Cerebrometabolic health: cognitive impairments and methods of their correction
- Autores: Lagoda O.V.1, Antonova K.V.1, Shishkina T.S.1, Spryshkov N.E.1, Tanashyan M.M.1
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Afiliações:
- Scientific Center of Neurology
- Edição: Volume 11, Nº 3 (2025)
- Páginas: 162-173
- Seção: ACTUAL ISSUES OF PHARMACOTHERAPY AND PREVENTIVE TREATMENT
- URL: https://journals.eco-vector.com/2412-4036/article/view/687180
- DOI: https://doi.org/10.18565/therapy.2025.3.162-173
- ID: 687180
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Resumo
The risk of cognitive impairments (CI) in patients suffering from cerebrovascular diseases (CVD) significantly increases in the presence of comorbid pathologies. The influence of carbohydrate metabolism disorders at the formation of CI has been studied the best, but obesity and thyroid dysfunction have recently been considered to be coequally important risk factors. The article describes the pathophysiological mechanisms leading to decrease of cognitive functions in patients with such common pathological conditions as obesity, diabetes mellitus and dysthyroidism. Understanding the stages of CI development in patients with CVD in the presence of metabolic disorders is the basis for the development of personalized strategies for their correction. An analysis of scientific publications devoted to neuroprotection is presented. A description of our own clinical experience in the treatment of cognitive dysfunction in CVD comorbid patients is given.
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Sobre autores
Olga Lagoda
Scientific Center of Neurology
Email: olga.lagoda@gmail.com
ORCID ID: 0000-0001-7562-4991
Código SPIN: 1789-4735
MD, PhD (Medicine), neurologist, senior researcher at the 1st Neurological Department
Rússia, 125367, Moscow, 80 Volokolamskoe HighwayKsenia Antonova
Scientific Center of Neurology
Autor responsável pela correspondência
Email: kseniya.antonova@mail.ru
ORCID ID: 0000-0003-2373-2231
Código SPIN: 7737-4712
MD, Dr. Sci. (Medicine), endocrinologist, leading researcher at the 1st Neurological Department
Rússia, 125367, Moscow, 80 Volokolamskoe HighwayTatyana Shishkina
Scientific Center of Neurology
Email: Shishkina.T.S@neurology.ru
ORCID ID: 0009-0001-1934-9902
1st year postgraduate student, neurologist
Rússia, 125367, Moscow, 80 Volokolamskoe HighwayNikita Spryshkov
Scientific Center of Neurology
Email: nikita_spryshkov@mail.ru
ORCID ID: 0000-0002-2934-5462
Código SPIN: 4604-7589
MD, 1st year postgraduate student, neurologist
Rússia, 125367, Moscow, 80 Volokolamskoe HighwayMarine Tanashyan
Scientific Center of Neurology
Email: mtanashyan@neurology.ru
ORCID ID: 0000-0002-5883-8119
Código SPIN: 7191-1163
MD, Dr. Sci. (Medicine), professor, corresponding member of RAS, deputy director for scientific work, head of the 1st Neurological Department
Rússia, 125367, Moscow, 80 Volokolamskoe HighwayBibliografia
- Rundek T, Tolea M, Ariko T, Fagerli EA, Camargo CJ. Vascular cognitive impairment (VCI). Neurotherapeutics. 2022;19(1):68–88.PMID: 34939171. PMCID: PMC9130444. https://doi.org/10.1007/s13311-021-01170-y
- Емелин А.Ю., Лобзин В.Ю. Критерии диагностики и классификация сосудистых когнитивных нарушений. Неврология, нейропсихиатрия, психосоматика. 2022;14(6):131–138. [Emelin AYu, Lobzin VYu. Criteria for diagnosis and classification of vascular cognitive impairment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(6):131–138 (In Russ.)].EDN: LDNFPA. https://doi.org/10.14412/2074-2711-2022-6-131-138
- Боголепова А.Н. Сосудистые когнитивные нарушения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2022;122(10):17–23. [Bogolepova AN. Vascular cognitive impairment. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(10):17–23 (In Russ.)].EDN: FXNABX. https://doi.org/10.17116/jnevro202212210117
