Citicoline for Vascular MCI
Susan London/IMNG Medical Media
Dr. Pietro Gareri
In the second trial, known as IDEALE, Dr. Pietro Gareri, a geriatrician with the Ambulatory Center for Dementia in Catanzaro, Italy, and his colleagues enrolled 349 patients in Italy at least 65 years of age who had evidence of vascular lesions on neuroradiologic imaging, and either an MMSE score of at least 21 or subjective memory complaints. (Those with probable Alzheimer’s disease were excluded.)
The patients were assigned in a 3:1 ratio to open-label treatment with citicoline (500 mg twice a day) or a control condition (no treatment).
"Citicoline has a number of different properties," Dr. Gareri explained. "For example, it inhibits apoptosis associated with cerebral ischemia. And it’s able to inhibit several models of neurodegeneration. It’s able to potentiate neuroplasticity. And it is a natural precursor of phospholipid synthesis."
Trial results showed a nonsignificant increase in MMSE scores over 6 months in the citicoline group (from 22.4 to 22.9), compared with a decrease in scores in the control group (from 21.5 to 19.6). Scores differed significantly between groups at 3 months and at 6 months.
Both groups had improvements in functional dependence, as assessed from activities of daily living and instrumental activities of daily living, with no significant between-group difference.
There was a trend toward better Geriatric Depression Scale scores with citicoline (P = .06). "This was not a surprise, because citicoline increases noradrenaline and dopamine levels in the central nervous system," Dr. Gareri commented. None of the patients experienced adverse events.
"Definitively, this study shows that citicoline is effective and safe. Therefore it can be recommended in vascular mild cognitive impairment," he concluded.
Neither Dr. Scheltens nor Dr. Gareri disclosed any relevant conflicts of interest.