nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2017-1-90-95nnp-704Research ArticleREVIEWSОБЗОРЫCognitive impairment in diabetes mellitusКогнитивные нарушения при сахарном диабетеСосинаВ. Б.SosinaV. B.

Кафедра нервных болезней и нейрохирургии

119021, Москва, ул. Россолимо, 11

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

ЗахаровВ. В.ZakharovV. V.

Кафедра нервных болезней и нейрохирургии

119021, Москва, ул. Россолимо, 11

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

zakharovenator@gmail.comСтроковИ. А.StrokovI. A.

Кафедра нервных болезней и нейрохирургии

119021, Москва, ул. Россолимо, 11

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

ВахнинаН. В.VakhninaN. V.

Кафедра нервных болезней и нейрохирургии

119021, Москва, ул. Россолимо, 11

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

ФГБОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaRussian Federation201727032017919095Copyright © Sosina V.B., Zakharov V.V., Strokov I.A., Vakhnina N.V., 20172017Сосина В.Б., Захаров В.В., Строков И.А., Вахнина Н.В.Sosina V.B., Zakharov V.V., Strokov I.A., Vakhnina 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/704

The paper sets forth the data available in the literature on the prevalence, pathogenesis, and clinical features of cognitive impairment (CI) in diabetes mellitus (DM). It presents the results of the authors' own studies of cognitive functions in patients with type 2 DM in relation to the presence or absence of a clinically significant vascular disease. It was established that CIs were mild and moderate, equally marked in both patient groups, which allows consideration of DM as an independent risk factor for cognitive dysfunction. Inadequate regulation of voluntary activity was a leading neuropsychological mechanism of CI in DM. The pathogenesis of CI in DM is largely due to the development of vascular complications. Methods for the prevention and treatment of CI in DM are proposed.

Изложены данные литературы о распространенности, патогенезе и клинических особенностях когнитивных нарушений (КН) при сахарном диабете (СД). Представлены результаты исследования когнитивных функций у больных СД 2-го типа в зависимости от наличия или отсутствия у них клинически значимой сосудистой патологии. Установлено, что КН носили легкий и умеренный характер и были одинаково выражены в обеих группах больных, что позволяет рассматривать СД как самостоятельный фактор риска когнитивной дисфункции. Ведущим нейропсихологическим механизмом КН при СД является недостаточность регуляции произвольной деятельности. Патогенез КН при СД в большей степени обусловлен развитием сосудистых осложнений. Описаны методы профилактики и лечения КН при СД.

