Stroke Clinical Trial
Official title:
A Randomized, Double-blind, Placebo-controlled Phase IV Trial for an Evaluation of the Efficacy of Gliatiline® on Post-stroke Patients With Vascular Cognitive Impairment no Dementia
To date, there are no approved treatments for vascular cognitive impairment (VCI) and the main therapeutic efforts are aimed at controlling vascular risk factors for countering VCI development or progression. Several studies have reported cholinergic deficits in brain and cerebrospinal fluid of patients with VCI. The effect of choline alphoscerate in clinical studies of Alzheimer's disease and VCI improved memory and attention impairments. The purpose of our study is to determine effectiveness of choline alphoscerate vs placebo in improving cognition in post-stroke patients with VCI-non dementia (VCI-ND).
Impaired brain cholinergic neurotransmission has a key role in the deterioration of
cognitive functions in Alzheimer's disease and vascular cognitive impairment (VCI). These
deficits, although are of different degree than those found in Alzheimer's disease, were
suggested to be associated with VCI.To date, there are no approved treatments for vascular
dementia(VaD)and the main therapeutic efforts in this field are aimed at controlling
vascular risk factors for countering VaD development or progression.
There have also been several trials of cholinesterase inhibitors for treatment of VCI.
Available data suggest some evidence of benefit of cholinesterase inhibitors in subcortical
vascular dementia and vascular cognitive impairment.
Treated patients had modest benefits in cognition, attention, executive functioning and
ability to perform instrumental activities of daily living, but the effect is too limited
due to the small numbers of subjects examined and it is complex to establish the clinical
relevance of these effects. The majority of clinical studies available on the effect of
choline alphoscerate in neurodegenerative and cerebrovascular disorders were reviewed. A
comparison of Alzheimer's disease assessment scale-cognitive subscale(ADAS-Cog)analysis with
the results obtained on the same item in 4 trials with the cholinesterase inhibitor revealed
a more positive trend with the cholinergic precursor choline alphoscerate than with this
cholinesterase inhibitor.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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