nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2009-59nnp-358Research ArticlePHARMACOTHERAPYФАРМАКОТЕРАПИЯCITICOLIN IN THE TREATMENT OF STROKE AND VASCULAR COGNITIVE DISORDERSЦитиколин в лечении инсульта и сосудистых когнитивных нарушенийПарфеновВ. А.ParfenovV. A.vladimirparfenov@mail.ruММА им. И.М. СеченоваРоссияI.M. Sechenov Moscow Medical AcademyRussian Federation20091512200913-4NO3-4 (2009)6974Copyright © Parfenov V.A., 20092009Парфенов В.А.Parfenov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/358

Citicolin (ceraxon) is used as a neuroprotector in the treatment of acute stroke and vascular cognitive disorders. Experimental animal studies have demonstrated that citicolin reduces the extent of cerebral infarct and increases the degree of functional recovery. A few clinical trials have provided evidence for the efficacy of intravenous or oral citicolin used within the first 24 hours of ischemic stroke or cerebral hemorrhage in recovery of neurological functions. Citicolin is effective in memory and behavioral disorders in elderly patients with chronic cerebrovascular diseases. The use of citicolin has been found to be safe in stroke and vascular cognitive disorders.

Цитиколин (цераксон) используется в качестве нейропротектора в лечении острой стадии инсульта и сосудистых когнитивных расстройств. В экспериментальных исследованиях на животных показано, что цитиколин уменьшает размеры церебрального инфаркта и увеличивает степень функционального восстановления. В ходе нескольких клинических исследований доказана эффективность цитиколина, применяемого внутривенно или перорально, начиная с 1-х суток ишемического инсульта или кровоизлияния в мозг, в отношении восстановления неврологических функций. Цитиколин эффективен при расстройствах памяти и поведения у пожилых больных, страдающих хроническим цереброваскулярным заболеванием. Отмечается безопасность применения цитиколина при инсульте и сосудистых когнитивных расстройствах.

инсультишемический инсульткровоизлияние в мозгсосудистые когнитивные расстройствацитиколинstrokeischemic strokecerebral hemorrhagevascular cognitive disordersciticolinReferences<div><p>Дамулин И.В., Парфенов В.А., Скоромец А.А., Яхно Н.Н. Нарушения кровообращения в головном и спинном мозге. В кн.: Болезни нервной системы. Руководство для врачей. Под ред. Н.Н. Яхно. М.: Медицина, 2005. Т.1, с. 232-303.</p><p>Инсульт: диагностика, лечение и профилактика. Под ред. З.А. Суслиной, М.А. Пирадова. М.: МЕДпресс-информ, 2008;288 с.</p><p>Adams H.P., del Zoppo G., Alberts M.J. et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 2007;38(5):1655-711.</p><p>European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis 2008;25:457-507.</p><p>Hacke W., Kaste M., Bluhmki E. et al. Trombolysis with alteplase 3 to 4,5 hours after acute ischemic stroke. N Engl J Med 2008;359:1317-29.</p><p>Lozano Fernandez R. Efficacy and safety of oral CDP-choline. Drug surveillance study in 2817 cases. Arzneimittelforschung 1983;33:1073-80.</p><p>Conant R., Schauss A.G. Therapeutic applications of citicoline for stroke and cognitive dysfunction in the elderly: a review of the literature. Altern Med Rev 2004;9:17-31.</p><p>Schabitz W.R., Weber J., Takano K. et al. The effects of prolonged treatment with citicoline in temporary experimental focal ischemia. J Neurol Sci 1996;138:21-5.</p><p>Hurtado O., Cаrdenas A., Pradillo J.M. et al. A chronic treatment with CDP-choline improves functional recovery and increases neuronal plas- ticity after experimental stroke. Neurobiol Dis 2007;26:105-11.