scholarly journals Vascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy)

2019 ◽  
Vol 11 (3S) ◽  
pp. 61-67 ◽  
Author(s):  
V. A. Parfenov
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Emotional Disorders ◽  
Blood Lipid ◽  
Vascular Cognitive Impairment ◽  
Considerable Proportion ◽  
Secondary Headache ◽  
Chronic Cerebral Ischemia ◽  
Dyscirculatory Encephalopathy ◽  
Blood Clots

The paper reviews the literature on vascular cognitive impairment (VCI), the diagnosis widely used in foreign neurological practice, as well as chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP), the common diagnoses in Russian neurological practice. According to the etiology, risk factors, and manifestations, Stages I and II DEP largely corresponds to moderate VCI; Stage III DEP does to severe VCI. The results of the author’s studies show that a considerable proportion of patients followed up with a diagnosis of CCI, DEP, have no signs of chronic cerebrovascular disease (CVD), but suffer from primary or secondary headache, vertigo of various origins, emotional disorders, and other diseases. The diagnosis of CCI, DEP should be based on the presence of CCI, the reliable neuroimaging signs of chronic CVD, and the ruling out of other diseases. When treating and preventing VCI, CCI, and DEP, a premium is placed upon both non-drug (regular physical activity, smoking cessation, rational nutrition) and drug therapy aimed at normalizing blood pressure and blood lipid spectrum, preventing blood clots, and improving cognitive functions.

scholarly journals Chronic cerebrovascular diseases: use of vinpocetine in neurological practice (Round Table proceedings)

2018 ◽  
Vol 10 (4) ◽  
pp. 139-145 ◽  
Author(s):  
V. A. Parfenov ◽  
S. A. Zhivolupov ◽  
V. V. Zakharov ◽  
L. A. Belova ◽  
O. V. Lagoda ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Neurological Diseases ◽  
Round Table ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Chronic Cerebral Ischemia ◽  
Dyscirculatory Encephalopathy ◽  
Clinical Presentations

The paper presents the proceedings of the Round Table with the participation of leading neurologists, which is devoted to chronic cerebrovascular diseases. It is noted that chronic cerebral ischemia (CCI), or dyscirculatory encephalopathy (DEP), is one of the most common neurological diagnoses in our country. The pathogenesis, clinical presentations, diagnosis and treatment of CCI (DEP) and its matching with vascular cognitive impairment (CI), which is regarded in foreign literature as the main manifestation of chronic cerebrovascular disease (CVD) were considered. The authors analyze clinical trials evaluating the efficacy of vinpocetine (Cavinton) in chronic CVD, dizziness, CI, as well as the use of new vinpocetine formulations, such as Cavinton Comforte, in various neurological diseases, dysphagia in particular, in poststroke patients.

scholarly journals Clinical manifestations and issues of diagnosis of chronic cerebrovascular disease (chronic cerebral ischemia) at an early (pre-dementia) stage

2021 ◽  
Vol 13 (1) ◽  
pp. 4-12
Author(s):  
A. A. Kulesh ◽  
A. Yu. Emelin ◽  
A. N. Bogolepova ◽  
O. B. Doronina ◽  
V. V. Zakharov ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Cerebrovascular Disease ◽  
Emotional Disorders ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Chronic Cerebral Ischemia ◽  
Common Diagnosis ◽  
Long Time ◽  
Vestibular Vertigo

The paper presents experts' opinion on the clinical manifestations and diagnosis of chronic cerebrovascular disease (CVD) (chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP)) at the pre-dementia stage. It is noted that DEP/CCI is a common diagnosis in Russian neurological practice, the criteria for which have not been updated for a long time. DEP/CCI most often develops in the presence of cerebral small artery (CSA) disease (cerebral microangiopathy (CMA)), the severity of which can be quantified by magnetic resonance imaging. The main clinical manifestation of DEP/CCI is cognitive impairment that may be subjective or moderate at the pre-dementia stage. Emotional disorders (apathy, depression, anxiety) and instability are considered as possible manifestations of CSA disease. It is noted that headache and vestibular vertigo are not caused by chronic CVD; while in patients with CMA, they are usually associated with other diseases (primary headache, peripheral vestibular vertigo, and vestibular migraine). The diagnosis of DEP/CCI should be based on the presence of cognitive impairment, reliable neuroimaging signs of CVD, and the exclusion of another cause of cognitive impairment.

scholarly journals Improving the management of patients with a diagnosis of chronic cerebral ischemia

2020 ◽  
pp. 11-17
Author(s):  
V. A. Parfenov
Keyword(s):  
Cognitive Function ◽  
Cerebral Ischemia ◽  
Effective Treatment ◽  
Emotional Disorders ◽  
Primary Headaches ◽  
Secondary Headache ◽  
Observation Data ◽  
Vertebrobasilar Insufficiency ◽  
Chronic Cerebral Ischemia ◽  
Therapeutic Exercises

