Possibilities of therapy for early manifestations of chronic cerebral ischemia: results of the PROFILE program
https://doi.org/10.14412/2074-2711-2017-3-36-41
Abstract
Objective: to investigate the efficacy and safety of Cavinton® Comforte (Vinpocetine) in patients with initial manifestations of chronic cerebrovascular disease (CVD) in outpatient neurological and therapeutic practice.
Patients and methods. The program included 4410 patients with a verified diagnosis of Stage I-II dyscirculatory encephalopathy. All the patients took Cavinton® Comforte 10 mg thrice daily for 3 months. The patients underwent neurological and general physical examinations, laboratory tests, functional diagnostic (electrocardiography, Doppler ultrasound), and neuroimaging techniques (magnetic resonance imaging).
Neuropsychological tests for attention, memory, visual-spatial and executive functions were used to assess cognitive impairment.
Results. Therapy with this drug showed a high efficiency in terms of both subjective characteristics and the data of neuropsychological tests for attention, memory, visual-spatial and executive functions. At the same time, the improvement was equally marked in young, middle-aged, and old patients. Positive changes in test results, as in patient complaints, were already evident after one month of treatment. A positive trend remained with the therapy continued for up to 3 months. More than 90% of physicians and patients assessed the efficacy and tolerability of treatment as good or excellent.
Conclusion. The investigation has demonstrated that it is appropriate to use the drug in patients at the early stages of chronic CVD. To further study the efficiency of this therapy in patients with chronic brain ischemia, it is advisable to conduct a comparative placebo-controlled investigation.
About the Authors
G. R. TabeevaRussian Federation
11, Rossolimo St., Moscow 119021
Department of Nervous System Diseases and Neurosurgery
E. Yu. Kalimeeva
Russian Federation
11, Rossolimo St., Moscow 119021
Department of Nervous System Diseases and Neurosurgery
N. N. Koberskaya
Russian Federation
11, Rossolimo St., Moscow 119021
Department of Nervous System Diseases and Neurosurgery
S. I. Gereeva
Russian Federation
11, Rossolimo St., Moscow 119021
Department of Nervous System Diseases and Neurosurgery
References
1. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Jan 10; 385(9963):117-71. doi: 10.1016/S0140-6736(14)61682-2. Epub 2014 Dec 18.
2. Roman GC, Erkinjuntti T, Wallin A, et al. Subcortical ischemic vascular dementia. Lancet Neurol. 2002 Nov;1(7):426-36.
3. White L. Brain lesions at autopsy in older Japanese-American men as related to cognitive impairment and dementia in the final years of life: a summary report from the Honolulu-Asia aging study. J Alzheimers Dis. 2009;18(3):713-25. doi: 10.3233/JAD-2009-1178.
4. Chui HC, Ramirez-Gomez L. Clinical and imaging features of mixed Alzheimer and vascular pathologies. Alzheimers Res Ther. 2015 Feb 27; 7(1):21. doi: 10.1186/s13195-015-0104-7.eCollection 2015.
5. 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.)].
6. Dubois B, Slachevsky A., Litvan I, Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000 Dec 12;55(11):1621-6.
7. Reitan RM. Validity of the Trail Making test as an indicator of organic brain damage. Percept Mot Skills. 1958;8:271-6.
8. Блейхер ВМ, Крук ИВ, Боков СН. Клиническая патопсихология. Руководство для врачей и клинических психологов. Москва: Издательство Московского психолого-социального института; 2002. 512 с. [Bleikher VM, Kruk IV, Bokov SN. Klinicheskaya patopsikhologiya. Rukovodstvo dlya vrachei i klinicheskikh psikhologov [Clinical pathopsychology. A guide for physicians and clinical psychologists]. Moscow: Izdatel'stvo Moskovskogo psikhologo-sotsial'nogo instituta; 2002. 512 p.].
9. Bereczki D, Fekete I. A systematic review of vinpocetine therapy in acute ischaemic stroke. Eur J Clin Pharmacol. 1999 Jul;55(5):349-52.
10. Chiu PJ, Tetzloff G, Ahn HS, Sybertz EJ. Comparative effects of vinpocetine and 8-Brcyclic GMP on the contraction and 45Ca-fluxes in the rabbit aorta. Am J Hypertens. 1988 Jul;1(3 Pt 1): 262-8.
11. Imamoto T, Tanabe M, Shimamoto N, et al. Cerebral circulatory and cardiac effects of vinpocetine and its metabolite, apovincaminic acid, in anaesthetized dogs. Arzneimittelforschung. 1984; 34(2):161-9.
12. Gulyas B, Halldin M, Karlsson P, et al. Brain uptake and plasma metabolism of [11C] vinpocetine: a preliminary PET study in a cynomolgus monkey. J Neuroimaging. 1999 Oct;9(4):217-22.
13. Bonoczk P, Gulyas B, Adam-Vizi V, et al. Role of sodium channel inhibition in neuroprotection: effect of vinpocetine. Brain Res Bull. 2000 Oct; 53(3):245-54.
14. Живолупов СА, Самарцев ИН, Яковлев ЕВ и др. Оценка эффективности винпоцетина (Кавинтона Комфорте) в лечении головокружения у пациентов с дисциркуляторной энцефалопатией по уровню нейротрофического фактора мозга (BDNF) в плазме крови. Клиническая фармакология и терапия. 2016;25(1):2-7. [Zhivolupov SA, Samartsev IN, Yakovlev EV, et al. Evaluation of the effectiveness of Vinpocetine (Cavinton Comforte) in the treatment of vertigo in patients with dyscirculatory encephalopathy by the level of brain neurotrophic factor (BDNF) in blood plasma. Klinicheskaya farmakologiya i terapiya. 2016;25(1):2-7. (In Russ.)].
15. Чуканова ЕИ, Никонов АА, Никонова АА. Новые возможности использования препарата Кавинтон в лечении пациентов с недостаточностью мозгового кровообращения. Русский медицинский журнал. 2009;(11):751-8. [Chukanova EI, Nikonov AA, Nikonova AA. New uses of the drug Cavinton in the treatment of patients with cerebrovascular insufficiency. Russkii meditsinskii zhurnal. 2009;(11):751-8. (In Russ.)].
16. Szatmari S, Whitehouse P. Vinpocetine for cognitive impairment and dementia. Cochrane Database Syst Rev. 2003;(1):CD003119.
17. Ковальчук ВВ. Возможности и преимущества терапии новой диспергируемой формой препарата Кавинтон для пациентов с неврологическими заболеваниями. Русский медицинский журнал. 2015;(24):1437-40. [Koval'chuk VV. Features and benefits of therapy with new dispersed form of the drug Cavinton for patients with neurological diseases. Russkii meditsinskii zhurnal. 2015;(24): 1437-40. (In Russ.)].
18. Парфенов ВА. Дисциркуляторная энцефалопатия и сосудистые когнитивные расстройства. Москва: ИМА-ПРЕСС; 2017. 128 с. [Parfenov VA. Distsirkulyatornaya entsefalopatiya i sosudistye kognitivnye rasstroistva [Dyscirculatory encephalopathy and vascular cognitive disorders]. Moscow: IMA-PRESS; 2017. 128 p.]
Review
For citations:
Tabeeva G.R., Kalimeeva E.Yu., Koberskaya N.N., Gereeva S.I. Possibilities of therapy for early manifestations of chronic cerebral ischemia: results of the PROFILE program. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(3):36-41. (In Russ.) https://doi.org/10.14412/2074-2711-2017-3-36-41