Citicoline has been widely used in clinical practice, mainly for the treatment of neurological sequelae caused by craniocerebral injury or cerebrovascular accident, and has found new uses in clinical practice. Its treatment in cerebral hemorrhage, Parkinson's disease, glaucoma, diabetic peripheral neuropathy and tinnitus and other diseases has also attracted increasing attention. So what is citicoline, what pharmacological effects, its indications (specific treatment of which diseases), efficacy and safety?

Citicoline is a single nucleotide composed of ribose, cytosine, pyrophosphate and choline. It is an endogenous nucleotide of the human body. It is involved in many important metabolic pathways in the body. It is a natural precursor of phospholipid synthesis of neuron cell membrane structure and a precursor of biosynthesis of the neurotransmitter acetylcholine.

Citicoline is a neuroprotective agent that can protect vulnerable neurons, thereby reducing or preventing disease progression. Currently, neuroprotective agents commonly used in clinical practice include calcium channel blockers, glutamate antagonists, free radical scavengers, and cell membrane stabilizers, among which citicoline belongs to cell membrane stabilizers.

Citicoline has multi-target pharmacological effects, and these action mechanisms make it have significant potential in neuroprotection and nerve repair. It has neuroprotection effect of blocking the occurrence of neuronal injury and nerve repair effect after the occurrence of neuronal injury, which broadens the therapeutic time window of citicoline.

Based on its pharmacological properties, citicoline is widely used in the treatment of stroke, cognitive impairment, traumatic brain injury, Parkinson's disease, glaucoma, diabetic peripheral neuropathy, tinnitus and other diseases, and its efficacy and safety have been verified in multiple clinical studies, with sufficient evidence-based medical evidence. Stroke: stroke is a kind of cerebral vascular blockage or rupture, resulting in brain damage of a class of diseases, including ischemic and hemorrhagic stroke, of which ischemic stroke is the main type of stroke, accounting for 75% to 90% of all strokes. The lifetime risk of stroke in our population is 35%-40.9%, ranking first in the world, not only that, stroke is also the first cause of death and disability in our residents.

Clinical research evidence:?

1. In 2002, the American Journal Stroke published a meta-analysis of clinical trials on patients with acute ischemic stroke, which showed that oral citicoline increased the possibility of stroke patients recovering after 3 months [1].

2. In 2009, a drug monitoring research experiment was conducted in South Korea for 4191 patients with acute ischemic stroke, and the results showed that citicoline improved NIHSS score and BI score of patients with benefits in early and late treatment, and long-term application benefits were greater, and the therapeutic effect was positively correlated with dose. The improvement was more significant in the high-dose group (≧2000mg/ day), and long-term application was safe and tolerated [2].

3. The results of a multicenter, randomized, double-blind, placebo-controlled pilot study on cerebral hemorrhage suggest that citicoline is a safe drug for the treatment of cerebral hemorrhage with a positive therapeutic effect [3].

4. An open-label, randomized, parallel study evaluated the effect of citicoline on post-stroke cognitive impairment, and the results showed that long-term use of citicoline significantly improved post-stroke cognitive impairment [4].