Neuropeptide therapy for cognitive disorders in the setting of the chronic cerebral ischemia
A.P. Rachin1, A.M. Tynterova2, M.B. Nuvakhova1, S.A. Rachin3
1National Medical Research Center for Rehabilitation and Health Resort Studies, Moscow
2Railway Hospital at Kaliningrad Station of the Russian Railways, Kaliningrad
3Pavlov First Saint Petersburg State Medical University
The article is devoted to domestic and foreign studies of the neuropeptide therapy application (exemplified by the drug Cerebrolysin) for cognitive disorders in patients with chronic cerebral ischemia.
Chronic cerebral ischemia, leading to structural and functional changes in white and gray matter along with neurodegenerative brain diseases, is the main cause of cognitive disorders. Over the years, scientists have focused on the study on severe cognitive disorders — vascular dementia and Alzheimer’s disease.
Nowadays, significant attention is paid to moderate (prior to dementia) cognitive sphere disorders — they are determined as the initial stage of vascular dementia and Alzheimer’s disease. The article demonstrates the Cerebrolysin effectiveness (mainly at 30 ml dosage, at least 20 infusions) during the therapy for moderate cognitive impairment and mild vascular and neurodegenerative dementia. Further research is needed in order to clearly determine the Cerebrolysin action mechanism in Alzheimer’s disease and vascular dementia treatment, including long-term tests and its further study in combination with cholinesterase inhibitors.
Keywords: cognitive disorders, chronic cerebral ischemia, Cerebrolysin.
For citation: Rachin A.P., Tynterova A.M., Nuvakhova M.B., Rachin S.A. Neuropeptide therapy for cognitive disorders in the setting of the chronic cerebral ischemia. RMJ. Medical Review. 2019;4(II):87–90.
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20. Ladurner G., Kalvach P., Moessler H. et al. Neuroprotective treatment with Cerebrolysin in patients with acute stroke: a randomized controlled trial. J Neural Transm. 2005;112:415–428.
21. Ruther E., Ritter R. Efficacy of the peptidergicnootropic drug Cerebrolysin in patients with senile dementia of the Alzheimer’s type (SDAT). Pharmacopsychiatrie. 1994;27(1):32–40.
22. Ruether E., Husmann R., Kinzler E. et al. A 28-week, double-blind, placebo-controlled study with Cerebrolysin in patients with mild to moderate Alzheimer’s disease. Int Clin Psychopharmacol. 2001;16:253–263.
23. Alvarez X.A., Cacabelos R., Laredo M. et al. A 24-week, double-blind, placebo-controlled study of three dosages of Cerebrolysin in patients with mild to moderate Alzheimer’s disease. Eur J Neurol. 2006;13(1):43–54.
24. Alvarez X.A., Cacabelos R., Sampedro C. et al. Efficacy and safety of Cerebrolysin in moderate to moderately severe Alzheimer’s disease: results of a randomized, double-blind, controlled trial investigating three dosages of Cerebrolysin. Eur J Neurol. 2011;18(1):59–68.
25. Bae C.Y., Cho C.Y., Cho K. et al. A double-blind, placebocontrolled, multicenter study of Cerebrolysin for Alzheimer’s disease. J Am Geriatr Soc. 2000;48(12):1566–1571.
26. Xiao S., Yan H., Yao P. Cerebrolysin Study Group. Efficacy of FPF 1070 (Cerebrolysin) in Patients with Alzheimer’s Disease. Clin. Drug Invest. 2000;19:43–53.
27. Plosker G.L., Gauthier S. Cerebrolysin: a review of its use in dementia. Drugs and Aging. 2009;26(11):893–915.
2. Cerebrovascular disease, cognitive impairment and dementia. Second edition of Cerebrovascular disease and dementia. Edited by O’Brien J., Ames D., Gustafson L. et al. Martin Dunitz; 2004.
3. Roman G.C., Sachdev P., Royall D.R. et al. Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia. J Neurol Sci. 2004;226(1–2):81–87.
4. Воробьева О.В., Камчатнов П.Р., Рачин А.П. Эффективность и безопасность нового нейротропного лекарственного препарата диваза в комплексной терапии хронической ишемии головного мозга. Эффективная фармакотерапия. 2014;31:62–68. [Vorobieva O.V., Kamchatnov P.R., Rachin A.P. Efficacy and safety of a new neurotropic drug divaza in the complex therapy of chronic cerebral ischemia. Effective pharmacotherapy. 2014;31:62–68 (in Russ.)].
5. Gauthier S., Touchon J. Subclassification of mild cognitive impairment in research and in clinical practice. Alzheimer’s Disease and Related Disorders Annual. 2004;61–70.
6. Erkinjuntti T., Gauthier S. The concept of vascular cognitive impairment. Front NeurolNeurosci. 2009;24:79–85.
7. Чуканова Е.И. Сравнительный анализ эффективности Церебролизина при лечении пациентов с хронической ишемией мозга. Фармакоэкономические аспекты. Трудный пациент. 2011;9(1):32–37. [Chukanova E.I. Comparative analysis of the effectiveness of Cerebrolysin in the treatment of patients with chronic cerebral ischemia. Pharmacoeconomic aspects. Difficult Patient. 2011;9(1):32–37 (in Russ.)].
