nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-27112025-4-4-10nnp-2654Research ArticleLECTURESЛЕКЦИЯCognitive changes in multiple sclerosis and factors of their development: association with taking disease-modifying therapiesКогнитивные изменения при рассеянном склерозе и факторы их развития: связь с приемом препаратов, изменяющих течение рассеянного склерозаhttps://orcid.org/0009-0000-4101-9873КомиссаренкоА. О.KomissarenkoA. O.

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

https://orcid.org/0000-0003-3524-3494ГринюкВ. В.GrinyukV. V.

Владислав Владимирович Гринюк

119048, Москва, ул. Трубецкая, 8, стр. 2

Vladislav Vladimirovich Grinyuk

18, Trubetskaya St., Build. 2, Moscow 119048

grinyuk_v_v@staff.sechenov.ruhttps://orcid.org/0009-0002-4532-196XБахчивановА. С.BakhchivanovA. S.

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

https://orcid.org/0009-0000-8338-4211ЯщукЭ. В.YashchukE. V.

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

https://orcid.org/0009-0003-9864-3927ФатуеваЕ. С.FatuevaE. S.

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

https://orcid.org/0009-0002-4886-3465КомиссаренкоК. Ю.KomissarenkoK. Yu.

105005, Москва, ул. Радио, 10

10A, Radio St., Moscow 105005

https://orcid.org/0000-0002-0834-4030ВахнинаН. В.VakhninaN. V.

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

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

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

https://orcid.org/0000-0001-8076-3494БабиеваН. С.BabievaN. S.

119048, Москва, ул. Трубецкая, 8, стр. 2

18, Trubetskaya St., Build. 2, Moscow 119048

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian FederationФГАОУ ВО «Государственный университет просвещения»РоссияFederal State University of EducationRussian Federation202523082025174410Copyright © Komissarenko A.O., Grinyuk V.V., Bakhchivanov A.S., Yashchuk E.V., Fatueva E.S., Komissarenko K.Y., Vakhnina N.V., Zakharov V.V., Babieva N.S., 20252025Комиссаренко А.О., Гринюк В.В., Бахчиванов А.С., Ящук Э.В., Фатуева Е.С., Комиссаренко К.Ю., Вахнина Н.В., Захаров В.В., Бабиева Н.С.Komissarenko A.O., Grinyuk V.V., Bakhchivanov A.S., Yashchuk E.V., Fatueva E.S., Komissarenko K.Y., Vakhnina N.V., Zakharov V.V., Babieva N.S.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/2654

Currently, there is an increase in the life expectancy of patients with multiple sclerosis (MS) due to the improvement of their medical care and the use of disease-modifying therapies (DMTs). Due to the increase in life expectancy, the problem of cognitive impairment (CI) in MS patients becomes relevant. It has been shown that the risk of developing Alzheimer's disease in MS patients aged 45 to 64 years is 4–6 times higher than in the general population. The main non-modifiable risk factors for CI in MS are carriage of HLA-DRB1*15:01, PSEN1, PSEN2, APP, APOE ε4 genes, old age (60 years and older), male gender, prolonged course of the disease, high degree of disability according to EDSS. Modifiable risk factors for CI in MS patients are high levels of anxiety and depression, presence of diabetes mellitus, vascular risk factors, smoking, and drug use. The protective factors for MS include the use of DMTs, high cognitive reserve, high level of physical and social activity.

В настоящий момент наблюдается увеличение продолжительности жизни пациентов с рассеянным склерозом (РС) благодаря совершенствованию их медицинского сопровождения, а также применению препаратов, изменяющих течение РС (ПИТРС). В связи с увеличением продолжительности жизни становится актуальной проблема когнитивных нарушений (КН) у пациентов с РС. Показано, что риск развития болезни Альцгеймера у пациентов с РС в возрасте от 45 до 64 лет в 4–6 раз выше, чем в популяции. Основными немодифицируемыми факторами риска развития КН при РС являются носительство генов HLADRB1*15:01, PSEN1, PSEN2, APP, APOE ε4, пожилой возраст (от 60 лет), мужской пол, длительное течение заболевания, высокая степень инвалидизации по EDSS. Модифицируемыми факторами риска КН у пациентов с РС являются высокий уровень тревоги и депрессии, наличие сахарного диабета, факторов сосудистого риска, курение, употребление наркотиков. К протективным факторам КН при РС относят прием ПИТРС, высокий когнитивный резерв, высокий уровень физической и социальной активности.

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