Citicoline preserves memory in dementia

August 1, 2012 (Vancouver, British Columbia) — The dietary supplement citicoline, which is sold over the counter in 70 different countries, including the United States, appears to help memory in patients with vascular mild cognitive impairment (VaMCI) and may hinder cognitive deterioration, new research suggests.

Preliminary results from a longitudinal study presented here at the Alzheimer’s Association International Conference (AAIC) 2012 showed that at 9 months, there was a significant difference in Mini–Mental State Examination (MMSE) scores in citicoline users vs nonusers.

To assess the safety and efficacy of citicoline in elderly individuals with VaMCI, the investigators conducted a multicenter study of 349 participants — 265 in the active treatment group and 84 control participants — aged 65 years and older who had an MMSE score of ≥21, or subjective memory complaints with no evidence of deficits on MMSE, or evidence of vascular lesions on neuroradiology.

Those in the active treatment group received oral citicoline at a dose of 500 mg twice a day.

Study outcomes included improvement in MMSE scores, ADL, and instrumental activities of daily living (IADL) compared with control participants.  Mood was measured using the geriatric depression scale (GDS), and behavioral disorders were assessed by use of the Neuropsychiatric Inventory scale.  All participants underwent brain imaging by computerized tomography or magnetic resonance imaging. In addition, they underwent assessment of vitamin B12 and folate levels and thyroid function at baseline and at 3, 6, and 9 months.

Boost in Mood

The researchers found that after 9 months, those in the active treatment group showed a slight but nonsignificant benefit in MMSE scores (22.4 at baseline, 22.9 after 9 months).  However, for those in the untreated control group, MMSE scores declined (21.5 at baseline, 19.6 at 9 months), and this difference was statistically significant.  The researchers found no difference between the 2 groups in ADL and IADL scores. In addition, no adverse events were recorded.

Alzheimer’s Association International Conference (AAIC) 2012. Developing Topics Sessions Presentation 04-12-05. Presented July 18, 2012.

Dr. Reinhardt’s comments:  Citicoline (cytidine 5′diphosphocholine) is a naturally occurring, water soluble, biological compound that is an essential intermediate for the synthesis of phosphatidylcholine, a major constituent of the grey matter of brain tissue (30%). It is metabolized to yield the free nucleotide cytidine and choline.

Citicoline counteracts neuronal degeneration and reduces the number of apoptotic cells present. Citicoline supplementation also improves memory retention.  Citicoline is approved for treatment in cases of head trauma, stroke, and neurodegenerative disease in Japan and Europe.

Research demonstrates that citicoline consumption promotes brain metabolism by enhancing the synthesis of acetylcholine, restoring phospholipid content in the brain, and regulation of neuronal membrane excitability.  It increases dopamine receptor densities, helps improve focus and mental energy and may possibly be useful in the treatment of attention deficit disorder.

Citicoline improves visual function in patients with glaucoma, amblyopia, and non-arteritic ischaemic optic neuropathy.  citicoline increases brain dopamine levels and reduces cravings.[16] In the general population citicoline increases brain responses to food stimuli, specifically in the amygdala, insula, and lateral orbitofrontal cortex, which correlate with decreased appetite.  Citicoline reduces oxidative stress. It also prevents excessive inflammatory response in the brain by inhibiting the release of free fatty acids and decreasing blood–brain barrier breakdown.  It is suggested that the neuroprotective effects of citicoline after a stroke are due in part to citicoline’s ability to decrease levels of glutamate in the brain.  Citicoline has a very low toxicity profile in animals and humans. Clinically it doses of 2000 mg per day have been observed and approved. Minor transient adverse effects are rare and most commonly include stomach pain and diarrhea.