Диагноз и лечение сосудистых когнитивных нарушений, применение цитиколина
Диагноз и лечение сосудистых когнитивных нарушений, применение цитиколина
Парфенов В.А. Диагноз и лечение сосудистых когнитивных нарушений, применение цитиколина. Consilium Medicum. 2024;26(2):112–116. DOI: 10.26442/20751753.2024.2.202719
Parfenov VA. Diagnosis and treatment of vascular cognitive impairment, the use of citicoline: A review. Consilium Medicum. 2024;26(2):112–116. DOI: 10.26442/20751753.2024.2.202719
Диагноз и лечение сосудистых когнитивных нарушений, применение цитиколина
Парфенов В.А. Диагноз и лечение сосудистых когнитивных нарушений, применение цитиколина. Consilium Medicum. 2024;26(2):112–116. DOI: 10.26442/20751753.2024.2.202719
Parfenov VA. Diagnosis and treatment of vascular cognitive impairment, the use of citicoline: A review. Consilium Medicum. 2024;26(2):112–116. DOI: 10.26442/20751753.2024.2.202719
Ведéние пациентов с когнитивными нарушениями (КН) является одной из актуальных проблем современной медицины. Сосудистые КН (СКН) представляют вторую по частоте после болезни Альцгеймера причину деменции. Диагноз СКН основывается на результатах нейропсихологического обследования, наличии клинических и нейровизуализационных признаков цереброваскулярного заболевания, отсутствии данных, свидетельствующих о других причинах КН. Основополагающее значение при ведéнии пациентов с СКН имеют социально-психологические методы, профилактика инсульта, коррекция сосудистых факторов риска, стимулирование пациентов к регулярной физической и умственной активности. Обсуждаются вопросы эффективности и безопасности цитиколина при СКН.
The management of patients with cognitive impairment (CI) is one of the urgent problems of modern medicine. Vascular CI (VCI) is the second most common cause of dementia after Alzheimer's disease. The diagnosis of VCI is based on the results of a neuropsychological examination, the presence of clinical and neuroimaging signs of cerebrovascular disease, and the absence of data for other causes of CI. Socio-psychological methods, stroke prevention, correction of vascular risk factors, and stimulation of patients to regular physical and mental activity are of leading importance in the management of patients with VCI. The effectiveness and safety of citicoline in VCI are discussed.
1. World Health Organization. Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization, 2019. Available at: https://www.who.int/publications/i/item/9789241550543. Accessed: 20.02.2024.
2. Verdelho A, Wardlaw J, Pavlovic A, et al. Cognitive impairment in patients with cerebrovascular disease: A white paper from the links between stroke ESO Dementia Committee. Eur Stroke J. 2021;6(1):5-17. DOI:10.1177/23969873211000258
3. Gorelick PB, Scuteri A, Black SE, et al.; American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia. Vascular contributions to cognitive impairment and dementia: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672-713. DOI:10.1161/STR.0b013e3182299496
4. Sachdev P, Kalaria R, O’Brien J, et al.; Internationlal Society for Vascular Behavioral and Cognitive Disorders. Diagnostic criteria for vascular cognitive disorders: A VASCOG statement. Alzheimer Dis Assoc Disord. 2014;28(3):206-18. DOI:10.1097/WAD.0000000000000034
5. Zanon Zotin MC, Sveikata L, Viswanathan A, Yilmaz P. Cerebral small vessel disease and vascular cognitive impairment: From diagnosis to management. Curr Opin Neurol. 2021;34(2):246-57. DOI:10.1097/WCO.0000000000000913
6. Casolla B, Caparros F, Cordonnier C, et al. Biological and imaging predictors of cognitive impairment after stroke: A systematic review. J Neurol.