The diagnosis of сhronic cerebral ischemia is widely used in domestic neurological practice. A significant part of the patients observed with a diagnosis of сhronic cerebral ischemia suffer from primary or secondary headache, dizziness of various origins, emotional disorders and other diseases that are not diagnosed and therefore do not have effective treatment. Improving the management of patients with a diagnosis of сhronic cerebral ischemia requires the diagnosis and treatment of other diseases that are erroneously defined as сhronic cerebral ischemia. The observation data of 90 patients are analyzed, in which the identification of primary headaches (chronic migraine, chronic tension headache) and drug-induced headache allowed an adequate and effective combination treatment, including rational pharmacotherapy, educational conversations, cognitive-behavioral therapy sessions, relaxation classes and therapeutic exercises, with a pronounced positive effect. The results of a survey of 700 patients are discussed, in which the identification of the causes of dizziness (benign paroxysmal positional vertigo, Meniere’s disease, vestibular neuronitis, emotional disorders with instability) made it possible to carry out effective treatment, while most patients were observed for a long time with a diagnosis of chronic cerebral ischemia or vertebrobasilar insufficiency. In the management of patients with vascular cognitive impairment, which is the main clinical manifestation of chronic cerebrovascular disease, the leading role is given to both non-drug methods (regular physical activity, smoking cessation) and drug therapy aimed at normalizing blood pressure and blood lipid spectrum, preventing blood clots and improving cognitive function. The possibilities of naftidrofuril and nimodipine as drugs for improving cognitive function are discussed.

scholarly journals Longitudinal tracing of neurochemical metabolic disorders in working memory neural circuit and optogenetics modulation in rats with vascular cognitive impairment

2020 ◽  
Author(s):  
Huawei Lin ◽  
Tingting Jin ◽  
Lewen Chen ◽  
Yaling Dai ◽  
Weiwei Jia ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Gray Matter ◽  
Metabolic Disorders ◽  
Neural Circuit ◽  
Vascular Cognitive Impairment ◽  
Chronic Cerebral Ischemia ◽  
Mediodorsal Thalamus ◽  
Ischemia Time

Abstract Objective: Chronic cerebral ischemia leads to vascular cognitive impairment (VCI) that exacerbates along with ischemia time and eventually develops into dementia. Recent advances in molecular neuroimaging contribute to understand its pathological characteristics. We previously traced the anisotropic diffusion of water molecules suggests that chronic cerebral ischemia leads to irreversible progressive damage to white matter integrity. However, the abnormalities of gray matter activity following chronic cerebral ischemia remains not entirely understood.Methods: In this study, in vivo hydrogen proton magnetic resonance spectroscopy (1H-MRS) was applied to longitudinally track the neurochemical metabolic disorder of gray matter associated with working memory, and optogenetics modulation of neurochemical metabolism was performed for targeted treatment of VCI. Results: The results showed that the concentration of N-acetylaspartate (NAA) in the right hippocampus, left hippocampus, right medial prefrontal cortex (mPFC) and mediodorsal thalamus was decreased as early as 7 days after chronic cerebral ischemia, subsequently gamma-aminobutyric acid (GABA) declined whereas myo-inositol (mI) and glutamate (Glu) increased at 14 days, as well as choline (Cho) lost at 28 days, concurrently the change of Glu and GABA in the mPFC and hippocampus was ischemia time-dependent manner within 1 month. Behaviorally, working memory and object recognition memory were impaired at 14 days, 28 days that significantly correlated with neurochemical metabolic disorders. Interestingly, using optogenetics modulation of PV neurons in the mPFC, the metabolic abnormalities of NAA and GABA in working memory neural circuit could be repaired after chronic cerebral ischemia, together with behavior improvements. Conclusions: These findings suggested that as early as 1~4 weeks after chronic cerebral ischemia, the metabolism of NAA, Glu, mI and Cho was synchronously impaired in neural circuit of hippocampus-mediodorsal thalamus-mPFC, and the loss of GABA delayed in the hippocampus, and optogenetics modulation of parvalbumin (PV) neurons in the mPFC can improve the neurochemical metabolism of working memory neural circuit and enhance working memory.

scholarly journals Cognitive functions, quality of life in patients with dyscirculatory (vascular) encephalopathy II stage in northerners from the position of ICF

2021 ◽  
Vol 27 (3) ◽  
pp. 351-364
Author(s):  
E. D. Yakovchuk ◽  
G. O. Penina
Keyword(s):  
Quality Of Life ◽  
Cerebral Ischemia ◽  
Emotional Disorders ◽  
Cognitive Functions ◽  
Komi Republic ◽  
International Classification Of Functioning ◽  
Chronic Cerebral Ischemia ◽  
Sf 36

