Preview

Неврология, нейропсихиатрия, психосоматика

Расширенный поиск

Деменции альцгеймеровского типа: современное состояние проблемы

https://doi.org/10.14412/2074-2711-2014-1-61-67

Аннотация

Представлены современные данные об эпидемиологии, диагностике и лечении болезни Альцгеймера и деменции альцгеймеровского типа. Рассмотрены различные подходы к терапии на основе современных представлений о патогенезе дегенеративного процесса и с учетом клинических особенностей заболевания (характера психопатологической симптоматики, стадии болезни). Особое внимание уделено компенсаторной терапии, направленной на восполнение дефицита холинергической и глутаматергической нейротрансмиссии. 

Об авторах

Н.А. Тювина
Кафедра психиатрии и наркологии ГБОУ ВПО «Первый Московский медицинский государственный университет им. И.М. Сеченова» Минздрава России, Москва, Россия
Россия


В.В. Балабанова
Кафедра психиатрии и наркологии ГБОУ ВПО «Первый Московский медицинский государственный университет им. И.М. Сеченова» Минздрава России, Москва, Россия
Россия


Список литературы

1. Alzheimer A. Жber eine eigenartige Erkrankung der Hirnrinde [About a peculiar disease of the cerebral cortex]. Allgemeine Zeitschrift fur Psychiatrie und Psychisch-Gerichtlich Medizin. 1907;64(1–2):146–8.

2. Kraepelin E. Psychiatrie. Ein Lehrbuch fü r Studierende und Ärzte. Achte, vollstКndig umgearbeitete Auflage. II. Band. Klinische Psychiatrie. I Teil. Leipzig: Barth Verlag; 1909.

3. Alzheimer A. Über eigenartige Krankheits fä lle des spä teren Alters. Z Gesamte Neurol Psychiat. 1911;(4) :356–85.

4. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington: DC, American Psychiatric Association; 1994.

5. World Health Organization: International Classification of Diseases, 8th Revision. Geneva: World Health Organization; 1967.

6. World Health Organization: International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Geneva: World Health Organization; 1992.

7. Гаврилова СИ, Калын ЯБ, Герасимов НП и др. Новая форма специализированной помощи пожилым больным с деменцией (организационные и фармако-экономические аспекты). Социальная и клиническая психиатрия. 2008;18(2):36–40. [Gavrilova SI, Kalyn YaB, Gherasimov NP, et al. A new form of specialized care for elderly people with dementia (organizational and pharmacoeconomic issues). Sotsial'naya i klinicheskaya psikhiatriya. 2008;18(2):36–40. (In Russ.)]

8. Rocca WA, Hofman A, Brayne C, et al. Frequency and distribution of Alzheimer's disease in Europe: a collaborative study of 1980–1990 prevalence findings.

9. The EURODEM-Prevalence Research Group. Ann Neurol. 1991;30(3):381–90. DOI: http://dx.doi.org/10.1002/ana.410300310.

10. Von Strauss E, Viitanen M, De Ronchi D, et al. Aging and the occurrence of dementia: findings from a population-based cohort with a large sample of nonagenarians. Arch Neurol. 1999;56(5):587–92. DOI: http://dx.doi.org/10.1001/archneur.56.5.587.

11. Hebert LE, Scherr PA, Beckett LA, et al. Age specific incidence of Alzheimer’s disease in a community population. JAMA. 1995;273(17):1354–9. DOI: http://dx.doi.org/10.1001/jama. 1995.03520410048025.

12. Jellinger KA, Attems J. Neuropathological evaluation of mixed dementia. Review. J Neurol Sci. 2007;257(1–2):80–7. DOI: http://dx.doi.org/10.1016/j.jns.2007.01.045. Epub 2007 Feb 26.

13. Штернберг ЭЯ. Клиника деменций пресенильного возраста. Москва: Медицина; 1967. 247 с. [Shternberg EYa. Klinika dementsii presenil'nogo vozrasta [Clinic of dementias of presenilny age]. Moscow: Meditsina; 1967. 247 p.]

14. Wang GD, Lai DJ, Burau KD, Du XL. Potential gains in life expectancy from reducing heart disease, cancer, Alzheimer’ disease or HIV/AIDS a major causes of death in the USA. Public Health. 2013;127(4):348–56. DOI: http://dx.doi.org/10.1016/j.puhe.2013.01.005. 14. Парфенов ВА. Профилактика болезни Альцгеймера. Неврология, нейропсихиатрия, психосоматика. 2011;(3):8–13. [Parfenov VA. Prevention of Alzheimer's disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2011;(3):8–13. (In Russ.)]. DOI: http://dx.doi.org/10. 14412/2074-2711-2011-159.

