Clinical Efficacy of Piracetam in the Management of Acute Stroke and Post-Stroke Sequelae: An Expert Panel Review and Opinion

Stroke is a major cause of death worldwide. Prompt treatment and decision-making is essential for good outcomes. The two major therapeutic approaches for acute ischemic stroke are thrombolytics and neuroprotectants. Piracetam, a nootropic drug aims to increase cerebral blood flow, enhance oxygen extraction, restore membrane fluidity and modulate neurotransmission. Likewise, citicoline has been shown to positively influence cerebral plasticity and neurorepair processes. The present article aims to offer insights on the current management of acute stroke and to position piracetam and its combination with citicoline in the management of acute stroke and post-stroke sequelae based on an expert panel discussion.

An open-label, randomized study to unfold the potential of Ficus benghalensis in modulation of cognitive impairment using diabetic (Streptozotocin induced) rats

Background: Diabetes mellitus is associated with cognitive, neurophysiological, and structural changes in the central nervous system. Aim and Objective: The aim of the study was to evaluate the effect of Ficus benghalensis on cognitive behavior and acetylcholinesterase levels in brain of diabetic rats, and to compare with Piracetam and Glimepiride. Material and Methods: Wistar rats of either sex weighing 150–200 g were randomized into ten groups of ten each (five groups of diabetic rats and five groups of non-diabetic rats) where one group of diabetic and one group of non-diabetic rats each received F. benghalensis dose I (50 mg/kg), F. benghalensis dose II (100 mg/kg), Piracetam (200 mg/kg) and Glimepiride (0.5 mg/kg), and one group of diabetic rats and one group of non-diabetic rats served as the control group. The blood glucose levels were assessed at 0 and 30th days. The assessment of acquisition phase of each cognitive behavior test was done on 0, 14th, and 29th days, whereas retention phase was assessed on 1st, 15th, and 30th days. Results: In comparison with diabetic control group, F. benghalensis at both doses showed significant decrease in blood glucose levels as well as acquisition and retention of Transfer Latency in elevated plus maze on 29th and 30th days, respectively. Further, both doses exhibited significant increase in retention of step-down latency (SDL) on 30th in continuous avoidance apparatus, but only dose II showed significant increase in acquisition of SDL on 29th day. Similarly, significant increase in retention of Quadrant-time in Morris Water Maze was also observed with both doses of F. benghalensis and other groups compared to controls on 30th day. However, significant decrease in brain AChE level, was observed with only F. benghalensis dose II. Conclusion: Overall, the positive effects of F. benghalensis on cognition were comparable to other two groups, namely, Piracetam and Glimepiride. Hence, it can be concluded that F. benghalensis might be effective in alleviating the behavioral and biochemical changes in diabetes mellitus.

Piracetam-induced neuroprotection in lipopolysaccharides-challenged EOC-20 cells and mouse brain via attenuating oxidative stress

Abstract Therapeutically, piracetam has been used for decades as a cognitive enhancer for memory- related neuronal disorders. The present study aimed to investigate the neuroprotective potential of piracetam on lipopolysaccharides (LPS)-induced neuronal deficit using both in-vitro and in-vivo experimental models. For the in-vitro analysis, EOC-20 murine microglial cells were induced with a neuronal toxicity of 100 µg/ml of LPS, and the formation of intracellular reactive oxygen species (ROS) and nitric oxide (NO) productions were determined. For in-vivo neuroprotective analysis, groups of mice were treated orally with two doses of piracetam (200 and 400 mg/kg) for 30 days. Neuronal toxicity was induced by four intraperitoneal injections of LPS (250 µg/kg/day). The malondialdehyde (MDA) level was measured for oxidative stress, and catalase reduced glutathione (GSH), glutathione reductase (GRD), and superoxide dismutase (SOD) levels were determined as the antioxidant parameters. The result of the cell viability study was that pre-treatment with piracetam significantly protected the LPS-induced cell loss, and attenuated the ROS generation and NO production in LPS-induced EOC-20 cells. Moreover, the treatment of piracetam significantly reduced the MDA levels and improved catalase, GSH, GRD, and SOD activities in LPS-induced mice brains. The overall results from this study supported the neuroprotective effects of piracetam against LPS-induced neuronal toxicity.

