Activity of Choline Alphoscerate on Adult-Onset Cognitive Dysfunctions: A Systematic Review and Meta-Analysis

Abstract

Background: Choline alphoscerate (alpha glyceryl phosphorylcholine, α-GPC) is a choline-containing phospholipid used as a medicine or nutraceutical to improve cognitive function impairment occurring in neurological conditions including adult-onset dementia disorders. Despite its 1985 marketing authorization, there are still discrepancies between countries regarding its approval as a prescription medicine and discussions about its effectiveness.

Objective: This study aimed to evaluate the efficacy of the α-GPC compound for treating cognitive impairment in patients with adult-onset neurological disorders.

Methods: Relevant studies were identified by searching PubMed, Web of Science, and Embase. Studies that evaluated the effects of α-GPC alone or in combination with other compounds on adult-onset cognitive impairment reporting cognition, function, and behavior were considered. We assessed the risk of bias of selected studies using the Cochrane risk of bias tool.

Results: A total of 1,326 studies and 300 full-text articles were screened. We included seven randomized controlled trials (RCTs) and one prospective cohort study that met our eligibility criteria. We found significant effects of α-GPC in combination with donepezil on cognition [4 RCTs, mean difference (MD):1.72, 95% confidence interval (CI): 0.20 to 3.25], functional outcomes [3 RCTs, MD:0.79, 95% CI: 0.34 to 1.23], and behavioral outcomes [4 RCTs; MD: -7.61, 95% CI: -10.31 to -4.91]. We also observed that patients who received α-GPC had significantly better cognition than those who received either placebo or other medications [MD: 3.50, 95% CI: 0.36 to 6.63].

Conclusion: α-GPC alone or in combination with donepezil improved cognition, behavior, and functional outcomes among patients with neurological conditions associated with cerebrovascular injury.

Keywords: Alzheimer’s disease; choline alphoscerate; cognitive function; dementia; donepezil.

Fig. 1

Selection of eligible studies.

Fig. 2

Comparison of effects of choline alphoscerate (1 r200 mg per day) and placebo or acetyl-L-carnitine (1 r500 mg per day) on patient cognition as measured by the MMSE after follow-up periods ranging from 90 days to 180 days.

Fig. 3

Comparison of the effects of choline alphoscerate (1 r200 mg/day) and donepezil (10 mg/day) rand placebo and donepezil (10 mg/day) on patient cognition as measured by the MMSE after follow-up periods ranging from 360 days to 720 days.

Fig. 4

Comparison of effects of choline alphoscerate (1 r200 mg/day) and donepezil (10 mg/day) rand placebo and donepezil (10 mg/day) on patient cognition as measured by the ADAS-Cog after follow-up periods ranging from 360 days to 720 days.

Fig. 5

Comparison of effects of choline alphoscerate (1 r200 mg/day) and donepezil (10 mg/day) rand placebo and donepezil (10 mg/day) on patient functional outcomes as measured by the BADL after follow-up periods ranging from 360 days to 720 days.

Fig. 6

Comparison of effects of choline alphoscerate (1200 mg/day) and donepezil (10 mg/day) rand placebo and donepezil (10 mg/day) on patient functional outcomes as measured by the IADL after follow-up periods ranging from 360 days to 720 days.

Fig. 7

Comparison of effects of choline alphoscerate (1,200 mg/day) and donepezil (10 mg/day), and placebo and donepezil (10 mg/day) on patient behavioral outcomes as measured by the NPI after follow-up periods ranging from 360 days to 720 days.