- Wong EC, Chui HC. Vascular cognitive impairment and dementia. Continuum (Minneap Minn). 2022;28(3):750–80.PMID: 35678401. PMCID: PMC9833847. https://doi.org/10.1212/CON.0000000000001124
- Boyle PA, Yu L, Wilson RS, Leurgans SE, Schneider JA, Bennett DA. Person-specific contribution of neuropathologies to cognitive loss in old age. Ann Neurol. 2018;83(1):74–83.PMID: 29244218. PMCID: PMC5876116. https://doi.org/10.1002/ana.25123
- Chatterjee S, Peters SAE, Woodward M, Arango SM, Batty GD, Beckett N et al. Type 2 diabetes as a risk factor for dementia in women compared with men: A pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care. 2016;39(2):300–7.PMID: 26681727. PMCID: PMC4722942. https://doi.org/10.2337/dc15-1588
- Jones A, Ali MU, Kenny M, Mayhew A, Mokashi V, He H et al. Potentially modifiable risk factors for dementia and mild cognitive impairment: An umbrella review and meta-analysis. Dement Geriatr Cogn Disord. 2024;53(2):91–106.PMID: 38346414. https://doi.org/10.1159/000536643
- Tian R, Zhang Y, Liu F, Xue X, Zhang Y, Tian Z et al. A neuropsychological profile and its correlation with neuroimaging markers in patients with subcortical ischaemic vascular dementia. Int J Geriatr Psychiatry. 2023;38(3):e5900.PMID: 36862560. https://doi.org/10.1002/gps.5900
- Антонова К.В., Лагода О.В., Шишкина Т.С., Танашян М.М. Метаболическая коморбидность при цереброваскулярной патологии. Терапия. 2024;10(5):101–110. [Antonova KV, Lagoda OV, Shishkina TS, Tanashyan MM. Metabolic comorbidity in case of cerebrovascular pathology. Terapiya = Therapy. 2024;10(5):101–110 (In Russ.)].EDN: DLHRKE. https://dx.doi.org/10.18565/therapy.2024.5.101-110
- Xue M, Xu W, Ou Y-N, Cao X-P, Tan M-S, Tan L et al. Diabetes mellitus and risks of cognitive impairment and dementia: A systematic review and meta-analysis of 144 prospective studies. Ageing Res Rev. 2019;55:100944.PMID: 31430566. https://doi.org/10.1016/j.arr.2019.100944
- Li Y-S, Li J-B, Wang J-J, Wang X-H, Jiang W-R, Qiu H-N et al. Risk factors for cognitive impairment in middle-aged type 2 diabetic patients: A cross-sectional study. BMJ Open. 2024;14(1):e074753.PMID: 38167287. PMCID: PMC10773412. https://doi.org/10.1136/bmjopen-2023-074753
- Пономарева М.С., Щепанкевич Л.А., Рерих К.В., Затынко А.В., Антонова К.В., Танашян М.М. Метаболические предикторы течения ишемического инсульта у молодых. Анналы клинической и экспериментальной неврологии. 2025;19(1):21–29. [Ponomareva MS, Shchepankevich LA, Rerikh KV, Zatynko AV, Antonova KV, Tanashyan MM. Metabolic predictors of the course of ischemic stroke in young people. Annaly klinicheskoy i eksperimental’noy nevrologii = Annals of Clinical and Experimental Neurology. 2025;19(1):21–29 (In Russ.)].EDN: GLJJKH. https://doi.org/10.17816/ACEN.1274
- Антонова К.В., Танашян М.М., Раскуражев А.А., Спрышков Н.Е., Панина А.А., Лагода О.В. с соавт. Ожирение и нервная система. Ожирение и метаболизм. 2024;21(1):68–78. [Antonova KV, Tanashyan MM, Raskurazhev AA, Spryshkov NE, Panina AA, Lagoda OV et al. Obesity and the nervous system. Ozhirenie i metabolism = Obesity and Metabolism. 2024;21(1):68–78 (In Russ.)].EDN: ZLNYDR. https://doi.org/.14341/omet13019
- Farruggia MC, Small DM. Effects of adiposity and metabolic dysfunction on cognition: A review. Physiol Behav. 2019;208:112578.PMID: 31194997. PMCID: PMC6625347. https://doi.org/10.1016/j.physbeh.2019.112578
- O’Brien PD, Hinder LM, Callaghan BC, Feldman EL. Neurological consequences of obesity. Lancet Neurol. 2017;16(6):465–77.https://doi.org/10.1016/S1474-4422(17)30084-4. PMID: 28504110. PMCID: PMC5657398.
