Combined effect of succinic acid, riboxin, nicotinamide, riboflavin for the treatment of chronic brain ischaemia

Introduction. Сhronicbrain ischaemiais associated with the generation of oxygen free radicals resulting in a condition of oxidativestress. Various studies have investigated that antioxidant compounds can neutralize reactive oxygen species and free radicals.
Aim. To evaluate effect of Cytoflavin (INN: inosine + nicotinamide + riboflavin + succinic acid) for the treatment of chronic brain ischemia.
Materialy and methods. In a double-blind, placebo-controlled clinical study 50 patients aged 61 ± 9 years with chronic brain ischemia (vascular cognitive impairment), were randomized into Cytoflavin (n = 32) group or placebo (n = 18) group. The sealed envelopes system was used to randomize patients; 10.0 ml of the compound were infused by drops intravenously for 10-day period. During the course of treatment, therapy with vasoactive, nootropic and psychotropic drugs was excluded. In addition to clinical evaluation were carried outa comprehensive neuropsychological testing of cognitive functions, registration of cognitive induced potentials (IP) P300 and study of cerebral hemoperfusion using single photon emission computed tomography. To assess the intensity of lipid peroxidation we estimated several kinetic parameters of ferrous iron-induced chemiluminescence.
Results. Prevalence of good and excellent results of treatment was registered in patients treated with Cytoflavin comparing with those placebo (56% vs. 22%; р = 0.036). Psychological examination showed more expressed positive dynamics of physic activity rate in treatment with the active preparation comparing with those placebo (972 ± 184 sec vs. 1 251 ± 449 sec; р = 0.005). In the group of patients treated with Cytoflavin IP P300 showed the increase of P300 peak amplitude (before treatment 5.2 ± 1.2 mV, after treatment 7.2 ± 2.1 mV; р = 0.035). The biochemical basis of the therapeutic action of Cytoflavin was its antioxidant activity: Cytoflavin increased the endogenous antioxidant background (before treatment 46.8 ± 16.1 sec, after treatment 62.4 ± 13.6 sec, р = 0.004).
Conclusions. Cytoflavin produces positive effects on the main symptoms in patients with chronic brain ischaemia, increases endogenous antioxidant background and possesses certain neurotropic activity.

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