Preview

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

Advanced search

A neurotropic approach to the treatment of multi-infarct dementia using l-a-glycerylphosphorylcholine

Abstract

A multicenter, unblinded, randomized, controlled clinical trial was conducted to evaluate the efficacy and tolerability of L-aglycerylphosphorylcholine (L-a-GPC) 1 gm/day IM compared with that of cytidine diphosphocholine (CDP-choline) 1 gm/day IM in 112 patients with mild to moderate multi-infarct dementia. A 90-day treatment period with the test drug was followed by a 90-day follow-up period without treatment to observe how long the results obtained with treatment could be maintained. A total of 97 patients completed the treatment period; of these, 73 completed the follow-up period. Eighteen patients did not complete the study because of poor compliance, and 21 patients at one center were not followed up. Treatments were started after a 2-week washout period during which other drugs that could affect cognitive function were withdrawn. Clinical efficacy was evaluated by comparing the results at baseline, after 30 days, at the end of treatment, and at the end of the follow-up period on the following psychometric tests: the Sandoz Clinical Assessment Geriatric (SCAG) Rating Scale, the Blessed Dementia Scale, the Blessed Information, Memory, Concentration test, the Wechsler Memory Scale (WMS), the Rapid Disability Rating Scale 2 (RDRS 2), the Word Fluency test, the Token test, and the Simple Drawing Copy (SDC). The patients receiving L-a-GPC showed a significant improvement of cognitive functions, behaviour, and personality at the end of the treatment, compared with baseline values. This improvement was still apparent at the end of the follow-up period. A comparison of the results obtained with L-a-GPC and CDP-choline shows that the performance of the patients treated with L-a-GPC was significantly better than that of the CDP-choline group on the Blessed Dementia Scale, WMS, RDRS 2, and SDC at the end of treatment and on the Blessed Dementia Scale, WMS, SCAG, and Token test at the end of the follow-up period.

About the Authors

Alberto Muratorio
Istituto di Clinica Neurologica, Universita di Pisa
Russian Federation


Ubaldo Bonuccelli
Istituto di Clinica Neurologica, Universita di Pisa
Russian Federation


Angelo Nuti
Istituto di Clinica delle Malattie Nervose e Mentali, Universita di Siena
Russian Federation


Noe Bavpistini
Istituto di Clinica delle Malattie Nervose e Mentali, Universita di Siena
Russian Federation


Stefano Passero
Istituto di Clinica delle Malattie Nervose e Mentali, Universita di Siena
Russian Federation


Vittoria Caruso
Istituto di Clinica delle Malattie Nervose e Mentali, Universita di Siena
Russian Federation


Barbara Batani
Centro di Geriatria Fraticini, I.N.R.C.A., Firenze
Russian Federation


Alberto Baroni
Centro di Geriatria Fraticini, I.N.R.C.A., Firenze
Russian Federation


Federico Mayer
Centro di Geriatria Fraticini, I.N.R.C.A., Firenze
Russian Federation


Tiziana Sorbi
Centro di Geriatria Fraticini, I.N.R.C.A., Firenze
Russian Federation


Attilio Franciosi
Servizio di Neurologia, Ospedale Civile di Arzignano
Russian Federation


Gianni Moro
Servizio di Neurologia, Ospedale Civile di Arzignano
Russian Federation


Luciano Agostini
Clinica Neurologica, Universita di Perugia
Russian Federation


Massimo Piccirilli
Clinica Neurologica, Universita di Perugia
Russian Federation


Diana Scatozza
Direzione Medico Scientifica, Italfarmaco S.p.A
Russian Federation


References

1. Govoni S., Battaini F., Lopez C.M. etal. Effetto antiamnesico di alfa-glicerilfosforilcolina: partecipazione di neuroni colinergici e non colinergici // Basi Raz. Ter. 1991; 21 (Suppl. 2): 59

2. Loeb С. Vascular dementia //Dementia. 1990; 1:175-184.

3. Loeb C. Clinical criteria for the diagnosis of vascular dementia // Eur. Neurol. 1988; 28: 87-92.

4. Carlsson A. Brain neurotransmitters in ageing and dementia: Similar changes across diagnostic dementia groups // Gerontology. 1987; 33: 159-167.