Evaluation of learning and memory effect of atorvastatin and simvastatin in alprazolam induced amnesia in mice

Background: The study was undertaken to evaluate the learning and memory effect of lipid lowering drugs atorvastatin and simvastatin in alprazolam induced amnesic mice.Methods: The study was carried out on albino mice, divided into 4 groups of 6 animals each (either sex, 3-4 months of age, weight 25-30g). Amnesia was induced by administering Alprazolam (2mg/kg for 14 days) in all 4 groups from 1st to 14th day. In addition, group 2, 3 and 4 received Piracetam (400mg/kg), Atorvastatin (5mg/kg) and Simvastatin (5mg/kg) from 8th to 14th day respectively. The learning and memory of the animals was assessed by employing Elevated plus maze (EPM) and Step-down type passive avoidance (SDA) model.Results: Results were compared among the different groups using one way-ANOVA followed by post hoc Tukey’s test. The measured parameters were compared with standard drug Piracetam. In EPM model Atorvastatin (p<0.049) and Simvastatin (p<0.007) were comparable with standard drug Piracetam, whereas in SDA model only simvastatin group (p<0.001) showed significant result.Conclusions: In EPM model, both the statins showed significant improvement in learning and memory in alprazolam induced amnesic mice. However further studies are required to support these observations.

Observation on therapeutic effect of Laci Staw combined with nimodipine on vascular dementia after cerebral infarction / 中国生化药物杂志

Objective To observe the effect of nimodipine combined with nimodipine on cerebral vascular dementia after cerebral infarction.MethodsFrom February 2009 to March 2012, 32 patients with vascular dementia after cerebral infarction were selected in Beijing Chaoyang hospital.Among them, there were 19 males and 13 females, aged 63~84 years old.The patients were randomly divided into two groups, each group of 16 patients.The patients in the treatment group were treated with oral nimodipine combined with Piracetam Tablets.ResultsThe effective rate of the treatment group was 93.8%, the adverse reaction rate was 6.3%, while the control group was effective, the adverse reaction rate was 18.8%, the difference between the two groups was significant (P<0.05).ConclusionIn the treatment of patients with vascular dementia after cerebral infarction, the use of nimodipine combined with nimodipine has significant curative effect and less adverse reaction rate, which is worthy of clinical application.

Comparison on effects of piracetam and oxiracetam on elderly cognitive dysfunction after cerebral hemorrhage / 药物评价研究

Objective To compare the effects of piracetam and oxiracetam on elderly cognitive dysfunction after cerebral hemorrhage.Methods Elderly patients (82 cases) with cerebral hemorrhage treated in Tongchuan People's Hospital from January 2012 to December 2015 were selected and divided into two groups according to the different treatment drugs.Two groups were treated by oxiracetam and piracetam respectively.The Montreal cognitive assessment scale (MoCA),simple mental state examination (MMSE),and daily life ability scale (ADL) score of the two groups before and after treatment were compared.The neuron-specific enolase levels and cognitive function after treatment of 1,3,and 6 months were also compared.Results After treatment,MoCA,MMSE,and ADL scores of two groups were significantly improved (P ＜ 0.05),and oxiracetam group were significantly better than piracetam group (P ＜0.05).After treatment 6 months,MoCA,MMSE,ADL effective and total effective rate of the two groups were significantly higher (P ＜0.05),and oxiracetam group were significantly better than those ofpiracetam group (P ＜ 0.05).After treatment for 1,3,and 6 months,the neuron-specific enolase levels were significantly lower than those before treatment (P ＜ 0.05),and in the treatment of 3 and 6 months,oxiracetam group were significantly lower than piracetam group (P ＜ 0.05).The incidence of adverse reactions had no significant difference.Conclusion Oxiracetam can improve the elderly cognitive dysfunction after cerebral hemorrhage,the curative effect was increased with the prolonging of the time,and can reduce the neuron-specific enolase levels,which has high clinical value.

