DHA and citicoline double-up to boost cognitive improvements after stroke: Japanese study
Cognizin Citicoline, manufactured by Japanese health ingredient firm Kyowa Hakko Bio, is a patented form of the naturally-occurring substance Citicoline, which is known to help increase alertness and boost energy
Both citicoline and DHA have been shown separately to have neuroprotective properties in cases of cerebral ischaemia, where insufficient blood flow to the brain and the resulting poor oxygen supply often lead to a cerebral infarction or ischaemic stroke.
However, the combined effect of citicoline and DHA has not been determined.
Based on this, researchers at Kyowa Hakko Bio's Research and Innovation Centre and Tohoku University conducted a study to investigate the combined effect of Cognizin Citicoline and DHA treatment on cognitive deficits — specifically, neuronal cell death and cognitive dysfunction — resulting from stroke.
They also aimed to find out if co-supplementation using both intermediates had any impact on molecular changes in the hippocampus of the mice.
They induced ischaemia (restriction of blood supply to the tissues) in 10-week-old male mice then treated each mouse daily for 11 days with either a combination of citicoline (40mg/kg of body weight) and DHA (30mg/kg of body weight), or with citicoline or DHA alone.
The researchers subsequently reported: "Combined citicoline and DHA synergistically and significantly improved learning and memory ability of ischaemic mice compared with either alone.
"Further, citicoline and DHA treatment significantly prevented neuronal cell death, and slightly increased DHA-containing PtdCho in the hippocampus, albeit not significantly."
They also determined, after running a series of tests on the mice's brain activity after cerebral ischaemia and citicoline and / or DHA treatment, that the mice that had been given the combined supplementation showed an improvement in their ability to learn and recall information.
In addition, the combination was said to be able to prevent further brain cell death after a stroke or brain infarction.
More on mechanisms
Despite showing that a combination of citicoline and DHA could partially improve cognitive dysfunction in the ischaemic mice, the researchers were unable to elucidate the underlying mechanisms of such treatment.
According to previous research, citicoline and DHA are "qualitatively and quantitatively effective treatments" for cerebral ischaemia via PtdCho metabolism, which decreases during ischaemia.
The researchers wrote: "Considering mechanisms, it is tempting to speculate that citicoline promotes the uptake of DHA into brain tissue and synergistically rescues deficits."
They added that they had found that DHA-PtdCho in the hippocampus might synergistically increase after combined treatment with citicoline and DHA, though no statistically significant difference was observed. This suggested that citicoline could indeed support the incorporation of DHA into brain tissue.
With regards to Cognizin specifically, Kyowa Hakko Bio USA’s regulatory affairs director Danielle Citrolo said: "Clinical studies show Cognizin® provides vital nutrients that support brain function by helping brain communication, maintain healthy neurons, and protect them from free radicals.
"This study showed that combining the two helped prevent further loss of brain cells and improved cognitive functions often damaged following cerebral ischaemia.
"Pairing Cognizin and DHA bridges good with good — the combo looks like it could have potential synergy, and further research would be interesting."
In conclusion, the researchers wrote: "Taken together, these findings suggest that combined citicoline and DHA treatment may exert synergistic activity for partially improving memory deficits by preventing neuronal cell death following transient brain ischaemia.
"Further, this effect may be related to PtdCho species, especially DHA-containing PtdCho. More studies in another animal model, or clinically, need to be performed in the future to determine the ability of DHA to enhance the neuroprotection of citicoline."
With regards to Cognizin's commercial activity, Kyowa Hakko Bio marketing specialist Mami Aoki told NutraIngredients-Asia: "Cognizin has been used in dietary supplements in Malaysia, where these products are sold mainly in pharmacies.
"So far, two brands, Opceden and Vitamode, have used Cognizin in their products."
One of the products, made by Australian supplement company Opceden's MemoGold, comes in bottles of 30 capsules each, and is touted as a "two-in-one formula to enhance memory, focus, and brain performance for better mental clarity".
It contains Cognizin, as well as astaxanthin, with the latter meant as an antioxidant to reduce oxidative stress in the brain.
The other product, CogniPro Tablet, was developed by Malaysian health solutions firm Vitamode. Sold in boxes of 30 tablets, each tablet contains 250mg of Cognizin, and is said to help enhance concentration, improve memory, and support overall cognitive function.
Aoki said, "Cognizin is also available in Germany and Italy, and we are currently conducting more studies to maximise its potential.
"We have no solid future business plans yet to expand to any specific market in addition to Malaysia, Europe, North America and New Zealand. However, we hope to eventually expand the business to other promising markets in Asia and other regions."
Source: Journal of Pharmacological Sciences
"Combined citicoline and docosahexaenoic acid treatment improves cognitive dysfunction following transient brain ischemia"
Authors; Eri Nakazaki, et al.