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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">bekhterev</journal-id><journal-title-group><journal-title xml:lang="ru">Обозрение психиатрии и медицинской психологии имени В.М.Бехтерева</journal-title><trans-title-group xml:lang="en"><trans-title>V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7053</issn><issn pub-type="epub">2713-055X</issn><publisher><publisher-name>V. M. BEKHTEREV  NATIONAL  RESEARCH  MEDICAL  CENTER  FOR  PSYCHIATRY  AND  NEUROLOGY                           OF    THE  RUSSIAN  FEDERATION   MINISTRY  OF  HEALTH</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31363/2313-7053-2021-57-4-97-105</article-id><article-id custom-type="elpub" pub-id-type="custom">bekhterev-624</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>В ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>GUIDELINES FOR THE PRACTITIONER</subject></subj-group></article-categories><title-group><article-title>Постковидные когнитивные расстройства. Современный взгляд на проблему, патогенез и терапию</article-title><trans-title-group xml:lang="en"><trans-title>The Post-COVID-19 cognitive impairment. A modern view of the problem, pathogenesis and treatment</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2266-9197</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захаров</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захаров Денис Валерьевич—д.м.н., врач-невролог, заведующий отделением интегративной терапии больных нейропсихиатрического профиля</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Denis V. Zakharov</p><p>St. Petersburg</p></bio><email xlink:type="simple">zaharov_dv@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1722-3000</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Буряк</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Buriak</surname><given-names>Y. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Буряк Юлия Владимировна—врач-невролог отделения интегративной терапии больных нейропсихиатрического профиля</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Yulia V. Buriak</p><p>St. Petersburg</p></bio><email xlink:type="simple">buryak-yulya@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>30</day><month>12</month><year>2021</year></pub-date><volume>55</volume><issue>4</issue><fpage>97</fpage><lpage>105</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Захаров Д.В., Буряк Ю.В., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Захаров Д.В., Буряк Ю.В.</copyright-holder><copyright-holder xml:lang="en">Zakharov D.V., Buriak Y.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.bekhterevreview.com/jour/article/view/624">https://www.bekhterevreview.com/jour/article/view/624</self-uri><abstract><p>Инфекция COVID-19 представляет собой значимую и малоизученную проблему современной мировой медицины. По мере распространения вируса накапливаются данные о клинической картине заболевания и поражении нервной системы. Такие симптомы как утомляемость, тревога, депрессия, нарушения сна и многие другие неврологические и соматические симптомы, фиксируются часто, длительно сохраняются даже после купирования острой инфекционной стадии заболевания и затрудняют полное выздоровление пациента. Что характерно, данные симптомы встречаются даже при легком течении заболевания и сохраняются в течение многих месяцев. Одним из наиболее часто встречающихся и инвалидизирующих симптомов постковидного синдрома являются когнитивные нарушения, в формировании которых помимо прямой способности вируса проникать в нервную систему и патологии микроциркуляторного русла участвуют различные патологические механизмы, в том числе, дизрегуляция холинергической трансмиссии.В лечении когнитивных нарушений важен всесторонний подход, целесообразно использовать как медикаментозные, так и немедикаментозные методы. Основные подходы к терапии вторичных когнитивных расстройств базируются на гипотезе восполнения дефекта медиаторных систем, в том числе, связанных с гибелью холинергических нейронов. При данных нарушениях целесообразно восполнение ацетилхолина. Среди предшественников холина особое место занимает холина альфосцерат благодаря доказанной эффективности в лечении нейродегенеративных поражений центральной нервной системы, а также благодаря данным о его многофакторном действии. В статье представлены актуальные литературные данные, посвященные механизмам развития и особенностям клинических проявлений постковидных когнитивных расстройств, а также материалы проведенных экспериментальных и клинических исследований препарата холина альфосцерат (Глиатилин).</p></abstract><trans-abstract xml:lang="en"><p>COVID-19 infection is a significant and poorly understood problem of modern world medicine. As the virus spreads, data on the clinical picture of the disease and damage to the nervous system are accumulating. Symptoms such as fatigue, anxiety, depression, sleep disturbances and many other neurological and somatic symptoms are often recorded, persist for a long time even after the acute infectious stage of the disease has been stopped, and make it difficult for the patient to fully recover. These symptoms occur even with a mild disease and persist for many months. One of the most common and disabling symptoms of post-COVID syndrome is cognitive impairment, in the formation of which, in addition to the direct ability of the virus to penetrate the nervous system and pathology of the microvasculature, various pathological mechanisms are involved, including dysregulation of cholinergic transmission. A comprehensive approach is important in the treatment of cognitive impairment; it is advisable to use both medication and non-medication methods. The main approaches to the treatment of secondary cognitive disorders are based on the hypothesis of replenishing the defect in mediator systems, including those associated with the death of cholinergic neurons. With these abnormalities, it is advisable to replenish acetylcholine. Among the precursors of choline, choline alfoscerate occupies a special place due to its proven efficacy in the treatment of neurodegenerative diseases, as well as due to data on its multifactorial action. The article presents the actual literature data on the mechanisms of development and features of the clinical manifestations of post-COVID cognitive impairment, as well as materials of experimental and clinical studies of the drug choline alfoscerate (Gliatilin).</p></trans-abstract><kwd-group xml:lang="ru"><kwd>постковидный синдром</kwd><kwd>когнитивная дисфункция</kwd><kwd>холинергический дефицит</kwd><kwd>холина альфосцерат</kwd></kwd-group><kwd-group xml:lang="en"><kwd>post-covid syndrome</kwd><kwd>cognitive dysfunction</kwd><kwd>cognitive impairment</kwd><kwd>cholinergic deficiency</kwd><kwd>Choline alfoscerate</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Балунов О.А., Захаров Д.В. Динамика показателей функционального состояния и качества жизни у пациентов с дисциркуляторной энцефалопатией в процессе лечения. Обозрение психиатрии и медицинской психологии им. 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