5. De Feudis F.V. Central cholinergic system, cholinergic drugs and Alzheimer’s disease. An overview // Drugs Today. 1988; 24: 473-490.

6. Wesnes K., Simpson P., KiddA. An investigation of the range of cognitive impairments induced by scopolamine 0.6 mg s.c. // Hum. Psychopharmacol. 1988; 3: 27-41.

7. Cohen E.L., Wurtmann R.J. Brain acetyl choline increase after systemic choline administration //Life Sci. 1975; 16:1095-1102.

8. Schmidt D.E., Wecker L. Central nervous system effects of choline administration evidence for temporal dependence // Neuro-pharmacology. 1981; 20: 535-539.

9. Wecker L., Schmidt D.E. Central cholinergic function in the rat relationship to choline administration // Life Sci. 1979; 25: 375-384.

10. Wecker L., Goldberg A.M. // International symposium on cholinergic mechanisms. - New York: Plenum Press, 1981.

11. Missale C., Sigala S., RizzonelliP., SpanoP.F. Trasmissione colinergica nelratto dopo trattamento acuto e cronico con a-GFC//

12. Basi Raz. Ter. 1991; 21 (Suppl. 2): 23-26.

13. Imperato A., Zocchi A., Angelucci L. Studio «in vivo» degli effetti e delmeccanismo dazione di colina alfoscerato sulla trasmis-sione colinergica striatale ed ippocampale // Basi Raz. Ter. 1991; 21 (Suppl. 2): 15-22.

14. Canal N., Franceschi M., De Moliner P., Castiglioni С. Ef-fetti di colina alfoscerato nella prevenzione delle amnesie indotte da scopolamina e benzodiazepina//Basi Raz. Ter. 1991; 21 (Suppl. 2): 75-78.

15. Loeb C., Gandolfo С. Diagnostic evaluation of degenerative and vascular dementia // Stroke. 1983; 14: 399-401.

16. Hachinski V.C., Lassen H.A., Marschal J. Multiinfarct dementia, a cause of mental deterioration in the elderly // Lancet. 1974; 2: 207-209.

17. Folstein M.F., Folstein S.E., McHug P.R. Mini Mental State // J. Psychiatr. Res. 1975; 12:189-198.

18. Hamilton M. A rating scale for depression // J. Neurol. Neurosurg. Psychiatr. 1960; 23: 56-62.

19. Reisberg B., Ferris S.H., De Leon M.J. et al. The Global Deterioration Scale for assessment of primary degenerative dementia // Am. J. Psychiatry. 1982; 139:1136-1139.

20. Blessed G., Tomlinson B.E., Roth M. The association between quantitative measures of dementia and senile changes in the cerebral grey matter of elderly subjects // Br. J. Psychiatry. 1968; 114: 797-811.

21. Venn R.D. The Sandoz Clinical Assessment Geriatric (SCAG) Scale // Gerontology. 1983; 29: 185-198.

22. Wechsler D. A standardized memory scale for clinical use // J. Psychol. 1945; 19: 87-95.

23. Barbizet J., Duizabo J., Flavigny R. Role des lobes Frontaux dans le langage. Un etude neuropsychologique experimentale//Rev. Neurol. 1975; 131: 525-544.

24. De Renzi E., Vignolo L.A. The Token test: A sensitive test to detect receptive disturbances in aphasia // Brain. 1962; 85: 665-678.

