Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Akatinol in the treatment of noncognitive neuropsychological disorders in neurogeriatric diseases

Full Text:


The author gives the data available in the literature and her materials on the prevalence and degree of noncognitive neuropsychological disorders (NNPDs) in dyscirculatory encephalopathy (DE) with non-dementia cognitive impairments (CI) and in Alzheimer’s disease (AD) with mild to moderate stage dementia. Memantine (akatinol) therapy-induced changes in NNPDs are shown. It is emphasized that the significance of NNPDs in the general disease picture is now underestimated; in this connection their adequate therapy is not performed. This may result in a rapider progression of CI and a more significant reduction in daily activities in the patient. The high prevalence and multisymptom
pattern of NNPD are determined in both patients with DE and non-dementia CI and in those with AD and mild to moderate stage dementia. The degree of NNPDs correlates with the severity of cognitive defect and the low quality of life. Akatinol is noted to be clinically efficacious in DE and moderate CI against not only CI, but also NNPDs. In AD, symptomatic antidementia drugs (galantine, memantine, or their combination) arrest NNPDs in the first 3 months of therapy. Combined therapy should be recognized as best. The data available in the literature and the results of the authorХs studies show the need for further investigations of NNPDs in patients with CI in order to optimize the diagnosis and treatment of neurogeriatric diseases.

About the Author

T. G. Voznesenskaya
A.Ya. Kozhevnikov Clinic of Nervous System Diseases, I.M. Sechenov First Moscow State Medical University
Russian Federation


