Cholinergic precursors have represented the first approach to counter cognitive impairment occurring in adultonset
dementia disorders. These compounds were early leaved because their clinical efficacy was not clearly demonstrated.
This is probably not true for some choline-containing phospholipids including choline alphoscerate. Choline alphoscerate
increases the release of acetylcholine in rat hippocampus, facilitates learning and memory in experimental
animals, improves brain transduction mechanisms and decreases age-dependent structural changes occurring in rat brain
areas involved in learning and memory. The compound exerts neuroprotective effects in models of altered cholinergic
neurotransmission and of brain vascular injury. In clinical studies choline alphoscerate improved memory and attention
impairment, as well as affective and somatic symptoms in dementia disorders. An ongoing trial indicates that association
between the acetylcholinesterase inhibitor donepezil and choline alphoscerate is accompanied by an improvement in several
cognitive tests superior to that induced by donepezil alone. It is suggested that this association may represent a therapeutic
option to prolong beneficial effects of cholinergic therapies in Alzheimer’s disease patients with concomitant
ischemic cerebrovascular disorders. In summary, choline alphoscerate has significant effects on cognitive function with a
good safety profile and tolerability. Although limited both in terms of size of the samples investigated and of the length of
treatment, preclinical and clinical results presented suggest that cognitive enhancing capabilities of choline alphoscerate
merit of being further investigated in appropriate trials.
Keywords: Adult-onset dementia, choline alphoscerate, cholinergic neurotransmission, clinical trials, preclinical studies.
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