Effectiveness of nootropic drugs with cholinergic activity in treatment of cognitive deficit: a review

Figures & data

Table 1 Piracetam and cognitive function

Reference	Title	Main results	Study type	Patients randomized
Holinski et al^Citation18	Cerebroprotective effect of piracetam in patients undergoing open heart surgery	Piracetam has no cerebroprotective effects in patients undergoing open heart cardiopulmonary bypass surgery	Clinical trial, randomized, double-blind	88 patients
Malykh and Sadaie^Citation1	Piracetam and piracetam-like drugs: from basic science to novel clinical applications to central nervous system disorders	A neuroprotective effect of piracetam in treatment of cerebrovascular and cognitive disorders of traumatic origin	Review
Fesenko^Citation11	Piracetam improves children’s memory after general anesthesia	Intravenously administered piracetam reduces cognitive dysfunction produced by anesthesia	Clinical trial, randomized, double-blind	250 children
Holinski et al^Citation14	Cerebroprotective effect of piracetam in patients undergoing coronary artery bypass surgery	Piracetam has cerebroprotective effects in patients undergoing non-open heart cardiopulmonary bypass surgery	Clinical trial, randomized, double-blind	120 patients

Table 2 Oxiracetam and cognitive function

Reference	Title	Main results	Study type	Patients randomized
Malykh and Sadaie^Citation1	Piracetam and piracetam-like drugs: from basic science to novel clinical applications to central nervous system disorders	Oxiracetam improves cognitive performances except in patients with dementia	Review	NA

Table 3 Lecithin and cognitive function

Reference	Title	Main results	Study type	Patients randomized
Amenta and Tayebati^Citation2	Pathways of acetylcholine synthesis, transport, and release as targets for treatment of adult-onset cognitive dysfunction	The data suggest that lecithin does not improve cognitive deficit in treated patients	Review	NA
Parnetti et al^Citation24	Cholinergic precursors in the treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation?	The data suggest that lecithin does not improve cognitive deficit in treated patients	Review	NA

Table 4 Citicoline and cognitive function

Reference	Title	Main results	Study type	Patients randomized
Secades^Citation29	Citicoline: pharmacological and clinical review, 2010 update	A neuroprotective effect of citicoline; it improves cognitive performance in healthy patients and in patients with dementia	Review	NA
Alvarez-Sabín and Román^Citation50	Citicoline in vascular cognitive impairment and vascular dementia after stroke	A neuroprotective effect of citicoline; it improves cognitive performances in healthy patients and in patients with dementia	Review	NA
Vale^Citation37	Current management of cognitive dysfunction in Parkinson’s disease: how far have we come?	The author proposes use of citicoline in Parkinson’s dementia	Meta analysis	NA
Parnetti et al^Citation24	Cholinergic precursors in treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation?	The data suggest citicoline improves cognitive performances in patients with dementia (of neurodegenerative and vascular origin)	Review	NA

Table 5 Acetyl-carnitine and cognitive function

Reference	Title	Main results	Study type	Patients randomized
Malaguarnera et al^Citation39	Acetyl-L-carnitine reduces depression and improves quality of life in patients with minimal hepatic encephalopathy	Acetyl-carnitine improves cognitive functions in patients with minimal hepatic encephalopathy; it increases energy and wellness and reduces anxiety and depression	Clinical trial, randomized, double-blind	67 patients
Malaguarnera et al^Citation40	Acetyl-L-carnitine treatment in minimal hepatic encephalopathy	Acetyl-carnitine improves cognitive function in patients with minimal hepatic encephalopathy	Clinical trial, randomized, double-blind	125 patients
Mancuso et al^Citation44	Natural antioxidants in Alzheimer’s disease	Authors suggest use of acetyl-carnitine in neurodegenerative disease because it can reduce or block typical neuronal death	Review	NA
Cagnon and Braissant^Citation45	Hyperammonemia-induced toxicity for the developing central nervous system	Authors suggest use acetyl-carnitine in hyperammonemia	Meta-analysis	NA
Malaguarnera et al^Citation42	Acetyl L-carnitine treatment in elderly patients with fatigue	Acetyl-carnitine reduces fatigue and age-related cognitive deficits	Clinical trial, randomized, double-blind	96 patients
Liu^Citation43	Effects and mechanisms of mitochondrial nutrient alpha-lipoic acid on improving age-associated mitochondrial and cognitive dysfunction: an overview	Acetyl-carnitine reduces age-related cognitive deficits	Overview	NA

