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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 9 Erzigkeit H. SKT. Ein Kurztest zur Erfassung von Gedächtnis- und Aufmerksamkeitsstörungen. Beltz
Test GmbH Weinheim; 1989
- 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
- 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
- 12
Grotemeyer K H, Hoffeberth B, Hirschberg M.
Normalisierung hyperreaktiver Thrombozyten bei Patienten mit TIAŽs unter Piracetam.
Nervenarzt.
1986;
57
180-183
- 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
- 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
- 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
- 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
- 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
- 19
Müller W E, Eckert G P, Eckert A.
Piracetam: Novelty in a unique mode of action.
Pharmacopsychiatry.
1999;
32
Suppl, 12-19
- 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
- 21
Pfitzenmeyer P, Musat A, Lenfant L, Turcu A, Musat A.
Postoperative cognitive disorders in the elderly.
Presse Med.
2001;
30
648-652
- 22
Peuvot J, Schanck A, Deleers M, Brasseurs R.
Piracetam-induced changes to membrane physical properties.
Biochem Pharmacol.
1995;
50
1129-1134
- 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
- 24
Sara S L, Lefevre D.
Hypoxia-induced amnesia in one-trial learning and pharmacological protection by piracetam.
Psychopharmacologia.
1972;
25
32-40
- 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
- 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
- 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
Prof. Dr. med. Ralf Uebelhack
Humboldt-Universität zu Berlin
Medizinische Fakultät/Charité
Universitätsklinik und Poliklinik für Psychiatrie
Schumannstr. 20/21
10098 Berlin
Telefon: +49/ (0)30 2802 3554
Fax: +49/ (0) 30 2802 3203
eMail: ralf.uebelhack@charite.de