Parkinson's disease is one of the common neurodegenerative diseases in clinical practice, which often occurs in middle-aged and elderly people with a high incidence.
The main clinical manifestations of Parkinson's disease are motor symptoms such as bradykinesia, muscle rigidity, abnormal gait, and resting tremor, while insufficient attention has been paid to the non-motor symptoms of Parkinson's disease. Parkinson's disease patients with cognitive impairment have a significantly increased risk of dementia, especially those with imagery memory and executive function impairment in the early stage. The activities of daily living and quality of life of Parkinson's disease patients with cognitive impairment are significantly reduced, and the life expectancy will also be affected.
Therefore, the early screening and treatment of Parkinson's disease with cognitive impairment is of great significance to prevent the progression of the disease and improve the daily life ability and quality of life of patients.
The pathogenesis of Parkinson's disease with cognitive impairment is still unclear, but with the deepening of research, recent studies have found that acetylcholine (Ach) is closely related to the occurrence of cognitive impairment in patients with Parkinson's disease. Ach is a neurotransmitter, which is closely related to memory and learning, and the lack of Ach content in the brain can lead to mental retardation.
Citicoline is a brain metabolism activator, which is mainly used for the treatment of disturbance of consciousness caused by brain surgery or acute traumatic brain trauma. The researchers used it for the treatment of Parkinson's disease patients with cognitive impairment. The results showed that the MMSE, MoCA, and PANDA scores of the patients in the observation group were higher than those in the control group, and their cognitive functions were significantly improved. The possible mechanism of action is as follows:
(1) Citicoline has a protective effect on neurons and can improve the cognitive function of patients. The reason is that citicoline can provide choline when it is hydrolyzed, and choline can promote the secretion of Ach and the synthesis of phospholipids in the nerve membrane.
(2) As a nucleoside derivative, citicoline can reduce cerebrovascular resistance and increase cerebral blood flow, thereby improving microcirculation and promoting brain substance metabolism; in addition, citicoline can also enhance the function of the ascending activation system of the brainstem reticular structure, thereby enhancing the function of the pyramidal system, improving motor paralysis, and promoting brain awakening and functional recovery. It has a good effect in the adjuvant treatment of Alzheimer's patients. Cognitive dysfunction in patients will affect their daily life, and citicoline can quickly improve the cognitive function of patients, so the ability of daily life has also been improved.
Therefore, the combination of citicoline on the basis of conventional treatment can improve the cognitive function and daily living ability of patients with Parkinson's disease with cognitive impairment, and has high clinical application value, but its specific mechanism of action needs further research.