The role of citicoline in the treatment of dyscirculatory encephalopathy and vascular cognitive impairment
Abstract
Vascular cognitive impairment (VCI) is the main manifestation of dyscirculatory encephalopathy (DEP). According to the severity of cognitive impairment, Stage I DEP corresponds to mild (subjective) cognitive impairment; stage II DEP to moderate cognitive impairment; stage III DEP to severe cognitive impairment or vascular dementia. VCI is diagnosed on the basis of cognitive impairment, the clinical and neuroimaging findings confirming the presence of cerebrovascular disease, and the neuropsychological study results indicating a cognitive defect.
Citicoline is one of the most widely used nootropic drugs for cerebrovascular pathology. The treatment of VCI involves the prevention of stroke and progressive chronic cerebrovascular disease (CCVD) and the use of drugs improving cognitive functions.
Citicoline is one of the most widely used nootropic drugs for cerebrovascular disease. This drug was synthesized in Japan to treat stroke, then it became widely used in different countries in patients with CCVD and VCI. The data of clinical trials and a Cochrane systematic review prove the efficacy and safety of citicoline in the elderly and senile patients.
Citicoline is one of the most widely used nootropic drugs for cerebrovascular pathology. The treatment of VCI involves the prevention of stroke and progressive chronic cerebrovascular disease (CCVD) and the use of drugs improving cognitive functions.
Citicoline is one of the most widely used nootropic drugs for cerebrovascular disease. This drug was synthesized in Japan to treat stroke, then it became widely used in different countries in patients with CCVD and VCI. The data of clinical trials and a Cochrane systematic review prove the efficacy and safety of citicoline in the elderly and senile patients.
About the Author
V. A. Golovacheva
Department of Nervous System Diseases and Neurosurgery, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021, Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021, Russia
References
1. Parfenov VA. Distsirkulyatornaya entsefalopatiya i sosudistye kognitivnye rasstroistva [Dyscirculatory encephalopathy and vascular cognitive disorders]. Moscow: IMA-PRESS; 2017. 128 p.
2. Parfenov VA. Diagnosis and treatment of chronic cerebrovascular disease, use of pentoxifylline. Nevrologiya, nei?ropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2016;8(3):4–9. (In Russ.)]. doi: 10.14412/2074-2711-2016-3-4-9
3. International statistical classification of diseases and problems related to health. Tenth revision. (IDC-10). Geneva; 1995.
4. Shmidt EV. Classification of vascular lesions of the brain and spinal cord. Zhurnal nevropatologii i psikhiatrii im. S.S. Korsakova. 1985;85(9):1281-8. (In Russ.).
5. Parfenov VA, Zakharov VV, Preobrazhenskaya IS. Kognitivnye rasstroistva [Cognitive disorders]. Moscow: Remedium; 2014. 224 p.
6. Hachinski V. Vascular dementia: radical re-definition. In: Carlson LA, Gottfties SG, Winblad B, editors. Vascular dementia: ethiology, pathogenesis and clinical aspects. Basel: S. Karger; 1994. P. 2-4.
7. Graff-Radford J. Vascular Cognitive Impairment. Continuum (Minneap Minn). 2019 Feb;25(1): 147-164. doi: 10.1212/CON.0000000000000684.
8. WHO Dementia (2017). http://www.who.int/media centre/facts heets/fs362/en/.
9. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association. American Stroke Association. Stroke. 2011 Sep;42(9):2672-713. doi: 10.1161/STR.0b013e3182299496. Epub 2011 Jul 21.
10. Michel JP. Is possible to delay or prevent agerelated cognitive decline? Korean J Fam Med. 2016 Sep;37(5):263-6. doi: 10.4082/kjfm.2016.37.5.263. Epub 2016 Sep 21..
11. Verbitskaya SV, Parfenov VA, Reshetnikov VA, et al. Post-stroke cognitive impairment (results of a 5-year follow-up). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(1):37–42. (In Russ.). doi: 10.14412/2074-2711-2018-1-37-42
12. Parfenov VA, Lokshina AB, Grishina DA, et al. The use of naftidrofuryl at moderate vascular cognitive disorders. Meditsinskii sovet. 2017;(1S): 22-6. (In Russ.)
