Choline
18 benefits mapped to clinical evidence across supplements.
Dose per serving from products
6,503 products in our catalogue print how much Choline a serving holds.
Most common: 10 mg to 25 mg, 22% of 6,503 products.
| Dose per serving | Products |
|---|---|
| 25 mcg or less | 168 |
| 25 mcg to 50 mcg | 265 |
| 50 mcg to 100 mcg | 56 |
| 100 mcg to 250 mcg | 12 |
| 250 mcg to 500 mcg | 31 |
| 500 mcg to 1 mg | 25 |
| 1 mg to 2.5 mg | 67 |
| 2.5 mg to 5 mg | 169 |
| 5 mg to 10 mg | 488 |
| 10 mg to 25 mg | 1,417 |
| 25 mg to 50 mg | 1,258 |
| 50 mg to 100 mg | 1,125 |
| 100 mg to 250 mg | 766 |
| 250 mg to 500 mg | 396 |
| over 500 mg | 260 |
Dose per serving from research
98 study groups in 60 studies say how much Choline participants took a day.
These are the doses the studies gave. They are not a recommendation.
Most common: 500 mg to 1 g, 38% of 98 study groups.
| Daily dose | Study groups |
|---|---|
| 50 mg or less | 4 |
| 50 mg to 100 mg | 4 |
| 100 mg to 250 mg | 6 |
| 250 mg to 500 mg | 27 |
| 500 mg to 1 g | 37 |
| 1 g to 2.5 g | 14 |
| 2.5 g to 5 g | 2 |
| over 5 g | 4 |
Commonly used together
28 of 107 study groups took Choline with something else. Shown: what 3 or more different studies gave.
What was given together, not what works together.
| Taken with | Study groups |
|---|---|
| Docosahexaenoic Acid | 16 |
| Folic Acid | 5 |
| Vitamin B12 | 5 |
| Selenium | 4 |
| Omega-3 Fatty Acids | 3 |
Benefit Evidence
Stress resilience: HRV/BP +14%
Stress resilience: fetal cortisol -33%
Research sources
Brain health (65)
- Metabolic Signature of Arsenic Exposure and Metabolism: The Folic Acid and Creatine Trial
PubMed ID: 40668877
Large metabolomics trial tying one‑carbon metabolites (including choline) to systemic metabolome and arsenic metabolism — mechanistically relevant to brain health via methylation pathways.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline+caffeine improved attention, learning and EEG markers — direct RCT evidence supporting acute brain function.
- Effects of citicoline on level of consciousness, serum level of fetuin-A and matrix Gla-protein (MGP) in trauma patients with diffuse axonal injury (DAI) and GCS≤8
PubMed ID: 25541919
IV citicoline in severe diffuse axonal injury altered brain‑related biomarkers (fetuin‑A, MGP) — moderate mechanistic support for brain repair.
- [CDP-choline improves the postoperative rehabilitation of patients with cerebral risk]
PubMed ID: 2088110
CDP‑choline around surgery increased number of patients with improved cognitive/functional scores—direct brain health signal.
- [Brain protection in heart surgery]
PubMed ID: 1763227
Higher‑dose CDP‑choline reduced persistent neuropsychological deficits and areas of hypoperfusion after cardiac surgery (neuroprotective effect).
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
CDP‑choline added to care improved global outcome after moderate–severe head injury, directly supporting brain recovery.
- Effect of phosphatidylcholine on explicit memory
PubMed ID: 9377589
Acute cognitive (memory) benefit from phosphatidylcholine supports short-term brain function implications.
- Effect of citicoline on visual acuity in amblyopia: preliminary results
PubMed ID: 7622080
Direct human evidence: citicoline injections improved visual function in adults with amblyopia, indicating neuroplastic/brain benefits of a choline compound.
- Citicoline in hypoxic ischemic encephalopathy in neonates: a randomized controlled trial
PubMed ID: 37173784
Citicoline in neonatal HIE produced large, clinically meaningful improvements in developmental scores and reduced seizures—strong neurodevelopmental benefit.
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
CDP‑choline increased gray matter volume in prefrontal and hippocampal regions and reduced craving—robust structural brain changes.
- Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 33978188
Citicoline improved memory in older adults with age‑associated memory impairment, supporting brain‑function benefits.
- Volume Analysis of Brain Cognitive Areas in Alzheimer's Disease: Interim 3-Year Results from the ASCOMALVA Trial
PubMed ID: 32508323
Choline alphoscerate + donepezil slowed cognitive decline and hippocampal/gray‑matter atrophy over 3 years in Alzheimer patients.
- Efficacy of Citicoline as a Neuroprotector in children with post cardiac arrest: a randomized controlled clinical trial
PubMed ID: 33169240
IV citicoline after pediatric cardiac arrest improved consciousness, functional outcomes, reduced seizures and NSE, indicating robust neuroprotection.
- The LipiDiDiet trial: what does it add to the current evidence for Fortasyn Connect in early Alzheimer's disease?
PubMed ID: 31616139
Fortasyn Connect (contains choline) reduced clinical decline and hippocampal atrophy in prodromal AD — supports an effect on brain health (multinutrient).
- Neuroenhancement and neuroprotection by oral solution citicoline in non-arteritic ischemic optic neuropathy as a model of neurodegeneration: A randomized pilot study
PubMed ID: 31348806
Oral citicoline improved retinal ganglion cell function and stabilized RNFL in NAION—evidence of neuronal/visual pathway benefit.
- Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial
PubMed ID: 30672317
Citicoline produced measurable cognitive improvements in VCIND, supportive of brain‑health effects.
- Citicoline (CDP-choline) add-on therapy to risperidone for treatment of negative symptoms in patients with stable schizophrenia: A double-blind, randomized placebo-controlled trial
PubMed ID: 29901250
Citicoline add‑on improved negative and total PANSS in schizophrenia and is consistent with neuroprotective/neurofunctional benefits.
- Citicoline Combination Therapy for Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial
PubMed ID: 28085707
Citicoline adjunct improved depressive symptoms and is a brain‑active choline donor (direct therapeutic evidence for a choline compound supporting brain function).
- Effects of Souvenaid on plasma micronutrient levels and fatty acid profiles in mild and mild-to-moderate Alzheimer's disease
PubMed ID: 26213579
Intervention containing choline raised brain‑relevant precursors in mild Alzheimer’s patients; strong biomarker support for neural membrane/synapse maintenance.
- Treatment with citicoline eye drops enhances retinal function and neural conduction along the visual pathways in open angle glaucoma
PubMed ID: 26004075
Topical citicoline improved retinal and visual pathway electrophysiologic measures in glaucoma—objective neural function improvement.
- The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males
PubMed ID: 26179181
Citicoline improved attention/motor speed and reduced impulsivity in adolescents—functional cognitive benefits supporting brain health.
- Effectiveness of the addition of citicoline to patching in the treatment of amblyopia around visual maturity: a randomized controlled trial
PubMed ID: 24618483
Adjunctive oral citicoline improved visual acuity in amblyopic children, reflecting enhanced visual cortical plasticity (brain health/plasticity signal).
- Targeting alpha-7 nicotinic neurotransmission in schizophrenia: a novel agonist strategy
PubMed ID: 23768813
Combination therapy including CDP‑choline improved overall functioning and some memory measures in schizophrenia (limited RCT evidence).
- Long-term treatment with citicoline may improve poststroke vascular cognitive impairment
PubMed ID: 23406981
Year‑long citicoline in first‑ever ischemic stroke associated with better attention/executive function—strong brain‑health signal.
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
PubMed ID: 17873684
RCT showed measurable cognitive (memory) benefit in psychiatric patients, supporting brain‑targeted effects.
- Electrophysiological assessment of glaucomatous visual dysfunction during treatment with cytidine-5'-diphosphocholine (citicoline): a study of 8 years of follow-up
PubMed ID: 16249960
Citicoline (IM) produced significant, persistent improvements in retinal and visual cortical electrophysiological responses — direct neural outcome.
- [Observation of therapeutic effect of Salviae miltiorrhiza and cytosine diphosphate-choline injection on patients with hypertensive cerebral hemorrhage]
PubMed ID: 11783323
CDP‑choline (citicoline) was part of treatment in hypertensive intracerebral hemorrhage and, in combination with Salvia, associated with better functional/neurologic outcomes.
- Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators
PubMed ID: 11079534
Randomized citicoline trial in acute ischemic stroke found reduced lesion growth and correlated clinical improvements—direct evidence for neuroprotective/brain-health effects of a choline-derived compound.
- Cytidine-5'-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma
PubMed ID: 10366081
Citicoline injections improved retinal and visual pathway electrophysiology—supportive brain/neuronal function evidence.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline improved cognitive scores, cerebral blood flow and EEG in Alzheimer's—direct brain-health evidence.
- A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group
PubMed ID: 9305321
Multicenter RCT: oral citicoline started after ischemic stroke improved functional, neurologic and cognitive outcomes — strong direct evidence for brain-health benefit of a choline-containing compound.
- Combined tacrine and estrogen replacement therapy in patients with Alzheimer's disease
PubMed ID: 9329702
Tacrine (cholinergic therapy) plus estrogen enhanced cognitive/global improvements in AD patients — supports cholinergic modulation of brain health.
- Cytidin-5'-diphosphocholine enhances the effect of part-time occlusion in amblyopia
PubMed ID: 9550353
Citicoline improved visual system function and enhanced rehabilitation in children—supports neural plasticity/brain health (clinical).
- Comparative study of choline alfoscerate as a combination therapy with donepezil: A mixed double-blind randomized controlled and open-label observation trial
PubMed ID: 38875437
Add‑on choline alfoscerate produced small‑to‑moderate cognitive and behavioral improvements in patients on donepezil—direct brain benefit.
- A multicentre trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia
PubMed ID: 1916007
Direct intervention trial: alpha‑GPC and CDP‑choline improved cognition in vascular dementia — supports brain health benefits of choline‑containing agents.
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline (choline donor) improved verbal memory in older adults — strong, directly relevant evidence for brain health.
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
Choline alfoscerate RCT produced clinically meaningful cognitive improvements in Alzheimer's disease, supporting brain‑health effects.
- [Efficacy and tolerability of choline alphoscerate (cereton) in patients with Parkinson's disease with cognitive disorders]
PubMed ID: 20032953
Choline alphoscerate produced short-term cognitive benefit in PD patients—direct clinical evidence for brain-related benefit.
- The ASCOMALVA trial: association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: interim results
PubMed ID: 22959283
Adjunct choline alphoscerate improved cognitive/behavioral outcomes in AD with vascular injury — supports brain health in disease context.
- Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk
PubMed ID: 23318559
Perinatal phosphatidylcholine randomized supplementation increased a neonatal brain inhibitory biomarker (P50) linked to later attentional risk — strong developmental brain-health evidence.
- Choline intake influences phosphatidylcholine DHA enrichment in nonpregnant women but not in pregnant women in the third trimester
PubMed ID: 23446897
Choline raised PC-DHA (a brain-relevant phospholipid) in nonpregnant women, a plausible mechanistic support for brain health.
- The ASCOMALVA (Association between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in Alzheimer's Disease) Trial: interim results after two years of treatment
PubMed ID: 24898643
Choline alphoscerate added to donepezil slowed cognitive/functional decline over 24 months in AD patients.
- The effect of souvenaid on functional brain network organisation in patients with mild Alzheimer's disease: a randomised controlled study
PubMed ID: 24475144
Souvenaid (multi-nutrient including choline) preserved EEG network organization in mild AD and related to memory performance.
- Choline supplementation in children with fetal alcohol spectrum disorders: a randomized, double-blind, placebo-controlled trial
PubMed ID: 26447156
Daily choline in young children with FASD improved hippocampal-dependent memory, supporting neurodevelopmental brain benefit in a sensitive window.
- Choline intakes exceeding recommendations during human lactation improve breast milk choline content by increasing PEMT pathway metabolites
PubMed ID: 26025328
Higher maternal choline intake increased breast‑milk choline metabolites — supports infant brain nutrient supply.
