Pilipovich A A, Vorob'eva O V
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(11):124-130. doi: 10.17116/jnevro2020120111124.
The article provides a review of current literature on the diagnosis and treatment of mild cognitive impairment (MCI). MCI is not a common outcome of brain aging; it is an intermediate state between normal cognitive status and mild dementia. The MCI concept has been actively developing over the past few decades, a lot of knowledge and clinical experience has been accumulated, and numerous clinical trials are being conducted to develop effective methods of diagnosis and therapy. Treatment of pre-dementia cognitive disorders differs in many ways from therapy for dementia and has a better prognosis, therefore, it is recommended to diagnose and begin treating cognitive disorders as early as possible. The main possibilities of drug and non-drug therapy are described, with an emphasis on the use of the dopamine receptor agonist piribedil in the treatment of MCI and sensory deficit in elderly patients. The mechanisms of action of the drug are analyzed, data from the main clinical studies of the efficacy and safety of piribedil are presented: the positive effect of the drug on cognitive functions has been shown in more than 10 international clinical trials including about 7000 patients and in a number of post-marketing works performed on the Russian population of patients. Piribedil is successfully used for various types of cognitive disorders, both neurodegenerative and vascular, of mild to moderate severity.
本文对当前关于轻度认知障碍（MCI）诊断与治疗的文献进行了综述。MCI并非大脑衰老的常见结果；它是正常认知状态与轻度痴呆之间的中间状态。在过去几十年中，MCI概念一直在积极发展，积累了大量知识和临床经验，并且正在进行众多临床试验以开发有效的诊断和治疗方法。痴呆前认知障碍的治疗在许多方面不同于痴呆治疗，且预后更好，因此，建议尽早诊断并开始治疗认知障碍。文中描述了药物和非药物治疗的主要可能性，重点介绍了多巴胺受体激动剂吡贝地尔在老年患者MCI治疗和感觉缺陷治疗中的应用。分析了该药物的作用机制，列出了吡贝地尔疗效和安全性主要临床研究的数据：在包括约7000名患者的10多项国际临床试验以及针对俄罗斯患者群体开展的多项上市后研究中，均显示该药物对认知功能有积极作用。吡贝地尔已成功用于治疗各种类型的轻度至中度严重程度的认知障碍，包括神经退行性和血管性认知障碍。
