Nimodipine Preventing Cognitive Impairment In Ischemic Erebrovascular Clinical Trial

Objective: It was a randomize double-blind and prospective placebo-controlledclinical trial which is investigate the safety and efficacy of nimodipine in the treatmentof ischemic cerebrovascular patients with mild vascular cognitive impairment.Methods: Select ischemic cerebrovascular patients from March2011to March2012in the hospital(according to ICD-10and CT/MRI diagnostic criteria) and screenedin line with mild cognitive impairment as the subjects. According to inclusion criteriaand exclusion criteria we screened them within7days of the onset of symptoms.Investigator assessed the level of cognitive by the same measure with Mini Mental StateExamination (MMSE). According to the culture of the different levels and the finalscore, select the MMSE score>based on the correction of dementia in patients withcritical value of years of education (illiteracy>7, primary level>20, at leastsecondary>24); and according to the Montreal Cognitive Assessment (MOCA) toassess the different cognitive domains, including: attention and concentration, executivefunction, memory, language, depending on the structure of skills, abstract thinking,calculation and orientation. We screened the patients of score<26points(education timeover12years) or <27points(education time in12years) according to the final score andeducational level bias correction. And Alzheimer’s disease Assessment Scale-cognitivesubscale (ADAS-cog) is an important assessment scale to evaluate cognitive level ofpatients in this trial. It was selected31patients after ischemic cerebrovascular with mildcognitive impairment (including18male cases, female13cases, aged50-80years old,the average age of64.65±7.87years). It was divided into the nimodipine treatmentgroup and the placebo control group randomly and given nimodipine or placebo (30mg,times/day) at the onset of7days, continued oral medication treatment for6months. Itwas reviewed the MMSE、MOCA、ADAS-cog scale score and related biochemical and imaging studies following by the same measure investigator in three months and sixmonths. To observe changes in cognitive function in patients enrolled and theoccurrence of adverse reactions. When all the patients reach the endpoint of the studywe break the blind and analyze the statistical of data.Results:1)Changes in cognitive function scores in the nimodipine treatment groupbefore and after treatment:6months after the treatment, MMSE, MOCA, ADAS-cog score were improved more than those before treatment, P<0.05,is considered statisticallysignificance.2) MMSE, MOCA, ADAS-cog score had no significant differencesbetween nimodipine treatment group and placebo group before treatment (P>0.05).After6months of treatment, MMSE, MOCA score of nimodipine group is higher than theplacebo control group,(P<0.05), is considered statistically significance. The ADAS-cogscore compared with the placebo group decreased after treatment for3months and after6months of treatment, Statistically significant difference(P<0.05or P<0.01).3) Therewere no adverse reaction after the treatment in nimodipine treatment group comparedwith the placebo control group.Conclusion:1) Nimodipine may be effective to improve cognitive function inischemic stroke patients with mild cognitive impairment. They can continue to benefitfrom the long-term used.2) Nimodipine has high security and fewer adverse reactions.3) Evaluation of nimodipine to improve cognitive function should be possible to takeinto account a variety of cognitive function scale and to analyze comprehension.