Effect of sequential treatment with butylphthalide on neurological and cognitive functions and collateral circulation in patients with acute cerebral infarction

Introduction:
This study aimed to investigate the effect of sequential treatment with butylphthalide on neurological and cognitive functions and collateral circulation in patients with acute cerebral infarction (ACI).

Material and methods:
A total of 62 patients with ACI treated in our hospital between March 2021 and May 2021 were selected by convenience sampling and divided into the observation group (n = 31) and the control group (n = 31) using a random number table. Patients in the control group received conventional treatment, and those in the observation group received sequential treatment with butylphthalide in addition to conventional treatment. Neurological and cognitive functions and collateral circulation were compared between the two groups.

Results:
Improvements in the neurological, activities of daily living (ADL) and cognitive functions were better in the sequential treatment group than in the control group, which received conventional treatment. Statistically significant differences in the National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index (MBI), Lawton Instrumental Activities of Daily Living (Lawton IADL), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were also noted between the two groups (F_{NIHSS treatment} = 142.414, p < 0.001; F_{MBI treatment} = 143.662; F_{IADL treatment} = 137.624; F_{MMSE treatment} = 87.418, p < 0.001; F_{MoCA treatment} = 122.724, p < 0.001). Collateral circulation assessment showed that the blood flow velocities of the anterior cerebral artery (50.21 ±7.56 vs. 44.96 ±8.33, t = 2.598, p = 0.012), middle cerebral artery (34.52 ±6.29 vs. 21.74 ±4.81, t = 8.986, p < 0.001) and posterior cerebral artery (37.92 ±6.36 vs. 34.44 ±6.74, t = 2.091, p = 0.041) after treatment were statistically significantly higher in the observation group than in the control group.

Conclusions:
Sequential treatment with butylphthalide improves the neurological and cognitive functions and collateral circulation, as well as the ADL of patients with ACI, with higher efficacy than conventional treatment and without compromising safety.