Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Morphofunctional bases for the development of vascular cognitive and emotional disorders

Full Text:


Objective: to investigate cerebrovascular reactivity (CVR) and brain matter structural changes in patients with moderate cognitive impairment.

Patients and methods. A total of 385 patients aged 57 to 79 years with moderate vascular cognitive impairment (VCI) were examined. A rela￾tionship of the clinical types of VCI and depression to the extent and location of ischemic brain matter damage and to the state of CVR in different vascular beds was investigated at the stage of inclusion into the study and following 20 months.

Results. There was a correlation of the neuropsychological profile and the severity of VCI with the features of brain matter structural damage, but with a greater CVR decrease in the carotid artery (CA) system and a concomitant CVR reduction in the CA and vertebrobasilar bed (VBB). There was an association of the incidence of depression with the location of ischemic damage in the frontal lobes and a CVR decrease in the left CA and with a concomitant CVR reduction in the CA and VBB.

Conclusion. The CVR determined in different vascular beds may serve as an early prognostic indicator of evolving VCI or depression. 

About the Author

Yu. V. Zhitkova
Interregional Clinical and Diagnostic Center, Kazan
Russian Federation

12a, Karbyshev St., Kazan, Republic of Tatarstan 420101 


1. Левин ОС. Диагностика и лечение деменции в клинической практике. Москва: МЕДпресс- информ; 2010. 256 с. [Levin OS. Diagnostika i lechenie dementsii v klinicheskoi praktike [Diagnosis and treatment of dementia in clinical practice]. Moscow: MEDpress-inform; 2010. 256 p.]

2. Rodrigue K.M. Contribution of Cerebrovascular Health to the Diagnosis of Alzheimer Disease. JAMA Neurol. 2013;70(4):438-439.

3. Carvalho JO, Tommet D, Crane PK, et al. Deconstructing Racial Differences: The Effects of Quality of Education and Cerebrovascular Risk Factors. J Gerontol B Psychol Sci Soc Sci. 2015 Jul;70(4):545-56. doi: 10.1093/geronb/gbu086. Epub 2014 Aug 5.

4. Gonzalez CE, Pacheco J, Beason-Held LL, Resnick SM. Longitudinal changes in cortical thinning associated with hypertension. J Hypertens. 2015 Jun;33(6):1242-8. doi: 10.1097/HJH.00000 00000000531.

5. Парфенов ВА. Профилактика болезни Альцгеймера. Неврология, нейропсихиатрия, психосоматика. 2011;3(3):8-13. [Parfenov VA. Prevention of Alzheimer's disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2011;3(3):8-13. (In Russ.)]. doi: 10.14412/2074-2711-2011-159

6. Неверовский ДВ, Случевская СФ, Парфенов ВА. Дифференциальный диагноз дисциркуляторной энцефалопатии в амбулаторной практике. Неврология, нейропсихиатрия, психосоматика. 2013;5(2):38-42. [Neverovskii DV, Sluchevskaya SF, Parfenov VA. Differential diagnosis of dyscirculatory encephalopathy in outpatient practice. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;5(2):38-42. (In Russ.)]. doi: 10.14412/2074-2711-2013-2411

7. Левин ОС. Современные подходы к диагностике и лечению смешанных деменций. Трудный пациент. 2014;(5):40-6. [Levin OS. Modern approaches to the diagnosis and treatment of mixed dementia. Trudnyi patsient. 2014;(5):40-6. (In Russ.)].

8. Левин ОС. Дисциркуляторная энцефалопатия: современные представления о механизмах развития и лечении. Consilium medicum. 2007; (8):72-9. [Levin OS. Dyscirculatory encephalopathy: current understanding of mechanisms of development and treatment. Consilium medicum. 2007;(8):72-9. (In Russ.)].

9. Яхно НН, Дамулин ИВ, Захаров ВВ. Дисциркуляторная энцефалопатия. Москва; 2000. 32 с. [Yakhno NN, Damulin IV, Zakharov VV. Distsirkulyatornaya entsefalopatiya [Dyscirculatory encephalopathy]. Moscow; 2000. 32 p.]

10. Korczyn AD, Vakhapova V. Is vascular cogni￾tive impairment a useful concept? J Neurol Sci. 2010 Dec 15;299(1-2):2-4. doi: 10.1016/j.jns. 2010.05.029. Epub 2010 Jul 3.

11. Bangen KJ, Nation DA, Delano-Wood L, et al. Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy-confirmed Alzheimer's disease. Alzheimers Dement. 2015 Apr;11(4):394-403.e1. doi: 10.1016/j.jalz.2013. 12.025. Epub 2014 Jul 9.

