Pathogenetic and therapeutic approaches to the correction of neurocognitive disorders in patients with chronic brucellosis

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Abstract

Aim. Evaluation of the efficacy of Cytoflavin in the correction of mild cognitive disorders in patients with chronic brucellosis.

Materials and methods. A total of 40 patients with inactive forms of chronic brucellosis who sought medical care were examined, including 17 men (42.5%) and 23 women (57.5%), with an average age of 46.4±3.7 years. In Group 1 patients received intravenous infusions of Cytoflavin for 10 days as a neuroprotector, and in Group 2 – "active placebo" (100 ml of 0.9% sodium chloride solution). Study design: open-label, randomized, comparative, random sampling.

Results. It has been established that inactive forms of chronic brucellosis are accompanied by damage to the nervous system with the development of mild (predementia) cognitive impairment and deterioration in quality of life. In the group of patients receiving Cytoflavin, there was a statistically significant decrease in the severity of neurological deficit, a significant increase in the total score of the MoCA test, and a statistically significant improvement in the indicators of both physical and psychological health components according to the scales of the SF-36 questionnaire. No side effects were recorded during the use of Cytoflavin in the patients of the study group, which indicates good tolerability of the drug.

Conclusion. The prescription of a course of infusion neuroprotective therapy with Cytoflavin contributes to a significant clinical improvement in patients with inactive chronic brucellosis with significant positive dynamics of cognitive functioning parameters assessed using MoCA testing and health indicators according to the SF-36 questionnaire.

About the authors

Andrey A. Shuldyakov

Razumovsky Saratov State Medical University

Author for correspondence.
Email: shuldaykov@mail.ru
ORCID iD: 0000-0002-3009-9262

д-р мед. наук, проф., зав. каф. инфекционных болезней

Russian Federation, Saratov

Anna N. Smagina

Razumovsky Saratov State Medical University

Email: shuldaykov@mail.ru
ORCID iD: 0000-0001-5139-2188

д-р мед. наук, проф., зав. каф. инфекционных болезней

Russian Federation, Saratov

Julia B. Barylnik

Razumovsky Saratov State Medical University

Email: shuldaykov@mail.ru
ORCID iD: 0000-0001-6837-5894

д-р мед. наук, зав. каф. психиатрии, наркологии, психотерапии и клинической психологии

Russian Federation, Saratov

Natal’a V. Filippova

Razumovsky Saratov State Medical University

Email: shuldaykov@mail.ru
ORCID iD: 0000-0002-3380-5935

канд. мед. наук, доц. каф. психиатрии, наркологии, психотерапии и клинической психологии

Russian Federation, Saratov

Elena P. Lyapina

Razumovsky Saratov State Medical University

Email: shuldaykov@mail.ru
ORCID iD: 0000-0001-6116-0567

д-р мед. наук, проф. каф. инфекционных болезней

Russian Federation, Saratov

Alexey D. Trubetskov

Federal Scientific Center for Medical and Preventive Health Risk Management Technologies – branch in Saratov