когнитивные расстройствасахарный диабетcognitive disordersdiabetes mellitusReferencesWild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53.Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53.Дедов ИИ, Шестакова МВ, Викулова ОК. Государственный регистр больных сахарным диабетом в РФ: статус 2014 г. и перспективы развития. Сахарный диабет. 2015; 18(3):5-22. [Dedov II, Shestakova MV, Vikulova OK. The state register of diabetes mellitus in the Russian Federation: status 2014 and prospects of development. Sakharnyi diabet. 2015;18(3):5-22. (In Russ.)].Дедов ИИ, Шестакова МВ, Викулова ОК. Государственный регистр больных сахарным диабетом в РФ: статус 2014 г. и перспективы развития. Сахарный диабет. 2015; 18(3):5-22. [Dedov II, Shestakova MV, Vikulova OK. The state register of diabetes mellitus in the Russian Federation: status 2014 and prospects of development. Sakharnyi diabet. 2015;18(3):5-22. (In Russ.)].Miles WR, Root HF. Psychologic tests applies in diabetic patients. Arch Intern Med (Chic). 1922;30(6):767-777. doi:10.1001/archinte.1922.00110120086003.Miles WR, Root HF. Psychologic tests applies in diabetic patients. Arch Intern Med (Chic). 1922;30(6):767-777. doi:10.1001/archinte.1922.00110120086003.De Jong RN. The nervous system complications in diabetes mellitus with special reference to cerebrovascular changes. J Nerv Ment Dis. 1950;111:181-206.De Jong RN. The nervous system complications in diabetes mellitus with special reference to cerebrovascular changes. J Nerv Ment Dis. 1950;111:181-206.Kooistra M, Geerlings MI, Mali WP, et al. Diabetes mellitus and progression of vascular brain lesions and brain atrophy in patients with symptomatic atherosclerotic disease. The SMART-MR study. J Neurol Sci. 2013 Sep 15;332(1-2):69-74. doi: 10.1016/j.jns.2013.06.019. Epub 2013 Jul 6.Kooistra M, Geerlings MI, Mali WP, et al. Diabetes mellitus and progression of vascular brain lesions and brain atrophy in patients with symptomatic atherosclerotic disease. The SMART-MR study. J Neurol Sci. 2013 Sep 15;332(1-2):69-74. doi: 10.1016/j.jns.2013.06.019. Epub 2013 Jul 6.Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med. 1999 Feb;16(2):93-112.Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med. 1999 Feb;16(2):93-112.Аметов АС, Соловьева ОЛ. Окислительный стресс при сахарном диабете 2-го типа и пути его коррекции. Проблемы эндокринологии. 2011;(6):52-6. [Ametov AS, Solov'eva OL. Oxidative stress in diabetes mellitus of the 2nd type and its correction. Problemy endokrinologii. 2011;(6):52-6. (In Russ.)].Аметов АС, Соловьева ОЛ. Окислительный стресс при сахарном диабете 2-го типа и пути его коррекции. Проблемы эндокринологии. 2011;(6):52-6. [Ametov AS, Solov'eva OL. Oxidative stress in diabetes mellitus of the 2nd type and its correction. Problemy endokrinologii. 2011;(6):52-6. (In Russ.)].UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macro vascular and micro vascular complications in type 2 diabetes (UKPDS 38). BMJ. 1998 Sep 12;317 (7160):703-13.UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macro vascular and micro vascular complications in type 2 diabetes (UKPDS 38). BMJ. 1998 Sep 12;317 (7160):703-13.Folsom AR, Rasmussen ML, Chambless LE, et al. Prospective associations of fasting insulin, body fat distribution, and diabetes with risk of ischemic stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Diabetes Care. 1999 Jul;22(7):1077-83.Folsom AR, Rasmussen ML, Chambless LE, et al. Prospective associations of fasting insulin, body fat distribution, and diabetes with risk of ischemic stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Diabetes Care. 1999 Jul;22(7):1077-83.Selvin E, Bolen S, Yeh HC, et al. Cardiovascular outcomes in trials of oral diabetes medications: a systematic review. Arch Intern Med. 2008 Oct 27;168(19):2070-80. doi: 10.1001/archinte.168.19.2070.Selvin E, Bolen S, Yeh HC, et al. Cardiovascular outcomes in trials of oral diabetes medications: a systematic review. Arch Intern Med. 2008 Oct 27;168(19):2070-80. doi: 10.1001/archinte.168.19.2070.Sima AA, Li ZG. The Effect of C-Peptide on Cognitive Dysfunction and Hippocampal Apoptosis in Type 1 Diabetic Rats. Diabetes. 