[Biomarkers of neuroinflammation in patients with chronic cerebral ischemia during the therapy with vinpocetine (study INFLAMARK)]. / Dinamika kontsentratsii biomarkerov neirovospaleniya v krovi u patsientov s khronicheskoi ishemiei golovnogo mozga na fone terapii vinpotsetinom: rezul'taty issledovaniya INFLAMARK.

OBJECTIVE: To evaluate the effect of vinpocetine therapy on clinical manifestations of chronic cerebral ischemia (CCI) and the blood concentrations of neuroinflammation markers (S100B, IL-1ß). MATERIAL AND METHODS: The study included 30 patients (mean age 61.6 [56.9; 67.9] years) with CCI that received vinpocetine (30 mg/day) for 3 months. Brain changes according to magnetic resonance imaging data were assessed using the STRIVE protocol. We analyzed the dynamics of changes in the clinical questionnaires: Montreal Cognitive Assessment Scale (MoCA), Hospital Anxiety and Depression Scale (HADS), Asthenic State Scale (ASS), Epworth Sleepiness Scale (ESS), general impressions of treatment (Global Rating of Change Scale, GRC). RESULTS: In 3 months after vinpocetine therapy there was a significant improvement in cognitive status (MoCA: 25.1±2.1 vs 26.6±1.4 p<0.05), emotional state (HADS: 8.4±1.4 vs 7.1±1.8 (p<0.05)), daytime sleep parameters (ESS 8.4±2.1 vs 6.2±2.3 p<0.05) and reduction in asthenia (ASS: 72.2±18.1 vs 52.3±9.3, p<0.05). A significantly larger proportion of patients assessed the improvement from therapy as «moderate¼ and «pronounced¼ (GRC, n=22, 73.3%). Concentrations of S100B and IL-1ß decreased significantly by the time therapy was completed. The overall severity of cerebrovascular changes according to MRI was significantly associated with blood levels of S100ß, but not IL-1ß: ß=0.504, p=0.026, 95% CI 0.149-0.901, mainly due to periventricular changes in white matter (ß=0.562, p=0.035, 95% CI (-0.024-0.820). Blood levels of S100ß correlated with MoCA test results (r=0.6795), and IL-1ß correlated with ESS scores (r=0. 6657). CONCLUSIONS: The use of vinpocetine can significantly reduce the severity of cognitive and affective disorders, asthenia, normalize the circadian rhythm of sleep, suppress the expression S100ß and IL-1ß in patients with CCI. One of the vinpocetine's mechanisms of action may be the inhibition of neuroinflammation.

[Analysis of the correlation between neuroimaging markers of the brain damage and the severity of postural instability in patients with chronic cerebrovascular insufficiency (NEMAN open observational study)]. / Svyaz' neirovizualizatsionnykh markerov porazheniya golovnogo mozga i vyrazhennosti postural'noi neustoichivosti u patsientov s khronicheskoi ishemiei golovnogo mozga (rezul'taty otkrytogo nablyudatel'nogo issledovaniya NEMAN).

