Metabolic syndrome is associated with dysmetabolic and proinflammatory pathophysiological mechanisms, which lead to cognitive impairment. Evaluation of the effect of osteopontin as a predictor of these changes with the analysis of the neuroimaging pattern of the brain is of interest.Purpose of the study: analysis of the role of osteopontin in patients with metabolic syndrome in the formation of cognitive impairment.Material and Methods: the study complies with generally accepted ethical rules and included 50 patients with type metabolic syndrome (which were divided into groups according to cognitive impairment) and 25 control groups. All underwent a general clinical examination, blood sampling for biochemical parameters, including osteopontin. Magnetic resonance imaging (MRI) was performed on a Signa Creator "E" magnetic resonance tomograph, GE Healthcare, 1.5 Tesla, China: techniques were dynamic contrast and arterial spin labels, proton spectroscopy, tractography. SPSS Statistic program was used for statistical analysis.Results: osteopontin was higher in patients with overweight, hyperglycemia, hyperuricemia, dyslipidemia, and cognitive impairment, and in the neuroimaging study with microangiopathy according to perfusion MRI, impaired integration of the white matter of the brain, as well as neurometabolism in the hippocampal region by choline, creatine and phosphocreatine metabolites in the hippocampal region, as well as their NAA/Cr, NAA/Cho, Cho/Cr ratios (p≤0.05).Conclusion: patients with metabolic syndrome and cognitive disorders revealed elevated levels of osteopontin, which is also associated with impaired cerebral vascularization in general and white matter organization, as well as neurometabolism in the hippocampus..