2019;266(11):2593-604. DOI:10.1007/s00415-018-9089-z
7. Levine DA, Galecki AT, Langa KM, et al. Trajectory of cognitive decline after incident stroke. JAMA. 2015;314(1):41-51. DOI:10.1001/jama.2015.6968
8. Sexton E, McLoughlin A, Williams DJ, et al. Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke. Eur Stroke J. 2019;4(2):160-71. DOI:10.1177/2396987318825484
9. Парфенов В.А. Сосудистые когнитивные нарушения и хроническая ишемия головного мозга (дисциркуляторная энцефалопатия). Неврология, нейропсихиатрия, психосоматика. 2019;11(Прил. 3):61-7 [Parfenov VA. Vascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy). Neurology, Neuropsychiatry, Psychosomatics. 2019;11(Suppl. 3):61-7 (in Russian)]. DOI:10.14412/2074-2711-2019-3S-61-67
10. Levit A, Hachinski V, Whitehead SN. Neurovascular unit dysregulation, white matter disease, and executive dysfunction: The shared triad of vascular cognitive impairment and Alzheimer disease. Geroscience. 2020;42(2):445-65. DOI:10.1007/s11357-020-00164-6
11. Vasquez BP, Zakzanis KK. The neuropsychological profile of vascular cognitive impairment not demented: A meta-analysis. J Neuropsychol. 2015;9(1):109-36. DOI:10.1111/jnp.12039
12. Iadecola C, Duering M, Hachinski V, et al. Vascular cognitive impairment and dementia: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019;73(25):3326-44. DOI:10.1016/j.jacc.2019.04.034
13. Парфенов В.А., Коберская Н.Н. Болезнь Альцгеймера. М.: ИМА-ПРЕСС, 2022 [Parfenov VA, Koberskaia NN. Bolezn’ Al’tsgeimera. Moscow: IMA-PRESS, 2022 (in Russian)].
14. Парфенов В.А. Ведение пациента с когнитивными нарушениями. Неврология, нейропсихиатрия, психосоматика. 2023;15(1):97-102 [Parfenov VA. Management of patients with cognitive impairment. Neurology, Neuropsychiatry, Psychosomatics. 2023;15(1):97-102 (in Russian)]. DOI:10.14412/2074-2711-2023-1-97-102
15. Skrobot OA, Black SE, Chen C, et al.; VICCCS group. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimers Dement. 2018;14(3):280-92. DOI:10.1016/j.jalz.2017.09.007
16. Парфенов В.А. Дисциркуляторная энцефалопатия и сосудистые когнитивные расстройства. М.: ИМА-ПРЕСС, 2017 [Parfenov VA. Distsirkuliatornaia entsefalopatiia i sosudistye kognitivnye rasstroistva. Moscow: IMA-PRESS, 2017 (in Russian)].
17. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-46.
DOI:10.1016/ S0140-6736(20)30367-6
18. Hallam B, Rees J, Petersen I, et al. How are people with mild cognitive impairment or subjective memory complaints managed in primary care? A systematic review. Fam Pract. 2021;38(5):669-83. DOI:10.1093/fampra/cmab014
19. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial. Lancet. 2015;385(9984):2255-63. DOI:10.1016/S0140-6736(15)60461-5
20. Barnes JN. Exercise, cognitive function, and aging. Adv Physiol Educ. 2015;39(2):55-62. DOI:10.1152/advan.00101.2014
21. Lewis M, Peiris CL, Shields N. Long-term home and community-based exercise programs improve function in community-dwelling older people with cognitive impairment: A systematic review. J Physiotherapy. 2017;63(1):23-9. DOI:10.1016/j.jphys.2016.11.005
22. Liu-Ambrose T, Best JR, Davis JC, et al. Aerobic exercise and vascular cognitive impairment: A randomized controlled trial. Neurology. 2016;87(20):2082-90. DOI:10.1212/WNL.0000000000003332
23. Xu W, Wang HF, Wan Y, et al. Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies. BMJ Open. 2017;7(10):e014706. DOI:10.1136/bmjopen-2016-014706
24. Blumenthal JA, Smith PJ, Mabe S, et al. Longer term effects of diet and exercise on neurocognition: 1-year follow-up of the ENLIGHTEN trial. J Am Geriatr Soc. 2020;68(3):559-68. DOI:10.1111/jgs.16252
25. Lourida I, Soni M, Thompson-Coon J, et al. Mediterranean diet, cognitive function, and dementia: A systematic review. Epidemiology. 2013;24(4):479-89. DOI:10.1097/EDE.0b013e3182944410
26. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: An updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017;7:41317. DOI:10.1038/srep41317
27. Chalfont G, Milligan C, Simpson J. A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia. Dementia (London). 2020;19(4):1086-130. DOI:10.1177/1471301218795289
28. Levi Marpillat N, Macquin-Mavier I, Tropeano AI, et al. Antihypertensive classes, cognitive decline and incidence of dementia: A network meta-analysis. J Hypertens.