OBJECTIVE: To analyze the relationship between the severity of postural instability in patients with CCI (chronic cerebral ischemia) and brain changes according to MRI, as well as to evaluate the efficacy and safety of vinpocetine. MATERIAL AND METHODS: The study included 60 patients with CCI: 40 people with postural instability made up the main group and 20 people without balance disorders - the control group. The severity of manifestations of cerebrovascular pathology was assessed according to the protocol STRIVE. Severity of postural instability was assessed with the VAS, anxiety syndrome - Hamilton Anxiety Rating Scale, asthenia - Asthenic Condition Scale, daytime sleepiness - Epworth Sleepiness Scale, cognitive impairment - Montreal scale assessment of cognitive functions, the overall impression of treatment - Global Rating of Change Scale. RESULTS: The main group was associated with older age, more significant decrease in cognitive functions, urination disorders, anxiety syndrome and asthenia, changes according to MRI of the brain. CCI burden scale was significantly associated with VAS: ß=0.479, P=0.035, 95% CI 0.023-0.928. The presence of lacunae was the most significant marker for the development of severe imbalance: ß=0.482, p=0.041, 95% CI 0.022-0.925. A significant relationship was found between the total number of lacunae and VAS (r=0.509, p=0.021), as well as between the number of lacunae in the basal ganglia (r=0.793, p=0.019), especially the lenticular nuclei (r=0.498, p=0.036), and VAS. After 3 months of vinpocetine treatment, a significant improvement in statodynamic function was noted in the main group, moreover - absence of anxiety, normalization of daytime sleep, «weak¼ asthenia, increasement in the value of the MoCA scale. Most of the patients regarded the improvement from the therapy as «moderate¼ and «pronounced¼. CONCLUSIONS: The presence of lacunes in the basal ganglia is a most prominent neuroimaging marker of brain damage in patients with CCI and postural instability. The use of vinpocetine can significantly reduce the severity of imbalance, anxiety and asthenia, and normalize the circadian rhythm of sleep.

[Quantative evaluation and analysis of the central mechanisms involved in analgesic effect of Alflutop in patients with chronic lower back pain]. / Kolichestvennaya otsenka i analiz tsentral'nykh mekhanizmov anal'geticheskogo effekta Alflutopa u patsientov s khronicheskoi bol'yu v nizhnei chasti spiny.

OBJECTIVE: Evaluation of Alfultop impact on nociceptive afferentation central mechanisms in patients with chronic lower back pain. MATERIALS AND METHODS: The study involved 40 patients with CLBP. The therapy included Alflutop, 2 ml once a day for 10 days. Mean VAS-pain, LANSS, Roland-Morris questionnaire, Global Rating of Change Scale (GRC), pressure pain thresholds data were analyzed. Follow-up duration was 3 months. RESULTS: Most of the patients were females (f:m=1.3:1); average age - 60.5 [54.2; 67.3] years with a mean disease duration of 14.3±4.2 mo. At visit 1, the VAS score was 63.2±9.4, LANSS 14.2±2.1 points, and the Roland-Morris questionnaire 9.9±3.5 points. There was a significant decrease in the pain threshold both in the zone of maximum pain, located in the lower back (3.97±0.9 kg/sm2), and in suprasegmental area (5.22±1.7 kg/sm2), and a pathological change in the temporal summation of pain (789.2±45.6 mm). After Alflutop therapy, significant changes in the parameters of the VAS, LANSS and Roland-Morris scores were recorded after 30 days of observation and maximum changes in 3 months. The pain threshold has significantly increased after 3 months of observation. The majority of patients rated the improvement from the therapy as «moderate¼ and «pronounced¼ (33/82.5%) according to the GRC scale. A significant relationship was established between the level of pain threshold and the intensity of pain on the VAS scale (R=0.714), its duration (R=0.799) and disability of the patients (R=0.706). CONCLUSIONS: Central sensitization develops in patients with CLBP, which correlates with VAS score of pain intensity, its duration and the degree of disability. Alflutop significantly reduces the intensity of the pain syndrome, its neuropathic component, significantly increases the level of pain threshold and improves the disability of patients in 3 months after the start of treatment.

[The open observational study of aceclofenac and vinpocetine effectiveness and tolerability in treatment of patients with chronic cerebrovascular disease after COVID-19 (AQUA study)]. / Otkrytoe nablyudatel'noe issledovanie effektivnosti i perenosimosti vinpotsetina i atseklofenaka pri lechenii patsientov s khronicheskoi ishemiei golovnogo mozga posle COVID-19 (issledovanie AKVA).

