CClinicalTrials.gg
CompletedNCT03408574Updated May 9, 2023

The Nicotinic Cholinergic System and Cognitive Aging

A Phase 1 interventional study of Nicotine patch, oral mecamylamine, placebo in Healthy Aging, sponsored by University of Vermont. Completed at 1 site in United States. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-05-09.

Sponsored by University of Vermont · Phase 1, Interventional, and Basic science

Phase
Phase 1
Study type
Interventional
Enrollment
104
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Prior research has shown that a chemical system in the brain called the cholinergic system is primarily responsible for cognitive symptoms seen in people with dementia. While therapeutic benefits are clear in dementia, what remains uncertain is the role that the cholinergic system in general and a subset of receptors called the nicotinic system plays in cognition in healthy non-demented older adults (referred to as normal cognitive aging). This is critical because the ever growing healthy aging population will show declines in cognition that fall short of dementia but still impact functional abilities and independence. Maintaining good nicotinic system functioning throughout adulthood may lessen the cognitive symptoms of aging. At this time, it is not clear what the biological cause of age-related changes in cognition is. This study will examine the role of the nicotinic system in the healthy aging brain and examine its role in memory and thinking processes in older and younger adults.

Read the detailed description

The cholinergic system has been shown to be the primary neurotransmitter system responsible for cognitive symptoms in dementia. While therapeutic benefits are clear in dementia, what remains uncertain is the role that the cholinergic system in general and the nicotinic system specifically plays in cognition in healthy non-demented older adults (referred to as normal cognitive aging in this application). This is critical because the expansion of the healthy aging population will nonetheless show declines in cognition that fall short of dementia but still impact functional abilities and independence. Understanding the effects of age-related functional changes on the nicotinic system will elucidate one neurochemical mechanism underlying age-related changes in cognition and will provide information about how nicotinic dysfunction affects cognition in healthy older adults. Prior research has shown that the nicotinic system has a roll in attention and memory in healthy adults. More recently, with the increased use of brain functional magnetic resonance imaging (fMRI) in combination with psychopharmacological manipulations, data patterns have emerged that further define the role of the nicotinic system in cognition, aging, and dementia.

The investigators propose that nicotinic system changes are responsible for age differences in working memory task performance and brain activation. The investigators can observe the functioning of the nicotinic system by examining brain activation patterns in response to nicotinic blockade and stimulation. Increased dorsolateral prefrontal cortex (DLPFC) activation has been shown for older adults compared to younger adults and is hypothesized to be a compensation response for the aging process. The investigators propose that temporary antagonism of the nicotinic system will also produce increased DLPFC activation. However, the relationship between this increased activation and performance will be in different directions for older and younger adults. In older adults, the increased activation will be positively correlated with performance because it is a compensatory response. In younger adults, the increased activation will be negatively correlated with performance because it is a non-adaptive response to the temporary nicotinic antagonism. Nicotinic stimulation in older adults will reveal decreased DLPFC activation that will be negatively correlated with performance and this represents the "younger" pattern of the performance and activation relationship. The younger adults will have a similar pattern of activation and performance as the older adults after nicotinic stimulation because they are already performing optimally and will not receive any further enhancement. These data will further the understanding of a neurochemical mechanism involved in normal aging and how brain activation patterns relate to receptor function.

02

Conditions studied

  • Healthy Aging

Keywords

  • nicotinic system
  • cognitive aging
  • working memory
  • fMRI
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Normal cognition, not demented, no mild cognitive impairment. IQ greater than 80.

Exclusion criteria

Exclusion Criteria:

  • Current use of barbiturates, rifampin, insulin, carbamezepine, oral hypoglycemics, antidepressants, diabetes, or untreated thyroid disease.
  • In addition, the following exclusions are specific for the challenge drugs: heavy alcohol or coffee use, significant cardiovascular disease, ischemic heart disease, asthma, chronic obstructive pulmonary disease, active peptic ulcer, hyperthyroidism, pyloric stenosis, narrow angle glaucoma, epilepsy, or current Axis I psychiatric disorders.
  • Current use of centrally active drugs and drugs with cholinergic properties. A minimum of 14 days will elapse between discontinuing centrally active or psychoactive agents and this study.
04

Study design

Phase
Phase 1
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
104 participants (actual)

Study arms

  • Experimental
    Older Adults

    Healthy adults aged 65-75 will participate in three study days where they are randomly assigned to receive either nicotine patch, oral mecamylamine, placebo and perform a working memory task during the fMRI. BOLD signal is the outcome measure.

    Drug: Nicotine patch, oral mecamylamine, placebo

  • Experimental
    Younger Adults

    Healthy adults aged 18-30 will participate in three study days where they are randomly assigned to receive either nicotine patch, oral mecamylamine, or placebo and perform a working memory task during the fMRI.BOLD signal is the outcome measure.

    Drug: Nicotine patch, oral mecamylamine, placebo

Interventions

  • DrugNicotine patch, oral mecamylamine, placebo

    Each participant randomly receives one active drug or placebo on each of three study days.

05

What researchers measure

Primary outcomes

  1. Age effects of nicotinic blockade

    Examine the effects of nicotinic blockade compared to placebo on the relationship between working memory performance and brain activation using fMRI BOLD signal in older and younger adults.

    Time frame: After the completion of the third study day.

  2. Age effects of nicotinic stimulation

    Examine the effects of nicotinic stimulation compared to placebo on the relationship between working memory performance and brain activation using fMRI BOLD signal in older and younger adults.

    Time frame: After the completion of the third study day.

06

Study locations

1 site
  • University of Vermont
    Burlington, Vermont 05401, United States
07

References and documents

Study documents

  • Protocol and statistical analysis plan · Jan 22, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided — Deidentified data will be available to be shared with other researchers. The Principal Investigator will make fMRI and behavioral data available as requested by researchers after the study is completed and data sets have been cleaned for quality and locked.

08

Registry details

Key details

Study ID
NCT03408574
Lead sponsor
University of Vermont
Collaborators
Vanderbilt University Medical Center
Responsible party
Julie Dumas (Associate Professor, University of Vermont) — Principal investigator
First posted
Jan 24, 2018
Start date
Oct 1, 2016
Primary completion
Dec 1, 2021
Completion
Jan 31, 2022
Last update
May 9, 2023

Study contacts

Julie A Dumas, Ph.D.
principal investigator · University of Vermont

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion