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Pharmacopsychiatry 2003; 36(3): 89-93
DOI: 10.1055/s-2003-39981
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Effect of Piracetam on Cognitive Performance in Patients Undergoing Bypass Surgery

R. Uebelhack1 , K. Vohs1 , M. Zytowski2 , H.-J. Schewe1 , C. Koch2 , W. Konertz2
  • 1Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin
    Psychiatrische Klinik,
  • 2Klinik für kardiovaskuläre Chirurgie
Further Information

Publication History

Received: 18.12.2001 Revised: 1.7.2002

Accepted: 3.7.2002

Publication Date:
13 June 2003 (online)

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In this study, the protective effect of piracetam on select aspects of cognitive function in patients undergoing bypass surgery was investigated.

Male patients (n = 64) with an indication for a surgical revascularization using artificial extracorporal circuits were randomly assigned in a double-blind fashion to receive a single challenge of 12-g piracetam infusion or placebo (sterile saline) prior to the bypass surgery. A brief battery of neuropsychological tests for verbal and non-verbal short-term memory and attention was administered 1 day before and 3 days after the surgical intervention.

There was a significant difference in short-term memory and attention, with the piracetam-treated patients producing a better level of performance 3 days after surgery compared to the placebo group. The overall postoperative cognitive function (z-transformation of all 6 test results) was more significantly (p < 0.001) reduced in the placebo group than in the piracetam group (z = -1.19 ± 0.72 vs. -0.46 ± 0.58, respectively).

A single challenge of 12-g piracetam infusion prior to surgical intervention might offer a short-term neuroprotective effect for patients undergoing cardiac bypass surgery. Whether this effect persists for a longer period of time requires further investigation.

