Effectiveness and Safety of Citicoline in Mild Vascular Cognitive Impairment: The IDEALE Study.

Effectiveness and safety of citicoline in mild vascular cognitive impairment: the IDEALE study.

Filed under: Depression Treatment

Clin Interv Aging. 2013; 8: 131-7
Cotroneo AM, Castagna A, Putignano S, Lacava R, Fantò F, Monteleone F, Rocca F, Malara A, Gareri P

The studio di intervento nel decadimento vascolare lieve (IDEALE study) was an open multicenter Italian study, the aim of which was to assess the effectiveness and safety of oral citicoline in elderly people with mild vascular cognitive impairment.The study was performed in 349 patients. The active or citicoline group was composed of 265 patients and included 122 men and 143 women of mean age 79.9 ± 7.8 years selected from six Italian regions. Inclusion criteria were age ? 65 years, Mini-Mental State Examination (MMSE) score ? 21, subjective memory complaints but no evidence of deficits on MMSE, and evidence of vascular lesions on neuroradiology. Those with probable Alzheimer’s disease were excluded. The control group consisted of 84 patients, including 36 men and 48 women of mean age 78.9 ± 7.01 (range 67-90) years. Patients included in the study underwent brain computed tomography or magnetic resonance imaging, and plasma dosage of vitamin B12, folate, and thyroid hormones. Functional dependence was investigated by scores on the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales, mood was assessed by the Geriatric Depression Scale (GDS), and behavioral disorders using the Neuropsychiatric Inventory scale. Comorbidity was assessed using the Cumulative Illness Rating Scale. An assessment was made at baseline (T0), after 3 months (T1), and after 9 months (T2, ie, 6 months after T1). The main outcomes were an improvement in MMSE, ADL, and IADL scores in the study group compared with the control group. Side effects were also investigated. The study group was administered oral citicoline 500 mg twice a day throughout the study.MMSE scores remained unchanged over time (22.4 ± 4 at T0; 22.7 ± 4 at T1; 22.9 ± 4 at T2), whereas a significant difference was found between the study and control groups, both in T1 and in T2. No differences were found in ADL and IADL scores between the two groups. A slight but not statistically significant difference was found in GDS score between the study and control groups (P = 0.06). No adverse events were recorded.In this study, citicoline was effective and well tolerated in patients with mild vascular cognitive impairment. Citicoline activates biosynthesis of phospholipids in neuronal membranes, increases brain metabolism as well as norepinephrine and dopamine levels in the central nervous system, and has neuroprotective effects during hypoxia and ischemia. Therefore, citicoline may be recommended for patients with mild vascular cognitive impairment.
HubMed – depression

Protective effect of IL-4 on IL-1?-induced behavioral, biochemical and immunological alterations.

Filed under: Depression Treatment

Neurosci Res. 2013 Feb 7;
Park HJ, Shim HS, Kim KS, Shim I

The aim of the present study is to investigate the role of pro- and anti-inflammatory cytokines in the modulation of the neurotransmitter system in the rats. We investigated whether centrally administered IL-1? is associated with activation of CNS inflammatory pathways and behavioral changes if IL-1?-associated changes in peripheral inflammatory pathways. Prostaglandin E (PGE(2)), or corticosterone (CORT) are associated with depressive like behaviors; and the effect of IL-4 on the neurotransmitter system in the CNS, concentration of serotonin (5-HT) and norepinephrine (NE) were examined after IL-1? intracerebroventricular (i.c.v.) injection. In the present study, IL-4 treatment (100ng and 200ng) significantly decreased anhedonic response and increased social exploration and total activity. Also, infusion of the IL-4 intracerebroventricular (i.c.v) markedly decreased IL-1?-induced PGE(2) and CORT and also influenced 5-HT and NE synthesis, which might contribute to the behavioral changes elicited by IL-1?. IL-4 is likely to play a role in mediating behavioral consequences by regulating 5-HT and NE monoamines synthesis. In summary, excess pro-inflammation may play a role in the development of depressive behavior, and IL-4 is an important link between the changes in hormonal and neurotransmitter systems that are of recognized relevance for IL-1?-induced depressive responses. Also, the present findings contribute another significant piece of the puzzle and can be used as an important guiding rubric for those who seek to understand the relationship between depression and neuroinflammation by regulating neurotransmitter metabolism.
HubMed – depression

Internet-based recruitment to a depression prevention intervention: lessons from the mood memos study.

Filed under: Depression Treatment

J Med Internet Res. 2013; 15(2): e31
Morgan AJ, Jorm AF, Mackinnon AJ

Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions.To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned.Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations.The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $ 12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards.Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable.ACTRN12609000925246.
HubMed – depression

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