Asthenia and vascular cognitive impairment in young patients after stroke

Post-stroke cognitive impairment (PSCI) is found in most patients over 50 years of age. At a young age, PSCI has a negative impact on daily activities, quality of life and return to work, regardless of physical recovery. Often PSCI are combined with asthenia, but there is very little information on the prevalence of post-stroke asthenia (PSA). Currently, the treatment of PSCI and PSA in young patients with citicoline is still controversial. Objective: to evaluate the prevalence of PSCI and PSA in young patients and the efficacy and safety of the domestic drug Noocil (citicoline) in the treatment of PSCI and PSA in stroke patients of young age. Material and methods . The work was conducted in two stages: the first stage was a longitudinal study of cognitive status using neurocognitive scales and assessment of signs of asthenia in patients aged 18 to 45 years; the second stage was an open prospective observational study of 47 patients aged 18 to 45 years with confirmed ischemic stroke (IS) who were randomly assigned to groups with Noocil administration (main group; n=26) or without treatment (control group; n=21). Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) and asthenia by manifestations of general fatigue (Multidimensional Fatigue Inventory, MFI-20). Results . High frequency of PSCI (51%) and the severity of asthenia according to MFI-20 scale were found in the hospital sample of young patients with IS. A direct correlation was found between the severity of PSA and the degree of cognitive decline. The positive effect of Noozil on cognitive functions, emotional state and severity of asthenia in the study group was noted. At the end of treatment, the mean MoCA score was 27.4±1.4 in the main group and 25.9±1.1 in the control group (p<0.01), and the mean MFI-20 score was 37.4±7.4 in the main group and 43.7±5.1 in the control group (p<0.01). Conclusion. The high incidence of PSCI and PSA and the positive effect of Noocil on the non-motor consequences of stroke in young patients and the high safety profile of the drug were shown.