15. Kalaria RN, Akinyemi R, Ihara M. Does vascular pathology contribute to Alzheimer changes? J Neurol Sci. 2012;322(1–2):141–7.

16. Li G, Rhew IC, Shofer JB, et al. Age-varying association between blood pressure and risk of dementia in those aged 65 and older: a community-based prospective cohort study. J Am Geriatr Soc. 2007;55(8):1161–7. DOI: http://dx.doi.org/10.1111/j.1532-5415.2007.01233.x.

17. Biessels GJ, Staekenborg S, Brunner E, et al. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006;5(1):64–74. DOI: http://dx.doi.org/10.1016/S1474-4422(05)70284-2.

18. Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev. 2011;12(5):e426–37. DOI: 10.1111/j.1467-789X.2010.00825.x. Epub 2011 Feb 23.

19. Ho L, Zhao W, Dams-O'Connor K, et al. Elevated plasma MCP-1 concentration following traumatic brain injury as a potential «predisposition» factor associated with an increased risk for subsequent development of Alzheimer's disease. J Alzheimers Dis. 2012;31(2):301–13.

20. Tan ZS, Vasan RS. Thyroid function and Alzheimer's disease. J Alzheimers Dis. 2009;16(3):503–7.

21. Wu KY, Hsiao IT, Chen CS, et al. Increased brain amyloid deposition in patients with a lifetime history of major depression: evidence on positron emission tomography. Eur J Nucl Med Mol Imaging. 2013 Nov 15. [Epub ahead of print]. DOI: http://dx.doi.org/10.1007/s00259-013-2627-0.

22. Ptok U, Papassotiropoulos A, Maier W, Heun R. Advanced parental age: a risk factor for Alzheimer's disease or depression in the elderly? Int Psychogeriatr. 2000;12(4):445–51. DOI: http://dx.doi.org/10.1017/S1041610200006566.

23. Pardon MC, Rattray I. What do we know about the long-term consequences of stress on ageing and the progression of age-related neurodegenerative disorders? Neurosci Biobehav Rev. 2008;32(6):1103–20. DOI: http://dx.doi.org/10.1016/j.neu-biorev.2008.03.005.

24. Vest RS, Pike CJ. Gender, sex steroid hormones, and Alzheimer's disease. Horm Behav. 2013;63(2):301–7. DOI: 10.1016/j.yhbeh.2012.04.006. Epub 2012 Apr 19.

25. Enciu AM, Popescu BO. Is there a causal link between inflammation and dementia? Biomed Res Int. 2013;2013:316495. DOI: 10.1155/2013/316495. Epub 2013 Jun 6. Review.

26. Barberger-Gateau P, Letenneur L, Deschamps V, et al. Fish, meat, and risk of dementia: cohort study. BMJ. 2002;325(7370):932–3. DOI: http://dx.doi.org/10.1136/bmj.325.7370.932.

27. Letenneur L. Risk of dementia and alcohol and wine consumption: a review of recent results. Biol Res. 2004;37(2):189–93. DOI: http://dx.doi.org/10.4067/S0716-97602004000200003.

28. Almeida OP, Hulse GK, Lawrence D, Flicker L. Smoking as a risk factor for Alzheimer’s disease: contrasting evidence from a systematic review of case-control and cohort studies. Addiction. 2002;97(1):15–28. DOI: http://dx.doi.org/10.1046/j.1360-0443.2002.00016.x.

29. Гаврилова СИ. Болезнь Альцгеймера: современные представления о диагностике и терапии. Русcкий медицинский журнал. 1997;5(20):1339–47. [Gavrilova SI. Alzheimer's disease: modern ideas of diagnostics and therapy. Rusckii meditsinskii zhurnal. 1997;5(20):1339–47. (In Russ.)]

30. Жислин СГ. Очерки клинической психиатрии. Москва: Медицина; 1965. 320 с. [Zhislin SG. Ocherki klinicheskoi psikhiatrii [Sketches of clinical psychiatry]. Moscow: Meditsina; 1965. 320 p.]

31. Scarmeas N, Albert M, Brandt J, et al. Motor signs predict poor outcomes in Alzheimer disease. Neurology. 2005;64(10):1696–703. DOI: http://dx.doi.org/10.1212/01. WNL.0000162054.15428.E9.