2005 May;54(5):1497-505.Sima AA, Li ZG. The Effect of C-Peptide on Cognitive Dysfunction and Hippocampal Apoptosis in Type 1 Diabetic Rats. Diabetes. 2005 May;54(5):1497-505.Dore GA, Elias MF, Robbins MA, et al. Presence of the APOE epsilon4 allele modifies the relationship between type 2 diabetes and cognitive performance: the Maine-Syracuse Study. Diabetologia. 2009 Dec;52(12):2551-60. doi: 10.1007/s00125-009-1497-2. Epub 2009 Aug 20.Dore GA, Elias MF, Robbins MA, et al. Presence of the APOE epsilon4 allele modifies the relationship between type 2 diabetes and cognitive performance: the Maine-Syracuse Study. Diabetologia. 2009 Dec;52(12):2551-60. doi: 10.1007/s00125-009-1497-2. Epub 2009 Aug 20.Gregg WE, Brown AA. Cognitive and Physical Disabilities and Aging-Related Complications of Diabetes. Clinical Diabetes. 2003 Jul;21(3):113-8.Gregg WE, Brown AA. Cognitive and Physical Disabilities and Aging-Related Complications of Diabetes. Clinical Diabetes. 2003 Jul;21(3):113-8.Захаров ВВ. Всероссийская программа исследований эпидемиологии и терапии когнитивных нарушений в пожилом возрасте «Прометей». Неврологический журнал. 2006;(11):27-32. [Zakharov VV. National research program the epidemiology and therapy of cognitive disorders in the elderly «Prometheus». Nevrologicheskii zhurnal. 2006; (11):27-32. (In Russ.)].Захаров ВВ. Всероссийская программа исследований эпидемиологии и терапии когнитивных нарушений в пожилом возрасте «Прометей». Неврологический журнал. 2006;(11):27-32. [Zakharov VV. National research program the epidemiology and therapy of cognitive disorders in the elderly «Prometheus». Nevrologicheskii zhurnal. 2006; (11):27-32. (In Russ.)].Bruce DG, Casey GP, Drange V, et al. Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study. Diabetes Res Clin Pract. 2003 Jul;61(1):59-67.Bruce DG, Casey GP, Drange V, et al. Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study. Diabetes Res Clin Pract. 2003 Jul;61(1):59-67.Petersen RS. Current concepts in mild cognitive impairment. Arch Neurol. 2001 Dec;58(12):1985-92.Petersen RS. Current concepts in mild cognitive impairment. Arch Neurol. 2001 Dec;58(12):1985-92.Яхно НН, Захаров ВВ. Легкие когнитивные расстройства в пожилом возрасте. Неврологический журнал. 2004;9(1):4-8. [Yakhno NN, Zakharov VV. Mild cognitive disorders in old age. Nevrologicheskii zhurnal. 2004;9(1):4-8. (In Russ.)].Яхно НН, Захаров ВВ. Легкие когнитивные расстройства в пожилом возрасте. Неврологический журнал. 2004;9(1):4-8. [Yakhno NN, Zakharov VV. Mild cognitive disorders in old age. Nevrologicheskii zhurnal. 2004;9(1):4-8. (In Russ.)].Захаров ВВ, Вознесенская ТГ. Нервно-психические нарушения: диагностические тесты. Москва: МЕДпресс-информ; 2013. 320 с. [Zakharov VV, Voznesenskaya TG. Nervno- psikhicheskie narusheniya: diagnosticheskie testy [Neuro-psychiatric disorders: diagnostic tests]. Moscow: MEDpress-inform; 2013. 320 p.]Захаров ВВ, Вознесенская ТГ. Нервно-психические нарушения: диагностические тесты. Москва: МЕДпресс-информ; 2013. 320 с. [Zakharov VV, Voznesenskaya TG. Nervno- psikhicheskie narusheniya: diagnosticheskie testy [Neuro-psychiatric disorders: diagnostic tests]. Moscow: MEDpress-inform; 2013. 