Saturday, September 17, 2011

Intranasal insulin treatment for Alzheimer's disease

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Alzheimer's Association

Currently, there is no cure for Alzheimer's disease. But drug and non-drug treatments may help with both cognitive and behavioral symptoms. Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia.

In an article published September 13, 2011, in the Archives of Neurology, results from a small, short-term treatment trial (four months) of intranasal insulin in Alzheimer's disease and mild cognitive impairment (MCI) showed statistically significant benefits on certain tests of memory and functioning, but no changes on some others. In those people who showed benefits on memory tests, the researchers also measured changes in chemicals in participants' spinal fluid that may indicate a beneficial effect of the treatment on Alzheimer's.

It is important to note that, quite often, preliminary studies like this generate positive results but fail to show long-term benefit in larger trials. That said, these findings are very encouraging, and further research — longer trials with larger numbers of participants — of intranasal insulin as a therapy for Alzheimer's and MCI is warranted.

We urgently need earlier detection and better treatments for Alzheimer's, which is a devastating, heartbreaking and fatal disease, and a growing epidemic. This requires a greater commitment to research — increasing funding for Alzheimer's research and recruiting more volunteers for Alzheimer's clinical trials.

Researchers selected 104 men and women for the study. All had either mild to moderate Alzheimer's or mild cognitive impairment, a condition that increases the risk of developing Alzheimer's, especially when memory is affected. The participants were divided into three groups. Using a nasal spray, each group received twice-daily doses of either lower or higher doses of insulin or a placebo.

The study found that men and women who used the lower dose of insulin nasal spray tended to score better on memory tests than those who used the placebo. No improvement was seen in those receiving the higher insulin dose. Both groups receiving insulin preserved their level of daily functioning, according to reports from their caregivers, while participants in the placebo group showed an overall decline in function. Few side effects occurred among those treated with the insulin spray, other than occasional light-headedness and dizziness or stuffy nose.

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The brain needs insulin

Over the past 10 years scientists have come to learn that insulin plays an important role in the brain, says clinical neuroscientist Suzanne Craft, of the Veterans Affairs Puget Sound Health Care System and the University of Washington School of Medicine. It helps the brain form memories, allows brain cells to communicate with one another and manages levels of brain chemicals.

All cells, including those that make up the brain, use glucose for energy. The hormone insulin makes it possible for glucose, aka blood sugar, to enter cells, enabling them to work properly. With age, however, many people develop a problem called insulin resistance, a condition in which the body and the brain do not use insulin effectively.

If glucose cannot enter brain cells, the cells won't carry out their tasks related to memory and thinking. "This sets the stage for problems in brain function that may develop into conditions like Alzheimer's disease," says Craft, lead author of the study. She and her colleagues set out to determine whether providing insulin directly to the brain could improve the cell's ability to use insulin.

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