Issue 24-1, 2025
Review
Rationale for the Use of Electrophoresis of Drugs in Post-Stroke Patients with Visual Impairments: a Review
Detelina B. Kulchitskaya,
Tatiana V. Konchugova, *
Tatyana V. Marfina,
Tatiana V. Apkhanova
National Medical Research Center for Rehabilitation and Balneology, Moscow, Russia
ABSTRACT
INTRODUCTION. Disorders of vision and oculomotor functions are widespread among patients who have suffered a cerebral stroke. The rehabilitation system for patients who have suffered a stroke makes use of physiotherapy methods that can significantly improve haemodynamic processes and regeneration. Among the best-known physiotherapeutic methods is drug electrophoresis.
MAIN CONTENT OF THE REVIEW. This review discusses the results of studies investigating the efficacy of electrophoresis techniques using various drugs developed for use in patients after stroke, including those complicated by visual impairment, based on publications in the international and domestic databases PubMed, Medline, Cochrane Library, and eLIBRARY.RU.
CONCLUSION. At present, there are already prerequisites for further development of the method of endonasal electrophoresis of neuroprotective drugs in patients with post-stroke after-effects. The application of this technique is most suitable for patients suffering from a stroke and concomitant visual impairments. However, these approaches are still under investigation and require randomized trials to ascertain their clinical efficacy in a representative patient population.
KEYWORDS: stroke, post-stroke visual impairment, electrophoresis
FOR CITATION:
Kulchitskaya D.B., Konchugova T.V., Marfina T.V., Apkhanova T.V. Rationale for the Use of Electrophoresis of Drugs in Post-Stroke Patients with Visual Impairments: a Review. Bulletin of Rehabilitation Medicine. 2025; 24(1):84–90. https://doi.org/10.38025/2078-1962-2025-24-1-84-90 (In Russ.).
FOR CORRESPONDENCE: Tatyana V. Marfina, Е-mail: marfinatv@nmicrk.ru
References:
- Centers for Disease Control and Prevention. Stroke Facts. Available at: https://www.cdc.gov/stroke (Accessed 15.10.2024).
- N.I.H. Stroke Scale. Available at: https://www.ninds.nih.gov/health-information/stroke/assess-and-treat/nih-stroke-scale (Accessed: 15.10.2024).
- Игнатьева В.И., Вознюк И.А., Шамалов Н.А. и др. Социально-экономическое бремя инсульта в Российской Федерации. Журнал неврологии и психиатрии им. С.С. Корсакова. 2023; 123(8–2): 5–15. https://doi.org/10.17116/jnevro20231230825 [Ignatieva V.I., Voznyuk I.A., Shamalov N.A et al. Social and economic burden of stroke in Russian Federation. S.S. Korsakov Journal of Neurology and Psychiatry. 2023; 123(8–2): 5–15. https://doi.org/10.17116/jnevro20231230825 (In Russ.).]
- O’Donnell M.J., Xavier D., Liu L. et al. INTERSTROKE investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010; 376: 112–123. https://doi.org/10.1016/S0140-6736(10)60834-3
- Winstein C.J., Stein J., Arena R. et al. American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke. 2016; 47(6): e98–e169. https://doi.org/10.1161/STR.0000000000000098
- Morrow C., Gasque H., Woodbury M. et al. Diagnosis of spatial neglect and rehabilitation access for stroke survivors. Cogent Gerontol. 2024; 3(1): 2375706. https://doi.org/10.1080/28324897.2024.2375706
- Helboe K.S., Eddelien H.S., Kruuse C. Visual symptoms in acute stroke — A systematic review of observational studies. Clinical Neurology and Neurosurgery, 2023; 229: 107749. https://doi.org/10.1016/j.clineuro.2023.107749
- Gilhotra J.S., Mitchell P., Healey P.R. et al. Homonymous visual field defects and stroke in an older population. Stroke. 2002; 33(10): 2417–2420. https://doi.org/10.1161/01.str.0000037647.10414.d
- Rowe F.J., Hepworth L.R., Howard C. et al. Impact of visual impairment following stroke (IVIS study): a prospective clinical profile of central and peripheral visual deficits, eye movement abnormalities and visual perceptual deficits. Disabil. Rehabil. 2022; 44(13): 3139–3153. https://doi.org/10.1080/09638288.2020.1859631