OBJECTIVE: To estimate the frequency of long-COVID in patients with chronic cerebrovascular disease, to identify the risk factors for the development of this condition and to analyze effectiveness and tolerability of Vinpocetine and Aertal in treatment of this disease. MATERIAL AND METHODS: The study included 97 patients (64.5±5.2 years), among which 42 were diagnosed with long-COVID. The effectiveness of treatment was analyzed with NRS-P, Post-COVID-19 Functional Status (PCFS), Global Rating of Change Scale (GROC). RESULTS: Predictors of long-COVID was female gender (p=0.022), severe COVID-19 (p=0.035), comorbidities: cardiovascular diseases (p=0.032), endocrinopathies (p=0.041), affective disorders (p=0.021). Significant changes in the functional status of patients were recorded after 20 days of treatment (PCFS), in pain after 10 days (NRS-P). The most pronounced clinical effect (PCFS) was obtained after 1 mth of therapy with vinpocetine and 20 days with aceclofenac (NRS-P). After 30 days 25/59.5% of patients noted a «pronounced¼ improvement in their own well-being (GROC) without the development of significant side effects. CONCLUSIONS: 43.3% of patients with chronic cerebrovascular disease and certain predictors develop long-COVID. Aceclofenac and vinpocetine are effective in relieving a number of symptoms of long-COVID, which requires further study.

[The significance of neuroplastic mechanisms in compensation of statodynamic impairments during vestibular disorders]. / Znachenie mekhanizmov neiroplastichnosti v kompensatsii statodinamicheskikh narushenii pri vestibulyarnykh rasstroistvakh.

The process of balance restoration in patients with the vestibular disorders is known as «vestibular compensation¼. It is obvious nowadays that this phenomenon is very complex and is associated with the deep brain neuroplastic changes involving reinnervation, habituation and adaptation. The research of the last decades has shown some fundamental physiologic mechanisms that form the basis of neuroplasticity, establish the staging of ongoing transformations and analyze the opportunity to improve and/or accelerate vestibular compensation with the help of vestibular rehabilitation and contemporary medications such as betaserc long.

[The evaluation of the efficacy of Alflutop in the complex treatment of patients with chronic lower back pain (the observational study ZEITNOT)]. / Otsenka terapevticheskoi effektivnosti Alflutopa v kompleksnom lechenii patsientov s khronicheskoi bol'yu v nizhnei chasti spiny (nablyudatel'noe issledovanie TsEITNOT).

OBJECTIVE: To analyze the effect of Alflutop on neuroinflammation in patients with chronic lower back pain (CBP). MATERIAL AND METHODS: Forty-one patients with a verified CBP diagnosis were enrolled in the study. Alflutop was used for treating CBP, 1 ml once/day, for 20 days. Treatment efficacy was monitored using the Visual Analogue Scale (VAS), DN4 test; the Roland-Morris questionnaire; the index of pain activity in the lumbar spine; and the level of tumor necrosis factor-α (TNF-α) in blood plasma. There were three visits in total: screening (visit 0), treatment start (visit 1, 0-3 days after screening) and visit 2 (3 months later (±7 days) from the start of treatment). RESULTS: Before the start of therapy, in some patients (group 1, n=14 (34.1%) the TNF-α concentration in the blood plasma was below the detectable level (less than 4.0 pg/ml), while in group 2 (n=27 (659%)), the expression of TNF-α in peripheral blood was observed at the level of 6.3 [4.9; 7.4] pg/ml. Patients in group 2 significantly (p<0.05) differed from patients in group 1 by the greater number of CBP exacerbations over the last year as well as by the results of testing on DN4 (higher values) and SBI (greater discomfort). In group 2, a significant relationship was found between the TNF-α level in blood plasma and the number of exacerbations as well as between the TNF-α level and the number of DN4 points. At visit 2, patients in group 2 had a significant (p<0.05) decrease in pain intensity according to VAS, an improvement in the quality of life according to the Roland-Morris questionnaire, a decrease in the severity of the neuropathic component of pain according to DN4 test as well as subjective condition improvement associated with the activity of pain in the lumbar spine. A significant relationship was found between the level of TNF-α and the number of DN4 points after treatment and the period of active observation. CONCLUSIONS: In the majority of CBP patients, the high relapse rate and neuropathic nature of pain may be associated with persistent neuroinflammation due to TNF-α synthesis. Alflutop inhibits the TNF-α expression substantially, which significantly correlates with a decrease in the neuropathic pain syndrome component according to the DN4 questionnaire. The use of Alflutop can be considered as an effective method of treating patients with CBP, which has an impact on the process of neuroinflammation as one of the leading causes of changes in the pain nature and its chronicity.