32. Plassman BL, Breitner JC. Recent advances in the genetics of Alzheimer's disease and vascular dementia with an emphasis on gene-environment interactions. J Am Geriatr Soc. 1996;44(10):1242–50.

33. Sleegers K, Van Duijn CM. Alzheimer's disease: genes, pathogenesis and risk prediction. Community Genet. 2001;4(4):197–203. DOI: http://dx.doi.org/10.1159/000064193.

34. Wragg M, Hutton M, Talbot C. The Alzheimer's Disease Collaborative Group. Genetic association between intronic polymorphism in presenilin-1 gene and late-onset Alzheimer's disease. Lancet. 1996;347(9000):509–12. DOI: http://dx.doi.org/10.1016/S0140-6736(96)91140-X.

35. Scheuner D, Eckman C, Jensen M, et al. Secreted amyloid І-protein similar to that in the senile plaques of Alzheimer's disease is increased in vivo by the presenilin 1 and 2 and APP mutations linked to familial Alzheimer's disease. Nat Med. 1996;2(8):864–70. DOI: http://dx.doi.org/10.1038/nm0896-864.

36. Kwok JB, Taddei K, Hallupp M, et al. Two novel (M233Tand R278T) presenilin-1 mutations in early-onset Alzheimer's disease pedigrees and preliminary evidence for association of presenilin-1 mutations with a novel phenotype. Neuroreport. 1997;8(6):1537–42. DOI: http://dx.doi.org/10.1097/00001756-199704140-00043.

37. Sato S, Kamino K, Miki T, et al. Splicing mutation of presenilin-1 gene for early-onset familial Alzheimer's disease. Hum Mutat. 1998;Suppl 1:S91–S94. DOI: http://dx.doi.org/10.1002/humu.1380110131. 38. Schilling S, DeStefano AL, Sachdev PS, et al. APOE genotype and MRI markers of cerebrovascular disease: systematic review and meta-analysis. Neurology. 2013;81(3):292–300. DOI: http://dx.doi.org/10.1212/ WNL.0b013e31829bfda4.

38. Lambert JC, Araria-Goumidi L, Myllykangas L, et al. Contribution of APOE promoter polymorphisms to Alzheimer's disease risk. Neurology. 2002;59(1):59–66. DOI: http://dx.doi.org/10.1212/WNL.59.1.59.

39. Strittmatter WJ, Saunders AM, Schmechel D, et al. Apolipoprotein E: highavidity binding to І-amyloid and increased frequency of type 4 allele in lateonset familial Alzheimer disease. Proc Natl Acad Sci U S A. 1993;90(5):1977–81. DOI: http://dx.doi.org/10.1073/pnas.90.5.1977.

40. Nathan BP, Chang KC, Bellosta S, et al. The inhibitory effect of apolipoprotein E4 on neurite outgrowth is associated with microtubule depolymerization. J Biol Chern. 1995;270(34):19791–9. DOI: http://dx.doi.org/10.1074/jbc.270.34.19791.

41. Jellinger KA. Challenges in neuronal apoptosis. Curr Alzheimer Res. 2006;3(4):377–91. DOI: http://dx.doi.org/10.2174/ 156720506778249434.

42. Davies P, Maloney AJ. Selective loss of central cholinergic neurons in Alzheimer’s disease (letter). Lancet. 1976;2(8000):1403. DOI: http://dx.doi.org/10.1016/S0140-6736(76)91936-X.

43. Drachman DA, Leavitt J. Human memory and the cholinergic system. Arch Neurol. 1974;30(2):113–21. DOI: http://dx.doi.org/10.1001/archneur.1974.00490320001001.

44. Ещенко НД. Биохимия психических и нервных болезней. Cанкт-Петербургг: СПБГУ; 2004. 204 с. [Eshchenko ND. Biokhimiya psikhicheskikh i nervnykh boleznei [Biochemistry of mental and nervous diseases]. St-Petersburg: SPBGU; 2004. 204 p.]

45. Weiner MF, Lipton AM, editor. The American Psychiatric Publishing textbook of Alzheimer disease and other dementias. 1st ed. American Psychiatric Publishing Inc; 2009. P. 317–24.

46. Преображенская ИС. Диагностика и лечение болезни Альцгеймера. Спецвыпуск: Когнитивные и другие нервно-прихические расстройства. Неврология, нейропсихитрия, психосоматика. 2012;(2S):5–10. [Preobrazhenskaya IS. Alzheimer's disease: diagnosis and treatment. Special issue: Сognitive and other neuropsychiatric disorders. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(2S):5–10. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2012-2502.