Email: shuldaykov@mail.ru
ORCID iD: 0000-0002-8890-0921

д-р мед. наук, проф., вед. науч. сотр. лаб. анализа медико-социальных проблем

Russian Federation, Saratov

Svetlana S. Savochkina

Razumovsky Saratov State Medical University

Email: shuldaykov@mail.ru
ORCID iD: 0009-0003-9870-7038

студентка

Russian Federation, Saratov

References

  1. Ляпина Е.П., Шульдяков А.А., Софьина А.В., и др. Клинические особенности и механизмы формирования органопатологии при хроническом бруцеллезе. Инфекционные болезни. 2021;19(3):67-77 [Lyapina EP, Shuldyakov AA, Sofina AV, et al. Clinical characteristics and mechanisms underlying the development of organ pathology in patients with chronic brucellosis. Infectious Diseases. 2021;19(3):67-77 (in Russian)]. doi: 10.20953/1729-9225-2021-3-67-77
  2. Pourmontaseri H, Rismani M, Karami B, et al. A rare case report of neuro-brucellosis with concurrence of depression, visual impairment, bilateral sensorineural hearing loss, and paraplegia. PLoS Negl Trop Dis. 2025;19(7):e0012824. doi: 10.1371/journal.pntd.0012824
  3. Zhuang W, He T, Tuerheng J, et al. Neurobrucellosis: laboratory features, clinical characteristics, antibiotic treatment, and clinical outcomes of 21 patients. BMC Infect Dis. 2024;24(1):485. doi: 10.1186/s12879-024-09308-x
  4. Soares CN, Angelim AIM, Brandão CO, et al. Neurobrucellosis: the great mimicker. Rev Soc Bras Med Trop. 2022;55:e05672021. doi: 10.1590/0037-8682-0567-2021
  5. Li Q, Liu J, Jiang W, et al. A case of brucellosis-induced Guillain-Barre syndrome. BMC Infect Dis. 2022;22(1):72. doi: 10.1186/s12879-021-07025-3
  6. Alikhani A, Ahmadi N, Frouzanian M, Abdollahi A. Motor polyradiculoneuropathy as an unusual presentation of neurobrucellosis: a case report and literature review. BMC Infect Dis. 2024;24(1):491. doi: 10.1186/s12879-024-09365-2
  7. Bouferraa Y, Bou Zerdan M, Hamouche R, et al. Neurobrucellosis: Brief Review. Neurologist. 2021;26(6):248-52. doi: 10.1097/NRL.0000000000000348
  8. Yakovlev N, Lyapina E, Komleva N, et al. Polyneuroрathy in рatients with сhroniс bruсellosis. Case study. Аrchiv euromedica. 2022;12(1):36-40. doi: 10.35630/2199-885X/2022/12/1.9
  9. Mahdavi FS, Abbasi Khoshsirat N, Madanipour A. Lumbosacral polyradiculitis associated with brucellosis. IDCases. 2021;23:e01028. doi: 10.1016/j.idcr.2020.e01028
  10. Шульдяков А.А., Смагина А.Н., Таранова Ю.Н. Качество жизни больных хроническим бруцеллезом. Инфекционные болезни. 2007; 5(3):48-50 [Shuldyakov AA, Smagina AN, Taranova YuN. Quality of life in patients with chronic brucellosis. Infectious Diseases. 2007;5(3):48-50 (in Russian)].
  11. Di Bari C, Venkateswaran N, Bruce M, et al. Methodological choices in brucellosis burden of disease assessments: A systematic review. PLoS Negl Trop Dis. 2022;16(12):e0010468. doi: 10.1371/journal.pntd.0010468
  12. García-Juárez G, Ramírez-Bribiesca E, Hernández-Calva LM, et al. Quality of life of patients with brucellosis in an endemic area of Mexico. Health. 2012;04(09):574-7. doi: 10.4236/health.2012.49090
  13. Atasoy PY, Yürük D. Evaluation of pain prevalence and quality of life in Brucella cases. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2022;24(3):510-6. doi: 10.24938/kutfd.1129777
  14. Okobi OE, Ayo-Farai O, Tran M, et al. The Impact of Infectious Diseases on Psychiatric Disorders: A Systematic Review. Cureus. 2024;16(8):e66323. doi: 10.7759/cureus.66323
  15. Izquierdo-Condoy JS, Vásconez-Gonzáles J, Morales-Lapo E, et al. Beyond the acute phase: a comprehensive literature review of long-term sequelae resulting from infectious diseases. Front Cell Infect Microbiol. 2024;14:1293782. doi: 10.3389/fcimb.2024.1293782