- Sand K.M., Wilhelmsen G., Naess H. et al. Vision problems in ischaemic stroke patients:effects on life quality and disability. Eur J Neurol. 2016; 23(Suppl. 1): 1–7. https://doi.org/10.1111/ene.12848
- Rowe F.J., Wright D., Brand D. et al. A prospective profile of visual field loss following stroke: prevalence, type, rehabilitation, and outcome. Biomed Res Int. 2013; 2013(1): 719096. https://doi.org/10.1155/2013/719096
- Saionz E.L., Busza A., Huxlin K.R. Rehabilitation of visual perception in cortical blindness. Handb Clin Neurol. 2022; 184: 357–373. https://doi.org/10.1016/B978-0-12-819410-2.00030-8
- Pollock A., Hazelton C., Rowe F.J. et al. Interventions for visual field defects in people with stroke. Cochrane Database of Systematic Reviews. 2019; Issue 5(5): CD008388. https://doi.org/10.1002/14651858.CD008388.pub3
- Wolter M., Preda S. Visual deficits following stroke:maximizing participation in rehabilitation. Top Stroke Rehabil. 2006; 13(3): 12–21. https://doi.org/10.1310/3JRY-B168-5N49-XQWA
- Загайнова А.Ю., Кузюкова А.А., Добрякова В.В. и др. Успешное преодоление односторонней пространственной агнозии в позднем восстановительном периоде ишемического инсульта: клинический случай. Вестник восстановительной медицины. 2023; 22(2): 102–111. https://doi.org/10.38025/2078-1962-2023-22-2-102-111 [Zagaynova A.Yu., Kuzyukova A.A., Dobryakova V.V. et al. Overcoming Unilateral Spatial Agnosia in the Late Recovery Period of Ischemic Stroke: A Case Report. Bulletin of Rehabilitation Medicine. 2023; 22(2): 102–111. https://doi.org/10.38025/2078-1962-2023-22-2-102-111 (In Russ.).]
- Кузюкова А.А., Пёхова Я.Г., Одарущенко О.И. и др. Сравнительный анализ влияния сенсомоторной реабилитации и психотерапевтической методики на психоэмоциональное состояние пациентов в восстановительном периоде инсульта. Вестник восстановительной медицины. 2023; 22(4): 80–89. https://doi.org/10.38025/2078-1962-2023-22-4-80-89 [Kuzyukova A.A., Pekhova Y.G., Оdarushenko O.O. et al. Sensorimotor Rehabilitation and Psychotherapeutic Techniques Effect on the Psychoemotion al State in the Stroke Recovery Period. Bulletin of Rehabilitation Medicine. 2023; 22(4): 80–89. https://doi.org/10.38025/2078-1962-2023-22-4-80-89 (In Russ.).]
- Saionz E.L., Tadin D., Melnick M.D. et al. Functional preservation and enhanced capacity for visual restoration in subacute occipital stroke. Brain. 2020; 143(6): 1857–1872. https://doi.org/10.1093/brain/awaa128
- National Clinical Guideline Centre (UK). Stroke Rehabilitation: Long Term Rehabilitation After Stroke [Internet]. London: Royal College of Physicians (UK). 10 Vision. NICE Clinical Guidelines, No. 162. 2013. Available at: https://www.ncbi.nlm.nih.gov/books/NBK327908/ (Accessed: 15.10.2024).
- Sabel B., Thut G., Haueisen J. et al. Vision modulation, plasticity and restoration using non-invasive brain stimulation – An IFCN-sponsored review. Clin Neurophysiol. 2020; 131(4): 887–911. https://doi.org/10.1016/j.clinph.2020.01.008
- Лебедева Д.И., Туровинина Е.Ф., Десятова И.Е. и др. Оценка эффективности транскраниальной магнитной стимуляции у пациентов после ишемического инсульта: проспективное исследование. Вестник восстановительной медицины. 2023; 22(4): 31–40. https://doi.org/10.38025/2078-1962-2023-22-4-31-40 [Lebedeva D.I., Turovinina E.F., Desyatova I.E. et al. Effectiveness of Transcranial Magnetic Stimulation in Patients after Ischemic Stroke: a Prospective Study. Bulletin of Rehabilitation Medicine. 2023; 22(4): 31–40. https://doi.org/10.38025/2078-1962-2023-22-4-31-40 (In Russ.).]
- Schuhmann T., Duecker F., Middag-van Spanje M. et al. Transcranial alternating brain stimulation at alpha frequency reduces hemispatial neglect symptoms in stroke patients. Int J Clin Health Psychol. 2022; 22(3): 100326. https://doi.org/10.1016/j.ijchp.2022.100326
- Улащик В.С. История, достижения и перспективы развития электрофореза лекарственных веществ. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2002; 5: 8–13. [Ulashchik et al. V.S. History, achievements and prospects of development of electrophoresis of medicinal substances. Problems of Balneology, Physiotherapy and Exercise Therapy. 2002; 5: 8–13 (In Russ.).]