Table 6 Choline alfoscerate and cognitive function

Reference	Title	Main results	Study type	Patients randomized
Parnetti et al^Citation24	Cholinergic precursors in the treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation?	Choline alfoscerate improves brain acetylcholine levels and contributes to a modest improvement of cognitive performances in patients with vascular and neurodegenerative dementia	Review	NA

Table 7 Nootropics and vascular dementia

Reference	Title	Main results	Study type	Patients randomized
Alvarez-Sabín and Román^Citation50	Citicoline in vascular cognitive impairment and vascular dementia after stroke	Citicoline prevents cognitive decline after stroke and improves time orientation, attention and executive functions	Review	NA
García-Cobos et al^Citation51	Citicoline, use in cognitive decline: vascular and degenerative	Citicoline improves recovery and cognitive improvement after stroke	Review	NA
Muresanu et al^Citation52	Persistence of the effects of cerebrolysin on cognition and qEEG slowing in vascular dementia patients: results of a 3-month extension study	Cerebrolysin produces significant improvements in cognitive function	Clinical trial, randomized, double-blind	33 patients
Guekht et al^Citation53	Cerebrolysin in vascular dementia: improvement of clinical outcome in a randomized, double-blind, placebo-controlled multicenter trial	Cerebrolysin produces significant improvements in cognitive function	Clinical trial, randomized, double-blind	242 patients

Table 8 Nootropics and Alzheimer’s disease

Reference	Title	Main results	Study type	Patients randomized
Alvarez et al^Citation28	Efficacy and safety of cerebrolysin in moderate to moderately severe Alzheimer’s disease: results of a randomized, double-blind, controlled trial investigating three dosages of cerebrolysin	Cerebrolysin is effective for global cognitive function and behavioral symptoms	Clinical trial, randomized, double-blind	133 patients
Plosker and Gauthier^Citation54	Cerebrolysin: a review of its use in dementia	Promising results with cerebrolysin in patients with Alzheimer’s disease	Review	NA
Akhondzadeh et al^Citation55	A 22-week, multicenter, randomized, double-blind controlled trial of Crocus sativus in the treatment of mild-to-moderate Alzheimer’s disease	Provides preliminary evidence of a possible therapeutic effect of saffron extract in treatment of patients with mild-to moderate Alzheimer’s disease	Clinical trial, randomized, double-blind	54 patients
Schaeffer et al^Citation57	Phospholipase A2 activation as a therapeutic approach for cognitive enhancement in early-stage Alzheimer’s disease	Phospholipase A2 could be a valid therapeutic strategy for cognitive enhancement in early-stage Alzheimer’s disease	Review	NA
Yurko-Mauro^Citation56	Cognitive and cardiovascular benefits of docosahexaenoic acid in aging and cognitive decline	Docosahexaenoic acid has significant positive effects on verbal recognition memory	Clinical trial, randomized, double-blind	485 patients

HolinskiSClausBAlaarajNCerebroprotective effect of piracetam in patients undergoing open heart surgeryAnn Thorac Cardiovasc Surg20111713714221597409

 PubMed Web of Science ®Google Scholar

MalykhAGSadaieMRPiracetam and piracetam-like drugs: from basic science to novel clinical applications to CNS disordersDrugs20107028731220166767

 PubMed Web of Science ®Google Scholar

FesenkoUAPiracetam improves children’s memory after general anaesthesiaAnestezjol Intens Ter2009411621 Polish19517672

 PubMedGoogle Scholar

HolinskiSClausBAlaarajNCerebroprotective effect of piracetam in patients undergoing coronary bypass surgeryMed Sci Monit200814153157

 Web of Science ®Google Scholar

AmentaFTayebatiSKPathways of acetylcholine synthesis, transport and release as targets for treatment of adult-onset cognitive dysfunctionCurr Med Chem20081548849818289004

