nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2015-2-93-100nnp-519Research ArticleREVIEWSОБЗОРЫCognitive impairments in some cardiovascular and somatic diseasesКогнитивные нарушения при некоторых сердечно-сосудистых и соматических заболеванияхПизоваН. В.PizovaN. V.pizova@yandex.ruКафедра неврологии и медицинской генетики с курсом нейрохирургии ГБОУ ВПО «Ярославский государственный медицинский университет» Минздрава России, Ярославль, Россия 150000, Ярославль, ул. Революционная, 5РоссияDepartment of Neurology and Medical Genetics with Course of Neurosurgery, Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia 5, Revolutsionnaya St., Yaroslavl 150000Russian Federation2015120620157293100Copyright © Pizova N.V., 20152015Пизова Н.В.Pizova N.V.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/519

The paper gives an update on the pathogenesis, clinical presentation, and pathomorphology of cognitive impairments (CIs) in different autoimmune, endocrine, and infectious diseases: systemic lupus erythematosus, Sjögren’s syndrome, Behchet’s disease, primary angiitis of the central nervous system, polyarteritis nodosa, cryoglobulinemic vasculitis, hypothyroidism, herpetic lesion, and neurosyphilis. It is noted that treatment for CIs should be individual in terms of virulence factors. In vascular CIs, therapy should be aimed primarily at modifying risk factors and eliminating or reducing chronic brain ischemia. The prevention of progressive CI encompasses antihypertensive and antithrombotic therapies and surgical correction of atherosclerotic great artery stenosis. Control of hyperlipidemia, hyperglycemia and treatment of other somatic diseases are also of great importance. Such patients are usually given cetylcholinesterase inhibitors, acetylcholine precursors, antiglutamatergic agents, and metabolic and vascular drugs. By taking into account brain ischemia/ hypoxia in the above diseases, it is shown to be advisable to use antioxidants, cerebral active agents in particular, which have a complex neurometabolic effect. 

Представлены современные данные о патогенезе, клинической картине и патоморфологии когнитивных нарушений (КН) при различных аутоиммунных, эндокринных и инфекционных заболеваниях: системной красной волчанке, синдроме Шёгрена, болезни Бехчета, первичном ангиите центральной нервной системы, узелковом полиартериите, криоглобулинемическом васкулите, гипотиреозе, герпетическом поражении, нейросифилисе. Отмечено, что лечение КН должно быть индивидуальным с учетом патогенетических факторов. При сосудистых КН терапия должна быть направлена в первую очередь на коррекцию факторов риска и устранение или уменьшение выраженности хронической ишемии головного мозга. Профилактика нарастания КН включает лечение АГ, антитромботическую терапию, хирургическую коррекцию атеросклеротического сужения магистральных артерий. Большое значение имеют также контроль гиперлипидемии, гипергликемии, лечение других соматических заболеваний. Таким пациентам традиционно назначают ингибиторы ацетилхолинэстеразы, прекурсоры ацетилхолина, антиглутаматергические средства, метаболические и сосудистые препараты. С учетом ишемически-гипоксического поражения головного мозга при перечисленных заболеваниях показана целесообразность использования антиоксидантов, в частности цереброактивных средств, оказывающих комплексное нейрометаболическое действие.

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