ABSTRACT
Reduced cerebral perfusion
and microcirculation are found among AD causes, which should be considered in
the development of new treatments for the disease. 165 patients with AD were
examined. The examination plan included clinical assessment of dementia
severity (CDR), cognitive function assessment (MMSE), laboratory examination,
cerebral scintigraphy (SG), rheoencephalography (REG), cerebral CT and MRI,
morphometric AD stages assessment (TDR) and cerebral multi-gated angiography
(MUGA). 89 patients aged 34 - 79 (average age 67) were selected for the
treatment: 31 (34.83%) male, 58 (65.17%) female patients. According to their AD
stage, the patients were divided into: TDR-0 (preclinical stage)—10 (11.24%)
patients, TDR-1 (early stage with mild dementia, mild cognitive impairment)—28
(31.46%) patients, TDR-2 (medium stage with moderate dementia, cognitive
impairment sufficiently persistent)—34 (38.20%) patients, TDR-3 (late stage
with sufficiently severe dementia and cognitive impairment)—17 (19.10%)
patients. Test Group—46 (51.68%) patients—had transcatheter treatment with
low-energy lasers. Control Group—43 (48.31%)—had conservative treatment with
Memantin and Rivastigmine. The Test Group had cerebral microcirculation
improvement leading to permanent dementia reduction and cognitive recovery
which allowed transferring the patients to a lighter TDR group or withdrawing
them from the scale. Control Group patients with earlier AD stages (TDR-0,
TDR-1, TDR-2) obtained stabilization for a period of 6 months-3 years, with
subsequent growth of dementia and cognitive impairment; patients with late AD
stage (TDR-3) showed further increase of cognitive impairment and dementia.
Transcatheter treatment allows reducing the effects of dyscirculatory
angiopathy of Alzheimer’s type (DAAT) improving cerebral microcirculation and
metabolism, which leads to permanent dementia regression and cognitive
impairment reduction. These data show that AD treatment should be comprehensive
and aimed at both the recovery of cerebral microcirculation and blood supply
and the normalization of amyloid beta metabolism in the cerebral tissue.