1. Батышева Т.Т., Матвиевская О.В., Маневич Т.М., Бойко А.Н. Фезам в лечении хронической усталости у больных молодого возраста с очаговым поражением головного мозга. Справ. поликлин. врача. 2005; 4. / Batysheva T.T., Matvievskaia O.V., Manevich T.M., Boiko A.N. Fezam v lechenii khronicheskoi ustalosti u bol'nykh molodogo vozrasta s ochagovym porazheniem golovnogo mozga. Sprav. poliklin. vracha. 2005; 4. [in Russian]
2. Бойко А., Лебедева А., Щукин И. и др. Новые подходы к ведению пациентов с хронической ишемией головного мозга и умеренными когнитивными расстройствами. Врач. 2014; 12: 54–9. / Boiko A., Lebedeva A., Shchukin I. i dr. Novye podkhody k vedeniiu patsientov s khronicheskoi ishemiei golovnogo mozga i umerennymi kognitivnymi rasstroistvami. Vrach. 2014; 12: 54–9. [in Russian]
3. Бойко А.Н., Кабанов А.А., Еськина Т.А. и др. Эффективность Фезама у больных с хронической ишемией мозга. Журн. неврологии и психиатрии им. С.С.Корсакова. 2005; 105 (1): 36–4. / Boiko A.N., Kabanov A.A., Es'kina T.A. i dr. Effektivnost' Fezama u bol'nykh s khronicheskoi ishemiei mozga. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2005; 105 (1): 36–4. [in Russian]
4. Дюкова Г.В. Астенический синдром: проблемы диагностики и терапии. Эффективная неврология и психиатрия. 2012; 1: 16–22. / Diukova G.V. Astenicheskii sindrom: problemy diagnostiki i terapii. Effektivnaia nevrologiia i psikhiatriia. 2012; 1: 16–22. [in Russian]
5. Сборник среднемосковских показателей деятельности медицинских организаций ДЗМ за 2013–2014 гг. / Sbornik srednemoskovskikh pokazatelei deiatel'nosti meditsinskikh organizatsii DZM za 2013–2014 gg. [in Russian]
6. Табеева Г.Р., Азимова Ю.Э. Цереброваскулярные расстройства в пожилом возрасте. Практ. медицина. 2010; 1–56. / Tabeeva G.R., Azimova Iu.E. Tserebrovaskuliarnye rasstroistva v pozhilom vozraste. Prakt. meditsina. 2010; 1–56. [in Russian]
7. Charidimou A et al. Cerebral amyloid angiopathy with and without hemorrhage: Evidence for different disease phenotypes. Neurology 2015; 84: 1206–12.
8. Bennett DA, Wilson RS, Gilley DW, Fox JH. Clinical diagnosis of Binswanger’s disease. J Neurol Neurosurg Psychiatry 1990; 53: 961–5.
9. Bornebroek M et al. Hereditary cerebral hemorrhage with amyloidosis Dutch type (AbetaPP 693): decreased plasma amyloid-beta 42 concentration. Neurobiol Dis 2003; 14 (3): 619–23.
10. Brandao F, Cadete-Leite A, Andrade JP et al. Piracetam promotes mossy fiber synaptic reorganization in rats withdrawn from alcohol. Alcohol 1996; 13: 239–49.
11. Broekaert A, Godfraind T. A comparison of the inhibitory effect of cinnarizine and papaverine on the noradrenalineand calcium-evoked contraction of isolated rabbit aorta and mesenteric arteries. Eur J Pharmacol 1979; 53 (3): 281–8.
12. Caplan LR. Binswanger’s disease – revisited. Neurology 1995; 45: 626–33.
13. Chang T-S, Lin VC-H. Melanogenesis inhibitory activity of two generic drugs: cinnarizine and trazodone in mouse B16 melanoma cells. Int J Molecular Sci 2011; 12, (12): 8787–96.
14. Chung YA, Hyun O J, Kim JY et al. Hypoperfusion and Ischemia in Cerebral Amyloid Angiopathy Documented by 99mTc-ECD Brain Perfusion SPECT. J Nucl Med 2009; 50 (12): 1969–74.
15. Cohen SA, Müller WE. Effects of piracetam on N-methyl-D-aspartate receptor properties in the aged mouse brain. Pharmacology 1993; 47: 217–22.
16. Eckert GP, Cairns NJ, Müller WE. Piracetam reverses hippocampal membrane alterations in Alzheimer’s disease. J Neural Transm 1999; 106: 757–61.
