nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2025-1-4-9nnp-2441Research ArticleLECTURESЛЕКЦИЯSubjective and functional cognitive impairment: diagnostics using biological markers of Alzheimer's diseaseСубъективные и функциональные когнитивные нарушения: диагностика с использованием биологических маркеров болезни Альцгеймераhttps://orcid.org/0000-0002-1992-7960ПарфеновВ. А.ParfenovV. A.

119021, Москва, ул. Россолимо, 11, стр. 1

Vladimir Anatolyevich Parfenov

11, Rossolimo St., Build. 1, Moscow 119021

vladimirparfenov@mail.ruhttps://orcid.org/0000-0003-2424-3245ГришинаД. А.GrishinaD. A.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

https://orcid.org/0000-0001-9467-6244ЛокшинаА. Б.LokshinaA. B.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

https://orcid.org/0000-0002-8447-3264ЗахаровВ. В.ZakharovV. V.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

https://orcid.org/0000-0003-4234-2503ШевцоваК. В.ShevtsovaK. V.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

https://orcid.org/0000-0002-3455-6440ЧервяковаЯ. И.ChervyakovaYa. I.

119021, Москва, ул. Россолимо, 11, стр. 1

11, Rossolimo St., Build. 1, Moscow 119021

Кафедра нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского, ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияDepartment of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian FederationИнститута клинической медицины им. Н.В. Склифосовского, ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияDepartment of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian Federation20251502202517149Copyright © Parfenov V.A., Grishina D.A., Lokshina A.B., Zakharov V.V., Shevtsova K.V., Chervyakova Y.I., 20252025Парфенов В.А., Гришина Д.А., Локшина А.Б., Захаров В.В., Шевцова К.В., Червякова Я.И.Parfenov V.A., Grishina D.A., Lokshina A.B., Zakharov V.V., Shevtsova K.V., Chervyakova Y.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2441

Cognitive impairment (CI) is one of the most common disorders in elderly. The development of dementia is usually preceded by subjective (SCI) and mild cognitive impairment (MCI) over several years. Patients with SCI are at increased risk of developing MCI and dementia, but SCI may not progress for a long time and in many cases is functional in nature (functional CI – FCI). The article discusses the manifestations and diagnostic issues of SCI and FCI and the possibilities of diagnosing Alzheimer's disease (AD) at the SCI stage using biological markers for AD in cerebrospinal fluid (CSF). The article presents the results of a long-term follow-up (more than 4 years) of two patients with SCI who showed no significant disturbances in repeated neuropsychological examinations. In one patient with SCI, positive biological markers for AD were found in the CSF, indicating an early (second) stage of AD, while in the other patient the absence of these markers indicated a functional nature of the CI. The article discusses the treatment of patients with SCI and the possibilities of anti-amyloid therapy when the Alzheimer's nature of CI is detected.

Нарушения когнитивных функций (КФ) являются одним из наиболее частых расстройств в пожилом возрасте. Развитию деменции на протяжении нескольких лет обычно предшествуют субъективные (СКН) и умеренные когнитивные нарушения (УКН). При СКН повышен риск развития УКН и деменции, однако СКН длительно могут не прогрессировать и во многих случаях носят функциональный характер (функциональные КН – ФКН). Обсуждаются проявления и вопросы диагностики СКН и ФКН, возможности диагностики болезни Альцгеймера (БА) на стадии СКН с использованием биологических маркеров БА в цереброспинальной жидкости (ЦСЖ). Представлены результаты длительного (более 4 лет) наблюдения двух пациентов с СКН, у которых при повторных нейропсихологических обследованиях не отмечалось существенных нарушений. У одного пациента с СКН выявлены положительные биологические маркеры БА в ЦСЖ, что позволило предположить раннюю (вторую) стадию БА, а в другом наблюдении их отсутствие свидетельствовало о функциональном характере КН. Обсуждаются вопросы ведения пациентов с СКН, возможности антиамилоидной терапии при установлении альцгеймеровской природы КН.

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The authors declare that there are no conflicts of interest present.