Objective. The aim of the study was to analyze cognitive functions, emotional disorders, the quality of life with the application of the International Classification of Functioning (ICF) in patients with chronic cerebrovascular diseases, dyscirculatory (vascular) encephalopathy II stage in the Komi Republic. Design and methods. In the clinics of the Komi Republic, we examined 126 people (mean age — 65,8 ± 10,1 years; women comprised 76 participants, 60,3 %, p ≤ 0,05) with dyscirculatory (vascular) encephalopathy. Complaints and anamnesis were analyzed, somatic and neurological status, cognitive functions, emotional status, and sleep were assessed. Results. Out of 126 patients, 44,5 % patients are employed (56 people). Among non-working patients with an established group of disability, 35,7 % (in 14,3 % disability 2nd degree (10 people), in 21,4 % — disability 3rd degree (15 people), p ≤ 0,05). Among the workers, 3 people (5,3%) had disability 3rd degree. Hypertension (HTN) I stage was detected in 10,6 %, HTN II stage — in 44,4 %, HTN III stage — in 45 % (p ≤ 0,05); 27,8 % had history of ischemic heart disease, 7,2 % — myocardial infarction, 19,1% — cerebrovascular accident, 8,6% — heart rhythm disturbances, 15,8 % — significant stenosis of the brachiocephalic arteries. Based on memory function assessment by ICF, none demonstrated normal results. Mild cognitive impairment was usually found, and there was no case of dementia. Dysfunction in the domain of blood pressure function was found in all patients. The dysfunction of blood vessels was found in all patients with chronic cerebral ischemia II stage. Daily activities were reduced due to the physical dysfunction. According to the total assessment of health status by the SF-36 scale, the physical and mental components of health were similarly decreased. Conclusions. The SF-36 (questionnaire for assessing the quality of life) and ICF (International Classification of Functioning, Disabilities and Health) complement each other. Cognitive scales are the basic tools for examination of patients with chronic cerebral ischemia, making diagnosis according to ICF, and treating cognitive, physical and emotional disorders in dyscirculatory (vascular) encephalopathy.

scholarly journals Transplantation of Stem Cells from Human Exfoliated Deciduous Teeth Decreases Cognitive Impairment from Chronic Cerebral Ischemia by Reducing Neuronal Apoptosis in Rats

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Shu Zhu ◽  
Dongyu Min ◽  
Jianhong Zeng ◽  
Yetao Ju ◽  
Yao Liu ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Neuronal Apoptosis ◽  
Deciduous Teeth ◽  
Stem Cell Population ◽  
Chronic Cerebral Ischemia ◽  
Nervous Disease ◽  
Human Exfoliated Deciduous Teeth

Stem cells from human exfoliated deciduous teeth (SHED) are a unique postnatal stem cell population with high self-renewal ability that originates from the cranial neural crest. Since SHED are homologous to the central nervous system, they possess superior capacity to differentiate into neural cells. However, whether and how SHED ameliorate degenerative central nervous disease are unclear. Chronic cerebral ischemia (CCI) is a kind of neurological disease caused by long-term cerebral circulation insufficiency and is characterized by progressive cognitive and behavioral deterioration. In this study, we showed that either systemic transplantation of SHED or SHED infusion into the hippocampus ameliorated cognitive impairment of CCI rats in four weeks after SHED treatment by rescuing the number of neurons in the hippocampus area. Mechanistically, SHED transplantation decreased the apoptosis of neuronal cells in the hippocampus area of CCI rats through downregulation of cleaved caspase-3. In summary, SHED transplantation protected the neuronal function and reduced neuronal apoptosis, resulting in amelioration of cognitive impairment from CCI. Our findings suggest that SHED are a promising stem cell source for cell therapy of neurological diseases in the clinic.

scholarly journals Cognitive and motor training for patients with moderate cognitive impairment and mild dementia

2018 ◽  
Vol 10 (4) ◽  
pp. 81-87 ◽  
Author(s):  
A. A. Naumenko ◽  
I. S. Preobrazhenskaya
Keyword(s):  
Cognitive Impairment ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Vascular Cognitive Impairment ◽  
Motor Training ◽  
Symptomatic Therapy ◽  
Additional Method ◽  
Individual Group ◽  
Mild Dementia ◽  
Moderate Dementia

Objective:to investigate the effectiveness of cognitive and motor training as an additional method to basic therapy in patients with Alzheimer's disease (AD) and vascular cognitive impairment (VCI).Patients and methods. The investigation enrolled 41 patients (15 women and 26 men; mean age. 73.59+6.3 years), including 32 patients with AD (mean age 74.94+5.15 years) and 9 patients with VCI (mean age, 72.31+4.98 years). Cognitive impairment (CI) corresponded to mild dementia in 15patients (5 women and 10 men; mean age 74.6+2.8years) and to moderate dementia in 29 (10 women and 19 men; mean age 72.1+3.2 years). The patients were randomly assigned to individual, group, and mixed (individual and then group) cognitive training groups. Quantitative scales were used to assess changes in CI and emotional and behavioral disorders after 1.5, 3, and 6 months of therapy.Results and discussion. During cognitive and motor training, all the groups showed a significant decrease in the severity of CI (p < 0.05), depression, anxiety, and apathy. The effectiveness of the training was further influenced by the severity of concomitant cardiovascular disease, the degree of apathy, adherence to the training, and the early initiation of basic symptomatic therapy.The greatest positive changes in anxiety and depressive disorders were noted in the patients receiving group cognitive and motor training.Conclusion. The results of the investigation allow group cognitive and motor training to be recommended as a mainstay in the therapy of patients with CI concurrent with emotional disorders.

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