Insulin Nasal Spray May Slow Alzheimer’s
September 13, 2011 by staff
Insulin Nasal Spray May Slow Alzheimer’s, Inhaled insulin via a nasal spray may slow the deterioration of cognitive function in people with Alzheimer’s disease and amnestic mild cognitive impairment, a condition thought to precede Alzheimer’s disease, according to the results of a pilot study published online for the first time in the journal Archives of Neurology on Monday.
Insulin has a number of functions in the central nervous system, and research shows that levels of insulin and insulin activity are lower in the central nervous system of patients with Alzheimer’s.
Previous studies have shown that deregulation of insulin in the brain appears to contribute to the development of Alzheimer’s disease, which in its early stages is marked by synaptic loss and impaired memory. Synaptic loss is where the connections between brain cells or neurons are destroyed.
More specifically, some studies in animals have shown that insulin can prevent synaptic loss and reduce deposits of A?, The main component of amyloid plaques found in the brains of people with Alzheimer’s disease.
In light of this, it has been suggested that restoration of normal insulin levels in patients with Alzheimer’s disease may protect cognitive ability, hence the reason for this study.
In their randomized controlled trial, Dr. Suzanne Craft System Puget Sound Veterans Affairs Health Care and the University of Washington School of Medicine, Seattle, USA, and colleagues evaluated the effects of insulin therapy Intranasal in patients with amnestic mild cognitive impairment or Alzheimer’s disease.
They randomly assigned 104 participants into three groups. The average age of participants was 72, and over half were men. 64 of them had amnestic mild cognitive impairment and 40 had mild to moderate Alzheimer’s disease.
For four months, 36 participants received 20 International Units (IU) of insulin per day, 38 received 40 IU per day and 30 received a placebo every day, all delivered through a nasal spray.
The researchersanlyzed the treatment effect on cognition, daily function, and for some participants, measured biomarkers of cerebral glucose metabolism and cerebrospinal fluid.
Primary measures were delayed story recall (the number of participants and recalled a story told to them immediately and shortly after he put it), and dementia severity rating scale (DSRS) scores of participants (a multiple choice questionnaire that is filled by caregivers).
The researchers also took secondary measures, including one that assesses the cognitive (ADAS-cog) and evaluates the activities of daily living for people with Alzheimer’s disease (ADCS-ADL scale).
Of biomarkers, 23 participants underwent a lumbar puncture and 40 underwent positron emission tomography (PET) evaluation of fludeoxyglucose F 18 (a measure of glucose metabolism) before and after treatment.
Of the primary measures, the results showed that compared with the placebo group:
Participants who took 20 IU of insulin per day had better story recall delayed (P <.05).
However, there was no improvement for the participants who took 40 IU of insulin per day.
The DSRS Rated caregiver remained functional capacity for groups of insulin (p <0.01).
For secondary measures, the authors note that:
“Both doses of insulin also preserved general cognition, as assessed by ADAS-cog score of the younger participants and functional abilities as assessed by ADCS-ADL scale for adults with AD (P <.05). ”
Although there seems to be no change in cerebrospinal fluid biomarkers of participants treated with insulin, as a group, exploratoryanlysis showed changes in memory and function were related to changes in the A? 42 levels, and tau protein in A? 42 cerebrospinal fluid relationship.
The PET images showed that participants in the placebo group had decreased absorption Fludeoxyglucose F 18 (suggesting poor glucose metabolism) in some brain regions, as the parietotemporal, frontal precuneus and cuneus.
No serious adverse events related to treatment during the study.
In their discussion, the authors suggest that the only reason why the lower dose of insulin appeared to make a positive difference in the extent to remember the story could be because previous research had seen a reverse U-shaped curve for this treatment, adverse effects occur at levels too low and too high insulin.
The authors conclude:
“… The results of our pilot study show that intranasal insulin administration stabilized or improved cognition, function and cerebral glucose metabolism in adults with aMCI [amnestic mild cognitive impairment] or AD [Alzheimer's] “.
“Overall, these results provide impetus for future clinical trials of intranasal insulin therapy and to further mechanistic studies of the role of insulin in the pathogenesis of AD,” they add.
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