):448–58. DOI:10.1212%2F01.wnl.0000266625.31615.f6.</p><p>Narasimhalu K, Effendy S, Sim CH et al. A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease. Acta Neurol Scand. 2010;121(4):217–24. DOI: 10.1111/j.1600-0404.2009.01263.x. Epub 2009 Sep 26.</p><p>Orgogozo JM, Rigaud AS, Sto¨ffler A et al. Efficacy and safety of memantine in patients with mild to moderate vascular dementia: a randomized, placebo-controlled trial (MMM 300). Stroke. 2002;33(7):1834–39. DOI: 10.1161%2F01.STR.0000020094.08790.49.</p><p>Wilcock G, Mobius HJ, Stoffler A; MMM 500 Group. A double-blind, placebo-controlled multicentre study of memantine in mild to moderate vascular dementia (MMM500). Int Clin Psychopharmacol. 2002;17(6):297–305. DOI: 10.1097%2F00004850-200211000-00005.</p><p>Kavirajan H, Schneider LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol. 2007;6(9):782–92. DOI: 10.1016%2FS1474-4422%2807%2970195-3.</p><p>Вербицкая СВ, Парфенов ВА. Вторичная профилактика инсульта в амбулаторных условиях. Неврологический журнал. 2011;16(1):42–46. [Verbitskaya SV, Parfenov VA. The secondary prevention of stroke in out-patient conditions. Nevrologicheskiy zhurnal. 2011;16(1):42–46.]</p></div><br />
Review
For citations:
Verbitskaya S.V. Management of patients with post-stroke dementia. Neurology, Neuropsychiatry, Psychosomatics. 2013;5(2S):46-49. (In Russ.) https://doi.org/10.14412/2074-2711-2013-2358