Strategy of membrane protection in pharmacotherapy of vascular cognitive impairment

The article considers modern views on the problem of vascular cognitive dysfunction, in particular, on the nature and options of treatment of mild cognitive impairment syndrome as one of the most common forms of cognitive decline in the elderly and senile patients. From this point of view, the requirements for the selection of the optimal pharmacological tool for pharmacotherapy and pharmacoprophylaxis of this syndrome, especially the strategy of membrane protection, are analyzed. Particular attention is paid to the mechanisms of action and features of clinical use of Lira (citicoline) — a drug with unique clinical and pharmacological properties that allow implementing a strategy of pathogenetically sound neuro- and geroprotective pharmacotherapy in cerebrovascular disorders. Mechanisms of action, clinical efficacy of Lira (citicoline), safety characteristics and recommendations for practical use of the drug are considered in detail.

Efficacy and Safety of Citicoline to Prevent Cognitive Deficiency Progression in First-Degree Relatives of Patients with Alzheimer’s Disease: Prospective Study

Objective: study of the prolonged effects of a three-month course of therapy with citicoline, carried out three times for three years, to prevent the progression of cognitive deficit in 1st-degree relatives of patients with Alzheimer’s disease (AD).Study participants: the study involved first-degree relatives of patients with an established diagnosis of AD.Study design: an openlabel comparative three-year prospective study of the dynamics of cognitive status in two groups of relatives, one of whom received citicoline therapy (1st group), and the other did not (2nd group). The 1st group made up 48 relatives (11 — with mild cognitive impairment syndrome and 37 — with signs of minimal cognitive dysfunction). 32 relatives who had not received drug treatment for 3 years (8 of them had objectively confirmed signs of minimal cognitive dysfunction, in 24 people — cognitive functioning corresponded to the normal aging) were included to 2nd group. The groups did not have significant differences in demographic characteristics and distribution of the ApoE4(+) genotype carriers.Methods: clinical and psychological, psychometric, ApoE genotyping, statistical.Results: in the therapeutic group, a significant improvement in the cognitive status was found in 75.0% of the treated relatives with cognitive disfunction on most scales and tests, with the exception of the clock drawing test. In the group of relatives who did not receive drug therapy, there was a significant deterioration of cognitive functioning — in 2 cases with the formation of mild cognitive impairment syndrome, in 21 cases — with the appearance of minimal cognitive signs.Conclusion: the results of a three-year preventive course of citicoline therapy showed a significant positive effect of the drug on the cognitive status of the 1st degree relatives of AD patients who had signs of cognitive impairment that did not reach the level of dementia.