Observation of the effect of piracetam combined with edaravone in the treatment of patients with acute cerebral infarction / 中国基层医药

Objective To investigate the clinical efficacy of piracetam combined with edaravone in the treatment of patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were selected,and they were randomly divided into control group and observation group according to the digital table,60 cases in each group.The patients in both two groups were treated with mannitol to reduce intracranial pressure,aspirin antiplatelet aggregation,combined with basic nutritional support,active prevention and treatment of complications.The control group was intravenously given piracetam.On this basis,the observation group was intravenously given edaravone injection.Both two groups were treated for 14 days.The clinical curative effect,neurological deficit and self-care ability score before and after treatment were observed,and the indicators of hemorheology before and after treatment were observed.Results Mter treatment,the neurological deficit and self-care ability scores of the two groups were significantly improved(t =3.43,4.12,5.67,6.89,all P ＜ 0.05),the improvements of the observation group were significantly better than those of the control group(t =2.10,4.21,all P ＜ 0.05).The total effective rate of the observation group was 85.00％,which was higher than 70.00％ of the control group,the difference was statistically significant (x2 =4.11,P ＜ 0.05).After treatment,the indicators of hemorheology of the two groups were significantly improved (t =1.43,2.98,2.32,4.56,1.67,2.11,1.46,1.98,all P ＜ 0.05),and the improvements of the observation group were significantly better than those of the control group (t =1.46,2.32,1.67,1.39,all P ＜ 0.05).Conclusion Piracetam combined with edaravone can significantly improve the neurological function,cognitive function and hemorheology of patients with acute cerebral infarction.

Effect of piracetam combine with hyperbaric oxygen in treatment of acute carbon monoxide poisoning patients with electrocardiogram and its effects on Lactate clearance / 中国生化药物杂志

Objective To study effect of piracetam combine with hyperbaric oxygen in treatment of acute carbon monoxide poisoning patients with electrocardiogram and its effects on Lactate clearance.Methods 60 patients of acute carbon monoxide poisoning who received therapy from February 2011 to February 2016 in our hospital were selected as research objects.All accord with the diagnostic criteria of acute carbon monoxide poisoning.According to draw method,those patients were divided into the experimental group(n=30)and the control group(n=30).The two groups were given a large number of sustained oxygen,intracranial pressure,protect brain cells,promote blood circulation and improve microcirculation and other basic symptomatic treatment.The control group on the basis,was treated with hyperbaric oxygen,one times a day,a total of ten times.while the experimental group was treated with piracetam combine with hyperbaric oxygen,hyperbaric oxygen method with the control group,intravenous drip of Piracetam and Sodium Chloride Injection,each 100ml,two times a day,a total of treatment for ten days.Then abnormal ECG,creatine kinase isoenzymes(CK-MB),troponin(cTnl),lactate clearance,incidence of delayed encephalopathy,mortality,therapeutic effect of two groups were compared.Results ECG abnormal rate there was no difference between the two groups before treatment,after treatment,the abnormal rate of the experimental group was significantly lower than the control group [6.66(2/30)vs.33.33％(10/30)](P<0.05); CK-MB、cTnl、6h and 24h after treatment,Lactate clearance rate was significantly higher than control group[(15.80±2.03)％vs.(10.26±2.01)％,(20.75±3.12)％vs.(13.07±2.56)％](P<0.05);DEACMP rate and mortality was significantly lower than the control group[6.66％(2/30)vs.33.33％(10/30),3.33％(1/30)vs.30.00％(9/30)](P<0.05); The total effective rate was significantly higher than the control group[95.56％(28/30)vs.75.56％(22/30)](P<0.05).Conclusion Piracetam combine with hyperbaric oxygen is well for acute carbon monoxide poisoning,which can improve the clearance rate of lactic acid,improve hypoxia and myocardial injury,and reduce the abnormal ecg.

Improvement of determination of related substances in piracetam and its injection by HPLC / 中国生化药物杂志

Objective To improve and establish an RP-HPLC method for the determination of related substances of piracetam and its injection. Methods Using thermo syncronis C18(4.6 mm ×250 mm,5μm)chromatographic column, mobile phase was acetonitrile-phosphate buffer (adjust pH of 1.0 g/L potassium hydrogen phosphate solution to 6.0 with phosphoric acid), gradient elution with initial mobile phase 5% acetonitrile.The flow rate was 1 mL/min, detected at 205 nm.Five calibration factors of the known impurities were separately measured.the related substances were determined using main component self-compare with calibration factor.Results Piracetam and their related substances were well separated.The calibration curves of five known impurity A~E were linear within the concentration range measured.The average recoveries were 99.46%,98.21%,97.22%,100.23% and 97.58%, respectively(n=9), RSDs of the average recoveries were lower than 2.0%.The calibration factors of five known impurity A ~E were 1.1, 1.4,1.5,0.8, 1.4, respectively.Conclusion The method can be used to determine the related substances in piracetam and its injection.The related substances can be determined accurately using main component self-compare with calibration factor.

