The Efficacy of Citicoline Combined with Ginkgo Biloba in Patients with Moderate Cognitive Impairment: Results of a Comparative Study with Monotherapy

Cardiovascular diseases, among which arterial hypertension (AH) occupies a priority place, are independent risk factors for the development and progression of cognitive disorders. The primary strategy in the prevention of dementia remains the correction of cardiovascular risk factors, as well as the search for additional approaches to prevent the development and progression of cognitive dysfunction with the involvement of neuroprotective and vasoprotective therapy. The objective: to evaluate the effect of a fixed combination (FC) of citicoline and ginkgo biloba (dietary supplement Axonal) on cognitive function indicators in patients with mild cognitive impairment (MCI) syndrome compared to monotherapy with citicoline or ginkgo biloba. Materials and methods. The research studied the dynamics of cognitive indicators in patients with AH, who took an FC of citicoline/ginkgo biloba (dietary supplement Axonal) and monotherapy with citicoline or ginkgo biloba for 90 days. A double-blind study enrolled 70 patients with MCI syndrome; their mean age at enrollment was 65.30 ± 5.54 years. All patients received treatment in accordance with the existing standards/protocols for providing medical care, approved by the Ministry of Health of Ukraine. Cognitive functions were assessed using the Montreal Cognitive Assessment Test (MoCA), Schulte tables, symbol-digit test and Stroop test. Results. Comparative analysis demonstrated the superiority of FC of citicoline/ginkgo biloba over the monotherapy group (citicoline or ginkgo biloba) in a significant increase in the MoCA integral test score by 11.4% (from 23.6 ± 1.5 to 26.3 ± 1.7 points, p < 0.001), restoration of cognitive functions in the domains of “executive skills” (0.33 ± 0.65 vs 0.26 ± 0.68 points, p = 0.03); “attention, counting” (0.09 ± 0.29 vs 0.01 ± 0.52 points, p = 0.01) and “memory, delayed repetition” (1.57 ± 1.51 vs 0.71 ± 1.51 points, p = 0.02) and improving the speed of information processing and concentration of attention (reducing the time to complete the symbolic-numeric coding test: 16% vs 8.3%, p = 0.04); increasing cognitive flexibility and strengthening cognitive control (the interference coefficient when performing the Stroop test decreased from 63.3 ± 24.2 to 54.3 ± 33.3 seconds (p = 0.03)), improving the quality of life up to 97.0% on the SF-36 scale (Short Form 36 Health Survey). Conclusions. Dual FC therapy compared to monotherapy demonstrated higher efficacy in improving cognitive functions, a good tolerability profile and a high level of adherence to treatment.