Selezneva N D, Gavrilova S I, Roshchina I F, Ponomareva E V
Mental Health Research Centre, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(10. Vyp. 2):30-36. doi: 10.17116/jnevro202112110230.
To study the effects of a three-month course of therapy with citicoline, aimed at preventing the progression of cognitive deficit in 1st-degree relatives of patients with Alzheimer's disease (AD), depending on the carriage of the (+) genotype.
Study participants: 82 blood relatives of AD patients, 66 of them with signs of minimal cognitive dysfunction (group 1) objectively confirmed by clinical neuropsychological examination and 16 people with mild cognitive decline syndrome (group 2). Open comparative multidisciplinary study of the dynamics of cognitive status in relatives of AD patients who received a three-month course of citicoline therapy. The baseline indicators of the cognitive functioning of the relatives of the two groups were compared with the indicators at the end of the three-month course of therapy with citicoline in a daily dose of 1000 mg, depending on whether the treated persons had genotypes (+) or (-). Clinical-psychopathological, neuropsychological, psychometric, molecular-genetic, statistical.
An association of the (-) genotype with a significantly more pronounced positive effect of the course therapy with citicoline was established according to the general clinical impression (CGI-I scale), indicators of cognitive functioning (MMSE and MoCA scales), as well as according to most psychometric tests (with the exception of the number repetition test in reverse order), as well as for almost all indicators of the neuropsychological «express method» (excluding the parameter of the volume of visual memory).
The results of course therapy with citicoline showed a negative effect of the carriage of the ε4 allele of the ApoE gene on the efficiency of treatment of blood relatives of AD patients who had signs of cognitive decline before the start of therapy, which did not reach the level of dementia. The obtained data can serve as the basis for the development of preventive therapeutic measures aimed at preventing the progression of cognitive deficit and the development of dementia in the group at high risk of developing dementia - in 1st degree relatives of AD patients, especially in carriers of the (+) genotype.
研究三个月的胞磷胆碱治疗疗程对预防阿尔茨海默病（AD）患者一级亲属认知功能障碍进展的影响，该影响取决于（+）基因型的携带情况。
研究参与者：82名AD患者的血亲，其中66人经临床神经心理学检查客观证实有轻度认知功能障碍迹象（第1组），16人有轻度认知功能减退综合征（第2组）。对接受为期三个月的胞磷胆碱治疗疗程的AD患者亲属的认知状态变化进行开放性对比多学科研究。根据治疗对象是否携带（+）或（-）基因型，比较两组亲属认知功能的基线指标与每日剂量为1000mg的胞磷胆碱三个月治疗疗程结束时的指标。采用临床心理病理学、神经心理学、心理测量学、分子遗传学、统计学方法。
根据总体临床印象（CGI-I量表）、认知功能指标（MMSE和MoCA量表）以及大多数心理测量测试（反向数字重复测试除外），以及几乎所有神经心理学“快速方法”指标（视觉记忆量参数除外），确定（-）基因型与胞磷胆碱疗程治疗的显著更明显积极效果相关。
胞磷胆碱疗程治疗结果表明，ApoE基因ε4等位基因的携带对治疗开始前有认知功能减退迹象但未达到痴呆水平的AD患者血亲的治疗效果有负面影响。所获数据可作为制定预防性治疗措施的依据，旨在预防痴呆高危人群——AD患者一级亲属，尤其是（+）基因型携带者的认知功能障碍进展和痴呆发生。