13. Parfenov VA, Zhivolupov SA, Zakharov VV, et al. Chronic cerebrovascular diseases: use of vinpocetine in neurological practice (Round Table proceedings). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):139–45. (In Russ.) doi: 10.14412/2074-2711-2018-4-139-145
14. Roman GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993 Feb;43(2):250-60.
15. Sposato LA, Kapral MK, Fang J, et al. Declining incidence of stroke and dementia: Coincidence or prevention opportunity? JAMA Otolaryngol Head Neck Surg. 2015 May 1;141(5): 428. doi: 10.1001/jamaoto.2015.0540.
16. Levi Marpillat N, Macquin-Mavier I, Tropeano AI, et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens. 2013 Jun;31(6):1073-82. doi: 10.1097/HJH.0b013e3283603f53.
17. Peng J, Lu F, Wang Z, et al. Excessive lowering of blood pressure is not beneficial for progression of brain white matter hyperintensive and cognitive impairment in elderly hypertensive patients: 4-year follow-up study. J Am Med Dir Assoc. 2014 Dec; 15(12):904-10. doi: 10.1016/j.jamda.2014.07.005. Epub 2014 Sep 18.
18. Parfenov VA Vascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3S):61–7. (In Russ.). doi: 10.14412/2074-2711-2019-3S-61-67
19. Henry G, Williamson D, Tampi RR. Efficacy and tolerability of antidepressants in the treatment of behavioral and psychological symptoms of dementia, a literature review of evidence. Am J Alzheimers Dis Other Demen. 2011 May;26(3):169-83. doi: 10.1177/1533317511402051. Epub 2011 Mar 23.
20. Herrmann N, Lanctot KL, Hogan DB. Pharmacological recommendations for the symptomatic treatment of dementia: the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia 2012. Alzheimers Res Ther. 2013 Jul 8;5(Suppl 1):S5. doi: 10.1186/alzrt201. Epub 2013 Jul 8.
21. Pizzi C, Rutjes AW, Costa GM, et al. Metaanalysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease. Am J Cardiol. 2011 Apr 1;107(7):972-9. doi: 10.1016/j.amjcard.2010.11.017. Epub 2011 Jan 20.
22. Hausner L, Frö lich L. Antidementia drug therapy of Alzheimer's dementia: Status 2018 and Outlook. Dtsch Med Wochenschr. 2019 Feb;144(3): 156-160. doi: 10.1055/a-0658-6720. Epub 2019 Jan 31.
23. Secades JJ, Frontera G. CDP-choline: pharmacological and clinical review. Methods Find Exp Clin Pharmacol. 1995 Oct;17 Suppl B:1-54.
24. 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 Apr 18;(2):CD000269.
25. Hurtado O, Lizasoain I, Moro MA. Neuroprotection and recovery: recent data at the bench on citicoline. Stroke. 2011 Jan;42(1 Suppl): S33-5. doi: 10.1161/STROKEAHA.110.597435. Epub 2010 Dec 16.
26. Gareri P, Castagna A, Cotroneo AM, et al. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives. Clin Interv Aging. 2015 Sep 3;10:1421-9. doi: 10.2147/CIA.S87886. eCollection 2015.
27. Fioravanti M, Yanagi M. 2005. Cytidinediphosphocholine (CDP choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2004;(2):CD000269.
28. Secades JJ. Citicoline in the Treatment of Cognitive Impairment. J Neurol Exp Neurosci. 2019;5(1):14-26. doi: 10.17756/jnen.2019-047
29. CotroneoAM, CastagnaA, PutignanoS, et al. Effectiveness and safety of citicoline in mild vascular сognitive impairment: the IDEALE study. Clin Interv Aging. 2013;8:131-7. doi: 10.2147/CIA.S38420. Epub 2013 Feb 5.
30. Alvarez-Sabin J, Ortega G, Jacas C, et al. Long-term treatment with citicoline may improve poststroke vascular cognitive impairment. Cerebrovasc Dis. 2013;35(2):146-54. doi: 10.1159/000346602. Epub 2013 Feb 7.
31. Alvarez-Sabin J, Santamarina E, Maisterra O, et al. Long-term treatment with citicoline prevents cognitive decline and predicts a better quality of life after a first ischemic stroke. Int J Mol Sci. 2016 Mar 16;17(3):390. doi: 10.3390/ijms17030390.
Review
Supporting agencies: This article has been supported by OZON Pharmaceuticals.
For citations:
Golovacheva V.A. The role of citicoline in the treatment of dyscirculatory encephalopathy and vascular cognitive impairment. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(2):119-124. (In Russ.) https://doi.org/10.14412/2074-2711-2020-2-119-124
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