2013;31(6):1073-82. DOI:10.1097/HJH.0b013e3283603f53
29. Peng J, Lu F, Wang Z, et al. Excessive lowering of blood pressure is not beneficial for progression of brain white matter hyperintensive and cognitive impairment in elderly hypertensive patients: 4-year follow-up study. J Am Med Dir Assoc. 2014;15(12):904-10. DOI:10.1016/j.jamda.2014.07.005
30. McGuinness B, Todd S, Passmore P, Bullock R. Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database Syst Rev. 2009;4:CD004034. DOI:10.1002/14651858.CD004034.pub3
31. Spinelli C, Fara De Caro M, Schirosi G. Impaired cognitive executive dysfunction in adult treated hypertensives with a confirmed diagnosis of poorly controlled blood pressure. Int J Med Sci. 2014;11(8):771-8. DOI:10.7150/ijms.8147
32. Henry G, Williamson D, Tampi RR. Efficacy and tolerability of antidepressants in the treatment of behavioral and psychological symptoms of dementia, a literature review of evidence. Am J Alzheimers Dis Other Demen. 2011;26(3):169-83. DOI:10.1177/1533317511402051
33. Pizzi C, Rutjes AW, Costa GM, et al. Meta-analysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease. Am J Cardiol.
2011;107(7):972-9. DOI:10.1016/j.amjcard.2010.11.017
34. Herrmann N, Lanctôt KL, Hogan DB. Pharmacological recommendations for the symptomatic treatment of dementia: The Canadian Consensus Conference on the Diagnosis and Treatment of Dementia 2012. Alzheimers Res Ther. 2013;5(Suppl. 1):S5. DOI:10.1186/alzrt201
35. Farooq MU, Min J, Goshgarian C, Gorelick PB. Pharmacotherapy for vascular cognitive impairment. CNS Drugs. 2017;31(9):759-76. DOI:10.1007/s40263-017-0459-3
36. Fioravanti M, Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2005;(2):CD000269. DOI:10.1002/14651858.CD000269.pub2
37. Alvarez-Sabin J, Ortega G, Jacas C. Long-term treatment with citicoline may improve poststroke vascular cognitive impairment. Cerebrovasc Dis. 2013;35(2):146-54. DOI:10.1159/000346602
38. Cotroneo AM, Castagna A, Putignano S. Effectiveness and safety of citicoline in mild vascular cognitive impairment: The IDEALE study. Clin Interv Aging. 2013;8:131-7. DOI:10.2147/CIA.S38420
39. Castagna A, Cotroneo AM, Ruotolo G, Gareri P. The CITIRIVAD Study: CITIcoline plus RIVAstigmine in elderly patients affected with Dementia study. Clin Drug Investig. 2016;36(12):1059-65. DOI:10.1007/s40261-016-0454-3
40. Nakazaki E, Mah E, Sanoshy K, Citrolo D, Watanabe F. Citicoline and memory function in healthy older adults: A randomized, double-blind, placebo-controlled clinical trial. J Nutr. 2021;151(8):2153-60. DOI:10.1093/jn/nxab119
41. Шутеева Т.В. Современные подходы к вопросам коррекции когнитивных и эмоциональных расстройств у пациентов с хронической ишемией головного мозга. РМЖ. 2017;21:1507-10 [Shuteeva TV. Modern approaches to the correction of cognitive and emotional disorders in patients with chronic cerebral ischemia. Russian Medical Journal. 2017;21:1507-10 (in Russian)].
________________________________________________
1. World Health Organization. Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization, 2019. Available at: https://www.who.int/publications/i/item/9789241550543. Accessed: 20.02.2024.
2. Verdelho A, Wardlaw J, Pavlovic A, et al. Cognitive impairment in patients with cerebrovascular disease: A white paper from the links between stroke ESO Dementia Committee. Eur Stroke J. 2021;6(1):5-17. DOI:10.1177/23969873211000258
3. Gorelick PB, Scuteri A, Black SE, et al.; American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia. Vascular contributions to cognitive impairment and dementia: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672-713. DOI:10.1161/STR.0b013e3182299496
4. Sachdev P, Kalaria R, O’Brien J, et al.; Internationlal Society for Vascular Behavioral and Cognitive Disorders. Diagnostic criteria for vascular cognitive disorders: A VASCOG statement. Alzheimer Dis Assoc Disord. 2014;28(3):206-18. DOI:10.1097/WAD.0000000000000034
5. Zanon Zotin MC, Sveikata L, Viswanathan A, Yilmaz P. Cerebral small vessel disease and vascular cognitive impairment: From diagnosis to management. Curr Opin Neurol. 2021;34(2):246-57. DOI:10.1097/WCO.0000000000000913
6. Casolla B, Caparros F, Cordonnier C, et al. Biological and imaging predictors of cognitive impairment after stroke: A systematic review. J Neurol.
2019;266(11):2593-604. DOI:10.1007/s00415-018-9089-z
7. Levine DA, Galecki AT, Langa KM, et al. Trajectory of cognitive decline after incident stroke. JAMA. 2015;314(1):41-51. DOI:10.1001/jama.2015.6968
8. Sexton E, McLoughlin A, Williams DJ, et al. Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke. Eur Stroke J. 2019;4(2):160-71. DOI:10.1177/2396987318825484
9. Parfenov VA. Vascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy). Neurology, Neuropsychiatry, Psychosomatics. 2019;11(Suppl. 3):61-7 (in Russian). DOI:10.14412/2074-2711-2019-3S-61-67
10. Levit A, Hachinski V, Whitehead SN. Neurovascular unit dysregulation, white matter disease, and executive dysfunction: The shared triad of vascular cognitive impairment and Alzheimer disease. Geroscience. 2020;42(2):445-65. DOI:10.1007/s11357-020-00164-6
11. Vasquez BP, Zakzanis KK. The neuropsychological profile of vascular cognitive impairment not demented: A meta-analysis. J Neuropsychol. 2015;9(1):109-36. DOI:10.1111/jnp.12039
12. Iadecola C, Duering M, Hachinski V, et al. Vascular cognitive impairment and dementia: JACC Scientific Expert Panel. J Am Coll Cardiol. 2019;73(25):3326-44. DOI:10.1016/j.jacc.2019.04.034
13. Parfenov VA, Koberskaia NN. Bolezn’ Al’tsgeimera. Moscow: IMA-PRESS, 2022 (in Russian).
14. Parfenov VA. Management of patients with cognitive impairment. Neurology, Neuropsychiatry, Psychosomatics. 2023;15(1):97-102 (in Russian).
DOI:10.14412/2074-2711-2023-1-97-102
15. Skrobot OA, Black SE, Chen C, et al.; VICCCS group. Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimers Dement. 2018;14(3):280-92. DOI:10.1016/j.jalz.2017.09.007
16. Parfenov VA. Distsirkuliatornaia entsefalopatiia i sosudistye kognitivnye rasstroistva. Moscow: IMA-PRESS, 2017 (in Russian).
17. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-46.
DOI:10.1016/ S0140-6736(20)30367-6
18. Hallam B, Rees J, Petersen I, et al. How are people with mild cognitive impairment or subjective memory complaints managed in primary care? A systematic review. Fam Pract. 2021;38(5):669-83. DOI:10.1093/fampra/cmab014
19. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial. Lancet. 2015;385(9984):2255-63. DOI:10.1016/S0140-6736(15)60461-5
20. Barnes JN. Exercise, cognitive function, and aging. Adv Physiol Educ. 2015;39(2):55-62. DOI:10.1152/advan.00101.2014
21. Lewis M, Peiris CL, Shields N. Long-term home and community-based exercise programs improve function in community-dwelling older people with cognitive impairment: A systematic review. J Physiotherapy. 2017;63(1):23-9. DOI:10.1016/j.jphys.2016.11.005
22. Liu-Ambrose T, Best JR, Davis JC, et al. Aerobic exercise and vascular cognitive impairment: A randomized controlled trial. Neurology. 2016;87(20):2082-90. DOI:10.1212/WNL.0000000000003332
23. Xu W, Wang HF, Wan Y, et al. Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies. BMJ Open. 2017;7(10):e014706. DOI:10.1136/bmjopen-2016-014706
24. Blumenthal JA, Smith PJ, Mabe S, et al. Longer term effects of diet and exercise on neurocognition: 1-year follow-up of the ENLIGHTEN trial. J Am Geriatr Soc. 2020;68(3):559-68. DOI:10.1111/jgs.16252
25. Lourida I, Soni M, Thompson-Coon J, et al. Mediterranean diet, cognitive function, and dementia: A systematic review. Epidemiology. 2013;24(4):479-89. DOI:10.1097/EDE.0b013e3182944410
26. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: An updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017;7:41317. DOI:10.1038/srep41317
27. Chalfont G, Milligan C, Simpson J. A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia. Dementia (London). 2020;19(4):1086-130. DOI:10.1177/1471301218795289
28. Levi Marpillat N, Macquin-Mavier I, Tropeano AI, et al. Antihypertensive classes, cognitive decline and incidence of dementia: A network meta-analysis. J Hypertens.