- Eggs early in complementary feeding increase choline pathway biomarkers and DHA: a randomized controlled trial in Ecuador
PubMed ID: 29092879
Daily eggs in infants increased plasma choline and DHA and were associated with better growth in parent trial — supports nutritional brain development.
- Nutritional intervention and neurodevelopmental outcome in infants with suspected cerebral palsy: the Dolphin infant double-blind randomized controlled trial
PubMed ID: 29023666
Infant DHA+choline+UMP trial suggested clinically meaningful (but non‑significant) cognitive/language improvements.
- The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial
PubMed ID: 28747210
Souvenaid (with choline) increased brain PME/PDE and tCho signals in mild AD, indicating effects on brain phospholipid metabolism.
- The Effect of the Association between Donepezil and Choline Alphoscerate on Behavioral Disturbances in Alzheimer's Disease: Interim Results of the ASCOMALVA Trial
PubMed ID: 28035924
Choline alphoscerate adjunct reduced behavioral symptoms in AD across 24 months—clinical brain-health relevance.
- Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750367
Randomized prenatal choline produced robust improvements in infant conditioning, growth and recognition memory — strong evidence for early brain‑development support.
- Four-year follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder
PubMed ID: 32164522
Randomized early choline supplementation after prenatal alcohol exposure produced durable cognitive benefits (strong brain health evidence).
- Choline Pathway Nutrients and Metabolites and Cognitive Impairment After Acute Ischemic Stroke
PubMed ID: 33467878
Higher plasma choline/betaine linked to lower risk of post‑stroke cognitive impairment (large observational cohort).
- Maternal choline supplementation mitigates alcohol exposure effects on neonatal brain volumes
PubMed ID: 34342017
Prenatal high‑dose choline mitigated neonatal brain volume deficits and mediated improved infant memory—direct structural/functional brain benefit.
- Prenatal choline supplementation improves biomarkers of maternal docosahexaenoic acid (DHA) status among pregnant participants consuming supplemental DHA: a randomized controlled trial
PubMed ID: 35575618
Prenatal choline increased maternal PC‑DHA and RBC DHA, facilitating DHA transport which supports fetal/infant brain development.
- Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study
PubMed ID: 37340479
Egg‑yolk choline raised plasma free choline and improved verbal memory in middle‑aged/older adults (12 weeks RCT).
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
α‑GPC improved cognition and memory in older adults with amnestic MCI (randomized double‑blind trial).
- Effects of choline alfoscerate on cognitive function and quality of life in type 2 diabetes: A double-blind, randomized, placebo-controlled trial
PubMed ID: 39703111
Choline alfoscerate RCT in older adults with MCI produced cognitive improvements consistent with neuroprotective/brain‑supporting effects.
- [Efficacy and safety of choline alfoscerate in the preventive therapy of dementia in elderly patients with Mild Cognitive Impairment: a three-year prospective comparative study]
PubMed ID: 38696157
Longitudinal clinical evidence: choline alfoscerate infusions in aMCI associated with markedly lower progression to dementia—strong human evidence for brain‑protective effects.
- Neuroprotective nutrients in pregnancy and infant brain function
PubMed ID: 40412614
Maternal choline associated with infant EEG/ERP measures (1 and 6 months), consistent with impacts on early brain development/function.
- Choline enhances elicited imitation memory performance in preschool children with prenatal alcohol exposure: a cumulative report of 3 randomized controlled trials
PubMed ID: 39956364
Pooled RCTs in children with prenatal alcohol exposure improved memory — clinically important brain function benefit.
- Neurochemical alterations in methamphetamine-dependent patients treated with cytidine-5'-diphosphate choline: a longitudinal proton magnetic resonance spectroscopy study
PubMed ID: 20043005
CDP‑choline (a choline donor) increased prefrontal NAA and Cho MRS signals and correlated with clinical abstinence — strong direct neurochemical evidence.
- Strength gains after 12 weeks of resistance training correlate with neurochemical markers of brain health in older adults: a randomized control (1)H-MRS study
PubMed ID: 36701005
Resistance training preserved neuronal metabolites (NAA/Glx) in older adults; choline ratios measured — supports interventions that maintain brain metabolic health (indirect choline link).
- Hippocampal neurochemicals are associated with exercise group and intensity, psychological health, and general cognition in older adults
PubMed ID: 36626020
Exercise intensity was associated with hippocampal neurochemical profile changes including Cho/Cr — directly relevant to brain choline biology.
- The study on delirium side-effects after ultra-brief pulse electroconvulsive therapy
PubMed ID: 40598058
ECT pulse‑width differences produced hippocampal MRS changes (including choline metrics) and different delirium outcomes — links choline‑related markers to brain outcomes.
- Non-Targeted Dried Blood Spot-Based Metabolomics Analysis Showed Rice Bran Supplementation Effects Multiple Metabolic Pathways during Infant Weaning and Growth in Mali
PubMed ID: 35276967
Infant rice‑bran intervention increased blood choline and GSH while improving growth — supports early‑life brain nutrient sufficiency (indirect evidence for brain health).
Cell health (39)
- Decreased mortality rate among small premature infants treated at birth with a single dose of synthetic surfactant: a multicenter controlled trial. American Exosurf Pediatric Study Group 1
PubMed ID: 1993961
Prophylactic surfactant reduced neonatal death; supports importance of choline‑containing phospholipids in surfactant/membrane function.
- Effects of two rescue doses of a synthetic surfactant on mortality rate and survival without bronchopulmonary dysplasia in 700- to 1350-gram infants with respiratory distress syndrome. The American Exosurf Neonatal Study Group I
PubMed ID: 2007938
Synthetic surfactant trials (phosphatidylcholine formulation) produced substantial clinical benefit in neonates — supports physiologic importance of phosphatidylcholine for membrane/surfactant function (indirect to oral choline).
- Choline deficiency increases lymphocyte apoptosis and DNA damage in humans
PubMed ID: 16825685
Human choline deficiency increased lymphocyte DNA damage and apoptosis which reversed on repletion—strong cellular-level evidence.
- Lymphocyte gene expression in subjects fed a low-choline diet differs between those who develop organ dysfunction and those who do not
PubMed ID: 17616785
Low-choline diet produced broad gene-expression changes affecting apoptosis, DNA repair, and folate pathways in humans.
- Sex and menopausal status influence human dietary requirements for the nutrient choline
PubMed ID: 17490963
Low-choline diets caused multi-system organ dysfunction in humans (hepatic/muscle) indicating major cellular impacts.
- Dietary choline requirements of women: effects of estrogen and genetic variation
PubMed ID: 20861172
Choline depletion induced organ dysfunction tied to PEMT genotype (PEMT catalyzes PtdCho synthesis) — strong evidence choline is required for phosphatidylcholine/cell membrane maintenance.
- Choline intake exceeding current dietary recommendations preserves markers of cellular methylation in a genetic subgroup of folate-compromised men
PubMed ID: 20220206
Higher choline intake preserved SAM and genomic DNA methylation and reduced DNA damage in folate‑compromised men—direct cellular health evidence.
- Choline intake and genetic polymorphisms influence choline metabolite concentrations in human breast milk and plasma
PubMed ID: 20534746
Maternal supplementation increased breast‑milk phosphatidylcholine and plasma choline—direct evidence choline supports phospholipid pools important for cell membranes.
- Pregnancy induces transcriptional activation of the peripheral innate immune system and increases oxidative DNA damage among healthy third trimester pregnant women
PubMed ID: 23133592
Controlled feeding RCT in pregnancy increased a leukocyte histone methylation mark (H3K4me2), indicating epigenetic/cellular effects of choline.
- Maternal choline intake modulates maternal and fetal biomarkers of choline metabolism in humans
PubMed ID: 22418088
Dose‑dependent changes in maternal/fetal choline metabolites indicate choline availability influences cellular methylation and one‑carbon metabolism in pregnancy.
- Pregnancy alters choline dynamics: results of a randomized trial using stable isotope methodology in pregnant and nonpregnant women
PubMed ID: 24132975
Feeding/stable-isotope trial showed pregnancy shifts choline into phosphatidylcholine and transfers PEMT-derived PC to fetus — direct membrane synthesis relevance.
- Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk
PubMed ID: 23318559
Perinatal PC supplementation directly supplies a precursor for membrane phospholipids in development.
- Choline intake influences phosphatidylcholine DHA enrichment in nonpregnant women but not in pregnant women in the third trimester
PubMed ID: 23446897
High choline increased PC-DHA enrichment, changing phosphatidylcholine composition — supports membrane fatty-acyl composition.
- One-carbon metabolites and telomere length in a prospective and randomized study of B- and/or D-vitamin supplementation
PubMed ID: 27379829
Supplementation study showed correlations between one-carbon metabolites (including choline) and telomere length — cell-aging/health relevance.
- The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial
PubMed ID: 28747210
Souvenaid increased PME/PDE ratio and tCho, consistent with altered phospholipid metabolism and membrane turnover in the brain.
- Reproductive state and choline intake influence enrichment of plasma lysophosphatidylcholine-DHA: a post hoc analysis of a controlled feeding trial
PubMed ID: 31782377
Higher dietary choline increased PEMT-derived LPC-DHA labeling—supports choline role in producing DHA-containing phosphatidylcholine for membranes.
- Prenatal choline supplementation improves biomarkers of maternal docosahexaenoic acid (DHA) status among pregnant participants consuming supplemental DHA: a randomized controlled trial
PubMed ID: 35575618
Prenatal choline increased PC‑DHA, indicating enhanced phospholipid composition of maternal circulation and potential fetal membrane support.
- Choline supplementation for preterm infants: metabolism of four Deuterium-labeled choline compounds
PubMed ID: 36460779
Different choline compounds produce distinct incorporation into plasma choline, betaine and phosphatidylcholine in preterm infants—cell membrane synthesis implications.
- Choline and Betaine Levels in Plasma Mirror Choline Intake in Very Preterm Infants
PubMed ID: 38004152
Enteral choline intake in preterm infants tracked plasma betaine and combined choline+betaine, indicating influence on cellular methylation status and health.
- Traditional Korean diet high in one-carbon nutrients increases global DNA methylation: implication for epigenetic diet
PubMed ID: 38867083
K‑diet increased global DNA methylation in blood cells and improved one‑carbon metabolites—direct cellular/epigenetic biomarker changes linked to choline‑rich diet.
- Dietary inclusion of salmon, herring and pompano as oily fish reduces CVD risk markers in dyslipidaemic middle-aged and elderly Chinese women
PubMed ID: 22221492
Oily‑fish intake raised plasma choline‑containing phosphoglycerides — direct evidence for increased choline availability for phosphatidylcholine and membrane phospholipids.
- Sex-Specific Associations between One-Carbon Metabolism Indices and Posttranslational Histone Modifications in Arsenic-Exposed Bangladeshi Adults
PubMed ID: 27765800
Circulating choline associated with histone methylation marks in arsenic‑exposed adults (sex‑dependent) — direct epigenetic/cellular regulation relevance.
- Gut Microbiome-Dependent Metabolic Pathways and Risk of Lethal Prostate Cancer: Prospective Analysis of a PLCO Cancer Screening Trial Cohort
PubMed ID: 34711629
Prospective association of higher prediagnostic serum choline/betaine with lethal prostate cancer — strong signal that choline-related metabolism impacts cellular disease risk.
- Integrated analysis of the association between methionine cycle and risk of moyamoya disease
PubMed ID: 37183324
Moyamoya case–control showed lower choline/betaine and higher homocysteine in patients — indicates systemic cellular metabolic disturbance.
- Metabolic Signature of Arsenic Exposure and Metabolism: The Folic Acid and Creatine Trial
PubMed ID: 40668877
Large randomized FACT trial linked one‑carbon metabolites (choline/betaine) with arsenic metabolism and broad plasma metabolomic perturbations — strong evidence for choline's role in cellular methylation/metabolism.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline supplies choline for phospholipid (membrane) synthesis; RCT showed improved EEG and cognition implying neuronal membrane functional benefits.
