[Multi-center open comparative randomized study of efficacy and safety of Akatinol Memantine 20 mg (single-doses) vs Akatinol Memantine 10 mg (double-doses) in patients with vascular dementia]. / Mnogotsentrovoe otkrytoe sravnitel'noe randomizirovannoe issledovanie effektivnosti i bezopasnosti primeneniya preparata Akatinol Memantin, 20 mg (odnokratnyi priem) v sravnenii s preparatom Akatinol Memantin, 10 mg (dvukratnyi priem) u patsientov s sosudistoi dementsiei.

OBJECTIVE: Evaluation of the efficacy and safety of the drug Acatinol Memantine, 20 mg (once daily) in comparison with the drug Acatinol Memantine, 10 mg (twice daily) in patients with moderate to moderate severe vascular dementia. MATERIAL AND METHODS: The study included 130 patients aged 50-85 years of both sexes with instrumentally and clinically confirmed vascular dementia. The patients were randomized into 2 groups. Group I consisted of 65 patients receiving Akatinol Memantine, 20 mg once daily, group II - 65 patients receiving Akatinol Memantine, 10 mg twice daily for 24 weeks. Clinical, parametric and statistical research methods were used. The Alzheimer's disease assessment scale, the cognitive subscale (ADAS-cog), the short mental Status Assessment Scale (MMSE) and the general clinical impression scale for patients condition and illness severity (CGI-C and CGI-S) and the Hamilton Depression Rating scale (HAM-D) were used. Adverse events were collected and analyzed. RESULTS: At week 24, both groups showed statistically significant positive change in ADAS-cog total score: in group I the total score was 27.2±8.76 points (absolute difference from baseline 3.5 points; p<0.01), and in group II - 26.1±7.86 points (absolute difference from baseline 2.5 points; p<0.01) with no statistically significant differences between groups. Evaluation of secondary efficacy criteria (change in ADAS-cog total score at week 12 and MMSE at weeks 4, 12, and 24) also revealed statistically significant benefit in both groups compared to baseline with no significant differences between groups. Statistically significant improvement was noticed on CGI-S and CGI-C scales in both groups. Akatinol Memantine was safe and well tolerated in both groups. CONCLUSION: The study showed no lesser efficacy and safety of Akatinol Memantine, 20 mg (once daily) compared to Akatinol Memantine, 10 mg (twice daily) in patients with moderate and moderately severe vascular dementia.

[Current approaches to the treatment of fronto-temporal dementia]. / Sovremennye podkhody k terapii lobno-visochnykh dementsii.

Frontotemporal dementias (FTD) are one of the prevalent forms of early neurodegenerative diseases. FTD are characterized by heterogeneous clinical manifestations and syndromes. The current methods of FTD treatment and the clinical trials of new methods of FTD treatment are considered in the article. Biomarkers and their relationships with the results of recently completed clinical trials, as well as future therapeutic perspectives, are reviewed.

[Clinical efficacy and safety of choline alfoscerate in the treatment of late-onset cognitive impairment]. / Klinicheskaia éffektivnost' i bezopasnost' primeneniia kholina al'fostserata v lechenii dodementnykh kognitivnykh narushenii v pozdnem vozraste.

AIM: To study the efficacy and safety of cereton (choline alfoscerate) in the treatment of elderly patients with amnestic type of mild cognitive impairment (aMCI), which often represents a pre-dementia (symptomatic) stage of Alzheimer's disease (AD). MATERIAL AND METHODS: Fifty patients (40 women and 10 men; mean age 68,8 years) received three-month therapy with cereton in a dose of 1200 mg/day in 3 divided doses. Fifteen patients received the same treatment again within 1 year. Immediate and delayed (7-9 months after treatment) effects of therapy, including those dependent on the ApoE genotype were assessed with a neuropsychological test battery. RESULTS: Psychometric measures showed a significant improvement after treatment with cereton. ApoE4 allele noncarriers performed better on tests of immediate and delayed reproduction of 10 words. Although, most indicators achieved in the end of therapy course decreased 7-9 months after treatment, the level of patients cognitive functioning remained at a higher level than before treatment. A repeated course of cereton treatment prevents cognitive deficit increasing during the follow-up period (10-12 months). CONCLUSION: The drug is well-tolerated and safe and can be recommended for preventive treatment of dementia in patients with high AD risk, in particular in elderly patients with aMCI syndrome.

