Glycerophosphocholine Research Articles

The effect of choline alphoscerate on non spatial memory and neuronal differentiation in a rat model of dual stress

Choline alphoscerate (α-GPC) is a choline-based compound and acetylcholine precursor commonly found in the brain; it has been known to be effective in treating neuronal injury and increasing the levels of acetylcholine (Ach) and brain-derived neurotrophic factor (BDNF) which in turn enhances memory and cognitive function. This study was designed to establish rat models of dual stress using noise and restraint in order to investigate the effect of α-GPC on cognitive function and neuronal differentiation after dual stress. The rats were randomly divided into four groups as follows: a control group (CG), a control with α-GPC group (CDG), a noise-restraint stress group (NRSG), and a noise-restraint stress with α-GPC group (NRSDG). Experimental groups were exposed to a 110 dB sound pressure level (SPL) white band noise and restraint at the same time for 3 h/day for 7 days. Alpha-GPC (400 mg/kg) was administered orally after stress exposure for 7 days. NRSG showed decreased memory function, increased stress hormone, hearing loss, and neuronal damage of the brain. In the hippocampus of NRSG, significantly increased expression of IL-1β and decreased expression of both choline acetyltransferase (ChAT) and BDNF were observed. On the contrary, NRSDG showed better memory function compared to NRSG, which indicates the neuroprotective effect of α-GPC. In addition, NRSDG showed decreased immune response and increased ChAT and BDNF expression as well as neuroblast expression in the hippocampus, which suggests that α-GPC enhances BDNF expression and protects the activity of immature cells in the hippocampus. To the best of our knowledge, this is the first study to show the protective effect of α-GPC on cognitive dysfunction by promotion of neuronal differentiation in an animal model of stress.

Differential diagnosis of vascular cognitive impairment

Background. Vascular cognitive impairment (VCI), аccording to world statistics, is the second most common cause of cognitive impairment after Alzheimer's disease (AD). Differential diagnosis between the two most common nosological forms of cognitive impairment is not always simple and is based on the clinical characteristic, neuropsychological and neuroradiological features of the disease.
 Aim. To present a differential diagnosis between VCI and AD using the example of a clinical case of vascular mild cognitive impairment.
 Materials and methods. A 68-year-old female patient with mild cognitive impairment underwent a neuropsychological testing: the Mini-mental state exam, Frontal assessment battery, the MoCA-test, the Clock-Drawing Test, the 12 Words test, Verbal Association Technique (literal and categorical), The Trail making test (A and B), The digit symbol substitution test, The Boston naming test (40 images), EXIT-25, Beck Depression Scale, Hospital anxiety and depression scale; neuroimaging magnetic resonance imaging in T1, T2, FLAIR, DWI, SWI sequence.
 Results. On the basis of clinical data, the results of neuropsychological testing and neuroimaging, the differential diagnosis with AD, the patient was diagnosed with vascular mild cognitive impairment. Nootropic therapy (choline alfoscerate) was prescribed and recommendations on risk factors correction were given.
 Conclusion. The article describes a patient with mild VCI. This case study discusses the main differences between AD and VCI that can be used as a basis for differential diagnosis. The features of cognitive impairments in VCI and AD are described, including the predominance of attention impairment, an executive function disorder in VCI and an impairment of memory progressing according to the Ribots law in AD. Differences in visuospatial skills and language in VCI and AD are discussed. The most reliable neuroradiological signs of cerebrovascular diseases are described.

The Endogenous Metabolite Glycerophosphocholine Promotes Longevity and Fitness in Caenorhabditis elegans.

Metabolism and aging are closely connected. The choline derivative glycerophosphocholine (GPC), an important precursor of the neurotransmitter acetylcholine, plays important roles in brain and nervous system function. Although it has been reported to alleviate cognitive decline in aged mice, whether GPC could promote longevity and other fitness factors remains unclear. Here, we find endogenous GPC level declines in the plasma of ageing humans. In Caenorhabditis elegans (C. elegans), GPC extends lifespan and improves exercise capacity during aging. Likewise, GPC inhibits lipofuscin accumulation. We further show that GPC treatment has no adverse effect on nematodes’ reproductive abilities and body length. In addition to its benefits under normal conditions, GPC enhances the stress resistance of C. elegans. Mechanically, we find GPC significantly inhibits the reactive oxygen species (ROS) accumulation in worms. Our findings indicate the health benefits of GPC and its potential application in strategies to improve lifespan and healthspan.

