Neuroprotective strategies in the early recovery period of lacunar stroke: Focus on combination therapy

Introduction. A promising approach to neuroprotection in ischemic stroke is the use of drugs that combine nootropic and vasoactive properties, providing a comprehensive effect on the processes of systemic reorganization of neuronal connections and the recovery of impaired motor, speech, and cognitive functions.

Aim. To evaluate the effect of combination therapy including Vinpotropile on the dynamics of cognitive function and neurological impairment in the acute period of lacunar stroke.

Materials and methods. This prospective comparative study included 51 patients with lacunar stroke: 26 patients in the study group and 25 patients in the comparison group. The mean age was 65.4 ± 0.8 years. In addition to standard therapy, patients in the study group received Vinpotropile (5 mg + 400 mg) at a dose of 2 capsules three times daily for 30 days after a lacunar stroke. The comparison group received only standard therapy, including aspirin, statins, and antihypertensive drugs.

Results. At the end of 30-days treatment, cognitive function, assessed using the Montreal Cognitive Assessment (MoCA) were statistically significant higher in the study group (+2.8 ± 0.2) than in the comparison group (+1.9 ± 0.3), p = 0.021. By day 30, the median score on the National Institutes of Health Stroke Scale (NIHSS) in the study group decreased to 2 [1; 3], while in the comparison group it remained 4 [2; 6] (p = 0.002). The proportion of patients with functional independence in daily life (mRS ≤ 2) in the study group increased from 76.9% to 84.6%, while in the comparison group it remained 60.0% (p = 0.032 on day 30).

Conclusion. The study results support the inclusion of Vinpotropile in the standard treatment of patients with early recovery period lacunar stroke. A positive therapeutic effect of Vinpotropile is observed after 30 days of treatment initiation, demonstrating the relatively rapid onset of clinically significant action of this drug.

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