Nicotine: A Targeted Therapy for Epilepsy Due to nAChR Gene Variants

source extracted confidence: high 2026-04-09
#administration-cutaneous #adolescent #adult #child #epilepsy

Nicotine: A Targeted Therapy for Epilepsy Due to nAChR Gene Variants

Fox et al., 2021 | J Child Neurol | Systematic Review

Citation

Fox Jordana, Thodeson Drew M, Dolce Alison M. Nicotine: A Targeted Therapy for Epilepsy Due to nAChR Gene Variants. J Child Neurol. 2021-Apr;36(5):371-377. doi:10.1177/0883073820974851

Abstract

OBJECTIVE: Genetic variants of the neuronal nicotinic acetylcholine receptor (nAChR) cause autosomal dominant sleep-related hypermotor epilepsy. Approximately 30% of autosomal dominant sleep-related hypermotor epilepsy patients are medically intractable. In preclinical models, pathogenic nAChR variants cause a gain of function mutation with sensitivity to acetylcholine antagonists and agonists. Nicotine modifies the activity of nAChRs and can be used as targeted therapy. METHODS: We reviewed next-generation sequencing epilepsy panels from a single laboratory (GeneDx) from patients at Children's Medical Center Dallas between 2011 and 2015 and identified patients with nAChR variants. Retrospective review of records included variant details, medical history, neuroimaging findings, and treatment history. RESULTS: Twenty-one patients were identified. Four patients were prescribed nicotine patches for intractable seizures. Three of 4 patients had a clinical response, with >50% seizure reduction. CONCLUSIONS: Treatment with a nicotine patch can be an effective therapy in epilepsy patients with nAChR gene variants. We propose consideration of transdermal nicotine treatment in intractable epilepsy with known nAChR variants as an experimental therapy. Further clinical trials are needed to fully define therapeutic effects.

Key Findings

Twenty-one patients were identified. Four patients were prescribed nicotine patches for intractable seizures. Three of 4 patients had a clinical response, with >50% seizure reduction.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population nachr variants
Sample Size 4
Age Range See abstract
Condition sleep

MeSH Terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Child
  • Epilepsy
  • Ganglionic Stimulants
  • Genetic Variation
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Male
  • Nicotine
  • Receptors, Nicotinic
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Case Reports, Journal Article, Systematic Review
  • Vertical: niacin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09