Transdermal Nicotine May Benefit Cognitive Impairment

Cognitive test improvement, but no significant change in clinical global impression

TUESDAY, Jan. 10 (HealthDay News) -- For nonsmokers with amnestic mild cognitive impairment (MCI), use of a transdermal nicotine patch for six months is associated with improved cognitive test performance, but not clinical global impression of change, according to a pilot study published in the Jan. 10 issue of Neurology.

Paul Newhouse, M.D., from the University of Vermont College of Medicine in Burlington, and colleagues investigated the safety and efficacy of six months of transdermal nicotine therapy on cognitive performance in individuals with MCI. Nonsmokers with amnestic MCI were randomly allocated to receive transdermal nicotine (39 participants enrolled; 34 completed) or placebo (35 participants enrolled; 33 completed) for six months. The primary outcome measures included attentional improvement (measured with the Connors Continuous Performance Test [CPT]), clinical improvement (assessed by clinical global impression), and safety measures. Computerized cognitive testing, and patient and observer ratings, were included as secondary outcomes.

The investigators found that there was a significant nicotine-induced improvement in the CPT. In the clinician-rated global improvement, there was no statistically significant effect seen. Safety and tolerability were excellent for the transdermal nicotine. Significant nicotine-induced improvements were seen in attention, memory, and psychomotor speed; and, in the patient/informant ratings of cognitive impairment, improvements were seen.

"This study found that transdermal nicotine over six months is a safe treatment for nonsmoking subjects with MCI," the authors write. "Measures of attentional, memory, and psychomotor performance did show an effect of nicotine and this finding provides strong justification for further treatment studies of nicotine for patients with early evidence of cognitive dysfunction."

Several authors disclosed financial ties to the pharmaceutical industry and/or holding patents related to use of nicotine and Alzheimer's disease.

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