Intervention experience of phlebitis caused by Laci Staw / 中国生化药物杂志

Objective factors and nursing interventions of phlebitis caused by Laci Staw's observation, evaluate its clinical effect. Methods From March 2014 to February 2017 as the study period, 71 cases of piracetam during this period were induced phlebitis were set as the research object, were given drug treatment and nursing intervention, summarize the clinical nursing experience. Results The treatment and nursing of the patients after 10d showed that the cure rate was 70.49% (43/61), effective rate was 29.51% (18/61), and all patients had no adverse reaction symptoms. Conclusion In the patients given piracetam treatment should pay attention to the occurrence of phlebitis, close observation of local reaction, to do preventive work, when patients have the symptoms should be promptly given Magnesium Sulfate, transparent paste, proper, effective nursing intervention, help to improve the clinical treatment effect, reduce the suffering of patients.

Clinical Observation of Piracetam Combined with Butylphthalide Soft Capsules in the Treatment of Patients with Lacunar Infarction Complicated with Vascular Cognitive Impairment / 中国药师

Objective:To observe the clinical efficacy and safety of piracetam tablets combined with butylphthalide soft capsules in the treatment of patients with lacunar infarction(LI) complicated with vascular cognitive impairment(VCI). Methods:Totally 87 cases of patients with LI and VCI were selected and randomly divided into the control group(44 cases)and the treatment group(43 cases). The control group was only treated with piracetam tablets(1. 2 g,tid),while the treatment group was treated with piracetam tablets(1. 2 g,tid)and butylphthalide soft capsules(0. 2 g,qid),and the treatment course was 30 days. The changes of MMSE score,serum of SOD level and adverse drug reactions were observed and compared in the two groups. Results:Compared with those before the treatment,the mini-mental state examination(MMSE)score and serum level of SOD of the two groups were increased(P < 0. 01)after the treatment,and the increase in the treatment group was more notable than that in the control group(P < 0. 01and P < 0. 05). The effective rate of the treatment group was 86. 05% ,which was higher than that of the control group(75. 00% ,P < 0. 05). Conclusion:Piracetam combined with butylphthalide soft capsules can effectively improve the cognitive impairment of the patients with LI and VCI,and the effect may be related with increasing the level of SOD.

Evaluation of nootropic activity of Curcuma longa leaves in diazepam and scopolamine-induced amnesic mice and rat.

Background: The present study was undertaken to assess the nootropic activity of hydroalcoholic extract of Curcuma longa leaves (HAECL) in diazepam-induced amnesia in mice using Morris water maze method and scopolamine-induced amnesia in rats by using elevated plus maze behavioral paradigm and its effect on acetylcholinesterase (AChE) and reduced glutathione (GSH) level were carried out. Methods: Amnesia was induced by administration of diazepam (1 mg/kg i.p.) and scopolamine (0.4 mg/kg i.p.) and treatment groups received HAECL (200 and 400 mg/kg p.o) for 14 and 10 days in scopolamine and diazepam-induced amnesia model, respectively. The extent of improvement in memory was measured by behavioral paradigm. Finally, animals were sacrificed, and the whole brain was isolated for estimation of concentration of AChE and reduced GSH levels. Results: The oral treatment with HAECL with a dose 400 mg/kg has shown an enhancement in the memory function compared to 200 mg/kg. Conclusion: This could be by inhibiting the levels of cholinesterase concentration of enzyme and thereby increasing the concentration of acetylcholine level in brain and improving cognition-memory performance.