References

  • 1 Bick R L. In vivo platelet inhibition by piracetam.  The Lancet. 1979;  8145 752-753
    PubMedGoogle Scholar
  • 2 Brown P, Steigert M J, Thompson P D, Day J C, Salama M, Waegemans T, Marsden C D. Effectiveness of piracetam in cortical myoclonus.  Movement Disord. 1993;  8 63-68
    PubMedGoogle Scholar
  • 3 Cheng D C, Karski J, Peniston C, Asokumar B, Raveendran G, Carroll J . et al . Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: a prospective randomized controlled trial.  J Thorac Cardiovasc Surg. 1996;  112 755-764
    CrossrefPubMedGoogle Scholar
  • 4 Christoffersen G RJ, von Linstow-Roloff E, Sandager-Nielsen K. Effect of piracetam on the performance of rats in a delayed match-to-position task.  Prog Neuro-Psychopharmacol & Biol Psychiat. 1998;  22 11-228
    PubMedGoogle Scholar
  • 5 Coq J O, Xerri C. Acute reorganization of the forepaw representation in the rat SI cortex after focal cortical injury: neuroprotective effects of piracetam treatment.  Eur J Neurosci.. 1999;  11 2597-2608
    CrossrefPubMedGoogle Scholar
  • 6 De Deyn P P, Reuck J D, Deberdt W, Vlietinck R, Orgogozo J M. Treatment of acute ischemic stroke with piracetam. Members of the piracetam in Acute Stroke Study (PASS) Group.  Stroke. 1997;  28 2347-2352
    PubMedGoogle Scholar
  • 7 Diegler A, Hirsch R, Schneider F, Scilling L -O, Falk V, Rauch T h, Mohr F W. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation.  Ann Thorac Surg. 2000;  69 1162-1166
    CrossrefPubMedGoogle Scholar
  • 8 Dupont J, Tavernier B, Ghosez Y, Durinck L, Thevenot A, Moktadir-Chalons N. et al . Recovery after anaesthesia for pulmonary surgery: desflurane, sevoflurane and isoflurane.  Br J Anaesth. 1999;  82 355-359
    PubMedGoogle Scholar
  • 9 Erzigkeit H. SKT. Ein Kurztest zur Erfassung von Gedächtnis- und Aufmerksamkeitsstörungen. Beltz Test GmbH Weinheim; 1989
    Google Scholar
  • 10 Grieco G, d’Hollosy M, Culliford A t, Jonas S. Evaluating neuroprotective agents for clinical anti-ischemic benefits using neuropsychological changes after cardiac surgery under cardiopulmonary bypass. Methodological strategies and results of a double-blind, placebo-controlled trial of GM1 ganglioside.  Stroke. 1996;  27 858-874
    PubMedGoogle Scholar
  • 11 Gallinat J, Möller H -J, Hegerl U. Piracetam in der Anästhesie zur Prophylaxe eines postoperativen Delirs.  Anästhesiol Intensivmed Notfallmed Schmerzther. 1999;  34 1-8
    PubMedGoogle Scholar
  • 12 Grotemeyer K H, Hoffeberth B, Hirschberg M. Normalisierung hyperreaktiver Thrombozyten bei Patienten mit TIAŽs unter Piracetam.  Nervenarzt. 1986;  57 180-183
    PubMedGoogle Scholar
  • 13 Kanowski S. Piracetam In: Riederer, Laux, Pöldinger (Hrsg) Neuropsychopharmaka Bd 5. Springer Verlag Wien; 1999: pp 189-204
  • 14 Kim Y S, Nibbelink D W, Overall J E. Factor structure and scoring of the SKT test battery.  J Clin Psychollogy. 1993;  49 61-71
    CrossrefPubMedGoogle Scholar
  • 15 Lagergren K, Levander S. A double-blind study on the effects of piracetam upon perceptual and psychomotoric performance at varied heart rates in patients treated with artificial pacemakers.  Psycgho pharmacologia. 1974;  39 97-104
    PubMedGoogle Scholar
  • 16 Means L W, Comer T R, Moore R. BMY 21 502 and piracetam facilitate performance of two-choice water-escape in normal rats.  J Neural Transm. 1991;  85 109-116
    CrossrefPubMedGoogle Scholar
  • 17 Moriau M, Crasborn L, Lavenne-Pardonge E, von Frenckell R, Col-Debeys C h. Platelet anti-aggregant and rheological properties of piracetam.  Drug Res. 1993;  43 110-118
    PubMedGoogle Scholar
  • 18 Murkin J M, Newman S P, Stump D A, Blumenthal J. Statement of consensus on assessment of neurobehavioral outcomes after cardiac surgery.  Ann Thorac Surg. 1995;  59 1289-1295
    CrossrefPubMedGoogle Scholar
  • 19 Müller W E, Eckert G P, Eckert A. Piracetam: Novelty in a unique mode of action.  Pharmacopsychiatry. 1999;  32 Suppl, 12-19
    PubMedGoogle Scholar
  • 20 Newman M F, Kirchner J L, Philips-Bute B, Gaver V, Grocott H, Jones R. et al . Longitudinal assessment of neurocognitive function after coronary artery bypass surgery.  N Eng J Med. 2001;  344 395-402
    PubMedGoogle Scholar
  • 21 Pfitzenmeyer P, Musat A, Lenfant L, Turcu A, Musat A. Postoperative cognitive disorders in the elderly.  Presse Med. 2001;  30 648-652
    PubMedGoogle Scholar
  • 22 Peuvot J, Schanck A, Deleers M, Brasseurs R. Piracetam-induced changes to membrane physical properties.  Biochem Pharmacol. 1995;  50 1129-1134
    CrossrefPubMedGoogle Scholar
  • 23 Saletu B, Hintzenberger G, Grünberge J, Anderer P, Zyhlarz G, Linzmayer L, Rameis H. Double-blind, placebo-controlled, pharmacokinetic and -dynamic studies with 2 new formulations of piracetam (infusion and sirup) under hypoxia in man.  Int J Clin Pharmacol Therapeutics. 1995;  33 49-262
    PubMedGoogle Scholar
  • 24 Sara S L, Lefevre D. Hypoxia-induced amnesia in one-trial learning and pharmacological protection by piracetam.  Psychopharmacologia. 1972;  25 32-40
    PubMedGoogle Scholar
  • 25 Selnes O A, Royall R M, Grega M A, Borowicz L M, Quaskey S, McKhann G M. Cognitive changes 5 years after coronary artery bypass grafting.  Arch Neurol. 2001;  58 598-604
    CrossrefPubMedGoogle Scholar
  • 26 Shaw P J, Bates D, Cartlidge N E, French J M, Heaviside D, Julian D G, Shaw D A. Early intellectual dysfunction following coronary bypass surgery.  Q J Med. 1986;  58 59-68
    PubMedGoogle Scholar
  • 27 Stockmans F, Deberdt W, Nyström A, Nyström E, Strassen J M, Vermylen J, Deckmyn H. Inhibitory effect of piracetam on platelet-rich thrombus formation in an animal model.  Thromb Haemost. 1998;  79 222-227
    PubMedGoogle Scholar

Prof. Dr. med. Ralf Uebelhack

Humboldt-Universität zu Berlin

Medizinische Fakultät/Charité

Universitätsklinik und Poliklinik für Psychiatrie

Schumannstr. 20/21

10098 Berlin

Phone: +49/ (0)30 2802 3554

Fax: +49/ (0) 30 2802 3203

Email: ralf.uebelhack@charite.de

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