[Medical adherence as the basis for effective therapy - current state of the art]. / Priverzhennost' lecheniyu kak klyuchevoi faktor povysheniya effektivnosti konservativnoi terapii.

OBJECTIVE: The study was to assess the importance of the problem of medical adherence (MA) among therapists in St. Petersburg (2021). MATERIAL AND METHODS: The study involved 96 doctors of various therapeutic specialties (neurologists, therapists and rheumatologists), who were asked to respond to an original questionnaire concerning MA, that was designed in neurology department of Military Medical academy n.a. S.M. Kirov, St. Petersburg It was found that, according to experts, the main negative factors that significantly decreases MA are the high cost of the drug (40.1%) and polypharmacy (22.1%); the main property of the drug associated with high MA is the convenience of taking it - once a day (51.1%). Such drugs include, for example, a new form of the muscle relaxant tolperisone hydrochloride prolonged release 450 mg. RESULTS AND CONCLUSIONS: According to experts, the main negative factors that significantly reduce MA are the high cost of the drug (40.1%) and polypharmacy (22.1%); the main property of the drug associated with high MA on the part of patients is the convenience of its administration - 1 once a day (51.1%). Such drugs include, for example, a new form of release of the muscle relaxant tolperisone hydrochloride prolonged release 450 mg. CONCLUSIONS: A systematic approach is required to improve MA, carried out both at the state level (changing public consciousness, financing systems, etc.) and in tandem doctor-patient (moving away from paternalistic medicine, prescribing depot forms of drugs, etc.).

[The optimization of differential diagnosis and treatment of cervical radiculopathy (SHERPA study)]. / Optimizatsiya differentsial'noi diagnostiki i terapii vertebrogennoi sheinoi radikulopatii (issledovanie ShERPA).

OBJECTIVE: To improve the algorithm of differential diagnosis and complex treatment of patients with CR. MATERIAL AND METHODS: Forty-two patients with CR were divided into 2 groups. Patients of the first group (n=21) received basic treatment (NSAID, myorelaxants, local injections with glucocorticoids (on demand), B vitamins and non-pharmacological methods) and the anticholinesterase drug ipidacrine. The second group (n=21) had only basic treatment. The total duration of the study was 45 days. The effectiveness of treatment was evaluated with VAS, NDI, GROC and total duration of disability period. RESULTS: A battery of tests for the diagnosis of CR that included Spurling test, motor strength deficiency, ULTT, pain pattern, shoulder adduction test (diagnostic complex SPASIBO), has been developed. A positive result of all 5 tests guarantees the 94.7% accuracy of CR diagnosis. The application of ipidacrine has allowed a significant (p<0.05) reduction of pain, enhancement of daily living activities and subjective improvement of well-being of patients after 1 month of treatment and mostly after 45 days. Besides, there was a considerable (p<0.05) reduction of the disability period in the first group of patients compared to the control one. CONCLUSION: The diagnostic complex SPASIBO should be used in diagnosis of CR. It is highly recommended to include ipidacrine in the complex treatment of CR.

[Cholinergic profile as a target of rational therapy of central nervous system diseases and injuries]. / Kholinergicheskii profil' kak mishen' ratsional'noi terapii zabolevanii i travm tsentral'noi nervnoi sistemy.

