Chronic cerebral ischemia, neuroplasticity, possibilities of therapy
https://doi.org/10.14412/2074-2711-2017-2-102-107
Abstract
The paper presents current views on the pathogenetic mechanisms of cerebral ischemia. It discusses the role of neurotrophins in the processes of neuroplasticity. Experimental and clinical studies of the neuropeptide drug Cerebrolysin are reviewed. The authors describe in detail the results of the clinical trial and a health economic analysis of the effects of Cerebrolysin on the time course of clinical changes, progression, and risk of exacerbations in patients with chronic cerebral ischemia.
About the Authors
E. I. Chukanova
N.I. Pirogov Russian National Medical Research University, Ministry of Health of Russia, Moscow
Russian Federation
Russian Federation
Department of Neurology, Neurosurgery, and Medical Genetics, Faculty of General Medicine
1, Ostrovityanov St., Moscow 117997
A. S. Chukanova
N.I. Pirogov Russian National Medical Research University, Ministry of Health of Russia, Moscow
Russian Federation
Russian Federation
Department of Neurology, Neurosurgery, and Medical Genetics, Faculty of General Medicine
1, Ostrovityanov St., Moscow 117997
References
1. Гусев ЕИ, Скворцова ВИ. Ишемия головного мозга. Москва: Медицина; 2001. 248 с. [Gusev EI, Skvortsova VI. Ishemiya golovnogo mozga [Cerebral ischemia]. Moscow: Meditsina; 2001. 248 p.]
2. Plum F. Neuroprotection in acute ischemic stroke. JAMA. 2001 Apr 4;285(13):1760-1.
3. Dahlof B, Devereux R, Kjeldsen S, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randopmised study against atenolol. Lancet. 2002 Mar 23;359(9311):995-1003.
4. Яхно НН, Захаров ВВ, Локшина АБ. Синдром умеренных когнитивных нарушений при дисциркуляторной энцефалопатии. Журнал неврологии и психиатрии им. С.С. Корсакова. 2005;105(2):13–7. [Yakhno NN, Zakharov VV, Lokshina AB. The syndrome of moderate cognitive disorders at dyscirculatory encephalopathy. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2005;105(2):13–7. (In Russ.)].
5. Левин ОС. Диагностика и лечение дисциркуляторной энцефалопатии. М., 2010. 6. Гусев ЕИ, Скворцова ВИ. Современные представления о лечении острого церебрального инсульта. Consilium medicum. 2000;(2):60-6. [Gusev EI, Skvortsova VI. Modern concepts on treatment of acute cerebral stroke. Consilium medicum. 2000;(2):60-6. (In Russ.)].
6. Скворцова ВИ. Участие апоптоза в формировании инфаркта мозга. Журнал неврологии и психиатрии им. С.С. Корсакова. Приложение «Инсульт». 2001;(2):12-9. [Skvortsova VI. The involvement of apoptosis in the formation of cerebral infarction. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Suppl. «Stroke». 2001;(2):12-9. (In Russ.)].
7. Болевич СБ, Войнов ВА. Молекулярные механизмы в патологии человека. Москва: МИА; 2012. 206 с. [Bolevich SB, Voinov VA. Molekulyarnye mekhanizmy v patologii cheloveka [Molecular mechanisms in human pathology]. Moscow: MIA; 2012. 206 p.]
8. Yung Y, Rosenberg GA. Blood-brain barrier breakdown in acute and chronic cerebrovascular disease. Stroke. 2011 Nov;42(11):3323-8. doi: 10.1161/STROKEAHA.110.608257. Epub 2011 Sep 22.
9. Alison MR, Sarraf CE. Chapter 1. Apoptosis as a gene-directed program of cell death. Principles of Medical Biology. 1998;13:1-55.
10. Mattson MP. Apoptosis in neurodegenerative disorders. Nat Rev Mol Cell Biol. 2000 Nov; 1(2):120-9.
11. Ferrer I, Blanco R, Cutillas B, Ambrosio S. Fas and Fas-L expression in Huntindtons disease and Parkinsons disease. Neuropathol Appl Neurobiol. 2000 Oct;26(5):424-33.
12. Гомазков ОА. Нейрохимия ишемических и возрастных патологий мозга. Москва; 2003. 200 с. [Gomazkov OA. Neirokhimiya ishemicheskikh i vozrastnykh patologii mozga [Neurochemistry of ischemic and age-related brain pathologies]. Moscow; 2003. 200 p.]
13. Чуканова ЕИ, Чуканова АС. Отдельные механизмы патогенеза формирования недостаточности мозгового кровообращения. Фарматека. 2014;(13):14-20. [Chukanova EI, Chukanova AS. Separate mechanisms of pathogenesis of cerebrovascular insufficiency. Farmateka. 2014;(13):14-20. (In Russ.)].
14. Onore CE, Nordahl CW, Young GS, et al. Levels of soluble platelet endothelial cell adhesion molecule-1 and P-selectin are decreased in children with autism spectrum disorder. Biol Psychiatry. 2012 Dec 15;72(12):1020-5. doi: 10.1016/j.biopsych.2012.05.004. Epub 2012 Jun 19.