2013;31(6):1073-82. DOI:10.1097/HJH.0b013e3283603f53
29. Peng J, Lu F, Wang Z, et al. Excessive lowering of blood pressure is not beneficial for progression of brain white matter hyperintensive and cognitive impairment in elderly hypertensive patients: 4-year follow-up study. J Am Med Dir Assoc. 2014;15(12):904-10. DOI:10.1016/j.jamda.2014.07.005
30. McGuinness B, Todd S, Passmore P, Bullock R. Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database Syst Rev. 2009;4:CD004034. DOI:10.1002/14651858.CD004034.pub3
31. Spinelli C, Fara De Caro M, Schirosi G. Impaired cognitive executive dysfunction in adult treated hypertensives with a confirmed diagnosis of poorly controlled blood pressure. Int J Med Sci. 2014;11(8):771-8. DOI:10.7150/ijms.8147
32. Henry G, Williamson D, Tampi RR. Efficacy and tolerability of antidepressants in the treatment of behavioral and psychological symptoms of dementia, a literature review of evidence. Am J Alzheimers Dis Other Demen. 2011;26(3):169-83. DOI:10.1177/1533317511402051
33. Pizzi C, Rutjes AW, Costa GM, et al. Meta-analysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease. Am J Cardiol.
2011;107(7):972-9. DOI:10.1016/j.amjcard.2010.11.017
34. Herrmann N, Lanctôt KL, Hogan DB. Pharmacological recommendations for the symptomatic treatment of dementia: The Canadian Consensus Conference on the Diagnosis and Treatment of Dementia 2012. Alzheimers Res Ther. 2013;5(Suppl. 1):S5. DOI:10.1186/alzrt201
35. Farooq MU, Min J, Goshgarian C, Gorelick PB. Pharmacotherapy for vascular cognitive impairment. CNS Drugs. 2017;31(9):759-76. DOI:10.1007/s40263-017-0459-3
36. Fioravanti M, Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2005;(2):CD000269. DOI:10.1002/14651858.CD000269.pub2
37. Alvarez-Sabin J, Ortega G, Jacas C. Long-term treatment with citicoline may improve poststroke vascular cognitive impairment. Cerebrovasc Dis. 2013;35(2):146-54. DOI:10.1159/000346602
38. Cotroneo AM, Castagna A, Putignano S. Effectiveness and safety of citicoline in mild vascular cognitive impairment: The IDEALE study. Clin Interv Aging. 2013;8:131-7. DOI:10.2147/CIA.S38420
39. Castagna A, Cotroneo AM, Ruotolo G, Gareri P. The CITIRIVAD Study: CITIcoline plus RIVAstigmine in elderly patients affected with Dementia study. Clin Drug Investig. 2016;36(12):1059-65. DOI:10.1007/s40261-016-0454-3
40. Nakazaki E, Mah E, Sanoshy K, Citrolo D, Watanabe F. Citicoline and memory function in healthy older adults: A randomized, double-blind, placebo-controlled clinical trial. J Nutr. 2021;151(8):2153-60. DOI:10.1093/jn/nxab119
41. Shuteeva TV. Modern approaches to the correction of cognitive and emotional disorders in patients with chronic cerebral ischemia. Russian Medical Journal. 2017;21:1507-10 (in Russian).
Авторы
В.А. Парфенов*
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*vladimirparfenov@mail.ru
________________________________________________
Vladimir A. Parfenov*
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*vladimirparfenov@mail.ru