title: Effects of citicoline on level of consciousness, serum level of fetuin-A and matrix Gla-protein (MGP) in trauma patients with diffuse axonal injury (DAI) and GCS≤8.
abstract: BACKGROUND
  Citicoline, a neuroprotective drug, has been suggested to improve level of consciousness, mitigating secondary to brain damage and ectopic vascular calcification, following post-traumatic neurogenesis and angiogenesis, inducing calcification modulators, like fetuin-A and matrix Gla-protein (MGP). This study aimed to investigate effects of citicoline on levels of consciousness, serum levels of fetuin-A and MGP in patients with severe traumatic brain injury.
  
  
  METHODS
  This double blind randomized controlled trial (RCT) was conducted on patients with diagnosis of diffuse axonal injury (DAI) and GCS≤8. The cases were treated with citicoline (500 mg every 6 hours) intravenously for fifteen days. Daily GCS assessment and intermittent blood sampling were done for both cases and controls.
  
  
  RESULTS
  Fifty-eight patients were included in the study and during the study period, mean GCS levels improved in both groups; however, the difference was inconsiderable (p>0.05). Serum levels of fetuin-A, a negative phase reactant, increased in the group treated with citicoline (p=0.012), while these changes were insignificant for the controls (p=0.455). Serum levels of MGP, a calcification inhibitor, increased in the cases (p=0.046). The alterations were inconsequential in the control group (p=0.405).
  
  
  CONCLUSIONS
  The findings of this study suggest neutral effects of citicoline on level of consciousness and GCS. Through increasing levels of fetuin-A and MGP, citicoline may have protective effects against inflammatory damage and vascular calcification secondary to head trauma.
authors.affiliation: Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ghaffar
authors.initials: G
authors.lastname: Shokouhi
authors.affiliation: Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Amir Ghorbani
authors.initials: AG
authors.lastname: Haghjoo
authors.affiliation: Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Neda
authors.initials: N
authors.lastname: Sattarnezhad
authors.affiliation: Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Asghari
authors.affiliation: Department of Pharmacy, Eastern Mediterranean University, Famagusta, Cyprus.
authors.forename: Aida
authors.initials: A
authors.lastname: Sattarnezhad
authors.affiliation: Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Asghari
authors.affiliation: Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Arastoo
authors.initials: A
authors.lastname: Pezeshki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D002135:Calcium-Binding Proteins / Q000097:blood; D003243:Consciousness; D003566:Cytidine Diphosphate Choline / Q000008:administration & dosage / Q000627:therapeutic use*; D020833:Diffuse Axonal Injury / Q000150:complications*; D004311:Double-Blind Method; D016326:Extracellular Matrix Proteins / Q000097:blood; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism; D000097568:Matrix Gla Protein
chemical_list: D002135:Calcium-Binding Proteins; D003566:Cytidine Diphosphate Choline; D016326:Extracellular Matrix Proteins; D018697:Nootropic Agents; D060749:alpha-2-HS-Glycoprotein; D000097568:Matrix Gla Protein