An important nutrient that is known to affect brain development and aging is choline. Choline is essential for several biological functions of cells. For example, choline metabolites acetylcholine and phosphatidylcholine, respectively, contribute to proper signaling functions for normal cholinergic neurotransmission and the structural integrity of cell membranes. Brain choline uptake is decreased in older adults and the lower supply of extracellular choline may contribute to aging-related cognitive decline. Not surprisingly, higher dietary choline is associated with better cognitive performance in elderly individuals. One method to increase dietary choline is through supplementation with citicoline (CDP-choline or cytidine-5-diphosphate choline). Compared with choline moiety obtained through other dietary sources such as phosphatidylcholine, choline in citicoline has been suggested to be less prone to conversion to trimethylamine (TMA) and trimethylamine N-oxide (TMAO),which have been implicated in the pathogenesis of cardiovascular disease. Citicoline is a naturally occurring mononucleotide comprised of cytosine, ribose, pyrophosphate, and choline. It is produced by the body as an intermediate product of phosphatidylcholine and sphingomyelin biosynthesis. The neuroprotective actions of citicoline include activating the biosynthesis of structural phospholipids in the neuronal membranes, increasing cerebral metabolism, noradrenaline, and dopamine levels in the central nervous system, preventing the loss of cardiolipin (an exclusive inner mitochondrial phospholipid enriched with unsaturated fatty acids), and protecting cell membranes by accelerating re-synthesis of phospholipids. Unsurprisingly, citicoline supplementation has shown beneficial effects on memory function and behavior in populations with awide range of impairments such as those with mild to moderate vascular cognitive impairment, vascular dementia, or senile dementia.
PUBLISHED ARTICLES :
** Nutr. 2021 Aug 7;151(8):2153-2160.doi: 10.1093/jn/nxab119.
Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349115/pdf/nxab119.pdf** J Neurochem. 2002 Jan;80(1):12-23.doi: 10.1046/j.0022-3042.2001.00697.x.
Citicoline: neuroprotective mechanisms in cerebral ischemia
https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.0022-3042.2001.00697.x** Clin Interv Aging. 2013;8:131-7.doi: 10.2147/CIA.S38420. Epub 2013 Feb 5.
Effectiveness and safety of citicoline in mild vascular cognitive impairment: the IDEALE study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3569046/pdf/cia-8-131.pdf** J Pharmacol Sci. 2011;116(2):232-7.doi: 10.1254/jphs.11013fp. Epub 2011 May 25.
Neuroprotective effects of citidine-5-diphosphocholine on impaired spatial memory in a rat model of cerebrovascular dementia
https://pubmed.ncbi.nlm.nih.gov/21613753/** Clin Interv Aging. 2012;7:113-8.doi: 10.2147/CIA.S29366.
Retrospective and observational study to assess the efficacy of citicoline in elderly patients suffering from stupor related to complex geriatric syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363302/pdf/cia-7-113.pdf** Clin Interv Aging. 2015; 10: 1421–1429. Published online 2015 Sep 3. doi: 10.2147/CIA.S87886
The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562749/pdf/cia-10-1421.pdf