The efficacy and safety of animal-derived nootropics in cognitive disorders: Systematic review and meta-analysis

Alsulaimani, Rayan A.; Quinn, Terence J

doi:10.1016/j.cccb.2021.100012

Cited by 6 publications

(7 citation statements)

References 41 publications

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“…Actovegin and cerebrolysin are animal-derived nootropics, that may have potential efficacy in the treatment of neurodegenerative disease. 133 These agents are used in many countries for conditions such as dementia, stroke and traumatic brain injury, but unlike other drugs considered in this guideline (cholinesterase inhibitors and memantine), the nootropics do not have international approval for use in dementia. The mechanisms of action of the nootropics are not clear, but putative vascular effects have been described, so there is an assumption of a potential efficacy in vascular cognitive syndromes.…”

Section: Resultsmentioning

confidence: 99%

European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment

Quinn

Richard

Teuschl

et al. 2021

European Stroke Journal

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Introduction: The optimal management of post stroke cognitive impairment remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making around prevention, diagnosis, treatment, and prognosis. Methods: These guidelines were developed according to ESO standard operating procedure and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and, where possible, meta-analyses of the literature, assessed the quality of the available evidence, and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available to provide recommendations based on the GRADE approach. Results: There was limited randomised controlled trial evidence regarding single or multicomponent interventions to prevent post stroke cognitive decline. Interventions to improve lifestyle and treat vascular risk factors may have many health benefits but a beneficial effect on cognition is not proven. We found no evidence around routine cognitive screening following stroke but recognise the importance of targeted cognitive assessment. We described the accuracy of various cognitive screening tests but found no clearly superior approach to testing. There was insufficient evidence to make a recommendation for use of cholinesterase inhibitors, memantine or cognitive rehabilitation for post stroke dementia. We made a weak recommendation against using the nootropics actovegin and cerebrolysin, but quality of evidence was very low. There was limited evidence on the use of prediction tools for post stroke cognitive syndromes (cognitive impairment, dementia and delirium). The association between post stroke cognitive impairment and most acute structural brain imaging features was unclear. Conclusions: These guidelines have highlighted fundamental areas where robust evidence is lacking. Further randomised controlled trials are needed and we suggest priority areas for future research.

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Section: Resultsmentioning

confidence: 99%

European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment

Quinn

Richard

Teuschl

et al. 2021

European Stroke Journal

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“…Actovegin and cerebrolysin are animal-derived nootropics, that may have potential efficacy in the treatment of neurodegenerative disease [133]. These agents are used in many countries for conditions such as dementia, stroke and traumatic brain injury, but unlike other drugs considered in this guideline (cholinesterase inhibitors, memantine) the nootropics do not have international approval for use in dementia.…”

Section: Analysis Of the Current Evidencementioning

confidence: 99%

European Stroke Organisation and European Academy of Neurology joint guidelines on post‐stroke cognitive impairment

Quinn

Richard

Teuschl

et al. 2021

Euro J of Neurology

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Background and purpose: The optimal management of post-stroke cognitive impairment (PSCI) remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making regarding prevention, diagnosis, treatment and prognosis. Methods: Guidelines were developed according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group © 2021 European Academy of Neurology and European Stroke OrganisationThe article has been published in the European Stroke Journal and European Journal of Neurology. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. To request permission to reuse any part of this article, please go to Wiley's HYPERLINK "https://www.wiley.com/en-gb/right s&permi ssion sportal testing. There was insufficient evidence to make a recommendation for use of cholinesterase inhibitors, memantine nootropics or cognitive rehabilitation. There was limited evidence on the use of prediction tools for post-stroke cognition. The association between PSCI and acute structural brain imaging features was unclear, although the presence of substantial white matter hyperintensities of presumed vascular origin on brain magnetic resonance imaging may help predict cognitive outcomes.Conclusions: These guidelines highlight fundamental areas where robust evidence is lacking. Further definitive RCTs are needed, and we suggest priority areas for future research.

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“…Moreover, the protective potential of Cerebrolysin for PTSD-induced short-term and long-term memory impairment was attributed to cerebral proteases preventing increased oxidative stress in the PTSD hippocampus [ 65 ]. Several studies are currently evaluating Cerebrolysin efficacy for other conditions, including cerebral palsy, vascular dementia, aneurysmal subarachnoid haemorrhage, and anosmia [ 66 ]. The main pharmacological effect of Cerebrolysin is the restoration of the surrounding and damaged nerve structures, which is deleterious to neurons, causing their degeneration, dysfunction, and death [ 67 ].…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 Anosmia and Therapies: Stay Tuned for New Drugs to Sniff Out

et al. 2023

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Background: Anosmia is defined as the complete absence of olfactory function, which can be caused by a variety of causes, with upper respiratory tract infections being among the most frequent causes. Anosmia due to SARS-CoV-2 infection has attracted attention given its main role in symptomatology and the social impact of the pandemic. Methods: We conducted systematic research in a clinicaltrials.gov database to evaluate all active clinical trials worldwide regarding drug therapies in adult patients for anosmia following SARS-CoV-2 infection with the intention of identifying the nearby prospects to treat Anosmia. We use the following search terms: “Anosmia” AND “COVID-19” OR “SARS-CoV-2” OR “2019 novel coronavirus”. Results: We found 18 active clinical trials that met our criteria: one phase 1, one phase 1–2, five phases 2, two phases 2–3, three phases 3, and six phases 4 studies were identified. The drug therapies that appear more effective and promising are PEA-LUT and Cerebrolysin. The other interesting drugs are 13-cis-retinoic acid plus aerosolized Vitamin D, dexamethasone, and corticosteroid nasal irrigation. Conclusions: COVID-19 has allowed us to highlight how much anosmia is an important and debilitating symptom for patients and, above all, to direct research to find a therapy aimed at curing the symptom, whether it derives from SARS-CoV-2 infection or other infections of the upper airways. Some of these therapies are very promising and are almost at the end of experimentation. They also provide hope in this field, which not addressed until recently.

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The efficacy and safety of animal-derived nootropics in cognitive disorders: Systematic review and meta-analysis

Cited by 6 publications

References 41 publications

European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment

European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment

European Stroke Organisation and European Academy of Neurology joint guidelines on post‐stroke cognitive impairment

Post-COVID-19 Anosmia and Therapies: Stay Tuned for New Drugs to Sniff Out

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