- Mattson MP, Arumugam TV. Hallmarks of brain aging: Adaptive and pathological modification by metabolic states. Cell Metab. 2018;27(6):1176–99.PMID: 29874566. PMCID: PMC6039826. https://doi.org/10.1016/j.cmet.2018.05.011
- Tang X, Zhao W, Lu M, Zhang X, Zhang P, Xin Z et al. Relationship between central obesity and the incidence of cognitive impairment and dementia from cohort studies involving 5,060,687 participants. Neurosci Biobehav Rev. 2021;130:301–13.PMID: 34464646. https://doi.org/10.1016/j.neubiorev.2021.08.028
- Leigh S-J, Morris MJ. Diet, inflammation and the gut microbiome: Mechanisms for obesity-associated cognitive impairment. Biochim Biophys Acta Mol Basis Dis. 2020;1866(6):165767.PMID: 32171891. https://doi.org/10.1016/j.bbadis.2020.165767
- Beyer F, Masouleh SK, Kratzsch J, Schroeter ML, Röhr S, Riedel-Heller SG et al. A metabolic obesity profile is associated with decreased gray matter volume in cognitively healthy older adults. Front Aging Neurosci. 2019;11:202.PMID: 31427957. PMCID: PMC6688742. https://doi.org/10.3389/fnagi.2019.00202
- Fitzpatrick S, Gilbert S, Serpell L. Systematic review: Are overweight and obese individuals impaired on behavioural tasks of executive functioning? Neuropsychol Rev. 2013;23(2):138–56.PMID: 23381140. https://doi.org/10.1007/s11065-013-9224-7
- Loprinzi PD, Frith E. Obesity and episodic memory function. J Physiol Sci. 2018;68(4):321–31.PMID: 29667132. PMCID: PMC10717800. https://doi.org/10.1007/s12576-018-0612-x
- Dye L, Boyle NB, Champ C, Lawton C. The relationship between obesity and cognitive health and decline. Proc Nutr Soc. 2017;76(4):443–54.PMID: 28889822. https://doi.org/10.1017/S0029665117002014
- Liu Y, Yu J, Shi Y-C, Zhang Y, Lin S. The role of inflammation and endoplasmic reticulum stress in obesity-related cognitive impairment. Life Sci. 2019;233:116707.PMID: 31374234. https://doi.org/10.1016/j.lfs.2019.116707
- De Felice FG, Ferreira ST. Inflammation, defective insulin signaling, and mitochondrial dysfunction as common molecular denominators connecting type 2 diabetes to Alzheimer disease. Diabetes. 2014;63(7):2262–72.PMID: 24931033. https://doi.org/10.2337/db13-1954
- Kim B, Feldman EL. Insulin resistance as a key link for the increased risk of cognitive impairment in the metabolic syndrome. Exp Mol Med. 2015;47(3):e149.PMID: 25766618. PMCID: PMC4351418. https://doi.org/10.1038/emm.2015.3
- Reilly SM, Saltiel AR. Adapting to obesity with adipose tissue inflammation. Nat Rev Endocrinol. 2017;13(11):633–43.PMID: 28799554. https://doi.org/10.1038/nrendo.2017.90
- Annweiler C, Duval GT, Cheng C-Y, Wong T-Y, Lamoureux EL, Milea D, Sabanayagam C. U-shaped relationship between serum leptin concentration and cognitive performance in older Asian adults. Nutrients. 2019;11(3):660.PMID: 30893833. PMCID: PMC6470536. https://doi.org/10.3390/nu11030660
- Teunissen CE, van der Flier WM, Scheltens P, Duits A, Wijnstok N, Nijpels G et al. Serum leptin is not altered nor related to cognitive decline in Alzheimer’s disease. J Alzheimers Dis. 2015;44:809–13.PMID: 25352450. https://doi.org/10.3233/jad-141503
- Naomi R, Teoh SH, Embong H, Balan SS, Othman F, Bahari H, Yazid MD. The role of oxidative stress and inflammation in obesity and its impact on cognitive impairments – a narrative review. Antioxidants (Basel). 2023;12(5):1071.PMID: 37237937. PMCID: PMC10215476. https://doi.org/10.3390/antiox12051071
- Трошина Е. Щитовидная железа. Все от анализов до методов лечения. М.: Эксмо. 2023; 240 с. [Troshina E. Thyroid gland. Everything from tests to treatment methods. Moscow: Eksmo. 2023; 240 pp. (In Russ.)]. ISBN: 978-5-04-185771-4.