320 p.]Augustina MA, Biessels GJ. The Effects of Type 1 Diabetes on Cognitive Performance A meta-analysis. Diabetes Care. 2005 Mar; 28(3):726-35.Augustina MA, Biessels GJ. The Effects of Type 1 Diabetes on Cognitive Performance A meta-analysis. Diabetes Care. 2005 Mar; 28(3):726-35.Asimakopoulou K, Hampson SE. Cognitive Functioning and Self-Management in Older People With Diabetes. Diabetes Spectrum. 2002; 15(2):116-21.Asimakopoulou K, Hampson SE. Cognitive Functioning and Self-Management in Older People With Diabetes. Diabetes Spectrum. 2002; 15(2):116-21.Elias PK, Elias MF, D'Agostino RB, et al. NIDDM and blood pressure as risk factors for poor cognitive performance. Diabetes Care. 1997 Sep;20(9):1388-95.Elias PK, Elias MF, D'Agostino RB, et al. NIDDM and blood pressure as risk factors for poor cognitive performance. Diabetes Care. 1997 Sep;20(9):1388-95.Gregg EW, Engelgau ME, Narayan V. Cognitive decline, physical disability, and other unappreciated outcomes of diabetes and aging. BMJ. 2002 Oct 26;325(7370):916-7.Gregg EW, Engelgau ME, Narayan V. Cognitive decline, physical disability, and other unappreciated outcomes of diabetes and aging. BMJ. 2002 Oct 26;325(7370):916-7.Vanhanen M. Cognitive function in glucose intolerance in the eldery: the role of hyperinsulinemia. Curr Opin Neurol. 1998 Dec;11(6):673-7.Vanhanen M. Cognitive function in glucose intolerance in the eldery: the role of hyperinsulinemia. Curr Opin Neurol. 1998 Dec;11(6):673-7.Arvanitakis Z, Wilson RS, Bienias JL, et al. Diabetes mellitus and risk of Alzheimer disease and decline in cognitive function. Arch Neurol. 2004 May;61(5):661-6.Arvanitakis Z, Wilson RS, Bienias JL, et al. Diabetes mellitus and risk of Alzheimer disease and decline in cognitive function. Arch Neurol. 2004 May;61(5):661-6.Okereke O, Kang JH, Cook NR, et al. Cognitive decline in two large cohorts of community- dwelling older adults. J Am Geriatr Soc. 2008 Jun;56(6):1028-36. doi: 10.1111/j.1532-5415.2008.01686.x. Epub 2008 Apr 1.Okereke O, Kang JH, Cook NR, et al. Cognitive decline in two large cohorts of community- dwelling older adults. J Am Geriatr Soc. 2008 Jun;56(6):1028-36. doi: 10.1111/j.1532-5415.2008.01686.x. Epub 2008 Apr 1.Luchsinger JA, Tang MX, Stern Y, et al. Diabetes mellitus and risk of Alzheimer’s disease and dementia with stroke in a multiethnic cohort. Am J Epidemiol. 2001 Oct 1; 154(7):635-41.Luchsinger JA, Tang MX, Stern Y, et al. Diabetes mellitus and risk of Alzheimer’s disease and dementia with stroke in a multiethnic cohort. Am J Epidemiol. 2001 Oct 1; 154(7):635-41.Ott A, Stolk RP, Hofman A, et al. Association of diabetes mellitus and dementia: The Rotterdam Study. Diabetologia. 1996 Nov;39(11):1392-7.Ott A, Stolk RP, Hofman A, et al. Association of diabetes mellitus and dementia: The Rotterdam Study. Diabetologia. 1996 Nov;39(11):1392-7.Biessels GJ, van der Heide LP, Kamal A, et al. Ageing and diabetes: implications for brain function. Eur J Pharmacol. 2002 Apr 19;441(1-2):1-14.Biessels GJ, van der Heide LP, Kamal A, et al. Ageing and diabetes: implications for brain function. Eur J Pharmacol. 2002 Apr 19;441(1-2):1-14.Cukerman T, Gerstein HC, Willamson JD. Cognitive decline and dementia in diabetes – systematic overview of prospective observation studies. Diabetologia. 2005 Dec;48(12):2460-9. Epub 2005 Nov 8.Cukerman T, Gerstein HC, Willamson JD. Cognitive decline and dementia in diabetes – systematic overview of prospective observation studies. Diabetologia. 2005 Dec;48(12):2460-9. Epub 2005 Nov 8.Roberts RO, Geda YE, Knopman DS, et al. Association of duration and severity of diabetes mellitus with mild cognitive impairment. Arch Neurol. 2008 Aug;65(8):1066-73. doi: 10.1001/archneur.65.8.1066.Roberts RO, Geda YE, Knopman DS, et al. Association of duration and severity of diabetes mellitus with mild cognitive impairment. Arch Neurol. 