Current evidence-based approaches to the treatment of vascular cognitive impairment

Zakharov V.V.; Chernousov P.A.

doi:https://doi.org/10.17116/jnevro202612604278

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Abstract:

Vascular cognitive impairment (VCI) is among the most prevalent neurological disorders. VCI typically results from small vessel disease (microangiopathy) associated with arterial hypertension, diabetes mellitus, and related conditions. A distinguishing characteristic of VCI due to small vessel disease is the subcortical-frontal pattern of cognitive impairment, primarily affecting attention and executive functions. Qualitative assessment of cognitive impairment profiles facilitates the differential diagnosis of VCI and other chronic, progressive cerebral disorders. Effective management of VCI requires rigorous control of vascular risk factors (ethiotropic therapy) and, during the pre-dementia stage, the implementation of pharmacological neuroprotection to prevent further cognitive decline. Neuroprotective therapy may include agents with multimodal mechanisms of action. This article presents findings from the MEMO randomised clinical trial, which demonstrated the efficacy of the neuroprotector Mexidol in improving cognitive, psychoemotional, and motor symptoms in patients with chronic cerebral ischemia (CBI) and moderate neurocognitive impairment syndrome.

Keywords:

vascular cognitive impairment

moderate cognitive impairment

small vessel disease

cerebral microangiopathy

chronic brain ischemia

dyscirculatory encephalopathy

antioxidants

neuroprotection

Authors:

Zakharov V.V.

Sechenov First Moscow Medical University, Moscow, Russia

SPIN RSCI: 6404-1030
Scopus AuthorID: 7402991374
ORCID: 0000-0002-8447-3264

Chernousov P.A.

Sechenov First Moscow Medical University, Moscow, Russia

ORCID: 0000-0003-2143-1806

Received:

02.03.2026

Accepted:

05.03.2026

Close metadata

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