15. Семченко ВВ, Степанов СС, Боголепов НН. Синаптическая пластичность головного мозга. Омск: Directmedia; 2008. 499 c. [Semchenko VV, Stepanov SS, Bogolepov NN. Sinapticheskaya plastichnost' golovnogo mozga [Synaptic plasticity of the brain]. Omsk: Directmedia; 2008. 499 p.]
16. Hsieh J, Gage FH. Chromatin remodeling in neural development and plasticity. Curr Opin Cell Biol. 2005 Dec;17(6):664-71. Epub 2005 Oct 13.
17. Duffau H. Brain plasticity: from pathophysiological mechanisms to therapeutic applications. J Clin Neurosci. 2006 Nov;13(9):885-97. Epub 2006 Oct 17.
18. Боголепова АН, Чуканова ЕИ. Проблема нейропластичности в неврологии. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010;110(8):72-5. [Bogolepova AN, Chukanova EI. The issue of neuroplasticity in neuroscience. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2010;110(8):72-5. (In Russ.)].
19. De Keyser J, Sulter G, Luiten PG. Clinical Trials with neuprotective drugs in acute ischemic stroke: are we Doing the right thing? Trends Neurosci. 1999 Dec;22(12):535-40.
20. Plum F. Neuroprotection in acute ischemic stroke. JAMA. 2001 Apr 4;285(13):1760-1.
21. Гомазков ОА. Апоптоз нейрональных структур и роль нейротрофических ростовых факторов. Биохимические механизмы эффективности пептидных препаратов мозга. Журнал неврологии и психиатрии им. С.С. Корсакова. Приложение «Инсульт». 2002;(7):17-22. [Gomazkov OA. Apoptoz neironal'nykh struktur i rol' neirotroficheskikh rostovykh faktorov. Biokhimicheskie mekhanizmy effektivnosti peptidnykh preparatov mozga. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Suppl. «Stroke». 2002; (7):17-22. (In Russ.)].
22. Чуканова ЕИ. Патогенетические и клинические моменты применения Церебролизина. Трудный пациент. 2009;7(6-7):3-7. [Chukanova EI. Pathogenetic and clinical aspects of application of Cerebrolysin. Trudnyi patsient. 2009;7(6-7):3-7. (In Russ.)].
23. Tymianski M. Novel approaches to neuroprotection trials in acute ischemic stroke. Stroke. 2013 Oct;44(10):2942-50. doi: 10.1161/ STROKEAHA.113.000731. Epub 2013 Sep 10.
24. Lang W, Stadler CH, Poljakovic Z, Fleet D; Lyse Study Group. A prospective, randomized, placebo-controlled, double-blind trial about safety and efficacy of combined treatment with alteplase (rt-PA) and Cerebrolysin in acute ischaemic hemispheric stroke. Int J Stroke. 2013 Feb;8(2):95-104. doi: 10.1111/j.17474949.2012. 00901.x. Epub 2012 Sep 26.
25. Masliah E, Diez-Tejedor E. The pharmacology of neurotrophic treatment with Cerebrolysin: brain protection and repair to counteract pathologies of acute and chronic neurological disorders. Drugs Today (Barc). 2012 Apr; 48 Suppl A:3-24. doi: 10.1358/ dot.2012.48(Suppl.A).1739716.
26. Heiss WD, Brainin M, Bornstein NM, et al; Cerebrolysin Acute Stroke Treatment in Asia (CASTA) Investigators. Cerebrolysin in patients with acute ischemic stroke in Asia: results of a double-blind, placebo-controlled randomized trial. Stroke. 2012 Mar;43(3):630-6. doi: 10.1161/STROKEAHA.111.628537. Epub 2012 Jan 26.
27. Чуканова ЕИ. Влияние церебролизина на прогрессирование и развитие инсульта у больных с дисциркуляторной энцефалопатией. Журнал неврологии и психиатрии. 2005;(1):42-5. [Chukanova EI. The influence of Cerebrolysin on the progression and development of stroke in patients with discirculatory encephalopathy. Zhurnal nevrologii i psikhiatrii. 2005;(1):42-5. (In Russ.)].
28. Wade DT. Measurement in neurological rehabilitation. Oxford university press; 1992.
29. Белова АН, Щепетова ОН, редакторы. Шкалы, тесты и опросники в медицинской реабилитации. Москва: Антидор; 2002. 439 с. [Belova AN, Shchepetova ON, editors. Shkaly, testy i oprosniki v meditsinskoi reabilitatsii [Scales, tests and questionnaires in medical rehabilitation]. Moscow: Antidor; 2002. 439 p.]
30. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967 Dec;6(4):278-96.
31. Folstein M, Folstein S, Mchugh R. Mini-mental state. A practical method for grading the cognitive state of patients for clinical. J Psychiatr Res. 1975 Nov;12(3):189-98.
32. Флетчер Р, Флетчер С, Вагнер Э. Клиническая эпидемиология: основы доказатель- ной медицины. Москва; 1998. 347 с. [Fletcher R, Fletcher S, Vagner E. Klinicheskaya epidemiologiya: osnovy dokazatel'noi meditsiny [Clinical epidemiology: basics of evidence-based medicine]. Moscow; 1998. 347 p.]
Review
For citations:
Chukanova EI, Chukanova AS. Chronic cerebral ischemia, neuroplasticity, possibilities of therapy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(2):102-107. (In Russ.) https://doi.org/10.14412/2074-2711-2017-2-102-107
Views:
1099
Email this article 