Abstract
Rationale
Enhancement of histaminergic neurotransmission or histaminergic plus cholinergic neurotransmission may represent novel strategies for improving cognition in Alzheimer's disease.
Objective
To evaluate the effects of a novel histamine H3 receptor inverse agonist (MK-3134), an acetylcholinesterase inhibitor (donepezil), and their combination in attenuating the cognitive impairment associated with scopolamine.
Methods
Thirty-one subjects were randomized, and 28 completed this double-blind, placebo-controlled, five-period crossover study. Cognition was assessed using the Groton Maze Learning Task (GMLT) as the primary outcome measure. The two primary hypotheses were that donepezil 10 mg and MK-3134 25 mg, respectively, would attenuate scopolamine (0.5 mg)-induced impairment as measured by the GMLT over the first 12 h after scopolamine administration (AUC1–12 h). A secondary hypothesis was that the combination of donepezil and MK-3134 would attenuate scopolamine-induced cognitive impairment to a greater extent than either agent alone as measured by the GMLT AUC1–12 h.
Results
The primary and secondary hypotheses were not met. Upon examining the time course of the scopolamine effects (an exploratory objective), peak effects were generally observed around 2 h after scopolamine administration. Administration of MK-3134 or donepezil improved performance on the GMLT at the 2-h time point, rather than AUC1–12 h, compared with scopolamine alone. Moreover, it appeared that the combination of MK-3134 and donepezil blunted the scopolamine effect to a greater extent than either drug alone.
Conclusions
Exploratory analyses provide evidence for cognitive improvement through inverse agonism of the H3 histamine receptor and for cooperation between human cholinergic and histaminergic neurotransmitter systems.
(ClinicalTrials.gov trial registration number: NCT01181310)
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Acknowledgements
The authors thank Gertrude Noonan from Merck for assistance in drafting and editing the manuscript and to Sheila Erespe from Merck for assistance in formatting. The experiments complied with the current laws of the country in which they were performed.
Financial disclosures
W Cho, C Gargano, N Calder, S Doran, S Fox-Bosetti, A Hassan, J Renger, G Herman, C Lines, and A Verma are or were employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., who may own stock and/or hold stock options in the company. J Connell had received research funding from Merck. P Maruff is a full-time employee of CogState, the company that provided the cognitive assessment tools used in this study.
Funding
The study was funded by Merck Sharp & Dohme Corp, a subsidiary of Merck & Co., Inc.
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Cho, W., Maruff, P., Connell, J. et al. Additive effects of a cholinesterase inhibitor and a histamine inverse agonist on scopolamine deficits in humans. Psychopharmacology 218, 513–524 (2011). https://doi.org/10.1007/s00213-011-2344-y
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DOI: https://doi.org/10.1007/s00213-011-2344-y