- Impact of the Association Between PNPLA3 Genetic Variation and Dietary Intake on the Risk of Significant Fibrosis in Patients With NAFLD
PubMed ID: 33306506
Higher choline intake associated with less fibrosis in NAFLD — indicates protective effects at tissue/cellular level in liver.
- Effect of phosphatidylcholine on explicit memory
PubMed ID: 9377589
Phosphatidylcholine is a direct membrane phospholipid; study administered phosphatidylcholine — mechanistic relevance to membrane health though endpoints were cognitive.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline supplies choline for phosphatidylcholine synthesis and showed EEG/CBF changes—supports membrane phospholipid maintenance.
- Electrophysiological assessment of glaucomatous visual dysfunction during treatment with cytidine-5'-diphosphocholine (citicoline): a study of 8 years of follow-up
PubMed ID: 16249960
Citicoline improved electrophysiological markers of neuronal function — indicates improved cellular neural signalling/viability.
- Effects of Souvenaid on plasma micronutrient levels and fatty acid profiles in mild and mild-to-moderate Alzheimer's disease
PubMed ID: 26213579
Souvenaid containing choline increased plasma choline and erythrocyte DHA—direct biomarker evidence supporting membrane phospholipid synthesis.
- Neuroenhancement and neuroprotection by oral solution citicoline in non-arteritic ischemic optic neuropathy as a model of neurodegeneration: A randomized pilot study
PubMed ID: 31348806
Citicoline improved RGC function and RNFL thickness in NAION, indicating neuronal cellular stabilization and recovery.
- Citicoline (CDP-choline) add-on therapy to risperidone for treatment of negative symptoms in patients with stable schizophrenia: A double-blind, randomized placebo-controlled trial
PubMed ID: 29901250
Clinical benefits from citicoline suggest improved neuronal function likely mediated via membrane phospholipid support.
- Efficacy of Citicoline as a Neuroprotector in children with post cardiac arrest: a randomized controlled clinical trial
PubMed ID: 33169240
IV citicoline reduced serum neuron‑specific enolase and improved neurological outcomes, indicating cellular neuroprotection.
- Volume Analysis of Brain Cognitive Areas in Alzheimer's Disease: Interim 3-Year Results from the ASCOMALVA Trial
PubMed ID: 32508323
Choline alphoscerate is a phospholipid precursor; trial showed structural brain preservation consistent with membrane/structural benefits.
- Egg Consumption in the Context of Plant-Based Diets and Cardiometabolic Risk Factors in Adults at Risk of Type 2 Diabetes
PubMed ID: 34494112
Two eggs/day markedly increased dietary choline (substrate for phosphatidylcholine), supporting membrane phospholipid synthesis.
- Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial
PubMed ID: 30672317
Citicoline's cognitive benefits in VCIND are consistent with support for neuronal cellular integrity/function.
- Improved outcome at 28 days of age for very low birth weight infants treated with a single dose of a synthetic surfactant
PubMed ID: 2246698
Synthetic surfactant improved early respiratory outcomes in very low birthweight infants — relevant to phosphatidylcholine's structural role.
- A controlled trial of synthetic surfactant in infants weighing 1250 g or more with respiratory distress syndrome. The American Exosurf Neonatal Study Group I, and the Canadian Exosurf Neonatal Study Group
PubMed ID: 1944470
Large randomized surfactant trial with dipalmitoylphosphatidylcholine showed improved neonatal outcomes — indirect evidence for phosphatidylcholine (a choline‑containing lipid) in membrane/surfactant biology.
Memory (39)
- The effect of souvenaid on functional brain network organisation in patients with mild Alzheimer's disease: a randomised controlled study
PubMed ID: 24475144
Souvenaid (includes choline) preserved network metrics linked to memory and showed prior memory benefits in mild AD.
- The ASCOMALVA (Association between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in Alzheimer's Disease) Trial: interim results after two years of treatment
PubMed ID: 24898643
Adjunctive choline precursor (choline alphoscerate) slowed cognitive decline in AD over 24 months (memory-relevant outcome).
- The ASCOMALVA trial: association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: interim results
PubMed ID: 22959283
Interim randomized trial: adding choline alphoscerate to donepezil improved MMSE/ADAS-cog and functional/behavioral measures in AD with vascular injury.
- [Efficacy and tolerability of choline alphoscerate (cereton) in patients with Parkinson's disease with cognitive disorders]
PubMed ID: 20032953
Choline alphoscerate gave greater short-term cognitive improvement vs comparator in PD patients (memory component).
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
Large RCT of choline alfoscerate showed significant improvements on cognitive scales (ADAS‑Cog, MMSE) in Alzheimer's patients (memory-relevant).
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline trial showed statistically significant improvements in immediate and delayed logical verbal memory at higher dose — direct, high-relevance evidence.
- A multicentre trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia
PubMed ID: 1916007
Alpha‑GPC and CDP‑choline produced symptomatic cognitive improvement in vascular dementia, directly relevant to memory support.
- Comparative study of choline alfoscerate as a combination therapy with donepezil: A mixed double-blind randomized controlled and open-label observation trial
PubMed ID: 38875437
Randomized add-on trial: choline alfoscerate improved MMSE and ADAS-Cog vs donepezil alone—direct evidence for memory/cognition.
- Citicoline in hypoxic ischemic encephalopathy in neonates: a randomized controlled trial
PubMed ID: 37173784
Citicoline treatment in neonatal HIE produced large, clinically meaningful improvements on developmental (cognitive) scores at 9–12 months.
- [The effect of the use of the drug recognan (citicoline) on the state of higher mental functions in patients with mild cognitive impairment]
PubMed ID: 34693689
Small 30‑day citicoline study reported subjective/psychometric improvements in memory in mild cognitive impairment.
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
Eight weeks of CDP‑choline increased hippocampal volumes (region important for memory) in methamphetamine users, correlated with reduced craving.
- Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 33978188
Randomized double‑blind trial: 12 weeks of citicoline (500 mg/day) improved composite and episodic memory vs placebo in older adults.
- Volume Analysis of Brain Cognitive Areas in Alzheimer's Disease: Interim 3-Year Results from the ASCOMALVA Trial
PubMed ID: 32508323
Multi‑year randomized trial: choline alphoscerate added to donepezil slowed cognitive decline and hippocampal atrophy in Alzheimer disease.
- The LipiDiDiet trial: what does it add to the current evidence for Fortasyn Connect in early Alzheimer's disease?
PubMed ID: 31616139
Fortasyn Connect (includes choline) reduced hippocampal atrophy and clinical decline in prodromal AD — supports memory‑preserving role of the nutrient mix.
- Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial
PubMed ID: 30672317
Citicoline in VCIND produced modest cognitive gains (ADAS‑cog), relevant to memory support.
- Effects of Souvenaid on plasma micronutrient levels and fatty acid profiles in mild and mild-to-moderate Alzheimer's disease
PubMed ID: 26213579
Medical food containing choline raised choline/uridine/DHA in mild AD patients—biomarker evidence relevant to synaptic phospholipid synthesis and memory support.
- Targeting alpha-7 nicotinic neurotransmission in schizophrenia: a novel agonist strategy
PubMed ID: 23768813
Small RCT of galantamine + CDP‑choline showed improved episodic memory recall versus placebo (moderate, confounded evidence).
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
PubMed ID: 17873684
Randomized add‑on citicoline improved declarative memory test performance (significant group effect).
- Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators
PubMed ID: 11079534
Citicoline (a choline derivative) produced correlated clinical improvements after stroke—relevant to memory/ cognition support.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline RCT in mild–moderate Alzheimer’s showed modest cognitive (memory) improvements.
- A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group
PubMed ID: 9305321
Citicoline improved cognitive and MMSE outcomes post-stroke, supporting memory-related recovery.
- Combined tacrine and estrogen replacement therapy in patients with Alzheimer's disease
PubMed ID: 9329702
Tacrine (AChE inhibitor) plus estrogen produced greater cognitive improvements in AD — mechanistic relevance to memory.
- Effect of phosphatidylcholine on explicit memory
PubMed ID: 9377589
25 g phosphatidylcholine (≈3.75 g choline) produced a significant acute improvement in explicit memory (90 min), direct evidence for memory benefit.
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
CDP‑choline improved cognitive outcome after head injury — supports memory recovery/rehabilitation potential.
- [Brain protection in heart surgery]
PubMed ID: 1763227
Fewer long‑term neuropsychological deficits and less hypoperfusion with higher CDP‑choline dose, supporting memory preservation.
- [CDP-choline improves the postoperative rehabilitation of patients with cerebral risk]
PubMed ID: 2088110
Postoperative cognitive screening improved with perioperative CDP‑choline, consistent with memory support.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline+caffeine improved maze learning and working memory measures — direct support for memory.
- Choline enhances elicited imitation memory performance in preschool children with prenatal alcohol exposure: a cumulative report of 3 randomized controlled trials
PubMed ID: 39956364
Pooled RCT data (n=104) show robust ~25% improvement on a memory task in children given choline vs placebo.
- Neuroprotective nutrients in pregnancy and infant brain function
PubMed ID: 40412614
Maternal choline status associated with infant EEG/ERP measures linked to early brain function that underpins later memory.
- [Efficacy and safety of choline alfoscerate in the preventive therapy of dementia in elderly patients with Mild Cognitive Impairment: a three-year prospective comparative study]
PubMed ID: 38696157
Annual choline alfoscerate therapy in aMCI greatly reduced conversion to dementia and cognitive decline—strong, direct memory/cognitive support signal.
- Effects of choline alfoscerate on cognitive function and quality of life in type 2 diabetes: A double-blind, randomized, placebo-controlled trial
PubMed ID: 39703111
12‑month RCT of choline alfoscerate in older adults with MCI produced small but significant cognitive (MMSE) gains consistent with memory benefit.
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
12‑week α‑GPC RCT in amnestic MCI produced significant improvement in memory subscore (double‑blind RCT).
- Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study
PubMed ID: 37340479
12‑week egg‑yolk choline increased plasma choline and produced modest improvements in verbal memory in older adults.
- The impact of micronutrient supplementation in alcohol-exposed pregnancies on reaction time responses of preschoolers in Ukraine
PubMed ID: 34942330
Prenatal multivitamin ± choline modestly improved preschool reaction‑time/attentional performance in boys, consistent with cognitive development supporting memory.
- Maternal choline supplementation mitigates alcohol exposure effects on neonatal brain volumes
PubMed ID: 34342017
Prenatal choline mitigated neonatal brain changes and improved infant recognition memory (direct developmental memory benefit).
- Four-year follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder
PubMed ID: 32164522
Long‑term randomized choline in prenatal alcohol‑exposed children produced sustained improvements in working and delayed memory.
- Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750367
Randomized prenatal choline improved infant eyeblink conditioning and recognition memory — strong direct evidence for memory support in early development.
- Choline intakes exceeding recommendations during human lactation improve breast milk choline content by increasing PEMT pathway metabolites
PubMed ID: 26025328
Higher maternal choline intake raised breast‑milk choline metabolites — biologically supports infant choline supply important for memory development.
- Choline supplementation in children with fetal alcohol spectrum disorders: a randomized, double-blind, placebo-controlled trial
PubMed ID: 26447156
Randomized trial: daily choline improved hippocampal-dependent delayed memory in younger children with FASD.
Healthy aging (31)
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline improved memory in older adults with inefficient memory, indicating potential to support cognition in aging.
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
CDP‑choline increased hippocampal/prefrontal volumes—structural changes relevant to preservation of cognition with aging.
- Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 33978188
Citicoline improved memory in older adults with age‑associated memory impairment over 12 weeks, supporting aging cognition.
- Volume Analysis of Brain Cognitive Areas in Alzheimer's Disease: Interim 3-Year Results from the ASCOMALVA Trial
PubMed ID: 32508323
Three‑year randomized trial in Alzheimer patients: choline alphoscerate slowed cognitive decline and brain atrophy—strong support for cognitive aging.
- The LipiDiDiet trial: what does it add to the current evidence for Fortasyn Connect in early Alzheimer's disease?
PubMed ID: 31616139
Fortasyn Connect reduced clinical decline (CDR‑SB) and hippocampal atrophy in prodromal AD — direct relevance to cognitive aging (product contains choline along with other nutrients).
- Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial
PubMed ID: 30672317
Citicoline showed modest benefits in VCIND (vascular cognitive impairment), a population at risk for cognitive aging.
- Effects of Souvenaid on plasma micronutrient levels and fatty acid profiles in mild and mild-to-moderate Alzheimer's disease
PubMed ID: 26213579
Medical food containing choline/uridine/DHA was used in mild Alzheimer’s patients and raised synapse‑related precursors—strong biomarker relevance to cognitive aging.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline in mild–moderate Alzheimer’s produced modest cognitive benefits and physiologic brain changes—relevant to cognitive aging.
- Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators
PubMed ID: 11079534
Citicoline's neuroprotective/lesion-reducing effects after stroke are relevant to protecting cognitive function and may extrapolate to cognitive aging support.
- A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group
PubMed ID: 9305321
Citicoline improved cognitive outcomes after stroke and may have relevance to age-related cognitive impairment; strong RCT evidence for neurocognitive benefit.
- Combined tacrine and estrogen replacement therapy in patients with Alzheimer's disease
PubMed ID: 9329702
Tacrine (cholinergic) showing benefit in AD when combined with estrogen supports cholinergic strategies in cognitive aging.
- Effect of citicoline on visual acuity in amblyopia: preliminary results
PubMed ID: 7622080
Citicoline's neuroprotective/neuroplastic effects (shown in amblyopia) support potential utility in cognitive aging contexts.
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
CDP‑choline improved cognitive/motor outcomes after brain injury — suggests possible neuroprotective/rehabilitative roles relevant to aging, though not specifically aged cognition.
- [Brain protection in heart surgery]
PubMed ID: 1763227
Higher‑dose CDP‑choline reduced rates of persistent postoperative neuropsychological impairment at 6 months—relevant to protecting cognitive trajectory.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline+caffeine improved attention/learning and EEG markers in young adults — suggests mechanisms potentially beneficial for preserving cognition with aging, though direct aging data absent.
- Hippocampal neurochemicals are associated with exercise group and intensity, psychological health, and general cognition in older adults
PubMed ID: 36626020
Exercise intensity linked to hippocampal neurochemical shifts (including Cho/Cr) in older adults — relevant to aging hippocampal chemistry.
- Strength gains after 12 weeks of resistance training correlate with neurochemical markers of brain health in older adults: a randomized control (1)H-MRS study
PubMed ID: 36701005
Resistance training in older adults preserved NAA/Glx that otherwise declined in controls — implies interventions preserve neuronal health relevant to cognitive aging; choline metrics measured.
- [Efficacy and safety of choline alfoscerate in the preventive therapy of dementia in elderly patients with Mild Cognitive Impairment: a three-year prospective comparative study]
PubMed ID: 38696157
Choline alfoscerate infusions in aMCI produced much lower progression to dementia over 3 years—strong human evidence relevant to slowing cognitive aging/progression.
- Effects of choline alfoscerate on cognitive function and quality of life in type 2 diabetes: A double-blind, randomized, placebo-controlled trial
PubMed ID: 39703111
RCT in older adults with T2DM and MCI showed small but statistically significant improvements in MMSE at 12 months with choline alfoscerate — strong aging‑related cognitive signal.
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
α‑GPC produced measurable cognitive improvements over 12 weeks in older adults with amnestic MCI—direct evidence for aging cognition support.
- Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study
PubMed ID: 37340479
Egg‑yolk choline improved verbal memory in middle‑aged/older adults over 12 weeks—supports cognitive aging resilience.
- Choline Pathway Nutrients and Metabolites and Cognitive Impairment After Acute Ischemic Stroke
PubMed ID: 33467878
Large cohort: higher plasma choline/betaine linked to lower post‑stroke cognitive impairment risk (relevance to cognitive outcomes with aging/vascular injury).
- The Effect of the Association between Donepezil and Choline Alphoscerate on Behavioral Disturbances in Alzheimer's Disease: Interim Results of the ASCOMALVA Trial
PubMed ID: 28035924
Donepezil plus choline alphoscerate reduced behavioral/mood symptoms in AD over 24 months, indicating clinical benefit in aging cognition context.
- The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial
PubMed ID: 28747210
Souvenaid (multinutrient including choline) changed brain phospholipid markers in mild AD patients—mechanistic support for age-related cognitive processes.
- The effect of souvenaid on functional brain network organisation in patients with mild Alzheimer's disease: a randomised controlled study
PubMed ID: 24475144
Souvenaid (contains choline) preserved EEG network metrics and related memory findings in mild AD — relevant to slowing age-related cognitive decline.
- The ASCOMALVA (Association between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in Alzheimer's Disease) Trial: interim results after two years of treatment
PubMed ID: 24898643
Choline alphoscerate with donepezil slowed cognitive/functional decline over 24 months in AD — strong evidence for cognitive-aging support in AD patients.
- The ASCOMALVA trial: association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: interim results
PubMed ID: 22959283
Adjunct choline alphoscerate improved cognitive outcomes in AD with cerebrovascular injury — relevant to cognitive aging/dementia contexts (interim analysis).
- [Efficacy and tolerability of choline alphoscerate (cereton) in patients with Parkinson's disease with cognitive disorders]
PubMed ID: 20032953
Short-term cognitive benefit of choline alphoscerate in PD suggests potential to slow/ameliorate cognitive decline aspects (limited-duration trial).
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
RCT in mild–moderate Alzheimer's showing cognitive improvements over 6 months supports a role in slowing/ameliorating aspects of cognitive aging.
- Comparative study of choline alfoscerate as a combination therapy with donepezil: A mixed double-blind randomized controlled and open-label observation trial
PubMed ID: 38875437
In older adults on donepezil, choline alfoscerate added cognitive and behavioral benefits—relevant to cognitive aging and symptomatic support.
- A multicentre trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia
PubMed ID: 1916007
Alpha‑GPC/CDP‑choline improved cognition in vascular dementia — directly relevant to therapies targeting cognitive decline.
Metabolism (29)
- Betaine as a determinant of postmethionine load total plasma homocysteine before and after B-vitamin supplementation
PubMed ID: 14699020
Baseline and post‑load plasma betaine strongly predicted homocysteine response to methionine load, supporting a metabolic role for choline-derived betaine.
- Betaine concentration as a determinant of fasting total homocysteine concentrations and the effect of folic acid supplementation on betaine concentrations
PubMed ID: 15941890
Plasma betaine (a choline metabolite) inversely associated with homocysteine; folic acid raised betaine — relevant to methylation/metabolic pathways.
- Sex and menopausal status influence human dietary requirements for the nutrient choline
PubMed ID: 17490963
Landmark feeding trial: inadequate choline caused widespread, reversible metabolic dysfunction (fatty liver, muscle enzymes, homocysteine changes).
- Choline intake exceeding current dietary recommendations preserves markers of cellular methylation in a genetic subgroup of folate-compromised men
PubMed ID: 20220206
12‑week feeding study: higher choline intake preserved SAM and genomic DNA methylation and reduced DNA damage in folate‑compromised men—strong mechanistic metabolic evidence.
- Choline supplementation and measures of choline and betaine status: a randomised, controlled trial in postmenopausal women
PubMed ID: 22172554
RCT in postmenopausal women: 1 g/day choline increased plasma choline/betaine and trended to lower homocysteine—direct metabolic effects.
- Choline intake in a large cohort of patients with nonalcoholic fatty liver disease
PubMed ID: 22338037
Large observational NAFLD cohort: low dietary choline associated with worse fibrosis — epidemiologic metabolic relevance.
- Maternal choline intake modulates maternal and fetal biomarkers of choline metabolism in humans
PubMed ID: 22418088
Maternal dosing trial: dose‑dependent changes in maternal/fetal choline metabolites indicating altered methyl donor utilization—metabolic impact.
- Plasma trimethylamine-N-oxide following supplementation with vitamin D or D plus B vitamins
PubMed ID: 27569255
B‑vitamin trial altered choline metabolites, lowered homocysteine and TMAO changes — indicates modulation of choline‑related metabolic pathways.
- Supplementation with Folic Acid, but Not Creatine, Increases Plasma Betaine, Decreases Plasma Dimethylglycine, and Prevents a Decrease in Plasma Choline in Arsenic-Exposed Bangladeshi Adults
PubMed ID: 27052531
Folic acid supplementation in arsenic-exposed adults altered plasma betaine/DMG and prevented choline decline—strong evidence of one-carbon metabolic interactions.
- Gut microbiota metabolites, amino acid metabolites and improvements in insulin sensitivity and glucose metabolism: the POUNDS Lost trial
PubMed ID: 29860242
Among overweight/obese subjects, reductions in plasma choline were associated with improvements in insulin and HOMA-IR during weight loss.
- Changes in Gut Microbiota-Related Metabolites and Long-term Successful Weight Loss in Response to Weight-Loss Diets: The POUNDS Lost Trial
PubMed ID: 29305401
In a weight-loss trial, larger decreases in plasma choline were strongly associated with greater weight and fat loss—relevant to metabolic changes during dieting.
- The Effects of Choline and Magnesium Co-Supplementation on Metabolic Parameters, Inflammation, and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial
PubMed ID: 31012803
RDB trial in T2DM: choline+magnesium improved inflammatory and endothelial markers (direct metabolic benefit).
- Betaine and choline status modify the effects of folic acid and creatine supplementation on arsenic methylation in a randomized controlled trial of Bangladeshi adults
PubMed ID: 32918135
Baseline choline/betaine modified response to folic acid/creatine for arsenic methylation—demonstrates choline's role in methylation/metabolism.
- Nutritional supplementation alters associations between one-carbon metabolites and cardiometabolic risk profiles in older adults: a secondary analysis of the Vienna Active Ageing Study
PubMed ID: 34240265
Changes in one‑carbon metabolites (DMG) associated with BMI, LDL and HOMA‑IR in older adults (mechanistic metabolic links).
- Choline and Betaine Levels in Plasma Mirror Choline Intake in Very Preterm Infants
PubMed ID: 38004152
In very preterm infants higher enteral choline intake correlated with plasma betaine and combined choline+betaine, indicating intake mirrors methyl‑donor/metabolic status.
- Traditional Korean diet high in one-carbon nutrients increases global DNA methylation: implication for epigenetic diet
PubMed ID: 38867083
Traditional Korean diet rich in choline/folate improved one‑carbon metabolites (5‑MTHF, homocysteine) and global DNA methylation—clear metabolic/biochemical effect.
- Benefits of Krill Oil Supplementation During Alternate-Day Fasting in Adults With Overweight and Obesity: A Randomized Trial
PubMed ID: 40671417
Krill oil (rich in phosphatidylcholine) attenuated loss of fat‑free mass and strength and lowered inflammation during weight loss — substantial metabolic benefit though source is combined LCn‑3/PC.
- Dietary inclusion of salmon, herring and pompano as oily fish reduces CVD risk markers in dyslipidaemic middle-aged and elderly Chinese women
PubMed ID: 22221492
Oily‑fish meals increased blood choline-containing phospholipids and improved triglycerides and inflammation in dyslipidemic women — supports choline-containing lipids improving metabolic markers.
- Consumption of wheat aleurone-rich foods increases fasting plasma betaine and modestly decreases fasting homocysteine and LDL-cholesterol in adults
PubMed ID: 20980654
Wheat aleurone raised betaine and modestly lowered homocysteine and LDL over 4 weeks — one‑carbon metabolic benefit related to choline metabolism.
- Non-Targeted Dried Blood Spot-Based Metabolomics Analysis Showed Rice Bran Supplementation Effects Multiple Metabolic Pathways during Infant Weaning and Growth in Mali
PubMed ID: 35276967
Heat‑stabilized rice‑bran in infants increased blood choline and improved weight measures — supports nutritional/metabolic benefit in early life.
- Metabolic Signature of Arsenic Exposure and Metabolism: The Folic Acid and Creatine Trial
PubMed ID: 40668877
Large randomized trial (FACT) linked one‑carbon metabolites (choline/betaine) to arsenic metabolism and systemic metabolome — strong human evidence of choline's role in systemic metabolism.