Improvement of the method to establish a rat model of vascular dementia / 中国实验动物学报

Objective To improve the method to establish a rat model of vascular dementia and to better serve the experimental studies on vascular dementia.Methods We used the method of“repeatedly clipping the carotid artery com-bined with injection of sodium nitroprusside and with permanent unilateral carotid artery ligation” to prepare a rat model of vascular dementia.The drug piracetam was used to validate the established rat model in respect of the behavior and histopa-thology.Results Different from the reports of previous research, firstly, the results of this study suggested that injection dose of sodium nitroprusside should be 2.0 mg/kg, room temperature should be controlled at 28℃ during surgical opera-tion, and kept at 25℃postoperatively for 24 hours.Under these experimental conditions, the rats were stable and the death rate was reduced.Secondly,“repeatedly clipping carotid artery combined with permanent unilateral carotid artery ligation”could cut off about a third of cerebral blood supply, and causing chronic cerebral ischemia, which is seemingly more con-sistent with the pathogenesis of vascular dementia.Experimental results showed that compared with the control group, the navigation incubation period was extended and space search ability became worse in the model group, cell number was de-creased, with blurred cell contour and deeply stained cytoplasm, and cell nuclei were not clear in the hippocampal tissue. Conclusions Our findings indicate that the improved methodrepeatedly clipping the carotid artery combined with injec-tion of sodium nitroprusside and with permanent unilateral carotid artery ligationcan be used to efficiently establish a rat model of vascular dementia.The similar results of experiment using piracetam validate that this rat model can be used in vascular dementia-related experimental studies.

Simultaneous Determination of Three Components in Compound Piracetam and Nimodipine Capsules by RP-HPLC-UV Wavelength Switching Method / 中国药师

Objective:To establish a RP-HPLC-UV wavelength switching method for the simultaneous determination of captopril, aspirin and nimodipine in compound piracetam and nimodipine capsules. Methods:The separation was carried out on a YMC-Pack Pro-C18 column(250 mm × 4. 6 mm,5μm) with acetonitrile-water(adjusting pH to 2. 5 with phosphpric acid)as the mobile phase with gra-dient elution. The flow rate was 1. 0 ml·min-1 . During 0-4. 3 min, the detection wavelength was 215 nm, during 4. 3-11. 0 min, the detection wavelength was 276 nm and during 11. 0-18. 0 min, the detection wavelength was 235 nm. The column temperature was 40℃. Results:The linear range of captopril, aspirin and nimodipine was 0. 054 7-1. 641 8 μg(r=0. 999 9),0. 055 3-1. 654 8 μg(r=0. 999 9) and 0. 077 7-2. 331 6 μg(r=0. 999 7), and the average recovery was 100. 69%(RSD=0. 69%,n=6),101. 04%(RSD=1. 05%,n=6)and 102. 56%(RSD=1. 14%,n=6), respectively. Conclusion: The method is simple, rapid and accurate, and can be used in the content determination of compound piracetam and nimodipine capsules.

The Combination of Antidepressant Duloxetine with Piracetam in Mice does not Produce Enhancement of Nootropic Activity

There is a strong association between depression and memory impairment. The present study aims to assess the nootropic activity of duloxetine and piracetam combination. Male Swiss Albino mice were divided randomly into 4 groups. Treatment of normal saline (10 ml/kg), duloxetine (10 mg/kg), piracetam (100 mg/kg), and duloxetine (5 mg/kg) plus piracetam (50 mg/kg) were given through intra-peritoneal route to group I-IV, respectively. Transfer latency in elevated plus maze (EPM) and time spent in target quadrant in Morris water maze (MWM) were recorded. Estimation of brain monoamines in hippocampus, cerebral cortex, and whole brain were done using HPLC with fluorescence detector. Piracetam treated group showed significant decrease in transfer latency in EPM and increase in time spent in target quadrant recorded in MWM. Combination treated group failed to produce statistically significant nootropic effect in both EPM and MWM. Combination treated group failed to increase brain monoamine levels when compared against duloxetine and piracetam treated groups, separately. But there was exception of significant increase in norepinephrine levels in hippocampi when compared against duloxetine treated group. Results indicate no cognitive benefits with piracetam plus duloxetine combination. These findings can be further probed with the aim of understanding the interaction between duloxetine and piracetam as a future endeavor.

Role of piracetam on cognitive function in epilepsy and with antiepileptics in rats.