12. Holsboer F. Stress, hypercortosolism and corticosteroid receptors in depression: implications for therapy. J Affect Disord. 2001 Jan;62(1-2):77-91.

13. Holsboer F. Corticotropin-releasing hormone modulators and depression. Curr Opin Investig Drugs. 2003 Jan;4(1):46-50.

14. Reul JM, Holsboer F. Corticotropin-releasing factor receptions 1 and 2 in anxiety and depression. Curr Opin Pharmacol. 2002 Feb;2(1):23-33.

15. Sapolsky RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry. 2000 Oct;57(10):925-35.

16. Fuchs E, Gould E. Mini-review: in vivo neurogenesis in the adult brain: regulation and functional implications. Eur J Neurosci. 2000 Jul;12(7):2211-4.

17. Smith MA, Makino S, Kvetnansky R, Post RM. Effects of stress on neurotrophic factor expression in the rat brain. Ann N Y Acad Sci. 1995 Dec 29;771:234-9.

18. Nibuya M, Morinobu S, Duman S. Regulation of BDNF and trkB mRNA in rat brain by chronic electroconvulsive seizure and antidepressant drug treatments. J Neurosci. 1995 Nov;15(11):7539-47.

19. Chen B, Dowlatshahi D, MacQueen GM, et al. Increased hippocampal BDNF immunoreactivity in subjects treated with antidepressant edication. Biol Psychiatry. 2001 Aug 15;50(4):260-5.

20. Sheline YI, Sanghavi M, Mintun MA, Gado MH. Depression duration but not age predicts hippocampal volume loss in medically healthy women with recurrent major depression. J Neurosci. 1999 Jun 15;19(12):5034-43.

21. Sheline YI, Wang PW, Gado MH, et al. Hippocampal atrophy in recurrent major depression. Proc Natl Acad Sci U S A. 1996 Apr 30;93(9): 3908-13.

22. Sheline YI, Gado MH, Price JL. Amygdala core nuclei volumes are decreased in recurrent major depression. Neuroreport. 1998 Jun 22;9(9): 2023-8.

23. Bremner JD, Vithilingham M, Vermetten E, et al. Reduced volume of orbitofrontal cortex in major depression. Biol Psychiatry. 2002 Feb 15; 51(4):273-9.

24. Coffey CE, Wilkinson WE, Weiner RD, et al. Quantitative cerebral anatomy in depression: a controlled magnetic resonance imaging study. Arch Gen Psychiatry. 1993 Jan;50(1):7-16.

25. Lai T, Payne ME, Byrum CE, et al. Reduction of orbital frontal cortex volume in geriatric depression. Biol Psychiatry. 2000 Nov 15;48(10):971-5.

26. Rajkowska G, Miguel-Hidalgo JJ, Wei J, et al Morphometric evidence for neuronal and glial prefrontal cell pathology in major depression. Biol Psychiatry. 1999 May 1;45(9):1085-98.

27. Louveau A, Smirnov I, Keyes TJ, et al. Structural and functional features of central nervous system lymphatic vessels. Nature. 2015 Jul 16; 523(7560):337-41. doi: 10.1038/nature14432. Epub 2015 Jun 1.

28. Iliff JJ, Wang M, Liao Y, et al. A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β. Sci Transl Med. 2012 Aug 15;4(147):147ra111. doi: 10.1126/scitranslmed.3003748.

29. Iliff JJ, Nedergaard M. Is There a Cerebral Lymphatic System? Stroke. 2013 Jun;44(6 Suppl 1):S93-5. doi: 10.1161/STROKEAHA.112.678698.

30. Gaberel T, Gakuba C, Goulay R, et al. Impaired Glymphatic Perfusion After Strokes Revealed by Contrast-Enhanced MRI. A New Target for Fibrinolysis? Stroke. 2014 Oct;45(10): 3092-6. doi: 10.1161/STROKEAHA.114.006617. Epub 2014 Sep 4.

31. Orr SK, Palumbo S, Bosetti F, et al. Unesterified docosahexaenoic acid is protective in neuroinflammation. J Neurochem. 2013 Nov;127(3): 378-93. doi: 10.1111/jnc.12392. Epub 2013 Aug 28.

32. Doyle KP, Quach LN, Sole? M, Buckwalter MS, et al. B-Lymphocyte-Mediated Delayed Cognitive Impairment following Stroke. J Neurosci. 2015 Feb 4;35(5):2133-45. doi: 10.1523/JNEU-ROSCI.4098-14.2015.

33. Емелин АЮ. Когнитивные нарушения при цереброваскулярной болезни. Неврология, нейропсихиатрия, психосоматика. 2014;6(4): 11–8. [Emelin AYu. Cognitive impairments in cerebrovascular disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2014;6(4):11–8. (In Russ.)]. doi: 10.14412/2074-2711-2014-4-11-18

34. Robinson RG, Kubos KL, Starr LB, et al. Mood disorders in stroke patients. Importance of location of lesion. Brain. 1984 Mar;107 ( Pt 1):81-93.

