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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">nnp</journal-id><journal-title-group><journal-title xml:lang="en">Neurology, Neuropsychiatry, Psychosomatics</journal-title><trans-title-group xml:lang="ru"><trans-title>Неврология, нейропсихиатрия, психосоматика</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2074-2711</issn><issn pub-type="epub">2310-1342</issn><publisher><publisher-name>"IMA-Press", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/2074-2711-2017-4-4-9</article-id><article-id custom-type="elpub" pub-id-type="custom">nnp-789</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LECTURES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛЕКЦИЯ</subject></subj-group></article-categories><title-group><article-title>Current approaches to diagnosing and treating major neurocognitive disorder</article-title><trans-title-group xml:lang="ru"><trans-title>Современные подходы к диагностике и лечению большого нейрокогнитивного расстройства</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кулеш</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kulesh</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>614990, Пермский край, Пермь, ул. Петропавловская, 26</p></bio><bio xml:lang="en"><p>26, Petropavlovskaya St., Perm, Perm Territory 614990</p></bio><email xlink:type="simple">aleksey.kulesh@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шестаков</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shestakov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>614990, Пермский край, Пермь, ул. Петропавловская, 26</p></bio><bio xml:lang="en"><p>26, Petropavlovskaya St., Perm, Perm Territory 614990</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>12</day><month>12</month><year>2017</year></pub-date><volume>9</volume><issue>4</issue><fpage>4</fpage><lpage>9</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Kulesh A.A., Shestakov V.V., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Кулеш А.А., Шестаков В.В.</copyright-holder><copyright-holder xml:lang="en">Kulesh A.A., Shestakov V.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://nnp.ima-press.net/nnp/article/view/789">https://nnp.ima-press.net/nnp/article/view/789</self-uri><abstract><p>The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) replaces the term «dementia» with «major neurocognitive disorder» (MNCD), which can reduce the  stigmatization of patients and focus the attention of specialists on  the preserved abilities of patients rather than deficit symptoms. In  the next 35 years, the number of patients with MNCD in the world is  predicted to almost triple. The article considers the concept,  epidemiology, and etiological pattern of this syndrome. It  characterizes in detail Alzheimer's disease (AD) that is a cause of  MNCD in 50–70% of cases. The current diagnostic criteria and  clinical presentations of the disease are given. The presence of early and significant episodic memory disorders as both alone or  concurrent with other cognitive and behavioral changes reflects the  main clinical phenotype of AD. Magnetic resonance morphometry,  amyloid positron emission tomography, and estimation of  cerebrospinal fluid β-amyloid and tau protein levels find increasing  applications in research and routine practice. Drug and non-drug  treatments for MNCD are considered. The use of akatinol memantine to treat this disorder and the issues related to the comprehensive management of patients with severe cognitive impairment are analyzed.</p></abstract><trans-abstract xml:lang="ru"><p>В DSM-5 термин «деменция» был заменен на понятие «большое нейрокогнитивное расстройство» (БНКР), что позволило уменьшить стигматизацию пациентов и сфокусировать  внимание специалистов не на дефицитарных симптомах, а на сохранных способностях  больных. В ближайшие 35 лет в мире прогнозируется увеличение числа пациентов с БНКР  почти в 3 раза. В статье рассматриваются понятие, эпидемиология и этиологическая  структура синдрома. Подробно охарактеризована болезнь Альцгеймера (БА), которая служит причиной БНКР в 50–70% случаев. Представлены актуальные диагностические критерии и  клиническая картина заболевания. Наличие раннего и значимого нарушения эпизодической  памяти как изолированного, так и в сочетании с другими когнитивными и поведенческими  изменениями отражает основной клинический фенотип БА. Все большее применение в научных исследованиях и рутинной практике находят магнитно-резонансная морфометрия,  позитронно-эмиссионная томография с индикатором амилоида, а также оценка содержания  бета-амилоида и тау-протеина в спинномозговой жидкости. Рассмотрено медикаментозное и немедикаментозное лечение БНКР. Проанализированы применение акатинола мемантина при данном расстройстве, а также вопросы комплексного ведения пациентов с выраженным нарушением когнитивных функций.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>большое нейрокогнитивное расстройство</kwd><kwd>болезнь Альцгеймера</kwd><kwd>акатинол мемантин</kwd></kwd-group><kwd-group xml:lang="en"><kwd>major neurocognitive disorder</kwd><kwd>Alzheimer's disease</kwd><kwd>akatinol memantine</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimer's disease and other dementias: a priority for European science and society. Lancet Neurol. 2016 Apr;15(5):455-532. doi: 10.1016/S1474-4422(16)00062-4.</mixed-citation><mixed-citation xml:lang="en">Winblad B, Amouyel P, Andrieu S, et al. 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