Background to a fascinating small study of 12 months of intranasal insulin therapy vs. placebo to reduce progression of white matter disease in MCI/AD:
A promising area of research in the treatment and prevention of AD focuses on metabolism, inflammation and...the role of insulin in the central nervous system. With respect to metabolism...insulin...has been shown to increase glucose uptake...in selected regions such as the hippocampus... Further, insulin increases glycogen storage in astrocytes, thereby providing an alternate energy source during glucose deprivation or intense neuronal activity.
Here are the methods and results:
Objective: We assessed the effects of intranasally administered insulin on white matter health and its association with cognition and cerebral spinal fluid biomarker profiles in adults with mild cognitive impairment or Alzheimer’s disease... Participants received either twice daily placebo or insulin (20 IU Humulin R U-100 b.i.d.) intranasally for 12 months. Seventy-eight participants were screened, of whom 49 (32 men) were enrolled. Measurements: Changes from baseline in global and regional white matter hyperintensity volume and gray matter volume were analyzed and related to changes in cerebral spinal fluid biomarkers, Alzheimer’s Disease Assessment Scale-Cognition, Clinical Disease Rating-Sum of Boxes, Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale, and a memory composite. Results: The insulin-treated group demonstrated significantly reduced changes in white matter hyperintensity volume in deep and frontal regions after 12 months, with a similar trend for global volume... Conclusion: Intranasal insulin treatment for 12 months reduced white matter hyperintensity volume progression and supports insulin’s potential as a therapeutic option for Alzheimer’s disease.
