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 tonicotine and 35 to placebo. 67 subjects completed (34nicotine, 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 withMCI 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.
RCT Entities:
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.
Authors: P A Newhouse; T Sunderland; P N Tariot; C L Blumhardt; H Weingartner; A Mellow; D L Murphy Journal: Psychopharmacology (Berl) Date: 1988 Impact factor: 4.530
Authors: A L Wilson; L K Langley; J Monley; T Bauer; S Rottunda; E McFalls; C Kovera; J R McCarten Journal: Pharmacol Biochem Behav Date: 1995 Jun-Jul Impact factor: 3.533
Authors: P J Whitehouse; A M Martino; P G Antuono; P R Lowenstein; J T Coyle; D L Price; K J Kellar Journal: Brain Res Date: 1986-04-16 Impact factor: 3.252
Authors: Anne Schmechtig; Jane Lees; Lois Grayson; Kevin J Craig; Rukiya Dadhiwala; Gerard R Dawson; J F William Deakin; Colin T Dourish; Ivan Koychev; Katrina McMullen; Ellen M Migo; Charlotte Perry; Lawrence Wilkinson; Robin Morris; Steve C R Williams; Ulrich Ettinger Journal: Psychopharmacology (Berl) Date: 2013-02-22 Impact factor: 4.530
Authors: Jason A Gandelman; Hakmook Kang; Ashleigh Antal; Kimberly Albert; Brian D Boyd; Alexander C Conley; Paul Newhouse; Warren D Taylor Journal: J Clin Psychiatry Date: 2018-08-28 Impact factor: 4.384