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Chronic cerebral circulatory disorders: possibilities of enhancing the efficiency of therapy

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Chronic cerebral circulatory disorders (CCCDs) are a group of syndromes manifested by cognitive, emotional disturbances and less commonly motor and sensory neurological symptoms, which is heterogeneous in the mechanisms of development. The prevention of CCCDs involves the control of blood pressure and glycemia and the use of antiplatelet and other drugs; however, the efficiency of these measures for an already formed defect is low.
The paper emphasizes the need for careful consideration of a patient's status at the beginning of treatment measures. Combined treatment, including secondary prevention of cerebrovascular disease, drugs that improve cerebral blood circulation and metabolism, and non-drug techniques, can be expected to have a more significant clinical effect. The possibilities of drug therapy, including the use of vinpotropile, in patients with CCCD, are considered.

About the Authors

P. R. Kamchatnov
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
1, Ostrovityanov St., Moscow 117997;

M. A. Evzelman
I.S. Turgenev Orel State University
Russian Federation

95, Komsomolskaya St., Orel 302026

Faculty of Medicine

Yu. A. Morozova
City Polyclinic Fifty-Six, Moscow Healthcare Department
Russian Federation
42, Plyushchikha St., Build. 1, Moscow 119121


1. Жетишев РР, Михайлова НА, Камчатнов ПР, Иващенко РА. Асимптомные инфаркты головного мозга: факторы риска и когнитивные нарушения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2014;3(2):3-7. [Zhetishev RR, Mikhailova NA, Kamchatnov PR, Ivashchenko RA. Asymptomatic brain infarcts: risk factors and cognitive impairment. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2014;3(2):3-7. (In Russ.)].

2. Гусев ЕИ, Скворцова ВИ. Ишемия головного мозга. Москва: Медицина; 2001. [Gusev EI, Skvortsova VI. Ishemiya golovnogo mozga [Cerebral ischemia]. Moscow: Meditsina; 2001.].

3. Парфенов ВА, Вербицкая СВ, Старчина ЮА. Вторичная профилактика инсульта на основе антигипертензивной терапии. Неврология, нейропсихиатрия, психосоматика. 2012;4(1):96-101. [Parfenov VA, Verbitskaya SV, Starchina YuA. Antyhypertensive therapy-based secondary prevention of ischemic stroke. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(1): 96-101. (In Russ.)]. doi: 10.14412/2074-2711-2012-370

4. Парфенов ВА, Хасанова ДР. Ишемический инсульт. Москва: МИА; 2012. 288 с. [Parfenov VA, Khasanova DR. Ishemicheskii insul't [Ischemic stroke]. Moscow: MIA; 2012. 288 p.].

5. Фрис ЯЕ, Камчатнов ПР, Шелякина ЛА. Информированность населения о факторах риска сосудистых заболеваний головного мозга и клинических проявлений инсульта. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010;9(2):3-12. [Fris YaE, Kamchatnov PR, Shelyakina LA. Awareness about the risk factors of vascular diseases of the brain and the clinical manifestations of stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2010;9(2):3-12. (In Russ.)].

6. Luo F, Guo Y, Peng R, et al. Polypill-Based Therapy: A Promising Therapeutic Strategy. Heart Lung Circ. 2017 Mar 6. pii: S1443-9506 (17)30088-4. doi: 10.1016/j.hlc.2017.02.004.

7. Gupta S, Singh P, Sharma B, Sharma B. Neuroprotective Effects of Agomelatine and Vinpocetine Against Chronic Cerebral Hypoperfusion Induced Vascular Dementia. Curr Neurovasc Res. 2015;12(3):240-52.

8. 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.

9. Cai Y, Knight W, Guo S, et al. Vinpocetine suppresses pathological vascular remodeling by inhibiting vascular smooth muscle cell proliferation and migration. J Pharmacol Exp Ther. 2012; 343(2): 479-88. doi: 10.1124/jpet.112.195446.

10. Wang H, Zhang K, Zhao L, et al. Antiinflammatory effects of vinpocetine on the functional expression of nuclear factor-kappa B and tumor necrosis factor-alpha in a rat model of cerebral ischemia-reperfusion injury. Neurosci Lett. 2014 Apr 30;566:247-51. doi: 10.1016/j.neulet.2014.02.045. Epub 2014 Mar 2.

11. Shang Y, Wang L, Li Y, Gu P. Vinpocetine Improves Scopolamine Induced Learning and Memory Dysfunction in C57 BL/6J Mice. Biol Pharm Bull. 2016 Sep 1;39(9):1412-8. doi: 10.1248/bpb.b15-00881.

12. Stockburger C, Miano D, Pallas T, et al. Enhanced Neuroplasticity by the Metabolic Enhancer PiracetamAssociated with Improved Mitochondrial Dynamics and Altered Permeability Transition Pore Function. Neural Plast. 2016;2016:8075903.

13. Reddy PH, Manczak M, Mao P, et al. Amyloid-beta and mitochondria in aging and Alzheimer's disease: implications for synaptic damage and cognitive decline. J Alzheimers Dis. 2010;20 Suppl 2:S499-512. doi: 10.3233/JAD-2010-100504.