8. Емелин А.Ю. Когнитивные нарушения при цереброваскулярной болезни. Неврология, нейропсихиатрия, психосоматика. 2014;(4):11–18. [Emelin A. Yu. Cognitive impairments in cerebrovascular disease. Nevrologiya, Neurology, Neuropsychiatry, Psychosomatics. 2014;(4):11–18 (in Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2014-4-11-18.
9. Яхно Н.Н., Локшина А.Б., Захаров В.В. Легкие и умеренные когнитивные расстройства при дисциркуляторной энцефалопатии. Клиническая геронтология. 2005;11(9):38–39. [Yakhno N.N, Lokshina A.B, Zakharov V.V. Light and moderate cognitive disorders in dyscirculatory encephalopathy. Klinicheskaya gerontologiya. 2005;11(9):38–39 (in Russ.)].
10. Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол. журн. 2006;11(1):4–12. [Yahno N.N. Cognitive disorders in the neurological clinic. Nevrol Journ. 2006;11(1):4–12 (InRuss.)].
11. Дамулин И.В. Болезнь Альцгеймера и сосудистая деменция. Под ред. H.Н. Яхно. М.; 2002. [Damulin I.V. Alzheimer’s disease and vascular dementia. Ed. H.N. Yahno. М.; 2002 (in Russ.)].
12. Xiao S., Yan H., Yao P. The efficacy of Cerebrolysin in patients with vascular dementia: Results of a Chinese multicentre, randomised, double-blind, placebo-controlled trial. Hong Kong Journal of Psychiatry. 1999;9(2):13–19.
13. Сорокина И.Б., Гудкова А.А., Гехт А.Б. Умеренные когнитивные расстройства при сосудистых заболеваниях головного мозга: диагностика и принципы терапии. Трудный пациент. 2010;8(3):9–13. [Sorokina I.B., Gudkova A.A., Hecht A.B. Moderate cognitive disorders in vascular diseases of the brain: diagnosis and principles of therapy. Difficult Patient. 2010;8(3):9–13 (in Russ.)].
14. Doody R.S., Stevens J.C., Beck C. et al. Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1154–1166.
15. Sommer H., Quandt J. Zur Wirkung eines Hirnhydrolysates auf zentral-nervoese Strukturen unter Berucksichtigung electronoptischer Ergebnisse. Schweiz Arch Neurol Neurochir Psychiat. 1973;112:373–386.
16. Верещагин Н.В., Лебедева Н.В. Легкие формы мультиинфарктной деменции: эффективность Церебролизина. Сов. мед. 1991;11:6–8. [Vereschagin N.V., Nekrasova E.M., Lebedova N.V. et al. Mild forms of multi-infarct dementia: effectiveness of cerebrolysin. Sov Med. 1991;(11):6–8 (in Russ.)].
17. Muresanu D.F., Heiss W.D., Hoemberg V. et al. A pilot study to evaluate the effects of Cerebrolysin on cognition and qEEG in vascular dementia: cognitive improvement correlates with qEEG acceleration. J Neurol Sci. 2008;267(1–2):112–119.
18. Muresanu D.F., Alvarez X.A., Moessler H. et al. Persistence of the effects of Cerebrolysin on cognition and qEEG slowing in vascular dementia patients: results of a 3-month extension study. J Neurol Sci. 2010;299(1–2):179–183.
19. Gheht A.B., Moessler H., Novak P.H., Gusev E.I. on behalf of the Cerebrolysin Investigators. Cerebrolysin in Vascular Dementia: Improvement of Clinical Outcome in Randomized, Double-Blind, Placebo-Controlled Multicenter Trial. J of Stroke and Cerebrovascular Diseases. 2010; 20 (4):310–318.
20. Ladurner G., Kalvach P., Moessler H. et al. Neuroprotective treatment with Cerebrolysin in patients with acute stroke: a randomized controlled trial. J Neural Transm. 2005;112:415–428.
21. Ruther E., Ritter R. Efficacy of the peptidergicnootropic drug Cerebrolysin in patients with senile dementia of the Alzheimer’s type (SDAT). Pharmacopsychiatrie. 1994;27(1):32–40.
22. Ruether E., Husmann R., Kinzler E. et al. A 28-week, double-blind, placebo-controlled study with Cerebrolysin in patients with mild to moderate Alzheimer’s disease. Int Clin Psychopharmacol. 2001;16:253–263.
23. Alvarez X.A., Cacabelos R., Laredo M. et al. A 24-week, double-blind, placebo-controlled study of three dosages of Cerebrolysin in patients with mild to moderate Alzheimer’s disease. Eur J Neurol. 2006;13(1):43–54.
24. Alvarez X.A., Cacabelos R., Sampedro C. et al. Efficacy and safety of Cerebrolysin in moderate to moderately severe Alzheimer’s disease: results of a randomized, double-blind, controlled trial investigating three dosages of Cerebrolysin. Eur J Neurol. 2011;18(1):59–68.
25. Bae C.Y., Cho C.Y., Cho K. et al. A double-blind, placebocontrolled, multicenter study of Cerebrolysin for Alzheimer’s disease. J Am Geriatr Soc. 2000;48(12):1566–1571.
26. Xiao S., Yan H., Yao P. Cerebrolysin Study Group. Efficacy of FPF 1070 (Cerebrolysin) in Patients with Alzheimer’s Disease. Clin. Drug Invest. 2000;19:43–53.
27. Plosker G.L., Gauthier S. Cerebrolysin: a review of its use in dementia. Drugs and Aging. 2009;26(11):893–915.
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