Effect of Infrared Low-Intensity Laser Irradiation on Lipid Peroxidation under Conditions of Experimental Circulatory Hypoxia of Visual Analyzer

The physiological stress modeled by circulatory hypoxia activates LPO processes in various tissues. In posthypoxic period, the infrared low-intensity laser irradiation significantly decreased the chemiluminescence parameters in blood plasma, normalized the retinal levels of diene and triene conjugates, and decreased MDA in the rat brain attesting to the correcting effect of this irradiation during various types of physiological stresses.

[Migraine burden and clinical inertia: what can we do?]

AIM

To study the compliance of neurologists and headache specialists to chronic headache and chronic migraine (CM) diagnosis and treatment guidelines.

MATERIAL AND METHODS

The survey included 634 neurologists from all regions of the Russian Federation. Mean age of respondents was 40.7±8.5 years, mean years of experience 14.2±7.8 years.

RESULTS

Most doctors work in outpatient or hospital settings (49% and 24%, respectively), 7% were headache specialists. Tension-type headache (TTH) was diagnosed in 30% and CM in 17% of patients while 44% of patients were presumed to have a mixed headache disorder (TTH+CM). Only 10% of physicians do not use instrumental diagnostic methods in chronic headache. This study has shown sufficient attention to comorbid conditions and frequent prescription of headache preventative treatment. Botox prescription data is equivocal: 35% of physicians recommend such treatment, 27% do not, while other doctors prescribe it for off-label indications.

CONCLUSION

To overcome clinical inertia, further education in chronic headaches and their optimal treatment is warranted.

[Real-world migraine burden: clinical and economic aspects]

AIM

To evaluate the rationale for different approaches to preventive chronic migraine (CM) treatment by comparing clinical outcomes and financial burden of the disease in the real-world practice.

MATERIAL AND METHODS

Sixty-six patients with CM were enrolled at the Alexander Vein Headache Clinic (60 women and 6 men, aged 28-51). All patients were divided into 3 groups: group 1 (n=22) received oral preventative treatment with topiramate, up to 100 mg daily, for three months; group 2 (n=20) received 12 acupuncture sessions (3 sessions a week); group 3 (n=24) received 155-195 units of botulinum toxin type A (botox, BTA). The follow-up period in all groups was 3 months. Efficacy was evaluated by clinical examination, the Headache Impact Test (HIT-6) and questionnaires to assess subjective patient satisfaction and treatment tolerability.

RESULTS

BTA demonstrated the highest efficacy in this study. Compared to the oral preventative treatment and acupuncture, BTA reduced the frequency of headache faster and more significantly facilitating CM transformation into episodic migraine (headache frequency was 16.1±0.1; 18.0±0.02; and 13.9±0.3 in groups 1, 2 and 3, respectively, after one month of treatment). BTA also improved the quality of life faster and more significantly and was better tolerated (good - 51%, 75% and 85% in groups 1, 2 and 3, respectively; satisfactory - 35%, 25% and 15% in groups 1, 2 and 3, respectively; bad 14% in the oral prevention group). In the BTA group, the majority of patients demonstrated earlier treatment satisfaction. Despite higher (compared to topiramate) direct costs in the BTA group (RUB 29 931.51 and RUB 32 085.87, respectively), the predicted cost of a headache-free day was the smallest and totaled RUB 652.15 (compared to RUB 692.86 and RUB 1017.60 in the topiramate and acupuncture groups, respectively).

CONCLUSION

The data on the efficacy and costs of different CM prevention strategies would facilitate optimal treatment choice for neurologists and patients.

[Strategies on the improvement of chronic migraine treatment efficacy]

OBJECTIVE

To determine the efficacy of type A botulinum toxin (lantox) in the treatment of chronic migraine.

MATERIAL AND METHODS

Authors examined 22 patients with chronic migraine at baseline and 4 and 12 weeks after the introduction of 150 U of lantox in head and cervical muscles using "follow the pain method". The drug was introduced into the following muscles: m. corrugator, m. procerus, m. frontalis, m. temporalis and m. оccipitalis. Clinical/neurological examinations, a study of the emotional sphere (anxiety and depression), daily activities, quality-of-life, patient's completion of questionnaires on the subjective satisfaction with treatment were carried out.

RESULTS AND CONCLUSION

There was a significant positive effect of treatment on the frequency of headache attacks that was important for reverse transformation of chronic pain to episodic headache. Barriers in compliance may be overcome by solving psychological problems, in particular, overcoming depression. The prescription of the drug with no side-effects and fast results allows to support the adherence of the patient to treatment.

[Tanakan as a multimodal cytoprotective factor in general medicine]

The first section of the review provides recent results regarding the mechanism of the action of a standardized extract of ginkgo biloba leaves EGb761 (tanakan), its effects on apoptosis, neuroplasticity, hemorheology, inhibition of the amyloid genesis and inflammatory response it cause, activation of proteasomes in conformational diseases. Current experimental and clinical results suggest that EGb761 (tanakan) is a high-effective cytoprotective agent in cognitive disorders of various genesis, cardiovascular diseases (in the process of rehabilitation and as a medicine capable to reduce the volume of brain damage in stroke). The effect of tanakan on anxiety and depression in patients with cognitive impairment should be considered as clinically significant.