A method of evaluating the effectiveness of therapy idebenone cognitive impairment

 

(57) Abstract:

The invention relates to medicine, namely to psychiatry. Electroencephalographic study carried out before and after psychodiagnostic load for the mental playback charged the standard set of visual stimuli from 12 graphic figures and 16 words. Determine the index of the reactivity of the alpha rhythm spectrometric method and when it is increased at least 20% compared to baseline diagnosed with a positive outcome. The method allows to increase the precision of estimates of treatment by obtaining objective data. table 2., 3 Il.

The invention relates to medicine, namely to psychiatry.

Idebenone refers to drugs nootropic action. On chemical structure is a derivative of benzoquinone: 6-(10-hydroxybenzyl)-2,3-dimethoxy-5-methyl-1,4-benzoquinone. Is a stimulator of the synthesis of NGF, neuropeptide receptors which are located on the cholinergic Terminalia in cortex and hippocampi (In kN.: Radar-2001, M., 2000, S. 340).

There is a method of assessing the effectiveness of enhancement through psychological tests before and after a single dose of the drug registration electroencephalo patients with acute disorders of cerebral circulation // In the book. In : proceedings of the Symposium "Clinical significance of drug nootropil". M., 1976, S. 99-105).

The disadvantage of this method is the low accuracy of the study due to lack of consideration of individual functional state of the Central nervous system (CNS) at the time of the study, which largely determines the results of psychological testing.

There is a method of assessing the effects of nootropic drugs on the bioelectrical activity of the brain - for example, drug piracetam. The evaluation was conducted on the change in the spectral power of the frequency bands of the EEG, including alpha-rhythm, before and after treatment (L. N. Stolyarova, A. S. Kadykov. The use of piracetam in the treatment of patients with residual effects of cerebral circulation. // In the book: Proceedings of the Symposium "Clinical use of the drug nootropil". M., 1976, S. 128-133).

The disadvantage of this method is the low diagnostic accuracy in the absence of consideration of clinical manifestations and actions of the drug on cognitive function, because the change of clinical and EEG indicators are not always synchronous.

The technical result of the proposed solution is to increase precision">

This result is achieved by the fact that the EEG recording is carried out before and after psychodiagnostic load with the presentation of a standard set of visual stimuli from 12 graphic figures and 16 words, determine the reactivity index of the alpha rhythm spectrometric method and when it is increased at least 20% compared to baseline before treatment diagnosed positive outcome.

Follows from the known level of the fact that the change in the index of reactivity of alpha-rhythm at least 20% compared to baseline levels can serve as an objective criterion for evaluating the effectiveness of treatment idebenone cognitive impairment.

The method is as follows.

Before treatment idebenone patients suffering from organic diseases of the Central nervous system with cognitive impairment, carry out background record EEG. Then the patient is conducted psychodiagnostic load with the presentation of a standard set of visual stimuli of 16 words and 12 graphic shapes - see figures 1, 2 (In Russian). : Atlas for research deviations of mental activity. Edited by Professor I. A. Polishchuk. Kiev, Health, 1968).

During mental play these visual stimuli make powtorki. The difference between these indicators is the index of the reactivity of the alpha rhythm to the test. After a course of therapy with idebenone to 90 mg per day for 30-45 days EEG study with the use of psychodiagnostic load with a repeat measurement of the reactivity index of the alpha rhythm after treatment. Then conduct a comparison of the reactivity index of the alpha rhythm before and after treatment with idebenone and increasing at least 20% compared to baseline diagnosed with a positive outcome.

The invention is illustrated by example.

Example. Patient M. , 1947, R., DS: Residual effects of organic lesions of the Central nervous system traumatic Genesis with cognitive impairment. Has been examined in clinical Advisory Department of the Moscow research Institute of psychiatry of the Russian Federation Ministry of health 11.09.2000, Complaints about memory loss, impaired concentration, low mood, fatigue. In 1999 - the closed craniocerebral injury with brief loss of consciousness in the accident.

Before treatment patients received background recording EEG. Then brought psychodiagnostic load, consisting of a standard set of visual stimuli: 16 words and 12 graphic shapes, see Fig is divided index alpha rhythm spectrometric method in the occipital and parietal regions of the right and left hemispheres before and after psychodiagnostic load.

The results are shown in table 1.

The reactivity index of the alpha rhythm, which is determined by the difference between the metric of spectral power of the alpha rhythm when playing graphic shapes, words and indicator background spectral power of the alpha rhythm, respectively 13 and 14.

Patients received a course therapy idebenone at a dose of 90 mg per day for 45 days. After treatment, the patient noted improvement in memory, increased efficiency, has become more concentrated when doing intellectual work. Repeated EEG study before and after psychodiagnostic load with the presentation of a standard set of visual stimuli of 16 words and 12 graphic shapes - see figures 1, 3 (to exclude the possibility of training after the first test).

The results are shown in table 2.

The reactivity index of the alpha rhythm was 15.8 and 16.8 up 21.5% and 20% respectively higher than the original index of the reactivity of the alpha rhythm.

Thus, the increase of the reactivity index of the alpha rhythm after therapy idebenone by 20% compared to baseline in the patient corresponded to a positive clinical outcome.

The decree is treated with idebenone. The coincidence of the results of clinical and EEG studies occurred in 29 patients and 97% of cases (p<0,01).

A method of evaluating the effectiveness of treatment idebenone cognitive impairment by conducting clinical psychological and electroencephalographic studies index definition of the alpha rhythm before and after treatment, characterized in that the electroencephalographic study conducted before and after psychodiagnostic load for the mental playback charged the standard set of visual stimuli from 12 graphic figures and 16 words, determine the reactivity index of the alpha rhythm spectrometric method and when it is increased at least 20% compared to baseline diagnosed with a positive outcome.

 

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1 ex, 1 tbl

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