RU2395279C2 - Application of tryptophan for treatment of psychoverbal development retardation in case of neuro-psychic diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to neurology, psychiatry, pediatrics, and deals with retardation of psychoverbal development in case of neuro-psychic diseases in children. For this purpose L-tryptophan into composition of standard complex treatment of given pathology is included.

EFFECT: invention insures considerable increase of efficiency and stability of treatment results, which allows to reduce hospitalisation terms and financial costs of treatment considerably.

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Description

The invention relates to the field of medicine, namely to neurology, pediatrics, psychiatry, and can be used in the complex treatment of delayed psycho-speech development in case of neuropsychiatric diseases.

Known methods for the treatment of delayed psycho-speech development using metabolic, neuroprotective, restorative drugs (various groups of pharmacotherapeutic drugs), electroreflexotherapy, similar in essence to the effects and improvement of metabolic processes, activation of mental processes and neurotransmission through specific receptors, meridians [1, 2].

The disadvantages of these methods are low efficiency, insufficient pathogenetic validity, the complexity of the therapeutic effect associated with the need for highly specialized training and hardware.

The participation of tryptophan in the pathogenesis of neurological and mental disorders, the use of tryptophan in epilepsy is known [3, 4].

The use of tryptophan in medicine in the treatment of mental retardation is unknown.

The objective of the invention is to increase the efficiency and expand the possibility of treating a delay in psycho-speech development in case of neuropsychiatric diseases by using the levorotatory isomer of aminoxylate tryptophan (L-tryptophan).

This task is achieved by the use of L-tryptophan as a medicine for the treatment of delayed psycho-speech development in case of neuropsychic diseases against the background of standard treatment regimens due to differentiation of complex therapy taking into account various links of pathogenesis.

Tryptophan is an essential amino acid belonging to the group of aromatic amino acids with a sodium-independent transport system. Its metabolites are serotonin, melatonin, kinurinine, kinurin, xanthuric and nicotinic acids. Tryptophan is not synthesized in humans and animals; it enters the body primarily with the protein components of food. Tryptophan metabolism is carried out in several ways, under physiological conditions, at least 95% of tryptophan is oxidized along the kinurenine pathway and about 1% through the serotonin pathway. The main metabolic pathway leads to the synthesis of nicotinamide. Both the amino acid itself and its metabolites participate in various processes that regulate the functions of most cells, including the central nervous system, and have significant neurotropic activity. The effect of tryptophan is mediated by a number of biological mechanisms, in particular, interaction with excitatory amino acid receptors, which is considered an integral part of the pathogenesis of a number of neurological and mental disorders. Tryptophan metabolites possess immunomodulating and neurotrophic actions, participate in neurochemical mechanisms of memory, affect learning by regulating the processes of extraction, consolidation and long-term storage of information in memory, as well as the development of a number of neurodegenerative diseases of the central nervous system and modulate the emotional-volitional sphere.

L-tryptophan is used in the form of powders of 25 and 50 mg. The effectiveness of L-tryptophan is shown in the following examples.

Patient A.S. 6 years. Diagnosis: "Delay in psycho-speech development against the background of persistent consequences of perinatal posthypoxic encephalopathy, mild lower paraparesis", was treated at the clinic from July 10 to July 27, 2007. Complaints about memory loss, restlessness, distracted attention, difficulty concentrating, low interest in cognitive activity , underdevelopment of speech, fatigue, awkwardness of movements.

Prescribed treatment: L-tryptophan 50 mg 1 time per day - fifteen days. In addition, physiotherapy, massage, vasoactive drugs, classes with a psychologist, speech therapist were prescribed.

Tables 1-5 show the research results: data on the dynamics of indicators of visual memory, auditory-speech memory, attention, thought processes, speech, conducted according to the methods: hardly verifiable figures, 10-word technique, proof-reading, Koos cubes, the fourth extra, drawing up a story from the picture, compilation of a story on the topic, sequential pictures.

Table 6 shows a comparative analysis of the dynamics of the mental and speech activity of children who underwent treatment with tryptophan.

Table 1
Data dynamics indicators of visual memory Indicators Before treatment After treatment Visual memory 3 figures (arithmetic mean) 4.05 figures (arithmetic mean)

From table 1 it is seen that the amount of visual memory increased by 1.35 times.

table 2
Data on the dynamics of indicators of auditory speech memory Indicators Before treatment After treatment RAM size
Long-term memory 3 words (arithmetic mean)
2 (arithmetic mean) 4.75 words (arithmetic mean)
3.5 words (arithmetic mean)

From table 2 it is seen that the amount of RAM in the auditory-speech modality has increased 1.58 times and is approaching the lower limit of the norm; long-term memory - 1.75 times.