Background: To study extent of cognitive impairment by epilepsy & antiepileptic treatment and evaluate the role of piracetam on it. Methods: 48 animals were divided into 6 groups: I-Control, II- Topiramate, III-Topiramate+Piracetam, IV-Valproate, V-Valproate+Piracetam, VI-Piracetam. Baseline cognitive functions were measured using Cook’s pole climbing apparatus (CPCA) and Elevated plus maze (EPM). In CPCA, on completion of training, number of avoidances (NOA) out of 10 trials were noted while in EPM, transfer latency (TL) was measured. Kindling was induced by 30mg/kg Pentylenetetrazol (PTZ), i.p. to all groups (except Group I) on alternate days till seizures developed. Groups were treated with respective drugs orally for 21 days and cognitive functions measured again. Results: Significant decrease in NOA & increase in TL was observed after PTZ kindling. Topiramate further significantly impaired NOA and TL whereas Valproate significantly reduced NOA in CPCA but increase in TL was not significant. Treatment with Piracetam significantly increased Topiramate, Valproate and PTZ kindling induced decrease in NOA as also significantly reduced Topiramate and PTZ kindling induced increase in TL. Conclusion: Seizures are associated with cognitive impairment. Cognitive impairment caused by Sodium valproate differs from Topiramate. Piracetam, a known nootropic can be used in alleviating cognitive impairment associated with epilepsy & chronic antiepileptic therapy.

Compatibilidad química del piracetam determinada por calorimetría diferencial de barrido / Chemical compatibility of piracetam determined by differential scanning calorimetry

Introducción: en la primera etapa de preformulación de un medicamento se seleccionan los excipientes y es importante la realización de los estudios de compatibilidad química entre el ingrediente activo farmacéutico (IFA) y excipientes. Una de las técnicas más rápidas para realizar dichos estudios es la Calorimetría diferencial de barrido (DSC), y como técnica complementaria la Termogravimetría (TG). Objetivo: empleando DSC y TG, se realiza un estudio de compatibilidad química entre IFA y excipientes preseleccionados, para comprobar la existencia o no de interacción química. Métodos: el equipo empleado fue el TA3000Mettler, aco­plado a la celda DSC20 y al horno TG50. El IFA utilizado fue Piracetam, y los excipientes: Kollidon VA 64, Estearato de magnesio, Celulosa microcristalina, Polietilenglicol 20 000 y Aerosil. Dichos excipientes se caracterizaron por DSC al igual que el IFA, al cual se le detectó la transición física de fusión. Para el estudio de compatibilidad se prepararon mezclas físicas binarias en una relación de concentración 1:1 Resultados: la figura 1 muestra la detección del punto de fusión por DSC del IFA. Se obtuvieron dos transiciones endotérmicas, comprobándose por TG cuál era la de fusión. La figura 2 muestra los termogramas de las mezclas formadas entre IFA y excipientes. Conclusiones: no se detectó aparición de nuevos picos, por lo que se infiere que no hay incompatibilidad química entre las sustancias estudiadas y se recomienda el uso de los excipientes para el desarrollo de la formulación farmacéutica

Introduction: the first phase of the drug preformulation comprises the selection of excipients and the conduction of studies on chemical compatibility between pharmacologically active ingredient and the excipients. One of the quickest techniques is the differential scanning calorimetry and the supplementary technique called thermogravimetic analysis. Objective: to conduct a chemical compatibility study of the pharmacologically active ingredient and of the preselected excipients by using differential scanning calorimentry (DSC) and thermogravimetric analysis (TG), in order to confirm the chemical interaction between them. Methods: this study used the thermal analysis equipment TA 3000 Mettler, coupled with the DSC 20 cell and the TG50 oven. The pharmacologically active ingredient was Piracetam and the excipients were Aerosil Kollidon VA64, magnesium stearate, microcrystalline cellulose, Polyethylene glycol 20 000. The differential scanning calorimetry characterized the excipients and the pharmacologically active ingredient as well, whose physical fusion transition was determined. Some binary physical mixtures with a concentration ratio of 1:1 were prepared to study compatibility. Results: figure 1 showed the pharmacologically active ingredient´s fusion point detection. Two endothermal transitions were determined as well as the fusion transition by the TG equipment. Figure 2 showed the thermograms of mixtures between pharmacologically active ingredient and excipients. Conclusions: the occurrence of new peaks was bit detected, so it was inferred from this study that there was no chemical incompatibility between the studied substances, and the excipients are recommended for the development of the final pharmaceutical formulation

The influence of edaravone on cognitive ability in patients with vascular dementia / 中国基层医药

