nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2015-1-94-98nnp-493Research ArticleREVIEWSОБЗОРЫCognitive impairments in cerebrovascular disease: What is between health and dementia?Когнитивные нарушения при цереброваскулярной болезни – что между нормой и деменцией?ЕмелинА. Ю.EmelinA. Yu.emelinand@rambler.ruФГБОУ ВПО «Военно-медицинская академия им. С.М. Кирова» Министерства обороны Российской Федерации, Санкт-Петербург, Россия 194044, Санкт-Петербург, ул. Академика Лебедева, 6РоссияS.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation, Saint Petersburg, Russia 6, Academician Lebedev St., Saint Petersburg 194044Russian Federation201520032015719498Copyright © Emelin A.Y., 20152015Емелин А.Ю.Emelin A.Y.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/493

The problem of cerebrovascular lesions takes on even greater significance with the higher prevalence of both acute and chronic forms of cerebrovascular diseases (CVD). Cognitive dysfunctions that have a pronounced negative impact on the quality of life in patients hold a special place among the various neurological symptoms resulting from cerebrovascular lesions. The incidence of vascular dementia increases with age. The paper considers the main issues of the etiology, pathogenesis and classification of vascular cognitive impairments (VCIs). It proposes criteria for the diagnosis of VCIs in the early stages of the disease. 

Potentially modifiable factors, such as hypertension, coronary heart disease, orthostatic hypotension, diabetes mellitus, hypercholesterolemia, hyperhomocysteinemia, obesity, et al., are indicated to have a special place among the main etiological causes of VCIs. The timely detection of etiological factors and the assessment of their role in the development of cognitive impairments (CI) in CVD form the basis for managing these patients. 

The issues of treating CI no dementia in patients with CVD are considered. These included the administration of nootropic, vasoactive drugs, as well as agents that exert a modulatory effect on the cholinergic and glutamatergic systems. The use of neuroprotective and neurotrophic drugs is noted to be promising in terms of the multicomponent mechanism of their action. 

Проблема сосудистых поражений головного мозга приобретает все большее значение на фоне увеличения распространенности как острых, так и хронических форм цереброваскулярных заболеваний (ЦВЗ). Среди разнообразных неврологических симптомов, развивающихся вследствие сосудистых поражений головного мозга, особое место занимают нарушения когнитивных функций, оказывающие выраженное негативное влияние на качество жизни пациентов. Частота сосудистой деменции увеличивается с возрастом. Рассмотрены основные вопросы этиологии, патогенеза и классификации сосудистых когнитивных нарушений (СКН). Предложены критерии диагностики СКН на ранних стадиях заболевания. 

Указано, что среди основных этиологических причин развития СКН особое место занимают потенциально корригируемые факторы, такие как артериальная гипертензия, ишемическая болезнь сердца, ортостатическая гипотензия, сахарный диабет, гиперхолестеринемия, гипергомоцистеинемия, ожирение и др. Своевременное выявление этиологических факторов и оценка их роли в развитии КН при ЦВЗ составляют основу ведения таких пациентов. 

Рассмотрены вопросы лечения недементных стадий КН у пациентов с ЦВЗ: применение ноотропных, «вазоактивных» лекарственных средств, препаратов, оказывающих модулирующее действие на холинергическую и глутаматергическую системы. Отмечена перспективность использования нейропротективных и нейротрофических препаратов, учитывая многокомпонентный механизм их действия. 

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