Cognitive impairments in a comorbid patient: possibilities for correction
- Authors: Kamchatnov P.R.1, Mityaeva E.V.2, Chipova D.T.3,4, Osmaeva Z.K.5
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Affiliations:
- N.I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of Russia
- I.S. Turgenev Oryol State University
- Republican Clinical Multidisciplinary Center for High Medical Technologies, Ministry of Health of the Kabardino-Balkarian Republic
- Kabardino-Balkarian State University
- Korolyov Hospital
- Issue: Vol 20, No 1 (2026)
- Pages: 111-119
- Section: CASE REPORT
- Published: 27.07.2026
- URL: https://klinitsist.abvpress.ru/Klin/article/view/724
- DOI: https://doi.org/10.17650/1818-8338-2026-20-1-K790
- ID: 724
Cite item
Abstract
Aim. To demonstrate the possibility of cognitive disorder (CD) development, its features and correction in comorbid patients with type 2 diabetes mellitus (DM) and metabolic syndrome (MS).
Materials and methods. Female patient A., 65 years old was suffering from metabolic syndrome (MS) and over a number of years showed worsening CD and behavioral disorders confirmed by the results of neuropsychological testing. Male patient T., 66 years old, suffering from type 2 diabetes, arterial hypertension, multifocal atherosclerosis, with a history of ischemic stroke, developed moderate cognitive impairment with emotional and behavioral disorders.
Results. Both patients received repeated courses of intravenous administration of Cerebrolysin (10 mL, 20 injections) along with basic therapy. In patient A., there was not only an improvement in cognitive function, but also a decrease in the severity of behavioral disorders, which manifested, in part, in increased adherence to treatment. In patient T. after the treatment, there was also a decrease in the severity of CD and depressive disorder, which did not require the use of antidepressants.
Conclusion. CD in patients with MS and type 2 diabetes is accompanied by decreased daily activity, which disrupts adherence to therapy and non-pharmacological risk factor management. The use of Cerebrolysin in such patients reduces the severity of CD and other disorders and is associated with increased adherence to medical recommendations.
About the authors
Pavel R. Kamchatnov
N.I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of Russia
Author for correspondence.
Email: pavkam7@gmail.com
ORCID iD: 0000-0001-6747-3476
Russian Federation, 1 Ostrovityanova St., Moscow 117513
E. V. Mityaeva
I.S. Turgenev Oryol State University
Email: pavkam7@gmail.com
ORCID iD: 0000-0001-9964-7549
Медицинский институт
Russian Federation, 95 Komsomolskaya St., Oryol 302026D. T. Chipova
Republican Clinical Multidisciplinary Center for High Medical Technologies, Ministry of Health of the Kabardino-Balkarian Republic; Kabardino-Balkarian State University
Email: pavkam7@gmail.com
ORCID iD: 0000-0002-1641-3681
Russian Federation, 7D Golovko St., Nalchik, Kabardino-Balkarian Republic 360001; 173 Chernyshevskogo St., Nalchik, Kabardino-Balkarian Republic 360004
Z. Kh. Osmaeva
Korolyov Hospital
Email: pavkam7@gmail.com
ORCID iD: 0000-0002-0889-4227
Russian Federation, 24 Tsiolkovskogo St., Korolyov 141070
References
- Churchill N., Le T.T., Nianogo R.A. Alzheimer’s disease and related dementias state policies and mortality in the United States: a descriptive study. J Alzheimers Dis 2026;112(2):970–6. doi: 10.1177/13872877261453609
- Hachinski V., Einhäupl K., Ganten D. et al. Special topic section: linkages among cerebrovascular, cardiovascular, and cognitive disorders: preventing dementia by preventing stroke: The Berlin Manifesto. Int J Stroke 2019:1747493019871915. doi: 10.1177/1747493019871915
- Ghiasvand S., Tegegne G.T., Tabatabaei-Jafari H. et al. Social and environmental determinants of dementia risk: an umbrella review. J Alzheimers Dis 2026:13872877261456777. doi: 10.1177/13872877261456777
- Pernoud L.E., Noll J.L., Gardiner P.A. et al. The LIFE study: a cross-sectional study protocol for LIfestyle risk Factors for chronic disease across the stagEs of reproductive ageing. BMJ Open 2026;16(6):e106377. doi: 10.1136/bmjopen-2025-106377
- Pyshkina L.I., Tyazhelnikov A.A., Kabanov A.A. et al. Risk factors and adherence to treatment of patients with cerebrovascular diseases. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry 2023;123(8-2): 84–9. (In Russ.). doi: 10.17116/jnevro202312308284
- Levin O.S. Diagnosis and treatment of cognitive disorders and dementia in clinical practice. Moscow: MEDpress-Inform, 2019. 448 p. (In Russ.).
