Metabolic and vascular factors in cognitive impairment: pathogenetic mechanisms and neuroprotection strategies
Akarachkova E.S., Lebedeva D.I., Kotova O.V., Karnaukhova A.E.
Cognitive impairment of vascular origin represents one of the most pressing issues in modern neurology. Its pathogenesis is rooted in a complex interplay between vascular factors (chronic ischemia, endothelial dysfunction, microcirculatory impairment) and metabolic factors (oxidative stress, neuronal energy deficit, insulin resistance, systemic inflammation). This review examines the key pathogenetic mechanisms underlying cognitive deficit in the context of cerebrovascular pathology and metabolic disorders, and analyzes therapeutic approaches targeting multiple sites of neuronal injury. Particular attention is paid to ethylmethylhydroxypyridine succinate, a drug with a multimodal mechanism of action that includes antioxidant, antihypoxic, and membrane-stabilizing properties.
Data from the international, multicenter, randomized, double-blind, placebo-controlled MEMO trial confirming the efficacy and safety of sequential therapy in patients with chronic cerebral ischemia and cognitive impairment are presented.
Data from clinical studies including results from the international, multicenter, randomized, double-blind, placebo-controlled MEMO trial confirming the efficacy and safety of sequential therapy in patients with chronic cerebral ischemia and cognitive impairment are presented.
For citations: Akarachkova E.S., Lebedeva D.I., Kotova O.V., Karnaukhova A.E. Metabolic and vascular factors in cognitive impairment: pathogenetic mechanisms and neuroprotection strategies. Pharmateca. 2026;33(6):34-38. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.6.34-38
Authors’ contribution: All authors made an equivalent contribution to the preparation of the publication.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Keywords
cognitive impairment
vascular cognitive impairment
chronic cerebral ischemia
oxidative stress
metabolic syndrome
neuroprotection
ethylmethylhydroxypyridine succinate
MEMO trial
About the Authors
Elena S. Akarachkova, Dr. Sci. (Med.), Professor, President of the International Society «Stress Under Control,» Moscow, Russia; nevrorus@mail.ru, ORCID: https://orcid.org/0000-0002-7629-3773 (corresponding author)Dzhinna I. Lebedeva, Dr. Sci. (Med.), Honored Doctor of the Russian Federation, Chief Physician of the Regional Medical and Rehabilitation Center, Tyumen; Professor at the Department of Medical Prevention and Rehabilitation, Institute of Public Health and Digital Medicine, Tyumen State Medical University, Tyumen, Russia; j.lebedeva1965@mail.ru, ORCID: https://orcid.org/0000-0003-2478-9619
Olga V. Kotova, Cand. Sci. (Med.), Associate Professor at the Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuous Medical Education, Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Moscow; Associate Professor at the Department of Fundamental and Applied Medical Activity (Psychiatry Course), M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow; Vice-President of the International Society «Stress Under Control,» Moscow, Russia; ol_kotova@mail.ru, ORCID:
https://orcid.org/0000-0002-3908-0381
Anna E. Karnaukhova, Radiologist, Head of the Diagnostic Department, City Polyclinic No. 6, Tyumen, Russia; gucheva_anna@mail.ru, ORCID:
https://orcid.org/0009-0004-5012-6602
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