AIM: A comparative analysis of the clinical efficacy of cholinergic drugs and acetylcholinesterase inhibitors (IHE), as well as their combination, in the treatment of cerebrovascular disease and consequences of intracranial injury according to clinical, instrumental and laboratory dynamic observations. MATERIAL AND METHODS: Ninety patients with cerebrovascular pathology, including 45 with chronic brain ischemia stage 2 (ICD-10 I67) and 45 with sequelae of intracranial injury (ICD-10 T90.5), were enrolled in the study. Complex treatment of patients included basic and specific therapy. The groups were divided into 3 subgroups of 15 people: the neuromidin group, the gliatilin group and the neuromidin + gliatilin group. The duration of treatment was 2 months. All patients underwent a comprehensive clinical, neurophysiological and laboratory examination prior to therapy, after 1 month and 2 month from the beginning of therapy: a study of cholinesterase activity in the blood, testing on MMSE and Hamilton scales, transcranial magnetic stimulation with determination of Central motor conduction time and somatosensory evoked potentials with calculation of Central afferent conduction time. RESULTS: Prior to treatment, a significant positive strong correlation was found between the age of patients and the level of CE activity in serum (Rs=0.77; p=0.0001). The treatment resulted in a significant (p<0.05) improvement of all parameters (except for MMSE that showed a trend towards improvement) in the neuromidin and the neuromidin + gliatilin subgroups of each group compared to those in the gliatilin subgroups. In addition, after 2 months from the beginning of treatment, there was a significant decrease in the activity of CE in serum in the neuromidin and the neuromidin + gliatilin subgroups. CONCLUSION: The study of deviations of the 'cholinergic profile' (the level of CE activity in the blood) in patients with cerebral pathology and the strategy using cholinergic drugs, IHE and their combination for the treatment of neuropsychiatric disorders, is one of the important directions in the optimization of combined therapy of patients of this profile.

[Identification of non-steroidal anti-inflammatory drugs as a necessity basis of effectiveness and risk correlation conception]. / Identifikatsiia nesteroidnykh protivovospalitel'nykh sredstv kak osnova kontseptsii neobkhodimosti sootneseniia éffektivnosti i riskov.

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for treatment of pain, fever and inflammatory diseases. However, along with a high rate of efficacy, NSAIDs have been associated with an increased risk of gastrointestinal and cardiovascular complications related to the inhibition of the enzymes cyclooxygenase 1 and 2. The review addresses contemporary mechanisms of NSAID's side-effects and analyzes clinical trials of the efficacy and tolerability of aceclofenac, which is the most frequently prescribed NSAID, as in its traditional release form (100 mg 2 times a day) as well as in the controlled-release (200 mg a day) form.

[Spinal mechanisms of neuroplasticity induced by neuromidin in treatment of traumatic neuropathies]. / Osobennosti spinal'nykh mekhanizmov neiroplastichnosti pri primenenii neiromidina v lechenii travmaticheskikh neiropatii.

AIM: To analyze the spinal mechanisms of neuroplastic changes induced by neuromidin (ipidacrine) in a model of traumatic axonotomy of the sciatic nerve in rats. MATERIAL AND METHODS: The histological study of the material from the anterior horn (lumbar portion of spinal cord) was performed in 6 rats using electron microscopy. RESULTS AND CONCLUSION: The comparative analysis of neuromorphological changes in rats of control and main groups revealed the neuroprotective and modifying effects of neuromidin on the spinal neuroplasticity.

[Main directions of differential diagnosis optimization and rational treatment of an acute vertigo attack]. / Osnovnye napravleniia optimizatsii differentsial'noi diagnostiki i ratsional'noi terapii ostrogo pristupa golovokruzheniia.

AIM: To develop and assess the validity of the clinical algorithm VERTIGO for the differential diagnosis of central and peripheral vertigo and optimization of treatment of patients with vertigo. MATERIAL AND METHODS: Sixty-five patients with an acute attack of vertigo, aged from 18 to 75 years (53±6.7 years), were studied. All patients underwent standard neurological examination. In case of signs of central vertigo, patients underwent neuroimaging. Diagnostic accuracy, sensitivity and specificity of the VERTIGO algorithm as well as its positive and negative prognostic values were calculated. RESULTS: The sensitivity of VERTIGO for the diagnosis of central vertigo was 100% (95% CI: 78.2-100%), specificity 94.0% (95% CI: 83.5-98.8%), positive prognostic value 83.3% (95% CI: 58.6-96.4%); negative prognostic value 100% (95% CI: 92.5-100%). Cohen's kappa estimated by the results of final diagnosis was 0.88. CONCLUSION: Differential treatment of patients with acute vertigo should be performed according to the current recommendations and include multimodal pharmacological medications, e.g. cavinton forte, to restore the vestibular control by the stimulation of neuroplasticity. The VERTIGO algorithm allows the increase of the efficacy of clinical differential diagnosis of central and peripheral vertigo.