- Eslami-Amirabadi M, Sajjadi SA. The relation between thyroid dysregulation and impaired cognition/behaviour: An integrative review. J Neuroendocrinol. 2021;33(3):e12948.PMID: 33655583. PMCID: PMC8087167. https://doi.org/10.1111/jne.12948
- Yang M-H, Yang F-Y, Lee D-D. Thyroid disease as a risk factor for cerebrovascular disease. J Stroke Cerebrovasc Dis. 2015;24(5):912–20.PMID: 25804562. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.11.032
- Shafia S, Khoramirad A, Akhoundzadeh K. Thyroid hormones and stroke, the gap between clinical and experimental studies. Brain Res Bull. 2024;213:110983.PMID: 38795852. https://doi.org/10.1016/j.brainresbull.2024.110983
- Papadopoulou AM, Bakogiannis N, Skrapari I, Moris D, Bakoyiannis C. Thyroid dysfunction and atherosclerosis: A systematic review. In Vivo. 2020;34(6):3127–36.PMID: 33144416. PMCID: PMC7811672. https://doi.org/10.21873/invivo.12147
- Rieben C, Segna D, da Costa BR, Collet T-H, Chaker L, Aubert CE et al. Subclinical thyroid dysfunction and the risk of cognitive decline: A meta-analysis of prospective cohort studies. J Clin Endocrinol Metab. 2016;101(12):4945–54.PMID: 27689250. PMCID: PMC6287525. https://doi.org/10.1210/jc.2016-2129
- Ye J, Huang Z, Liang C, Yun Z, Huang L, Liu Y, Luo Z. Thyroid dysfunction and risk of different types of dementia: A systematic review and meta-analysis. Medicine (Baltimore). 2024;103(34):e39394.PMID: 39183422. PMCID: PMC11346895. https://doi.org/10.1097/md.0000000000039394
- Correia N, Mullally S, Cooke G, Tun TK, Phelan N, Feeney J et al. Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism. J Clin Endocrinol Metab. 2009;94(10):3789–97.PMID: 19584178. https://doi.org/10.1210/jc.2008-2702
- Miller KJ, Parsons TD, Whybrow PC, Van Herle K, Rasgon N, Van Herle A et al. Verbal memory retrieval deficits associated with untreated hypothyroidism. J Neuropsychiatry Clin Neurosci. 2007;19(2):132–36.PMID: 17431058. https://doi.org/10.1176/jnp.2007.19.2.132
- Zhang Y, Yang Y, Tao B, Lv Q, Lui S, He L. Gray matter and regional brain activity abnormalities in subclinical hypothyroidism. Front Endocrinol (Lausanne). 2021;12:582519.PMID: 33716959. PMCID: PMC7943870. https://doi.org/10.3389/fendo.2021.582519
- Alhemedi AJ, Qasaimeh MG, Alzoubia S, Alhallaq LS, Alzoubi N, AlAzzam R et al. Adherence to thyroid therapy and depressive status among patients with hypothyroidism in the northern of Jordan: A cross-sectional study. Medicine (Baltimore). 2024;103(6):e37181.PMID: 38335430. PMCID: PMC10860971. https://doi.org/10.1097/md.0000000000037181
- Song R-H, Wang B, Yao Q-M, Li Q, Jia X, Zhang J-A. The impact of obesity on thyroid autoimmunity and dysfunction: A systematic review and meta-analysis. Front Immunol. 2019;10:2349.PMID: 31681268. PMCID: PMC6797838. https://doi.org/10.3389/fimmu.2019.02349
- Głombik K, Detka J, Kurek A, Budziszewska B. Impaired brain energy metabolism: Involvement in depression and hypothyroidism. Front Neurosci. 2020;14:586939.PMID: 33343282. PMCID: PMC7746780. https://doi.org/10.3389/fnins.2020.586939