- Effect of acarbose and vildagliptin on plasma trimethylamine N-oxide levels in patients with type 2 diabetes mellitus: a 6-month, two-arm randomized controlled trial
PubMed ID: 40395816
T2DM trial showed interventions lowered plasma TMAO (a choline‑pathway metabolite) with links to insulin‑resistance improvements — metabolic pathway relevance.
- Efficacy and Safety of Fenofibrate-Statin Combination Therapy in Patients With Inadequately Controlled Triglyceride Levels Despite Previous Statin Monotherapy: A Multicenter, Randomized, Double-blind, Phase IV Study
PubMed ID: 34518033
Choline‑fenofibrate added to statin markedly lowered triglycerides and raised HDL over 8 weeks — strong metabolic/lipid evidence (combination product contains choline).
- Impact of the Association Between PNPLA3 Genetic Variation and Dietary Intake on the Risk of Significant Fibrosis in Patients With NAFLD
PubMed ID: 33306506
Large NAFLD cohort: higher dietary choline linked with substantially less fibrosis — strong metabolic (hepatic) support.
- Metabolomic analysis of serum samples from a clinical study on ipragliflozin and metformin treatment in Japanese patients with type 2 diabetes: Exploring human metabolites associated with visceral fat reduction
PubMed ID: 37772313
Ipragliflozin reduced visceral fat and decreased plasma choline — directly ties choline changes to metabolic/visceral fat outcomes.
- Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial
PubMed ID: 27377678
Crossover feeding trial shows microbiome‑dependent TMAO responses to choline/carnitine foods — key metabolic insight for choline metabolism.
- Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study
PubMed ID: 18348715
Dietary intervention increased anti‑phosphorylcholine antibodies and markedly reduced LDL — links to lipid/atheroprotective changes involving PC epitopes.
- The triglyceride-lowering effect of supplementation with dual probiotic strains, Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032: Reduction of fasting plasma lysophosphatidylcholines in nondiabetic and hypertriglyceridemic subjects
PubMed ID: 26044516
Probiotic trial altered choline‑containing lysoPC species and lowered triglycerides, indicating modulation of choline‑related lipid metabolism (indirect).
- Two untargeted metabolomics reveals yogurt-associated metabolic alterations in women with multiple metabolic disorders from a randomized controlled study
PubMed ID: 34666202
Yogurt (vs milk) caused systemic metabolomic shifts including choline metabolism and fatty‑acid oxidation pathways in obese women, supporting metabolic effects.
Pregnancy support (27)
- Prenatal choline supplementation improves biomarkers of maternal docosahexaenoic acid (DHA) status among pregnant participants consuming supplemental DHA: a randomized controlled trial
PubMed ID: 35575618
Prenatal choline (550 mg/day) increased maternal PC‑DHA and RBC DHA — strong mechanistic support for fetal DHA transport and neurodevelopment.
- Dynamic Metabolic Signatures of Choline and Carnitine across Healthy Pregnancy and in Cord Blood: Association with Maternal Dietary Protein
PubMed ID: 36780943
Pregnancy observational study documented rises in free choline and altered carnitine metabolites and cord enrichment—relevant to prenatal nutrient status.
- Choline intake and genetic polymorphisms influence choline metabolite concentrations in human breast milk and plasma
PubMed ID: 20534746
Randomized supplementation in pregnant women increased breast‑milk and plasma choline metabolites—directly relevant to infant choline supply and development.
- Pregnancy induces transcriptional activation of the peripheral innate immune system and increases oxidative DNA damage among healthy third trimester pregnant women
PubMed ID: 23133592
Higher choline intake in pregnancy increased leukocyte H3K4me2 — indicates prenatal epigenetic responsiveness.
- Maternal choline intake modulates maternal and fetal biomarkers of choline metabolism in humans
PubMed ID: 22418088
Randomized maternal dose trial produced dose‑dependent maternal/fetal metabolite changes (including cord DMG) indicating enhanced methyl donor supply to fetus.
- Pregnancy alters choline dynamics: results of a randomized trial using stable isotope methodology in pregnant and nonpregnant women
PubMed ID: 24132975
Stable-isotope feeding showed pregnancy-specific partitioning of choline into PC and PEMT flux and transfer of PEMT-derived PC to fetus — mechanistic prenatal relevance.
- Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk
PubMed ID: 23318559
Large randomized perinatal phosphatidylcholine trial produced significant normalization of neonatal P50 inhibition, a strong developmental endpoint.
- Choline intakes exceeding recommendations during human lactation improve breast milk choline content by increasing PEMT pathway metabolites
PubMed ID: 26025328
Higher maternal choline intake during lactation increased breast‑milk choline metabolites — supports postnatal nutrient supply for infant development.
- Choline and polyunsaturated fatty acids in preterm infants' maternal milk
PubMed ID: 27164830
Breast milk of mothers delivering preterm had substantially lower choline than term milk, implying increased choline need for preterm infants.
- Eggs early in complementary feeding increase choline pathway biomarkers and DHA: a randomized controlled trial in Ecuador
PubMed ID: 29092879
Provision of eggs to infants raised plasma choline and DHA and correlated with better growth outcomes — supports early developmental nutrition.
- Feasibility and Acceptability of Maternal Choline Supplementation in Heavy Drinking Pregnant Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750366
Feasibility RCT in pregnant heavy drinkers showed maternal choline supplementation reliably raised plasma choline — supports prenatal supplementation potential.
- Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750367
Randomized prenatal choline (2 g/day) in heavy‑drinking mothers produced improved infant conditioning, memory and catch‑up growth — direct, strong evidence.
- Neurodevelopmental outcome of nutritional intervention in newborn infants at risk of neurodevelopmental impairment: the Dolphin neonatal double-blind randomized controlled trial
PubMed ID: 29806081
Neonatal multi-nutrient (DHA+choline+uridine) supplement in high-risk newborns produced clinically meaningful cognitive trends—relevant to early development.
- Choline metabolome response to prenatal choline supplementation across pregnancy: A randomized controlled trial
PubMed ID: 34820909
Prenatal supplementation markedly raised maternal and newborn choline pathway metabolites—clear biochemical prenatal exposure effect.
- Maternal choline supplementation mitigates alcohol exposure effects on neonatal brain volumes
PubMed ID: 34342017
Randomized prenatal choline in heavy‑drinking mothers improved neonatal brain volumes and infant memory—strong direct prenatal developmental benefit.
- The impact of micronutrient supplementation in alcohol-exposed pregnancies on reaction time responses of preschoolers in Ukraine
PubMed ID: 34942330
Maternal multivitamin ± choline modestly improved preschool attentional performance in boys — evidence of prenatal supplement effects on child outcomes.
- Metabolic Signature of Arsenic Exposure and Metabolism: The Folic Acid and Creatine Trial
PubMed ID: 40668877
FACT trial's one‑carbon metabolite data underpin methylation pathways essential for prenatal development (mechanistic support).
- Non-Targeted Dried Blood Spot-Based Metabolomics Analysis Showed Rice Bran Supplementation Effects Multiple Metabolic Pathways during Infant Weaning and Growth in Mali
PubMed ID: 35276967
Randomized complementary‑feeding trial increased infant blood choline and improved growth (WAZ/WLZ) — strong developmental nutrition signal (postnatal but developmentally relevant).
- Neuroprotective nutrients in pregnancy and infant brain function
PubMed ID: 40412614
Maternal choline intake/status associated with infant EEG/ERP measures at 1 and 6 months — supportive of prenatal/early development effects.
- Traditional Korean diet high in one-carbon nutrients increases global DNA methylation: implication for epigenetic diet
PubMed ID: 38867083
K‑diet rich in choline/folate improved one‑carbon metabolites and DNA methylation—pathways central to fetal development (biomarker evidence relevant to prenatal needs).
- Choline and Betaine Levels in Plasma Mirror Choline Intake in Very Preterm Infants
PubMed ID: 38004152
Higher enteral choline intake in very preterm infants correlated with plasma betaine and combined choline+betaine — relevant to early neonatal nutrition and development.
- Genetic Variants in One-Carbon Metabolism and Their Effects on DHA Biomarkers in Pregnant Women: A Post-Hoc Analysis
PubMed ID: 36145177
Post‑hoc genetics analysis showed one‑carbon gene variants interact with prenatal choline intake to affect maternal and cord DHA—relevant to prenatal nutrient interactions.
- Estimated Choline Intakes and Dietary Sources of Choline in Pregnant Australian Women
PubMed ID: 36145195
Observational data show many pregnant women have intakes below recommended AIs and eggs are main source—supports need for prenatal choline attention.
- Choline supplementation for preterm infants: metabolism of four Deuterium-labeled choline compounds
PubMed ID: 36460779
PK differences of choline forms in preterm infants inform which forms best supply PC and betaine to the developing neonate.
- Impacts of an egg intervention on nutrient adequacy among young Malawian children
PubMed ID: 33974324
Large RCT in infants showed eggs increased choline intake and reduced prevalence of choline inadequacy—supports nutrient availability critical for brain development.
- Vitamin D Metabolism Varies among Women in Different Reproductive States Consuming the Same Intakes of Vitamin D and Related Nutrients
PubMed ID: 27335139
Controlled feeding study included defined choline doses in pregnant women; while outcome focused on vitamin D, it documents safe choline exposure in pregnancy context.
- Metabolomic profile of umbilical cord blood plasma from early and late intrauterine growth restricted (IUGR) neonates with and without signs of brain vasodilation
PubMed ID: 24312458
Cord plasma choline was markedly lower in IUGR newborns—strong observational evidence linking choline status to fetal development.
Learning (25)
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
Hippocampal and prefrontal volume increases with CDP‑choline support structures important for learning and memory consolidation.
- Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 33978188
Citicoline improved episodic and composite memory measures relevant to learning and retention.
- Volume Analysis of Brain Cognitive Areas in Alzheimer's Disease: Interim 3-Year Results from the ASCOMALVA Trial
PubMed ID: 32508323
Slower hippocampal atrophy and cognitive decline with choline alphoscerate suggests preserved capacity for learning in AD patients.
- CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study
PubMed ID: 32851421
Enhanced MMN after CDP‑choline+galantamine in low responders indicates improved sensory encoding that supports learning.
- Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750367
Prenatal choline increased infant eyeblink conditioning and recognition memory — strong evidence for enhanced early learning/discrimination.
- Choline supplementation in children with fetal alcohol spectrum disorders: a randomized, double-blind, placebo-controlled trial
PubMed ID: 26447156
Daily choline produced age-dependent gains on a hippocampal-dependent elicited-imitation (delayed memory) task in FASD children — supports learning enhancement in a sensitive window.
- Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk
PubMed ID: 23318559
Perinatal PC improved neonatal P50 inhibition linked to later attentional outcomes; implies potential for improved learning/attentional development.
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
Cognitive improvements in Alzheimer's patients indicate potential for enhancing learning‑related performance in impaired populations.
- Maternal choline supplementation mitigates alcohol exposure effects on neonatal brain volumes
PubMed ID: 34342017
Prenatal choline preserved neonatal brain structures linked to cognitive outcomes, supporting later learning.
- Effect of phosphatidylcholine on explicit memory
PubMed ID: 9377589
Improved explicit memory on serial learning tasks after phosphatidylcholine dose — supports enhanced learning-related processes.
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
α‑GPC improved memory domains in amnestic MCI, which can facilitate learning processes in impaired adults.
- The impact of micronutrient supplementation in alcohol-exposed pregnancies on reaction time responses of preschoolers in Ukraine
PubMed ID: 34942330
Prenatal (multi‑)nutrient ± choline improvements in preschool reaction‑time and accuracy in boys suggest modest learning/attentional gains.
- Effect of citicoline on visual acuity in amblyopia: preliminary results
PubMed ID: 7622080
Citicoline improved visual acuity and likely enhances neural plasticity — supportive of learning-related neural processes.
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline produced improvements in verbal memory tasks that translate to enhanced learning performance in older adults with inefficient memory.
