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Neurology:尼古丁或可防治老年人慢性记忆功能减退

  1. 尼古丁贴片
  2. 老年人
  3. 记忆力减退

来源:生物谷 2012-11-18 10:45

2012年1月10日,美国神经病学会医学杂志Neurology刊登的一项关于尼古丁治疗慢性记忆功能减退的文章"Nicotine treatment of mild cognitive impairment A 6-month double-blind pilot clinical trial"证实,尼古丁贴片可以改善老年患者慢性记忆功能减退。 尼古丁已经被证实可以改善已戒烟者的认知功能。

2012年1月10日,美国神经病学会医学杂志Neurology刊登的一项关于尼古丁治疗慢性记忆功能减退的文章"Nicotine treatment of mild cognitive impairment A 6-month double-blind pilot clinical trial"证实,尼古丁贴片可以改善老年患者慢性记忆功能减退。

尼古丁已经被证实可以改善已戒烟者的认知功能。同时以往的短期研究发现尼古丁可以改善Alzheimer’s病患者的注意力和记忆能力。纳什维尔市范德比特大学医学院,Paul Newhouse博士团队的这项研究重点探讨了尼古丁对轻度记忆功能障碍患者的影响。

该项研究收纳了74名轻度认知功能障碍的非吸烟患者,平均年龄在76岁。其中一半的患者接受了6个月尼古丁贴片治疗,剂量为15mg/天;而另一半患者接受安慰剂治疗。在接受治疗之前以及6个月疗程之后,所有的患者接受了一系列关于记忆及思考技巧的测试。

经过6个月疗程后,有46%的尼古丁治疗组患者的长程记忆恢复到同年龄段正常的水平,而有26%的安慰剂组患者的病情在这6个月中进一步加重。患者使用尼古丁贴片没有出现严重的副作用。

尼古丁可以刺激大脑中相应受体,而这些受体在大脑思考及记忆技巧中发挥重要作用。而在Alzheimer's患者中存在部分此类受体的丢失。该项研究结果为今后使用尼古丁治疗那些具有记忆丧失前兆的患者提供了强有力的证据。但该治疗方法的长期效果及确切疗效目前还不清楚。(生物谷 Bioon.com)

Nicotine treatment of mild cognitive impairment A 6-month double-blind pilot clinical trial

P. Newhouse, MD, K. Kellar, PhD, P. Aisen, MD, H. White, MD, K. Wesnes, PhD, E. Coderre, MSc, A. Pfaff, BA, H. Wilkins, BA, D. Howard, MS and E.D. Levin, PhD

Objective: To preliminarily assess the safety and efficacy of transdermal nicotine therapy on cognitive performance and clinical status in subjects with mild cognitive impairment (MCI).
Methods: Nonsmoking subjects with amnestic MCI were randomized to transdermal nicotine (15 mg per day or placebo) for 6 months. Primary outcome variables were attentional improvement assessed with Connors Continuous Performance Test (CPT), clinical improvement as measured by clinical global impression, and safety measures. Secondary measures included computerized cognitive testing and patient and observer ratings.
Results: Of 74 subjects enrolled, 39 were randomized to nicotine and 35 to placebo. 67 subjects completed (34 nicotine, 33 placebo). The primary cognitive outcome measure (CPT) showed a significant nicotine-induced improvement. There was no statistically significant effect on clinician-rated global improvement. The secondary outcome measures showed significant nicotine-associated improvements in attention, memory, and psychomotor speed, and improvements were seen in patient/informant ratings of cognitive impairment. Safety and tolerability for transdermal nicotine were excellent.
Conclusion: This study demonstrated that transdermal nicotine can be safely administered to nonsmoking subjects with MCI over 6 months with improvement in primary and secondary cognitive measures of attention, memory, and mental processing, but not in ratings of clinician-rated global impression. We conclude that this initial study provides evidence for nicotine-induced cognitive improvement in subjects with MCI; however, whether these effects are clinically important will require larger studies.
Classification of evidence: This study provides Class I evidence that 6 months of transdermal nicotine (15 mg/day) improves cognitive test performance, but not clinical global impression of change, in nonsmoking subjects with amnestic MCI.

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