Drugs show promise in stroke, dementia prevention

Two drugs, in use for treating heart disease and angina, have shown promise in an early trial in preventing stroke and dementia caused by damage to small blood vessels in the brain.

The drugs — cilostazol and isosorbide mononitrate — were tested in a group of patients in Britain. The results showed that patients tolerated the drugs, with no serious side-effects, even when they were given in full doses or in combination with other medicines.

“The results of this trial show promise for treating a common cause of stroke and the most common cause of vascular dementia, since currently there are no effective treatments. Further trials are underway,” said lead researcher. 

Damage to small blood vessels in brain is responsible for around a quarter of strokes. It is also a common cause of memory problems and dementia. At present, the only way to reduce risk of the disease is by controlling blood pressure and cholesterol, stopping smoking and managing symptoms of diabetes.

For the study, researchers recruited 57 patients who had experienced stroke caused by damaged small blood vessels, known as a lacunar stroke. They took the two medicines either individually or in combination for up to nine weeks, in addition to usual treatments aimed at preventing further strokes.

They completed health questionnaires and had regular blood pressure checks, blood tests and brain scans. The findings suggest the drugs are safe for use in stroke patients, taken alone or in combination, at least in the short term.

There were also signs that the treatment helped improve blood vessel function in the arms and brain, and may improve thinking skills, but researchers stressed further studies to test this. 

Experts believe the findings pave the way for larger studies to check if the treatment can prevent brain damage and reduce risk of stroke and vascular dementia. A larger study, called LACI-2, is underway, said a statement.

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Probiotics prevent deadly complications of liver disease: Study

Probiotics are effective in preventing hepatic encephalopathy in patients with cirrhosis of the liver, according to a study by the Govind Ballabh Pant Hospital, New Delhi.


Hepatic encephalopathy is the deterioration of brain function - a serious complication of liver disease.
The research shows that probiotics modify the gut microbiota to prevent hepatic encephalopathy.
According to experts, the results offer a safe, well tolerated and a cheaper alternative to current treatments.

The researchers at G.B. Pant conducted a single-centre, randomised trial with cirrhosis patients who showed risk factors for hepatic encephalopathy, but had yet to experience an obvious episode.
When comparing treatment with probiotics versus placebo, the researchers found that the incidence of hepatic encephalopathy was lower in patients treated with probiotics.

Probiotic supplementation was not associated with any side effects and none of the patients required discontinuation of therapy.

“These results suggest that probiotics are similar in effectiveness to the current standard of care, lactulose, in the prevention of hepatic encephalopathy, yet they appear to be much better tolerated,” researchers added.

Up to 45 percent of patients with cirrhosis develop hepatic encephalopathy, a loss of brain function that occurs when the liver is unable to remove toxins from the blood.

Prognosis is poor, with a 58 percent mortality rate at one year, and a 77 percent mortality rate at three years.

"These results offer a safe, well tolerated and perhaps cheaper alternative to current treatments," said David W. Victor III, who contributed an editorial in the journal Clinical Gastroenterology and Hepatology on this research.

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