25. Arrigoni C., De Rossi E. Constructional apraxia and hemispheric locus of lesion // Cortex. 1964; 1: 170-197.

26. Linn M.W., Linn B.S. The Rapid Disability Rating Scale-2// J. Am. Geriatr. Soc. 1982; 30:378-382.

27. Scheinberg P. Dementia due to vascular disease. A multifacto-rial disorder// Stroke. 1988; 19:12911299.

28. Diagnosis and treatment of old age dementias // Ban Т.А., Lehmann H.E. (eds). Modern problems in pharmacopsychiatry. - Vol. 23. - Basel: Karger, 1989. - 1-20.

29. Spinnler H., Tognoni G. Standardizzzazione e taratura italiana di test neuropsicologici // Ital. J. Neurol. Sci. 1987; 6 (Suppl. 8): 8-20.

30. Moglia A., Arrigo A., Bono G. et al. Citicoline in patients with chronic cerebrovascular disease (CCVD): Quantitative EEG study// Curr. Ther. Res. 1984; 36: 309-313.

31. Motta L., Fichera G., Tiralosi G. et al. La citicolina nel trattamento delle cerebrovasculopatie croniche // G. Gerontol. 1984; 32: 753-754.

32. Cucinotta D., Romagnoli S., Godoli G. et al. Comparison of sulfomucopolysaccharides andcytidine diphosphocholine in the treatment of multi-infarct dementia // Curr. Ther. Res. 1988; 43:12-20.

33. Canonico P.L., Nicoletti F., Scapagnini U. Effetti neurochi-mici e comportamentali di a-GFC (colina alfoscerato)//Basi Raz. Ter. 1990; 20 (Suppl. 1): 53.

34. Drago F., D’Agata V., Nardo L. et al. Effetti comportamentali di a-GFC in modelli di interazione farmacologica // Basi Raz. Ter. 1991; 21 (Suppl. 2): 67-70.

35. Schettini G., Florio T., Ventura C. et al. Effetto del trattamen-to prolungato con a-GFC (colina alfoscerato) sull′apprendimento, sulla memoria e sulla trasduzione del segnale recettoriale in animali giovani e invecchiati // Basi Raz. Ter. 1991; 21 (Suppl. 2): 27-34.

36. Frattola L., Piolti R., Bassi S. et al. Multicenter clinical comparison of the effects of choline alphoscerate and cytidine di-phosphocholine in the treatment of multi-infarct dementia // Curr. Ther. Res. 1991; 49: 683-693.

37. Di Perri R., Coppola G., Ambrosio L.A. et al. A multicentre trial to evaluate the efficacy and tolerability of a -glycerylphosphorylcholine versus cytidine diphosphocholine in patients with vascular dementia // J. Int. Med. Res. 1991; 19: 330-341.

38. Bassi S., Albizzati M.G., Piolti R., Frattola L. Esperienza clinica con colina alfoscerato in pazienti affetti da demenza degen-erativa primaria e multinfartuale // Gnosis. 1990; 5: 55-62.

39. Abbati C., Rondi G., Rosola R. et al. Nootropic therapy of cerebral aging // Adv. Ther. 1991; 8: 251276.

40. Amenta F., Bronzetti E., Mancini M. et al. Invecchiamento del sistema colinergico ippocampale. Effetti del trattamento con colina alfoscerato // Basi Raz. Ter. 1991; 21 (Suppl. 2): 35-40.

41. Vega J.A., Del Valle M., Amenta F. Aspetti immunocitochimici del sistema nervoso centrale nella senescenza: sensibilita al. trattamento con colina alfoscerato // Basi Raz. Ter. 1991; 21 (Suppl. 2): 47-54.


Review

For citations:


Muratorio A., Bonuccelli U., Nuti A., Bavpistini N., Passero S., Caruso V., Batani B., Baroni A., Mayer F., Sorbi T., Franciosi A., Moro G., Agostini L., Piccirilli M., Scatozza D. A neurotropic approach to the treatment of multi-infarct dementia using l-a-glycerylphosphorylcholine. V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY. 2016;(2):53-60. (In Russ.)

Views: 1072


ISSN 2313-7053 (Print)
ISSN 2713-055X (Online)