Objective To observe the influence of edaravone on the cognitive ability in patients with vascular dementia(VD).Methods 70 cases with mild to moderate VD were randomly divided into observation group( edaravone treatment) and control group( piracetarn treatment),35 cases in each group.Treatment cycle was two weeks.The scores of MMSE,CDT,MoCA were compared before and after treatment between the two groups.Results The scores were found to be significantly higher after use edaravone in the observation group ( t =4.21,1.45,12.37,all P ＜0.05 ).The score had no difference before and after treatment in the control group ( P ＞ 0.05 ).Conclusion Edaravone could improve cognitive abilitys in VD patients through its function of anti-oxidant and free-radical scavenging.

Quantitative pharmacoelectroencephalographic effects of levetiracetam / 中华神经科杂志

Objective The quantitative pharmacoelectroencephalography ( QPEEG ) of many antiepileptic drugs (AEDs), such as carbamazepine, valproic acid, phenobarbital and topiramate but not levetiracetam (LEV), have been studied. This study is to investigate the effect of LEV on QPEEG. Methods One dose of LEV at l g was administrated to 12 healthy adults (6 males, average age at 26 years, average height at l.67 m). The EEG samples (of 180 seconds each) were obtained prior to and at regular intervals ( 1, 1.5, 2, 3, 4, 6, 7, 8, 12, 24 hours) after administration of LEV. The EEG activity was processed with the power spectral analysis and separated into different frequency bands. The absolute powers of both occipital and frontal lobes were calculated through 30 seconds epochs without artifacts for each recording. The statistical difference between baseline pre-drug control and each post-drug assessment was evaluated by the Wilcoxon matched-paired rank test. Results The power of α1-band and β-band increased bilaterally over both frontal and occipital lobes after the administration of LEV. There was no change of α2-band over bilateral frontal lobes, but increased in double peaks shape with the low point at the 6 hours after the administration. The power of α1-band showed the significant change after the administration at the 1.5 hours (18.8950, Z= -3.059, P=0.002) in the left front, 3 hours (18.6150, Z= -2.981, P =0.003)in the right front, 1.5, 2, 3 and 4 hours (61.0233, 53.9425, 47.6192 and 51.8250 respectively, Z =-3.059, -3.059, -2.903 and -3.059, all P ＜ 0.01 ) in the left occipital, and 1, 1.5, 2 and 3 hours (53.5358, 56.8092, 50.3500 and 47.1733 respectively, Z = -2.903, -3.059, -3.059 and -2.981,all P ＜ 0.01 ) in the right occipital. The power of α2-band showed the significant change after the administration at the 3 hours (73.5450, Z = - 3.059, P = 0.002) in the left occipital, and 1, 3 hours (80. 6808 and 87. 1750, Z = -2.903 and - 3.059, P = 0.004 and 0.002 respectively ) in the right occipital. The power of β-band showed the significant change after the administration at the 3 hours (3.8000, Z = -3.059, P = 0.002) in the left front, 1.5, 2 and 3 hours (4.0408, 4.3217 and 4. 1050,Z= -2.903, -3.059 and -3.061, all P＜0.01) in the right frontal, 3 hours (9.1408, Z= -3.059,P =0.002) in the left occipital, and 1.5, 3 hours (8.9267 and 9.3033, Z = -2.981 and -2.981, both P = 0.003) in the right occipital. Conclusions LEV can change the background activity of QPEEG. The changes are different from those of the other AEDs.

A Comparison of Curative Effect of Ganglioside and Piracetam in treatment of Patients with Hypertensive Cerebral Hemorrhage / 中国基层医药

Objective To observe the effects of ganglioside and piracetam in improving the neurological function in patients with hypertensive cerebral hemorrhage.Methods Ninety-six patients with hypertensive cerebral hemorrhage Were randomly divided into 2 groups,ganglioside group(48 patients)and piracetam group(48 patients).Ganglioside group used the amount 40mg ganglioside mixed with sodium chloride injection(100ml,concentration 0.9%),and the piracetam group uesd piracetam(20g)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 3 weeks,the general information and the improvement of nerve were observed.Results The effective rate and excellent rate of ganglioside group were remarkably higher than piracetam group,there was significant difference between the two groups(P＜0.05).Conclusion Ganglioside was better than pimcetam in improving clinical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage.