Вопросы терапии умеренных когнитивных нарушений

Развитию деменции предшествуют умеренные когнитивные нарушения (УКН), лечение которых может замедлить трансформацию УКН в деменцию. В статье обсуждаются лекарственные и нелекарственные методы терапии УКН. Проводится анализ множественных фармакологических эффектов цитиколина по влиянию на когнитивные функции у пациентов с УКН и легкой деменцией сосудистого генеза или при болезни Альцгеймера. Актуализируется необходимость длительной терапии цитиколином, повышение приверженности терапии путем назначения удобной формы выпуска препарата Нооцил (флакон 240 мл, жидкая форма цитиколина для приема внутрь).

1. Meijer E, Casanova M, Kim H, et al. Economic costs of dementia in 11 countries in Europe: Estimates from nationally representative cohorts of a panel study. Lancet Reg Health Eur. 2022 Jun 24;20:100445. doi:10.1016/j.lanepe.2022.100445

2. WHO, World Health Organization. Methodology for Producing Global Dementia Cost Estimates. 2021. Global status report on the public health response to dementia, Web Annex. Geneva: World Health Organization; 2021.

3. Kua EH, Ho E, Tan HH, et al. The natural history of dementia. Psychogeriatrics. 2014 Sep;14(3):196-201. doi:10.1111/psyg.12053

4. Overton M, Pihlsgаrd M, Elmstahl S. Prevalence and Incidence of Mild Cognitive Impairment across Subtypes, Age, and Sex. Dement Geriatr Cogn Disord. 2019;47(4-6):219-32. doi:10.1159/000499763. Epub 2019 Jul 16.

5. Han F, Luo C, Lv D, et al. Risk Factors Affecting Cognitive Impairment of the Elderly Aged 65 and Over: A Cross-Sectional Study. Front Aging Neurosci. 2022 Jun16;14:903794. doi:10.3389/fnagi.2022.903794

6. Patnode CD, Perdue LA, Rossom RC, et al. Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Feb. Report No.: 19-05257-EF-1.

7. Wardlaw JM, Debette S, Jokinen H, et al. ESO Guideline on covert cerebral small vessel disease. Eur Stroke J. 2021 Jun;6(2):CXICLXII. doi:10.1177/23969873211012132. Epub 2021 May 11.

8. Парфенов ВА. Сосудистые когнитивные нарушения и хроническая ишемия головного мозга (дисциркуляторная энцефалопатия). Неврология, нейропсихиатрия, психосоматика. 2019;11(3S):61-7. doi:10.14412/2074-2711-2019-3S-61-67

9. Громова ОА, Торшин ИЮ, Гришина ТР и др. Молекулярные и клинические аспекты действия цитидиндифосфохолина на когнитивные функции. Журнал неврологии и психиатрии им. С.С. Корсакова. 2021;121(5):8897. doi:10.17116/jnevro202112105188

10. Singh B, Parsaik AK, Mielke MM, et al. Association of mediterranean diet with mild cognitive impairment and Alzheimer's disease: a systematic review and meta-analysis. J Alzheimers Dis. 2014;39(2):271-82. doi:10.3233/JAD-130830

11. Ertel KA, Glymour MM, Berkman LF. Effects of social integration on preserving memory function in a nationally representative US elderly population. Am J Public Health. 2008 Jul;98(7):1215-20. doi:10.2105/AJPH.2007.113654. Epub 2008 May 29.

12. Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD009132. doi:10.1002/14651858.CD009132.pub2

13. Smith E. Vascular Cognitive Impairment. Continuum (Minneap Minn). 2016 Apr;22(2 Dementia):490-509. doi:10.1212/CON.0000000000000304

14. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018 Jan 16;90(3):126-35. doi:10.1212/WNL.0000000000004826. Epub 2017 Dec 27.

15. Herskovits AZ, Guarente L. SIRT1 in neurodevelopment and brain senescence. Neuron. 2014 Feb 5;81(3):471-83. doi:10.1016/j.neuron.2014.01.028

16. Xu J, Jackson CW, Khoury N, et al. Brain SIRT1 Mediates Metabolic Homeostasis and Neuroprotection. Front Endocrinol. 2018;9:702. doi:10.3389/fendo.2018.00702

17. Bonda DJ, Lee H-G, Camins A, et al. The sirtuin pathway in ageing and Alzheimer disease: Mechanistic and therapeutic considerations. Lancet Neurol. 2011;10:275-9. doi:10.1016/S1474-4422(11)70013-8

18. Donmez G, Arun A, Chung C-Y, et al. SIRT1 protects against α-synuclein aggregation by activating molecular chaperones. J Neurosci. 2012;32:124-32. doi:10.1523/JNEUROSCI.3442-11.2012

19. Secades JJ. Citicoline: Pharmacological and clinical review, 2016 update. Rev Neurol. 2016 Dec 23;63(S03):S1-S73.

20. Synoradzki K, Grieb P. Citicoline: A Superior Form of Choline? Nutrients. 2019;11:1569. doi:10.3390/nu11071569

21. Blusztajn JK, Slack BE, Mellott TJ. Neuroprotective Actions of Dietary Choline. Nutrients. 2017;9:815. doi:10.3390/nu9080815

22. Roohi-Azizi M, Torkaman-Boutorabi A, Akhondzadeh S, et al. Influence of citicoline on citalopram-induced antidepressant activity in depressive-like symptoms in male mice. Physiol Behav. 2018;195:151-7. doi:10.1016/j.physbeh.2018.08.002

23. Babb S, Wald L, Cohen B, et al. Chronic citicoline increases phosphodiesters in the brains of healthy older subjects: An in vivo phosphorus magnetic resonance spectroscopy study. Psychopharmacology. 2002;161:248-54.

24. Adibhatla RM, Hatcher JF. Citicoline decreases phospholipase A2 stimulation and hydroxyl radical generation in transient cerebral ischemia. J Neurosci Res. 2003;73:308-15. doi:10.1002/jnr.10672

25. Mosharrof AH, Petkov VD. Effects of citicholine and of the combination citicholine + piracetam on the memory (experiments on mice) Acta Physiol Pharm Bulg. 1990;16:25-31.

26. Gareri P, Cotroneo AM, Castagna A, et al. Effectiveness and safety of citicoline in mild vascular cognitive impairment: The IDEALE study. Clin Interv Aging. 2013;8:131-7. doi:10.2147/CIA.S38420

27. Castagna A, Cotroneo AM, Ruotolo G, Gareri P. The CITIRIVAD Study: CITIcoline plus RIVAstigmine in Elderly Patients Affected with Dementia Study. Clin Drug Investig. 2016;36:1059-65. doi:10.1007/s40261-016-0454-3

28. Gareri P, Castagna A, Cotroneo AM, et al. The Citicholinage Study: Citicoline Plus Cholinesterase Inhibitors in Aged Patients Affected with Alzheimer’s Disease Study. J Alzheimer’s Dis. 2017;56:557-65. doi:10.3233/JAD-160808

29. Alvarez XA, Mouzo R, Pichel V, et al. Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer’s disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion. Methods Find Exp Clin Pharm. 1999;21:633-44.

30. Amenta F, Battineni G, Traini E, Pallotta G. Choline-containing phospholipids and treatment of adult-onset dementia disorders. In: Diagnosis and Management in Dementia. Academic Press; 2020. P. 477-93.