 PubMed Web of Science ®Google Scholar

ParnettiLMigniniFTomassoniDTrainiEAmentaFCholinergic precursors in the treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation?J Neurol Sci200725726426917331541

 PubMed Web of Science ®Google Scholar

SecadesJJCiticoline: pharmacological and clinical reviewRev Neurol201052Suppl 2S1S62 Spanish21432836

 PubMed Web of Science ®Google Scholar

Alvarez-SabínJRománGCCiticoline in vascular cognitive impairment and vascular dementia after strokeStroke201142Suppl 1S40S4321164117

 PubMed Web of Science ®Google Scholar

ValeSCurrent management of the cognitive dysfunction in Parkinson’s disease: how far have we come?Exp Biol Med (Maywood)200823394195118535172

 PubMed Web of Science ®Google Scholar

MalaguarneraMBellaRVacanteMAcetyl-L-carnitine reduces depression and improves quality of life in patients with minimal hepatic encephalopathyScand J Gastroenterol20114675075921443422

 PubMed Web of Science ®Google Scholar

MalaguarneraMGarganteMPCristaldiEAcetyl-L-carnitine treatment in minimal hepatic encephalopathyDig Dis Sci2008533018302518357530

 PubMed Web of Science ®Google Scholar

MancusoCBatesTEButterfieldDANatural antioxidants in Alzheimer’s diseaseExpert Opin Investig Drugs20071619211931

 PubMed Web of Science ®Google Scholar

CagnonLBraissantOHyperammonemia-induced toxicity for the developing central nervous systemBrain Res Rev20075618319717881060

 PubMedGoogle Scholar

MalaguarneraMGarganteMPCristaldiEAcetyl L-carnitine (ALC) treatment in elderly patients with fatigueArch Gerontol Geriatr20084618119017658628

 PubMed Web of Science ®Google Scholar

LiuJThe effects and mechanisms of mitochondrial nutrient alpha-lipoic acid on improving age-associated mitochondrial and cognitive dysfunction: an overviewNeurochem Res20083319420317605107

 PubMed Web of Science ®Google Scholar

García-CobosRFrank-GarcíaAGutiérrez-FernándezMDíez-TejedorECiticoline, use in cognitive decline: vascular and degenerativeJ Neurol Sci201029918819220875651

 PubMed Web of Science ®Google Scholar

MuresanuDFAlvarezXAMoesslerHPersistence of the effects of cerebrolysin on cognition and qEEG slowing in vascular dementia patients: results of a 3-month extension studyJ Neurol Sci201029917918320923712

 PubMed Web of Science ®Google Scholar

GuekhtABMoesslerHNovakPHGusevEICerebrolysin InvestigatorsCerebrolysin in vascular dementia: improvement of clinical outcome in a randomized, double-blind, placebo-controlled multicenter trialJ Stroke Cerebrovasc Dis20112031031820656516

 PubMed Web of Science ®Google Scholar

AlvarezXACacabelosRSampedroCEfficacy and safety of cerebrolysin in moderate to moderately severe Alzheimer’s disease: results of a randomized, double-blind, controlled trial investigating three dosages of cerebrolysinEur J Neurol201118596820500802

 PubMed Web of Science ®Google Scholar

PloskerGLGauthierSCerebrolysin: a review of its use in dementiaDrugs Aging20092689391519848437

 PubMed Web of Science ®Google Scholar

AkhondzadehSShafiee SabetMHarirchianMHToghaMA 22-week, multicenter, randomized, double-blind controlled trial of Crocus sativus in the treatment of mild-to-moderate Alzheimer’s diseasePsychopharmacology (Berl)201020763764319838862

 PubMed Web of Science ®Google Scholar

SchaefferELForlenzaOVGattazWFPhospholipase A2 activation as a therapeutic approach for cognitive enhancement in early-stage Alzheimer diseasePsychopharmacology (Berl)2009202375118853146

 PubMed Web of Science ®Google Scholar

Yurko-MauroKCognitive and cardiovascular benefits of docosahexaenoic acid in aging and cognitive declineCurr Alzheimer Res2010719019620088810

 PubMed Web of Science ®Google Scholar