The possibility of enhancing the efficiency of early comprehensive rehabilitation in patients with poststroke aphasia

Introduction. Given due regard to the urgency of the issue of pharmaceutical support in neurorehabilitation after stroke, an open multicenter study was designed and conducted.Aim. To evaluate the efficacy and safety of therapy with Brainmax®, which is an original combination of two drugs: ethylmethylhydroxypyridine succinate (EMHPS) (100 mg/ml) and meldonium dihydrate (100 mg/ml) in the form of a solution for intravenous and intramuscular injections in patients with ischemic stroke in the acute and early recovery period.Materials and methods. The study included 60 patients aged 18 to 80 years with the first ischemic stroke in the carotid or vertebrobasilar system, meeting the inclusion/exclusion criteria. The total duration of therapy was 24 days. The efficacy of therapy was assessed using the following tools: modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), Rivermead Mobility Index (RMI), Montreal Cognitive Assessment scale (MoCA).Results. All patients showed improvement of their general condition by the end of therapy. The vast majority of patients noted that they had fewer difficulties with movement, self-care and daily activities as compared to the first visit. There was also a significant improvement in the total scores on the NIHSS scale, the Rivermead Mobility Index, and the Montreal Cognitive Assessment Scale (p < 0.05) by the end of therapy. The proportion of patients with reported adverse events (AEs) accounted for 3.33%. All AEs were transient and did not require cessation of the therapy. No serious side effects were recorded in any of the groups.Conclusions. The study showed significant improvement of the key symptoms of ischemic stroke: regression of neurological deficit, functional and cognitive impairment. On top of that, it was noted that the incidence of adverse events associated with the use of Brainmax® was low, which did not lead to cessation of therapy. No serious side effects were recorded in any of the groups.

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New opportunities in the treatment of asthenic symptoms after a new coronavirus infection

Shishkova¹,

Martynov

2022

Medicinskij sovet

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Introduction. Asthenia is an urgent problem during the pandemic of new coronavirus infection (COVID-19) because of its high frequency regardless of the severity of the disease.The purpose of this subanalysis of data from the multicenter controlled randomized clinical trial TONUS was to evaluate the efficacy and safety of meldonium therapy for аsthenia in COVID-19 survivors.Materials and methods. A total of 880 patients with asthenia who underwent COVID-19 within the last 6 months were included in the analysis. The efficacy of asthenia therapy was assessed by the MFI-20 scale, Schulte tables, and the General Clinical Impression (CGI) scale. All patients were previously randomized in two parallel branches of the TONUS study, including patients without concomitant disease in TONUS-1 (who received meldonium 500 mg/day for 14 days in the main group) and patients with cardiovascular or cerebrovascular disease in TONUS-2, who received meldonium at a dose of 1000 mg/day for 42 days in the main group. In both arms of the study, the drugs in the comparison groups were multivitamin complexes.Results. For the TONUS-1 groups.In the group of patients receiving meldonium compared with the control group (p < 0.001): total MFI-20 score decreased and was 31 (25; 40); MFI-20 –35 (–46; 23); performance value –5 (–11; –2) seconds; proportion of patients with significant improvement (by CGI-I) by the end of follow-up was 92.8%. For TONUS-2 groups.In the group of patients receiving meldonium compared with the control group (p < 0.001): total MFI-20 score decreased to 35 (27; 44); MFI-20 –34 (–46; –21), performance value –5 (–11; –2), proportion of patients with significant improvement (by CGI-I) by end of follow-up – 90.8%.Conclusion. Significant positive dynamics and regression of asthenia were noted in the groups of patients receiving meldonium in comparison with the control groups.

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The possibility of enhancing the efficiency of early comprehensive rehabilitation in patients with poststroke aphasia

Cited by 7 publications

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Clinical characteristics and metabolic therapy of fatigue in the acute and early recovery periods of ischemic stroke

Clinical characteristics and metabolic therapy of fatigue in the acute and early recovery periods of ischemic stroke

A current view on the prospects for the pharmaceutical therapy in neurorehabilitation after stroke

New opportunities in the treatment of asthenic symptoms after a new coronavirus infection

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