- Филимонов Д.А., Евтушенко С.К., Федорова А.А. Молекулярные механизмы нейропротекторных эффектов тиреоидных гормонов и их метаболитов при острой ишемии головного мозга. Анналы клинической и экспериментальной неврологии. 2023;17(1):43–54. [Filimonov DA, Evtushenko SK, Fedorova AA. Molecular mechanisms of neuroprotective effects of thyroid hormones and their metabolites in acute brain ischemia. Annaly klinicheskoy i eksperimental’noy nevrologii = Annals of Clinical and Experimental Neurology. 2023;17(1):43–54 (In Russ.)].EDN: BXXQJD. https://doi.org/10.54101/ACEN.2023.1.6
- Villanueva I, Alva-Sánchez C, Pacheco-Rosado J. The role of thyroid hormones as inductors of oxidative stress and neurodegeneration. Oxid Med Cell Longev. 2013;2013:218145.PMID: 24386502. PMCID: PMC3872098. https://doi.org/10.1155/2013/218145
- Lin H-Y, Davis FB, Luidens MK, Mousa SA, Cao JH, Zhou M, Davis PJ. Molecular basis for certain neuroprotective effects of thyroid hormone. Front Mol Neurosci. 2011;4:29.PMID: 22016721. PMCID: PMC3193027. https://doi.org/10.3389/fnmol.2011.00029
- da Silva MIO, Liz MA. Linking alpha-synuclein to the actin cytoskeleton: Consequences to neuronal function. Front Cell Dev Biol. 2020;8:787.PMID: 32903460. PMCID: PMC7434970. https://doi.org/10.3389/fcell.2020.00787
- AlAnazi FH, Al-Kuraishy HM, Alexiou A, Papadakis M, Ashour MHM, Alnaaim SA et al. Primary hypothyroidism and Alzheimer’s disease: A tale of two. Cell Mol Neurobiol. 2023;43(7):3405–16.PMID: 37540395. PMCID: PMC10477255. https://doi.org/10.1007/s10571-023-01392-y
- Razvi S, Jabbar A, Pingitore A, Danzi S, Biondi B, Klein I et al. Thyroid hormones and cardiovascular function and dseases. J Am Coll Cardiol. 2018;71(16):1781–96.PMID: 29673469. https://doi.org/10.1016/j.jacc.2018.02.045
- Танашян М.М., Антонова К.В. Цереброметаболическое здоровье. В кн.: Аметов А.С., Антонова К.В., Арутюнов Г.П., Булаева Н.И., Голухова Е.З., Гриценко О.В. с соавт. Управление метаболическим здоровьем. М.: ГЭОТАР-Медиа. 2025. Т. II: 117–148. [Tanashyan MM, Antonova KV. Сerebrometabolic health. In the book: Ametov AS, Antonova KV, Arutyunov GP, Bulaeva NI, Golukhova EZ, Gritsenko OV et al. Metabolic health management. Moscow: GEOTAR-Media. 2025. Vol. II: 117–148 (In Russ.)]. ISBN: 978-5-9704-9057-0.
- Танашян М.М., Антонова К.В., Лагода О.В., Корнилова А.А., Щукина Е.П. Приверженность к лечению больных с цереброваскулярными заболеваниями как мультифакториальная проблема. Неврология, нейропсихиатрия, психосоматика. 2023;15(1):18–27. [Tanashyan MM, Antonova KV, Lagoda OV, Kornilova AA, Shchukina EP. Adherence to treatment in patients with cerebrovascular disease as a multifactorial problem. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2023;15(1):18–27 (In Russ.)].EDN: RYHAHF. https://doi.org/10.14412/2074-2711-2023-1-18-27
- Клинические рекомендации. Когнитивные расстройства у лиц пожилого и старческого возраста. Всероссийское общество неврологов, общественная организация «Российское общество психиатров», общероссийская общественная организация «Российская ассоциация геронтологов и гериатров». Рубрикатор клинических рекомендаций Минздрава России. 2020. ID: 617_5. Доступ: https://cr.minzdrav.gov.ru/preview-cr/617_5 (дата обращения – 22.04.2025). [Clinical guidelines. Cognitive disorders in the elderly and seniors. All-Russian Society of Neurologists, Russian Society of Psychiatrists, Russian Association of Gerontologists and Geriatricians. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2020. ID: 617_5. URL: https://cr.minzdrav.gov.ru/preview-cr/617_5 (date of access – 22.04.2025) (In Russ.)].
