Nicotine

Nicotine Treatment for Mild Cognitive Impairment

October 2, 2024
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Paul Newhouse, MD, Vanderbilt Center for Cognitive Medicine, Nashville, TN, talks on the use of nicotine treatment for mild cognitive impairment (MCI) in the ongoing MIND Study. Over the past 40 years, researchers have been studying the effect of nicotinic stimulation and blockade on cognitive function, and exploring whether stimulating nicotinic receptors chronically (continually) in patients with MCI could be therapeutically helpful.

Based on positive preclinical data, a small pilot study in the early 2000s gave participants nicotine patches for up to 6 months, which resulted in a significant increase in cognitive function. Therefore, The MIND (Memory Improvement through Nicotine Dosing) Study was proposed.  This is a 2-year, double blind, placebo-controlled study of long-term transdermal nicotine for cognitive enhancement in patients with MCI. The goal of the study is to determine whether there is a sustained cognitive benefit to patients.  Secondarily, the study will look at biomarkers of Alzheimer’s disease progression to see if there is a long-term benefit to brain integrity.

Researchers involved in The MIND Study are working with experts in the pharmacokinetics of nicotine to investigate metabolism genes and their potential role in the outcome of the study. It is known that people metabolize nicotine at different rates, therefore the nicotinic metabolic status will be measured for all participants  At the same time, the study will also look at the relationship of nicotinic response to a range of AD-related genes.

This interview took place at the Clinical Trials on Alzheimer’s Disease Congress 2022 in San Francisco. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.

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Visit Vanderbilt Center for Cognitive Medicine to learn more about The MIND (Memory Improvement through Nicotine Dosing) Study .  [Under the Study Design tab, nicotine patch dosage is listed for this clinical study.]  Their research shows nicotine does not cause cancer, heart disease, or respiratory illness. It is the tar and thousands of other chemicals in cigarettes that do.  Also, nicotine is not addictive!

Before implementing anything listed here, you should consult with your doctor.

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Glossary


ALZ

abbreviation for Alzheimer’s Disease

Alzheimer’s Disease

a type of dementia and a progressive disease of the brain that slowly causes impairment in memory and cognitive function. Alzheimer’s disease happens when the brain tries to protect itself from three metabolic and toxic threats:

1 - Inflammation (from infection, diet or other causes)

2 - Decline and shortage of supportive nutrients, hormones and other brain-supporting molecules

3 - Toxic substances such as metals or biotoxins (poisons produced by microbes such as molds)


The protective response causes APP (Amyloid Precursor Protein, the long molecule that protrudes from neurons) to be cut into four fragments, including amyloid-beta, that downsize the neural network and eventually destroy synapses and neurons. When the APP molecule is cut into those four pieces, it is not cut into the two pieces that nourish and maintain synapses.

Alzheimer's disease is a state of the brain in which there is an imbalance between the reorganization of synapses that have outlived their usefulness (and which the brain can stand to lose - healthy destruction) and the maintenance or creation of existing and new synapses (which the brain needs to sustain old memories and form new ones, as well as perform other cognitive functions). That imbalance  comes from too many  of the synapse- and neuron-destroying quartet  of molecules snipped from APP and too few  of the synapse- and neuron-sustaining duo  of molecules snipped from APP.


ApoE4

abbreviation for apolipoprotein E, a gene variant (allele) which is a protein that carries lipids – i.e. fats. Carrying one ApoE4 (inherited from one parent) increases your lifetime risk of Alzheimer’s to 30 percent. Carrying two copies (from both parents) increases it to 50 to 90 percent. That compares to a risk of only about 9 percent in those who carry zero copies of this allele.

APP

abbreviation for Amyloid Precursor Protein, the long molecule that protrudes from neurons


Cognoscopy

metabolic and genetic testing that identifies cognitive decline or what may be putting you at risk for it

Dementia

umbrella term for a group of symptoms (a syndrome) without a definitive diagnosis. Dementia is a group of symptoms that affect mental cognitive tasks such as memory and reasoning. (Alzheimer’s Disease is the most common type of dementia.)

Early Alzheimer’s Disease

an early onset of Alzheimer’s Disease and uncommon form of dementia that typically affects those under the age of 65

Functional Medicine

a systems biology–based approach that focuses on identifying and addressing the root cause of disease

Heterozygous

carrying 1 copy of the ApoE4 genetic variant

Homozygous

carrying 2 copies of the ApoE4 genetic variant

Integrative Medicine

healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.

Ketoflex 12/3

anti-Alzheimer’s diet to include at least 12 hours of fasting, with the first 3 hours of that fast starting after dinner. It is largely plant based, but flexible as it does allow for small amounts of meat or fish.

MCI

Mild Cognitive Impairment

MCT oil

an abbreviation for medium chain triglyceride (a saturated fat) which is found in coconut oil.  Alzheimer's impairs the brain's ability to use sugar.  An MCT ketogenic diet offers an alternative energy source:  ketones.  This allows brain cells to survive better, blocking a receptor in the brain that causes memory loss.

SCI

Subjective Cognitive Impairment – a precursor to MCI (Mild Cognitive Impairment)

The Bredesen Protocol

treatment program developed by Dr. Dale E. Bredesen to prevent and reverse cognitive decline (also known as The ReCODE ProtocolTM)