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Drug therapy and cognitive stimulation in patients with poststroke cognitive impairments

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Objective: to compare a multimodal drug approach to treating poststroke cognitive impairments (CI).

Patients and methods. Eighty patients with postroke CI in the early recovery period were examined. They were allocated to 4 groups:1) secondary stroke prevention only (a comparison nontreatment group); 2) actovegin infusions; 3) cerebrolysin infusions; 4) drug therapy in combination with non-drug cognitive training using the standard procedure. Follow-ups and neuropsychological assessments were made at the inclusion in the study and 3 and 6 months after stroke. The state of cognitive functions 6 months after stroke was considered to be an endpoint of the study.

Results and discussion. At the inclusion in the study, the mini-mental state examination and the frontal lobe dysfunction scale showed no statistical differences in cognitive functions in different patient groups. At a 3-month follow-up, the cognitive status in the neuronal plasticity stimulation groups was significantly better than in the comparison group (p≤0.05). At a 6-month follow-up, there was a significant cognitive improvement in the combined stimulation group versus the drug-therapy and comparison groups (p≤0.05). Day-to-day activities and independent functioning also improved significantly more promptly in the patients receiving drug or combined therapies. More complex instrumental activities of daily living recovered significantly better during combined cognitive function stimulation than during pharmacological stimulation only. There was evidence that the drugs with proven stimulating effects on neuronal plasticity and nondrug cognitive training were effective in treating CI in the early recovery period of stroke. The combined drug and nondrug poststroke CI treatments reflecting the multimodal approach versus drug therapy were found to be most effective in these patients.

About the Authors

D.R. Khasanova
Interregional Clinical and Diagnostic Center, Kazan; 12a, Karbyshev St., Kazan, 420101
Russian Federation

Yu.V. Zhitkova
Interregional Clinical and Diagnostic Center, Kazan; 12a, Karbyshev St., Kazan, 420101
Russian Federation

L.M. Yu.V.
Interregional Clinical and Diagnostic Center, Kazan; 12a, Karbyshev St., Kazan, 420101
Russian Federation


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For citations:

Khasanova D., Zhitkova Yu., Yu.V. L. Drug therapy and cognitive stimulation in patients with poststroke cognitive impairments. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(2S):23-27. (In Russ.)

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