Abstract
Impaired oxygenation due to microcirculatory changes within the cerebral parenchyma may contribute to deterioration of intellectual function in vascular senile dementia (Hachinski score ≥ 7). The action of naftidrofuryl, used for treating elderly patients with senile dementia, was evaluated objectively in two groups of patients given naftidrofuryl either as a single intravenous dose or by chronic oral administration for three months. Their cerebral, microcirculatory flow rate was assessed before and after treatment by in vivo cineangioscintigraphy following an i.v. bolus of Tc-99m labelled erythrocytes. The deformability of erythrocytes from orally treated patients was also measured using an in vitro cellular transit time analyser (CTA) technique. A further experiment assessed the rheology of a rigid sub-population of erythrocytes in pathological samples when exposed to naftidrofuryl at concentrations appropriate to clinical use. Cerebral flow rates increased by about 20% and 30% after intravenous or chronic oral naftidrofuryl, respectively and these differences were statistically significant. In 10 orally treated patients, mean transit times by CTA decreased from 3.12 ms (day 0) to 2.70 ms (day 87 of treatment) (p<0.01). In the presence of naftidrofuryl, the proportion of the least deformable erythrocytes in pathological samples decreased by at least 50%. Clinical effects of naftidrofuryl on the cerebral microcirculation were not restricted to acute exposure. Naftidrofuryl may enhance the deformability of individual erythrocytes.
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