[MRI morphometry of neuroplastic changes in the brain after conservative treatment of traumatic brachial plexopathy]. / Magnitno-rezonansnaia morfometriia neiroplasticheskikh izmenenii golovnogo mozga pri konservativnoi terapii travmaticheskoi plechevoi pleksopatii.

AIM: To identify neuroplastic changes in the brain structures during treatment of traumatic axonotomy of the brachial plexus (the pathology of peripheral nervous system). MATERIAL AND METHODS: MRI morphometry of white and grey matter was studied in 62 patients with traumatic axonotomy of the brachial plexus. RESULTS: There were correlations between the thickness of sensorimotor cortex, morphometric parameters (volume, diffusion, fractional anisotropy) of subcortical formations (corticospinal tracts, the forceps minor), severity of neurological deficit and dynamics of clinical course depending on the therapeutic strategy. CONCLUSION: The results expand the current view on central mechanisms of posttraumatic axon regeneration on the model of traumatic brachial plexopathy and establish a neuromodulative effect of neuromidin and noofen. Some morphometric parameters may be used as the markers of reactive neuroplastic processes in the central nervous system.

[Contemporary paradigm of rational stroke treatment]. / Sovremennaia paradigma ratsional'noi terapii insul'tov.

Stroke was and remains one of the world's leading medical and social problems. Nowadays we are watching permanent sometimes cardinal changes in view about etiology, pathogenetic mechanisms and therapy of patients with stroke. In this work there have been elucidated contemporary theoretical and practical aspects of stroke treatment and prophylaxis based on the results of multicenter clinical trials and experience of leading foreign and native specialists. Much attention is devoted to the pharmacotherapy of patients with stroke. It is showed that application of neuroprotective drugs is of great importance, among which antihypoxants with pleiotropic action play a crucial role (mexidol).

[Neurogenic copulative dysfunction in men: theoretical aspects, differential diagnosis, and rational therapy].

UNLABELLED: Neurogenic copulative dysfunction (CD) is observed in different diseases and injuries of both the central and peripheral nervous system. CD concurrent with actual nervous system diseases has been established to be an important psychotraumatic factor that significantly reduces quality of life in these patients. AIM: To investigate the effect of aminophenylbutyric acid (Noophen) on male copulative function. SUBJECTS AND METHODS: Forty patients with chronic lumbosacral radiculopathy on an exacerbation and mild and moderate closed head injury were examined. RESULTS: The findings suggest that Noophen is effective in the combination therapy of neurogenic CD. CONCLUSION: The drug can normalize an autonomic control over nerve centers involved in the regulation of copulative function, and improve the psychoemotional status of patients.

[A comparative analysis of the efficacy of neuromidin and galantamine in Alzheimer's disease]. / Sravnitel'nyi analiz effektivnosti neiromidina i galantamina pri bolezni Al'tsgeimera.

OBJECTIVE: To evaluate the cognitive changes in patients with mild to moderate Alzheimer's disease after the treatment with acetylcholinesterase inhibitors - neuromidin and galantamine. MATERIAL AND METHODS: Fifty-eight patients with probable Alzheimer's disease, aged 60-84 years (mean 73.2±6.7), were enrolled in a 20-week double-blind parallel group study. All patients were randomized in 2 groups: group 1 (n=28) received neuromidin, group 2 (n=30) - galantamine. Treatment efficacy was evaluated with the ADAS-cog/11 scale. RESULTS: Both drugs significantly improved or stabilized cognitive function in the patients. The most marked changes were obtained in the group of patients treated with neuromidin (р<0.05). CONCLUSION: The results suggest that the effectiveness of anticholinesterase treatment of Alzheimer's disease could be determined not only by the central but also peripheral cholinergic action.

