Festival bites: BNA 2013 Day 4
Over the past four days BNA 2013: Festival of Neuroscience has filled the Barbican with an extravaganza of brain science. A lucky group of science writers from the Wellcome Trust attended the Festival. Each day, we asked them to give a short account of the seminars and lectures which they attended, to share the new research, stimulating discussions, and the unanswered questions, which they encountered. In this, the final post in our Festival bites series, Theresa Taylor gives an account of Professor David Smith’s research into the power of Vitamin B to stave off dementia and Ryan O’Hare guides us through the discussion which dominated the Workshop on Drugs in Society.
by Ryan O’Hare
The morning Workshop on Drugs in Society on Day 4 of the BNA Festival of Neuroscience delved into the shadowy world of cognitive enhancers – a minefield of neuroethics.
It’s been a long day, your deadline is looming and you need a mental boost. It’s a familiar situation, and most of us wouldn’t think twice about reaching for the coffee for a mental pick-me-up, but what about drugs?
Cognitive enhancers are increasingly being used to increase mental performance and as a ‘lifestyle drug’, with a nature survey from 2008 indicating a proportion of students and even academics using cognitive enhancements to boost their brain power. Professor Barbara Sahakian, of the University of Cambridge, spoke about the increasing incidence of these substances in everyday life. Drugs such as modafinil, which generates hundreds of millions of dollars a year in sales, are largely used for ‘off label’ use, that is for uses other than what they are registered and legally prescribed for.
The drugs work in a similar way to amphetamines, by blocking the reuptake of the neurotransmitters dopamine and nor-adrenaline in the brain, and show beneficial results in studies with healthy volunteers. Modafinil is prescribed for those with narcolepsy to increase and maintain mental alertness, but has been used as a general cognitive enhancer by many. It has the ability to increase a person’s motivation and enjoyment of tasks, and to reduce impulsivity, and without the tremors associated with caffeinated drinks. It has even been shown to increase cognitive flexibility in sleep deprived doctors.
Although there may be benefits for healthy individuals taking these types of drug, such as increased performance with reduced effort, Professor Sahakian added that longitudinal studies are needed to look into the long-term effects. The idea of future enhancement in the workplace is looking increasingly likely, and could benefit certain groups of workers who need to remain mentally alert for extended periods such as soldiers, surgeons, or night drivers. All this raises some difficult questions – will the drugs become a commodity? If so will they be accessible and affordable to all? And then there’s the ethics – if we chastise doping in competitive sports should the workplace be any different?
Vitamin B – a potential preventation for dementia?
by Theresa Taylor
Dementia is a debilitating disease that is estimated to effect 500 new patients each day in the UK. Today Professor David Smith, from Oxford University’s Department of Pharmacology told the symposium on improving cognitive functions in ageing about research he has conducted which indicates that cheap and readily available vitamin B could be extremely important in slowing the onset of dementia.
Professor Smith’s research centres around an amino acid present in the blood and cells called homocysteine. The levels of homocysteine in the cell are regulated by by three types of B vitamins: folate, B12 and B6. Smith said that other studies have linked increased shrinking of the brain to increased homocysteine levels. A normal brain shrinks at about 0.5% per year in over 60-year-olds, but at about 3% per year in Alzheimer’s patients.
Based on this evidence, and his own preliminary data, Smith launched the Vitacog trial, which gave patients Vitamin B for two years. The study found that Vitamin B treatment slows wasting of the brain by 53 per cent and significantly slows degradation in areas of the brain with are known to be associated with Alzheimer’s and dementia. They also discovered that it slowed cognitive decline. Although Smith stressed that these results only applied to cognitive decline in patients with increased homocysteine levels (raised homocysteine is believed to account for between 16-20per cent of dementia cases) and that the study was a small one of 270 patients.
Smith concluded that the results of the trial showed that vitamin B may have a “disease modifying” effect on some of the processes that lead to Alzheimer’s. In terms of health policy however the trial presented a dilemma. Smith explanined, “Do we now go ahead and do much bigger trials to confirm these findings and look at the effect on dementia which will take another five to seven years? Or do we say to people coming into the memory clinic with raised homocysteine, it’s been shown in a small trial in Oxford that vitamin B might help and as far as we know there’s no harmful effects?”.
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