2008 Aug;65(8):1066-73. doi: 10.1001/archneur.65.8.1066.Дедов ИИ, Шестакова МВ, Миленская ТМ. Сахарный диабет: ретинопатия, нефропатия. Москва: Медицина; 2001. 184 с. [Dedov II, Shestakova MV, Milenskaya TM. Sakharnyi diabet: retinopatiya, nefropatiya [Diabetes mellitus: retinopathy, nephropathy]. Moscow: Meditsina; 2001. 184 p.]Дедов ИИ, Шестакова МВ, Миленская ТМ. Сахарный диабет: ретинопатия, нефропатия. Москва: Медицина; 2001. 184 с. [Dedov II, Shestakova MV, Milenskaya TM. Sakharnyi diabet: retinopatiya, nefropatiya [Diabetes mellitus: retinopathy, nephropathy]. Moscow: Meditsina; 2001. 184 p.]Строков ИА, Моргоева ФА. Стратегия профилактики и лечения неврологических осложнений сахарного диабета. Русский медицинский журнал. 2003;(6):342-5. [Strokov IA, Morgoeva FA. Strategy for the prevention and treatment of neurological complications of diabetes. Russkii meditsinskii zhurnal. 2003;(6):342-5. (In Russ.)].Строков ИА, Моргоева ФА. Стратегия профилактики и лечения неврологических осложнений сахарного диабета. Русский медицинский журнал. 2003;(6):342-5. [Strokov IA, Morgoeva FA. Strategy for the prevention and treatment of neurological complications of diabetes. Russkii meditsinskii zhurnal. 2003;(6):342-5. (In Russ.)].Munshi M, Grande L, Hayes M, et al. Cognitive dysfunction is associated with poor diabetes control in older adults. Diabetes Care. 2006 Aug;29(8):1794-9.Munshi M, Grande L, Hayes M, et al. Cognitive dysfunction is associated with poor diabetes control in older adults. Diabetes Care. 2006 Aug;29(8):1794-9.Yaffe K, Blackwell T, Whitmer RA, et al. Glycosylated hemoglobin level and development of mild cognitive impairment or dementia in older women. J Nutr Health Aging. 2006 Jul-Aug;10(4):293-5.Yaffe K, Blackwell T, Whitmer RA, et al. Glycosylated hemoglobin level and development of mild cognitive impairment or dementia in older women. J Nutr Health Aging. 2006 Jul-Aug;10(4):293-5.Hassing LB, Hofer SM, Nilsson SE, et al. Comorbid type 2 diabetes mellitus and hypertension exacerbates cognitive decline: evidence from a longitudinal study. Age Ageing. 2004 Jul; 33(4):355-61. Epub 2004 May 10.Hassing LB, Hofer SM, Nilsson SE, et al. Comorbid type 2 diabetes mellitus and hypertension exacerbates cognitive decline: evidence from a longitudinal study. Age Ageing. 2004 Jul; 33(4):355-61. Epub 2004 May 10.Wessels AM, Lane KA, Gao S, et al. Diabetes and cognitive decline in elderly African Americans: a 15-year follow-up study. Alzheimers Dement. 2011 Jul;7(4):418-24. doi: 10.1016/j.jalz.2010.07.003.Wessels AM, Lane KA, Gao S, et al. Diabetes and cognitive decline in elderly African Americans: a 15-year follow-up study. Alzheimers Dement. 2011 Jul;7(4):418-24. doi: 10.1016/j.jalz.2010.07.003.Feinkohl I, Keller M, Robertson CM, et al. Clinical and subclinical macrovascular disease as predictors of cognitive decline in older patients with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetes Care. 2013 Sep;36(9):2779-86. doi: 10.2337/dc12-2241. Epub 2013 Apr 11.Feinkohl I, Keller M, Robertson CM, et al. Clinical and subclinical macrovascular disease as predictors of cognitive decline in older patients with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetes Care. 2013 Sep;36(9):2779-86. doi: 10.2337/dc12-2241. Epub 2013 Apr 11.Занозина ОВ, Боровков НН, Балаболкин МИ и др. Необходимость и достаточность использования антиоксидантов в терапии больных сахарным диабетом 2-го типа. Бюллетень экспериментальной биологии и медицины. 2006;(Прил. 1):112-8. [Zanozina OV, Borovkov NN, Balabolkin MI, et al. The necessity and sufficiency of using antioxidants in the treatment of patients with diabetes of the 2nd type. Byulleten' eksperimental'noi biologii i meditsiny. 