1. <div><p>Teng E., Cummings J.L. Behaviour. In: Clinical diagnosis and management of Alzheimer disease. 3ed. Ed. by Gauthier S. Informa UK Limited, 2007;189–204.</p><p>Robert P.H.H., Berr C., Volteau M. et al. Apathy in patients with MCI and the risk of developing dementia of Alzheimer disease a one-year follow-up study. Clin Neur Neurosurg 2006;108(8):733–6.</p><p>Palmer K., Berger A.K., Monastero R. et al. Predictors of progression from MCI to Alzheimer disease. Neurology 2007;68(19):1596–602.</p><p>Waldemar G., Dubois B., Emre M. et al. Alzheimer disease and other disorders associated with dementia. In: Hughes R., Brainin M., Gilhus N.E. European Guidelines: Acute Stroke Parkinson’s dis. Alzheimer’s disease, Sleep disorders. Blackwell Publishing Ltd.,2007;123–72.</p><p>Lyketsos C.G., Lopez O., Jones B. et al. Prevalens of neuropsychiatric symptoms in dementia and MCI: results from the cardiovascular health study. JAMA 2002;288(12):1475–83.</p><p>Cummings J.L., Mega M., Gray K. et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–14.</p><p>Lyketsos C.G., Steinberg M., Tschans J.T. et al. Mental and behavioral disturbances in dementia: findigs from the Cache Country Stude on Memory in Aging. Am J Psychiatry 2000;157(5):708–14.</p><p>Rozzini L., Vicini Chilovi B., Conti M. et al. Neuropsychiatric symptoms inamnestic and nonamnestic mild cognitive impairment. Dement Geriatr Cogn Dis 2008;25(1):32–6.</p><p>Baguero M., Blasco R., Campos-Garcia A. et al Descriptive study of behavioural disorders in MCI.- Rev/Neurol 2004;38(4):323–6.</p><p>Demey I., Zimerman M., Allegri R.F. et al. Neuropsychiatric symptoms in MCI. Vertex 2007;18(74):252–7.</p><p>Ellison J.M., Harper D.G, Berlow Y. et al. Beyond the “C” in MCI: noncognitive symptoms in amnestic and non-amnestic MCI. CNS Spectr 2008;13(1):66–72.</p><p>Feldman H., Scheltens P., Scarpini E. et al. Behavioral symptoms in MCI. Neurology 2004;62(7):1199–201.</p><p>Geda Y.E., Smith G.E., Knopman D.S. et al. De novo genesis of neuropsychiatric symptoms in MCI. Int Psychogeriatr. 2004;16(1):51–60.</p><p>Hwang T.G., Masterman D.L., Ortiz F. et al. MCI is associated with characteristic neuropsychiatric symptoms. Alzheimer Dis Ass Dis 2004;18(1):17–21.</p><p>Hwang T.G., Cummings J.L. Neuropsychiatric symptoms of MCI. In: Gauthier S., Cummings J.L. (eds). Alzheimer disease and related disorders annual. London: Martin Dunitz, 2004;71–80.</p><p>Apostolova L.G. Cummings J.L. Neuropsychiatric manifestation in MCI a systematic reviw of the literature. Dement Geriatr Cogn Dis 2008;25:115–26.</p><p>Локшина А.Б., Захаров В.В. Легкие и умеренные когнитивные расстройства при дисциркуляторной энцефалопатии. Неврол журн 2006;11(прил. 1):57–63.</p><p>Локшина А.Б., Захаров В.В., Яхно Н.Н. Эмоциональные нарушения у пациентов с легкими и умеренными когнитивными расстройствами при дисциркуляторной энцефалопатии. Мат-лы ХI науч-практич конф «Новые стратегии в неврологии». Под. ред. С.М. Кузнецовой. Судак, 26–29 апреля 2009;248–53.</p><p>Локшина А.Б. Легкие и умеренные когнитивные расстройства при дисциркуляторной энцефалопатии. Дисс. … канд. мед. наук. М., 2005;138 с.</p><p>Lovestone S., Gauthier S. Management of dementia. Martin Dunits Ltd., 2001;168 p.</p><p>Bozzola F.G., Gorelic F.B., Freels S. Personality Changes in Alzheimer disease. Arch Neurol 1992;49:297–300.</p><p>Koponen H.J. Assessment of Behavioral symptoms. Abstracts The Fourth Kuopia Alzheimer symposium Febr 2–4, 2006. Kuopia Finland, 2006;23.</p><p>Vataja R. Prevalence and Significance of Behavioral Symptoms .- abstracts The Fourth Kuopia Alzheimer symposium, Febr 2–4, 2006; Kuopia Finland.</p><p>Kanner A.M. Depression in neurological disorders. Chicago, Illinois, USA: The Lundbeck Institute, 2005;161 p.</p><p>Mega M.S., Cummings J.L., Fiorelio T. et al. The spectrum of behavioral changes in A.D. Neurology 1996;46(1):130–5.</p><p>Steinberg M.S., Shepard J.M., Tschanz J.T. et al. The incidence of mental and behavioral disturbances in dementia: the Cache County Study. J Neuropsychiatry Clin Neurosci 2003;15:340–5.</p><p>Landes A.M., Sperry S.D., Straus M.E. Prevalence of Apathy, Disphoria, and depression in relation to dementia severity in AD. J Neuropsychiatry Clin Neurosci 2005;17:342–9.