17. Fassoulaki A, Kostopanagiotou G, Kaniaris P, Varonos DD. Piracetam attenuates the changes in the surface potential of the phosphatidylcholine monolayer produced by alcohols. Acta Anaesthesiol Belg 1985; 36: 47–51.
18. Haasler T, Homann G, Duong Dinh TA et al. Pharmacological modulation of transmitter release by inhibition of pressure-dependent potassium currents in vestibular hair cells. Naunyn-Schmiedeberg’s Archives of Pharmacology 2009; 380 (6): 531–8.
19. Herrschaft H. The effect of piracetam on global and regional cerebral blood flow in acute cerebral ischemia of man. MedKlin 1978; 73: 195–202.
20. Ichiro Akiguchi et al. MRI features of Binswanger’s disease predict prognosis and associated pathology. Ann Clin Transl Neurol 2014; 1 (10): 813–82.
21. Lo´pez MG, Moro MA, Castillo CF et al. Variable, voltage-dependent, blocking effects of nitrendipine, verapamil, diltiazem, cinnarizine and cadmium on adrenomedullary secretion. Br J Pharmacol 1989; 96 (3): 725–31. 
22. Levy E, Lopez-Otin C et al. Stroke in Icelandic patients with hereditary amyloid angiopathy is related to a mutation in the cystatin C gene, an inhibitor of cysteine proteases. J Exp Med 1989; 169 (5): 1771–8.
23. Medeiros YS, Calixto JB. Influence of calcium entry blockers and calmodulin inhibitors on 5-hydroxytryptamine-,potassium- and calcium-induced contractions in humanumbilical artery in-vitro. J Pharm Pharmacol 1991; 43 (6): 411–6.
24. Melkas S, Putaala J, Oksala NK et al. Small-vessel disease relates to poor poststroke survival in a 12-year follow-up. Neurology 2011; 76: 734–9.
25. Mingeot-Leclercq M-P, Lins L, Bensliman M et al. Piracetam inhibits the lipid-destabilising effect of the amyloid peptide Aâ C-terminal fragment. Biochim Biophys Acta 2003; 1609: 28–38.
26. Mondadori C, Schmutz M. Synergistic effects of oxiracetam and piracetam in combination with antiepileptic drugs. Acta Neurol Scand 1986; 74 (Suppl. 109): 113–6.
27. Moriau M, Crasborn L, Lavenne-Pardonge E et al. Platelet anti-aggregant and rheological properties of piracetam. Arzneimittelforschung 1993; 43: 110–8.
28. Müller WE, Eckert GP, Eckert A. Piracetam: Novelty in a unique mode of action. Pharmacopsychiatry 1999; 32 (Suppl. 1): 2–9.
29. Müller WE, Koch S, Scheuer K et al. Effects of piracetam on membrane fluidity in the aged mouse, rat and human brain. Biochem Pharmacol 1997; 53: 135–40.
30. Müller WE. Age related quantitative and qualitative receptor changes and pharmacological reactivity. In: Racagni G, Mendlewicz J, Eds. Treatment of age-related cognitive dysfunction: Pharmacological and clinical evaluation. Int Acad Biomed Drug Res 1992; 2: 35–40.
31. Oh U, Gupta R, Krakauer JW et al. Reversible leukoencephalopathy associated with cerebral amyloid angiopathy. Neurology 2004; 62 (3): 494–7.
32. Olpe H-R, Steinmann MW. The activating action of vincamine, piracetam and hydergine on the activity of the noradrenergic neurons of the locus coeruleus. Behav Neural Biol 1981; 33: 249–51.
33. Olszewski J. Subcortical arteriosclerotic encephalopathy. Review of the literature on the so-called Binswanger's disease and presentation of two cases. World Neurol 1962; 3: 359–75.
34. Paula-Barbosa MM, Brandao F, Pinho MC et al. The effects of piracetam on lipofuscin of the rat cerebellar and hippocampal neurons after long-term alcohol treatment and withdrawal: A quantitative study. Alcohol Clin Exp Res 1991; 15: 834–8.
35. Peuvot J, Schank A, Deleers M, Brasseur R. Piracetam-induced changes to membrane physical properties. A combined approach by 31P nuclear magnetic resonance and conformational analysis. Biochem Pharmacol 1995; 50: 1129–34.
36. Pezzini A, Del Zotto E, Volonghi I et al. Cerebral amyloid angiopathy: a common cause of cerebral hemorrhage. Curr Med Chem 2009; 16 (20): 2498–513.
37. Pilch H, Müller WE. Piracetam elevates muscarinic cholinergic receptor density in the frontal cortex of aged but not of young mice. Psychopharmacology 1988; 94: 74–8.
