From the data reported in the literature , it emerges that nootropics may be an effective alternative for strengthening and enhancing cognitive performance in patients with a range of pathologies .
Although nootropics , and specifically the cholinergic precursors , already have a long history behind them , according to recent renewal of interest , they still seem to have a significant therapeutic role .
Drugs with regulatory indications for symptomatic treatment of Alzheimer 's disease , such as cholinesterase inhibitors and memantine , often have transient effects in dementia disorders .
Nootropics represent probably the first " smart drugs " used for the treatment of cognitive deficits .
The aim of this paper is to verify , by a systematic analysis of the literature , the effectiveness of nootropics in this indication .
The analysis was limited to nootropics with cholinergic activity , in view of the role played by acetylcholine in learning and memory .
Acetylcholine was the first neurotransmitter identified in the history of neuroscience and is the main neurotransmitter of the peripheral , autonomic , and enteric nervous systems .
Acetyl-l-Carnitine Treatment in Minimal Hepatic Encephalopathy
Minimal hepatic encephalopathy ( MHE ) is characterized by disturbance of mental state and neuromuscular function . To assess the clinical efficacy of acetyl-l-carnitine ( ALC ) in the treatment of MHE , we performed a r and omized , double-blind , placebo-controlled study administering ALC in cirrhotic patients with this disease and evaluating their cognitive functions . One hundred and twenty-five cirrhotic patients , of whom 21 were infected by hepatitis B virus , 75 by hepatitis C virus and 29 with cryptogenic cirrhosis , were enrolled in our study . Patients were r and omly divided into two groups , and using double-blind administration , group A was treated with ALC and group B with placebo for 90 days . The two groups were similar in demographic characteristics , aetiology of cirrhosis , duration and Child-Pugh grade . Minimal hepatic encephalopathy was diagnosed with the Trail Making Test ( TMT ) , Symbol Digit Modalities Test ( SDMT ) and Auditory Verbal Learning Test ( AVL ) and cognitive function with the Mini Mental State Examination ( MMSE ) . After 90 days in group A treated with ALC , we observed a significant decrease in prothrombin time ( P < 0.001 ) , bilirubin serum levels ( P < 0.01 ) , AST ( P < 0.001 ) , fasting NH4 serum levels ( P < 0.001 ) , Trail Making Test-A ( P < 0.001 ) and Trail Making Test-B ( P < 0.001 ) , and a significant increase in albumin serum levels ( P < 0.005 ) , MMSE test ( P < 0.001 ) , Symbol Digit Modalities Test ( P < 0.001 ) , BDT ( P < 0.001 ) , AVL long-term test ( P < 0.001 ) and AVL total test ( P < 0.001 ) . No significant differences were observed in EEG in either group of patients treated with ALC or placebo . The benefits of ALC in comparison with placebo are demonstrated in greater reductions in serum ammonia levels , as well as in improvements of neuropsychological functioning
From the data reported in the literature , it emerges that nootropics may be an effective alternative for strengthening and enhancing cognitive performance in patients with a range of pathologies .
Although nootropics , and specifically the cholinergic precursors , already have a long history behind them , according to recent renewal of interest , they still seem to have a significant therapeutic role .
Drugs with regulatory indications for symptomatic treatment of Alzheimer 's disease , such as cholinesterase inhibitors and memantine , often have transient effects in dementia disorders .
Nootropics represent probably the first " smart drugs " used for the treatment of cognitive deficits .
The aim of this paper is to verify , by a systematic analysis of the literature , the effectiveness of nootropics in this indication .
The analysis was limited to nootropics with cholinergic activity , in view of the role played by acetylcholine in learning and memory .
Acetylcholine was the first neurotransmitter identified in the history of neuroscience and is the main neurotransmitter of the peripheral , autonomic , and enteric nervous systems .