Phosphatidylserine and Choline

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Phosphatidylserine (PS) is a glycerophospholipid that is an important component of cell membranes. It has been shown to increase acetylcholine, norepinephrine, serotonin, and dopamine levels in patients with Alzheimer's disease. While some work suggests that 300 mg of PS in divided doses might help to improve cognition in dementia of the Alzheimer's type,38 other work seems to be less encouraging.39 In this context, perhaps one of the most important studies is one in which subjects who took supplemental PS were assessed by several techniques, including neuropsychologic testing, monitoring their cerebral metabolism of glucose, and measuring electroencephalograms over the course of six months. While improvements were noted during the study, it is interesting that the improvement was most noticeable at 8 and 16 weeks and that the improvement faded toward the end of the six-month study. Thus, it may be important to bear in mind that this therapy might offer only short-term instead of long-term benefit for patients with Alzheimer's dementia. What is noteworthy is that the variance seen among studies of PS could have been caused, in part, by the origin of the PS. The original studies used animal-tissue derivatives, which have a very different fatty-acid composition than PS from soy, which is used more typically by many clinicians and researchers today. An important concern about using animal-derived PS in the current research and clinical environment is the risk of exposing patient populations to prion-infected material.

Choline is of interest and has been studied in the treatment of Alzheimer's disease because it is a precursor to acetylcholine. In a double-blind, randomized, placebo-controlled trial, patients affected by mild to moderate dementia of the Alzheimer type were treated with the cholinergic precursor choline alfoscerate at a dose of 400 mg three times daily for 180 days. According to the Mini-Mental State Examination, Global Deterioration Scale, Alzheimer's Disease Assessment Scale-Behavioral Subscale, Alzheimer's Disease Assessment Scale, and Clinical Global Impression, the choline alfoscerate supplemented group consistently improved after 90 and 180 days versus baseline, whereas in the placebo group they remained unchanged or worsened.40

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