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血管性认知障碍 - 认知康复的综合框架。

VaD - An Integrated Framework for Cognitive Rehabilitation.

机构信息

Department of Clinical Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

"RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania.

出版信息

CNS Neurol Disord Drug Targets. 2018 Apr 26;17(1):22-33. doi: 10.2174/1871527317666180219164545.

Abstract

BACKGROUND & OBJECTIVE: Vascular dementia is the second most common cause of dementia, with clinical features that depend on neural substrates affected by the vascular lesions. Like most neurological disorders, it involves alterations that range from the molecular level to neuronal networks. Such alterations begin as compensatory mechanisms that reshape every subsystem involved in the brain's homeostasis. Although there have been recent huge advances in understanding the pathophysiology of cognitive dysfunction, a suitable therapeutic approach to vascular dementia remains elusive. Pharmacological interventions have failed to sustainably improve cognitive function, and it is a well-known fact that there is a need to change the current view for providing neuroprotection and enhancing neurorecovery after stroke. Studies regarding cognitive training are also faced with the difficulty of drawing up protocols that can embrace a holistic approach in cognitively impaired patients.

CONCLUSION

This review will present a brief synthesis of current results from basic research data and clinical studies regarding pharmacological and non-pharmacological interventions in vascular dementia and will offer an integrated view from the perspective of systems biology.

摘要

背景与目的

血管性痴呆是痴呆的第二大常见病因,其临床特征取决于受血管病变影响的神经基质。与大多数神经疾病一样,它涉及从分子水平到神经元网络的各种改变。这些改变最初是作为重塑大脑内稳态所涉及的每个子系统的代偿机制出现的。尽管近年来在理解认知功能障碍的病理生理学方面取得了巨大进展,但血管性痴呆仍缺乏合适的治疗方法。药物干预未能持续改善认知功能,众所周知,需要改变目前对中风后提供神经保护和促进神经恢复的看法。关于认知训练的研究也面临着制定能够涵盖认知障碍患者整体方法的方案的困难。

结论

本文将简要综合目前关于血管性痴呆的药物和非药物干预的基础研究数据和临床研究的结果,并从系统生物学的角度提供综合观点。

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