14. Waegemans T, Wilsher C, Danniau S, et al. Clinical efficacy of piracetam in cognitive impairment: a meta-analysis. Dement Geriatr Cogn Disord. 2002;13(4):217-24.

15. Winblad B. Piracetam: a review of pharmacological properties and clinical uses. CNS Drug Rev. 2005 Summer;11(2):169-82.

16. Fang Y, Qiu Z, Hu W, et al. Effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery: a metaanalysis. Exp Ther Med. 2014 Feb;7(2):429-434. Epub 2013 Nov 26.

17. Zhang J, Wei R, Chen Z, Luo B. Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. CNS Drugs. 2016 Jul;30(7):575-87. doi: 10.1007/s40263-016-0348-1.

18. Melnikov OA, Lilenko SV, Nauta J, Ouwens MJ. Betahistine plus piracetam dual therapy versus betahistine monotherapy for peripheral vestibular vertigo: a confounder-corrected subanalysis of the OSVaLD study. Curr Med Res Opin. 2015 Nov;31(11):1951-62. doi: 10.1185/03007995.2015.1067193. Epub 2015 Sep 16.

19. Старчина ЮА, Захаров ВВ. Недементные когнитивные нарушения: роль нейрометаболической терапии. Эффективная фармакотерапия. 2017;(3):8–18. [Starchina YuA, Zakharov VV. Non-dement cognitive impairment: the role of neurometabolic therapy. Effektivnaya farmakoterapiya. 2017;(3):8–18. (In Russ.)].

20. Захаров ВВ. Винпотропил в лечении дисциркуляторной энцефалопатии с додементными когнитивными нарушениями. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010;110(11):13-6. [Vinpotropil in the treatment of dyscirculatory encephalopathy with pre-dement cognitive impairment. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2010; 110(11):13-6. (In Russ.)].

21. Филимонов ВА, Клюева ВН, Кондрашова ИН. Винпотропил в лечении сосудистых заболеваний головного мозга. Журнал неврологии и психиатрии им. С.С. Корсакова. 2007;(2):52-6. [Filimonov VA, Klyueva VN, Kondrashova IN. Vinpotropil in the treatment of vascular diseases of the brain. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2007;(2):52-6. (In Russ.)].

22. Кузнецов АН, Даминов ВД. Применение Винпотропила в восстановительном лечении больных, перенесших церебральный инсульт. Лечение нервных болезней. 2008;(1):36-40. [Kuznetsov AN, Daminov VD. Application Vinpotropile in rehabilitation of patients after cerebral stroke. Lechenie nervnykh boleznei. 2008;(1):36-40. (In Russ.)].

23. Deshmukh R, Sharma V, Mehan S, et al. Amelioration of intracerebroventricular streptozotocin induced cognitive dysfunction and oxidative stress by vinpocetine – a PDE1 inhibitor. Eur J Pharmacol. 2009; 620(1-3): 49-56. doi: 10.1016/j.ejphar.2009.08.027.

24. Баранцевич ЕР, Посохина ОВ. Подходы к терапии неврологических проявлений сахарного диабета. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010;110(4): 63-6. [Barantsevich ER, Posokhina OV. Approaches to the treatment of neurological manifestations of diabetes. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2010;110(4):63-6. (In Russ.)].

25. Воробьева ОВ, Тамарова ЕС. Эффективность винпотропила в терапии ранних проявлений цереброваскулярной патологии. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010;110(9):39-44. [Vorob'eva OV, Tamarova ES. Efficacy of vinpotropil in the treatment of early manifestations of cerebrovascular disease Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2010;110(9):39-44. (In Russ.)].

26. Sweatt D. Neural plasticity and behavior – sixty years of conceptual advances. J Neurochem. 2016 Oct;139 Suppl 2:179-199. doi: 10.1111/jnc.13580. Epub 2016 Mar 10.

27. Albert S, Kesselring J. Neurorehabilitation of stroke. J Neurol. 2012 May;259(5):817-32. doi: 10.1007/s00415-011-6247-y. Epub 2011 Oct 1.

28. Fotuhi M, Lubinski B, Hausterman N, et al. A personalized 12-week «brain fitness program» for improving cognitive function and increasing the volume of hippocampus in elderly with mild cognitive impairment. J Prev Alz Dis. 2016; 3(3):133-7.

29. Teixeira C, Gobbi S, Pereira J, et al. Effects of square-stepping exercise on cognitive functions of older people. Psychogeriatrics. 2013 Sep;13(3):148-56. doi: 10.1111/psyg.12017.

30. Dimitriou T, Tsolaki M. Evaluation of the efficacy of randomized controlled trials of sensory stimulation interventions for sleeping disturbances in patients with dementia: a systematic review. Clin Interv Aging. 2017 Mar 17; 12:543-548. doi: 10.2147/CIA.S115397. eCollection 2017.

For citation:

Kamchatnov P.R., Evzelman M.A., Morozova Y.A. Chronic cerebral circulatory disorders: possibilities of enhancing the efficiency of therapy. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(3):105-110. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)