[Metabolic syndrome and cognitive impairment in aging patients with dyscirculatory encephalopathy].

The relationship between metabolic syndrome and its individual components, leptin levels and the severity of cognitive impairment in patients of different age with dyscirculatory encephalopathy (DE) and metabolic syndrome (MS) was studied. There were 503 patients aged 45-89 years with DE enrolled into the study, who were divided into two groups: patients without MS (n=198) and with MS (n=305). All patients were divided into three age subgroups. All patients underwent clinical-neurological examination, laboratory tests, high resolution B-mode ultrasound examination, MRI. Cognitive functions were assessed by Mini Mental State Examination (MMSE). In middle age and elderly patients a significant inverse relationship between the total score of MMSE and the level of blood pressure, blood glucose level was found. A direct significant correlation between blood pressure level and a total score of MMSE was revealed in senile patients. The duration of hypertension significantly influenced on the severity of cognitive impairment in patients of middle and old age. The results obtained indicate a definite relationship between the level of leptin in the blood of patients with MS and the state of their cognitive functions. The influence of leptin level on cognitive function in patients with the metabolic syndrome increases with age. Timely and adequate correction of blood pressure, blood glucose and triglycerides may have a positive effect on cognitive function in patients with MS.

[Special features of mild cognitive impairment in patients with metabolic syndrome].

Aim: to establish special features of mild cognitive impairment (MCI) in patients with chronic insufficiency of cerebral circulation (CICC) with metabolic syndrome (MS) depending on the age of patients. Investigation involved 282 patients aged 45-89 with CICC. All the patients also were divided into three groups depending on age; each group was divided into two subgroups: with MS and without it. Total MMSE score in patients with MS and without it of all age groups was not significantly different. We found significant difference between groups of patients in some MMSE tests: orientation in time, orientation in space, remembering of three words, attention and count, words reproduction. Presence of MS in patients with MCI syndrome of all age groups negatively influenced on such cognitive functions as: storage and reproduction of information, attention, orientation in time (processes depicting state of executive functions). In patients with MS, comparing with those without MS, we found significantly worse characteristics of immediate and delayed memory for verbal stimuli, especially in old aged patients, the rate of sensorimotor reactions, mental capacity, the amount of active attention of patients on tables Schulte, information processing speed and attention according to SCWT for all age groups.

[Cognitive impairment in patients of different age with metabolic syndrome].

OBJECTIVE: To analyze the characteristics of cognitive impairment (CI) in patients of different age with dyscirculatory encephalopathy (DE) and metabolic syndrome (MS). There were 503 patients aged 45-89 years with DE enrolled into the study, who were divided into two groups: patients without MS (n = 198) and with MS (n = 305). All patients were divided into three subgroups depending on age. In patients with MS more severe CI was diagnosed, compared with patients without MS. The negative impact of MS on the state of cognitive function was found mainly in patients of middle and old age, while in elderly patients we did not find significant influence of MS on cognitive decline. In patients with DE MS influenced more significantly on executive cognitive functions.

[Identification of clinical features of cognitive impairment and depressive disorders in patients with metabolic syndrome with insufficiency of cerebral circulation].

Investigation involved 221 patients aged 50-84 with chronic insufficiency of cerebral circulation, who were divided into four groups: patients without metabolic syndrome (MS) and without depressive disorders (DD); subjects with MS without DD; subjects without MS with DD; subjects with MS with DD. All the patients also were divided into three subgroups depending on age. Patients with MS and DD and with MS without DD had significantly more vascular risk factors, comparing with other groups of patients. Mild cognitive impairment (CI) significantly more often were detected in patients without MS and without DD; dementia more often was observed in patients with MS and DD. Significant interrelationship between severity of CI and depression level was observed only in patients with MS. These data underline important role of MS as a risk factor of both DD and CI in patients with chronic insufficiency of cerebral circulation. Severity of DD significantly increased with age only in patients with MS. We observed significant growth of CI severity in all the groups of patients with increasing age. However stage of chronic insufficiency of cerebral circulation significantly influenced the severity of DD in patients with MS and without it.

[Lipid peroxidation and antioxidant defence enzyme activity in multiple sclerosis].

Changes of state of lipid peroxidation and activity of antioxidant defence enzymes katalase, superoxide dismutase, glutathione peroxidase and glutathione reductase - in the brain and liver tissue of guinea-pig in conditions of different stages of experimental autoimmune encephalomyelitis (EAE; 11th, 21st, 27th day after inoculation) and in blood of multiple sclerosis (MS) patients with different types, degrees of severity and length of disease and blood level of reduced glutathione have been investigated. We have found, that the development of oxidative stress in animal organism during the disease development is progressive and intensive lipid peroxide oxidation without compensation by antioxidant mechanisms have been shown in the late period (27th day) of the experiment. In MS conditions this state was accompanied with high activity of demyelination process, severe degree of neuronal injury and length of disease above 5 years. In addition reduced glutathione level was increased in many patient groups: remitting type, light (II) degree of severity and among the patients with strongly disturbed neurological functions and long course of the disease. The obtained data allow us to suppose that the development of oxidative stress under demyelination conditions is a result of strong metabolic disorders and decrease of antioxidant defence in the patients during the disease development. The necessity of individual approaches for antioxidant therapy of patients with MS is discussed.