Pathogenetic Aspects of Preventive Correction of Cognitive Impairment in Metabolic Syndrome

Abstract

Objective. To study the opportunities to increase the efficiency of pathogenetic therapy in patients with chronic cerebrovascular diseases (CVD) (discirculatory encephalopathy, DE) on the background of metabolic syndrome (MS) using the drug Vitaxon®. The feature of the work was to identify strategic areas of the brain in cognitive and emotional disorders in patients with MS and its absence. Materials and methods. We observed 49 patients with DE II degree aged 37 to 73 years against the background of MS. The main group — 30 patients — received Vitaxon® as a part of treatment. The control group consisted of 19 patients with DE degree II following MS, comparable in the age and stage of the disease, who were not taking Vitaxon®. Patients were observed for 12 weeks. In addition to neurological, general clinical examinations, detection of MS signs, we have used neuropsychological tests by Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (МоСА), Spielberger anxiety scale; Beck depression scale; study of attention: search of numbers by Schulte tables with the assessment of task-performance time. The brain and its liquor system in 41 patients (27 patients with MS — the first group and 14 patients without MS — the second group) were evaluated using the method of volumetry (measuring the volume of certain brain regions), on the magnetic resonance imaging scanner Toshiba Vantage Titan 1.5. Results. Cognitive impairment in both groups manifested by the loss of memory, attention disorders, slowing of mental processes. After 12 weeks, the median by the MMSE significantly increased by 3.3 % (p < 0.05 compared with the first test) in patients who received Vitaxon®. By МоСА, which is more sensitive when determining the mild cognitive impairment, in a group of Vitaxon® cognitive functions improved by 5 %, while in the control group — by 1.66 %. By Spielberger scale, state anxiety indicators improved more in the group of patients who received study drug: at baseline — 42.4 ± 3.4 points and 24.6 ± 2.8 points at week 12 (p < 0.05). It was determined that cognitive performance by МоСА scale was inversely dependent on the parameters of glycated hemoglobin. Results of volumetric studies showed significant (p < 0.05) reduction in the volume of the brain substance, cortex and the volume of white matter of the cerebral hemispheres, temporal lobe in patients with CVD on the background of MS compared with those of similar age with no signs of MS. In addition, patients with MS had the likely decrease in the area of the corpus callosum (p < 0.05) compared to patients without MS. Conclusions. During the treatment of patients with CVD following MS, it is necessary to consider anxiety-asthenic conditions and cognitive disorders that often occur at this pathology. Addition of Vitaxon® to the generally accepted drug therapy helps to eliminate psycho-emotional disorders. In patients with chronic CVD on the background of MS, the degree of the atrophy of the cortex and white matter of the cerebral hemispheres, the frontal and temporal lobes, as well as the corpus callosum, was significantly higher (p < 0.05) compared to patients without MS.

Keywords

• metabolic syndrome
• discirculatory encephalopathy
• treatment
• Vitaxon®.