38. Reuse-Blom S. Microcirculation of the pial vessels in the rabbit. Acta Cardiol 1979; 34: 35–6.
39. Sato M, Heiss WD. Effect of piracetam on cerebral blood flow and somatosensory evoked potential during normotension and hypotensive ischemia in cats. Arzneimittelforschung 1985; 35: 790–2.
40. Schwartz RB, Jones KM, Kalina P et al. Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. AJR Am J Roentgenol 1992; 159 (2): 379–83.
41. Raghuvanshi S, Pathak K. Recent Advances in Delivery Systems and Therapeutics of Cinnarizine: A Poorly Water Soluble Drug with Absorption Window in Stomach. J Drug Delivery 2014.
42. Staekenborg SS, van Straaten EC, van der Flier WM et al. Small vessel versus large vessel vascular dementia: risk factors and MRI findings. J Neurol 2008; 255: 1644–51.
43. Turner D, Lurie Y, Finkelstein Y et al. Pediatric cinnarizine overdose and toxicokinetics. Pediatrics 2006; 117 (5): e1067–e1069.
44. Valzelli L, Bernasconi S, Sala A. Piracetam activity may differ according to the age of the recipient mouse. Int Pharmacopsychiatry 1980; 15: 150–6.
45. Waegemans T, Wilsher CR, Danniau A et al. Clinical efficacy of piracetam in cognitive impairment: A meta-analysis. Dement Geriatr Cogn Disord 2002; 13: 217–24.
46. Weller RO, Preston SD, Subash M, Carare RO. Cerebral amyloid angiopathy in the aetiology and immunotherapy of Alzheimer disease. Alzheimers Res Ther 2009; 1 (2): 6.

________________________________________________

1. Batysheva T.T., Matvievskaia O.V., Manevich T.M., Boiko A.N. Fezam v lechenii khronicheskoi ustalosti u bol'nykh molodogo vozrasta s ochagovym porazheniem golovnogo mozga. Sprav. poliklin. vracha. 2005; 4. [in Russian]
2. Boiko A., Lebedeva A., Shchukin I. i dr. Novye podkhody k vedeniiu patsientov s khronicheskoi ishemiei golovnogo mozga i umerennymi kognitivnymi rasstroistvami. Vrach. 2014; 12: 54–9. [in Russian]
3. Boiko A.N., Kabanov A.A., Es'kina T.A. i dr. Effektivnost' Fezama u bol'nykh s khronicheskoi ishemiei mozga. Zhurn. nevrologii i psikhiatrii im. S.S.Korsakova. 2005; 105 (1): 36–4. [in Russian]
4. Diukova G.V. Astenicheskii sindrom: problemy diagnostiki i terapii. Effektivnaia nevrologiia i psikhiatriia. 2012; 1: 16–22. [in Russian]
5. Sbornik srednemoskovskikh pokazatelei deiatel'nosti meditsinskikh organizatsii DZM za 2013–2014 gg. [in Russian]
6. Tabeeva G.R., Azimova Iu.E. Tserebrovaskuliarnye rasstroistva v pozhilom vozraste. Prakt. meditsina. 2010; 1–56. [in Russian]
7. Charidimou A et al. Cerebral amyloid angiopathy with and without hemorrhage: Evidence for different disease phenotypes. Neurology 2015; 84: 1206–12.
8. Bennett DA, Wilson RS, Gilley DW, Fox JH. Clinical diagnosis of Binswanger’s disease. J Neurol Neurosurg Psychiatry 1990; 53: 961–5.
9. Bornebroek M et al. Hereditary cerebral hemorrhage with amyloidosis Dutch type (AbetaPP 693): decreased plasma amyloid-beta 42 concentration. Neurobiol Dis 2003; 14 (3): 619–23.
10. Brandao F, Cadete-Leite A, Andrade JP et al. Piracetam promotes mossy fiber synaptic reorganization in rats withdrawn from alcohol. Alcohol 1996; 13: 239–49.
11. Broekaert A, Godfraind T. A comparison of the inhibitory effect of cinnarizine and papaverine on the noradrenalineand calcium-evoked contraction of isolated rabbit aorta and mesenteric arteries. Eur J Pharmacol 1979; 53 (3): 281–8.
12. Caplan LR. Binswanger’s disease – revisited. Neurology 1995; 45: 626–33.
13. Chang T-S, Lin VC-H. Melanogenesis inhibitory activity of two generic drugs: cinnarizine and trazodone in mouse B16 melanoma cells. Int J Molecular Sci 2011; 12, (12): 8787–96.
