Neuroprotective Effects of Citicoline in Diffuse Axonal Injuries

Firooz Salehpou, Ghaffar Shokouhi, Moslem Shakeri, Mohammad Shimia, Atta Mahdkhah, Ali Baradaran, Mohammad Taghi Imani, arhad Mirzaee, Aydin Kazempour Azar, Amir Mohammad Bazzazi, Hadi Mohammad Khanli

Abstract


Citicoline is a neuroprotective agent and fundamental item of phospholipid biosynthesis in cell walls. In this study, we aimed at examining the effect of citicoline in patients suffering from traumatic brain injury with Glasgow Coma Score (GCS) ≤ 8, and diffuse axonal injury (DAI) diagnosis. Efficacy of citicoline was evaluated by measurement of malondialdehyde (MDA) plasma levels as a marker of oxidative stress. Forty patients were randomly divided into two groups of cases (treated with citicoline) and controls (treated without citicoline). The duration of study was 15 days and 13 blood samplings were performed on the 1st, 10th and12th days of admission to evaluate the plasma levels of MDA.
Citicoline was administered intravenously with dosage of 500mg/6h. In the control group, the mean plasma levels of MDA were 2.54±0.83, 2.43±0.79 and 2.39±0.97 ng/dL in first, second, and third blood samplings, respectively (P=0.85). In the case group, the mean plasma levels of MDA were 2.46±1.08, 1.99± 0.81 and 1.60±0.6 ng/dL in first, second and third blood samplings, respectively (P=0.01). The mean total plasma levels of MDA were comparable in the case (2.64±1.08 ng/dL) and control groups (2.54±0.83 ng/dL) (P=0.78). The results of this study suggest that citicoline is an effective neuroprotective agent which might be used in order to reduce MDA levels.


Keywords: Citicoline; malondialdehyde; traumatic brain injury


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References


Adibhatla RM, Hatcher JF, Dempsey RJ. Effects of citicoline on phospholipid and glutathione levels in transient cerebral ischemia. Stroke. 2001;32:2376-2381.

Adibhatla RM, Hatcher JF, Larsen EC, Chen X, Sun D, Tsao FH. CDP-choline significantly restores phosphatidylcholine levels by differentially affecting phospholipase A2 and CTP: phosphocholine cytidylyltransferase after stroke. J Biol Chem. 2006;281:6718-6725.

Başkaya MK, Doğan A, Rao AM, Dempsey RJ. Neuroprotective effects of citicoline on brain edema and blood-brain barrier breakdown after traumatic brain injury. J Neurosurg. 2000;92:448-452.

Baydas G, Canatan H, Turkoglu A. Comparative analysis of the protective effects of melatonin and vitamin E on streptozocin-induced diabetes mellitus. J Pineal Res. 2002;32:225-230.

Bricourt MO, Ghnassia MD, Legout-Montdargent V. CDP-choline improves the postoperative rehabilitation of patients with cerebral risk. Agressologie. 1990;31:457-463.

Choi BH. Oxygen, antioxidants and brain dysfunction. Yonsei Med J. 1993;34:1-10.

Clark W, Gunion-Rinker L, Lessov N, Hazel K. Citicoline treatment for experimental intracerebral hemorrhage in mice. Stroke. 1998;29:2136-2140.

Conant R, Schauss AG. herapeutic applications of citicoline for stroke and cognitive dysfunction in the elderly: a review of the literature. Altern Med Rev. 2004;9:17-31.

Drago F, Mauceri F, Nardo L, Valerio C, Genazzani AA, Grassi M. Effects of cytidine-diphosphocholine on acetylcholine-mediated behaviors in the rat. Brain Res Bull. 1993;31:485-489.

Fujimoto T, Nakamura T, Ikeda T, Takagi K. Potent protective effects of melatonin on experimental spinal cord injury. Spine (Phila Pa 1976). 2000;25:769-775.

Hsu CH, Chi BC, Casida JE. Melatonin reduces phosphine-induced lipid and DNA oxidation in vitro and in vivo in rat brain. J Pineal Res. 2002;32:53-58.

Inci S, Ozcan OE, Kilinç K. Time-level relationship for lipid peroxidation and the protective effect of alpha-tocopherol in experimental mild and severe brain injury. Neurosurgery. 1998;43:330-335.

Kaptanoglu E, Tuncel M, Palaoglu S, Konan A, Demirpençe E, Kilinç K. Comparison of the effects of melatonin and methylprednisolone in experimental spinal cord injury. J Neurosurg. 2000;93:77-84.

Kheir-Eldin AA, Motawi TK, Gad MZ, Abd-ElGawad HM. Protective effect of vitamin E, beta-carotene and N-acetylcysteine from the brain oxidative stress induced in rats by lipopolysaccharide. Int J Biochem Cell Biol. 2001;33:475-482.

Pablos MI, Reiter RJ, Chuang JI, Ortiz GG, Guerrero JM, Sewerynek E, Agapito MT, Melchiorri D, Lawrence R, Deneke SM. Acutely administered melatonin reduces oxidative damage in lung and brain induced by hyperbaric oxygen. J Appl Physiol. 1997;83:354-358.

Sarrafzadeh AS, Thomale UW, Kroppenstedt SN, Unterberg AW. Neuroprotective effect of melatonin on cortical impact injury in the rat. Acta Neurochir (Wien). 2000;142:1293-1299.

Secades JJ, Alvarez-Sabín J, Rubio F, Lozano R, Dávalos A, Castillo J; Trial Investigators. Citicoline in intracerebral haemorrhage: a double-blind, randomized, placebo-controlled, multi-centre pilot study. Cerebrovasc Dis. 2006;21:380-385.

Elangovan V, Kohen R, Shohami E. Neurological recovery from closed head injury is impaired in diabetic rats. J Neurotrauma. 2000;17:1013-1027.

Wakatsuki A, Okatani Y, Shinohara K, Ikenoue N, Fukaya T. Melatonin protects against ischemia/reperfusion-induced oxidative damage to mitochondria in fetal rat brain. J Pineal Res. 2001;31:167-172.

Yücel N, Cayli SR, Ateş O, Karadağ N, Firat S, Turköz Y. Evaluation of the neuroprotective effects of citicoline after experimental spinal cord injury: improved behavioral and neuroanatomical recovery. Neurochem Res. 2006;31:767-775.


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