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 .
Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery.
BACKGROUND Reduction of cognitive function is a possible side effect after cardiac surgery using cardiopulmonary bypass . We investigated the cerebroprotective effect of piracetam on cognitive performance in patients undergoing coronary artery bypass surgery under cardiopulmonary bypass . MATERIAL / METHODS Patients scheduled for elective , primary and isolated coronary bypass surgery were r and omised either to piracetam or  placebo  group . The study was performed in a double blind fashion . Patients received either 12 g piracetam or placebo at the beginning of the operation . Six neuropsychological subtests from the Syndrom Kurz Test and the Alzheimer 's Disease Assessment Scale were performed preoperatively and on the third postoperative day . To assess the overall cognitive function and the degree of cognitive decline across all tests after surgery we combined the six test-scores by principal component analysis . RESULTS A total number of 120 patients were enrolled into the study . Preoperative overall cognitive function were not significantly different between the groups . The postoperative combined score of the neuropsychological tests showed a deterioration of cognitive function in both groups ( placebo-pre : -0.06+/-0.99 vs placebo-post : -1.38+/-1.11 ; p<0.0005 and piracetam-pre : 0.06+/-1.02 vs piracetam-post : -0.65+/-0.93 ; p<0.0005 ) . However , the piracetam patients performed significantly better compared to the placebo patients after the operation and had a less decline of overall cognitive function ( p<0.0005 ) . CONCLUSIONS Piracetam has a cerebroprotective effect in patients undergoing coronary artery bypass surgery with the use of cardiopulmonary bypass . It reduces an early postoperative substantial decline of neuropsychological abilities
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 .