Like most racetams, and really most nootropics, pramiracetam affects the release of brain chemicals, called neurotransmitters, which permit the transmission of signals between nerve cells. But, pramiracetam does things a little differently. It does not directly stimulate specific neurotransmitter receptor sites, the effect of which would be a boost in production and release of that particular neurotransmitter.
Pramiracetam helps with clear thinking. Pramiracetam works by increasing high-affinity Choline in the hippocampus. As luck would have it, Choline happens to be a precursor of a neurotransmitter called Acetylcholine, which is a key player in cognitive processes like concentration, learning speed and memory. So, what pramiracetam does is indirectly modulate receptor sites for Acetylcholine, which then stimulates increased activity in the hippocampus. This extra activity improves the formation of new memories and the reference of older ones.