2006;(Suppl 1): 112-8. (In Russ.)].Занозина ОВ, Боровков НН, Балаболкин МИ и др. Необходимость и достаточность использования антиоксидантов в терапии больных сахарным диабетом 2-го типа. Бюллетень экспериментальной биологии и медицины. 2006;(Прил. 1):112-8. [Zanozina OV, Borovkov NN, Balabolkin MI, et al. The necessity and sufficiency of using antioxidants in the treatment of patients with diabetes of the 2nd type. Byulleten' eksperimental'noi biologii i meditsiny. 2006;(Suppl 1): 112-8. (In Russ.)].Янсен В, Брукнер ГВ. Лечение хронической цереброваскулярной недостаточности с использованием драже актовегин-форте (двойное слепое плацебо-контролируемое исследование). Русский медицинский журнал. 2002;10(12-13):543-6. [Yansen V, Brukner GV. Treatment of chronic cerebrovascular insufficiency with Actovegin Forte (a double- blind, placebo-controlled study). Russkii meditsinskii zhurnal. 2002;10(12-13): 543-6. (In Russ.)].Янсен В, Брукнер ГВ. Лечение хронической цереброваскулярной недостаточности с использованием драже актовегин-форте (двойное слепое плацебо-контролируемое исследование). Русский медицинский журнал. 2002;10(12-13):543-6. [Yansen V, Brukner GV. Treatment of chronic cerebrovascular insufficiency with Actovegin Forte (a double- blind, placebo-controlled study). Russkii meditsinskii zhurnal. 2002;10(12-13): 543-6. (In Russ.)].Oswald WD, Steger W, Oswald B, et al. Die Verbesserung fluider Kognitiver Leistungen mit Actovegin-Infusionen bei Alterpatienten mit leichtem bis mittelschwerem organischem Psychosyndrom Z. Gerontopsychol.-Psychiatr. 1992;(5):251-66.Oswald WD, Steger W, Oswald B, et al. Die Verbesserung fluider Kognitiver Leistungen mit Actovegin-Infusionen bei Alterpatienten mit leichtem bis mittelschwerem organischem Psychosyndrom Z. Gerontopsychol.-Psychiatr. 1992;(5):251-66.Guekht A, Skoog I, Korczyn AD, et al. A Randomised Double-Blind, Placebo- Controlled Trial of Actovegin in Patients with Post-Stroke Cognitive Impairment: ARTEMIDA Study Design. Dement Geriatr Cogn Dis Extra. 2013 Dec 14;3(1):459-67. doi: 10.1159/000357122. eCollection 2013.Guekht A, Skoog I, Korczyn AD, et al. A Randomised Double-Blind, Placebo- Controlled Trial of Actovegin in Patients with Post-Stroke Cognitive Impairment: ARTEMIDA Study Design. Dement Geriatr Cogn Dis Extra. 2013 Dec 14;3(1):459-67. doi: 10.1159/000357122. eCollection 2013.Строков ИА, Моргоева ФЭ, Строков КИ и др. Терапевтическая коррекция диабетической полиневропатии и энцефалопатии Актовегином. Русский медицинский журнал. 2006;(9):698–703. [Strokov IA, Morgoeva FE, Strokov KI, et al. Therapeutic correction of diabetic polyneuropathy and encephalopathy with Actovegin. Russkii meditsinskii zhurnal. 2006; (9):698–703. (In Russ.)].Строков ИА, Моргоева ФЭ, Строков КИ и др. Терапевтическая коррекция диабетической полиневропатии и энцефалопатии Актовегином. Русский медицинский журнал. 2006;(9):698–703. [Strokov IA, Morgoeva FE, Strokov KI, et al. Therapeutic correction of diabetic polyneuropathy and encephalopathy with Actovegin. Russkii meditsinskii zhurnal. 2006; (9):698–703. (In Russ.)].Шмырев ВИ, Остроумова ОД, Боброва ТА. Возможности препарата Актовегин в профилактике и лечении деменции. Русский медицинский журнал. 2003;(4):216–20. [Shmyrev VI, Ostroumova OD, Bobrova TA. Actovegin in the prevention and treatment of dementia. Russkii meditsinskii zhurnal. 2003;(4):216–20. (In Russ.)]Шмырев ВИ, Остроумова ОД, Боброва ТА. Возможности препарата Актовегин в профилактике и лечении деменции. Русский медицинский журнал. 2003;(4):216–20. [Shmyrev VI, Ostroumova OD, Bobrova TA. Actovegin in the prevention and treatment of dementia. Russkii meditsinskii zhurnal. 2003;(4):216–20. (In Russ.)]

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