- Choline enhances elicited imitation memory performance in preschool children with prenatal alcohol exposure: a cumulative report of 3 randomized controlled trials
PubMed ID: 39956364
Pooled RCTs demonstrated sizable improvements in a memory/learning task in children given choline.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline+caffeine improved maze learning and working memory measures — strong RCT evidence for enhanced learning.
- Four-year follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder
PubMed ID: 32164522
Early choline supplementation improved nonverbal IQ and working memory years later in prenatal‑exposed children—supports enhanced learning capacity.
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
Better cognitive recovery after head injury with CDP‑choline could support relearning capacities during rehabilitation.
- Citicoline in hypoxic ischemic encephalopathy in neonates: a randomized controlled trial
PubMed ID: 37173784
Significant improvements in developmental (cognitive) scores after neonatal citicoline indicate enhanced early learning/development.
- Cytidin-5'-diphosphocholine enhances the effect of part-time occlusion in amblyopia
PubMed ID: 9550353
Citicoline enhanced visual recovery and presumably neural plasticity in amblyopia—clinical evidence for facilitation of learning/plasticity in sensory system.
- A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group
PubMed ID: 9305321
Citicoline improved MMSE and cognitive outcomes post-stroke — supportive of enhanced cognitive/learning-related recovery.
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
PubMed ID: 17873684
Significant improvement on a declarative memory measure (RAVLT alternate list) implies enhanced learning/retention.
- Effectiveness of the addition of citicoline to patching in the treatment of amblyopia around visual maturity: a randomized controlled trial
PubMed ID: 24618483
Citicoline added to patching increased visual acuity in amblyopia, reflecting improved visual cortical plasticity and learning.
- Effects of Souvenaid on plasma micronutrient levels and fatty acid profiles in mild and mild-to-moderate Alzheimer's disease
PubMed ID: 26213579
Biomarker increases relevant for synapse formation could support learning in neurodegenerative contexts (indirect).
- Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial
PubMed ID: 30672317
Citicoline improved cognitive test scores in VCIND, consistent with potential benefits for learning/processing.
Nerve health (30)
- Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators
PubMed ID: 11079534
Citicoline supports phospholipid and acetylcholine pathways; stroke trial showed neuroprotective effects consistent with enhanced nerve-signaling support.
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline is a choline donor and precursor for acetylcholine and phospholipid synthesis; cognitive improvements imply support for neurotransmission/nerve signaling.
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
Choline alfoscerate improved cognitive performance in AD where cholinergic neurotransmission is relevant — supports nerve signaling benefit.
- The ASCOMALVA trial: association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: interim results
PubMed ID: 22959283
Choline alphoscerate (a cholinergic precursor) added to donepezil improved cognition/behavior in AD, implying enhanced cholinergic signaling.
- [Diagnosis and treatment of neurogenic dysphagia after acute ischemic stroke]
PubMed ID: 30830119
Choline alfoscerate (a choline donor) improved swallowing/laryngeal function after stroke, implying enhanced neural control of swallowing.
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
α‑GPC improved cognition in MCI, implying beneficial effects on cholinergic pathways important for signaling.
- Effects of choline alfoscerate on cognitive function and quality of life in type 2 diabetes: A double-blind, randomized, placebo-controlled trial
PubMed ID: 39703111
Choline alfoscerate (a choline ester) improved cognition in MCI — consistent with enhanced cholinergic neurotransmission/nerve signaling.
- Choline enhances elicited imitation memory performance in preschool children with prenatal alcohol exposure: a cumulative report of 3 randomized controlled trials
PubMed ID: 39956364
Memory improvements in children with prenatal alcohol exposure imply support for cholinergic/neuronal signaling pathways.
- Neurochemical alterations in methamphetamine-dependent patients treated with cytidine-5'-diphosphate choline: a longitudinal proton magnetic resonance spectroscopy study
PubMed ID: 20043005
CDP‑choline produced robust prefrontal MRS changes (NAA/Cho) consistent with improved neuronal integrity and signaling.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline (a choline donor) improved attention/ERP measures — strong evidence that choline availability enhances neural signaling and electrophysiology.
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
CDP‑choline improved motor/cognitive outcomes after head injury — implies beneficial effects on neuronal repair/signaling.
- Effects of intracameral carbachol and acetylcholine on early postoperative intraocular pressure after cataract extraction
PubMed ID: 7853733
Intracameral carbachol/acetylcholine directly stimulate cholinergic receptors—clear evidence of cholinergic (nerve) signaling effects.
- Effect of citicoline on visual acuity in amblyopia: preliminary results
PubMed ID: 7622080
Citicoline acts as a precursor to phosphatidylcholine and acetylcholine, supporting cholinergic neurotransmission relevant to nerve signaling.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline (a choline donor) produced EEG/CBF changes and cognitive benefits—strong evidence of supporting cholinergic neuronal signaling.
- Cytidine-5'-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma
PubMed ID: 10366081
Citicoline injections improved electrophysiologic retinal and visual pathway function—direct neuronal signaling improvement.
- Effect of intracameral carbachol on intraocular pressure following clear corneal phacoemulsification
PubMed ID: 10450383
Intracameral carbachol reduced postoperative IOP and high-pressure events—direct cholinergic receptor-mediated effect on ocular nerve/muscle signaling.
- Electrophysiological assessment of glaucomatous visual dysfunction during treatment with cytidine-5'-diphosphocholine (citicoline): a study of 8 years of follow-up
PubMed ID: 16249960
Direct electrophysiological evidence (VEP/PERG) that citicoline improved retinal and cortical electrical responses — strong support for neural signaling.
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
PubMed ID: 17873684
Improved memory performance and decreased cocaine‑positive urines indicate improved neural function/behavioral control.
- [Clinical effect of ligustrazine combined with citicoline for treatment of diabetic peripheral neuropathy]
PubMed ID: 18822909
Adding citicoline improved nerve conduction and symptoms in diabetic peripheral neuropathy — direct evidence for nerve conduction support.
- The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males
PubMed ID: 26179181
Improved attention and reduced impulsivity after citicoline imply better executive/neuronal signaling.
- Treatment with citicoline eye drops enhances retinal function and neural conduction along the visual pathways in open angle glaucoma
PubMed ID: 26004075
Topical citicoline improved PERG and VEP measures, showing improved retinal ganglion cell and visual pathway signaling.
- Citicoline Combination Therapy for Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial
PubMed ID: 28085707
Citicoline is a precursor to phosphatidylcholine and can enhance acetylcholine availability; clinical RCT showed mood improvement consistent with central cholinergic/neurotransmission effects.
- Citicoline (CDP-choline) add-on therapy to risperidone for treatment of negative symptoms in patients with stable schizophrenia: A double-blind, randomized placebo-controlled trial
PubMed ID: 29901250
Clinical symptom improvements with citicoline suggest functional enhancement of neural circuits.
- Combining CDP-choline and galantamine: Effects of a selective α7 nicotinic acetylcholine receptor agonist strategy on P50 sensory gating of speech sounds in healthy volunteers
PubMed ID: 30920339
CDP‑choline + galantamine improved auditory P50 gating in low suppressors—direct evidence of improved early neural signaling.
- Neuroenhancement and neuroprotection by oral solution citicoline in non-arteritic ischemic optic neuropathy as a model of neurodegeneration: A randomized pilot study
PubMed ID: 31348806
Citicoline improved retinal ganglion cell electrophysiology and visual conduction—direct evidence of improved nerve signaling.
- Efficacy of Citicoline as a Neuroprotector in children with post cardiac arrest: a randomized controlled clinical trial
PubMed ID: 33169240
Citicoline improved consciousness, reduced seizures and enhanced neurological recovery after cardiac arrest—strong support for neural signaling recovery.
- Can Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebo-controlled Clinical Trial
PubMed ID: 32541370
Topical citicoline slowed visual field loss and RNFL thinning in glaucoma, supporting retinal/optic nerve signaling preservation.
- CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study
PubMed ID: 32851421
Acute CDP‑choline+galantamine increased MMN in low‑baseline individuals, reflecting enhanced cortical auditory signaling.
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
CDP‑choline increased prefrontal and hippocampal GM volumes—structure and cholinergic substrate improvements imply enhanced neuronal signaling.
- Citicoline in hypoxic ischemic encephalopathy in neonates: a randomized controlled trial
PubMed ID: 37173784
Neonatal citicoline reduced seizures and improved development, consistent with stabilization/enhancement of neural signaling mechanisms.
Mental clarity (26)
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline (a choline donor) produced clinically meaningful improvements in verbal memory and cognition in older adults, supporting clearer thinking/mental clarity.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline (choline precursor) produced modest cognitive/EEG improvements consistent with enhanced clarity.
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
PubMed ID: 17873684
Small RCT of citicoline showed improved memory performance and reduced cocaine use -> plausible subjective clarity/cognitive benefit.
- The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males
PubMed ID: 26179181
Citicoline improved attention and psychomotor speed in healthy adolescents, which can manifest as greater perceived clarity.
- Citicoline (CDP-choline) add-on therapy to risperidone for treatment of negative symptoms in patients with stable schizophrenia: A double-blind, randomized placebo-controlled trial
PubMed ID: 29901250
Citicoline add‑on improved negative symptoms and overall PANSS, indicating clearer cognitive/behavioral function in schizophrenia.
- Effectiveness of acupuncture for vascular cognitive impairment no dementia: a randomized controlled trial
PubMed ID: 30672317
Citicoline produced modest cognitive improvements vs baseline in VCIND, consistent with improved mental clarity.
- [Current treatment options for autonomic, cognitive and emotional disorders in patients with asthenic syndrome treated with recognan (citicoline)]
PubMed ID: 31464286
Oral citicoline improved fatigue‑related cognitive/emotional symptoms (direct choline compound → plausible mental clarity benefit).
- CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study
PubMed ID: 32851421
Acute CDP‑choline+galantamine increased auditory deviance detection (MMN) in low‑responders, implying improved signal processing/clarity.
- Volume Analysis of Brain Cognitive Areas in Alzheimer's Disease: Interim 3-Year Results from the ASCOMALVA Trial
PubMed ID: 32508323
Choline alphoscerate + donepezil slowed cognitive decline in AD, supporting clearer cognition and reduced confusion.
- Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 33978188
Citicoline improved composite and episodic memory in older adults, which can manifest as improved mental clarity.
- Citicoline in hypoxic ischemic encephalopathy in neonates: a randomized controlled trial
PubMed ID: 37173784
IV citicoline in neonates improved developmental scores and reduced seizures, consistent with clearer neurologic function in early life.
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
CDP‑choline increased prefrontal gray matter and reduced craving, indicating improved cortical integrity that can support clarity.
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
Choline alfoscerate RCT improved global/cognitive scores (ADAS‑Cog, MMSE) in mild–moderate AD, implying improved overall cognitive clarity.
- [Efficacy and tolerability of choline alphoscerate (cereton) in patients with Parkinson's disease with cognitive disorders]
PubMed ID: 20032953
Short-term choline alphoscerate produced cognitive improvement in Parkinson patients (supports acute mental clarity).
- Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750367
Prenatal choline produced stronger early neurobehavioral and recognition‑memory measures in infants, implying clearer cognitive processing.
- Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study
PubMed ID: 37340479
Egg‑yolk choline (300 mg/d) in older adults raised plasma choline and modestly improved verbal memory, consistent with clearer cognition.
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
α‑GPC improved global and memory-specific cognition in amnestic MCI, implying clearer mental functioning in impaired adults.
- Effects of choline alfoscerate on cognitive function and quality of life in type 2 diabetes: A double-blind, randomized, placebo-controlled trial
PubMed ID: 39703111
Choline alfoscerate RCT in older adults with MCI showed small but significant improvements in global cognition/QoL, consistent with clearer cognitive function.
- [Efficacy and safety of choline alfoscerate in the preventive therapy of dementia in elderly patients with Mild Cognitive Impairment: a three-year prospective comparative study]
PubMed ID: 38696157
Choline alfoscerate infusions in aMCI slowed cognitive progression—plausible improvement in clarity/processing (clinical cognitive benefit).
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline (choline donor) + caffeine improved attention, maze learning and EEG — strong direct support for acute mental clarity.