35. Hama S, Yamashita H, Yamawaki S, Kurisu K. Post-stroke depression and apathy: Interactions between functional recovery, lesion location, and emotional response. Psychogeriatrics. 2011 Mar;11(1): 68-76. doi: 10.1111/j.1479-8301.2011.00358.x.p

36. Емелин АЮ. Когнитивные нарушения при цереброваскулярной болезни – что между нормой и деменцией? Неврология, нейропсихиатрия, психосоматика. 2015;7(1):94–8. [Emelin AYu. Cognitive impairments in cerebrovascular disease: What is between health and dementia? Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(1):94–8. (In Russ.)]. DOI: 10.14412/2074-2711-2015-1-94-98

37. Suri S, Mackay CE, Kelly ME, et al. Reduced cerebrovascular reactivity in young adults carrying the APOE ε4 allele. Alzheimers Dement. 2015 Jun; 11(6):648-57.e1. doi: 10.1016/j.jalz.2014.05.1755. Epub 2014 Aug 23.

38. Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011 May;7(3):270-9. doi: 10.1016/j.jalz.2011.03.008. Epub 2011 Apr 21.g

39. Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987 Aug; 149(2):351-6._358 6

40. Wahlund LO, Barkhof F, Fazekas F, et al. A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT. Stroke. 2001 Jun;32(6):1318-22.8

41. Орлова ЯА, Агеев ФТ. Жесткость артерий как интегральный показатель сердечно-сосудистого риска: физиология, методы оценки и медикаментозной коррекции. Сердце. 2006; 5(2):65-9. [Orlova YaA, Ageev FT. Arterial stiffness as an integral indicator of cardiovascular risk: physiology, methods of assessment and pharmacological correction. Serdtse. 2006;5(2):65-9. (In Russ.)].

42. Farias ST, Mungas D, Reed BR, et al. Progression of Mild Cognitive Impairment to Dementia in Clinicvs Community-Based Cohorts. Arch Neurol. 2009 Sep;66(9):1151-7. doi: 10.1001/ archneurol.2009.106.

43. Захаров ВВ. Умеренные когнитивные нарушения как мультидисциплинарная проблема. Неврология, нейропсихиатрия, психосоматика. 2010;2(2):5-10. [Zakharov VV. Moderate cognitive disorders as a multidisciplinary problem. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2010;2(2):5-10. (In Russ.)]. doi: 10.14412/2074- 2711-2010-77

44. Захаров ВВ. Эволюция когнитивного дефицита: легкие и умеренные когнитивные нарушения. Неврология, нейропсихиатрия, психосоматика. 2012;4(2):16-21. [Zakharov VV. Evolution of cognitive deficit: mild and moderate cognitive impairments. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2):16-21. (In Russ.)]. doi: 10.14412/2074-2711-2012-376

45. Frisoni GB, Galluzzi S, Pantoni L, et al. The effect of white matter lisions on cognition in the elderly. Nat Clin Pract Neurol. 2007 Nov;3(11):620-7.

46. Ферстл Г, Мелике А, Вейхель К. Деменция. Москва: Медпресс-информ; 2010. 250 с. [Ferstl G, Melike A, Veikhel' K. Dementsiya [Dementia]. Moscow: Medpress-inform; 2010. 250 p.]

47. Гринько ЕВ. Церебральная гемодинамика и когнитивные функции у больных с дисциркуляторной энцефалопатией. Автореф. дисс. ... канд. мед. наук. Санкт-Петербург; 2008. [Grin'ko EV. Cerebral hemodynamics and cognitive function in patients with dyscirculatory encephalopathy. Autoref. diss. ... cand. med. sci. Saint-Petersburg; 2008.]

48. Захарова НИ. Когнитивные нарушения сосудистого генеза у мужчин среднего возраста с хронической ишемией головного мозга (клинико-лабораторно-инструментальное сопоставление). Дисс. ... канд. мед. наук. Санкт-Петербург; 2013. [Zakharova NI. Cognitive disorders of vascular etiology in middle-aged men with chronic cerebral ischemia (clinical and laboratory-instrumental mapping). Diss. ... cand. med. sci. Saint-Petersburg; 2013.]

49. Robinson RG, Szetela B. Mood changes following left hemisphere brain injury. Ann Neurol. 1981 May;9(5):447-53.


For citations:

Zhitkova Yu.V. Morphofunctional bases for the development of vascular cognitive and emotional disorders. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(2):40-45. (In Russ.)

Views: 383

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

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