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Citicoline increases likelihood of achieving minimal clinically important difference in Parkinson's disease by OR 2.06Trial shows citicoline may improve movement in Parkinson's disease

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Key Takeaway
Consider citicoline as a well-tolerated supportive therapy to improve motor scores in Parkinson's disease.

This randomized, double-blind, multicenter trial enrolled 485 patients with Parkinson's disease who were already receiving dopaminergic therapies. Participants were randomized to receive either citicoline (1000 mg/day intramuscular, administered in two six-week cycles) or a placebo. The primary outcome was the change in Movement Disorder Society-Unified PD Rating Scale (MDS-UPDRS) total score over a 24-week follow-up period.

Citicoline treatment resulted in an increased likelihood of achieving a minimal clinically important difference in MDS-UPDRS total scores compared with placebo (OR 2.06; 95% CI 1.06-3.99; P = 0.031). Significant improvements were also noted in motor function (MDS-UPDRS III: -2.97 vs -0.13; p = 0.009) and clinical global impressions (CGI-II: 3.26 vs 3.59; p = 0.021; CGI-III: 9.30 vs 10.38; p = 0.018).

Safety data indicated that citicoline was well tolerated. Adverse events occurred in 22.1% of the citicoline group and 27.1% of the placebo group. While the trial suggests citicoline may be an effective supportive therapy for Parkinson's disease, the evidence is currently limited by the lack of reported specific limitations or detailed safety data beyond general tolerability.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in pharmacological supportive therapies for Parkinson's disease. While previous coverage highlighted non-pharmacological interventions like Tai Chi for balance and mood, and robot-assisted gait training for walking endurance, this study provides evidence for a pharmacological adjunct. It does not directly relate to the genetic associations of TLE4, HLA-V/HLA-G, and LRRK2, or the role of IL-34/CSF1R signaling in neurodegeneration.

Living with Parkinson's disease means managing daily challenges with movement and physical coordination. A large study of 485 patients looked at whether adding a substance called citicoline to standard dopamine-based treatments could provide extra support. The participants received citicoline injections over two six-week cycles, while others received a placebo.

The results showed that those who received citicoline saw improvements in their motor functions and overall clinical scores compared to those who received the placebo. Specifically, the group receiving the treatment showed better scores on scales measuring movement and general clinical impressions. The study also noted that the treatment was well tolerated by the patients.

While these results are encouraging, it is important to remember that this study shows an association rather than a guaranteed cure. The findings suggest that citicoline could be a safe and helpful addition to current therapies, but patients should talk to their doctors to see if this specific treatment fits their personal care plan.

What this means for you:
Citicoline may improve motor function and overall clinical scores for people with Parkinson's disease.

Common questions

What did the study find about motor skills?

The study found that patients who received citicoline showed a significant improvement in motor function scores compared to those who received a placebo. This suggests that the treatment may help with the physical movements affected by Parkinson's disease.

Is citicoline safe for people with Parkinson's?

The study reported that citicoline was well tolerated by the participants. The rate of adverse events was 22.1% in the citicoline group and 27.1% in the placebo group, suggesting it is a manageable option for those already on dopaminergic therapies.

How does this differ from current treatments?

While standard treatments focus on dopamine, this study looks at citicoline as a supportive therapy. It aims to provide additional benefits for motor function and overall clinical impressions in patients already taking standard medications.

Study Details

Study typeRct
Sample sizen = 485
EvidenceLevel 2
Follow-up5.5 mo
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Citicoline is a promising therapeutic option for improving both motor and non-motor symptoms in Parkinson's disease (PD) beyond levodopa and other standard dopaminergic treatments. OBJECTIVES: The CITIPARK study evaluated the efficacy and safety of citicoline in improving clinical outcomes and quality of life (QOL) in PD patients on dopaminergic therapies. METHODS: The randomized, double-blind, multicenter trial compared citicoline (1000 mg/day intramuscular, two six-week cycles) with placebo for 24 weeks in PD under stable medications. The primary endpoint was change in Movement Disorder Society-Unified PD Rating Scale (MDS-UPDRS) total score; secondary endpoints included motor and non-motor subscores, QOL, clinical global impression (CGI) and safety. RESULTS: The study enrolled 485 participants, randomizing 474 (citicoline: 303; placebo: 171). Citicoline significantly increased the likelihood of achieving a minimal clinically important difference compared with placebo (OR 2.06, 95% CI 1.06-3.99; P = 0.031) on the MDS-UDPRS total score in the modified intention-to-treat population. Among secondary outcomes, the citicoline group showed greater improvement in motor function (MDS-UPDRS III -2.97 vs -0.13; p = 0.009) and a greater improvement on CGI -II and CGI-III (3.26 vs 3.59; p = 0.021 and 9.30 vs 10.38; p = 0.018, respectively). AEs occurred in 22.1% and 27.1% of the citicoline and placebo groups, respectively. CONCLUSIONS: Citicoline was well tolerated and associated with motor benefits compared with placebo in a highly compliant population. The results suggest a role of citicoline as a safe and possibly effective supportive therapy in PD treated with concomitant dopaminergic agents.
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