  16. Пшеничная Н.Ю., Гопаца Г.В., Сергеева Т.В. Редкие клинические формы хронического бруцеллеза. Журнал инфектологии. 2023;15(1): 121-5 [Pshenichnaya NY, Gopatsa GV, Sergeeva TV. Rare clinical forms of chronic brucellosis. Journal Infectology. 2023;15(1):121-5 (in Russian)]. doi: 10.22625/2072-6732-2023-15-1-121-125
  17. Esmael A, Elsherif M, Elegezy M, Egilla H. Cognitive impairment and neuropsychiatric manifestations of neurobrucellosis. Neurol Res. 2021;43(1):1-8. doi: 10.1080/01616412.2020.1812805
  18. Arazi F, Haddad M, Sheybani F, et al. Neurobrucellosis: a retrospective cohort of 106 patients. Trop Med Health. 2025;53(1):9. doi: 10.1186/s41182-025-00680-1
  19. Jin M, Fan Z, Gao R, et al. Research progress on complications of Brucellosis. Front Cell Infect Microbiol. 2023;13:1136674. doi: 10.3389/fcimb.2023.1136674
  20. Kanjo MA, Ahmed HM, Alnahari EA. Unusual presentation of neurobrucellosis in Jeddah, Kingdom of Saudi Arabia. Neurosciences (Riyadh). 2021;26(4):385-8. doi: 10.17712/nsj.2021.4.20210030
  21. Soares CN, da Silva MTT, Lima MA. Neurobrucellosis. Curr Opin Infect Dis. 2023;36(3):192-9. doi: 10.1097/QCO.0000000000000920
  22. Patra S, Kalwaje Eshwara V, Pai AR, et al. Evaluation of clinical, diagnostic features and therapeutic outcome of neurobrucellosis: a case series and review of literature. Int J Neurosci. 2022;132(11):1080-100. doi: 10.1080/00207454.2020.1860969
  23. Fusetti C, Petri F, Murad MH, et al. Neurobrucellosis Presenting with Motor Damage or Hearing Loss, and Use of Steroids are Associated with a Higher Risk of Sequelae or Relapse: A Systematic Review of Individual Participant Data. Neurol Sci. 2024;45(11):5441-8. doi: 10.1007/s10072-024-07621-6
  24. Ляпина Е.П., Шульдяков А.А., Софьина А.В., и др. Хронический бруцеллез: совершенствование терапии. Инфекционные болезни. 2019;17(3):39-47 [Lyapina EP, Shuldyakov AA, Sofina AV, et al. Chronic brucellosis: improving therapy. Infectious Diseases. 2019;17(3):39-47 (in Russian)]. doi: 10.20953/1729-9225-2019-3-39-47
  25. Красова Е.К., Титович И.А., Сидоров К.О., Оковитый С.В. Оценка эффективности и безопасности цитофлавина в качестве нейропротектора на основе систематического обзора. Разработка и регистрация лекарственных средств. 2025;14(1):285-318 [Krasova EK, Titovich IA, Sidorov KO, Okovityi SV. Evaluation of the efficacy and safety of cytoflavin as a neuroprotector based on a systematic review. Drug Development & Registration. 2025;14(1):285-318 (in Russian)]. doi: 10.33380/2305-2066-2025-14-1-1948
  26. Шульдяков А.А., Смагина А.Н., Рамазанова К.Х., и др. Патогенетические подходы к коррекции сосудистого звена гомеостаза при COVID-19: обзор. Терапевтический архив. 2023;95(11):1004-8 [Shuldyakov AA, Smagina AN, Ramazanova KK, et al. Pathogenetic approaches to the correction of vascular homeostasis in patients with COVID-19: A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(11):1004-8 (in Russian)]. doi: 10.26442/00403660.2023.11.202487
  27. Шульдяков А.А., Барыльник Ю.Б., Филиппова Н.В., и др. Нейропротекция как способ реабилитации пациентов, перенесших геморрагическую лихорадку с почечным синдромом. Инфекционные болезни. 2025;23(1):47-54 [Shuldyakov AA, Barylnik YuB, Filippova NV, et al. Neuro protection as a method of rehabilitation of patients who have suffered hemorrhagic fever with renal syndrome. Infectious Diseases. 2025;23(1):47-54 (in Russian)]. doi: 10.20953/17299225202514754

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