Uric acid: friend or foe? Uric acid and cognitive function "Gout kills more wise men than simple".

OBJECTIVE: The association be - tween hyperuricemia and cardiovascular risk is widely known, and hyperuricemia is associated with many pathological conditions due to its ef - fect on the endothelial function and metabolic homeostasis. The aim of this study was to verify whether the available literature may support the hypothesis that uric acid has a protective and stimulating effect on the cerebral cortex. MATERIALS AND METHODS: We reviewed the actual knowledge of the positive effects of uric acid in terms of antioxidant action, neuro - protection, cognitive function, and intellectual performance. CONCLUSIONS: Uric acid has a stimulating ef - fect on the cerebral cortex, and this could have allowed humans, compared with other animals, to develop higher brain mass volume, better in - tellectual performances, and maybe evolutionary supremacy. On the other, a growing body of evi - dence is accumulating on the independent asso - ciation between uric acid and cardiovascular risk. A careful interpretation of uric acid levels is appropriate and necessary in different kinds of patients, both at risk of cardiovascular or neu - rodegenerative diseases, due to its contrasting significance.