ALZHEIMER’S DISEASE: DIAGNOSIS AND TREATMENT

Early diagnosis of Alzheimer's disease (AD) is one of the most important tasks of modern medicine. Even before its obvious clinical symptoms develop, AD can be now identified from the data of functional neuroimaging, including that with the Pittsburgh compound, which can detect amyloid protein accumulation in the brain structures, and from those of an analysis of biomarkers in the cerebrospinal fluid. If there are clinical symptoms, a diagnosis can be established by the correct evaluation of mnestic disorders; the latter in BA are so-called hippocampal. Treatment for AD should be initiated as early as possible; methods for pathogenetic therapy are being actively developed. When treating AD, one should adhere to a comprehensive approach involving the use of drugs for basic symptomatic treatment and those enhancing its efficiency, and non-drug treatments (cognitive and motor training). It is important to timely identify and eliminate potentially reversible conditions and to work with caregivers and guardians.

1. Гаврилова СИ, Федорова ЯБ, Колыхалов ИВ и др. Терапевтический потенциал Церебролизина в превентивной терапии болезни Альцгеймера. Журнал неврологии и психиатрии им. С.С. Корсакова. 2008;(8): 24-9. [Gavrilova SI, Fedorova YaB, Kolykhalov IV, et al. The therapeutic potential of Cerebrolysin in the preventative treatment of Alzheimer's disease. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2008;(8):24-9. (In Russ.)].

2. Гусев ЕИ, Гехт АБ, Белоусов ЮБ и др. Клинические и фармакоэкономические особенности применения Церебролизина в восстановительном лечении ишемического инсульта. Журнал неврологии и психиатрии им. С.С.Корсакова. 2007;(10):26-33. [Gusev EI, Gekht AB, Belousov YuB i dr. Clinical and pharmacoeconomic peculiarities of application of Cerebrolysin in rehabilitation of ischemic stroke. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2007;(10):26-33. (In Russ.)].

3. Захаров ВВ, Яхно НН. Нарушения памяти. Москва: ГЭОТАР-Медиа; 2001. 160 с. [Zakharov VV, Yakhno NN. Narusheniya pamyati [Memory impairments]. Moscow: GEOTAR-Media; 2001. 160 p.]

4. Samadi H, Sultzer D. Solanezumab for Alzheimer's disease. Expert Opin Biol Ther. 2011 Jun;11(6):787-98. doi: 10.1517/14712598.2011.578573. Epub 2011 Apr 20.

5. Яхно НН, Захаров ВВ, Локшина АБ и др. Деменции. Руководство для врачей. 3-е издание. Москва: МЕДпресс-информ; 2011. С. 53-75. [Yakhno NN, Zakharov VV, Lokshina AB, et al. Dementsii. Rukovodstvo dlya vrachei [Dementia. A guide for physicians]. 3rd edition. Moscow: MEDpress-inform; 2011. P. 53-75.]

6. Edison P, Archer HA, Hinz R, et al. Amyloid, hypometabolism, and cognition in Alzheimer disease: an [11C]PIB and [18F]FDG PET study. Neurology. 2007 Feb 13;68(7):501-8. Epub 2006 Oct 25.

7. Парфенов ВА, Захаров ВВ, Преображенская ИС. Когнитивные расстройства. Москва: Ремедиум; 2014. 224 с. [Parfenov VA, Zakharov VV, Preobrazhenskaya IS. Kognitivnye rasstroistva [Cognitive impairments]. Moscow: Remedium; 2014. 224 p.]

8. Преображенская ИС, Громова ДО. Некоторые аспекты терапии нейродегенеративных деменций. Медицинский совет. 2014;(10):36-42. [Preobrazhenskaya IS, Gromova DO. Some aspects of the therapy of neurodegenerative dementia. Meditsinskii sovet. 2014;(10):36-42. (In Russ.)].

9. Brickman AM, Siedlecki KL, Stern Y. Cognitive and Brain reserve. In: Depp CA, Jeste DV, editors. Successful Cognitive and Emotional Aging. Arlington: American Psychiatric Publishing, Inc; 2010. P. 157-72.

10. Erickson KI, Colcombe SJ, Wadhwa R, et al. Training-induced plasticity in older adults: effects of training on hemispheric asymmetry. Neurobiol Aging. 2007 Feb;28(2):272-83. Epub 2006 Feb 9.

11. Chan D, Fox NC, Scahill RI, et al. Patterns of temporal lobe atrophy in semantic dementia and Alzheimer's disease. Ann Neurol. 2001 Apr;49(4):433-42.