- Kumar P., Waris M., Rao A.R. et al. Early diagnosis of cognitive impairment in the ageing population: determinants and barriers. Indian J Community Med 2026;51(1):52–7. doi: 10.4103/ijcm.ijcm_402_24
- Kamchatnov P.R. The problem of cognitive abilities and the story of Terry Pratchett. Effektivnaya farmakoterapiya = Effective Pharmacotherapy 2025;21(25):90–6. (In Russ.). doi: 10.33978/2307-3586-2025-21-25-90-96
- Behavioral neurology. Ed.: V.V. Zakharov. Moscow: Profmedpress, 2022. 433 p. (In Russ.).
- Creese B., Ismail Z. Mild behavioral impairment: measurement and clinical correlates of a novel marker of preclinical Alzheimer’s disease. Alzheimers Res Ther 2022;14(1):2. doi: 10.1186/s13195-021-00949-7
- Blasutto B., Fattapposta F., Casagrande M. Mild behavioral impairment and cognitive functions: a systematic review and meta-analysis. Ageing Res Rev 2025;105:102668. doi: 10.1016/j.arr.2025.102668
- Martynova O.O., Zakharov V.V. Differential diagnosis of vascular cognitive impairment. Consilium Medicum 2022;24(2):85–9. (In Russ.). doi: 10.26442/20751753.2022.2.201520
- Ricciardi N., Di Liberto V., Di Majo D. et al. Cognition at the core of metabolic syndrome: linking metabolic load to behavioural impairment in a longitudinal high-fat diet rat model. Brain Behav Immun Health 2026;55:101287. doi: 10.1016/j.bbih.2026.101287
- Te Hoonte F., Rietman M.L., Wesenhagen K.E.J. et al. Association of body mass index, waist circumference, (abdominal) overweight and obesity with sex- and age-specific cognitive function over time – the Doetinchem Cohort Study. Int J Obes (Lond) 2026;50(5):1150–7. doi: 10.1038/s41366-026-02034-1
- Sun C., Wu T., Yu C. et al. Dementia burden and modifiable risk factors in type 2 diabetes: population based, prospective cohort study. Diabetes Obes Metab 2026;28(6):5113–24. doi: 10.1111/dom.70712
- Gevaert B., D’Hondt M., Bracke N. et al. Peptide profiling of internet-obtained Cerebrolysin using high performance liquid chromatography – electrospray ionization ion trap and ultra-high performance liquid chromatography – ion mobility – quadrupole time of flight mass spectrometry. Drug Test Anal 2015;7(9):835–42. doi: 10.1002/dta.1817
- Karimian A., Abdolmaleki A., Asadi A. et al. The role of Cerebrolysin in promoting axonal regeneration and functional recovery after peripheral nerve injury: a focus on macrophage activation. Adv Pharm Bull 2025;15(4):917–27. doi: 10.34172/apb.025.46084
- Gavrilova S.I., Safarova T.P. Neurotrophins and neurotrophic therapy (based on the cerebrolysin model) in the treatment of elderly patients with cognitive disorders and depression. Part 2. Psikhiatriya = Psychiatry (Moscow) 2021;19(3):80–9. (In Russ.). doi: 10.30629/2618-6667-2021-19-3-80-89
- Coleman R.L., Adler A.I., Clarke P.M. et al. Estimating the risk of cardiovascular outcomes and all-cause mortality in individuals with type 2 diabetes: validation of the UKPDS outcomes model using TECOS and EXSCEL data. Diabetes Obes Metab 2026;28(2):1068–75. doi: 10.1111/dom.70280
