Department of Neurology, Chungnam National University Hospital, Daejeon, Korea.
Department of Neurology, Seoul National University Hospital, Seoul, Korea.
Medicine (Baltimore). 2024 Jun 14;103(24):e38067. doi: 10.1097/MD.0000000000038067.
Choline alfoscerate (alpha-glycerylphosphorylcholine) is a phospholipid that includes choline, which increases the release of acetylcholine. The ASCOMALVA trial, a combination of donepezil and choline alfoscerate, slowed cognitive decline in Alzheimer disease. This study aims to replicate the effect by combining donepezil with other nootropics currently used in South Korea.
The 119 patients with cognitive decline who were eligible to use donepezil, with an mini-mental state examination (MMSE) score of 26 or less, were assigned to: donepezil alone (DO); donepezil and choline alfoscerate (DN); donepezil and acetyl-l-carnitine (DA); or donepezil and ginkgo biloba extract (DG). Cognitive evaluations such as MMSE, clinical dementia rating, Alzheimer disease assessment scale-cognitive subscale (ADAS-Cog), and Alzheimer disease assessment scale-noncognitive subscale were performed at the 12th and 24th weeks from the baseline time point.
At the 12th week, the MMSE score increased 3.52% in the DN group, whereas it increased by 1.36% in the DO group. In the DA + DG group, it decreased by 2.17%. At the 24th week, the MMSE score showed an increase of 1.07% in the DO group and 1.61% in the DN group, but decreased by 5.71% in the DA + DG group. ADAS-Cog decreased by 0.9% in the DO group, while it improved by 13.9% in the DN group at the 12th week. At the 24th week, ADAS-Cog showed improvement in the DN group by 18.5%, whereas it improved by 9.4% in the DO group. Alzheimer disease assessment scale-noncognitive subscale also revealed better performance in the DN group than in the DO group at the 12th and 24th weeks.
Choline alfoscerate exhibits additional cognitive improvement in both cognitive and noncognitive domains, supporting the findings of the ASCOMALVA trial.
胆碱酒石酸氢盐（alpha-甘油磷酸胆碱）是一种含有胆碱的磷脂，可增加乙酰胆碱的释放。ASCOMALVA 试验表明，多奈哌齐与胆碱酒石酸氢盐联合使用可减缓阿尔茨海默病的认知能力下降。本研究旨在通过联合使用多奈哌齐与韩国目前使用的其他益智药来复制该效果。
共有 119 名认知能力下降的患者符合使用多奈哌齐的条件，他们的简易精神状态检查（MMSE）评分为 26 或更低，被分配到以下组别：多奈哌齐单药治疗（DO）组；多奈哌齐与胆碱酒石酸氢盐（DN）组；多奈哌齐与乙酰-L-肉碱（DA）组；或多奈哌齐与银杏叶提取物（DG）组。从基线时间点开始，在第 12 周和第 24 周进行认知评估，包括 MMSE、临床痴呆评定量表、阿尔茨海默病评估量表-认知分量表（ADAS-Cog）和阿尔茨海默病评估量表-非认知分量表。
在第 12 周，DN 组的 MMSE 评分增加了 3.52%，而 DO 组仅增加了 1.36%。在 DA+DG 组中，评分下降了 2.17%。在第 24 周，DO 组的 MMSE 评分增加了 1.07%，DN 组增加了 1.61%，而 DA+DG 组则下降了 5.71%。ADAS-Cog 在 DO 组中下降了 0.9%，而在第 12 周时，DN 组的评分提高了 13.9%。在第 24 周，DN 组的 ADAS-Cog 评分提高了 18.5%，而 DO 组的评分提高了 9.4%。阿尔茨海默病评估量表-非认知分量表也显示，DN 组在第 12 周和第 24 周的表现优于 DO 组。
胆碱酒石酸氢盐在认知和非认知领域均表现出额外的认知改善，支持 ASCOMALVA 试验的结果。
