Efektivitas Citicoline terhadap Perbaikan Status Fungsional dan Gangguan Neurologis pada Pasien dengan Stroke Perdarahan Intraserebral Supratentorial Akut

Authors

  • Ariel Valentino Soetedjo Dokter Umum

DOI:

https://doi.org/10.55175/cdk.v51i1.978

Keywords:

Citicoline, intracerebral hemorrhage, supratentorial

Abstract

Supratentorial intracerebral hemorrhage (ICH) is the second most common stroke and can potentially have poor outcomes. Citicoline has been researched extensively for ischemic stroke yet has little evidence for hemorrhagic stroke. This study aims to critically appraise evidence regarding efficacy of citicoline in improving functional status and neurological deficit in supratentorial ICH. The literature search utilized 5 databases: PubMed, Embase, Cochrane, Scopus, EBSCOHost. From 802 studies identified at the start of the search, 5 articles were selected for critical appraisal. A study by Zang demonstrated improvement in the NIHSS score (p=0.015) and Barthel index (p=0.001). A study by Mousavi showed improvement in the Barthel index (p=0.008) when compared to the control, but no difference when compared to the baseline in both groups. A study by Iranmanesh demonstrated improvement in the motoric strength (p=0.019). A study by Chua demonstrated improvement in the Barthel index at 3 months follow-up (p<0.05). However, there are no differences in the modified Rankin scale and NIHSS score. A study by Secades demonstrated improvement in the NIHSS score (p<0.001) when compared to baseline, but no difference when compared to the control. Citicoline has the potential to improve patient mobility in supratentorial intracerebral hemorrhage stroke, but in terms of improvement in functional status and neurological impairment requires further research. 

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References

Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global stroke fact sheet 2022. Internat J Stroke. 2022;17(1):18–29.

Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021;20(10):795–820.

Boehme AK, Esenwa C, Elkind MSV. Stroke risk factors, genetics, and prevention. Circ Res. 2017;120(3):472–95.

Murphy SJX, Werring DJ. Stroke: Causes and clinical features. Medicine (Abingdon) 2020;48(9):561–6.

Patel VD, Garcia RM, Swor DE, Liotta EM, Maas MB, Naidech A. Natural history of infratentorial intracerebral hemorrhages: two subgroups with distinct presentations and outcomes. J Stroke Cerebrovasc Dis. 2020;29(8):104920.

Kirkman MA, Smith M. Supratentorial intracerebral hemorrhage: A review of the underlying pathophysiology and its relevance for multimodality neuromonitoring in neurointensive care. J Neurosurg Anesthesiol. 2013;25(3):228.

Secades JJ, Alvarez-Sabín J, Castillo J, Díez-Tejedor E, Martínez-Vila E, Rios J, et al. Citicoline for acute ischemic stroke: A systematic review and formal meta-analysis of randomized, double-blind, and placebo-controlled trials. J Stroke Cerebrovasc Dis. 2016 Aug;25(8):1984–96.

Martí-Carvajal AJ, Valli C, Martí-Amarista CE, Solà I, Martí-Fàbregas J, Cosp XB. Citicoline for treating people with acute ischemic stroke. Cochrane Database Syst Rev. 2020 Aug 29;8(8):CD013066.

Perna R, Temple J. Rehabilitation outcomes: Ischemic versus hemorrhagic strokes. Behav Neurol. 2015;2015:891651.

OCEBM Levels of evidence - centre for evidence-based medicine. University of Oxford [Internet]. 2011 [cited 2022 Jun 3]. Available from: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence.

Critical appraisal tools - Centre for evidence-based medicine. University of Oxford [Internet]. [cited 2023 Jun 25]. Available from: https://www.cebm.ox.ac.uk/resources/ebm-tools/critical-appraisal-tools.

Zang J, Xian LA, Qi L. The cytological mechanism and effects of hypertensive cerebral hemorrhage treatment by citicoline on serum gfap and copeptin level. Eur J Inflamm. 2019;17:2058739219867244.

