Neuromodulation for Neurodegenerative Disease

*Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice*

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**Chapter 7**

*Sara Schatz*

**Abstract**

competence.

**1. Introduction**

Intranasal Insulin as Promising

Competence in MCI and AD

**Keywords:** MCI, intranasal insulin, brain atrophy, pragmatics

Therapy for Preserving Pragmatic

Our chapter contends that extended intranasal insulin administration can preserve pragmatic functioning even when there are temporal lobe and frontal lobe brain volume losses consistent with AD disease progression. CT scans of a patient receiving extended intranasal insulin 6 years after AD diagnosis are compared with his CT scans at the original MCI diagnosis. The results demonstrate that areas of the brain associated with pragmatic functioning were not as affected as expected in late-stage AD patients. This, along with linguistic evidence of preserved pragmatic competence, indicates the likely effectiveness of intranasal insulin treatment in enhancing neuronal activity in certain areas of the brain associated with pragmatic

This chapter explores, on a brain circuitry level, why patients receiving extended intranasal insulin therapy continue to be able to ambulate independently, pay attention, speak, and participate in jokes even throughout late-stage AD [1–3]. We find that extended intranasal insulin administration can preserve pragmatic functioning even when there are temporal lobe and frontal lobe volume losses consistent with Alzheimer's brain (AD) volume loss. A series of CT scans of a patient receiving

extended intranasal insulin from mild cognitive impairment (MCI) diagnosis and those from the same patient 5.5 years after AD diagnoses are examined. At baseline, this patient's original MCI CT scans indicated no significant intracranial pathology and normal aging brain morphology. Over time, we show how this patient demonstrates slower atrophy rates in occipital and thalamic structures as compared with the structural imaging of patients with disease progression from MCI to AD not receiving intranasal insulin therapy. Enhancing neuronal activity in the areas of the brain associated with pragmatic competence reduces the likelihood of anomia typical of late-stage AD.

This chapter is structured as follows: Section 1 examines studies of the perfusion of intranasal insulin in older adults concerning neuropsychiatric tests of cognitive decline in MCI and AD. Section 2 discusses CT scans and the medical and social history of the patient case study used in this chapter. Section 3 examines CT scans at three distinctive points in the patient's MCI to AD progression (at MCI diagnosis and 3.5 and 5.5 years receiving intranasal insulin therapy). Section 4 suggests that results demonstrating extended intranasal insulin treatment may slow disease progression
