Abstract
Objectives
Chronic transdermal nicotine has been found to improve attentional performance in patients with Alzheimer’s disease (AD), but little is known about chronic nicotine effects in age-associated memory impairment (AAMI), a milder form of cognitive dysfunction. The current study was performed to determine the clinical and neuropsychological effects of chronic transdermal nicotine in AAMI subjects over a 4-week period.
Design
The double-blind, placebo-controlled, cross-over study consisted of two 4-week periods separated by a 2-week washout period.
Setting
An outpatient setting was used.
Participants
The subjects (n=11) met criteria for AAMI.
Interventions
The subjects were given nicotine patches (Nicotrol) to wear for 16 h a day at the following doses: 5 mg/day during week 1, 10 mg/day during week 2 and week 3 and 5 mg/day during week 4.
Measurements
The effects of nicotine treatment were determined with the clinical global impressions questionnaire, Conners’ Continuous Performance test, and the automated neuropsychologic assessment metrics (ANAM) computerized neuropsychology battery.
Results
Nicotine significantly improved the clinical global impression score as assessed by participants, as well as objective tests of attentional function on the Connors’ Continuous Performance Test and decision reaction time on the neuropsychology test battery. Nicotine did not improve performance on other tests measuring motor and memory function.
Conclusion
Chronic transdermal nicotine treatment in AAMI subjects caused a sustained improvement in clinical symptoms and objective computerized tests of attention. These results support the further investigation of nicotinic treatment as a promising therapy for AAMI.
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References
Conners CK (1994) The continuous performance test (CPT): use as a diagnostic tool and measure of treatment outcome. Annual convention of the American Psychological Association, Los Angeles, CA, 12–16 August 1994
Conners CK (1995) The continuous performance test. Multi-Health Systems, Toronto
Crook T, Bartus T, Ferris S, Whitehouse P (1986) Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change. Report of a National Institute of Mental health work group. Dev Neurobiol 2:261–276
Crook T, Feher E, Larrabee G (1992) Assessment of memory complaints in age-associated memory impairment: The MAC-Q. Int Psychogeriatr 4:165–175
Epstein JN, Conners CK, Sitarenios G, Erhardt D (1998) Continuous performance test results of adults with attention deficit hyperactivity disorder. Clin Neuropsychol 12:155–168
Folstein M, Folstein S, McHugh P (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Giacobini E, DeSarno P, McIlhany M, Clark B (1988) The cholinergic receptor system in the frontal lobe of Alzheimer’s patients. In: Clementi F, Gotti C, Sher E (eds) Nicotinic acetylcholine receptors in the nervous system. Springer, Berlin Heidelberg New York, pp 367–378
Guy W (1976) Clinical global impressions. ECDEU assessment manual for psychopharmacology, revised edn. Department of Health, Education, and Welfare, Rockville, pp 218–222
Howe M, Price I (2001) Effects of transdermal nicotine on learning, memory, verbal fluency, concentration, and general health in a healthy sample at risk for dementia. Int Psychogeriatr 13:465–475
Jones GMM, Sahakian BJ, Levy R, Warburton DM, Gray JA (1992) Effects of acute subcutaneous nicotine on attention, information processing and short-term memory in Alzheimer’s disease. Psychopharmacology 108:485–494
Joseph AM, Norman SM, Ferry LH, Prochazka AV, Westman EC, Steele BG, Sherman SE, Cleveland M, Antonnucio DO, Hartman N, McGovern PG (1996) The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease. N Engl J Med 335:1792–1798
Kellar KJ, Whitehouse PJ, Martino-Barrows AM, Marcus K, Price DL (1987) Muscarinic and nicotinic cholinergic binding sites in Alzheimer’s disease. Brain Res 436:62–68
Kelton MC, Kahn HJ, Conrath CL, Newhouse PA (2000) The effects of nicotine on Parkinson’s disease. Brain Cogn 43:274–282
Levin ED, Rezvani AH (2001) Nicotinic involvement in cognitive function in rats. In: Levin ED (ed) Nicotine and the nervous system. Methods in neuroscience. CRC Press, New York
Levin E, Rezvani A (2002) The promise of nicotinic treatment for cognitive dysfunction. Curr Drug Targets 1:423–431
Levin ED, Rose JE (1995) Acute and chronic nicotinic interactions with dopamine systems and working memory performance. In: Lajtha A, Abood L (eds) Functional diversity of interacting receptors. The New York Academy of Sciences, New York, pp 218–221
Levin ED, Simon BB (1998) Nicotinic acetylcholine involvement in cognitive function in animals. Psychopharmacology 138:217–230
Levin ED, Lee C, Rose JE, Reyes A, Ellison G, Jarvik M, Gritz E (1990) Chronic nicotine and withdrawal effects on radial-arm maze performance in rats. Behav Neural Biol 53:269–276
