[Investigation of the effect of vinpocetine on cerebral blood flow and cognitive functions].
BACKGROUND
Vinpocetine has been widely used in the treatment of ischaemic cerebrovascular diseases and dementias of vascular type. Chronic cerebral hypoperfusion plays an important role in the development of certain types of dementia. In consequence of complex mode of action vinpocetine plays a significant role in the improvement of cerebral hypoperfusion. The symptoms of mild cognitive impairment considered as "predementia" are similar to those of dementia, although milder.


OBJECTIVE
The authors investigated the characteristics of the blood flow parameters of patients with ischemic stroke and mild cognitive impairment both in resting conditions or following chemical stimulus as well as they investigated the severity of mental deterioration in the two patient groups. In a pilot study the authors examined the influence of 12-week long oral vinpocetine therapy on the blood flow parameters and cognitive functions in the two patient groups.


METHODS
The authors studied the blood flow velocity of a. cerebri media in resting conditions and after 30 sec of breath holding with transcranial Doppler before treatment and after a 12-week long oral vinpocetine treatment. At the same time psychometric tests (MMSE, ADAS-Cog) were used in order to examine cognitive functions, while the general condition of the patients were scored by Clinical Global Impression (CGI) scale.


RESULTS
After a 12-week long oral vinpocetine treatment the increase of blood flow velocity in resting conditions compared to the baseline values was significant in the vascular group. The percent increase of mean velocity after the breath holding TCD test showed a significant increase compared to the baseline in both patient groups. The authors found a significant improvement of cognitive functions after a 12-week long oral vinpocetine therapy using psychometric tests. The improvement was identical in both groups. The general condition of patients improved significantly according to both the investigator's and the patients' opinion; patients with mild cognitive impairment judged the improvement higher.


CONCLUSIONS
Vinpocetine improved the cerebrovascular reserve capacity in both patient groups and favourably influenced the cognitive status and general condition of patients with chronic hypoperfusion. The authors recommend the use of vinpocetine for the treatment of patients with mild cognitive impairment.
Valikovics
Attila
A
Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Neurológia-Toxikológia-Stroke Osztály, Miskolc.
D000284:Administration, Oral; D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control*; D015140:Dementia, Vascular / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000187:drug effects / Q000503:physiopathology; D018696:Neuroprotective Agents / Q000494:pharmacology; D018697:Nootropic Agents / Q000494:pharmacology; D010865:Pilot Projects; D011594:Psychometrics; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D014748:Vinca Alkaloids / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
D018696:Neuroprotective Agents; D018697:Nootropic Agents; D014665:Vasodilator Agents; D014748:Vinca Alkaloids; C013983:vinpocetine