By Mark Waghorn via SWNS
Ritalin given to children to combat attention deficit hyperactivity disorder could treat Alzheimer's, according to new research.
It works by reducing inflammation and boosting the cleaning activity of cells called microglia.
The drug belongs to a group known as noradrenergic medications. Clinical trials are now warranted, say scientists.
They target a neurotransmitter called noradrenaline - released by specialized neurons.
The network is critical for arousal, attention, learning, memory, readiness for action and suppression of inappropriate behaviors.
It is disrupted early in Alzheimer's - fuelling devastating symptoms of memory loss and confusion.
Corresponding author Dr Michael David, of Imperial College London, said: "Repurposing of established noradrenergic drugs is most likely to offer effective treatment in Alzheimer's disease for general cognition and apathy."
The British team pooled data from ten 10 previous trials involving 1,300 neurodegenerative disease patients since 1980.
Drugs like Ritalin and Intuniv - also prescribed for ADHD - improved their orientation, attention, memory, verbal fluency, language and visuospatial ability.
A significant, positive effect was identified on overall global cognition, as measured by the Mini-Mental State Exam or the Alzheimer’s Disease Assessment Scale.
An analysis of a subset of 425 patients in eight of the trials showed a big reduction in apathy.
Dr. David said: "There is a strong rationale for further, targeted clinical trials of noradrenergic treatments in Alzheimer’s disease.”
The researchers called for appropriate targeting of particular groups of patients and understanding the dose effects of individual drugs and their interactions with other treatments to minimize the cons and maximize the pros.
Noradrenaline also called norepinephrine, is critical for arousal and many cognitive processes, said Dr. David.
He explained: "It is predominantly synthesized and released by specialized noradrenergic neurons originating from the locus coeruleus (LC)."
Alzheimer's is linked to a build-up of rogue proteins called tau which tangle together - killing neurons.
Dr. David said: "The progression of tau pathology in Alzheimer's may begin in the LC, where neuronal loss occurs early in the disease.
"The noradrenergic system’s role in attention, memory and executive functions makes the loss of LC noradrenergic cells of immediate relevance to Alzheimer's dementia.
"The LC-NA system is also related to behavioral and neuropsychiatric symptoms in Alzheimer's disease.
"For example, apathy is common in Alzheimer’s disease, and motivation is influenced by the noradrenergic system.
"Given the early changes in the LC-NA system in Alzheimer's disease, it is
a potential target for treatments of cognitive and behavioral dysfunction."
The number of cases of Alzheimer's and other cases of dementia worldwide will triple to more than 150 million by 2050. There is no cure.
Added Dr David: "In patients with dementia or MCI (mild cognitive impairment) caused by Alzheimer's disease, pharmacotherapies targeting the noradrenergic system can
improve cognition and apathy.
"These therapies do not appear to have any beneficial effects on attention or episodic memory.
"Based on this meta-analysis, and recognition of the importance of LC-NA system in multiple neurodegenerative diseases, there is a case for further clinical trials of noradrenergic agents in Alzheimer's disease and other neurodegenerative conditions."
The study was published in the Journal of Neurology Neurosurgery & Psychiatry.
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