(Stroke. 1997;28:1060-1065.)
© 1997 American Heart Association, Inc.
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From the Department of Neurology, Medical Center of Central Massachusetts, Worcester (M.Z.Ö., F.L., T.T., M.F.); Departments of Neurology and Radiology, University of Massachusetts Medical School, Worcester (M.F.); and Interneuron Pharmaceuticals Inc, Lexington, Mass (K.W.L., B.W.S.).
Correspondence to Marc Fisher, MD, Department of Neurology, Medical Center of Central Massachusetts, 119 Belmont St, Worcester, MA 01605-2982.
Background and Purpose Citicoline, a naturally occurring precursor of phosphatidylcholine, is neuroprotective and is currently being assessed in clinical trials. To evaluate potential synergistic neuroprotective effects of prolonged citicoline treatment and early N-methyl-D-aspartate (NMDA) antagonist therapy, suboptimal treatment regimens of citicoline and MK-801 were tested alone and in combination in a rat model of temporary focal ischemia.
Methods Four groups of Sprague-Dawley rats (n=12 per group) underwent 90 minutes of temporary middle cerebral artery occlusion (MCAO) with the suture model. Animals were randomly and blindly assigned to one of four treatment groups: (1) saline, vehicle; (2) MK-801, 0.5 mg/kg IV bolus at 60 minutes after MCAO followed by saline 1 mL/kg IP daily for 7 days; (3) saline IV at 60 minutes after MCAO followed by citicoline 250 mg/kg IP daily for 7 days; or (4) both MK-801 and citicoline (daily for 7 days) active treatment. Triphenyltetrazolium chloride staining was used to assess postmortem infarct volume. Neurological scores were determined daily.
Results Premature mortality between days 2 and 4 was 33.3% in group 1, 41.7% in groups 2 and 3, and 25.0% in group 4. Mean corrected infarct volume was significantly reduced in group 4 compared with the others (175.2±89.3 mm3 in group 1, 179.1±78.5 mm3 in group 2, 163.9±73.7 mm3 in group 3, and 84.7±56.8 mm3 in group 4 [P<.02, ANOVA and P<.05, Scheffé's test for group 1 versus group 4]). Mean infarct volume in animals dying prematurely was significantly (P<.05, Student's t test) larger in group 1 than those surviving for 7 days (247.2±89.5 versus 139.2±68.2 mm3), but there was no significant difference in infarct volume in groups 2, 3, and 4 between animals dying prematurely and those surviving for 7 days.
Conclusions These results demonstrate synergistic neuroprotective effects of citicoline and an NMDA antagonist in temporary experimental focal ischemia.
Key Words: citicoline MK-801 cerebral ischemia, focal neuroprotection rats
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