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Post-traumatic cognitive impairment (CI) and asthenia are common, disabling and often obligatory manifestations of traumatic brain injury (TBI). The search for effective drugs against CI and asthenia after TBI is of great importance. Objective: to investigate the efficacy and safety of Prospekta in the treatment of post-traumatic CI and asthenia in real-life clinical practice. Material and methods. The observational study involved 50 patients of both sexes aged 21–45 years (mean age 41.5 ± 5.9 years) with complaints of CI and fatigue after TBI received within the last 2 years, who were prescribed 1 tablet of Prospekta twice daily for 4 weeks. Cognitive functions, particularly the speed of attention switching, were assessed using the Schulte table method, visual-motor abilities were assessed using the Trail Making Test (TMT). Asthenic syndrome was assessed using the subjective asthenia rating scale (Multidimensional Fatigue Inventory, MFI-20). At the end of treatment, the safety of therapy and TBI outcomes were assessed using Dobrokhotova's differentiated TBI outcomes scale. Results. The average time to complete the Schulte table technique after 4 weeks of therapy with Prospekta decreased by 16.2 seconds, part A of the TMT – by 6.6 seconds and part B – by 19.8 seconds (p < 0.0001). The average score on the MFI-20 scale decreased by an average of 8 points after 4 weeks of therapy (p < 0.0001), which was mainly due to an increase in motivation (by 22 %), activity (by 16 %) and a decrease in emotional lability (by 20 %). The average score on Dobrokhotova's differentiated TBI outcome scale at the end of therapy was 3.2 ± 1.2 (mild/moderate asthenia). Treatment with Prospekta halved the number of patients with clinically significant mental asthenia, reduced motivation and reduced activity after TBI. No adverse events were recorded. Conclusion. The drug Prospekta can be recommended for monotherapy in patients with TBI to improve cognitive function and reduce asthenic syndrome in real-life clinical practice, contributing to the improvement of quality of life and functional activity of the injured individuals.
Post-traumatic cognitive impairment (CI) and asthenia are common, disabling and often obligatory manifestations of traumatic brain injury (TBI). The search for effective drugs against CI and asthenia after TBI is of great importance. Objective: to investigate the efficacy and safety of Prospekta in the treatment of post-traumatic CI and asthenia in real-life clinical practice. Material and methods. The observational study involved 50 patients of both sexes aged 21–45 years (mean age 41.5 ± 5.9 years) with complaints of CI and fatigue after TBI received within the last 2 years, who were prescribed 1 tablet of Prospekta twice daily for 4 weeks. Cognitive functions, particularly the speed of attention switching, were assessed using the Schulte table method, visual-motor abilities were assessed using the Trail Making Test (TMT). Asthenic syndrome was assessed using the subjective asthenia rating scale (Multidimensional Fatigue Inventory, MFI-20). At the end of treatment, the safety of therapy and TBI outcomes were assessed using Dobrokhotova's differentiated TBI outcomes scale. Results. The average time to complete the Schulte table technique after 4 weeks of therapy with Prospekta decreased by 16.2 seconds, part A of the TMT – by 6.6 seconds and part B – by 19.8 seconds (p < 0.0001). The average score on the MFI-20 scale decreased by an average of 8 points after 4 weeks of therapy (p < 0.0001), which was mainly due to an increase in motivation (by 22 %), activity (by 16 %) and a decrease in emotional lability (by 20 %). The average score on Dobrokhotova's differentiated TBI outcome scale at the end of therapy was 3.2 ± 1.2 (mild/moderate asthenia). Treatment with Prospekta halved the number of patients with clinically significant mental asthenia, reduced motivation and reduced activity after TBI. No adverse events were recorded. Conclusion. The drug Prospekta can be recommended for monotherapy in patients with TBI to improve cognitive function and reduce asthenic syndrome in real-life clinical practice, contributing to the improvement of quality of life and functional activity of the injured individuals.
No abstract
Traumatic brain injury is a serious medical condition that can be attributed to falls, motor vehicle accidents, sports injuries and acts of violence, causing a series of neural injuries and neuropsychiatric symptoms. However, limited accessibility to the injury sites, complicated histological and anatomical structure, intricate cellular and extracellular milieu, lack of regenerative capacity in the native cells, vast variety of damage routes, and the insufficient time available for treatment have restricted the widespread application of several therapeutic methods in cases of central nervous system injury. Tissue engineering and regenerative medicine have emerged as innovative approaches in the field of nerve regeneration. By combining biomaterials, stem cells, and growth factors, these approaches have provided a platform for developing effective treatments for neural injuries, which can offer the potential to restore neural function, improve patient outcomes, and reduce the need for drugs and invasive surgical procedures. Biomaterials have shown advantages in promoting neural development, inhibiting glial scar formation, and providing a suitable biomimetic neural microenvironment, which makes their application promising in the field of neural regeneration. For instance, bioactive scaffolds loaded with stem cells can provide a biocompatible and biodegradable milieu. Furthermore, stem cells-derived exosomes combine the advantages of stem cells, avoid the risk of immune rejection, cooperate with biomaterials to enhance their biological functions, and exert stable functions, thereby inducing angiogenesis and neural regeneration in patients with traumatic brain injury and promoting the recovery of brain function. Unfortunately, biomaterials have shown positive effects in the laboratory, but when similar materials are used in clinical studies of human central nervous system regeneration, their efficacy is unsatisfactory. Here, we review the characteristics and properties of various bioactive materials, followed by the introduction of applications based on biochemistry and cell molecules, and discuss the emerging role of biomaterials in promoting neural regeneration. Further, we summarize the adaptive biomaterials infused with exosomes produced from stem cells and stem cells themselves for the treatment of traumatic brain injury. Finally, we present the main limitations of biomaterials for the treatment of traumatic brain injury and offer insights into their future potential.
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