Population pharmacokinetic modeling and simulation of choline in healthy Korean subjects after oral administration of choline alfoscerate

Population pharmacokinetic modeling and simulation of choline in healthy Korean subjects after oral administration of choline alfoscerate

Cryoprotective Metabolites Are Sourced from Both External Diet and Internal Macromolecular Reserves during Metabolic Reprogramming for Freeze Tolerance in Drosophilid Fly, Chymomyza costata.

Many cold-acclimated insects accumulate high concentrations of low molecular weight cryoprotectants (CPs) in order to tolerate low subzero temperatures or internal freezing. The sources from which carbon skeletons for CP biosynthesis are driven, and the metabolic reprogramming linked to cold acclimation, are not sufficiently understood. Here we aim to resolve the metabolism of putative CPs by mapping relative changes in concentration of 56 metabolites and expression of 95 relevant genes as larvae of the drosophilid fly, Chymomyza costata transition from a freeze sensitive to a freeze tolerant phenotype during gradual cold acclimation. We found that C. costata larvae may directly assimilate amino acids proline and glutamate from diet to acquire at least half of their large proline stocks (up to 55 µg per average 2 mg larva). Metabolic conversion of internal glutamine reserves that build up in early diapause may explain the second half of proline accumulation, while the metabolic conversion of ornithine and the degradation of larval collagens and other proteins might be two additional minor sources. Next, we confirm that glycogen reserves represent the major source of glucose units for trehalose synthesis and accumulation (up to 27 µg per larva), while the diet may serve as an additional source. Finally, we suggest that interconversions of phospholipids may release accumulated glycero-phosphocholine (GPC) and -ethanolamine (GPE). Choline is a source of accumulated methylamines: glycine-betaine and sarcosine. The sum of methylamines together with GPE and GPC represents approximately 2 µg per larva. In conclusion, we found that food ingestion may be an important source of carbon skeletons for direct assimilation of, and/or metabolic conversions to, CPs in a diapausing and cold-acclimated insect. So far, the cold-acclimation- linked accumulation of CPs in insects was considered to be sourced mainly from internal macromolecular reserves.

UDP-glucose dehydrogenase expression is upregulated following EMT and differentially affects intracellular glycerophosphocholine and acetylaspartate levels in breast mesenchymal cell lines.

Metabolic rewiring is one of the indispensable drivers of epithelial–mesenchymal transition (EMT) involved in breast cancer metastasis. In this study, we explored the metabolic changes during spontaneous EMT in three separately established breast EMT cell models using a proteomic approach supported by metabolomic analysis. We identified common proteomic changes, including the expression of CDH1, CDH2, VIM, LGALS1, SERPINE1, PKP3, ATP2A2, JUP, MTCH2, RPL26L1 and PLOD2. Consistently altered metabolic enzymes included the following: FDFT1, SORD, TSTA3 and UDP‐glucose dehydrogenase (UGDH). Of these, UGDH was most prominently altered and has previously been associated with breast cancer patient survival. siRNA‐mediated knock‐down of UGDH resulted in delayed cell proliferation and dampened invasive potential of mesenchymal cells and downregulated expression of the EMT transcription factor SNAI1. Metabolomic analysis revealed that siRNA‐mediated knock‐down of UGDH decreased intracellular glycerophosphocholine (GPC), whereas levels of acetylaspartate (NAA) increased. Finally, our data suggested that platelet‐derived growth factor receptor beta (PDGFRB) signalling was activated in mesenchymal cells. siRNA‐mediated knock‐down of PDGFRB downregulated UGDH expression, potentially via NFkB‐p65. Our results support an unexplored relationship between UGDH and GPC, both of which have previously been independently associated with breast cancer progression.

Церебропротекторна терапія як компонент інтенсивної терапії при ішемічному інсульті

Метою дослідження було обґрунтування ефективності церебропротекторної терапії шляхом застосування холіну альфосцерату при ішемічному інсульті. Було проведено обстеження й лікування 25 хворих на ішемічний інсульт. Встановлено, що нейронспецифічна єнолаза є маркером тяжкості нейродеструктивних процесів в ішемізованому головному мозку, а також ефективності терапії. Встановлено, що холіну альфосцерат (Гліатилін) знижує нейродеструктивні процеси в ішемізованому головному мозку, підтверджує вірогідне зниження рівня нейронспецифічної єнолази. Отримані результати є підґрунтям для включення холіну альфосцерату (Гліатилін) у програму інтенсивної терапії мозкового інсульту як ефективного церебропротектора.