14. Chung YA, Hyun O J, Kim JY et al. Hypoperfusion and Ischemia in Cerebral Amyloid Angiopathy Documented by 99mTc-ECD Brain Perfusion SPECT. J Nucl Med 2009; 50 (12): 1969–74.
15. Cohen SA, Müller WE. Effects of piracetam on N-methyl-D-aspartate receptor properties in the aged mouse brain. Pharmacology 1993; 47: 217–22.
16. Eckert GP, Cairns NJ, Müller WE. Piracetam reverses hippocampal membrane alterations in Alzheimer’s disease. J Neural Transm 1999; 106: 757–61.
17. Fassoulaki A, Kostopanagiotou G, Kaniaris P, Varonos DD. Piracetam attenuates the changes in the surface potential of the phosphatidylcholine monolayer produced by alcohols. Acta Anaesthesiol Belg 1985; 36: 47–51.
18. Haasler T, Homann G, Duong Dinh TA et al. Pharmacological modulation of transmitter release by inhibition of pressure-dependent potassium currents in vestibular hair cells. Naunyn-Schmiedeberg’s Archives of Pharmacology 2009; 380 (6): 531–8.
19. Herrschaft H. The effect of piracetam on global and regional cerebral blood flow in acute cerebral ischemia of man. MedKlin 1978; 73: 195–202.
20. Ichiro Akiguchi et al. MRI features of Binswanger’s disease predict prognosis and associated pathology. Ann Clin Transl Neurol 2014; 1 (10): 813–82.
21. Lo´pez MG, Moro MA, Castillo CF et al. Variable, voltage-dependent, blocking effects of nitrendipine, verapamil, diltiazem, cinnarizine and cadmium on adrenomedullary secretion. Br J Pharmacol 1989; 96 (3): 725–31. 
22. Levy E, Lopez-Otin C et al. Stroke in Icelandic patients with hereditary amyloid angiopathy is related to a mutation in the cystatin C gene, an inhibitor of cysteine proteases. J Exp Med 1989; 169 (5): 1771–8.
23. Medeiros YS, Calixto JB. Influence of calcium entry blockers and calmodulin inhibitors on 5-hydroxytryptamine-,potassium- and calcium-induced contractions in humanumbilical artery in-vitro. J Pharm Pharmacol 1991; 43 (6): 411–6.
24. Melkas S, Putaala J, Oksala NK et al. Small-vessel disease relates to poor poststroke survival in a 12-year follow-up. Neurology 2011; 76: 734–9.
25. Mingeot-Leclercq M-P, Lins L, Bensliman M et al. Piracetam inhibits the lipid-destabilising effect of the amyloid peptide Aâ C-terminal fragment. Biochim Biophys Acta 2003; 1609: 28–38.
26. Mondadori C, Schmutz M. Synergistic effects of oxiracetam and piracetam in combination with antiepileptic drugs. Acta Neurol Scand 1986; 74 (Suppl. 109): 113–6.
27. Moriau M, Crasborn L, Lavenne-Pardonge E et al. Platelet anti-aggregant and rheological properties of piracetam. Arzneimittelforschung 1993; 43: 110–8.
28. Müller WE, Eckert GP, Eckert A. Piracetam: Novelty in a unique mode of action. Pharmacopsychiatry 1999; 32 (Suppl. 1): 2–9.
29. Müller WE, Koch S, Scheuer K et al. Effects of piracetam on membrane fluidity in the aged mouse, rat and human brain. Biochem Pharmacol 1997; 53: 135–40.
30. Müller WE. Age related quantitative and qualitative receptor changes and pharmacological reactivity. In: Racagni G, Mendlewicz J, Eds. Treatment of age-related cognitive dysfunction: Pharmacological and clinical evaluation. Int Acad Biomed Drug Res 1992; 2: 35–40.
31. Oh U, Gupta R, Krakauer JW et al. Reversible leukoencephalopathy associated with cerebral amyloid angiopathy. Neurology 2004; 62 (3): 494–7.
32. Olpe H-R, Steinmann MW. The activating action of vincamine, piracetam and hydergine on the activity of the noradrenergic neurons of the locus coeruleus. Behav Neural Biol 1981; 33: 249–51.
33. Olszewski J. Subcortical arteriosclerotic encephalopathy. Review of the literature on the so-called Binswanger's disease and presentation of two cases. World Neurol 1962; 3: 359–75.
34. Paula-Barbosa MM, Brandao F, Pinho MC et al. The effects of piracetam on lipofuscin of the rat cerebellar and hippocampal neurons after long-term alcohol treatment and withdrawal: A quantitative study. Alcohol Clin Exp Res 1991; 15: 834–8.
