Clinical Application of Citicoline in Treating Vascular Cognitive Impairment

 

Citicoline is an essential intermediate in the biosynthesis of cell membrane structural phospholipids (especially lecithin). Exogenous administration of citicoline can promote the synthesis of cell membrane phospholipids, promote brain metabolism, and increase central nervous system function. The level of systemic catecholamines has a significant effect on the treatment of cognitive dysfunction caused by various reasons, especially vascular cognitive dysfunction. In addition, given that oral administration has similar bioavailability to intravenous administration, complete oral absorption, and more convenient clinical application, oral administration will become the main route of clinical administration.

A large number of studies on citicoline in the treatment of cognitive impairment and dementia have confirmed that citicoline can improve cognition and behavior.

García-Cobos R et al conducted a double-blind, crossover design study to evaluate the efficacy and tolerability of citicoline in elderly patients with cerebral insufficiency. A total of 111 patients were enrolled in the study, with an average age of (74.6±6.9) years old and clinically diagnosed as senile cerebral insufficiency. After the washout period of taking placebo, the patients were divided into two balanced groups. Patients in group I took citicoline 600 mg·d-1 orally for 5 weeks, and then took placebo for 5 weeks. A washout period of taking placebo was required; patients in group II were given the drugs in the opposite order to group I. Patients were evaluated at 2, 7, 9, and 12 weeks. The results showed that citicoline can significantly improve the clinical performance of patients, and the six tests (digital recall, maze test, digital connection test, neuropsychiatric assessment scale (NAS), elderly observation scale) of patients in the citicoline treatment group Table (NAB), Clinical Assessment Scale for Geriatrics (SCAG)), the scores of 5 items were significantly improved after treatment than before treatment. The comparison between the groups still showed that the curative effect of citicoline was significant (P>0.05),

Fioravanti M et al. used PET (positron emission tomography) technology to find that the improvement of cognitive function and cerebral blood flow in patients with vascular dementia who received citicoline therapy (1 g·d-1×1 week, intravenous infusion) associated with a marked increase.

Systematic review of the literature analyzing the effects of citicoline on cognitive, affective and behavioral impairments in elderly patients with chronic brain disorders. The results showed that citicoline had no effect on the patient's attention, on the contrary, it had a significant improvement on memory and behavior. In the clinical global impression assessment, compared with placebo patients, the odds ratio (OR) of improvement in the citicoline group was 8.89 [5.19; 15.22]. The author believes that citicoline is effective in the treatment of memory and behavior disorders, and its efficacy on cognitive impairment secondary to cerebrovascular disease has been recognized by more patients.

Studies have also proved that citicoline is beneficial to changes in neurophysiology and neuroimmunity.

After the central nervous system is injured, citicoline can participate in the repair and regeneration, and play a neuroprotective role; it also plays an important role in the transfer of nerve mediators and the conduction of bioelectricity. Citicoline can not only treat the sequelae of the nervous system caused by craniocerebral injury and cerebrovascular accident, but also can be used as an adjuvant treatment for Parkinson's syndrome and Alzheimer's disease. It has obvious clinical therapeutic effect on acute stroke, neurological injury caused after surgery, disturbance of consciousness, glaucoma, etc. The combined application of citicoline and thrombolytic drugs or other neuroprotective drugs should be one of the future research directions.

*Special note - This article is for informational purposes only and cannot replace a doctor's treatment diagnosis and advice. It should not be regarded as a recommendation or proof of efficacy of the medical products involved. If it involves disease diagnosis, treatment, and rehabilitation, please be sure to go to a professional medical institution to seek professional advice.