The number of people with dementia is expected to increase globally by 2050 as the rising prevalence and socioeconomic burden of mild cognitive impairment (MCI) and dementia pose significant challenges for patients, caregivers and healthcare systems Twice as many cases, reaching 152 million cases, researchers suggest that improving nutritional status can prevent or slow the onset of dementia, and there is consensus that intervention strategies must be initiated as early as possible, before any obvious symptoms begin to appear.
One of the most promising nutritional supplements is citicoline, which is the pharmaceutical form of the endogenous compound cytidine-5'-diphosphate (CDP) choline. As shown in different animal studies, it increases the concentration of acetylcholine within synapses, promoting phospholipid synthesis and neuronal repair. Furthermore, studies have demonstrated that it can inhibit apoptosis associated with cerebral ischemia and several models of neurodegeneration, and that it has neuroprotective properties in different modes of cognitive impairment, Parkinson's disease or dementia (Alzheimer's disease or vascular This property is shown in dementia).
Researchers such as Al-kuraishy have shown that citicoline also appears to be effective in stimulating cognitive function in normal, healthy people. It improved human psychomotor vigilance, arousal and visual working memory and significantly improved oxidative stress after two weeks of administration to healthy volunteers (age range 21-22 years).
The study was a double-blind study, involving 40 healthy volunteers and divided into two groups: Group A: 20 volunteers received 500 mg/day starch capsules for two weeks; Group B: 20 volunteers received 500 mg/day starch capsules Citicoline capsules for two weeks. Human vigilance, visual working memory and oxidative stress markers were assessed in each volunteer before and after taking citicoline and placebo.
After two weeks of treatment, placebo had no significant effect on human alertness and visual working memory (P>0.05), whereas citicoline improved most variables of psychomotor performance and working memory (P<0.01). Placebo significantly increased serum MDA levels from 19.44±2.11 to 29.66±3.28 nmol/mL (P=0.0001), while citicoline significantly decreased MDA serum levels from 19.11±2.66 to 15.63±1.33 nmol/mL. (P=0.0001).
1. Citicoline can improve human psychomotor performance and working memory accuracy.
2. Citicoline can attenuate oxidative stress induced by high vigilance.
3. Citicoline stimulates the cognitive function of normal healthy volunteers.
Different molecular mechanisms of Citicoline are involved in improving working memory and psychomotor performance; it can improve neuroplasticity as it is a precursor of membrane phosphatidylcholine and choline and plays a crucial role in the activation of brain metabolism effect. Citicoline restores damaged neurons by accelerating membrane phospholipid synthesis, stabilizing neuronal Na 2+/K 2+ ATPase, reducing free radical generation and releasing free fatty acids (Knott et al., 2014). In addition, the central effects of citicoline may be mediated by modulating immune responses and activating repair processes after brain injury. Citicoline significantly regulates the expression and activity of neuronal protein kinases (extracellular signal-regulated kinase and mitochondrial-activated protein kinase) involved in brain neuron death.
Thus, citicoline has been shown to be effective in the treatment of Alzheimer's disease and vascular dementia, as long-term citicoline treatment may prevent cognitive decline in memory by accelerating executive function, temporal orientation, and attention. In addition, citicoline can promote verbal memory, short-term and long-term memory, and can also improve motor perception and emotional and behavioral problems.
 Al-Kuraishy HM, Al-Gareeb AI. Citicoline Improves Human Vigilance and Visual Working Memory: The Role of Neuronal Activation and Oxidative Stress. Basic Clin Neurosci. 2020 Jul-Aug;11(4):423-432. doi: 10.32598/bcn.11.4.1097.1. Epub 2020 Jul 1. PMID: 33613880; PMCID: PMC7878037.
 Bonvicini M, Travaglini S, Lelli D, Antonelli Incalzi R, Pedone C. Is Citicoline Effective in Preventing and Slowing Down Dementia?-A Systematic Review and a Meta-Analysis. Nutrients. 2023 Jan 12;15(2):386. doi: 10.3390/nu15020386. PMID: 36678257; PMCID: PMC9866349.