Застосування препарату Гліатилін при консервативній фармакотерапії тяжкої черепно-мозкової травми з контузійним ураженням речовини головного мозку

Наведені дані дослідження ефективності препарату Гліатилін (холіну альфосцерат) у терапії гострого періоду черепно-­мозкової травми (ЧМТ), забою головного мозку тяжкого ступеня з порушенням свідомості у випадку, коли оперативне втручання не показано, але є верифіковані контузійні вогнища з порушенням свідомості. У дослідження були включені 40 пацієнтів (28 чоловіків і 12 жінок) віком від 21 до 63 років (середній вік — 42 роки) із ЧМТ тяжкого ступеня. Пацієнти були розділені на 2 групи по 20 осіб (по 14 чоловіків та 6 жінок) за призначеною терапією. I група отримувала стандартизовану метаболічну, протинабрякову, антибіотикотерапію та ноотропну терапію. II група — таку ж терапію, доповнену Гліатиліном у дозі 1000 мг/добу внутрішньовенно краплинно. На тлі проведеної фармакотерапії в динаміці відстежувалася її ефективність протягом усього курсу (14 діб) за шкалою коми Глазго, за даними епідурального сенсора внутрішньочерепного тиску та за даними спіральної комп’ютерної томограми головного мозку.

Вивчення впливу Гліятону® (холіну альфосцерату) на перебіг післяопераційного періоду у хворих після загальної анестезії

У статті розглянуто проблему післяопераційних когнітивних дисфункцій, що виникають в пацієнтів після загальної анестезії, та можливий спосіб їх корекції за допомогою вітчизняного препарату холіну альфосцерату (Гліятону). Загальна анестезія негативно впливає на стан когнітивних функцій у пацієнтів із вихідною відсутністю когнітивних порушень. Одним із методів корекції післяопераційних когнітивних дисфункцій є застосування холіну альфосцерату (Гліятону) у періопераційному періоді.

Комплексна корекція тривожних і когнітивних розладів в ангіоневрології: цілі, завдання, інструменти

У статті розглянуто проблему поєднаних психоемоційних і когнітивних порушень в рамках ангіоневрологічної патології. Велика увага приділена сучасним можливостям фармакотерапії згаданих розладів. Проаналізовано можливості та недоліки нейрофармакології засобів, що широко застосовуються з метою корекції тривожних і когнітивних порушень при цереброваскулярній патології. Особливу увагу приділено етилметилгідроксипіридину сукцинату (ЕМГПС) як унікальному лікарському засобу, що має поєднані нейропротекторні й анксіолітичні властивості. Розглянуто механізми дії і клінічні можливості ЕМГПС при тривожних розладах в рамках порушень мозкового кровообігу. Також обґрунтовано необхідність активації холінергічної нейромедіації в ЦНС в умовах ішемії як основного шляху корекції когнітивної дисфункції. Проаналізовано критерії вибору інструменту холінергічної фармакотерапії, і зокрема холіну альфосцерату, як оптимального засобу регуляції активності холінергічних процесів в мозку на рівні всіх ланок синаптичної передачі. Обґрунтовано переваги та особливості практичного застосування вітчизняних препаратів ЕМГПС (Армадін) і холіну альфосцерат (Ренейро) з точки зору їх комбінованого застосування при тривожно-когнітивних порушеннях у пацієнтів з цереброваскулярною патологією.

Медотилін у лікуванні постінсультних когнітивних порушень

Стаття присвячена питанням лікування пацієнтів, які перенесли інсульт. Робиться акцент на корекції когнітивних порушень. Наведено дані дослідження впливу генеричного препарату Медотилін (холіну альфосцерат) на стан когнітивних функцій, показники повсякденної життєвої активності у хворих у відновному періоді ішемічного інсульту.

