No 7 (2009)

The main theme of the International XLVIII Nevrol-Psychiatric Congress, 2008, June, 18-21, Pula (Croatia), was psyhoimmunology - actual interdisciplinary research field, assessing the interaction of the nervous and immune systems. The reports and communications submitted to the Congress encompassed a number of studies of the role of immunological disturbances in the pathogenesis and pathophysiology of schizophrenia and affective disorders as well as general questions for principles and mechanisms of bi-directional interaction between the nervous and immune systems, in which the special role played cytokines and chemokines.

According to modern concepts, the early use of symptomatic therapy in Parkinson's disease (PD) has a favorable effect on the motor function, as well as the quality of life of patients, decrease the risk of motor fluctuations and dyskinesias on the progression of the disease. Razagilin (Azilekt) is a high effective long-lasting irreversible inhibitor of type B monoamine oxidase. The drug has a good symptomatic effect as monotherapy in early stages PD and in combination with levodopa therapy for the full-scaled disease states, has a neuroprotective effect and modifies the course of the disease. Azilekt important features are: single daily intake without dose titration, no need for dose adjustment in elderly people. The use of the drug at different stages PD in various age patients is effective due to lack of effect on cognitive function, behavior and temper.

Cognitive impairments are the one of the most common and disabling manifestations of cerebrovascular insufficiency. They often develop due to stroke and dyscirculatory encephalopathy. Cognitive disorders are the fundamental symptom reflecting the severity of vascular cerebral lesions after chronic insufficiency of cerebral circulation. The most common "frontal" type cognitive impairments are concentration, intellectual processes, and spatial praxis disorders. They are usually accompanied by temper tantrum, emotional lability and irritability. Memory suffers to a lesser extent, what distinguishes the cognitive impairment in dyscirculatory encephalopathy from neurodegenerative process. Treatment of vascular cognitive impairments should be directed to the main cardiovascular disease, as well as to optimization of cerebral microcirculation and neurometabolic processes.

The article is dedicated to the problem of the calcium channel blockers use for treatment of hypertensive patients with cognitive dysfunction. In neurological practice, the well-studied representative of this group is Nimodipine (Nimotop), which was associated with the main hope in the treatment of such patients. Moreover, there is the possibility of nimodipine use in cardiology practice, in particular in patients with coronary heart disease.

In recent years there has been significant progress in the treatment of multiple sclerosis (MS). The article reviews current approaches to the pathogenetic treatment of multiple sclerosis. Authors consider the mechanism of action of drugs modulating disease course. The treatment regimens of the MS with glucocorticoids, interferon beta, glatiramere acetate, mitoksantron, natalizumab are presented. It is emphasized that the management of patients with MS requires an individual approach with the involvement of many specialists in various medical fields.

Increase in the number of patients with acute and chronic ischemic cerebrovascular disturbances determines the relevance of the problem of their effective treatment. Recently, special attention is paid to the combined drugs with neuroprotective, antihypoxic and vasoactive effects. The article discusses the main pathogenetic aspects of the drug Vazobral (digidroergokriptin + caffeine) efficacy in insufficiency of cerebral circulation; the results of clinical trials of this drug in the treatment of patients with cerebrovascular diseases are presented.

The article discusses the treatment of postischemic neuritis in patients with chronic critical ischemia of lower limbs (CCILL). Successful experience of Neurodiclovit use in the treatment of postischemic neuritis is submitted. Authors conducted perspective analysis of the results of treatment of postischemic neuritis in patients with CCILL, treated at the Department of vascular surgery and angiosexology of I.M. Sechenov Moscow Medical Academy Research Centre from February 2008 to March 2009. All 47 patients enrolled in the study, received Neurodiclovit 1 capsule 3 times daily within 2 weeks. The results were followed up in 41 patients, 6 patients dropped from the study. The full pain syndrome relief was achieved in 27.7% patients; pain syndrome was substantially reduced in 46.4%. It was concluded that Neurodiclovit shows significiant positive effect in the treatment of postischemic neuritis in patients with CCILL.