Nicotinic Receptor Intervention in Parkinson's Disease: Future Directions

Sufficient preclinical and epidemiological data are available to justify nicotinic intervention in Parkinson's disease (PD). Although use of nicotine patch has been suggested in some neurodegenerative disorders, including PD, the key for success with nicotinic intervention, particularly in PD, appears to rely not only on the dose but also on the mode of nicotine administration. Our aim in this short review is to provide justification for such contention. Thus, following a short introduction of nicotinic receptor pharmacology, the potential of nicotine in alleviating not only the motor symptoms, but also the mood disorders (e.g. depression) and mild cognitive impairments that are commonly co-morbid with PD will be presented. Moreover, since current PD therapy is associated with dyskinesia, the effectiveness of nicotine in ameliorating levodopa (L-Dopa)-induced dyskinesia will also be discussed. It is suggested that pulsatile nicotine administration (e.g. via inhalation or nasal spray) may be the optimal route in nicotinic intervention in PD.