Login Register Cart 0
Generic placeholder image

Reviews on Recent Clinical Trials

Editor-in-Chief

ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Opinion Article

The Importance of Citicoline in Combined Treatment in Dementia: What did the Citimem Study Teach us?

Author(s): Pietro Gareri*, Antonino Maria Cotroneo, Giuseppe Orsitto and Salvatore Putignano

Volume 16, Issue 2, 2021

Published on: 26 November, 2020

Page: [126 - 130] Pages: 5

DOI: 10.2174/1574887115999201126205538

Price: $65

Abstract

Background: Citicoline is a drug used both in degenerative and in vascular cognitive decline; memantine is a drug used for the treatment of mild to moderate Alzheimer’s disease (AD). Our hypothesis is that their combined use could have enhanced action in patients having AD and mixed dementia (MD). We report the main tips from a recent study on the use of these drugs, the CITIMEM study.

Methods: The study was retrospective and was performed on 126 patients aged 65 years old or older affected with AD or MD (mean age 80.7 ± 5.2 years old) who had been visited between 2015 and 2017 in four different centers for dementia all over Italy. Neuropsychological and functional tests were administered at baseline (T0), after 6 (T1), and 12 months (T2). The effects of combined treatment versus memantine alone on cognitive functions assessed by Mini-Mental State Examination (MMSE) and the possible onset of side effects or adverse events, as well as the influence on daily life functions and behavioral symptoms, were investigated.

Results: Patients undergoing combined treatment showed a significant increase in MMSE vs. memantine alone, both at T1 (p=0.003) and T2 (p =0.000).

Conclusion: The CITIMEM study confirms our hypothesis that the combined administration of memantine plus citicoline is safe and more effective than memantine alone on cognition in patients suffering from AD or MD.

Keywords: Citicoline, memantine, cholinergic precursor, alzheimer’s disease, mixed dementia, old people, combined treatment.

