PERSPECTIVES OF PHARMACOLOGICAL THERAPY USE IN NEUROREHABILITATION

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Aim.To study dynamics of neural cell adhesion molecules (NCAM), brain-derived neurotrophic factor (BDNF), and N-methyl-D-aspartate (NMDA) receptor NR2-subunit antibodies in patients after first ischemic stroke at the background of using medication Ipigrix in dosage 60 mg per day in addition to standard neurorehabilitation complex. Materials and methods. The study included 45 patients aged 60 to 85 years at the moment of first ischemic stroke. Neurorehabilitation complex was performed for 21 days and included background therapy, everyday individual and group sessions with speech pathologists and neuropsychologists, rehabilitation exercise therapy, massage therapy, and physiotherapeutic procedures. Patients were randomized in two groups using envelopes method. Group 1 included 30 patients for whom Ipigrix in dosage 20 mg per day was added to standard neurorehabilitation complex, therapy duration was 21 days. Group 2 included 15 patients who received standard neurorehabilitation complex without Ipigrix intake. In every patient included in the study NCAM, BDNF, and NMDA receptor NR2-subunit antibodies testing was performed twice. Results. During neurorehabilitation treatment in group of patients receiving Ipigrix in dosage 60 mg per day BDNF concentration increased significantly in group 1 (p=0.002), while in group 2 no significant changes were observed. Study of neurotrophic function marker BDNF concentration dynamics (А) showed 2.1 (0.5; 2.5) ng/ml in group 1; and -1.1 (-2.9; 0.6) ng/ml in group 2. These changes were considered significant (p=0.003). NCAM concentration significantly decreased in group 1 (p=0.005), while in group 2 no significant changes were observed. Study of neural cell adhesion molecules concentration dynamics (А) showed -0.56 (-1.72; 0.06) ng/ml in group 1, and - 0.65 (-0.19; 3.00) ng/ml in group 2, these changes were considered significant (p=0.002). In our study no significant changes in NMDA receptor NR2-subunit antibodies were observed in both groups. Conclusions. Use of medication Ipigrix in dosage 60 mg per day in addition to standard neurorehabilitation complex in patients after first ischemic stroke results in significant changes in neuroplasticity markers concentration that allows to perform more effective neurorehabilitation treatment.

About the authors

Veronika N. Shishkova

Yevdokimov Moscow State University of Medicine and Dentistry

Email: veronika-1306@mail.ru
канд. мед. наук, ст. науч. сотр., врач-эндокринолог

Alla Iu. Remennik

Center for Speech Pathology and Neurorehabilitation

канд. мед. наук, зав. клинико-биохимической лаб.

Elena I. Kerimova

Center for Speech Pathology and Neurorehabilitation

врач-лаборант клинико-биохимической лаб.

Lubov I. Zotova

Center for Speech Pathology and Neurorehabilitation

врач-невролог, зав. неврологическим стационаром

Natalia G. Maliukova

Center for Speech Pathology and Neurorehabilitation

канд. психол. наук, зав. отд-нием клинической психологии

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