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CDP-Choline and Working Memory After TBI: A Neuroimaging Study

This study has been completed.
National Institutes of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by (Responsible Party):
Patricia M. Arenth, University of Pittsburgh Identifier:
First received: July 29, 2008
Last updated: June 10, 2013
Last verified: June 2013

July 29, 2008
June 10, 2013
March 2009
May 2013   (Final data collection date for primary outcome measure)
Follow-up neuropsychological testing Follow-up fMRI Follow-up Working memory task performance during fMRI [ Time Frame: 6 weeks ]
Same as current
Complete list of historical versions of study NCT00727246 on Archive Site
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CDP-Choline and Working Memory After TBI: A Neuroimaging Study
CDP-Choline and Working Memory After TBI: A Neuroimaging Study.
The purpose of this study is to determine whether an investigational drug, called "CDP-Choline", improves memory in people with traumatic brain injury (TBI). To do this, we are asking for people with traumatic brain injury and people without traumatic brain injury to be a part of this study. We will compare results between each group to see if this investigational drug makes a difference with memory. We will also compare brain imaging results and information collected before and after the taking of the study medication to see if there are any differences. We hypothesize that there will be differences in brain activation patterns between individuals with TBI and healthy controls, as well as differences in performance on memory testing at baseline. We further hypothesize that, after treatment with CDP-Choline, the patterns in neuroimaging findings and cognitive testing results for individuals with TBI will more closely resemble results observed for healthy individuals. We hope that what we learn from this study will be helpful in the future treatment of individuals with head injury.
Despite the prevalence of working memory deficits following traumatic brain injury (TBI), the scientific data regarding pharmacological treatment of this problem is limited. As deficits in working memory are known to have a significant impact on functional outcomes for individuals with TBI, further research in this area is essential in order for physicians to be able to treat this problem more effectively. The primary goal of the proposed project is to examine the efficacy of a particular pharmacological agent, CDP-Choline, in the treatment of working memory deficits following traumatic brain injury (TBI). The study sample will consist of 48 subjects: A group of 24 individuals who have sustained moderate to severe TBI, and a group of 24 healthy controls. Each group will be divided into a placebo and treatment group. The project will utilize functional Magnetic Resonance Imaging (fMRI) to investigate the cerebral neurophysiological effects of treatment with CDP-Choline. A working memory task (N-Back) will be employed during fMRI sessions. In addition, the effects of treatment with CDP-Choline on neuropsychological testing performance will also be evaluated, and the correlations between behavioral performance and neuroimaging results will be observed. We will achieve these goals by comparing baseline neuropsychological testing results as well as fMRI results, with a second set of testing and neuroimaging results obtained following 1 month of pharmacological treatment with CDP Choline or placebo. Based on our preliminary studies and the available literature, we expect to see the following: Baseline fMRI results are expected to show that individuals with TBI display altered patterns of cerebral activation during a working memory task, as compared to healthy controls. With CDP-Choline treatment, we expect TBI subjects to display fMRI laterality and dispersion patterns that more closely resemble patterns of healthy controls. In addition, we anticipate improvements in behavioral performance on both the specific working memory task (N-Back), and on traditional neuropsychological tests to be associated with CDP-Choline treatment, with greater magnitude of change on testing results for the TBI group as compared to any changes noted for the control or placebo groups. Finally, we anticipate that specific significant correlations will be observed between neuropsychological testing results and neuroimaging findings, and that the strength of these relationships will be greater for the TBI treatment group, as compared to the placebo or healthy control groups. By conducting the proposed study in this manner, we hope to provide scientific data that will allow for improved treatment, and ultimately improved functional outcomes for individuals who have sustained TBI.
Phase 2
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Brain Injuries
  • Drug: CDP-Choline
    1000 mg CDP-Choline 2 x per day for 6 weeks.
    Other Names:
    • Citicoline
    • Cytidine 5'-diphosphocholine
  • Drug: Placebo
    Treatment with placebo for 6 weeks
  • Experimental: 1
    Treatment with CDP-Choline
    Intervention: Drug: CDP-Choline
  • Placebo Comparator: 2
    Treatment with Placebo
    Intervention: Drug: Placebo
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*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
May 2013
May 2013   (Final data collection date for primary outcome measure)

Inclusion Criteria:

For individuals with TBI and Health Controls:

  • right hand dominant
  • English speaking
  • No history of neurological illness (for example, stroke, seizure or brain tumor.
  • No significant history of psychiatric illness (for example, schizophrenia or bipolar disorder) or current severe emotional distress.
  • No visual difficulties that would not allow for reading and following written instructions.
  • Free of alcohol or substance abuse.
  • Capable of following basic written and oral instructions.
  • Not taking certain medications that may interact with study medication or interfere with neuroimaging.
  • Be able to take medication in tablet form, or crushed and dissolved in a liquid.
  • Meet the additional criteria associated with MRI safety standards, as required by the University of Pittsburgh Department of Radiology. For example, these criteria include exclusion due to surgical placement of metal plates or electronic implants.

In addition:

Individuals with TBI must:

  • Have a specific diagnosis of a moderate to severe traumatic brain injury, which can be confirmed through review of medical records or assessments.
  • Be at least 1 year, but no more than 3 years since injury.
  • Must have significant working memory problems, as indicated by performance on a screening test.

Normal Control subjects must:

  • Perform within the normal range on a test of working memory.

Exclusion Criteria:

  • Prisoners.
  • Males with sexual partners who are planning to become pregnant during the treatment period.
  • Females who are currently pregnant or who are planning to become pregnant during the treatment period.
  • Individuals who are currently enrolled in another medication study
  • Individuals who are currently, or have previously been, treated with CDP-Choline (Citicoline) for research or clinical purposes.
  • Currently in a nursing home in the state of Pennsylvania.
Sexes Eligible for Study: All
18 Years to 55 Years   (Adult)
Contact information is only displayed when the study is recruiting subjects
United States
K23HD049626 ( US NIH Grant/Contract Award Number )
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Patricia M. Arenth, University of Pittsburgh
University of Pittsburgh
  • National Institutes of Health (NIH)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Principal Investigator: Patricia M. Arenth, Ph.D. University of Pittsburgh
University of Pittsburgh
June 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP