amiridine and Peripheral-Nervous-System-Diseases

To evaluate the efficacy of combination of alpha-lipoic acid and acetylcholinesterase inhibitor (ipidacrine hydrochloride) to prevent the development and improve the course of paclitaxel-induced peripheral neuropathy (PIPN) in patients with breast cancer according to the Total Neuropathy Score.. 32 patients with breast cancer T1-4N0-3M0 received six cycles of polychemotherapy according to the AT scheme (paclitaxel, doxorubicin) or ET scheme (paclitaxel, epirubicin). Patients were randomized into two groups - without (group I) or with (group II) medication for prevention of neuropathy. A comprehensive neurological examination of patients was performed according to all ten parameters of the Total Neuropathy Score before chemotherapy, and after third and sixth cycles of chemotherapy. Each parameter was evaluated from 0 (no deficit) to 4 (no function/the most severe deficit). The scores obtained from the scale were summarized to obtain a total score from 0 to 40.. The use of alpha-lipoic acid in combination with an acetylcholinesterase inhibitor (ipidacrine hydrochloride) significantly reduces the symptoms and severity of PIPN. The manifestations of PIPN in patients of the control group were significantly more severe compared to the group in which the study drugs were used. The average severity of neuropathy after 3 and 6 cycles was 1.75 and 2.62 in group I, and 1.12 and 1.62 - in group II, respectively (improvement by 15.75% (p < 0.05) and 25.00% (p < 0.001) after 3 and 6 cycles).. Proposed combination of alpha-lipoic acid and ipidacrine hydrochloride led to a statistically significant reduction in the severity of PIPN, and thus to improvement of the functional capacity and quality of life of patients.

Topics: Acetylcholinesterase; Aminoquinolines; Breast Neoplasms; Cholinesterase Inhibitors; Female; Humans; Paclitaxel; Peripheral Nervous System Diseases; Quality of Life; Thioctic Acid

To investigate the neurofunctional parameters in breast cancer (BC) patients with paclitaxel-induced peripheral neuropathy (PIPN) and to clarify the feasibility of using alpha-lipoic acid (ALA) in combination with the acetylcholinesterase inhibitor ipidacrine hydrochloride (IPD) for its prevention.. 100 BC patients (T1-4N0-3M0-1) prescribed for polychemotherapy (PCT) by the AT (paclitaxel, doxorubicin) or ET (paclitaxel, epirubicin) regimens in the neoadjuvant, adjuvant or palliative modes, were enrolled. The patients were randomized into two groups (n = 50 per group): group I treated by PCT only; group II treated with PCT plus the studied PIPN prevention scheme (ALA in combination with IPD). An electroneuromyography (ENMG) of the sensory (superficial peroneal and sural) nerves was performed before PCT, and after the 3 and 6 PCT cycles.. According to ENMG data, the electrophysiological disturbances in the sensory nerves were manifested in the form of axonal sensory peripheral neuropathy of a symmetrical nature, which was reflected in a decrease in the amplitude of the action potential (AP) of the studied nerves. The AP reduction in sensory nerves was dominant, in contrast to the nerve conduction velocity, which in most patients remained within the reference values, thus evidencing on axonal degeneration rather than demyelination as an underlying cause of PIPN. The ENMG testing of the sensory nerve in the groups of BC patients treated by PCT with paclitaxel with or without PIPN prevention treatment established that the use of ALA in combination with IPD significantly improved AP amplitude, duration and area of ​​the response to the stimulation of the superficial peroneal and sural nerves after 3 and 6 PCT cycles.. The use of ALA in combination with IPD significantly reduced the severity of damage to the superficial peroneal and sural nerves caused by PCT with paclitaxel and could be recommended for PIPN prevention.

Topics: Acetylcholinesterase; Breast Neoplasms; Female; Humans; Paclitaxel; Peripheral Nervous System Diseases; Sural Nerve; Thioctic Acid

An open randomized trial of 58 patients with focal neuropathies of upper extremities has compared the efficacy of neyromidin (ipidacrinum) used in intramuscular injections and by the introduction of local injection perineural therapy. Both methods were combined with the following electroneurostimulation at the peak of drug action (30 min after the injection). The efficacy of treatment was assessed 14 days and 1 month after the end of treatment course by specific questionnaires and scales and an electroneuromyographic study. The data obtained indicate the efficacy of neyromidin in the treatment of patients with focal neuropathies of upper extremities. The introduction of the drug using local injection perineural therapy has demonstrated significantly better results.

Topics: Adult; Aged; Aminoquinolines; Cholinesterase Inhibitors; Female; Humans; Injections, Intramuscular; Middle Aged; Peripheral Nervous System Diseases; Upper Extremity

Compression-ischemic neuropathies remain one of the most actual problems of contemporary neurology due to the prevalence and commonly poor outcome. In the present work, we studied pathogenetic mechanisms of the formation and restoration of neural conductivity in the compression-ischemic model in rabbits and analyzed some features of therapeutic efficacy of the anticholinesterase drug neuromidin in clinical treatment of compression-ischemic neuropathies. We observed a generalized reaction of the nervous system to the acute limb compression in experimental animals. The ability of neuromidin to improve the central conductivity has been clearly shown. The results obtained allow recommending neuromidin in the treatment of patients with compression-ischemic neuropathies owing to its central and peripheral effects.

Topics: Aminoquinolines; Animals; Cholinesterase Inhibitors; Disease Models, Animal; Ischemia; Male; Nerve Compression Syndromes; Neural Conduction; Peripheral Nervous System Diseases; Rabbits

Topics: Adolescent; Adult; Aged; Aminoquinolines; Female; Humans; Male; Middle Aged; Neostigmine; Neural Conduction; Parasympathomimetics; Peripheral Nervous System Diseases; Treatment Outcome; Wounds and Injuries