The mechanistic role of piracetam in the management of vascular dementia.

Piracetam is a cyclic derivative of gamma aminobutyric acid, has a neuroprotective effect against neurodegenerative disease by inhibiting neuroinflammation. Piracetam augments the effect of acetylcholine on the muscarinic receptors thereby improving learning and memory. In addition, piracetam through modulation of ion channels increases the activity of different neurotransmitters involved in cognitive function. Excitingly, piracetam improves blood flow by increasing erythrocyte deformability and reducing adhesion of erythrocytes to the vascular endothelium by inhibiting fibrinogen; thus, it improves microcirculation and can be used in the management of vascular dementia (VaD). Also, piracetam improves cognitive function in VaD by reducing mitochondrial dysfunction and oxidative stress. Hence, piracetam has a neuroprotective effect against VaD. However, the exact neuroprotective mechanism of piracetam against the development and progression of VaD was not fully clarified. Consequently, this review attempts to discuss the potential effect of piracetam in VaD.