The effect of citicoline on stroke: A comparative study from the Eastern part of India

Abstract

Background: Citicoline is a novel neuroprotective agent used in acute stroke with a significantly favorable outcome. Materials and Methods: A hundred patients who suffered from either an ischemic and hemorrhagic stroke and who presented to the hospital within 48 h of stroke onset were enrolled for the study. Of these 100 patients (age- and sex-matched), 50 patients were treated with citicoline along with the standard stroke management and considered as 'cases'. The other 50 patients who were administered the standard stroke treatment were considered as 'controls.' The baseline parameters of the patients was assessed using the National Institute of Health Stroke Scale. The patients were reassessed at follow up at the end of the 1^st and 3^rd month of the commencement of the therapy and their outcome was evaluated by the Barthel Index score (BI). Results: The mean BI scores of all categories at the 1^st and 3^rd month were significantly higher in the citicoline treatment group (P < 0.001 at the 1^st month and P = 0.002 at the 3^rd month). An analysis of the categorized BI score showed that there was a significant difference in the number of patients in the categorized BI score (85-100) (at the 1^st month follow-up: 0% in control vs. 7% in case group [P < 0.05]; and, at the 3^rd month follow-up: 10% in control vs. 36% in citicoline case group [P < 0.05]). In the subgroup analysis, both patients suffering from either ischemic and hemorrhagic stroke (including all categories of BI score) in the citicoline treatment group showed a significantly higher mean BI score at the 1^st month (ischemic: P = 0.003, hemorrhagic: P =0.04) and also at the end of the 3^rd month (ischemic: P = 0.03, hemorrhagic: P = 0.03). An analysis of the categorized BI score (85-100) at the end of the 3^rd month in both the hemorrhagic as well as the ischemic subgroups showed a significant incidence of improvement in the citicoline group compared with the control group (hemorrhagic-- control: 6.66% vs. case: 31.81%, P < 0.05 and ischemic-- control: 11.41% vs. case: 35.71%, P < 0.05). Conclusion: In patients suffering from stroke and presenting within 48 h of onset, treatment with citicholine increases the probability of complete recovery and a favorable outcome at the 1^st month and at the end of the 3^rd month in all the stroke groups.