Analysis of the correlation between neuroimaging markers of the brain damage and the severity of postural instability in patients with chronic cerebrovascular insufficiency (NEMAN open observational study)

Samartcev I.N.; Zhivolupov S.A.; Efimtsev A.Yu.; Ponomarev V.V.

doi:https://doi.org/10.17116/jnevro202212207166

Samartcev I.N.

Kirov Military Medical Academy

SPIN RSCI: 9857-4986
Scopus AuthorID: 57218542945
ORCID: 0000-0002-7659-9756

Zhivolupov S.A.

Kirov Military Medical Academy

Efimtsev A.Yu.

Almazov National Medical Research Center

Ponomarev V.V.

Belarusian Medical Academy of Postgraduate Education

Analysis of the correlation between neuroimaging markers of the brain damage and the severity of postural instability in patients with chronic cerebrovascular insufficiency (NEMAN open observational study)

Authors:

Samartcev I.N., Zhivolupov S.A., Efimtsev A.Yu., Ponomarev V.V.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(7): 66‑73

DOI: 10.17116/jnevro202212207166

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Samartcev IN, Zhivolupov SA, Efimtsev AYu, Ponomarev VV. Analysis of the correlation between neuroimaging markers of the brain damage and the severity of postural instability in patients with chronic cerebrovascular insufficiency (NEMAN open observational study). S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(7):66‑73. (In Russ.)
https://doi.org/10.17116/jnevro202212207166

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)

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Abstract:

OBJECTIVE

To analyze the relationship between the severity of postural instability in patients with CCI (chronic cerebral ischemia) and brain changes according to MRI, as well as to evaluate the efficacy and safety of vinpocetine.

MATERIAL AND METHODS

The study included 60 patients with CCI: 40 people with postural instability made up the main group and 20 people without balance disorders — the control group. The severity of manifestations of cerebrovascular pathology was assessed according to the protocol STRIVE. Severity of postural instability was assessed with the VAS, anxiety syndrome — Hamilton Anxiety Rating Scale, asthenia — Asthenic Condition Scale, daytime sleepiness — Epworth Sleepiness Scale, cognitive impairment — Montreal scale assessment of cognitive functions, the overall impression of treatment — Global Rating of Change Scale.

RESULTS

The main group was associated with older age, more significant decrease in cognitive functions, urination disorders, anxiety syndrome and asthenia, changes according to MRI of the brain. CCI burden scale was significantly associated with VAS: β=0.479, P=0.035, 95% CI 0.023—0.928. The presence of lacunae was the most significant marker for the development of severe imbalance: β=0.482, p=0.041, 95% CI 0.022—0.925. A significant relationship was found between the total number of lacunae and VAS (r=0.509, p=0.021), as well as between the number of lacunae in the basal ganglia (r=0.793, p=0.019), especially the lenticular nuclei (r=0.498, p=0.036), and VAS. After 3 months of vinpocetine treatment, a significant improvement in statodynamic function was noted in the main group, moreover — absence of anxiety, normalization of daytime sleep, «weak» asthenia, increasement in the value of the MoCA scale. Most of the patients regarded the improvement from the therapy as «moderate» and «pronounced».

CONCLUSIONS

The presence of lacunes in the basal ganglia is a most prominent neuroimaging marker of brain damage in patients with CCI and postural instability. The use of vinpocetine can significantly reduce the severity of imbalance, anxiety and asthenia, and normalize the circadian rhythm of sleep.

Keywords:

chronic cerebrovascular insufficiency

postural instability

neuroimaging markers

vinpocetine

Authors:

Samartcev I.N.

Kirov Military Medical Academy

SPIN RSCI: 9857-4986
Scopus AuthorID: 57218542945
ORCID: 0000-0002-7659-9756

Zhivolupov S.A.

Kirov Military Medical Academy

Efimtsev A.Yu.

Almazov National Medical Research Center

Ponomarev V.V.

Belarusian Medical Academy of Postgraduate Education

Received:

24.05.2022

Accepted:

07.06.2022

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