From Dr Emily Deans's Evolutionary Psychology
......The second article I was excited to
hear about is probably a watershed paper in the treatment of Alzheimer's
dementia: Intranasal
Insulin Therapy for Alzheimer Disease and Amnestic Mild Cognitive
Impairment. This paper discusses a pilot trial of 104 adults with amnestic
mild cognitive impairment or Alzheimer's disease vs controls with a couple of
doses of intranasal insulin.
Why intranasal? None of the subjects had diabetes, and obviously systemic insulin could cause dangerous hypoglycemia. The intranasal dose goes pretty much straight to the central nervous system via the olfactory and trigeminal nerve perivascular channels, and none of the subjects had hypoglycemia during the trial.
Why insulin? Well, as I've discussed at great length (I really ought to repost some of those dementia articles up on Psychology Today…), there are very clear issues with the ability of a dementing brain to metabolize glucose (the example in that article is Parkinson's disease, but the principle is very similar for Alzheimer's). This problem results in inefficient use of energy, free radical generation, and neuronal toxicity and death. There are several ways to (theoretically) improve this issue - one of them is to use a therapeutic ketogenic diet. The other way is to jack up insulin in the central nervous system to improve the ability of the cells to pull in and utilize glucose, theoretically. In addition, insulin seems to have an effect on amyloid-beta peptides that may protect the neurons, and insulin and insulin activity are generally low in the CNS of folks with dementia (though hyperinsulinemia with insulin resistance seems to be a long-term risk factor for developing Alzheimer's dementia eventually).
My question is - and this is highly speculative - without improving the energetics, does jacking up the insulin help in the short term but hasten the problems in the long term? No long term studies have been done. In the absence of insulin resistance and with insulin in the CNS low already, perhaps not? I'll have to think a little more on that one.
Why intranasal? None of the subjects had diabetes, and obviously systemic insulin could cause dangerous hypoglycemia. The intranasal dose goes pretty much straight to the central nervous system via the olfactory and trigeminal nerve perivascular channels, and none of the subjects had hypoglycemia during the trial.
Why insulin? Well, as I've discussed at great length (I really ought to repost some of those dementia articles up on Psychology Today…), there are very clear issues with the ability of a dementing brain to metabolize glucose (the example in that article is Parkinson's disease, but the principle is very similar for Alzheimer's). This problem results in inefficient use of energy, free radical generation, and neuronal toxicity and death. There are several ways to (theoretically) improve this issue - one of them is to use a therapeutic ketogenic diet. The other way is to jack up insulin in the central nervous system to improve the ability of the cells to pull in and utilize glucose, theoretically. In addition, insulin seems to have an effect on amyloid-beta peptides that may protect the neurons, and insulin and insulin activity are generally low in the CNS of folks with dementia (though hyperinsulinemia with insulin resistance seems to be a long-term risk factor for developing Alzheimer's dementia eventually).
My question is - and this is highly speculative - without improving the energetics, does jacking up the insulin help in the short term but hasten the problems in the long term? No long term studies have been done. In the absence of insulin resistance and with insulin in the CNS low already, perhaps not? I'll have to think a little more on that one.
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