</p><p>Andersen M., Overgaard K., Meden P. et al. Effects of citicoline combined with thrombolytic therapy in a rat embolic stroke model. Stroke 1999;30:1464-71.</p><p>Alonso de Lecinana M., Gutierrez M., Roda J.M. et al. Effect of combined therapy with thrombolysis and citicoline in a rat model of embolic stroke. J Neurol Sci 2006;247:121-9.</p><p>Shuaib A., Yang Y., Li Q. Evaluating the efficacy of citicoline in embolic ischemic stroke in rats: neuroprotective effects when used alone or in combination with urokinase. Exp Neurol 2000;161:733-9.</p><p>Tazaki Y., Sakai F., Otomo E. et al. Treatment of acute cerebral infarction with a choline precursor in a multicenter double-blind placebo-controlled study. Stroke 1988;19:211-6.</p><p>Clark W.M., Warach S.J., Pettigrew L.C. et al. A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group. Neurology 1997;49:671-8.</p><p>Clark W.M., Williams B.J., Selzer K.A. et al. A randomized efficacy trial of citicoline in patients with acute ischemic stroke. Stroke 1999;30:2592-97.</p><p>Clark W.M., Wechsler L.R., Sabounjian L.A., Schwiderski U.E. Citicoline Stroke Study Group. A phase III randomized efficacy trial of 2000 mg citicoline in acute ischemic stroke patients. Neurology 2001;57:1595-602.</p><p>Davalos A., Castillo J., Alvarez-Sabin J. et al. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials. Stroke 2002;33:2850-7.</p><p>Cho H.J., Kim Y.J. Efficacy and safety of oral citicoline in acute ischemic stroke: drug surveil- lance study in 4,191 cases. Methods Find Exp Clin Pharmacol 2009;31:171-6.</p><p>Bolland K., Whitehead J., Cobo E.,Secades J.J. Evaluation of a sequential global test of improved recovery following stroke as applied to the ICTUS trial of citicoline. Pharm Stat 2009;8:136-49.</p><p>Secades J.J., Alvarez-Sabin J., Rubio F. et al. Citicoline in intracerebral haemorrhage: a dou- ble-blind, randomized, placebo-controlled, multi-centre pilot study. Cerebrovasc Dis 2006;21:380-5.</p><p>Alvarez X.A., Laredo M., Corzo D. et al. Citicoline improves memory performance in eld- erly subjects. Methods Find Exp Clin Pharmacol 1997;19:201-10.</p><p>Aronowski J., Strong R., Grotta J.C. Citicoline for treatment of experimental focal ischemia: histologic and behavioral outcome. Neurol Res 1996;18:570-4.</p><p>Petkov V.D., Kehayov R.A., Mosharrof A.H. et al. Effects of cytidine diphosphate choline on rats with memory deficits. Arzneimittelforschung 1993;43:822-8.</p><p>Lee H.J., Kang J.S., Kim Y.I. Citicoline pro- tects against cognitive impairment in a rat model of chronic cerebral hypoperfusion. J Clin Neurol 2009;5:33-8.</p><p>Fioravanti M., Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev 2005;(2):CD000269.</p><p>Zafonte R., Friedewald W.T., Lee S.M. et al. Citicoline Brain Injury Treatment (COBRIT) Trial: Design and Methods. J Neurotrauma 2009; Oct 5 [Epub ahead of print].</p></div><br /><div><p>Дамулин И.В., Парфенов В.А., Скоромец А.А., Яхно Н.Н. Нарушения кровообращения в головном и спинном мозге. В кн.: Болезни нервной системы. Руководство для врачей. Под ред. Н.Н. Яхно. М.: Медицина, 2005. Т.1, с. 232-303.</p><p>Инсульт: диагностика, лечение и профилактика. Под ред. З.А. Суслиной, М.А. Пирадова. М.: МЕДпресс-информ, 2008;288 с.</p><p>Adams H.P., del Zoppo G., Alberts M.J. et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 2007;38(5):1655-711.</p><p>European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis 2008;25:457-507.</p><p>Hacke W., Kaste M., Bluhmki E. et al. Trombolysis with alteplase 3 to 4,5 hours after acute ischemic stroke. N Engl J Med 2008;359:1317-29.