[Compression of nerves and senses: ipidacrine as the light at the end of the tunnel].

OBJECTIVE

To evaluate the efficacy of the AChE inhibitor ipidacrine when added to traditional therapy in outpatients with tunnel syndromes (TS) based on clinical, neurophysiological and psycho-emotional indicators.

MATERIAL AND METHODS

Ninety-two patients with a verified diagnosis of TS were randomized into a main group (MG), in which ipidacrine was added to the therapy (=50), and a control group (CG), which received conventional therapy (=42). Clinical neurological examination, provocative (Tinel, Falen, Goldberg finger compression, elevator and tourniquet) tests, pain questionnaires (VAS, DN4, PainDetect, Pain Disability Index), Beck's depression scale, the Spielberger Trait and State Anxiety Inventory, electroneuromyography (ENMG) were used.

RESULTS

Most of the examined subjects were patients with mild TS without muscle weakness or amyotrophy (80%). In the main group, there was a significant decrease in hypoesthesia, normalization of provocative tests, the increase of SNAP amplitudes, as well as nerve conduction velocities over motor and sensory fibers of the studied nerves (<0.05). Besides, the regression of neuropathic pain syndrome was objectified according to VAS, DN4 and PainDetect scales, which indexes decreased significantly (<0.01) in the course of therapy combined with ipidacrine. The positive dynamics, in its turn, contributed to the reduction of depression according to Beck's depression scale, comorbid chronic pain syndrome and improvement of patients' quality of life according to Pain Disability Index (<0.05). There was no significant improvement of clinical and neurophysiological parameters in the CG (>0.05). There were no significant differences in the assessment of pain, depression and quality of life (>0.05), except for a decrease in VAS scores (=0.03).

CONCLUSION

In patients treated with traditional therapy in combination with ipidacrine, the follow-up study after 4 weeks showed the reliable positive dynamics of clinical, neurophysiological and psycho-emotional indicators without application of psychoactive drugs.