New Strategies in the Management of Parkinson’s Disease: A Biological Approach Using a Phospholipid Precursor (CDP-Choline)

Abstract

CDP-choline, an intermediate in the phospholipid metabolic pathway supposed to improve the functionality of the dopamine (DA) system, was administered to parkinsonian patients in a double-blind cross-over study versus placebo. All patients were already treated with L-dopa + dopa decarboxylase inhibitor. Clinical evaluations were carried out using the Webster Rating Scale (WRS), the Northwestern University Disability Scale (NUDS) and a semiquantitative rating scale for tremor, rigidity and bradykinesia. CDP-choline treatment showed a significant improvement of rigidity and bradykinesia and a less important amelioration of tremor. NUDS and WRS showed a similar positive result. Comparing the results obtained by placebo, we found that the actual clinical efficacy of CDP-choline regards mainly bradykinesia and rigidity (23 and 33% improvement, respectively). The positive effect of CDP-choline on parkinsonian patients already treated with L-dopa + dopa decarboxylase inhibitor stands for a possible action on the DA receptor through an activation of the phospholipid metabolism.

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“…Citicoline is involved as an essential intermediate in the synthesis of structural phospholipids of cell membranes [14]. Potential neuromodulating and neuroprotective activity of citicoline has been effectively tried in patients with stroke [15], cognitive disorders [16,17] and Parkinson's disease [18,19,20]. In addition, a beneficial effect of citicoline has been described in a number of conditions affecting the visual system, like amblyopia [21,22,23,24] and nonarteritic ischemic optic neuropathy [25].…”

Citicoline – a neuroprotector with proven effects on glaucomatous disease

“…Many authors have studied the role of Citicoline in Parkinson's disease [8][9][10] and concluded that the basis of symptoms improvement is the stimulation of the dopaminergic system. Agnoli et al [8] administered Citicoline to patients with Parkinson disease already treated with L-dopa + dopa decarboxylase inhibitor and revealed that Citicoline determined an important improvement of bradykinesia and rigidity.…”

“…Agnoli et al [8] administered Citicoline to patients with Parkinson disease already treated with L-dopa + dopa decarboxylase inhibitor and revealed that Citicoline determined an important improvement of bradykinesia and rigidity. Citicoline could decrease the incidence of side effects and slow down the loss of efficacy of levodopa in the long-term treatment [9].…”

Some aspects of treatment for cognitive impairments. Cyticolin: pharmacological characteristics, possible benefits, aspects of use

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