Substantiated therapy of pre-dementia cognitive impairment with calcium-channel blockers

Abstract

Pre-dementia cognitive impairments are a significant part of a cognitive impairment range, considered the most perspective in terms of conversion into dementia prevention. At the same time pre-dementia cognitive impairment treatment presents certain difficulties in connection with the absence of precise medicinal strategies with the high evidence level. According to current clinical recommendations, the priority in cognitive pre-dementia treatment lies in the correction of modifiable risk factors of cognitive impairment progression and non-drug therapy methods. Nevertheless, there is a great need in receiving the proofs of pathogenetically justified use of drugs with a potentially effective mechanism of action. Universal and early pathogenetical mechanism of many diseases of central nervous system, leading to the development of cognitive impairments, including Alzheimer’s disease, is Ca2+ dyshomeostasis. In this connection, the use of drugs, regulating Ca2+ metabolism in neurons in treatment of patients with pre-dementia cognitive impairments, especially high brain penetrance drugs, is potentially well-grounded. The article gives the data review of modern researches, studying the efficiency and safety of nimodipin a selective Ca+ channel blocker of the 2 class. The article provides examples of the use of nimodipin in treatment and prevention of pre-dementia syndroms of various genesis: Alzheimer’s disease, chronic brain hypoperfusion damage, post-radiation and postoperative cognitive dysfunction, etc. The article presents experimental data about nimodipin use in the prevention of postoperative delirium in elderly people and in the treatment of non-cognitive neurological disorders. Justification of the perspectives of the application area extension and directions for the further research of nimodipin are as well given in the article.