47. Noetzli M, Eap CB. Pharmacodynamic, pharmacokinetic and pharmacogenetic aspects of drugs used in the treatment of Alzheimer's disease. Clin Pharmacokinet. 2013;52(4):225–41. DOI: 10.1007/s40262-013-0038-9.

48. Гаврилова СИ, Герасимов НП, Калын ЯБ и др. Долговременные эффекты глутаматергической терапии болезни Альцгеймера на стадии умеренно-тяжелой и тяжелой деменции (Результаты 26-недельного сравнительного клинического исследования в параллельных группах больных: леченных акатинолом мемантином и получавших симптоматическую нейролептическую терапию). Социальная и клиническая психиат- рия. 2006;16(1):32–7. [Gavrilova SI, Gerasimov NP, Kalyn YaB, et al. Long-term effects of the glutamate therapy in moderate and severe alzheimer disease: results of a 26- week comparative trial of akatinol-memantine vs. symptomatic neuroleptic medication. Sotsial'naya i klinicheskaya psikhiatriya. 2006;16(1):32–7. (In Russ.)]

49. Grossberg GT, Manes F, Allegri RF, et al. The safety, tolerability, and efficacy of once-daily memantine (28 mg): a multinational, randomized, double-blind, placebo-con- trolled trial in patients with moderate-to-severe Alzheimer's disease taking cholinesterase inhibitors. CNS Drugs. 2013;27(6):469–78. DOI: http://dx.doi.org/10.1007/s40263-013- 0077-7.

50. Вознесенская ТГ. Акатинол в лечении некогнитивных нервно-психических расстройств при нейрогериатрических заболеваниях. Спецвыпуск: Когнитивные и другие нервно-пcихические расстройства. Неврология, нейропсихиатрия, психосоматика. 2012;(2S):11–7. [Voznesenskaya TG. Akatinol in the treatment of noncognitive neuropsychological disorders in neurogeriatric diseases. Special issue: Сognitive and other neuropsychiatric disorders. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(2S):11–7.]. DOI: http://dx.doi.org/10.14412/2074-2711-2012-2503.

51. Reisberg B, Doody R, StЪffler A, et al. Memantine Study Group. Memantine in moderate-to-severe Alzheimer's disease. N Engl J Med. 2003;348(14):1333–41. DOI: http://dx.doi.org/10.1056/NEJMoa013128.

52. Вознесенская ТГ, Медведева АВ, Яхно НН. Некогнитивные нейропсихические расстройства при БА и их коррекция. Неврологический журнал. 2010;15(4):18–24. [Voznesenskaya TG, Medvedeva AV,

53. Yakhno NN. Not cognitive neuromental disorders at OH and their correction. Nevrologicheskii zhurnal. 2010;15(4):18–24. (In Russ.)]

54. Maidment ID, Fox CG, 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. DOI: http://dx.doi.org/10.1345/aph.1K372.

55. Gauthier S, Loft H, Cummings J. Improvement in behavioural symptoms in patients with moderate to severe AD by memantine: a pooled data analysis. Int J Geriatr Psychiatry. 2008;23(5):537–45. DOI: http://dx.doi.org/10.1002/gps.1949.

56. Wilcock GK, Ballard CG, Cooper JA, 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. DOI: http://dx.doi.org/10.4088/JCP.v69n0302.

57. Lopez OL, Becker JT, Wahed AS, et al. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatr. 2009;80(6):600–7. DOI: http://dx.doi.org/10.1136/jnnp.2008.158964. 58. Chow TW, Pollock BG, Milgram NW. Potential cognitive enhancing and disease modification effects of SSRIs for Alzheimer’s disease. Neuropsychiatr Dis Treat. 2007;3(5):627–36.


Рецензия

Для цитирования:


Тювина Н, Балабанова В. Деменции альцгеймеровского типа: современное состояние проблемы. Неврология, нейропсихиатрия, психосоматика. 2014;6(1):61-67. https://doi.org/10.14412/2074-2711-2014-1-61-67

For citation:


Tyuvina N, Balabanova V. Dementia of the Alzheimer type: current state of the problem. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2014;6(1):61-67. (In Russ.) https://doi.org/10.14412/2074-2711-2014-1-61-67

Просмотров: 1445


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


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