From: drarwingnuttephd@gmail.com   
      
   Neurology Today:   
   19 January 2012 - Volume 12 - Issue 2 - pp 37,38   
   doi: 10.1097/01.NT.0000411148.89241.8e   
      
      
   Growing List of Positive Effects of Nicotine Seen in Neurodegenerative   
   Disorders   
   Hurley, Dan   
      
      
   ARTICLE IN BRIEF   
      
   A new randomized, placebo-controlled study found "significant ni   
   otine-associated improvements in attention, memory, and psychomotor speed,"   
   with excellent safety and tolerability in patients with amnestic mild   
   cognitive impairment. The story looks at    
   this and other recent data suggesting that transdermal nicotine could be   
   neuroprotective for neurological disorders.   
   COULD A TRANSDERMAL ...   
   COULD A TRANSDERMAL ...   
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   Dyskinesia and impulsivity in Parkinson disease, cognitive defects in   
   attention deficit-hyperactivity disorder (ADHD), and now attention and memory   
   in mild cognitive impairment (MCI): the list of reported neurological benefits   
   just keeps growing in    
   animal and human studies of nicotine.The latest study, published in the Jan.   
   10 Neurology, involved 67 subjects with amnestic MCI randomized for six months   
   to either placebo or 15 mg per day of transdermal nicotine. The results found   
   "significant    
   nicotine-associated improvements in attention, memory, and psychomotor speed,"   
   with excellent safety and tolerability."The idea that nicotine would have   
   positive therapeutic effects on brain function is still a novel idea to a lot   
   of people," said the    
   senior author of the paper, Paul Newhouse, MD, professor of psychiatry,   
   pharmacology and medicine, and director of the Center for Cognitive Medicine   
   at Vanderbilt University School of Medicine in Nashville."Nicotine obviously   
   carries a lot of baggage,"    
   he told Neurology Today, "but this paper is based on work we started doing in   
   the late 1980s on the beneficial effects of nicotine in Alzheimer disease.   
   There are now clinical trials of nicotine in Parkinson disease. What we're   
   trying to discover is the    
   range of benefits."Dr. Newhouse has previously published studies showing that   
   nicotine improves cognitive defects in young adults with ADHD."Nicotinic   
   receptors in the brain appear to work by regulating other receptor systems,   
   like a gain amplifier," he    
   said. "If you're sleepy, it tends to make you more alert. If you're anxious,   
   it tends to calm you. Obviously the results of small studies often aren't   
   replicated in larger studies, but at least nicotine certainly looks safe. And   
   we've seen absolutely no    
   withdrawal symptoms. There doesn't seem to be any abuse liability whatsoever   
   in taking nicotine by patch in non-smokers. That's reassuring."   
   DR. PAUL NEWHOUSE Th...   
   DR. PAUL NEWHOUSE Th...   
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   On the primary outcome variable in his MCI study, the Conners' Continuous   
   Performance Test -- a task-oriented computerized assessment of attention   
   disorders and neurological functioning -- Dr. Newhouse and colleagues found a   
   significant improvement among    
   the 34 subjects who were randomized to nicotine and completed the study,   
   compared with the 33 completers randomized to placebo (p=0.031). Significant   
   nicotine-associated improvements were also seen in computerized tests of   
   attention, memory and    
   psychomotor speed, and in patient/informant ratings of cognitive   
   impairment.The only measure on which no statistically significant benefit was   
   seen was clinician-rated global improvement. But according to Dr. Newhouse,   
   "We were never powered sufficiently    
   for the global impression rating."   
   DR. MARYKA QUIK Park...   
   DR. MARYKA QUIK Park...   
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   The potential for nicotine has been borne out in other recent trials. At the   
   University of Vermont College of Medicine, a small, randomized 12-week trial   
   is now underway testing whether nicotine can reduce impulsivity in people with   
   Parkinson disease."   
   Nicotine has been associated with a reduction in impulsivity in ADHD," said   
   the study's principal investigator, James Boyd, MD, assistant professor of   
   neurology. "It could hypothetically normalize decision-making."In early 2012,   
   the German and US    
   Parkinson Study Groups will collaborate to conduct a multi-center phase 2   
   trial investigating the potential disease-modifying effects of transdermal   
   nicotine in early Parkinson disease, Dr. Boyd said.   
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