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Clinical Indications: Chronic Cerebral Vascular Ischemia
Two PET studies in chronic stroke patients have shown that vinpocetine has a significant effect in increasing glucose uptake and metabolism in the healthy cortical and subcortical regions of the brain, particularly in the area surrounding the region of the stroke. ₂₁ A study in 15 chronic ischemic stroke patients found that a two-week vinpocetine trial significantly increased cerebral blood flow in the non-symptomatic hemisphere. ₁₀ Recent studies using Doppler sonography and near infrared spectroscopy have shown increased perfusion of the middle cerebral artery in patients with chronic cerebrovascular disease given a single infusion of vinpocetine. ₁₀

• BACKGROUND: In multiple sclerosis during periods of remission a limited degree of myelin repair can be observed mediated by oligodendroglial precursor cells. Phosphodiesterase inhibitors act as anti-inflammatory agents and might hold promise for future multiple sclerosis treatment.
  
  AIMS: To investigate whether phosphodiesterase inhibitors could also influence myelin repair.
  
  METHODS: We stimulated primary oligodendroglial precursor cells with cilostazol, rolipram and vinpocetine and assessed their effects on repair related cellular processes.
  
  RESULTS: We found that vinpocetine exerted a strong negative effect on myelin expression while cilostazol and rolipram did not show such effects. In addition, vinpocetine decreased morphological complexities suggesting an overall negative impact on oligodendroglial cell maturation. We provide evidence that this is not mediated via a blockade of phosphodiesterase-1 but rather by inhibition of IĸB kinase.
  
  CONCLUSION: These findings suggest that vinpocetine via IĸB inhibition exerts a strong negative impact on oligodendroglial cell maturation and may therefore provide the rationale to restrict its application during periods of remission in multiple sclerosis patients. This is of particular interest since vinpocetine is widely used as a health supplement thought to act as a cognitive and memory enhancer for healthy people and patients with neurological or muscle diseases.