</p><p>Guimardes H.C., Levy R., Teixeira A.L. et al. Neurobiology of apathy in Alzheimer disease. Arq Neuropsiquiatr 2008;66(2B):436–43.</p><p>Левин О.С. Диагностика и лечение деменции в клинической практике. М.: МЕДпресс, 2010;254 с.</p><p>Некогнитивные нервно-психические расстройства при когнитивных нарушениях в пожилом возрасте (обзор). Неврол журн 2010;15(2):4–18.</p><p>Sarazin M., Horne N., Dubois B. Natural decline and prognostic factors In Clinical diagnosis and management of Alzheimer disease. 3ed Ed. Ed by Gauthier S. Informa UK Limited, 2007;137–47.</p><p>Moran M., Walsh C., Lynch A. et al. Syndromes of behavioural and psychological symptoms in mild Alzheimer disease. Int J Geriatr Psychiatry 2004;19:359–64.</p><p>Гаврилова С.И., Колыхалов И.В., Калын Я.Б. и др. Новые возможности холинергической терапии болезни Альцгеймера. Журн психиатр 2005;2:1–8.</p><p>Гаврилова С.И. Болезнь Альцгеймера: новые терапевтические возможности. Консилиум Медикум 2004;6(2):142–9.</p><p>Feldman H., Gauthier S., Hecker J. et al. A 24-week,randomised, doubl blind study of donepezil in moderate to severe Alzheimer disease. Neurology 2001;57:613–20.</p><p>Herrmann N. Management of neuropsychiatric symptoms In Clinical diagnosis and management of Alzheimer disease. 3ed. Ed. Ed. by Gauthier S. Informa UK Limited, 2007;265–79.</p><p>Francis P.T. Glutamatergic approaches to the treatment of cognitive and behavioural symptoms in Alzheimer disease. Neurodegener Dis 2008;5(3–4):241–3.</p><p>Tariot P.N., Farlow M.R., Grosberg G.T. et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receving donepezil: a randomized controlled trial. JAMA 2004;291(3):317–24.</p><p>Wilcock G.K., Ballard C.G., Cooper J.A. et al Memantine for agitation/aggression and psychosis in moderate severe AD: a pooled analisis of 3 studies. J Clin Psychiatry 2008;69(3):341–8.</p><p>Gauthier S., Loft H., Cummings J. Improvement in behavioural symptoms in patients with moderate to severe AD by memantine6 a pooled data analysis. Int J Geriatr Psychiatry 2008;23(5):537–45.</p><p>Grossberg G.T., Pejovic V., Miller M.L. et al. Memantine therapy of behavioural symptoms in Community-Dwelling patients with moderate to severe AD Dement. Geriatr Cogn Dis 2009;27:164–72.</p><p>Posteinson A.P., Grossberg G.T., Mintzer J. et al. Memantine treatment in patients with mild to moderate AD already receiving cholinesterase inhibitor: a randomized? Double-blind, placebo- controlled trial. Curr Alzheim Res 2008;5(1):83–9.</p><p>Reisberg B., Doody R., Stoftler A. et al. Memantine in moderate-to-severe Alzheimer disease. N Engl J Med 2003;348:1333–41.</p><p>Gauthier S., Wirth Y., Mobius H.J. Effects of memantine on behavioural symptoms in Alzheimer disease patients- an analysis of the NPI data of two randomized controlled studies. Int J Geriatr Psychiatry 2005;20(5):459–64.</p><p>Gauthier S., Loft H., Cummings J. Improvement in behavioural symptoms in patients with moderate to severe Alzheimer disease by memantine – a pooled data analysis Int. J Geriatr Psychiatry 2008;23(5):537–45.</p><p>Gauthier S., Cooper L.H. Specific benefits of memantine on behavioural symptoms in patients with moderate to severe AD. Poster J Alzcheim dementia 2006;2(3 Suppl.):S370.</p><p>Maidment I.D., Fox C.G., Boustani M. et al. Efficacy of memantine on behavioural and psychological symptoms related to dementia – a systematic meta-analyses. Ann Pharmacother 2008;42(1):32–8.</p><p>Вознесенская Т.Г. Эмоционально-аффективные и поведенческие нарушения при легких и умеренных когнитивных расстройствах. Опыт применения мемантина. Неврол журн 2009;14(3):49–55.</p><p>Вознесенская Т.Г., Медведева А.В., Яхно Н.Н. Некогнитивные нейропсихические расстройства при БА и их коррекция. Неврол журн 2010;15(4):18–25.</p><p>Захаров В.В., Яхно Н.Н. Синдромы нарушения высших психических функций. В кн.: Болезни нервной системы. Под ред Н.Н. Яхно, Д.Р. Штульмана. Т. 1. М.: Медицина, 2003;177.</p><p>Захаров В.В., Яхно Н.Н. Когнитивные расстройства в пожилом и старческом возрасте: Метод. Пособ. для врачей. М., 2005;71 с.</p></div><br />


For citations:

Voznesenskaya T.G. Akatinol in the treatment of noncognitive neuropsychological disorders in neurogeriatric diseases. Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2S):11-17. (In Russ.)

Views: 892

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)