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Choline alphoscerate + nimodipine is a combination therapy investigated by the Azienda Ospedaliero-Universitaria Careggi for the treatment of subcortical vascular cognitive impairment (VCI) associated with cerebral small vessel disease. Choline alphoscerate (alpha-glycerylphosphorylcholine) is a cholinergic precursor that increases the synthesis and release of acetylcholine in the brain, potentially counteracting cholinergic deficits. Nimodipine is a dihydropyridine calcium channel antagonist that selectively acts on cerebral arteries to increase blood flow and provide neuroprotective effects by preventing calcium overload in neurons. The combination was evaluated in the CONIVaD clinical trial (NCT03228498) to determine if the synergistic effect of enhancing cholinergic transmission and improving cerebral hemodynamics could reduce cognitive decline in patients with small vessel disease.
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