[Clinical significance and possibilities of therapy of post-stroke depression]. / Klinicheskaia znachimost' i vozmozhnosti terapii postinsul'tnoi depressii.

Depression often complicates the course of the post-stroke period, adversely affecting the functional recovery and quality of life of patients, and is associated with an increased risk of mortality. Over the recent years, the role of inflammatory processes, genetics, white matter damage, cerebrovascular reactivity disorders, changes in the level of monoamines and cortisol, impaired neuroplasticity and glutamate neurotransmission in the pathophysiological mechanisms of post-stroke depression (PSD) is increasingly discussed. Randomized clinical trials (RCTs) have shown that antidepressants are highly effective in the treatment and prevention of PSD. The action of antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), can be directed to the main pathophysiological processes of post-stroke depression. Treatment of PSD with antidepressants not only reduces the severity of depression, but also improves the functional state, rehabilitation and quality of life of patients.

[Clinical and neuropsychological features of Alzheimer's disease in the combination with cerebrovascular disease]. / Kliniko-neiropsikhologicheskie osobennosti bolezni Al'tsgeimera pri ee sochetanii s tserebrovaskulyarnym zabolevaniem.

AIM: To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). MATERIAL AND METHODS: Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT). Affective and behavioral disorders were assessed with the Cornell Depression Scale in patients with dementia and a short version of NPI-4 in AD patients. Focal and diffuse changes were assessed with MRI. RESULTS AND CONCLUSION: Patients with MD were older, had more often pseudobulbar syndrome (74%), postural instability (66%), frontal gait disorders (57%), Neuropsychological profile of patients with MD had mixed amnestic-dysexecutive character and, depending on the severity of vascular pathology, was closer to AD or to vascular dementia. Neuroimaging changes of patients with MD were correlated with clinical manifestations. The authors propose the approaches to the differential diagnosis of MD that allow to determine the main directions of treatment more precisely and to predict disease course.

[Validation of the Russian version of the modified Addenbrooke's cognitive examination for Alzheimer's disease diagnosis]. / Validizatsiia russkoiazychnoi versii modifitsirovannoi Addenbrukskoi kognitivnoi shkaly dlia diagnostiki bolezni Al'tsgeimera.

AIM: To evaluate the validity of the Russian version of the modified Addenbrooke's cognitive examination (ACE-m) for Alzheimer's disease (AD) diagnosis. MATERIAL AND METHODS: ACE-m and MMSE, as a comparison scale, were administered to 78 patients including 49 patients with AD and 29 healthy people. RESULTS AND CONCLUSION: ACE-m demonstrated the high validity in the diagnosis of dementia in AD. Cronbach's alpha was 0.89. ACE-m is a brief and simple in use test that measures a wide spectrum of cognitive functions, gives a general impression about cognitive deficit and diagnoses dementia in AD with the greater validity compared to MMSE. This scale is useful not only in diagnosis of AD but also in differentiation with other causes of dementia.

[Clinical, neuropsychological and neuroimaging features of patients with mixed dementia]. / Neiropsikhologicheskaia i neirovizualizatsionnaia kharakteristika smeshannoi dementsii.

Objective. Mixed dementia (MD), characterized by a combination of Alzheimer's disease (AD) and cerebrovascular disease, is one of the most common and, at the same time, poorly diagnosed forms of dementia in the elderly. The aim of our study was to investigate features of AD with its combination with cerebrovascular disease on the basis of clinical, neuropsychological and neuroimaging data. Material and methods. Authors examined 79 patients with dementia: 30 patients with AD, 33 patients with MD and 16 patients with vascular dementia. Patients with MD were older, had more often frontal gait disorders (48.5%), postural instability (45%), pseudobulbar syndrome (60%). Results and conclusion. The neuropsychological profile of patients with MD had mixed amnestic-dysexecutive character and, depending on the severity of vascular pathology, in some cases was closer to AD and in others to vascular dementia. A negative effect of vascular risk factors on medial temporal atrophy was found. Neuroimaging changes in MD were correlated with clinical manifestations. Proposed approaches to the diagnosis of MD help to determine more precisely the main directions of the treatment of patients and predict the course of the disease.

[Vascular risk factors for Alzheimer's disease].

Recent studies support a role of the vascular factor in the development of not only cerebrovascular disease but also Alzheimer's disease (AD). Mechanisms of vascular risk factors involved in the pathogenesis of AD remain poorly studied so far. In a number of studies on the evaluation of the efficacy of antihypertensive drugs, statins, aspirin in patients with already developed AD, neuroprotective effect was not shown. Nevertheless, there is evidence that hypertension, diabetes mellitus, metabolic syndrome, hyperlipidemia, hyperhomocysteinemia, obesity, atherosclerosis, atrial fibrillation, smoking play a role in the pathogenesis of AD. It is important to study the role of these factors in the pathogenesis of AD since the timed modification of vascular factors in the middle age can reduce the risk of AD and offers new perspectives for its prevention.

[Neuroprotective potential of akatinol-memantine in ischemic stroke].

NMDA-mediated excitotoxicity considered as a main cause of neuronal death after stroke. Memantine is a non-competitive NMDA-receptor antagonist. This article reviews the recent results of experimental studies on the efficacy of memantine as an add-on to improve the safety of thrombolytic therapy.