- [CDP-choline improves the postoperative rehabilitation of patients with cerebral risk]
PubMed ID: 2088110
Perioperative CDP‑choline improved short‑term postoperative cognitive/functional scores (direct cognitive benefit).
- [Brain protection in heart surgery]
PubMed ID: 1763227
Higher‑dose CDP‑choline around cardiac surgery associated with fewer persistent cognitive deficits (supports clarity/processing preservation).
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
CDP‑choline improved global outcome and cognitive recovery after head injury — supports clearer cognitive function after brain insult.
- Effect of phosphatidylcholine on explicit memory
PubMed ID: 9377589
Single high-dose phosphatidylcholine improved explicit memory/recall in healthy students — supports acute mental clarity.
- Effect of citicoline on visual acuity in amblyopia: preliminary results
PubMed ID: 7622080
Citicoline (CDP‑choline) improved visual function and is associated with central nervous system benefits that can support clarity of perception and cognition.
- A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group
PubMed ID: 9305321
Citicoline (choline-containing) RCT improved cognitive/MMSE after ischemic stroke — plausible benefit for mental clarity.
Focus & concentration (21)
- Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study
PubMed ID: 34507102
Prefrontal gray matter increases after CDP‑choline imply improved executive region integrity linked to sustained attention/focus.
- Neuroprotective nutrients in pregnancy and infant brain function
PubMed ID: 40412614
Maternal choline associated with infant ERP measures (latency/amplitude) that reflect early attentional processing.
- Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage
PubMed ID: 25046515
Citicoline+caffeine improved sustained attention (CPT reaction time/errors) — strong randomized evidence supporting attention support.
- Effects of CDP-choline on the recovery of patients with head injury
PubMed ID: 1940960
Improved overall cognitive outcomes after CDP‑choline in head injury could translate to better sustained attention/focus during recovery.
- Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion
PubMed ID: 10669911
Citicoline showed EEG and some cognitive improvements consistent with improved focus/attention.
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
PubMed ID: 17873684
Cognitive improvements and reduced substance use suggest better attention/impulse control in the studied group.
- Long-term treatment with citicoline may improve poststroke vascular cognitive impairment
PubMed ID: 23406981
Citicoline improved attention/executive outcomes after ischemic stroke across 6–12 month follow‑up.
- The effect of lactose-isomaltulose-containing growing-up milks on cognitive performance of Indonesian children: a cross-over study
PubMed ID: 23680182
Formula with extra choline/vitamins produced the best attention performance 3 h after breakfast in children.
- The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males
PubMed ID: 26179181
Randomized placebo‑controlled trial demonstrated citicoline improved attention accuracy and related measures in adolescents.
- Combining CDP-choline and galantamine: Effects of a selective α7 nicotinic acetylcholine receptor agonist strategy on P50 sensory gating of speech sounds in healthy volunteers
PubMed ID: 30920339
CDP‑choline + galantamine improved P50 indices in low suppressors, indicating improved attentional gating.
- [Current treatment options for autonomic, cognitive and emotional disorders in patients with asthenic syndrome treated with recognan (citicoline)]
PubMed ID: 31464286
Citicoline improved cognitive and asthenic symptoms, plausibly including focus/attentional capacity.
- CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study
PubMed ID: 32851421
CDP‑choline+galantamine acutely increased MMN (an attention‑related electrophysiological marker) in low‑baseline individuals.
- Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 33978188
Citicoline improved composite memory and some working‑memory measures, consistent with better sustained cognitive performance/focus.
- Efficacy and safety of choline alphoscerate for amnestic mild cognitive impairment: a randomized double-blind placebo-controlled trial
PubMed ID: 39300341
α‑GPC improved naming and memory domains (MoCA naming), reflecting improvements in attention‑dependent tasks in MCI.
- Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study
PubMed ID: 37340479
Verbal memory gains with egg‑yolk choline may partly reflect improved attentional processes in older adults.
- The impact of micronutrient supplementation in alcohol-exposed pregnancies on reaction time responses of preschoolers in Ukraine
PubMed ID: 34942330
Prenatal multivitamin ± choline modestly improved preschool reaction‑time performance and attentional regulation in boys — direct attention‑related outcome.
- Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
PubMed ID: 29750367
Improved infant eyeblink conditioning and recognition memory indicate enhanced attentional processing in infants exposed prenatally to choline.
- Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk
PubMed ID: 23318559
Perinatal phosphatidylcholine significantly increased normal neonatal P50 inhibition and linked deficient P50 to later increased attentional symptoms — strong evidence for attention support.
- [Efficacy and tolerability of choline alphoscerate (cereton) in patients with Parkinson's disease with cognitive disorders]
PubMed ID: 20032953
Observed cognitive improvements with choline alphoscerate included attention-related measures in short trial.
- Cognitive improvement in mild to moderate Alzheimer's dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial
PubMed ID: 12637119
General cognitive benefits seen in AD trial can include attention/processing speed improvements reflected in global scores.
- Citicoline improves verbal memory in aging
PubMed ID: 8624220
Citicoline's positive effects on cognitive tasks imply benefit for attention-related processes, though no dedicated attention trial in the dataset.
Fat burn (16)
- Reproductive state and choline intake influence enrichment of plasma lysophosphatidylcholine-DHA: a post hoc analysis of a controlled feeding trial
PubMed ID: 31782377
Higher dietary choline increased PEMT-derived LPC-DHA labeling in women—direct mechanistic evidence linking choline to DHA-containing phospholipid metabolism.
- Effects of Souvenaid on plasma micronutrient levels and fatty acid profiles in mild and mild-to-moderate Alzheimer's disease
PubMed ID: 26213579
Souvenaid increased erythrocyte DHA and plasma precursors important for phospholipid synthesis and healthy lipid handling.
- Protein Intake at Twice the RDA in Older Men Increases Circulatory Concentrations of the Microbiome Metabolite Trimethylamine-N-Oxide (TMAO)
PubMed ID: 31547446
High‑protein diet markedly raised TMAO and modestly increased LDL — clear implication for choline‑derived metabolites and lipid metabolism.
- Metabolomic analysis of serum samples from a clinical study on ipragliflozin and metformin treatment in Japanese patients with type 2 diabetes: Exploring human metabolites associated with visceral fat reduction
PubMed ID: 37772313
Ipragliflozin reduced visceral fat and decreased plasma choline — links choline changes with fat metabolism improvements.
- Impact of the Association Between PNPLA3 Genetic Variation and Dietary Intake on the Risk of Significant Fibrosis in Patients With NAFLD
PubMed ID: 33306506
Large NAFLD cohort: higher choline intake linked with less fibrosis, directly supporting hepatic fat metabolism and health.
- Efficacy and Safety of Fenofibrate-Statin Combination Therapy in Patients With Inadequately Controlled Triglyceride Levels Despite Previous Statin Monotherapy: A Multicenter, Randomized, Double-blind, Phase IV Study
PubMed ID: 34518033
Choline‑fenofibrate produced large triglyceride lowering and HDL raising on top of statin therapy — strong evidence for improved fat metabolism in this combination context.
- Dietary inclusion of salmon, herring and pompano as oily fish reduces CVD risk markers in dyslipidaemic middle-aged and elderly Chinese women
PubMed ID: 22221492
Oily fish increased choline‑phospholipids and improved triglycerides in dyslipidemic women — supports healthy lipid handling.
- Benefits of Krill Oil Supplementation During Alternate-Day Fasting in Adults With Overweight and Obesity: A Randomized Trial
PubMed ID: 40671417
Krill oil (phosphatidylcholine source) attenuated loss of fat‑free mass and reduced inflammation during weight loss — favorable body‑composition/metabolic effects.
- Prenatal choline supplementation improves biomarkers of maternal docosahexaenoic acid (DHA) status among pregnant participants consuming supplemental DHA: a randomized controlled trial
PubMed ID: 35575618
Prenatal choline with DHA increased maternal PC‑DHA and RBC DHA — strong evidence choline supports phospholipid (fat) transport/ metabolism important for membranes and fetal DHA delivery.
- Changes in Gut Microbiota-Related Metabolites and Long-term Successful Weight Loss in Response to Weight-Loss Diets: The POUNDS Lost Trial
PubMed ID: 29305401
Reductions in plasma choline during weight loss associated with greater weight/fat loss—observational linkage to fat metabolism changes.
- Choline Supplementation With a Structured Lipid in Children With Cystic Fibrosis: A Randomized Placebo-Controlled Trial
PubMed ID: 26465792
Choline-rich structured lipid improved fat absorption and corrected choline status in cystic fibrosis children.
- Choline intake in a large cohort of patients with nonalcoholic fatty liver disease
PubMed ID: 22338037
Observational human data linking low choline intake with worse NAFLD fibrosis supports role of choline in hepatic lipid export/VLDL and fat metabolism.
- Dietary choline requirements of women: effects of estrogen and genetic variation
PubMed ID: 20861172
Choline depletion induced organ dysfunction with genotype/estrogen interactions (PEMT pathway relevant to phosphatidylcholine synthesis and lipid export) — mechanistic human evidence.
- Supplemental choline for prevention and alleviation of fatty liver in dairy cattle
PubMed ID: 17430945
Animal data: rumen-protected choline reduced hepatic TAG accumulation and aided fat clearance (supports fat metabolism role).
- Sex and menopausal status influence human dietary requirements for the nutrient choline
PubMed ID: 17490963
Feeding trial: choline deficiency caused fatty liver and impaired fat export—strong human evidence for fat metabolism role.
- Efficacy of docosahexaenoic acid-choline-vitamin E in paediatric NASH: a randomized controlled clinical trial
PubMed ID: 28511023
Marked improvement in hepatic steatosis in pediatric NASH trial (multi‑ingredient) suggests improved hepatic fat handling; choline is a plausible contributor.
Heart health (11)
- Depressed plasma platelet-activating factor acetylhydrolase in patients presenting with acute myocardial infarction
PubMed ID: 9778550
Observational study found lower PAF-acetylhydrolase activity in acute MI patients; PAF/PAF-AH are choline-phospholipid-related biomarkers, indirectly relevant to cardiovascular biology.
- Effect of Choline Forms and Gut Microbiota Composition on Trimethylamine-N-Oxide Response in Healthy Men
PubMed ID: 32722424
Choline salts produce much higher TMAO vs phosphatidylcholine; TMAO links to cardiovascular risk (directly relevant to heart health decisions).
- The Effects of Choline and Magnesium Co-Supplementation on Metabolic Parameters, Inflammation, and Endothelial Dysfunction in Patients With Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial
PubMed ID: 31012803
Choline+magnesium improved endothelial dysfunction markers in T2DM—endothelial health is important for cardiovascular risk.
- Daily Ingestion of Eggplant Powder Improves Blood Pressure and Psychological State in Stressed Individuals: A Randomized Placebo-Controlled Study
PubMed ID: 31744060
Eggplant powder (acetylcholine source) RCT produced meaningful reductions in systolic/diastolic BP in mild hypertensives—cardiovascular benefit.
- Randomized, double-blind, multicenter study of the Endeavor zotarolimus-eluting phosphorylcholine-encapsulated stent for treatment of native coronary artery lesions. Clinical and angiographic results of the ENDEAVOR II Trial
PubMed ID: 17287679
Randomized trial showed phosphorylcholine‑coated zotarolimus stent reduced restenosis and MACE vs bare metal stent (device-level cardiovascular benefit related to phosphocholine moiety).
- Latin American randomized trial of balloon angioplasty versus coronary stenting in diabetic patients with small vessel reference size (Latin American Small Vessel [LASMAL II] Trial): immediate and long-term results
PubMed ID: 16086559
PC-coated stents reduced restenosis and improved vessel outcomes in diabetic small-vessel PCI—strong cardiac-relevant evidence for phosphorylcholine technology.
- Latin American randomized trial of balloon angioplasty vs coronary stenting for small vessels (LASMAL): immediate and long-term results
PubMed ID: 15989908
Phosphorylcholine-coated stent improved procedural/angiographic outcomes in small coronary arteries—direct clinical cardiac benefit from a choline-derived surface coating.