[Therapeutic monitoring and prediction of the efficacy of neurotrophic treatment in patients with amnestic type of mild cognitive impairment]. / Terapevticheskii monitoring i prognoz éffektivnosti neirotroficheskoi terapii u patsientov s sindromom miagkogo kognitivnogo snizheniia amnesticheskogo tipa.

AIM: To perform therapeutic monitoring and prediction of the neurotrophic therapy efficacy in patients with amnestic type of mild cognitive impairment (aMCI) in a model of course cerebrolysin therapy. MATERIAL AND METHODS: The study involved a group of 19 elderly patients who met the diagnostic criteria of aMCI. All patients received a course of neurotrophic therapy consisting of 20 intravenous infusions of cerebrolysin (30 ml of cerebrolysin in 100 ml of isotonic sodium chloride solution). To assess the therapy efficacy, psychometric scales (CGI, MMSE, MoCA-test, МDRS, FAB, Clock Drawing Test, BNT, Word Recall test, delayed reproduction of 10 words, naming digits in a direct and reverse order) were used at 0, 4, 10 and 26 weeks of the study. Antibodies to p75 neurotrophin receptor (NTR) were measured by ELISA in blood serum of 19 patients before cerebrolysin therapy and after 10 and 26 weeks of treatment. RESULTS AND CONCLUSION: The study showed that аMCI patients had an increased level of antibodies against P75NTR that was significantly decreased after 5.5 month of cerebrolysin treatment. Therefore, it can be a potential biomarker of long-term therapeutic effect of cerebrolysin treatment in aMCI patients. The modified fragment 155-164 of P75 NTR determined in the serum of patients can be an effective indicator for monitoring and predicting the efficacy of long-term neurotrophic therapy.

[Detection of effective treatment of amnestic mild cognitive impairement with cereton by testing of lipids markers]. / Issledovanie éffektivnosti tseretona pri miagkom kognitivnom snizhenii amnesticheskogo tipa na osnove testirovaniia markerov lipidnoi prirody.

AIM: Determination of effectivity and safety of Cereton (Choline alfoscerate, production by Sotex) 1200 mg/day in the treatment of cognitive functioning disorders in patients with amnestic mild cognitive impairment (aMCI) and determining its influence in the process (after a 3 month course of taking the drug) and 3 months after the end of treatment of aMCI on the change in the content of phosphatidylcholine, sphingomyelin, ceramide-metabolite sphingolipids and the activity of genes controlling the synthesis of enzymes, which control ithe metabolism of sphingomyelin and ceramide (sphingomyelinase and ceramidase). MATERIAL AND METHODS: The study involved a group of elderly patients (20 people), consisting of 14 women and 6 men, aged 51 to 82 years (mean age 70.3±9.1 years). The patients' condition met the criteria for diagnosing aMCI syndrome. Analysis of phosphatidylcholine, sphingomyelin and ceramide in the blood plasma of patients was carried out by thin layer chromatography, expression of sphingomyelinase and ceramidase genes by RtPCR. RESULTS AND CONCLUSION: A sharp increase in the content of phosphatidylcholine and ceramide, the product of sphingomyelin hydrolysis, was detected. Expression of genes (acidic sphingomyelinase and ceramidase), controlling the metabolism of ceramide, is significantly reduced in the majority of patients in the treatment with ceretone. An increase in the level of phosphatidylcholine and a decrease in the expression level of the ceramide metabolism genes during treatment with ceretone and other drugs that affect the metabolism of phosphatidylchodine and sphingolipids can be used as markers of the effectiveness of therapy.