Levin ED, Briggs SJ, Christopher NC, Rose JE (1992) Persistence of chronic nicotine-induced cognitive facilitation. Behav Neural Biol 58:152–158
Levin E, Wilson W, Rose J, McEvoy J (1996a) Nicotine-haloperidol interactions and cognitive performance in schizophrenics. Neuropsychopharmacology 15:429–436
Levin ED, Conners CK, Sparrow E, Hinton S, Meck W, Rose JE, Ernhardt D, March J (1996b) Nicotine effects on adults with attention-deficit/hyperactivity disorder. Psychopharmacology 123:55–63
Levin ED, Conners CK, Silva D, Hinton SC, Meck W, March J, Rose JE (1998) Transdermal nicotine effects on attention. Psychopharmacology 140:135–141
Levin ED, Conners CK, Silva D, Canu W, March J (2001) Effects of chronic nicotine and methylphenidate in adults with ADHD. Exp Clin Psychopharmacol 9:83–90
Min S, Moon I, Ko R, Shin H (2001) Effects of transdermal nicotine on attention and memory in healthy elderly nonsmokers. Psychopharmacology 159:83–88
Newhouse PA, Kelton M (2000) Nicotinic systems in central nervous systems disease: degenerative disorders and beyond. Pharm Acta Helv 74:91–101
Newhouse P, Potter A, Kelton M, Corwin J (2001) Nicotinic treatment of Alzheimer’s disease. Biol Psychiatry 49:268–278
Nordberg A (1994) Human nicotinic receptors—their role in aging and dementia. Neurochem Int 25:93–97
Perry EK, Perry RH, Smith CJ, Dick DJ, Candy JM, Edwardson JA, Fairbairn A, Blessed G (1987) Nicotinic receptor abnormalities in Alzheimer’s and Parkinson’s diseases. J Neurol Neurosurg Psychiatry 50:806–809
Provost SC, Woodward R (1991) Effects of nicotine gum on repeated administration of the Stroop test. Psychopharmacology 104:536–540
Reeves D, Bleiberg J, Spector J (1993a) Validation of the ANAM battery in multi-center head injury rehabilitation studies. Arch Clin Neuropsychol 8:356
Reeves D, Kane R, Winter K, Raynsford K, Pancella T (1993b) Automated neuropsychological assessment metrics (ANAM): test administrator’s guide, version 1.0. Missouri Institute of Mental Health, St. Louis, MO
Rusted J, Graupner L, Oconnell N, Nicholls C (1994) Does nicotine improve cognitive function? Psychopharmacology 115:547–549
Sahakian B, Jones G, Levy R, Gray J, Warburton D (1989) The effects of nicotine on attention, information processing, and short-term memory in patients with dementia of Alzheimer type. Br J Psychiatry 154:797–800
Seidl R, Tiefenthaler M, Hauser E, Lubec G (2000) Effects of transdermal nicotine on cognitive performance in Down’s syndrome. Lancet 356:1409–1410
Shimohama S, Taniguchi T, Fujiwara M, Kameyama M (1986) Changes in nicotinic and muscarinic cholinergic receptors in Alzheimer-type dementia. J Neurochem 46:288–293
Snaedal J, Johannesson T, Jonsson JE, Gylfadottir G (1996) The effects of nicotine in dermal plaster on cognitive functions in patients with Alzheimer’s disease. Dementia 7:47–52
Warburton DM, Arnall C (1994) Improvements in performance without nicotine withdrawal. Psychopharmacology 115:539–542
Wesnes K, Revell A (1984) The separate and combined effects of scopolamine and nicotine on human information processing. Psychopharmacology 84:5–11
White HK, Levin ED (1999) Chronic four-week nicotine skin patch treatment effects on cognitive performance in Alzheimer’s disease. Psychopharmacology 143:158–165
Whitehouse PJ, Martino AM, Marcus KA, Zweig RM, Singer HS, Price DL, Kellar KJ (1988) Reductions in acetylcholine and nicotine binding in several degenerative diseases. Arch Neurol 45:722–724
Wilson AL, Langley LK, Monley J, Bauer T, Rottunda S, McFalls E, Kovera C, McCarten JR (1995a) Nicotine patches in Alzheimer’s disease: pilot study on learning, memory, and safety. Pharmacol Biochem Behav 51:509–514
Wilson AL, McCarten JR, Langley LK, Bauer T, Monley J, Rottunda S, McFalls E, Kovera C (1995b) Transdermal nicotine administration in Alzheimer’s disease: effects on cognition, behavior and cardiac function. In: Iqbal K, Mortimer JA, Winblad B, Wisniewski HM (eds) Research advances in alzheimer’s disease and related disorders. John Wiley and Sons, Ltd., Chichester, pp 305–314
Acknowledgements
The authors thank Channelle Christopher for her help gathering data, the staff of the Duke University Geriatric Evaluation and Treatment Center for their logistic support and Pharmacia, Inc. for donating the nicotine patches and placebos. The abstract of this research was presented at the American College of Neuropsychopharmacology, San Juan, PR, December, 2002.
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White, H.K., Levin, E.D. Chronic transdermal nicotine patch treatment effects on cognitive performance in age-associated memory impairment. Psychopharmacology 171, 465–471 (2004). https://doi.org/10.1007/s00213-003-1614-8
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DOI: https://doi.org/10.1007/s00213-003-1614-8