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 .
Cognitive outcome after coronary artery bypass: a one-year prospective study.
BACKGROUND Cognitive deficits have been reported in patients after coronary artery bypass grafting  , but the incidence of these deficits varies widely . We studied prospect ively the incidence of cognitive change and whether the changes persisted over time . METHODS Cognitive testing was done preoperatively and 1 month and 1 year postoperatively in 127 patients undergoing coronary artery bypass grafting .  Tests were grouped into eight cognitive domains . A change of 0.5 st and ard deviation or more at 1 month and 1 year from patient 's preoperative Z score was the outcome measure . RESULTS We identified four main outcomes for each cognitive domain : no decline ; decline and improvement ; persistent decline ; and late decline . Only 12 % of patients showed no decline across all domains tested ; 82 % to 90 % of patients had no decline in visual memory , psychomotor speed , motor speed , and executive function ; 21 % and 26 % had decline and improvement in verbal memory and language ; approximately 10 % had persistent decline in the domains of verbal memory , visual memory , attention , and visuoconstruction ; and 24 % had late decline ( between 1 month and 1 year ) in visuoconstruction . CONCLUSIONS This study establishes that the incidence of cognitive decline varies according to the cognitive domain studied and that some patients have persistent and late cognitive changes in specific domains after coronary artery bypass grafting
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 .