Correction of clinical and metabolic disorders in patients with cerebrovascular disease in the presence of metabolic syndrome

Abstract

Abstract. Aims of the study. Analysis of the effectiveness and safety of treatment of patients with chronic cerebrovascular disease (encephalopathy) in the presence of  metabolic syndrome (MS), using Dialipon® and Vitaxon®, and assessment of the potential impact of Dialipon® and Vitaxon® on insulin resistance, indices of  cognitive function and quality of life in patients with MS. The peculiarity of the work was determination of strategic brain regions in case of cognitive and emotional  disorders in patients with MS and without MS. Materials and methods. 70 patients with degree II discirculatory encephalopathy (DE), aged 47 to 74 years, in the  presence of MS, were followed up. A study group of 50 patients in the framework of treatment received Dialipon® and Vitaxon®. The control group consisted of 20  patients with DE, of similar age and stage, who has not taken Dialipon® and Vitaxon®. In addition to neurological and clinical examinations, determination of metabolic syndrome (MS) criteria, the following neuropsychological testing scales were used: MMSE; MoCA; anxiety and depression scales; headaches using BAIII  pain scale; dizziness using points according to the Dizziness Handicap Inventory scale. The brain and its liquor system were tested in 47 patients (29 patients with MS  — main group, and 18 patients without MS — control group) using the volumometer method (measurement of volumes of individual brain regions). Results and  discussion. As a result of treatment, a decrease in dizziness was achieved. This manifested itself in an increasing number of patients without signs of dizziness and  transition of patients from the group with more marked giddiness into the group with a lesser dizziness. According to BAIII scale, headache diminished in primary  group by 2 points, in control group by 1.25 points. This process occurred significantly faster in patients receiving Dialipon® and Vitaxon®. The results of the volumetric measurements of the hippocampus showed that in patients with MS hippocampal volume (right Me =3.293058* and left Me=2.84*) was significantly  lower (p<0.05) than in patients without MS (right Me= 3.93, left Me= 3.55). Cognitive impairment manifested itself in a loss of memory, impaired attention, slowing of  mental processes, and limited ability to plan and control. As a result of treatment an improvement in cognitive and emotional functions was achieved in both  groups, but adding Dialipon® and Vitaxon® to conventional therapy has contributed to improving concentration, memory, to reducing situational anxiety and thus patients’ attitude to different life situations. As a result of treatment using a low-caloric diet and exercise, a positive dynamics has been established with regard  to an improvement of insulin resistance in both groups, that manifested itself in a reduction of HOMA index. But in the patients’ group receiving the drugs under  study, the degree of improvement achieved a degree of reliability. The level of total cholesterol in the main group decreased from 6.27±1.3 mmol/L to 5.12±1.8  mmol/L and in controls to 6.08±1.12 and 5.54±0.4 mmol/L (p<0.05), respectively. Conclusions. The use of Dialipon® and Vitaxon® in the combined treatment of  chronic cerebrovascular diseases in the presence of MS contributed to an improvement of attention, concentration, memory; had a positive impact on reactive  anxiety; contributed to a normalization of insulin resistance and body mass index, and lipid spectrum. Possibly, in patients with chronic cerebrovascular  disease the  MS cluster components contributed to the development of atrophy processes in the hippocampus. A combination of arterial hypertension, insulin resistance,  yslipidemia, etc., accelerated the atrophy processes in the hippocampus to a greater extent than separately would do each of the components that were tested in  patients with DE without MS.