Mousavi S, Zare M, Khorvash F, Nikbakht K. Evaluation of citicholine effect in acute phase of supratentorial hemorrhage: A randomized placebocontrolled clinical trial. J Cell Tissue Res. 2009;9:1773–6.

Iranmanesh F, Vakilian A. Efficiency of citicoline in increasing muscular strength of patients with nontraumatic cerebral hemorrhage: A doubleblind randomized clinical trial. J Stroke Cerebrovasc Dis. 2008;17(3):153–5.

Chua RH. Role of intravenous citicoline for supratentorial hemorrhage. Cerebrovascular diseases. 2007 May 30;23(Suppl 2):1–147.

Secades JJ, Ðlvarez-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(5–6):380–5.

Grieb P. Neuroprotective properties of citicoline: Facts, doubts and unresolved issues. Cns drugs 2014;28(3):185–93.

Jasielski P, Piędel F, Piwek M, Rocka A, Petit V, Rejdak K. Application of citicoline in neurological disorders: A systematic review. Nutrients 2020 Oct 12;12(10):3113. doi: 10.3390/nu12103113.

Roy P, Tomassoni D, Nittari G, Traini E, Amenta F. Effects of choline containing phospholipids on the neurovascular unit: A review. Front Cell Neurosci. 2022;16:988759.

Conant R, Schauss AG. Therapeutic applications of citicoline for stroke and cognitive dysfunction in the elderly: A review of the literature. Altern Med Rev. 2004;9(1):17–31.

Kuriakose D, Xiao Z. Pathophysiology and treatment of stroke: present status and future perspectives. Int J Mol Sci. 2020 Oct 15;21(20):7609. doi: 10.3390/ijms21207609.

McGlade E, Agoston AM, DiMuzio J, Kizaki M, Nakazaki E, Kamiya T, et al. The effect of citicoline supplementation on motor speed and attention in adolescent males. J Atten Disord. 2019;23(2):121–34.

Senn R, Elkind MS, Montaner J, Christ-Crain M, Katan M. Potential role of blood biomarkers in the management of nontraumatic intracerebral hemorrhage. Cerebrovasc Dis. 2014;38(6):395-409. doi: 10.1159/000366470.

Alvarez-Sabín J, Román GC. The role of citicoline in neuroprotection and neurorepair in ischemic stroke. Brain Sci. 2013 Sep 23;3(3):1395-414. doi: 10.3390/brainsci3031395.

Liu F, Tsang RC, Zhou J, Zhou M, Zha F, Long J, et al. Relationship of barthel index and its short form with the modified rankin scale in acute stroke patients. J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105033. doi: 10.1016/j.jstrokecerebrovasdis.2020.105033.

Davis AG, Nightingale S, Springer PE, Solomons R, Arenivas A, Wilkinson RJ, et al. Neurocognitive and functional impairment in adult and paediatric tuberculous meningitis. Wellcome Open Res. 2019 Nov 13;4:178. doi: 10.12688/wellcomeopenres.15516.1.

Cohen RA, Browndyke JN, Moser DJ, Paul RH, Gordon N, Sweet L. Long-term citicoline (cytidine diphosphate choline) use in patients with vascular dementia: Neuroimaging and neuropsychological outcomes. Cerebrovasc Dis. 2003;16(3):199-204. doi: 10.1159/000071116.

Shokouhi G, Haghjoo AG, Sattarnezhad N, Asghari M, Sattarnezhad A, Asghari A, et al. Effects of citicoline on level of consciousness, serum level of fetuin-a and matrix gla-protein (mgp) in trauma patients with diffuse axonal injury (dai) and gcs≤8. Ulus Travma Acil Cerrahi Derg. 2014 Nov;20(6):410-6. doi: 10.5505/tjtes.2014.05769.

Published

02-01-2024

How to Cite

Soetedjo, A. V. (2024). Efektivitas Citicoline terhadap Perbaikan Status Fungsional dan Gangguan Neurologis pada Pasien dengan Stroke Perdarahan Intraserebral Supratentorial Akut. Cermin Dunia Kedokteran, 51(1), 44–50. https://doi.org/10.55175/cdk.v51i1.978