- Мусаев А.В., Балакишиева Ф.К. Электрофорез вазоактивных препаратов в лечении и реабилитации больных с ишемическими заболеваниями головного мозга. Журнал неврологии и психиатрии им. С.С. Корсакова. 2010; 110(2): 79–82. [Musaev A.V., Balakishieva F.K. Electrophoresis of vasoactive drugs in the treatment and rehabilitation of patients with cerebral ischemic diseases. S.S. Korsakov Journal of Neurology and Psychiatry. 2010; 110(2): 79–82 (In Russ.).]
- Мирютова Н.Ф., Самойлова И.М., Барабаш Л.В. и др. Комплексная реабилитация больных с последствиями острого нарушения мозгового кровообращения. Физиотерапия, бальнеология и реабилитация. 2015; 14(1): 13–18. https://rjpbr.com/1681-3456/article/view/41489 [Miryutova N.F., Samoilova I.M., Barabash L.V. et al. The combined rehabilitative treatment of the patients suffering from the consequences of acute disturbances to cerebral circulation. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2015; 14(1): 13–18. https://rjpbr.com/1681-3456/article/view/41489 (In Russ.)].
- Penionzhkevich D.Iu., Peregonchaia O.V. Intranasal electrophoresis using a neurotropic preparation as a promising technique for the rehabilitative treatment of patients with cerebrovascular diseases. Vopr Kurortol Fizioter Lech Fiz Kult. 2009; 3: 3–8.
- Борисова H.A., Иванова M.A., Аверцев Г.H. и др. Применение эндоназального электрофореза с Мексидолом при ранних формах сосудистых заболеваний мозга. (Дата обращения: 15.10.2024). Доступно на: https://cortexmed.ru/articles/nauchnye-stati/primenenie-endonazalnogo-elektroforeza-s-meksidolom-pri-rannikh-formakh-sosudistykh-zabolevaniy-mozg/ [Borisova H.A., Ivanova M.A., Avertsev G.H. et al. Application of endonasal electrophoresis with Mexidol in early forms of cerebral vascular diseases. Available at: https://cortexmed.ru/articles/nauchnye-stati/primenenie-endonazalnogo-elektroforeza-s-meksidolom-pri-rannikh-formakh-sosudistykh-zabolevaniy-mozg/ (Accessed: 15.10.2024) (In Russ.).]
- Бровко М.А., Чехонацкий А.А., Ковалев Е.П. и др. Физиотерапевтические методы лечения цереброваскулярной патологии (обзор). Саратовский научно-медицинский журнал. 2022; 3(18): 370–374. [Brovko M.A., Chekhonatsky A.A.; Kovalev E.P. et al. Physiotherapeutic methods of treatment of cerebrovascular pathology (review). Saratov Scientific Medical Journal. 2022; 3(18): 370–374 (In Russ.).]
- Царёв А.Ю., Лазарев А.С. Электрофорез пирацетама, даларгина и магния в комплексном лечении больных церебральным атеросклерозом, перенесших «малый инсульт». Актуальные вопросы курортологии, физиотерапии и медицинской реабилитации. Ялта, 2001; 201–205 [Tzarev A.Yu. Lazarev A.S. Electrophoresis of piracetam, dalargin and magnesium in the complex treatment of patients with cerebral atherosclerosis who suffered a “minor stroke”. Topical issues of balneology, physiotherapy and medical rehabilitation. Yalta. 2001; 201–205 (In Russ.).]
- Пирогова Л.А., Новицкая Т.А., Хованская Г.Н. Опыт клинического использования электрофореза 1 % раствора мидокалма в реабилитации больных мозговым инсультом. Актуальные вопросы клинической неврологии и нейрохирургии. Гродно. 2011; 93–98. [Pirogova L.A., Novitskaya T.A., Khovanskaya G.N. Experience of clinical use of electrophoresis of 1 % solution of midocalm in rehabilitation of patients with cerebral stroke. Topical issues of clinical neurology and neurosurgery. Grodno. 2011; 93–98 (In Russ.).]
- Данилова И.Н., Неретин В.И., Нестерова Л.А. Влияние электрофореза аминалона на биоэлектрическую активность мозга у пациентов с церебральным атеросклерозом и нарушением мозгового кровообращения. Вопросы курортологии, физиотерапии и лечебной физической культуры. 1980; 4: 13–17. [Danilova I.N., Neretin V.I., Nesterova L.A. The effect of aminalon electrophoresis on the bioelectric activity of the brain in patients with cerebral atherosclerosis and impaired cerebral circulation. Problems of Balneology, Physiotherapy and Exercise Therapy 1980; 4: 13–17 (In Russ.).]