Table 3
Attention Index Dynamics Data Indicators Before treatment After treatment Number of errors in 1 min. 6 (arithmetic mean) 4.7 (arithmetic mean)

From table 3 it is seen that arbitrary attention has become more stable, the number of errors has decreased by 1.3 errors.

Table 4
Data on the dynamics of indicators of productivity of thinking Indicators Before treatment After treatment Number of completed tasks 3.3 (arithmetic mean) 4.6 (arithmetic mean)

From table 4 it is seen that after the last course of treatment with tryptophan, thinking became more productive with the formation of a constructive component of thinking, the child was able to complete an average of 1.3 more tasks.

Table 5
Data on the dynamics of speech activity indicators Indicators (quantity) Before treatment After treatment Using simple sentences 6 9 Using common offers 2 3 Dictionary Volume: - nouns 7 fifteen - Verbs 8 12 - adjectives 0 four - other parts of speech (adverb, participle, participle) 0 one

Table 5 shows that after the last course of treatment with tryptophan, there was an improvement in speech activity: the use of simple sentences increased by 1.5 times; use of common offers - 1.5 times; there was a qualitative change in the volume of the dictionary - the number of nouns increased by 2.14 times, the number of verbs - 1.5 times, the number of adjectives - 4 times, other parts of speech appeared.

According to the results of the studies, a comparative analysis of the dynamics of the mental activity of children who underwent treatment with tryptophan was performed, the data are shown in table 6.

All children were divided into four groups:

1. 0 points - children who did not have the dynamics of mental and speech activity; 2. 1 point - children who showed weak dynamics of mental and speech activity and slight dynamics in one of the studied indicators; 3. 2 points - children who showed slight dynamics in all studied indicators; 4. 3 points - children who showed significant positive dynamics in all studied indicators.

Table 6
Analysis of indicators of the dynamics of mental and speech activity of children Indicators 0 points - lack of dynamics 1 point - weak dynamics 2 points - moderate dynamics 3 points - pronounced dynamics Groups one 2 3 four Amount of children (%) 9% 43% 45% 3%

Table 6 shows that in 48% of cases in children (see indicators of groups 3 and 4) who took tryptophan, there was a positive dynamics of mental and speech activity of a moderate and pronounced degree, in 43% of children a weakly positive dynamics and only in 9% of cases lack of dynamics. 3% of children have a positive dynamics of a pronounced degree, these children have a significant increase in the volume of operational and long-term auditory-speech memory, increased productivity of thinking, increased speech activity and vocabulary, and the appearance in speech, except for verbs and nouns, other parts of speech.

While taking this therapy in patients, an increase in the volume of visual, auditory-speech memory, an improvement in concentration, concentration; the emergence of the ability to generalize, exclude, the development of constructive thinking; an increase in speech activity and an increase in vocabulary, the appearance of all parts of speech in one's own speech.

The state of memory, thinking, perception, speech depends on many factors, including the state of neurotransmitter systems, amino acid metabolism. Tryptophan, which has neurotransmitter, neuromodulating properties, changes the state of cerebral metabolism, significantly improves targeted activity, attention, memory, promotes the formation of speech mechanisms, provides a more stable effect.

For comparison, we present the results of patient correction without the use of tryptophan, carried out according to the standard treatment regimen (neurometabolic, nootropic, vascular, stimulating therapy, classes with a psychologist, speech therapist).

Example 2. Patient M.I. 6 years. Diagnosis: “Delay in psycho-speech development against the background of persistent consequences of perinatal hypoxic-traumatic encephalopathy, myatonic syndrome”, was treated at the clinic from June 07 to 25, 2007. Complaints about memory loss, restlessness, distractability, difficulty concentrating, low interest in cognitive activity , underdevelopment of speech, fatigue, irritability, moodiness.

Tables 7–11 show the results of studies: data on the dynamics of indicators of visual memory, auditory-speech memory, attention, thought processes, speech, conducted according to the methods: hardly verifiable figures, 10-word technique, proof-reading, Koos cubes, the fourth extra, drawing up a story from the picture, compilation of a story on the topic, sequential pictures.

Table 12 shows a comparative analysis of the dynamics of the mental and speech activity of children who underwent treatment according to the standard scheme.

Table 7
Data dynamics indicators of visual memory Indicators Before treatment After treatment Visual memory 3 figures (arithmetic mean) 3.5 figures (arithmetic mean)

From table 7 it is seen that the amount of visual memory increased 1.17 times

Table 8
Data dynamics of indicators of auditory speech memory. Indicators Before treatment After treatment RAM size 3 words (arithmetic mean) 3.75 words (arithmetic mean) Long-term memory 2.0 (arithmetic mean) 2.0 words (arithmetic mean)

Table 8 shows that the amount of RAM in the auditory-speech modality increased by 1.25 times, the amount of long-term memory has not changed.