« Previous Next »
Graphical Abstract

[1]
World Alzheimer Report 2019; Attitudes to dementia.. 2019; 5-166.
[2]
Cotroneo AM, Castagna A, Putignano S, et al. Effectiveness and safety of citicoline in mild vascular cognitive impairment: the IDEALE study. Clin Interv Aging 2013; 8: 131-7.
[PMID: 23403474]
[3]
Castagna A, Cotroneo AM, Ruotolo G, Gareri P. The CITIRIVAD Study: CITIcoline plus RIVAstigmine in Elderly Patients Affected with Dementia Study. Clin Drug Investig 2016; 36(12): 1059-65.
[http://dx.doi.org/10.1007/s40261-016-0454-3] [PMID: 27587069]
[4]
Gareri P, Castagna A, Cotroneo AM, et al. The Citicholinage Study: Citicoline Plus Cholinesterase Inhibitors in Aged Patients Affected with Alzheimer’s Disease Study. J Alzheimers Dis 2017; 56(2): 557-65.
[http://dx.doi.org/10.3233/JAD-160808] [PMID: 28035929]
[5]
Gareri P, Castagna A, Cotroneo AM, Putignano S, De Sarro G, Bruni AC. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives. Clin Interv Aging 2015; 10: 1421-9.
[http://dx.doi.org/10.2147/CIA.S87886] [PMID: 26366063]
[6]
Secades JJ, Lorenzo JL. Citicoline: pharmacological and clinical review, 2006 update. Methods Find Exp Clin Pharmacol 2006; 28(Suppl. B): 1-56.
[PMID: 17171187]
[7]
García-Cobos R, Frank-García A, Gutiérrez-Fernández M, et al. Citicoline, use in cognitive decline: vascular and degenerative. J Neurol Sci 2010; 299(1-2): 188-92.
[8]
Secades JJ, Frontera G. CDP-choline: pharmacological and clinical review. Methods Find Exp Clin Pharmacol 1995; 17(Suppl. B): 1-54.
[PMID: 8709678]
[9]
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; 18(2): CD000269.
[http://dx.doi.org/10.1002/14651858.CD000269.pub3] [PMID: 15846601]
[10]
Hurtado O, Lizasoain I, Moro MÁ. Neuroprotection and recovery: recent data at the bench on citicoline. Stroke 2011; 42(1)(Suppl.): S33-5.
[http://dx.doi.org/10.1161/STROKEAHA.110.597435] [PMID: 21164125]
[11]
Cacabelos R, Takeda M, Winblad B. The glutamatergic system and neurodegeneration in dementia: preventive strategies in Alzheimer’s disease. Int J Geriatr Psychiatry 1999; 14(1): 3-47.
[http://dx.doi.org/10.1002/(SICI)1099-1166(199901)14:1<3::AID-GPS897>3.0.CO;2-7] [PMID: 10029935]
[12]
Dubois B, Feldman HH, Jacova C, et al. Revising the definition of Alzheimer’s disease: a new lexicon. Lancet Neurol 2010; 9(11): 1118-27.
[http://dx.doi.org/10.1016/S1474-4422(10)70223-4] [PMID: 20934914]
[13]
Rinaldi P, Mecocci P, Benedetti C, et al. Validation of the five-item geriatric depression scale in elderly subjects in three different settings. J Am Geriatr Soc 2003; 51(5): 694-8.
[http://dx.doi.org/10.1034/j.1600-0579.2003.00216.x] [PMID: 12752847]
[14]
Gareri P, Cotroneo AM, Orsitto G, Putignano S. The CITIMEM study: A pilot study. Optimizing pharmacological treatment in dementia. Arch Gerontol Geriatr 2020; 89: 104073.
[http://dx.doi.org/10.1016/j.archger.2020.104073] [PMID: 32447126]
[15]
Martynov MY, Gusev EI. Current knowledge on the neuroprotective and neuroregenerative properties of citicoline in acute ischemic stroke. J Exp Pharmacol 2015; 7: 17-28.
[http://dx.doi.org/10.2147/JEP.S63544] [PMID: 27186142]
[16]
Adibhatla RM, Hatcher JF, Dempsey RJ. Effects of citicoline on phospholipid and glutathione levels in transient cerebral ischemia. Stroke 2001; 32(10): 2376-81.
[http://dx.doi.org/10.1161/hs1001.096010] [PMID: 11588329]
[17]
Secades JJ, Frontera G. CDP-choline: pharmacological and clinical review. Methods Find Exp Clin Pharmacol 1995; 17(Suppl. B): 1-54.
[PMID: 8709678]
[18]
Secades JJ. Citicoline in the Treatment of Cognitive Impairment. J Neurol Exp Neurosci 2019; 5(1): 14-26.
[http://dx.doi.org/10.17756/jnen.2019-047]
[19]
Hurtado O, Moro MA, Cárdenas A, et al. Neuroprotection afforded by prior citicoline administration in experimental brain ischemia: effects on glutamate transport. Neurobiol Dis 2005; 18(2): 336-45.
[http://dx.doi.org/10.1016/j.nbd.2004.10.006] [PMID: 15686962]
[20]
Krupinski J, Abudawood M, Matou-Nasri S, et al. Citicoline induces angiogenesis improving survival of vascular/human brain microvessel endothelial cells through pathways involving ERK1/2 and insulin receptor substrate-1. Vasc Cell 2012; 4(1): 20.
[http://dx.doi.org/10.1186/2045-824X-4-20] [PMID: 23227823]
[21]
Hurtado O, Hernández-Jiménez M, Zarruk JG, et al. Citicoline (CDP-choline) increases Sirtuin1 expression concomitant to neuroprotection in experimental stroke. J Neurochem 2013; 126(6): 819-26.
[http://dx.doi.org/10.1111/jnc.12269] [PMID: 23600725]
[22]
Hurtado O, Cárdenas A, Pradillo JM, et al. A chronic treatment with CDP-choline improves functional recovery and increases neuronal plasticity after experimental stroke. Neurobiol Dis 2007; 26(1): 105-11.
[http://dx.doi.org/10.1016/j.nbd.2006.12.005] [PMID: 17234423]
[23]
Gutiérrez-Fernández M, Rodríguez-Frutos B, Fuentes B, et al. CDP-choline treatment induces brain plasticity markers expression in experimental animal stroke. Neurochem Int 2012; 60(3): 310-7.
[http://dx.doi.org/10.1016/j.neuint.2011.12.015] [PMID: 22226841]
[24]
Zhuravin IA, Nalivaeva NN, Kozlova DI, et al. The activity of blood serum cholinesterases and neprilysin as potential biomarkers of mild-cognitive impairment and Alzheimer’s disease. Zh Nevrol Psikhiatr 2015; 11: 77-85.
[http://dx.doi.org/10.17116/jnevro2015115112110-117]
[25]
D’Orlando KJ, Sandage BW Jr. Citicoline (CDP-choline): mechanisms of action and effects in ischemic brain injury. Neurol Res 1995; 17(4): 281-4.
[http://dx.doi.org/10.1080/01616412.1995.11740327] [PMID: 7477743]

Rights & Permissions Print Cite
Article Metrics
35
© 2024 Bentham Science Publishers | Privacy Policy