The role of association between the cholinergic precursor choline alphoscerate and sulodexide in vascular dementia

Dementia is a syndrome of acquired intellectual deficit resulting in significant impairment of social or occupational functioning. Vascular dementia (VaD) is the second most common causes of dementia after Alzheimer’s disease, causing around 15% of cases. However, unlike Alzheimer’s disease an involvement of the cerebral cholinergic system in the pathophysiology of VaD has been hypothesized and there is no standard treatment. In the Vascular Dementia Italian Sulodexide Study (VA.D.I.S.S.) the positive results obtained with the sulodexide are worthy of note. In this study 40 elderly subjects with recent onset (less than 9 month) slight to moderate mental deterioration due to vascular origin were observed for nine months during oral treatment with sulodexide and choline alphoscerate with the aim of analyzing whether therapeutic effects can be enhanced. These preliminary results suggest that the additional therapy of choline alphoscerate with sulodexide represents a way to increase the beneficial effects of cholinergic therapies in the VaD and improve all the different examinate score: mini mental state evaluation (MMSE), basic activities of daily living (ADL), instrumental activities of daily living (IADL).

Regulatory Effects of Functional Soluble Dietary Fiber from Saccharina japonica Byproduct on the Liver of Obese Mice with Type 2 Diabetes Mellitus.

Though the relationship between dietary fiber and physical health has been investigated widely, the use of dietary fiber from marine plants has been investigated relatively rarely. The Saccharina japonica byproducts after the production of algin contain a large amount of insoluble polysaccharide, which will cause a waste of resources if ignored. Soluble dietary fiber (SDF)prepared from waste byproducts of Saccharina japonica by alkaline hydrolysis method for the first time had a wrinkled microscopic surface and low crystallinity, which not only significantly reduced liver index, serum levels of aspartate aminotransferase (AST) and alanine amiotransferase (ALT), and liver fat accumulation damage to the livers of obese diabetic mice, but also activated the PI3K/AKT signaling pathway to increase liver glycogen synthesis and glycolysis. By LC-MS/MS employing a Nexera UPLC tandem QE high-resolution mass spectrometer, the 6 potential biomarker metabolites were screened, namely glycerophosphocholine (GPC), phosphocholine (PCho), pantothenic acid, glutathione (GSH), oxidized glutathione (GSSG), and betaine; several pathways of these metabolites were associated with lipid metabolism, glycogen metabolism, and amino acid metabolism in the liver were observed. This study further provided a detailed insight into the mechanisms of SDF from Saccharina japonica byproducts in regulating the livers of obese mice with type 2 diabetes and laid a reliable foundation for the further development and utilization of Saccharina japonica.

Lipid profiling of coral symbiosomes in response to copper-induced carbon limitation: A metabolic effect of algal symbionts on the host immune status

Copper micropollutants are known to constrain coral's assimilation of carbonate, affecting the carbon available to algal symbionts and thus inducing a light stress. However, little is known regarding the physiological relevance of lipid metabolism in coral symbiotic algae in a carbon-limited state. Membrane lipids exhibit multiple physicochemical properties that are collectively responsible for the dynamic structure of cells depending on the physiological demands of the circumstances. To gain insight into lipid metabolism's importance in this regard, glycerophosphocholine (GPC) profiling of symbiosomes in coral (Seriatopora caliendrum) exposed to environmentally relevant copper levels (2.2–7.5 μg/L) for 4 days was performed in this study. Notably, reducing the number of 22:6-processing GPCs and increasing that of lyso-GPCs likely addressed the demands of metabolizing excess light energy, such as affecting the membrane dynamics to promote mitochondrial uncoupling. The decrease in 22:6-processing GPCs additionally protected cellular membranes from elevated oxidative stress, reducing their susceptibility to peroxidation and offsetting oxidized lipid-induced effects on membrane dynamics. The change in plasmanylcholines specifically localized within the symbiosome membrane also met the membrane requirements for responding to oxidative stress conditions. Moreover, increasing the 20:4-possessing plasmanylcholines and lysoplasmanylcholines and reducing the 22:6-possessing plasmanylcholines likely resulted in an imbalance of the immune reaction, influencing the coral–algae symbiosis given the role of such plasmanylcholines in cell signaling. In summary, carbon limitations induced by copper enrichment lead to a shift in the membrane lipid profile of coral symbiosomes, accommodating themselves to light stress conditions while compromising the symbiosis's stability.