- Марфина Т.В., Кончугова Т.В., Кульчицкая Д.Б. и др. Нарушения зрения у пациентов, перенесших инсульт: обзор из двух частей. Часть I — распространенность нарушений. Вестник восстановительной медицины. 2024; 23(5): 108–115. https://doi.org/10.38025/2078-1962-2024-23-5-108-115 [Marfina T.V., Konchugova T.V., Kulchitskaya D.B. et al. Visual Impairment in Stroke Patients: a Two-Part Review. Part I — Prevalence. Bulletin of Rehabilitation Medicine. 2024; 23(5): 108–115. https://doi.org/10.38025/2078-1962-2024-23-5-108-115 (In Russ.).]
- Cabrera F.J., Wang D.C., Reddy K. et al. Challenges and opportunities for drug delivery to the posterior of the eye. Drug Discov Today. 2019; 24(8): 1679–1684. https://doi.org/10.1016/j.drudis.2019.05.035
- Li S.K., Hao J. Transscleral passive and iontophoretic transport:theory and analysis. Expert Opin Drug Deliv. 2018; 15(3): 283–299. https://doi.org/10.1080/17425247.2018.1406918
- Wei D., Pu N., Li S.Y. et al. Application of iontophoresis in ophthalmic practice: an innovative strategy to deliver drugs into the eye. Drug Deliv. 2023; 30(1): 2165736. https://doi.org/10.1080/10717544.2023.2165736
- Tomi M, Hosoya K. The role of blood-ocular barrier transporters in retinal drug disposition: an overview. Expert Opin Drug Metab Toxicol. 2010; 6(9): 1111–1124. https://doi.org/10.1517/17425255.2010.486401
- Thrimawithana T.R., Young S., Bunt C.R. et al. Drug delivery to the posterior segment of the eye. Drug Discov Today. 2011; 16(5–6): 270–277. https://doi.org/10.1016/j.drudis.2010.12.004
- Дракон А.К., Патеюк Л.С., Шелудченко В.М. и др. Лекарственный электрофорез в офтальмологии. Вестник офтальмологии. 2021; 137(6): 119–127. https://doi.org/10.17116/oftalma2021137061119 [Drakon A.K., Pateyuk L.S., Sheludchenko V.M. et al. Ocular iontophoresis. Russian Annals of Ophthalmology. 2021; 137(6): 119–127. https://doi.org/10.17116/oftalma2021137061119 (In Russ.).]
- Юрова О.В., Назарова Г.А., Кончугова Т.В. и др. Аппаратная физиотерапия в медицинской реабилитации пациентов с офтальмопатологией. Аппаратная реабилитация 2014; 13(101): 50–55. [Yurova O.V., Nazarova G.A., Konchugova T.V. et al. Hardware physiotherapy in the medical rehabilitation of patients with ophthalmopathology. Hardware rehabilitation 2014; 13(101): 50–55 (In Russ.).]
- Терешин А.Е., Кирьянова В.В., Иванова Н.Е. и др. Эндоназальный электрофорез 0,1% раствора семакса в восстановлении когнитивных функций пациентов, перенесших мозговой инсульт. Российский нейрохирургический журнал имени профессора А.Л. Поленова. 2019; 11(1): 53–59. [Tereshin A.E., Kiryanova V.V., Ivanova N.E. et al. Endonasal electrophoresis of 0.1% semax solution in the restoration of cognitive functions of patients who have suffered a cerebral stroke. The Russian Neurosurgical Journal named after Professor A.L. Polenov. 2019; 11(1): 53–59 (In Russ.).]
- Рахимкулов А.С., Борисова Н.А., Аверцев Г.Н. Организационные аспекты и результаты лечения цереброваскулярных заболеваний церулоплазмином, церебролизатом и танаканом. Медицинский вестник Башкортостана. 2009; 3(4): 35–38 [Rakhimkulov A.S., Borisova N.A., Avertsev G.N. Organizational aspects and results of treatment of cerebrovascular diseases with ceruloplasmin, cerebrolysate and tanakan. Medical Bulletin of Bashkortostan. 2009; 3(4): 35–38 (In Russ.).]
- Хоменко М.А., Резниченко Е.К. Эффективность применения препарата кортексин методом эндоназального электрофореза в лечении больных ишемическим инсультом. Международный неврологический журнал. 2015; 4(74): 138–139. [Khomenko M.A., Reznichenko E.K. Efficacy of the drug cortexin by endonasal electrophoresis in the treatment of patients with ischemic stroke. International Journal of Neurology. 2015; 4(74): 138–139 (In Russ.).]
- Маркин С.П., Чижов А.Я., Борисов В.А. Применение электрофореза кортексина в профилактике мозговых инсультов. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2004; 2: 13–15. [Markin S.P., Chizhov A.Ya., Borisov V.A. Stroke Prophylaxis with Cortexin. Problems of Balneology, Physiotherapy, and Exercise Therapy. 2004; 2: 13–15 (In Russ.).]

The content is available under the Creative Commons Attribution 4.0 License.
©
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.