</p><p>Lozano Fernandez R. Efficacy and safety of oral CDP-choline. Drug surveillance study in 2817 cases. Arzneimittelforschung 1983;33:1073-80.</p><p>Conant R., Schauss A.G. Therapeutic applications of citicoline for stroke and cognitive dysfunction in the elderly: a review of the literature. Altern Med Rev 2004;9:17-31.</p><p>Schabitz W.R., Weber J., Takano K. et al. The effects of prolonged treatment with citicoline in temporary experimental focal ischemia. J Neurol Sci 1996;138:21-5.</p><p>Hurtado O., Cаrdenas A., Pradillo J.M. et al. A chronic treatment with CDP-choline improves functional recovery and increases neuronal plas- ticity after experimental stroke. Neurobiol Dis 2007;26:105-11.</p><p>Andersen M., Overgaard K., Meden P. et al. Effects of citicoline combined with thrombolytic therapy in a rat embolic stroke model. Stroke 1999;30:1464-71.</p><p>Alonso de Lecinana M., Gutierrez M., Roda J.M. et al. Effect of combined therapy with thrombolysis and citicoline in a rat model of embolic stroke. J Neurol Sci 2006;247:121-9.</p><p>Shuaib A., Yang Y., Li Q. Evaluating the efficacy of citicoline in embolic ischemic stroke in rats: neuroprotective effects when used alone or in combination with urokinase. Exp Neurol 2000;161:733-9.</p><p>Tazaki Y., Sakai F., Otomo E. et al. Treatment of acute cerebral infarction with a choline precursor in a multicenter double-blind placebo-controlled study. Stroke 1988;19:211-6.</p><p>Clark W.M., Warach S.J., Pettigrew L.C. et al. A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group. Neurology 1997;49:671-8.</p><p>Clark W.M., Williams B.J., Selzer K.A. et al. A randomized efficacy trial of citicoline in patients with acute ischemic stroke. Stroke 1999;30:2592-97.</p><p>Clark W.M., Wechsler L.R., Sabounjian L.A., Schwiderski U.E. Citicoline Stroke Study Group. A phase III randomized efficacy trial of 2000 mg citicoline in acute ischemic stroke patients. Neurology 2001;57:1595-602.</p><p>Davalos A., Castillo J., Alvarez-Sabin J. et al. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials. Stroke 2002;33:2850-7.</p><p>Cho H.J., Kim Y.J. Efficacy and safety of oral citicoline in acute ischemic stroke: drug surveil- lance study in 4,191 cases. Methods Find Exp Clin Pharmacol 2009;31:171-6.</p><p>Bolland K., Whitehead J., Cobo E.,Secades J.J. Evaluation of a sequential global test of improved recovery following stroke as applied to the ICTUS trial of citicoline. Pharm Stat 2009;8:136-49.</p><p>Secades J.J., Alvarez-Sabin J., Rubio F. et al. Citicoline in intracerebral haemorrhage: a dou- ble-blind, randomized, placebo-controlled, multi-centre pilot study. Cerebrovasc Dis 2006;21:380-5.</p><p>Alvarez X.A., Laredo M., Corzo D. et al. Citicoline improves memory performance in eld- erly subjects. Methods Find Exp Clin Pharmacol 1997;19:201-10.</p><p>Aronowski J., Strong R., Grotta J.C. Citicoline for treatment of experimental focal ischemia: histologic and behavioral outcome. Neurol Res 1996;18:570-4.</p><p>Petkov V.D., Kehayov R.A., Mosharrof A.H. et al. Effects of cytidine diphosphate choline on rats with memory deficits. Arzneimittelforschung 1993;43:822-8.</p><p>Lee H.J., Kang J.S., Kim Y.I. Citicoline pro- tects against cognitive impairment in a rat model of chronic cerebral hypoperfusion. J Clin Neurol 2009;5:33-8.</p><p>Fioravanti M., Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev 2005;(2):CD000269.</p><p>Zafonte R., Friedewald W.T., Lee S.M. et al. Citicoline Brain Injury Treatment (COBRIT) Trial: Design and Methods. J Neurotrauma 2009; Oct 5 [Epub ahead of print].</p></div><br />

The authors declare that there are no conflicts of interest present.