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Background:Chronic medical disorders are often complicated by cognitive impairments, making medical intervention that can alleviate cognitive disturbances desirable. Vinpocetine enhances cerebral utilization of oxygen and glucose and consequently improves cerebral functions including memory.Aim:This study assessed the efficacy of vinpocetine (Cognitol™) in improving memory and concentration in cognitively impaired patients.Subjects and Methods:A prospective analytical study of 56 cognitively impaired patients compared with age, sex and level of education matched 56 controls. Cognitive performance was assessed with the Short Blessed Test, which was pilot-tested. Baseline cognitive performances of the patients and controls were obtained and thereafter cognitive performances of the patients were assessed at 6 and 12 weeks after administration of vinpocetine at a dose of 5 mg twice-a-day. Comparative analysis of their performances at baseline was done using the Student t-test, while the improvement in patients’ performances and effect of disease variables on cognitive performances were analyzed with one-way analysis of variance and likelihood ratio analysis respectively.Results:The mean (standard deviation) [SD] ages of the cognitively impaired patients (56/112) and controls (56/112) were 49.5 (18.9) and 53.8 (15.8) years respectively (P = 0.19; 95% confidence interval [CI]: 2.2-10.8). The pilot study yielded an optimal cut-off error score of 6 with a sensitivity of 71.4%, specificity of 96.4% and accuracy of 83.9%. Patients performed significantly worse than the controls (P < 0.001; 95% CI 6.7-11.4). There were significant improvements in memory and concentration with vinpocetine therapy (P < 0.05). The clinical variables of the patients had no effect on the trend of cognitive performances.Conclusions:Vinpocetine was effective in improving memory and concentration of patients with epilepsy and dementia although the efficacy was minimal in demented patients.

This study shows that PWE had significant intellectual impairment when compared with controls. In addition, long duration of epilepsy, long duration of AED therapy, earlier age of onset, increased seizure frequency, and low educational status had a negative impact on intellectual functioning in PWE.

There are conflicting reports on the presence of neurocognitive dysfunction during the initial, medically asymptomatic stage of HIV infection. This study aimed to assess the psychomotor speed and attention ability of antiretroviral treatment-naïve Nigerian Africans with HIV/AIDS and the impact of CD4 levels on their cognitive performance. Two hundred and eighty-eight randomly selected age-, sex- and level of education-matched subjects participated, comprising 96 HIV-positive asymptomatic and 96 HIV-positive symptomatic patients and 96 HIV-negative controls. The simple reaction and binary choice reaction time tasks were used for cognitive assessment. The binary choice reaction time indicated that the HIV-positive patients had impaired attention ability and significant psychomotor slowing compared with the controls (P<0.05), but psychomotor slowing was obvious among the symptomatic HIV-positive patients only using the simple reaction time tasks. Significant psychomotor retardation was observed in HIV-positive patients with CD4 levels of 200-499 cells/mm(3) (P=0.02) and <200 cells/mm(3) (P<0.001), and impaired ability for sustained attention was present irrespective of the CD4 level (P<0.001). We conclude that psychomotor retardation and impaired attention are significantly worse in HIV-positive subjects compared with controls and are adversely affected by decreasing CD4 levels. The sensitivity of the neuropsychological tool used can affect the degree of impairment measured.

RÉSUMÉ CONTEXTE: Toxoplasma encéphalite est une présentation commune des T gondii infection oxoplasma du système nerveux central dans la phase tardive de l'immunodéficience humaine virale (VIH). Le diagnostic définitif nécessite la démonstration de la toxoplasmose dans le tissu cérébral. Toutefois, la démonstration neuro-radiologie (en utilisant la tomodensitométrie ou imagerie par résonance magnétique) de l'anneau d'aide à l'unique ou multiple focal lésions intracrâniennes, en présence de l'immunosuppression et une réponse rapide au traitement présomptif sont de diagnostic en l'absence d'installations histologique. La rareté des lésions toxoplasmiques dans le cervelet provoque un indice élevé de suspicion clinique et l'établissement précoce d'un traitement présomptif en Afrique sub-saharienne des ressources des pays

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