Table 9
Attention Index Dynamics Data Indicators Before treatment After treatment Number of errors in 1 min. 8 (arithmetic mean) 7.0 (arithmetic mean)

From table 9 it is seen that arbitrary attention has become more stable, the number of errors has decreased by 1 error.

Table 10
Data on the dynamics of indicators of productivity of thinking Indicators Before treatment After treatment Number of completed tasks 3.0 (arithmetic mean) 3.1 (arithmetic mean)

From table 10 it can be seen that after the last course of treatment, the child was able to complete an average of 0.1 more tasks, improving the productivity of thinking is unreliable.

Table 11
Data on the dynamics of speech activity indicators Indicators (quantity) Before treatment After treatment Using simple sentences 5 6.5 Using common offers 2 2 Dictionary Volume: - nouns 5.8 7.5 - Verbs 5.5 8 - adjectives one 2 - other parts of speech (communion, participle, adverb) 0 0

From table 11 it is seen that after the last course of treatment according to the standard scheme, there was a slight improvement in speech activity: the use of simple sentences increased by 1.3 times, the use of common sentences did not change; a slight qualitative change in the volume of the dictionary was noted - the number of nouns increased by 1.3 times, the number of verbs - 1.45 times, the number of adjectives - 2 times, other parts of speech did not appear.

According to the results of the studies, a comparative analysis of the dynamics of the mental activity of children who underwent treatment according to the standard scheme was carried out, the data are shown in table 12.

All children were divided into four groups:

1. 0 points - children who did not have the dynamics of mental and speech activity; 2. 1 point - children who showed weak dynamics of mental and speech activity and slight dynamics in one of the studied indicators; 3. 2 points - children who showed slight dynamics in all studied indicators; 4. 3 points - children who showed significant positive dynamics in all studied indicators.

Table 12
Analysis of indicators of the dynamics of mental and speech activity of children Indicators 0 points - lack of dynamics 1 point - weak dynamics 2 points - moderate dynamics 3 points - pronounced dynamics Groups one 2 3 four Amount of children (%) fifteen% 55% 29% one%

From table 12 it is seen that in 30% of cases in children (see indicators of groups 3 and 4) there is a positive dynamics of mental and speech activity of moderate and pronounced degree, 55% of children have a weakly positive dynamics and in 15% of cases there is a lack of dynamics. Only 1% of children have a positive dynamics of a pronounced degree, these children have an improvement in concentration, voluntary activity, increased speech activity and an increase in vocabulary.

While taking this therapy, patients showed a slight increase in memory in the visual and auditory-speech modalities, an improvement in concentration, concentration, increased speech activity and an increase in vocabulary.

Amino acid L-tryptophan, which has neurotropic and immunomodulating properties, improves metabolic processes in the nervous system, reduces cerebral growth, improves attention, memory, increases mental and speech activity and significantly reduces hospitalization time and financial costs of treatment.

The action of the amino acid L-tryptophan was studied in 312 patients aged 4 to 8 years who were treated at the clinic in 2002-2008 with the diagnosis: “Delayed psycho-speech development in case of neuropsychiatric diseases”. In 91% of cases, an improvement in psycho-speech development was revealed, of which in 48% of cases in moderate and pronounced dynamics groups. They noted a significant improvement in indicators of memory, attention, thinking, which was much faster and more stable than without taking the proposed amino acid - L-tryptophan.

The use of tryptophan significantly increases the effectiveness and sustainability of treatment results, which can significantly reduce the hospitalization time and financial costs of treatment.

Information sources

1. RF patent No. 2305537, A61H 39/00. “A method for the treatment of delayed psycho-speech development in neuropsychiatric diseases”, September 10, 2007

2. Petrukhin AS “Neurology of childhood”. M .: "Medicine", 2004, S. 690-691.

3. I.D. Surkina, K. G. Gurevich. “Some Aspects of Amino Acid Exchange in Nervous and Mental Illness (Tryptophan Metabolism)”, J. Neurology and Psychiatry, M.: “Media Sphere”, 8, 2001, pp. 65-69.

4. V.A. Abzoleev. "Systemic mechanisms of epilepsy. Aspects of pathogenesis and treatment. ” - Irkutsk: RIO IGIUVA, 2001, p. 48-50 - prototype.

Claims (1)

The use of L-tryptophan as a medicine in the complex treatment of delayed psycho-speech development in neuropsychiatric diseases.