Abstract
Objectives: The present study assessed the potential cognitive-enhancing effects of citicoline, a dietary supplement, in healthy adult women. Specifically, it was hypothesized that citicoline supplementation would be associated with improved attention compared to placebo. Methods: The investigation was a double-blind, randomized, placebo-controlled three-arm study. Sixty healthy adult women ages 40 - 60 completed a clinical screening visit, including a medical exam. After study enrollment each subject was randomly assigned to one of three groups: a daily oral dose of 250 mg citicoline, 500 mg citicoline, or placebo for 28 days. Participants were evaluated with the Continuous Performance Test II (CPT-II), a measure sensitive to attentional function, during a baseline visit and 28 days after baseline. Results: All 60 participants were included in the analyses, which included an ANOVA with Tukey’s post-hoc tests and t-tests. After 28 days of supplementation, individuals in the 250 mg group made fewer omission (p = 0.04) and commission (p = 0.03) errors compared to those in the placebo group. Individuals in the 500 mg group made significantly fewer commission errors compared to those in the placebo group (p = 0.03) and trended toward making fewer omission errors (p = 0.07). Conclusion: After 28 days of daily citicoline supplementation, participants who were administered either the 250 mg or the 500 mg citicoline doses showed significantly better ability to produce correct responses on the CPT-II, likely due to improved cognitive inhibition. Our findings suggest that citicoline may improve attentional performance in middle-aged women and may ameliorate attentional deficits associated with central nervous system disorders.
Highlights
Citicoline is a natural product that is marketed as a nutritional supplement in the United States
A compound composed of choline and cytidine, citicoline is instrumental in the synthesis of cell membrane phospholipids that aid in neuronal membrane repair [3,4], and provides a choline source needed for acetylcholine (ACh) and phosphatidylcholine synthesis [3,5]
One group took the low dose of citicoline (250 mg), one group took the high dose of citicoline (500 mg), and one group took a placebo for 28 days
Summary
Citicoline is a natural product that is marketed as a nutritional supplement in the United States. Exogenous administration of citicoline (CDP-choline; cytidine 5’-diphosphocholine) has been shown to influence brain cellular metabolism and citicoline has demonstrated a variety of cognitive-enhancing and neuroprotective properties in pre-clinical and clinical studies [1,2,3]. Pharmacokinetic studies on the absorption of citicoline through the oral route have shown that the drug is rapidly absorbed with less than one percent excreted in the feces. Citicoline is metabolized during intestinal absorption yielding choline and uridine [6]. Citicoline is distributed throughout the body by way of systemic circulation in the form of choline and uridine for utilization in many biosynthetic pathways. After crossing the blood-brain barrier, uridine is synthesized into uridine 5’-triphosphate, which can be further metabolized to cytidine triphosphate and CDP-choline [6]
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