Thursday, July 5, 2012

Is Nicotine Good for Chemo Brain?

An interesting study but please don't start smoking...

In a study published in the January 10, 2012 issue of Neurology, lead author Paul Newhouse, MD at Vanderbilt University Medical Center, and colleagues, found that nicotine patches may help with mild memory loss.

About 75 seniors with mild cognitive impairment (MCI) participated in the study. None smoked. Half wore nicotine patches (15/mg per day) for six months. Half got a placebo. All went through memory tests at the start of the study and again three and six months later.

Results: The group wearing patches regained 46 percent of normal performance for their age on tests of long-term memory. Those not wearing the patches got worse by 26 percent.

It’s hard to know how this study relates to people with “chemo brain” as it didn’t specifically look at cancer-related cognitive impairment. But it is interesting to note that secondary findings included nicotine-induced improvements in psychomotor speed, attention and long-term memory. Deficits in those areas also happen to be hallmarks of chemo brain.

And there was another finding that in my mind falls into the category of weird science. If you read “Your Brain After Chemo,” then you may recall our discussion of research by Tim Ahles, PhD and Andrew Saykin, Psy.D., who looked at a specific gene type called apolipoprotein E, epsilon 4 allele (ApoE4). What they discovered was that long-term lymphoma and breast cancer survivors with this allele scored lower in visual memory, spatial ability and psychomotor functioning than survivors without the allele.

This allele has also been identified in about one-third of people with Alzheimer’s. Carriers of this allele are two-to-three times more likely to develop the disease and they are younger at diagnosis than others without the allele. Not a cheerful thought, I know.

The weird connection is in the discussion portion of the Neurology article (full text version). According to the authors, “A recent study in young individuals demonstrated that nicotine had a greater cognitive activity in APOE4-positive individuals, suggesting that the cholinergic system may be upregulated in APOE4-positive individuals or in MCI.” In people language, those with this allele who are cognitively impaired may especially benefit from nicotine therapy. I wonder if the same could be said for people with chemo brain who are APOE4 positive.

Certainly we know that nicotine is dangerous to our health. So although these results are intriguing, further research hopefully will help explain the mechanism for HOW nicotine protects the brain. Once science moves forward on that, we’ll be one step closer to emerging cognitively unscathed after cancer treatment.


  1. Idelle,

    This study is really interesting. I wonder how the idea for using nicotine patches to combat chemobrain came up. Thank for a wonderfully informative post. I own a signed copy (from you) of Your Brain After Chemo that I won in a giveaway, and it is an outstanding book and validates what I've been telling doctors all along.

  2. Hi Beth,

    Thanks so much for your kind words about our book. I'm thrilled to know that you won the copy!

    About the research, from what I understand, the authors relied on several previous studies, including one that used nicotine to help improve memory in people with Alzheimer's.

    I am also curious to know how the nicotine-cognition hypothesis came about in the first place. If anyone out there knows the history of the research, or if you're a researcher in the field, I'd love to have you come on as a guest blogger or at least, post a comment.