[A multicenter observation study of the efficacy of cortexin and recognan (citicoline) in the treatment of cognitive impairments in chronic cerebrovascular pathology]

[Recognan (citicoline) efficacy and safety in cognitive impairment correction of various nosological forms]

Insufficiency of a choline derivative (acetylcholine) can lead to the development of cognitive impairment (CI). One of the most well-known and well-studied medical drugs (MD) containing choline and having neuroprotective properties is citicoline (Recognan). A number of studies have demonstrated the effectiveness of Recognan in relation to mild CI, chronic cerebrovascular diseases (CVD), acute vascular disorders (including post-traumatic genesis). Recognan improves memory and other cognitive functions in healthy young people against the background of asthenia due to stress or increased cognitive and emotional stress or infection, and also has a preventive effect on fading cognitive functions in the process of age-related changes. The duration of neuroprotection can reach 6 months or more - up to 12 months, depending on the patient's condition. Therapy regimens include two-stage Recognan prescribing: with CVD intramuscularly (i/m) at 1000 mg /d for 30 days, in the acute period of ischemic stroke, i/m or intravenously (i/v) at 1000 mg every 12 hours from the first day after diagnosis, 3-5 days after the start of therapy, with preservation functions of swallowing, it is possible to switch to per oral (p/o) drug administration.

[The effect of the use of the drug recognan (citicoline) on the state of higher mental functions in patients with mild cognitive impairment]

OBJECTIVE

The aim of the observational program was to study the effect of the use of the drug recognan (citicoline) on the state of higher mental functions (memory, attention, visual-motor coordination, dynamic praxis,verbal thinking and imagination) in patients with mild cognitive impairment.

MATERIAL AND METHODS

A survey of 54 subjects (16 of them male and 38 female) aged 18-50 years (average age 28.5±10.5 years) was conducted with a diagnosis of «Mild cognitive impairment» («F06.7»). The group was randomized into 2 subgroups: the main subgroup (26 people) received oral therapy with the drug Recognan, for 30 days, with the daily dosage of the drug being 500 mg. In the control group (28 people), nootropic drug therapy was not performed. Standard psychometric techniques were used to study higher mental functions. All subjects were examined three times (initially, in the middle of the study - on day 15, at the end of the study - on day 30).

RESULTS AND CONCLUSION

After 2 weeks of treatment with recognan, there was an improvement in concentration in 81.9%, memory in 50% (p=0.008), verbal imagination productivity in 68.2% (p=0.015), counting functions in 60% (p=0.015), visual-motor coordination and dynamic praxis - in 86.4% (p=0.003), increased speed and efficiency of mental work (p=0.001). After a 30-day course of treatment with recognan, there was an improvement in memory in 58.3% of patients (p=0.007), an increase in concentration in 64%, an improvement in counting functions in 64.3% (p=0.011), verbal imagination productivity in 63.3%, visual-motor coordination and dynamic praxis in 86.4% (p=0.007), speed and efficiency of mental work (p=0.006), which indicates a complex positive effect of recognan on higher mental functions in patients with mild cognitive impairment cognitive impairment.

Transcriptomics- and metabolomics-based integration analyses revealed the potential pharmacological effects and functional pattern of in vivo Radix Paeoniae Alba administration

Background

Radix Paeoniae Alba (RPA) and other natural medicines have remarkable curative effects and are widely used in traditional Chinese Medicine (TCM). However, due to their multi-component and multi-target characteristics, it is difficult to study the detailed pharmacological mechanisms for those natural medicines in vivo. Therefore, their real effects on organisms is still uncertain.

Methods

RPA was selected as research object, the present study was designed to study the complex mechanisms of RPA in vivo by integrating and interpreting the transcriptomic based RNA-seq and metabolomic based NMR spectrum after RPA administration in mice. A variety of dimension-reduction algorithms and classifier models were applied to the processing of high-throughput data.

Results

Among serum metabolites, the contents of PC and glucose were significantly increased, while the contents of various amino acids, lipids and their metabolites were significantly decreased in mice after RPA administration. Based on the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases, differential analysis showed that the liver was the site where RPA exerted a significant effect, which confirmed the rationality of “meridian tropism” in the theory in TCM. In addition, RPA played a role in lipid metabolism by regulating genes encoding enzymes of the glycerolipid metabolism pathway, such as 1-acyl-sn-glycerol-3-phosphate acyltransferase (Agpat), phosphatidate phosphatase (Lpin), phospholipid phosphatase (Plpp) and endothelial lipase (Lipg). We also found that RPA regulates several substance addiction pathways in the brain, such as the cocaine addiction pathway, and the related targets were predicted based on the sequencing data from pathological model in the GEO database. The overall effective pattern of RPA was intuitively presented with a multidimensional radar map through a self-designed model which found that liver and brain were mainly regulated by RPA compared with the traditional meridian tropism theory.

Conclusions

Overall this study expanded the potential application of RPA and provided possible targets and directions for further mechanism study, meanwhile, it also established a multi-dimensional evaluation model to represent the overall effective pattern of TCM for the first time. In the future, such study based on the high-throughput data sets can be used to interpret the theory of TCM and to provide a valuable research model and clinical medication reference for the TCM researchers and doctors.

[Current treatment options for autonomic, cognitive and emotional disorders in patients with asthenic syndrome treated with recognan (citicoline)]

AIM

To study the efficacy of recognan (citicoline) in the treatment of cognitive, emotional, autonomic, asthenic disorders in patients with asthenic syndrome.

MATERIAL AND METHODS

Thirty-eight subjects (17 men and 41 women), mean age 27.75±12.05 years, with asthenic syndrome (ICD-10 F48.0 - Neurasthenia) were studied. The sample was randomized into 2 subgroups: the main group (n=20) received oral therapy with recognan (100 mg in 1 ml) for 30 days, while the daily dosage was 500 mg (5 ml). In the control group (n=18), no drug therapy was performed. Patient's state was assessed with a large battery of psychological tests and psychometric scales. The follow-up period was 30 days. All participants were examined three times (initially, in the middle of the study (day 15), in the end of the study (day 30)).

RESULTS AND CONCLUSION

Asthenic syndrome was detected in 100% of the patients (total asthenia was noted in 70%, decreased activity in 70%, decreased motivation in 40%, physical asthenia in 45%, mental asthenia in 50%). Recognan (citicoline), used for 2 weeks or one month, has a positive effect on the compensation of autonomic, asthenic cognitive and emotional disorders and increases stress resilience of the patients.