The use of inhaled nitric oxide (Tianox device) in patients with moderate cognitive impairment

Abstract

Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive function (CF) and dementia. In the general population of elderly, it is diagnosed in 10–15% of cases; in patients attending outpatient appointments, the frequency of diagnosis is 70%. In our country, there is positive experience with the inhalation of nitric oxide, using a device that synthesizes it from the air, for pulmonary and cardiovascular diseases.Objective: to investigate the use of inhaled nitric oxide (Tianox device) in patients with MCI due to cerebrovascular (CVD) and neurodegenerative diseases (NDD) of the brain.Material and methods. We observed 36 patients (8 men, 28 women, mean age 66±8.9 years, from 50 to 76 years) with MCI that developed on the background of CVD and NDD. In addition to stroke prevention therapy, the patients with MCI received daily inhalation of a nitric oxideenriched air mixture via a Tianox device for 30 minutes. The patients had from 7 to 10 inhalation sessions (the first, experimental – 20 minutes, the following sessions – 30 minutes). Detailed neuropsychological tests were performed at baseline and 3 months after the end of treatment.Results. The therapy was well tolerated and no adverse events occurred. After 3 months, the average score on the Montreal Cognitive Assessment increased from 23.7±3.5 to 25.6±3.9 points (p<0.001), the ability to memorize 12 words – from 7.5±1.8 to 8.7±2.1 words (p<0.05), categorical associations – from 14.8±5.0 to 16.9±4.6 words (p<0.05), the number of words found in the Munsterberg test – from 14.9±5.8 to 18.1±5.8 (p<0.001).The emotional state of the patients improved, the signs of depression decreased according to the Beck Depression Inventory from 13.65±8.5 to 11.4±6.7 points (p<0.05), on the Hospital Anxiety and Depression Scale – from 8.6± 5.0 to 7.3±4.1 points (p<0.05); anxiety decreased on the Hospital Anxiety and Depression Scale – from 7.0±5.0 to 5.4±4.5 points (p<0.05), Insomnia Severity Index – from 11.1±7.9 to 7.8±6.3 points (p<0.05).Conclusion. Good tolerability and a positive effect of inhaled nitric oxide on CF and emotional state of patients with MCI against the background of CVD and NDD were found.