- Танашян М.М., Лагода О.В., Антонова К.В. Цереброваскулярная патология и метаболический синдром. М.: АСТ. 2019; 376 с. [Tanashyan MM, Lagoda OV, Antonova KV. Cerebrovascular pathology and metabolic syndrome. Moscow: AST. 2019; 376 pp. (In Russ.)]. ISBN: 978-5-6041430-2-5.EDN: SBMYLF. https://doi.org/10.33901/978-5-6041430-2-5-2019-1-370
- Brainin M. Cerebrolysin: A multi-target drug for recovery after stroke. Expert Rev Neurother. 2018;18(8):681–87.PMID: 30004268. https://doi.org/10.1080/14737175.2018.1500459
- Kojder K, Jarosz K, Bosiacki M, Andrzejewska A, Zacha S, Solek-Pastuszka J, Jurczak A. Cerebrolysin in patients with subarachnoid hemorrhage: A systematic review and meta-analysis. J Clin Med. 2023;12(20):6638.PMID: 37892776. PMCID: PMC10607250. https://doi.org/10.3390/jcm12206638
- Sarode LP, Ghatage T, Mardhekar V, Verma B, Prakash A, Ugale RR. Cerebrolysin reduces excitotoxicity by modulation of cell-death proteins in delayed hours of ischemic reperfusion injury. Metab Brain Dis. 2023;38(7):2401–16.PMID: 37273080. https://doi.org/10.1007/s11011-023-01240-4
- Avci S, Gunaydin S, Ari NS, Sulukoglu EK, Polat OE, Gecili I et al. Cerebrolysin alleviating effect on glutamate-mediated neuroinflammation via glutamate transporters and oxidative stress. J Mol Neurosci. 2022;72(11):2292–2302.PMID: 36333611. https://doi.org/10.1007/s12031-022-02078-8
- Chen N, Yang M, Guo J, Zhou M, Zhu C, He L. Cerebrolysin for vascular dementia. Cochrane Database Syst Rev. 2013;(1):CD008900.PMID: 23440834. https://doi.org/10.1002/14651858.CD008900.pub2
- Танашян М.М., Антонова К.В., Лагода О.В., Раскуражев А.А., Панина А.А. Цереброметаболическая когнитивная дисфункция: пути мультитаргетной коррекции. Нервные болезни. 2024;(2):3–10. [Tanashyan MM, Antonova KV, Lagoda OV, Raskurazhev AA, Panina AA. Cerebrometabolic cognitive dysfunction: Approaches to multitarget therapy. Nervnyye bolezni = Nervous Diseases. 2024;(2):3–10 (In Russ.)].EDN: HHIOGO. https://doi.org/10.24412/2226-0757-2024-13120
- Левин О.С., Вознюк И.А., Иллариошкин С.Н., Ткачева О.Н., Боголепова А.Н., Васенина Е.Е. с соавт. Когнитивные нарушения и тактика применения препарата Церебролизин. Резолюция международного совета экспертов (12 мая 2023 г.). Журнал неврологии и психиатрии им. С.С. Корсакова. 2023;123(9):121–130. [Levin OS, Voznyuk IA, Illarioshkin SN, Tkacheva ON, Bogolepova AN, Vasenina EE et al. Cognitive impairment and tactics of using the drug Cerebrolysin. Resolution of the International Council of Experts (May 12, 2023). Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(9):121–130 (In Russ.)].EDN: QQAHXT. https://doi.org/10.1007/s11011-023-01240-4
- Клинические рекомендации. Гипотиреоз. Российская ассоциация эндокринологов. Рубрикатор клинических рекомендаций Минздрава России. 2024. ID: 531_4. Доступ: https://cr.minzdrav.gov.ru/preview-cr/531_4 (дата обращения – 22.04.2025). [Clinical guidelines. Hypothyroidism. Russian Association of Endocrinologists. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2024. ID: 531_4. URL: https://cr.minzdrav.gov.ru/preview-cr/531_4 (date of access – 22.04.2025) (In Russ.)].
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