The heterogeneity of vascular cognitive impairments and the issues of therapy

Vascular cognitive impairments (CIs) are heterogeneous in the mechanism of their occurrence and may develop in different extent of brain damage, in different locations, and the number of foci. Their etiological factors are various. The mechanism for the development of CIs may be associated with impairments of both per se the structures responsible for cognitive functions (frontal cortex, subcortical-cortical interactions, and hippocampus) and deafferentation of the cortex and limbic structures due to periventricular white matter lesion or local lesion of the basal ganglia and thalamus. The pattern of CIs depends on the predominant involvement of cortical or subcortical regions or their combinations. The progression of CIs is also variable. In chronic cerebral circulatory insufficiency, CIs develop gradually over several years. Poststroke CIs manifest themselves acutely or subacutely. 6-27% of patients are diagnosed with dementia 3 months after acute cerebrovascular accident. The risk of subsequent dementia is 7% within the first year and 48% after 25 years.The paper reviews the most important trials of citicoline used in CIs. The drug has a multicomponent activity spectrum that permits its use in CIs of varying genesis. By taking into account its good tolerability and safety, the drug may be recommended for a wide circle of patients, including for elderly patients with comorbidity

Experience in using levodopa-benserazide

Levodopa remains the most effective drug for the treatment of Parkinson's disease. The paper considers the mechanism of action, recommended levodopa doses, the time of therapy initiation, and risk factors for motor complications. A few dosage forms of levodopa are currently being used. The results of comparative trials of levodopa-benserazide and levodopa-carbidopa and the clinical experience with Levodopa/Benserazide-Teva are given. An open-label multicenter trial of Levodopa/Benserazide-Teva has shown its high efficacy and good tolerability

Advanced Parkinson's or "complex phase" Parkinson's disease?:Re-evaluation is needed

Holistic management of Parkinson's disease, now recognised as a combined motor and nonmotor disorder, remains a key unmet need. Such management needs relatively accurate definition of the various stages of Parkinson's from early untreated to late palliative as each stage calls for personalised therapies. Management also needs to have a robust knowledge of the progression pattern and clinical heterogeneity of the presentation of Parkinson's which may manifest in a motor dominant or nonmotor dominant manner. The "advanced" stages of Parkinson's disease qualify for advanced treatments such as with continuous infusion or stereotactic surgery yet the concept of "advanced Parkinson's disease" (APD) remains controversial in spite of growing knowledge of the natural history of the motor syndrome of PD. Advanced PD is currently largely defined on the basis of consensus opinion and thus with several caveats. Nonmotor aspects of PD may also reflect advancing course of the disorder, so far not reflected in usual scale based assessments which are largely focussed on motor symptoms. In this paper, we discuss the problems with current definitions of "advanced" PD and also propose the term "complex phase" Parkinson's disease as an alternative which takes into account a multimodal symptoms and biomarker based approach in addition to patient preference.NT is supported by an academic educational grant from Britannia, UCB pharmaceuticals and the Parkinson’s Disease NonMotor Group.S

Promising directions for the use of pollen in preventive nutrition

The ways to solve a global problem - preventive-metabolic processes of the body through nutrition are discussed at the article. The purpose of the article is to substantiate promising directions for the use of bee pollen in nutrition. Samples of polyfloral pollen of various collections were selected: light (LPF), dark (DPF), lipophilic extract (LPI) and lyophilized extract (IZ). Complex lipids are studied. The expediency of the use of dark bee pollen in the diet for the prevention of diseases associated with metabolic disorders in the membranes of nerve cells, and light bee pollen for the prevention of diseases associated with protein metabolism disorders in the human body are proved

Post-stroke cognitive impairments

Post-stroke cognitive impairments are common effects of stroke. Vascular cognitive impairments are characterized by the heterogeneity of the neuropsychological profile in relation to the site and pattern of stroke. Their common trait is the presence of dysregulation secondary to frontal dysfunction. The treatment of vascular cognitive impairments should be multimodality and aimed at stimulating neuroplasticity processes, restoring neurotransmitter imbalance, and preventing recurrent vascular episodes

Genetic Markers as Risk Factors for the Development of Impulsive-Compulsive Behaviors in Patients with Parkinson’s Disease Receiving Dopaminergic Therapy

Impulsive–compulsive and related behavioral disorders (ICD) are drug-induced non-motor symptoms of Parkinson’s disease (PD). Recently research has focused on evaluating whether ICD could be predicted and managed using a pharmacogenetic approach based on dopaminergic therapies, which are the main risk factors. The aim of our study was to evaluate the role of candidate genes such as DBH, DRD2, MAOA, BDNF, COMT, SLC6A4, SLC6A3, ACE, DRD1 gene polymorphisms in the pathogenesis of ICD in PD. We compared patients with PD and ICD (n = 49), patients with PD without ICD (n = 36) and a healthy control group (n = 365). ICD was diagnosed using the QUIP questionnaires and specific diagnostic criteria for subtypes of ICD. Genotyping was conducted using a number of PCR techniques and SNaPshot. Statistical analysis was performed using WinPepi and APSampler v3.6 software. PCA testing was conducted using RStudio software v1.4.1106-5. The following substitutions showed statistically significant correlations with PD and ICD: DBH (rs2097629, rs1611115), DRD2 (rs6275, rs12364283, rs1076560), ACE (rs4646994), DRD1 (rs686), BDNF (rs6265), these associations are novel in Russian PD patients. Our findings suggest that polymorphisms in DBH, BDNF, DRD2, ACE genes in Russian subjects are associated with an increased risk of ICD development

COMPARATIVE ANALYSIS OF ACTOPROTECTIVE PROPERTIES OF NEW CHEMICAL COMPOUNDS

Aim. This study was aimed at searching and investigating new substances among phenylethyl derivatives of 3-hydroxypyridine, which exhibit a high actoprotective activity under the conditions of normoxia and acute hypobaric hypoxia.Materials and methods. New compounds of phenylethyl derivatives of 3-hydroxypyridine under the SC code (n = 23) were investigated in comparison with bemethyl and bromantane. The actoprotective activity of new compounds was assessed in experimental animals using a treadmill running test under the conditions of normoxia and acute hypobaric hypoxia. The studied chemical substances and comparative drugs were administered 1 hour prior to exposure of animals to the test. Statistical processing of the obtained experimental results was performed using Microsoft Excel and Statistica for Windows 6.0 software.Results. Among the studied substances, active compounds exhibiting an actoprotective effect have been distinguished. SC-119 chemical substance was revealed, which exceeds the other studied chemicals and bemethyl and bromantane reference actoprotectors in terms of the range of effective doses and actoprotective activity under the conditions of normoxia and acute hypobaric hypoxia.Conclusion. According to the results of the study, the SC-119 compound seems to be a prospective candidate for further research into highly effective actoprotective drugs