Cognitive disorders in discirculatory encephalopathy
Abstract
Background. Discirculatory encephalopathy (DEP) is a chronic progressive form of cerebrovascular failure which is characterized by the development of multicentric or diffuse brain lesions.
The objective of work was to present the review of current methods of treatment of discirculatory encephalopathy.
Results. DEP treatment should be held complexly. It should include measures for prevention of further damage of brain vessels and medullary substance, improvement andlongterm stabilization of cognitive functioning, and correction of other clinical manifestations of the disease. Impact on vascular risk factors, first of all correct hypotensive therapy is the most effective measure for prevention of further progression of the disease especially at an early stage of its development
Conclusion. Taking into consideration the multifold character of DEP pathogeny, combination of means, influencing various mechanisms of the development of the disease and its separate symptoms, seems the most promising.
About the Authors
O. S. Levin
Russian medical academy of continuing professional education MOH
Russian Federation
Russian Federation
Levin Oleg - PhD, MD, professor.
Moscow.
A. Sh. Chimagomedova
Russian medical academy of continuing professional education MOH
Russian Federation
Russian Federation
Chimagomedova Achcha - postgraduate student.
Moscow.
References
1. Vereshchagirv N.V., Morgunov, V.A., Gulevskaya, T.S. Patdogiya golovnogo mozga pri ateroskleroze i arteriafnoj gipertonii. M.: Medicina; 1997 (In Russ.)
2. Shmidt E. (red.). Sosudistye zabdevaniya nervnoj sistemy. M.: Medicina; 1975 (In Russ.)
3. Yakhno N.N. Aktuafnye voprosy nejrogeriatrii. V kn.: Dostizheniya v nejrogeriatrii. M.; 1995:9-27 (In Russ.)
4. Yakhnok N.N., Damulin, I.V., Zaharov V.V. Discirkulyatornaya encefalopatiya. M.; 2000 (In Russ.)
5. Levin O.S. Dyscirculatory encephalopathy: current concept on pathogenesis and treatment Consilium medicum. 2007;8:72-79 (In Russ.)
6. Levin, O.S., Damulirv LV. Diffuznye izmeneniya belogo veshchestva i problema sosudistoj demencii. Dostizheniya v nejrogeriatrii / Pod red. N.N. Yahnok I.V. Damulina. M.: MMA, 1995:189-228 (In Russ.)
7. ShtuCman D.R., Levin O.S. Nevrologiya. Spravochnik prakticheskogo vracha. M.: Medpress-inform; 2008 (In Russ.)
8. Levia O.S. Diagnostika ilechenie demencii v klinicheskoj praktike. M.: Medpress-inform; 2009 (In Russ.)
9. Rockwood K., Wentzel C., Hachinscki V. et al. Prevalence and outcomes of vascular cognitive impairment Neurology. 2000; 54:447-451. doi: 10.1212/WNL.54.2.447
10. van der Flier W.M., Skoog I., Schneider J.A. et al. Vascular cognitive impairment Nature reviews. Disease primers. 2018;4. doi: 10.1038/nrdp2018.3
11. Allard P., Englund E., Marcusson J. Caudate nucleus dopamine D2-receptors in vascular dementia. Dementia and geriatric cognitive disorders. 2002;14:22-25.
12. Court J.A., Perry E.K., Kalaria R.N. Neurotransmitter changes in vascular dementia. 3. O'Brien et al. (eds). Cerebrovascular disease, cognitive impairment and dementia. London: Martin Dunitz; 2004:133-152.
13. Benarroch E. Neurovascular unit dysfunction. Neurology. 2007;68:1730-1732. doi: 10.1212/01.wnl.0000264502.92649.ab
14. Iadecola C. The neurovascular unit coming of age: A journey through neurovascular coupling in health and disease. Neuron. 2017:96. doi: 10.1016/j.neuron.2017.07.030
15. Levin O., Unishenko N. Diagnosis and treatment of cognitive impairment in dyscirculatory encephalopathy. Consilium medicum. 2007;8:47-53 (In Russ.)
16. Girouard H., Iadecola C. Neurovascular coupling in the normal brain and in hypertension. Stroke and Alzheimer disease. J. Appl. Physiol. 2006;100:328-335. doi: 10.1016/j.neurobiolaging.2007.07.015
17. Damulin I. Vascular dementia. Nevrol. zhurn. 1999;4:4-11 (In Russ.)
18. Cordonnier C., van der Flier W.M., Sluimer J.D., Leys D., Barkhof F., Scheltens P. Prevalence and severity of microbleeds in a memory clinic setting. Neurology. 2006;66:1356-1360. doi: 10.1212/01.wnl.0000210535.20297.ae
19. O'Brien J.T., Erkinjuntti T., Reisberg B. et al. Vascular cognitive impairment Lancet Neurology. 2003;2:89-98.
20. Pantoni L., Poggesi A., Inzitari D. The relation between white matterlesions and cognition. Curr. Opin. Neurol. 2007;20:390- 397. doi: 10.1097/WC0.0b013e328172d661.
