Мембранные характеристики и сосудистые когнитивные нарушения

Objective : to study the clinical phenomenology of vascular cognitive impairment (VCI) in individuals with different rates of passive transmembrane ion transport. Patients and methods. Cognitive functions were evaluated in 372 patients with different clinical variants of moderate VCI after 1, 5, and 10 years of follow-up. Quantile analysis was used to group  patients into quartiles according to the ranges in the rate of passive  transmembrane ion transport reflecting the genetically determined  properties of cell membranes and identified by the study of Na+–Li+ countertransport (NLC) in the erythrocyte membrane. Results. There was initially a monofunctional non-amnestic type in 11.0% of the patients, a monofunctional amnestic type in 16.1%, a multifunctional non-amnestic type in 34.9%, and a multifunctional amnestic type in 37.9%. At the same type, in the patients with high-speed NLC, the number of amnestic VCI types statistically dominated: 77.1% of the patients belonging to IV quartile. After 1 year and 5 years of follow-up, there was an increase in the number of patients with severe cognitive impairment, reaching the degree of dementia (33.2% of all the examinees following 1 year). The patients with high-speed NLC showed a significant predominance of not only the total number of dementias (86.7% of the patients in IV quartile; p<0.001), but also a more unfavorable mixed (disregulatory + Alzheimer's disease) type of dementia (74.7% of the patients in IV quartile; p<0.001). The dysregulatory type of dementia was more common in patients with low- and moderate-speed NLC. 70% of all dementias formed from the multifunctional amnestic type of mild cognitive impairment (MCI). Different types of MCI were observed to be transformed to the prognostically unfavorable multifunctional amnestic type of MCI. The study conducted 10 years later noted the same trends. Conclusion. The NLC speed has been shown to be associated with the VCI profile, which makes this indicator promising for predicting the course of VCI in the early stage of the disease and for choosing a treatment policy.