Pharmacological Management of Apathy in Dementia

Apathy is a highly prevalent symptom of dementia. Despite its association with faster cognitive and functional decline, decreased quality of life and increased mortality, no therapies are currently approved to treat apathy. The objective of this review was to summarize the drugs that have been studied for apathy treatment in patients with dementia (specifically Alzheimer's disease [AD], Huntington's disease [HD] and Parkinson's disease [PD] dementia; dementia with Lewy bodies [DLB]; vascular dementia [VaD]; and frontotemporal dementia [FTD]) based on their putative mechanisms of action. A search for relevant studies was performed using ClinicalTrials.gov and PubMed. Eligible studies were randomized controlled trials that were available in English and included at least one drug intervention and an apathy measure scale. A total of 52 studies that included patients with AD (n = 33 studies), PD (n = 5), HD (n = 1), DLB (n = 1), FTD (n = 3), VaD (n = 1), VaD and AD (n = 4), VaD and mixed dementia (n = 1), and AD, VaD and mixed dementia (n = 3) were eligible for inclusion. These studies showed that methylphenidate, olanzapine, cholinesterase inhibitors, choline alphoscerate, citalopram, memantine, and mibampator are the only beneficial drugs in AD-related apathy. For PD-related apathy, only methylphenidate, rotigotine and rivastigmine showed benefits. Regarding FTD- and DLB-related apathy, initial studies with agomelatine and rivastigmine showed benefits, respectively. As for HD- and only-VaD-related apathy, no drugs demonstrated benefits. With regards to mixed populations, memantine, galantamine and gingko biloba showed effects on apathy in the AD plus VaD populations and nimodipine in the VaD plus mixed dementia populations. Of the drugs with positive results, some are already prescribed to patients with dementia to target other symptoms, some have characteristics-such as medical contraindications (e.g., cardiovascular) and adverse effects (e.g., gastrointestinal disturbances)-that limit their clinical use and some require further study. Future studies should investigate apathy as a primary outcome, making use of appropriate sample sizes and study durations to ensure durability of results. There should also be a consensus on using scales with high test/retest and interrater reliabilities to limit the inconsistencies between clinical trials. In conclusion, there are currently no US FDA-approved drugs that target apathy in dementia, so there is an ongoing need for the development of such drugs.

Clinical and immunological effects of choline alfoscerate in the treatment of amnestic type Mild Cognitive Impairment

To evaluate the change of a number of clinical and immunological parameters of patients with amnestic type Mild Cognitive Impairment (aMCI) in the course of therapy with Choline alfoscerate (α-GPC) in order to develop a monitoring and predicting system of its effectiveness in people at risk for Alzheimer's disease. Thirty patients with aMCI, aged 56 to 82 years (mean age 68.8±9.4 years), received course therapy with α-GPC in capsules of 400 mg 3 times a day (1200 mg per day) for 3 months. Therapeutic efficacy evaluation according to psychometric tests and scales was carried out three times (0, 45 and 90 days), immunological parameters of leukocyte elastase (LE) and α1-protease inhibitor (α1-PI) were evaluated twice on days 0 and 90 of therapy. A good therapeutic effect over the course treatment with α-GPC, both in terms of cognitive functioning and a number of immunological parameters in patients with aMCI was shown. Significant clinical and immunological correlations included both an improvement in cognitive functions (according to MMSE and the Boston Naming Test) and an increase in LE activity level after the completion of a course of α-GPC therapy, which suggest that an increase in LE functional activity can be considered as a potential marker of a positive therapeutic response to α-GPC treatment in aMCI patients. This study shows high significance of further research in assessing the role of immune mechanisms of α-GPC therapeutic efficacy in aMCI patients and the possibility of using immunological parameters as prognostic markers of its therapeutic effect.

Glycerophosphoinositol is Elevated in Blood Samples From CLN3 Δex7-8 pigs, Cln3 Δex7-8 Mice, and CLN3-Affected Individuals.