- Liu Y., Yang M., Liao Y., Hu Z. Global research trends, reporting and handling of missing data in observational studies of type 2 diabetes mellitus with mild cognitive impairment from 2020 to 2025: a systematic review. Front Endocrinol (Lausanne) 2026;17:1649881. doi: 10.3389/fendo.2026.1649881
- Li Z., Liu J., Zhao C. et al. Hybrid PET/fMRI reveals interactive effects of T2DM and MCI on cerebral glucose metabolism and ALFF. Front Endocrinol (Lausanne) 2026;17:1778600. doi: 10.3389/fendo.2026.1778600
- Sun C., Wu T., Yu C. et al. Dementia burden and modifiable risk factors in type 2 diabetes: population based, prospective cohort study. Diabetes Obes Metab 2026;28(6):5113–24. doi: 10.1111/dom.70712
- Esin R.G., Khayrullin I.Kh., Esin O.R. Diabetic encephalopathy: current insights and potential therapeutic strategies. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry 2021;121(7):49–54. (In Russ.). doi: 10.17116/jnevro202112107149
- Kinattingal N., Bovilla V., Mehdi S. et al. Reversal of diabetes-associated cognitive impairment through modulation of BDNF, insulin, and NF-κB pathways by a marketed herbal formulation. 3 Biotech 2026;16(6):236. doi: 10.1007/s13205-026-04827-7
- Huang G., Chen S., He W. et al. Associations of diabetes mellitus with/without diabetic retinopathy and cognitive outcomes in older adults: the potential role of the dietary inflammatory index in a multi-dataset observational study. Front Nutr 2026;13:1775880. doi: 10.3389/fnut.2026.1775880
- Duering M., Biessels G.J., Brodtmann A. et al. Neuroimaging standards for research into small vessel disease-advances since 2013. Lancet Neurol 2023;22(7):602–18. doi: 10.1016/S1474–4422(23)00131-X
- Rejdak K., Sienkiewicz-Jarosz H., Bienkowski P., Alvarez A. Modulation of neurotrophic factors in the treatment of dementia, stroke and TBI: effects of Cerebrolysin. Med Res Rev 2023;43(5):1668–700. doi: 10.1002/med.21960
- Georgy G.S., Nassar N.N., Mansour H.A., Abdallah D.M. Cerebrolysin ameloriates cognitive deficits in type III diabetic rats. PLoS One 2013;8(6):e64847. doi: 10.1371/journal.pone.0064847
- Rodakowski J., Jennie D.L., Stahl S. Depressive symptoms associated with social participation in older adults living with mild cognitive impairment. Gerontol Geriatr Med 2024;10:23337214231223637. doi: 10.1177/23337214231223637
- Dedov I.I., Shestakova M.V. Cerebral vascular lesions in diabetes mellitus: solved and unresolved questions. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry 2015;115(8):79–82. (In Russ.). doi: 10.17116/jnevro20151156179-82
- Brainin M. Cerebrolysin: a multi-target drug for recovery after stroke. Expert Rev Neurother 2018;18(8):681–7. doi: 10.1080/14737175.2018.1500459
- Beghi E., Binder H., Birle C. et al. European Academy of Neurology and European Federation of Neurorehabilitation Societies guideline on pharmacological support in early motor rehabilitation after acute ischaemic stroke. Eur J Neurol 2021;28:2831–45. doi: 10.1111/ene.14936
- Bogolepova A.N., Levin O.S. Cognitive rehabilitation of patients with focal brain damage. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry 2020;120(4):115–22. (In Russ.). doi: 10.17116/jnevro2020120041115
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