Modern Therapy in Psychiatry and Neurology Journal Modern Therapy in Psychiatry and Neurology Journal Современная терапия в психиатрии и неврологии 2304-9707 115195 10.32416/2304-9707-2026-1-20-27 ПСИХОФАРМАКОТЕРАПИЯ PSYCHOPHARMACOTHERAPY ПСИХОФАРМАКОТЕРАПИЯ Analysis of the correlation between clinical and neuroimaging markers and response to memantine therapy in patients with mild Alzheimer's dementia (KIPRIDA open observational study) Анализ корреляции между клиническими и нейровизуализационными маркерами и ответом на терапию мемантином у пациентов с легкой деменцией альцгеймеровского типа (открытое наблюдательное исследование КИПРИДА) Самарцев Игорь Николаевич Samarcev Igor' Nikolaevich

доктор медицинских наук;

doctor of medical sciences;

 Живолупов Сергей Анатольевич Zhivolupov Sergey A.

доктор медицинских наук;

doctor of medical sciences;

 Пономарев Владимир Владимирович Ponomarev Vladimir Vladimirovich

доктор медицинских наук;

doctor of medical sciences;

 Бутакова Юлия Сергеевна Butakova Yuliya Sergeevna Военно-медицинская академия имени С.М. Кирова Министерства обороны Российской Федерации Санкт-Петербург Россия Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation St. Petersburg Russian Federation Военно-медицинская академия имени С.М. Кирова Министерства обороны Российской Федерации Санкт-Петербург Россия Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation St. Petersburg Russian Federation Белорусский государственный медицинский университет Минск Беларусь Belarusian State Medical University Minsk Belarus Новодвинская центральная городская больница Новодвинск Россия Novodvinsk Central City Hospital Novodvinsk Russian Federation 19 02 2026 19 02 2026 2026 1 20 27 17 02 2026 https://logospress.editorum.ru/en/nauka/article/115195/view

Резюме. Применение мемантина вот уже длительное время является основой современной симптоматической терапии пациентов с умеренной и тяжелой деменцией при болезни Альцгеймера. В то же самое время эффективность применения препарата в терапии легкой деменции при данной патологии остаётся предметом широкой дискуссии. Целью настоящего открытого наблюдательного исследовании является анализ взаимосвязи между клиническими, нейровизуализационными маркерами и ответом на терапию мемантином у пациентов с легкой деменцией альцгеймеровского типа. Материалы и методы. 40 пациентов (66,7 [60,8; 71,5] лет) в течение 3 месяцев получали мемантин в дозе 20 мг/сут. Анализировали параметры МРТ (общую выраженность цереброваскулярных изменений (ОВЦИ), Medial Temporal lobe Atrophy (MTA)), результаты опросников Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (МоСА), Addenbrooke’s Cognitive Examination, revised (ACE-R), Interlocking finger test (IFT), Free and Cued Selective Reminding Test – Immediate Recall (FCSRT-IR), Global Rating of Change Scale (GROC), наличие и характеристику побочных эффектов. Для анализа взаимосвязи между ответом на проводимую терапию и основными анализируемыми параметрами использовали модели множественной линейной регрессии c расчетом β-коэффициентов. Результаты. Достоверное улучшение когнитивных функции по ряду тестов было зарегистрировано по прошествии 2 месяцев лечения (MoCA, IFT, MMSE). Значимые улучшение по опроснику ACE-R (78,4 ± 2,7 vs 83,1 ± 2,7 баллов) было отмечено через 3 месяца терапии. Достоверных изменений значений FCSRT-IR в период наблюдения зарегистрировано не было. Большая часть пациентов расценила улучшение от проведенной терапии как «умеренное» и «выраженное» (GROC: 26/65 %). Отказа от дальнейшего лечения по причине развития нежелательных явлений (НЯ) не встречалось. Наиболее значимыми факторами, влияющими на успешность терапии мемантином, оказались ОВЦИ (-0,552 (-0,034–0,814), МТА (-0,417 (-0,015–0,811)), наличие сахарного диабета (0,481 (0,028–0,825)) и нарушений мочеиспускания (-0,414 (-0,074–0,997)). Выводы. Краткосрочное применение мемантина в терапии легкой деменции альцгемеровского типа является эффективным и безопасным. Наличие сопутствующей выраженной атрофии медиальных отделов лобной доли, значимых цереброваскулярных изменений по данным МРТ, а также нарушения мочеиспускания являются негативными предикторами на пути успешной терапии когнитивных расстройств, в то время как у пациентов с сахарным диабетом эффективность лечения мемантином оказалось более выраженной.

Resume. The use of memantine has long been the basis of modern symptomatic therapy for patients with moderate and severe dementia with Alzheimer's disease. At the same time, the effectiveness of the drug in the treatment of mild dementia in this pathology remains the subject of wide discussion.The purpose of this open-label observational study is to analyze the relationship between clinical, neuroimaging markers and response to memantine therapy in patients with mild Alzheimer's dementia. Materials and methods. 40 patients (66.7 [60.8; 71.5] years old) received memantine at a dose of 20 mg/day for 3 months. The MRI parameters (overall severity of cerebrovascular changes, Medial Temporal lobe Atrophy (MTA)), the results of the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MCA), Addenbrooke's Cognitive Examination, revised (ACE-R), Interlocking finger test (IFT), Free and Cued questionnaires were analyzed Selective Reminding Test – Immediate Recall (FCSRT-IR), Global Rating of Change Scale (GROC), the presence and characterization of side effects. Multiple linear regression models with calculation of β-coefficients were used to analyze the relationship between the response to therapy and the main analyzed parameters. Results. A significant improvement in cognitive function according to a number of tests was recorded after 2 months of treatment (MoCA, IFT, MMSE). Significant improvement in the ACE-R questionnaire (78.4 ± 2.7 vs 83.1 ± 2.7 points) was noted after 3 months of therapy. No significant changes in FCSRT-IR values were recorded during the follow-up period. The majority of patients regarded the improvement from the therapy as "moderate" and "pronounced" (GROC: 26/65%). There was no refusal of further treatment due to the development of adverse events. The most significant factors influencing the success of memantine therapy were OVCI (-0.552 (-0.034–0.814), MTA (-0,417 (-0,015–0,811)), the presence of diabetes mellitus (0.481 (0.028–0.825)) and urinary disorders (-0,414 (-0,074–0,997)). Conclusions. Short-term use of memantine in the treatment of mild Alzheimer's type dementia is effective and safe. The presence of concomitant marked atrophy of the medial frontal lobe, significant cerebrovascular changes according to MRI data, as well as urinary disorders are negative predictors of successful treatment of cognitive disorders, while in patients with diabetes mellitus, the effectiveness of memantine treatment was more pronounced.

 легкая деменция альцгеймеровского типа мемантин нейропсихологические тесты магнитно-резонансная томография предикторы эффективности терапии mild Alzheimer's type dementia memantine neuropsychological tests magnetic resonance imaging predictors of therapy effectiveness

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