[Innovation in differential diagnosis and monitoring of rational therapy in patients with lumbosacral radiculopathies].

OBJECTIVE: Unfortunately, nowadays there are no reliable ways to predict the outcomes of the conservative treatment in patients with dorsopathies. Otherwise, we could identify patients that demand intensive treatment including therapeutic blockades. We approbated and modified a method for assessment of radicular latency duration in patients with lumbosacral radiculopathies to evaluate its diagnostic value and the possibility of using in monitoring of effectiveness of conservative treatment. MATERIAL AND METHODS: We studied the effectiveness of conservative treatment in 60 patients with lumbosacral dorsopathies, including 35 patients manifested with exacerbation of sciatica and 25 patients diagnosed with failed back surgery syndrome (FBSS). RESULTS: There was a definite resistance to treatment in patients with FBSS. The complex management of patients, including neuromidin and epidural glucocorticoid blockades, demonstrated the greater effectiveness. The evaluation of radicular latency duration with neuromidin test turned out to have important predictive value which could be used to stratify treatment of patients with dorsopathies.

[The role of cholinesterase inhibitors in optimization of brain`s vascular pathology treatment (theoretical basis and clinical phenomenology)]. / Rol' antikholinésteraznykh sredstv v optimizatsii lecheniia tserebrovaskuliarnykh zabolevanii (teoreticheskie predposylki i klinicheskaia fenomenologiia).

Cholinergic system of mediation is the most prevalent in the human body. Acetylcholine provides interaction of neurons in the central nervous system and transmission of nerve impulses from the peripheral neurons to the effectors. The results of the recent studies have demonstrated the significance of cholinergic system dysfunction in development of different neurological diseases. Cholinesterase inhibitors are among the most common drugs used in treatment of this pathology. This review is dwelling upon the features of cholinesterase inhibitors and their practical application in treatment of the nervous system`s vascular pathology.

[The comparative pattern of neuromidin and magnetic stimulation influence on neuroplasticity in experimental traumatic neuropathy].

OBJECTIVE: Traumatic neuropathies are among the most actual problems in neurology due to the severe neurological deficit in most cases and poor prognosis of recovery. We evaluated the effect of ipidacrin (cholinesterase inhibitor) and magnetic stimulation on neuroplastic axonal changes after experimental neurotmesis of rat's sciatic nerve. MATERIAL AND METHODS: Animals (20 rats) were stratified into 3 groups. There was no treatment in the control group; in the second -group experimental animals underwent 3-5 min daily rhythmic magnetic stimulation (0,8-1T, 3 Hz) The third group of animals received intramuscular 0,035 mg of ipidacrin daily within 1 month. RESULTS AND CONCLUSIONS: Based on the received data on the restoration of myelin, axons, myelin nodes structure and lemmocyte ultrastructure), we have concluded that both magnetic stimulation and ipidacrin can trigger restorative and compensative processes in traumatic neuropathies.

[Theoretical and practical aspects of treatment and prevention of acute cerebral blood cerculation disorders]. / Teoreticheskie i prakticheskie aspekty terapii i profilaktiki ostrykh narushenii mozgovogo krovoobrashcheniia.

Stroke is an important medical and social problem. Views about etiology, pathogenetic mechanisms and therapy of patients with stroke have undergone significant changes. In this work, we elucidate contemporary theoretical and practical aspects of stroke treatment and prevention based on the results of multicenter clinical trials and experience of leading foreign and native specialists. Much attention is devoted to the pharmacotherapy of patients with stroke. It has been shown that neuroprotective drugs, in particular, antihypoxants with pleiotropic action (mexidol), play an important role in treatment of ischemic stroke.