12. Dickerson BC, Goncharova I, SullivanMP, et al. MRI-derived entorhinal and hippocampal atrophy in incipient and very mild Alzheimer's disease. Neurobiol Aging. 2001 Sep-Oct;22(5): 747-54.

13. Killiany RJ, Hyman BT, Gomez-Isla T, et al. MRImeasures of entorhinal cortex vs hippocampus in preclinical AD. Neurology. 2002 Apr 23;58(8):1188-96.

14. Scahill RI, Schott JM, Stevens JM, et al. Mapping the evolution of regional atrophy in Alzheimer's disease: Unbiased analysis of fluidregistered serial MRI. Proc Natl Acad Sci USA. 2002 Apr 2;99(7):4703-7.

15. Braak H, Braak E. Neuropathological staging of Alzheimer-related changes. Acta Neuropathol (Berl). 1991;82:239-59.

16. Johnson KA, Fox NC, Sperling RA, Klunk WE. Brain Imaging in Alzheimer Disease. Cold Spring Harb Perspect Med. 2012 Apr;2(4):a006213. doi: 10.1101/cshperspect.a006213.

17. Jack CR Jr, Knopman DS, Jagust WJ, et al. Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. Lancet Neurol. 2010 Jan;9(1):119-28. doi: 10.1016/S1474-4422(09)70299-6.

18. Whitwell JL. Longitudinal imaging: change and causality. Curr Opin Neurol. 2008 Aug;21(4):410-6. doi: 10.1097/WCO.0b013e32830719d4.

19. Toyn JH, Rowley A, Matsuoka Y, et al. γ-Secretase Pharmacology: What Pharmacology Will Work for Alzheimer's Disease? Int JAlzheimers Dis. 2013;2013:849128. doi: 10.1155/2013/849128. Epub 2013 Apr 18.

20. Kerchner GA, Boxer AL. Bapineuzumab. Expert Opin Biol Ther. 2010 Jul;10(7):1121-30. doi: 10.1517/14712598.2010.493872.

21. Novakovic D, Feligioni M, Scaccianoce S, et al. Profile of gantenerumab and its potential in the treatment of Alzheimer's disease. Drug Des Devel Ther. 2013 Nov 13;7:1359-64. doi: 10.2147/DDDT.S53401.eCollection 2013.

22. Vellas B, Carrillo MC, Sampaio C, et al; EU/US/CTAD Task Force Members. Designing drug trials for Alzheimer's disease: what we have learned from the release of the phase III antibody trials: a report from the EU/US/CTAD Task Force. Alzheimers Dement. 2013 Jul;9(4):438-44. doi: 10.1016/j.jalz.2013.03.007.

23. Koenigsknecht-Talboo J, Meyer-Luehmann M, Parsadanian M, et al. Rapid microglial response around amyloid pathology after systemic anti-Abeta antibody administration in PDAPP mice. J Neurosci. 2008 Dec 24;28(52):14156-64. doi: 10.1523/JNEUROSCI.4147-08.2008.

24. Ostrowitzki S, Deptula D, Thurfjell L, et al. Mechanism of amyloid removal in patients with Alzheimer disease treated with gantenerumab. Arch Neurol. 2012 Feb;69(2):198-207. doi: 10.1001/archneurol.2011.1538.Epub2011 Oct 10.

25. Senior K. Dosing in phase II trial of Alzheimer's vaccine suspended. Lancet Neurol. 2002 May;1(1):3.

26. Forman MS, Trojanowski JQ, Lee VM. Neurodegenerative diseases: a decade of discoveries paves the way for therapeutic breakthroughs. Nat Med. 2004 Oct;10(10):1055-63.

27. Qaseem A, Snow V, Cross JT Jr, et al. Current pharmacologic treatment of dementia: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2008 Mar 4;148(5):370-8.

28. Oertel W, Ross JS, Eggert K, et al. Rationale for transdermal drug administration in Alzheimer's disease. Neurology. 2007 Jul 24;69(4 Suppl 1):S4-9.

29. Alvarez XA, Cacabelos R, Laredo M, et al. A 24-week, double-blind, placebo-controlled study of three dosages of Cerebrolysin in patients with mild to moderate Alzheimer's disease. Eur J Neurol. 2006 Jan;13(1):43-54.

30. Rockenstein E, Adame A, Mante M, et al. Amelioration of the cerebrovascular amyloidosis in a transgenic model of Alzheimer's disease with the neurotrophic compound cerebrolysin. J Neural Transm (Vienna). 2005 Feb;112(2):269-82. Epub 2004 Jul 7.