- Efficacy and Safety of Fenofibrate-Statin Combination Therapy in Patients With Inadequately Controlled Triglyceride Levels Despite Previous Statin Monotherapy: A Multicenter, Randomized, Double-blind, Phase IV Study
PubMed ID: 34518033
Choline‑fenofibrate added to statin sharply lowered triglycerides and raised HDL — strong cardiometabolic lipid improvements (combination product contains choline moiety).
- Effect of acarbose and vildagliptin on plasma trimethylamine N-oxide levels in patients with type 2 diabetes mellitus: a 6-month, two-arm randomized controlled trial
PubMed ID: 40395816
Acarbose decreased plasma TMAO more than vildagliptin in T2DM, and TMAO changes correlated with insulin‑resistance improvements — relevant to choline‑pathway cardiovascular risk.
- Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women
PubMed ID: 30535398
Red‑meat diets raised TMAO (atherogenic gut‑microbiota metabolite from choline/carnitine) — indicates potential adverse heart risk from choline precursors.
- Dietary inclusion of salmon, herring and pompano as oily fish reduces CVD risk markers in dyslipidaemic middle-aged and elderly Chinese women
PubMed ID: 22221492
Oily‑fish meals increased choline‑containing lipids and improved triglycerides and inflammatory markers in dyslipidemic women — supports cardiometabolic benefit.
Liver support (8)
- Choline requirements of White Pekin ducks from hatch to 21 days of age
PubMed ID: 25260528
Dietary choline prevented fatty liver in growing ducks — clear liver-protective effect in animals though not directly in humans.
- Choline intake in a large cohort of patients with nonalcoholic fatty liver disease
PubMed ID: 22338037
Large observational NAFLD cohort: low dietary choline associated with more severe fibrosis in postmenopausal women — strong epidemiologic link to liver health.
- Dietary choline requirements of women: effects of estrogen and genetic variation
PubMed ID: 20861172
Controlled low‑choline depletion trial: organ dysfunction (including liver) provoked especially in PEMT risk allele carriers and postmenopausal women — strong human evidence for choline requirement and liver vulnerability.
- Supplemental choline for prevention and alleviation of fatty liver in dairy cattle
PubMed ID: 17430945
Dairy-cattle experiments: supplemental rumen-protected choline reduced liver fat accumulation and improved TAG clearance—animal evidence for hepatic effects.
- Sex and menopausal status influence human dietary requirements for the nutrient choline
PubMed ID: 17490963
Controlled human feeding trial: low choline caused fatty liver in many subjects and repletion reversed it—direct, high-quality evidence.
- Efficacy of docosahexaenoic acid-choline-vitamin E in paediatric NASH: a randomized controlled clinical trial
PubMed ID: 28511023
Children with NASH receiving DHA + choline + vit E had large reductions in severe steatosis and ALT — strong clinical liver signal though multi‑ingredient.
- Polyunsaturated phosphatidyl-choline and interferon alpha for treatment of chronic hepatitis B and C: a multi-center, randomized, double-blind, placebo-controlled trial. Leich Study Group
PubMed ID: 9684137
Large RCT: polyunsaturated phosphatidylcholine improved biochemical ALT response in hepatitis C when added to interferon (adjunctive liver benefit).
- Impact of the Association Between PNPLA3 Genetic Variation and Dietary Intake on the Risk of Significant Fibrosis in Patients With NAFLD
PubMed ID: 33306506
Large NAFLD cohort: higher dietary choline strongly associated with less fibrosis — direct and strong evidence for hepatic support.
Muscle maintenance (10)
- Excellent intubating conditions with remifentanil-propofol and either low-dose rocuronium or succinylcholine
PubMed ID: 19440810
Rocuronium vs succinylcholine for intubation assesses onset/duration of muscle relaxation — directly about muscle function (drug-level).
- To asses the effects of rocuronium pretreatment on succinylcholine induced fasciculations and postoperative myalgias
PubMed ID: 20201179
Pretreatment reduced succinylcholine-induced fasciculations and pain — directly relevant to drug-induced muscle effects.
- Reversal of profound neuromuscular block by sugammadex administered three minutes after rocuronium: a comparison with spontaneous recovery from succinylcholine
PubMed ID: 19387176
Study compares neuromuscular blockade reversal (sugammadex vs succinylcholine recovery) — high relevance to pharmacologic muscle function.
- Efficiency of citicoline in increasing muscular strength of patients with nontraumatic cerebral hemorrhage: a double-blind randomized clinical trial
PubMed ID: 18436157
Small RCT: citicoline associated with greater muscle‑strength improvement after nontraumatic cerebral hemorrhage — direct evidence.
- Benefits of Krill Oil Supplementation During Alternate-Day Fasting in Adults With Overweight and Obesity: A Randomized Trial
PubMed ID: 40671417
Krill oil (phosphatidylcholine source) attenuated loss of fat‑free mass and strength during alternate‑day fasting versus placebo — direct muscle function benefit.
- The Effect of Choline and Resistance Training on Strength and Lean Mass in Older Adults
PubMed ID: 37764658
Older adults with ~50% recommended choline intake gained far less strength from 12 weeks resistance training versus adequate intake—strong evidence choline supports training‑related strength gains.
- Topical lipoic acid choline ester eye drop for improvement of near visual acuity in subjects with presbyopia: a safety and preliminary efficacy trial
PubMed ID: 33514891
Topical lipoic acid–choline ester eye drops improved near vision/presbyopia likely via effects on the lens/ciliary apparatus (ocular muscle/accommodation).
- [Diagnosis and treatment of neurogenic dysphagia after acute ischemic stroke]
PubMed ID: 30830119
Choline alfoscerate improved sip control and laryngeal movement in dysphagic stroke patients—direct effect on oropharyngeal muscle function.
- Evaluation of the effects of two doses of alpha glycerylphosphorylcholine on physical and psychomotor performance
PubMed ID: 29042830
Short A‑GPC trial raised serum free choline and produced modest improvements in some explosive power measures (CMJ power).
- Sex and menopausal status influence human dietary requirements for the nutrient choline
PubMed ID: 17490963
In the feeding trial many developed muscle enzyme elevations (CPK) on low-choline diet that reversed with repletion—direct evidence.
Mood balance (8)
- [Current treatment options for autonomic, cognitive and emotional disorders in patients with asthenic syndrome treated with recognan (citicoline)]
PubMed ID: 31464286
Citicoline produced improvements in emotional symptoms in asthenic patients, supporting mood‑related effects.
- Citicoline (CDP-choline) add-on therapy to risperidone for treatment of negative symptoms in patients with stable schizophrenia: A double-blind, randomized placebo-controlled trial
PubMed ID: 29901250
Citicoline reduced negative symptoms in schizophrenia, which include affective/motivational components related to mood balance.
- Daily Ingestion of Eggplant Powder Improves Blood Pressure and Psychological State in Stressed Individuals: A Randomized Placebo-Controlled Study
PubMed ID: 31744060
Eggplant powder (acetylcholine source) RCT showed improvements in POMS mood subscales—direct mood benefit.
- Effect of modified electroconvulsive therapy on neuro metabolites and magnetic resonance spectroscopy imaging signals in patients with refractory obsessive-compulsive disorder
PubMed ID: 34644618
Modified ECT reduced Cho/Cr and improved OCD/anxiety/depression scores; Cho/Cr changes implicate cholinergic/metabolic involvement in mood symptom change.
- Apathy Treatment in Alzheimer's Disease: Interim Results of the ASCOMALVA Trial
PubMed ID: 26402001
Adding choline alphoscerate to donepezil reduced apathy and caregiver distress in AD — direct clinical effect on a mood/behavior domain.
- The Effect of the Association between Donepezil and Choline Alphoscerate on Behavioral Disturbances in Alzheimer's Disease: Interim Results of the ASCOMALVA Trial
PubMed ID: 28035924
Choline alphoscerate adjunct to donepezil reduced mood/behavioral symptom clusters in AD over 24 months.
- A randomized, double-blind, placebo-controlled trial of citicoline for bipolar and unipolar depression and methamphetamine dependence
PubMed ID: 22974472
Small randomized trial found significant improvements in depressive symptoms with citicoline versus placebo.
- Citicoline Combination Therapy for Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial
PubMed ID: 28085707
Randomized double‑blind trial: adding citicoline to citalopram produced significantly greater reductions in HDRS and higher remission rates — strong direct evidence for mood benefit.
Digestive support (7)
- Protein Intake at Twice the RDA in Older Men Increases Circulatory Concentrations of the Microbiome Metabolite Trimethylamine-N-Oxide (TMAO)
PubMed ID: 31547446
Doubling protein markedly raised fasting TMAO (choline/carnitine‑derived metabolite) — clear digestive/microbial metabolite effect.
- A Pilot Study of Human Milk to Reduce Intestinal Inflammation After Bone Marrow Transplant
PubMed ID: 30916575
Human milk peri‑BMT reduced intestinal inflammation markers and altered stool choline‑related metabolites — suggests choline‑related gut metabolic effects (indirect).
- Choline Supplementation With a Structured Lipid in Children With Cystic Fibrosis: A Randomized Placebo-Controlled Trial
PubMed ID: 26465792
In children with cystic fibrosis, LXS (choline-rich lipid) reduced stool PC loss and improved the coefficient of fat absorption.
- Post hoc analysis of fecal samples from responders and non-responders to Lactobacillus reuteri DSM 17938 intervention
PubMed ID: 32945647
Baseline fecal choline levels predicted response to L. reuteri in childhood diarrhea (gut metabolic marker relevance).
- Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women
PubMed ID: 30535398
Red‑meat diets markedly increased TMAO production from gut microbiota (choline/carnitine precursors) — strong digestive/gut‑microbiome relevance.
- Effect of acarbose and vildagliptin on plasma trimethylamine N-oxide levels in patients with type 2 diabetes mellitus: a 6-month, two-arm randomized controlled trial
PubMed ID: 40395816
Acarbose/vildagliptin lowered plasma TMAO in T2DM — shows modulation of gut‑derived choline metabolites by therapy.
- Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial
PubMed ID: 27377678
Food challenge showed massive TMAO spikes and microbiome prediction of response — central study for gut production of choline metabolites.
Stress resilience (3)
- Benefits of Krill Oil Supplementation During Alternate-Day Fasting in Adults With Overweight and Obesity: A Randomized Trial
PubMed ID: 40671417
Krill oil group showed greater reductions in inflammatory markers (TNF‑α, CRP) during weight‑loss fasting — inflammation/stress axis modulation relevant to stress response.
- Daily Ingestion of Eggplant Powder Improves Blood Pressure and Psychological State in Stressed Individuals: A Randomized Placebo-Controlled Study
PubMed ID: 31744060
Eggplant powder trial reported improvements in POMS mood subscales (psychological stress measures), suggesting stress‑related benefit.
- Efficacy of Citicoline as a Neuroprotector in children with post cardiac arrest: a randomized controlled clinical trial
PubMed ID: 33169240
IV citicoline reduced seizures and improved neurologic recovery after cardiac arrest—indicative of enhanced resilience to severe brain injury/stress.
Energy & Fatigue (2)
- Sex and menopausal status influence human dietary requirements for the nutrient choline
PubMed ID: 17490963
Choline deficiency caused organ dysfunction including muscle enzyme derangements suggesting impaired cellular energetics.
- [Current treatment options for autonomic, cognitive and emotional disorders in patients with asthenic syndrome treated with recognan (citicoline)]
PubMed ID: 31464286
Citicoline improved asthenia/fatigue symptoms — supports cellular energy/subjective energy production.
Forms of Choline
The 2 forms a label may print instead of Choline. Each is a different substance with its own identifier, and none of them has research of its own — the studies are the ones on this page.
Similar by evidence
Supplements the same benefits carry qualifying findings for — a fact about the evidence graph, not a recommendation to swap.
Products with Choline
Search all8006 products whose verified label declares Choline — not every bottle that mentions it in a title.
Being studied right now
Recruiting clinical trials registered on ClinicalTrials.gov. A trial in progress has no result yet — this is what the field is asking, not what it found.