[Levels of proinflammatory cytokines and vascular endothelial growth factor in patients with Alzheimer's disease and mild cognitive impairment]. / Uroven' provospalitel'nykh tsitokinov i faktora rosta VEGF u patsientov s bolezn'yu Al'tsgeimera i myagkim kognitivnym rasstroistvom.

OBJECTIVE: to evaluate the levels of cytokines (IFNα, IFNγ, IL-2, Il-4, IL-6, IL-8, IL-10, IL-12, IL-15), IL-1ß receptor antagonist (IL-1RA), vascular endothelial growth factor (VEGF) and its antagonist, the soluble form of receptor 1 (sVEGFR1) in the blood serum of patients with Alzheimer's disease, with early onset (ADEO) and late onset (ADLO), and in patients with mild cognitive impairment (MCI). MATERIAL AND METHODS: Levels of interleukins, IL-1RA, VEGF and sVEGFR1 were measured in 20 patients with AD and 11 patients with MCI using ELISA. These parameters were compared to the severity of cognitive impairment assessed by the performance on neurocognitive tests. RESULTS AND CONCLUSION: The levels of key cytokines (IL-8, TNFα, IL-12), VEGF and sVEGFR1 as well as anti-inflammatory proteins were different in patients with ADEO, ADLO and MCI. These differences suggest the phenotypic and genotypic heterogeneity of the disease that demands further research.

[Clinical experience of the use of memantal in patients with moderate and severe Alzheimer's disease].

OBJECTIVE: To assess the efficacy and safety of memantal, a generic formulation of memantine, in patients with moderate and severe dementia due to Alzheimer's disease (AD). MATERIAL AND METHODS: Thirty patients with moderate and severe AD, aged from 55 to 84 years, were examined. Memantal was used in the dose of 20 mg per day after the titration period. Duration of treatment was 3 months. RESULTS: To the end of the study, there was a moderate positive effect as assessed by the CGI. During the treatment, cognitive functions and different forms of daily activity have improved. Significant positive changes in behavioral symptoms of dementia were noted. No adverse effects were observed during the treatment. CONCLUSION: The results of the analysis revealed the clinical efficacy and safety of memantal in treatment of AD.

[The activity of blood serum cholinesterases and neprilysin as potential biomarkers of mild-cognitive impairment and Alzheimer's disease].

OBJECTIVE: To analyze the activity of acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and neprilysin (NEP) in the blood serum in elderly people with different types of cognitive impairment and evaluate the effect of ceraxon on the biochemical parameters. MATERIAL AND METHODS: Three groups of patients: without cognitive disorders (controls--CG), with amnestic mild cognitive impairment (а-MCI) and with Alzheimer's disease (AD were studied). RESULTS AND CONCLUSION: The activity of AChE, BChE and NEP was reduced in the blood serum of patients with a-MCI and, to the greater extent, in patients with AD compared to CG and correlated with the level of cognitive dysfunction evaluated by MMSE, ADAS-cog, and other tests. For the first time, it has been shown that treatment of a-MCI patients with ceraxon (citicolin) results in an increase of the activity of blood serum AChE, BChE and NEP to the values observed in the CG. Thus, the activities of blood serum AChE, BChE and NEP reflect the level of cognitive dysfunction and can be used as prognostic biomarkers of the level of dementia progression in patients with impaired memory.

Prognosis of mild cognitive impairment syndrome: data from a two-year clinical follow-up study.

The psychopathological structure and prognostic significance of mild cognitive impairment syndrome (MCI) were studied in a two-year prospective study of randomized cohorts of elderly subjects whose mental state corresponded to the criteria for MCI. A total of 40 patients aged from 50 to 80 years were studied. Patients underwent clinical history-taking, neuropsychological, psychometric, and genetic investigations (genotyping for ApoE), as well as brain imaging studies. The psychopathological structure and psychometric characteristics of MCI syndrome are presented. Clinical and genetic factors with prognostic significance are identified.