21. Levin O.S., Damulin I.V. Diffuznye izmenenija belogo veshhestva i problema sosudistoj demencii / V kn.: Dostizhenija v nejrogeriatrii / Pod red. N.N. Jahno, I.V. Damulina. M.: MMA, 1995. S. 189-228 (In Russ.)
22. Schmidt R., Berghold A., Jokinen H. et al. for the LADIS Study Group White matterlesion progression in LADIS: Frequency, clinical effects and sample size calculations. Stroke. 2012;43:2643- 2647. doi: 10.1161/STROKEAHA.112.662593
23. Yakhno N., Levin 0., Damulin I. Clinical and MRI data in dyscirculatory encephalopathy. Cognitive impairment Nevrol. zhurn. 2001;3:10-18 (In Russ.)
24. Gavrilova S.I. Mild cognitive impairment — prodromal stage of Alzheimer's disease? Consilium medicum. 2004;2:153-156 (In Russ.)
25. Damulin I.V. Legkie kognitivnye narusheniya. Sonsilium medicum. 2004;2:138-141 (In Russ.)
26. Zaharov V.V., Yahno N.N. Sindrom umerennyh kognitivnyh rasstrojstv v pozhilom vozraste: diagnostika ilechenie. Russkij medicinskij zhurnal. 2004;10:573-576 (In Russ.)
27. Levin O.S., Sagova M.M., Golubeva L.V. Faktory, vliyayushchie na faktory zhizni bol'nyh discirkulyatornoj ehncefalopatii s umerennym kognitivnym rasstrojstvom. Rossijskij medicinskij zhurnal. 2006;2:26-28 (In Russ.)
28. Steffens D.C., Taylor W.D., Krishnan K.R. Progression of sub-cortical ischemic disease from vascular depression to vascular dementia. Am. J. Psychiatry. 2003;160:1751-1756. doi: 10.1176/appi.ajp.l60.10.1751
29. Schmidtke K., Hull M. Cerebral small vessel disease: how does it progress? J. Neurol. Sciences. 2005;229/230:13-20. doi: 10.1016/j.jns.2004.11.048
30. Levin 0., Golubeva L. Heterogeneity of mild cognitive impairment: diagnostic and therapeutic aspects. Consilium medicum. 2006;12:106-110 (In Russ.)
31. Roman G.C., Erkinjuntti T., Wallin A. et al. Subcortical ischemic vascular dementia. Lancet Neurology. 2002;1:426-436. doi: 10.1016/S1474-4422(02)00190-4
32. Levin O.S., Ahmetov V.V., Golubeva L.V. Dinamika kognitivnyh funkcij u bol'nyh ateroskleroticheskim stenozom sonnyh arterij posle karotidnoj ehndoarterehktomii. Nevrobgicheskij zhurnal. 2006; 11 (4): 14-19 (In Russ.)
33. Chen W.H., Jin W., Lyu P.Y. et al. Carotid atherosclerosis and cognitive impairment in nonstroke patients. Chin. Med. J. 2017;130:2375-2379. doi: 10.4103/0366-6999.215331.
34. Toth Tarantini S., Csiszar A., Ungvari Z. Functional vascular contributions to cognitive impairment and dementia: mecha¬nisms and consequences of cerebral autoregulatory dysfunction endothelial impairment and neurovascular uncoupling in aging. Am. J. PhysioL Heart Circ. Physiol. 2017;312:1-20. doi: 10.1152/ajpheart00581.2016
35. Baor K.J., Boettger M.K., Seidler N. et al. Influence of galantamine on vasomotor reactivity in Alzheimer's disease and vascular dementia due to cerebral microangiopathy. Stroke. 2007;38:3186-3192. doi: 10.1161/STROKEAHA.107.492033
36. Filosa J., Blanco V. Neurovascular coupling in the mammalian brain. Exp. Physiol. 2007;92:641-646. doi: 10.1113/expphysiol.2006.036368
37. Watters M., Muir S., Shah I. Effect of Perindopril on Cerebral Vasomotor Reactivity in Patients With Lacunar Infarction. Stroke. 2004;35:1899-1902. doi: 10.1161/01.STR.0000131748.12553.ed
38. DeKosky S.T., Williamson J.D., Fitzpatrick A.L et al. Ginkgo biloba for prevention of dementia. A randomized controlled trial. JAMA. 2008;300(19):2253-2262. doi: 10.1001/jama.2008.683
39. Marcilhac A., Dakine N., Bourhim N. Effect of chronic administration of ginkgo biloba extract or ginkgolide on the hypothalamic-pituitary-adrenal axis in the rat Life Sci. 1998;62(25):2329- 2340.
40. Woelk H., Arnoldt K.H., Kieser M., Hoerr R. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: a randomized double-blind placebo-controlled trial. J. Psychiatr. Res. 2007;41(6):472-480. doi: 10.1016/j.jpsychires.2006.05.004
41. Pantoni L, del Ser T., Soglian A. Efficacy and safety of nimodipine in subcortical vascular dementia. Stroke. 2005;36(3):619- 624. doi: 10.1161/01.STR.0000155686.73908.3e
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For citations:
Levin O.S., Chimagomedova A.Sh. Cognitive disorders in discirculatory encephalopathy. Psychiatry (Moscow) (Psikhiatriya). 2018;(78):158-166. (In Russ.)
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