Neurotrophic approach in preventive therapy of alzheimer disease

IntroductionDuring the last years a great number of new facts of involving nerve growth factors (NGF) in pathogenesis of Alzheimer Disease (AD) and other neurodegenerative diseases have been received. Discovery of neurotrophic effects of Cerebrolysin similar to NGF attracted new attention to it (Rockenstein E. et al. 2000).Clinical study of long-term effects of Cerebrolysin has proved that Cerebrolysin has positive modifying action on the dementia progression (Gavrilova S.I. et al., 2003). That's why we suggest that Cerebrolysin may prevent or slow down clinical manifestation of dementia in patients with mild cognitive impairment (MCI) of amnestic type.The aim of the present study was to investigate in an open comparative prospective clinical trial ability of Cerebrolysin to slow down or prevent transition of MCI syndrome into the clinically evident AD in 2 groups of patients repeatedly treated with 1 month courses of Cerebrolysin or Cavinton during a period of 3 years.Methods110 patients who met the diagnostic criteria of MCI of amnestic typewere included. During the clinical trial patients were assessed with a set of clinical scales and a battery of neuropsychological cognitive tests. Genotyping for the APOE polymorphism was performed as well.ResultsThe superiority of Cerebrolysin over Cavinton in slowing down of the cognitive deficit progression and delaying the time or transition of MCI patients to the diagnostic category of Alzheimer disease during 3 years was demonstrated. Cerebrolysin was particularly effective in MCI patients with the ApoE4 (+) genotype.ConclusionCerebrolysin could be recommended as a preventive AD therapy.