35. Peuvot J, Schank A, Deleers M, Brasseur R. Piracetam-induced changes to membrane physical properties. A combined approach by 31P nuclear magnetic resonance and conformational analysis. Biochem Pharmacol 1995; 50: 1129–34.
36. Pezzini A, Del Zotto E, Volonghi I et al. Cerebral amyloid angiopathy: a common cause of cerebral hemorrhage. Curr Med Chem 2009; 16 (20): 2498–513.
37. Pilch H, Müller WE. Piracetam elevates muscarinic cholinergic receptor density in the frontal cortex of aged but not of young mice. Psychopharmacology 1988; 94: 74–8.
38. Reuse-Blom S. Microcirculation of the pial vessels in the rabbit. Acta Cardiol 1979; 34: 35–6.
39. Sato M, Heiss WD. Effect of piracetam on cerebral blood flow and somatosensory evoked potential during normotension and hypotensive ischemia in cats. Arzneimittelforschung 1985; 35: 790–2.
40. Schwartz RB, Jones KM, Kalina P et al. Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. AJR Am J Roentgenol 1992; 159 (2): 379–83.
41. Raghuvanshi S, Pathak K. Recent Advances in Delivery Systems and Therapeutics of Cinnarizine: A Poorly Water Soluble Drug with Absorption Window in Stomach. J Drug Delivery 2014.
42. Staekenborg SS, van Straaten EC, van der Flier WM et al. Small vessel versus large vessel vascular dementia: risk factors and MRI findings. J Neurol 2008; 255: 1644–51.
43. Turner D, Lurie Y, Finkelstein Y et al. Pediatric cinnarizine overdose and toxicokinetics. Pediatrics 2006; 117 (5): e1067–e1069.
44. Valzelli L, Bernasconi S, Sala A. Piracetam activity may differ according to the age of the recipient mouse. Int Pharmacopsychiatry 1980; 15: 150–6.
45. Waegemans T, Wilsher CR, Danniau A et al. Clinical efficacy of piracetam in cognitive impairment: A meta-analysis. Dement Geriatr Cogn Disord 2002; 13: 217–24.
46. Weller RO, Preston SD, Subash M, Carare RO. Cerebral amyloid angiopathy in the aetiology and immunotherapy of Alzheimer disease. Alzheimers Res Ther 2009; 1 (2): 6.

И.А.Щукин*1, А.В.Лебедева1, С.Г.Бурд1, М.С.Фидлер2, Р.К.Шихкеримов3, А.М.Исмаилов4, А.В.Болотов5, М.Х.Бельгушева6

1 ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ГБУЗ Городская клиническая больница №1 им. Н.И.Пирогова Департамента здравоохранения г. Москвы. 117049, Россия, Москва, Ленинский просп., д. 8;
3 ГБУЗ Городская поликлиника №166 Департамента здравоохранения г. Москвы. 155551, Россия, Москва, Домодедовская ул., д. 9;
4 ГБУЗ Городская поликлиника №218 Департамента здравоохранения г. Москвы. 129642, Россия, Москва, пр. Шокальского, д. 8;
5 ГБУЗ Городская клиническая больница им. С.С.Юдина Департамента здравоохранения г. Москвы. 115487, Россия, Москва, ул. Академика Миллионщикова, д. 1;
6 ГБУЗ ГБ г. Московский Департамента здравоохранения г. Москвы. 142784, Москва, Московский, 1-й мкр., д. 54
*ivashchukin@gmail.com

________________________________________________

I.A.Shchukin*1, A.V.Lebedeva1, S.G.Burd1, M.S.Fidler2, R.K.Shikhkerimov3, A.M.Ismailov4, A.V.Bolotov5, M.Kh.Belgusheva6

1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
2 N.I.Pirogov City Clinical Hospital №1 of the Department of Health of Moscow. 119049, Russian Federation, Moscow, Leninskii pr-t., d. 8;
3 Сity Clinic №166 of the Department of Health of the Russian Federation. 155551, Russian Federation, Moscow, Domodedovskaia ul., d. 9;
4 Сity Clinic №218 of the Department of Health of the Russian Federation. 129642, Russian Federation, Moscow, pr. Shokal'skogo, d. 8;
5 S.S.Yudin City Clinical Hospital of the Department of Health of Moscow. 115487, Russian Federation, Moscow, ul. Akademika Millionshchikova, d. 1;
6 Moskovsky City Hospital of the Department of Health of Moscow. 142784, Federation, Moscow, Moskovsky, 1-i mkr., d. 54
*ivashchukin@gmail.com