Correction of cognitive dysfunction in chronic brain ischemia

Maintenance of cognitive health and prevention of cognitive dysfunction (CD) in chronic brain ischemia (CBI) is a critical scientific and public health priority, as these impairments create barriers to healthy aging, reduce the quality of life of the elderly, and lead to chronic disability. A promising direction in the treatment of cognitive disorders is to create metabolic protection of the brain against ischemia by directly affecting the brain’s neurotransmitter and neuromodulator systems, provided that the ratio of excitatory and inhibitory neurotransmission processes is normalized.

The purpose of the study: assessment of the dynamics of correction of CD and reduction of concentration of attention in patients with CBI with the help of hopanthenic acid (the drug Kognum), confirmation of the effectiveness and safety of the use of this drug.

The object and methods of the study. 100 patients with cognitive impairment on the background of CBI were examined, who were divided into 2 groups: the 1^st group took hopanthenic acid (the drug Kognum) 1 tablet 3 times a day for 2 months, 2^nd — the control group. The presence of cognitive decline in patients was detected using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (МОСА); impaired concentration of attention — using the Zazzo’s Cancellation Task (ZCT). Examinations were carried out on the 1^st day of hospitalization, on the 30^th and 60^th day. Side effects of the drug were determined during the entire period of observation.

Results. Against the background of the therapy in the main group, there was an improvement in the condition and a decrease in CD according to the MMSE by 6.8 points in 1st group and by 3.0 points in 2nd group, according to the МОСА CD regressed by 6.8 points in the main group, in compared with the control group, the decrease in scores was 3.2 points. Also, patients who received hopanthenic acid in the ZCT test registered a significant increase in the speed of performance of the task and a decrease in errors, which indicates an increase in concentration of attention and an improvement in working capacity in general, compared to the control group.

Conclusion. The obtained results testify to the effectiveness of the use of hopanthenic acid (the drug Kognum) for the purpose of correcting CD in patients with CBI. The use of the drug was not accompanied by the presence of pronounced side effects and was safe.

References

1. Зозуля І.С., Волосовець А.О., Пархоменко Б.Л. (2023) Щодо деяких захворювань та станів, які можуть бути причиною гострого порушення мозкового кровообігу. Укр. мед. часопис, 2(154): 71–73.

2. Бурчинський С.Г. (2022) Стрес, когнітивні порушення та хронічна ішемія головного мозку: як розірвати хибне коло? Здоров’я України, 12(529): 32–33.

3. Черній Т.В., Фокіна Д.О., Черній В.І. (2020) Комплексне лікування хворих з хронічною ішемією мозку, цілеспрямована корекція когнітивних порушень та відновлення рухових функцій після перенесеного мозкового інсульту. Клін. проф. мед., 4(14): 33–43.

4. Fulop G.A., Tarantini S., Yabluchanskiy A. et al. (2019) Role of age-related alterations of the cerebral venous circulation in the pathogenesis of vascular cognitive impairment. Am. J. Physiol. Heart Circ. Physiol., 316(5): H1124–H1140.

5. Giorelli M. (2023) Current and future perspectives of an early diagnosis of cognitive impairment. Front. Neurol., 14: 1171681. DOI: 10.3389/fneur.2023.1171681.

6. McKenzie A.T., Marx G.A., Koenigsberg D. et al. (2022) Interpretable deep learning of myelin histopathology in age-related cognitive impairment. Acta Neuropathol. Commun., 10(1): 131. DOI: 10.1186/s40478-022-01425-5.

7. Rundek T., Tolea M., Ariko T. et al. (2022) Vascular Cognitive Impairment (VCI). Neurotherapeutics, 19(1): 68–88. DOI: 10.1007/s13311-021-01170-y.

8. Ungvari Z., Toth P., Tarantini S. et al. (2021) Hypertension-induced cognitive impairment: from pathophysiology to public health. Nat. Rev. Nephrol., 17(10): 639–654.

9. Khan S., Barve K.H., Kumar M.S. (2020) Recent Advancements in Pathogenesis, Diagnostics and Treatment of Alzheimer’s Disease. Curr. Neuropharmacol., 18(11): 1106–1125. doi: 10.2174/1570159X18666200528142429.

10. Живолупов C.А., Самарцев И.Н., Сыроежкин Ф.А. (2013) Современная концепция нейропластичности (теоретические аспекты и практическая значимость). Журн. неврол. психиатр., 113(10): 102–108.