Гетерогенность сосудистых когнитивных нарушений и вопросы терапии
https://doi.org/10.14412/2074-2711-2015-3-62-69
Аннотация
Сосудистые когнитивные нарушения (КН) гетерогенны по механизму возникновения и могут развиваться при различном объеме поражения головного мозга, различной локализации и количестве очагов. Разнообразны и этиологические факторы, их вызывающие. Механизм развития КН может быть связан с нарушением как непосредственно структур, отвечающих за когнитивные функции (лобная кора, гиппокамп), так и подкорково-корковых взаимодействий, диафферентацией коры, лимбических структур вследствие поражения белого вещества околожелудочкого пространства или локального поражения базальных ганглиев и таламуса. Паттерн КН зависит от преимущественного вовлечения корковых или подкорковых отделов или их комбинации. Характер нарастания КН также вариабелен. При хронической недостаточности мозгового кровообращения КН развиваются постепенно, в течение нескольких лет. Постинсультные КН проявляются остро или подостро. У 6–27% пациентов деменция диагностируется через 3 мес после острого нарушения мозгового кровообращения. В последующем риск развития деменции составляет 7% в течение первого года и 48% через 25 лет.
Представлен обзор наиболее значимых исследований, посвященных применению цитиколина при КН. Цитиколин оказывает многокомпонентное действие, позволяющее использовать его при КН различного генеза. С учетом хорошей переносимости и безопасности препарат можно рекомендовать широкому кругу пациентов, в том числе пожилым больным с сопутствующей патологией.
Об авторе
Елена Анатольевна Катунина
ГБОУ ВПО «Российский национальный исследовательский университет им. Н.И. Пирогова» Минздрава России
Россия
Россия
Кафедра неврологии, нейрохирургии и медицинской генетики,
117997, Москва, ул. Островитянова, 1
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Рецензия
Для цитирования:
Катунина ЕА. Гетерогенность сосудистых когнитивных нарушений и вопросы терапии. Неврология, нейропсихиатрия, психосоматика. 2015;7(3):62-69. https://doi.org/10.14412/2074-2711-2015-3-62-69
For citation:
Katunina EA. The heterogeneity of vascular cognitive impairments and the issues of therapy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(3):62-69. (In Russ.) https://doi.org/10.14412/2074-2711-2015-3-62-69
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