Combination of Citicoline and Physiotherapy in Children with Cerebral Palsy

BACKGROUND The most common cause of physical disability in children is cerebral palsy. This study was aimed to evaluate the effect of citicoline in combination to physiotherapy versus physiotherapy alone, to improve the functional outcome in pediatric cerebral palsy. METHODS The clinical trial was performed on 50 pediatric patients aged 18-75 months with spastic diplegia or quadriplegic cerebral palsy. Patients were assessed in two groups: case group, under treatment, using injection of citicoline (10 mg/kg) every other day for 3 months and physiotherapy. Gross motor function classification system (GMFCS) levels were assessed in all patients before and after treatment. RESULTS Patient's mean age was 38.7 ± 17.2 months, and 52% were girls. Differences in the frequency of GMFCS levels between groups were not statistically significant, before (P = 0.09) and after (P = 0.47) treatment. In case group improving in GMFCS, level was occurred in 9/11 with level 2 to level 1, 3/5 with level 3 to other levels and 3/7 with level 4 to other levels. In the control group improving in GMFCS, level was occurred in 3/9 with level 2 to level 1, 3/10 with level 3 to other levels, and 2/4 with level 4 other levels. GMFCS level in 64% of cases was improved, whereas in control group, 32% was improved (P = 0.02). CONCLUSIONS Results demonstrated that citicoline in combination to physiotherapy appears to be a promising agent to improve gross motor function in patients with cerebral palsy versus physiotherapy alone. Although, further studies are need to be done.