Introduction:CLN3 Batten disease is a rare pediatric neurodegenerative lysosomal disorder caused by biallelic disease-associated variants in CLN3. Despite decades of intense research, specific biofluid biomarkers of disease status have not been reported, hindering clinical development of therapies. Thus, we sought to determine whether individuals with CLN3 Batten disease have elevated levels of specific metabolites in blood.Methods:We performed an exhaustive metabolomic screen using serum samples from a novel minipig model of CLN3 Batten disease and validated findings in CLN3 pig serum and CSF and Cln3 mouse serum. We further validate biomarker candidates with a retrospective analysis of plasma and CSF samples collected from participants in a natural history study. Plasma samples were evaluated from 22 phenotyped individuals with CLN3 disease, 15 heterozygous carriers, and 6 non-affected non-carriers (NANC).Results:CLN3 pig serum samples from 4 ages exhibited large elevations in 4 glycerophosphodiester species: glycerophosphoinositol (GPI), glycerophosphoethanolamine (GPE), glycerophosphocholine (GPC), and glycerophosphoserine (GPS). GPI and GPE exhibited the largest elevations, with similar elevations found in CLN3 pig CSF and Cln3 mouse serum. In plasma samples from individuals with CLN3 disease, glycerophosphoethanolamine and glycerophosphoinositol were significantly elevated with glycerophosphoinositol exhibiting the clearest separation (mean 0.1338 vs 0.04401 nmol/mL for non-affected non-carriers). Glycerophosphoinositol demonstrated excellent sensitivity and specificity as a biomarker, with a receiver operating characteristic area under the curve of 0.9848 (P = .0003).Conclusions:GPE and GPI could have utility as biomarkers of CLN3 disease status. GPI, in particular, shows consistent elevations across a diverse cohort of individuals with CLN3. This raises the potential to use these biomarkers as a blood-based diagnostic test or as an efficacy measure for disease-modifying therapies.

Modern approaches to the diagnostics and treatment of the consequences of traumatic brain injury in children and adolescents

The article is devoted to an important problem of modern pediatric neurology and rehabilitation, - the issues of diagnosis and comprehensive restorative treatment of the consequences of traumatic brain injury (TBI) in children and adolescents. It is known that TBI is characterized by a high frequency of disability, while asthenic, vegetative, cognitive, emotional, motor and postural disorders are leading in the clinical picture. It is shown that the factors influencing the severity of the consequences of TBI in children are not only the severity of the injury itself, but also the age at which the injury occurred, as well as the localization of the lesion. The article describes modern methods of complex diagnosis and rehabilitation of the consequences of TBI in children, as well as pathogenetically justified approaches to drug therapy, while showing the high effectiveness of the drug choline alfoscerate (Cereton) in restoring cognitive functions and improving the clinical condition in children with the consequences of TBI, according to the results of a double-blind placebo-controlled multicenter randomized trial.

Chronic cerebral ischemia and dizziness

Older age is characterized by a high prevalence of dizziness/vertigo, including various variants - central and peripheral vestibular disorders, feelings of instability, balance disorders. High frequency of dizziness and chronic cerebral ischemia in the elderly age category supports traditional ideas about relationship of these pathologies. However, there is a known overestimation of Chronic cerebral ischemia as a cause dizziness of and unclear mechanisms of this process. With a high prevalence of vestibular disorders in the elderly and their verification, in some cases, the causes of dizziness cannot be identified. This has prompted the designation of this type of dizziness as «unexplained». The article cites recent studies demonstrating a relationship between «unexplained» dizziness and chronic cerebrovascular pathology. The theories explaining the mechanisms of this association are proposed. The role of choline alphoscerate in the treatment of dizziness in Chronic cerebral ischemia has been demonstrated. The mechanisms of positive effect of choline alphocerate and prospects of its using.

The Post-COVID-19 cognitive impairment. A modern view of the problem, pathogenesis and treatment

COVID-19 infection is a significant and poorly understood problem of modern world medicine. As the virus spreads, data on the clinical picture of the disease and damage to the nervous system are accumulating. Symptoms such as fatigue, anxiety, depression, sleep disturbances and many other neurological and somatic symptoms are often recorded, persist for a long time even after the acute infectious stage of the disease has been stopped, and make it difficult for the patient to fully recover. These symptoms occur even with a mild disease and persist for many months. One of the most common and disabling symptoms of post-COVID syndrome is cognitive impairment, in the formation of which, in addition to the direct ability of the virus to penetrate the nervous system and pathology of the microvasculature, various pathological mechanisms are involved, including dysregulation of cholinergic transmission. A comprehensive approach is important in the treatment of cognitive impairment; it is advisable to use both medication and non-medication methods. The main approaches to the treatment of secondary cognitive disorders are based on the hypothesis of replenishing the defect in mediator systems, including those associated with the death of cholinergic neurons. With these abnormalities, it is advisable to replenish acetylcholine. Among the precursors of choline, choline alfoscerate occupies a special place due to its proven efficacy in the treatment of neurodegenerative diseases, as well as due to data on its multifactorial action. The article presents the actual literature data on the mechanisms of development and features of the clinical manifestations of post-COVID cognitive impairment, as well as materials of experimental and clinical studies of the drug choline alfoscerate (Gliatilin).