31. Rockenstein E, Torrance M, Mante M, et al. Cerebrolysin decreases amyloid-beta production by regulating amyloid protein precursor maturation in a transgenic model of Alzheimer's disease. J Neurosci Res. 2006 May 15;83(7): 1252-61.

32. Gauthier S, ProaЦo JV, Jia J, et al. Cerebrolysin in Mild-to-Moderate Alzheimer's Disease: A Meta-Analysis of Randomized Controlled Clinical Trials. Dement Geriatr Cogn Disord. 2015;39(5-6):332-47. doi: 10.1159/000377672. Epub 2015 Mar 26.

33. Wey ZH, He QB, Wang H, et al. Metaanalysis: the efficacy of nootropic agent Cerebrolysin in the treatment of Alzheimer's disease. J Neural Transm (Vienna). 2007;114(5):629-34. Epub 2007 Feb 23.

34. Weiner MW. Commentary on «Diagnosis of Alzheimer's disease: two decades of progress.» Central role of technology in the treatment and prevention of Alzheimer's disease. Alzheimers Dement. 2005 Oct;1(2):112-3.

35. Colcombe S, Kramer AF.. Fitness effects on the cognitive function of older adults a meta-analytic study. Psychol Sci. 2003 Mar; 14(2):125-30.

36. Gates N, Fiatarone Singh MA, Sachdev PS, Valenzuela M. The effect of exercise training on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials. Am J Geriatr Psychiatry. 2013 Nov;21(11):1086-97. doi: 10.1016/j.jagp.2013.02.018. Epub 2013 Jul 3.

37. Rodakowski J, Saghafi E, Butters MA, Skidmore ER. Non-pharmacological interventions for adults with mild cognitive impairment and early stage dementia: An updated scoping review. Mol Aspects Med. 2015 Jun-Oct;43-44: 38-53. doi: 10.1016/j.mam.2015.06.003.Epub 2015 Jun 10.

38. Kawashima R. Mental Exercises for Cognitive Function: Clinical Evidence. J Prev Med Public Health. 2013 Jan;46 Suppl 1:S22-7. doi: 10.3961/jpmph.2013.46.S.S22. Epub 2013 Jan 30.

39. Rozzini L, Costardi D, Chilovi BV, et al. Efficacy of Cognitive Rehabilitation in Patients with Mild Cognitive Impairment Treated with Cholinesterase Inhibitors. 4th ed. JohnWiley & Sons; 2007. P. 356-60.

40. Yates LA, Orrell M, Spector A, Orgeta V. Service users' involvement in the development of individual Cognitive Stimulation Therapy (iCST) for dementia: a qualitative study. BMC Geriatr. 2015 Feb 6;15:4. doi: 10.1186/s12877-015-0004-5.

41. Boripuntakul S, Kothan S, Methapatara P, et al. Short-Term Effects of Cognitive Training Program for Individuals with Amnestic Mild Cognitive Impairment: a Pilot Study. 2nd ed. Taylor & Francis; 2012. P. 138-49.

42. van Paasschen J, Clare L, Yuen KS, et al. Cognitive rehabilitation changesmemory-related brain activity in people with Alzheimer disease. Neurorehabil Neural Repair. 2013 Jun;27(5):448-59. doi: 10.1177/1545968312471902. Epub 2013 Jan 31.

43. Belleville S, Bherer L. Biomarkers of cognitive training effects in aging. Curr Transl Geriatr Exp Gerontol Rep. 2012 Apr 19;1(2): 104-110. Print 2012 Jun.

44. Baker LD, Frank LL, Foster-Schubert K, et al. Effects of Aerobic Exercise on Mild Cognitive Impairment: A Controlled Trial. Arch Neurol. 2010 Jan;67(1):71-9. doi: 10.1001/archneurol.2009.307.

45. Suzuki T, Shimada H, Makizako H, et al. Effects of multicomponent exercise on cognitive function in older adults with amnesticmild cognitive impairment: a randomized controlled trial. BMC Neurol. 2012 Oct 31;12:128. doi: 10.1186/1471-2377-12-128.

46. Schmidt W1, Endres M, Dimeo F, Jungehulsing GJ. Train the vessel, gain the brain: physical activity and vessel function and the impact on stroke prevention and outcome in cerebrovascular disease. Cerebrovasc Dis. 2013;35(4):303-12. doi: 10.1159/000347061. Epub 2013 Apr 10.