soccertese, thanks for bringing to my attention the MJFF article. It highlights in a specific way what I would like us to discuss in general. The debate is more topical than I expected.

Unfortunately the article having set expectations high by being titled "Nicotine Patches to Stop... Parkinson's Disease?" contains the following assertion:
"Of course, smoking a pack a day to maybe prevent the onset of PD hardly makes sense — the adverse effects of puffing on nicotine cigarettes certainly outweigh any potential benefits."
This, it seems to me, underestimates the seriousness of PD.

The article also, IMHO, confuses possible pre-diagnostic outcomes - "prevent the onset of PD" - with a post diagnostic trial cohort - "will enroll 160 PD patients". This is exactly the kind of reasoning that I think is found in many posts. At least, we are in good company.

It goes on to say:
"The good news for people with Parkinson's, says Boyd, is that pre-clinical studies have shown that nicotine could protect dopamine-producing neurons in the brain from dying."
Whether this is good news to all PwP depends on your view of the etiology of PD. If you take the view that 80% of the doperminergic neurons in the SN are dead before symptoms occur and that this process continues during the course of the disease, it is probably too late to benefit advanced PwP. If, however, you have a different view of the disease's etiology, this protection property could be very useful.

The issue of timing is also important. The article says that it is hoped that "high level results" are available by 2015. That sounds great, but wait...
"A best case scenario: The results both show that disease progression is slowed, and are convincing enough to encourage a larger follow-up study which could prove to be more definitive." When is the earliest it could be approved? Probably too late for me.

I think that many of us on this forum are here because we believe that new, more effective therapies will arrive too late to benefit us; and, more positively, that we can short-cut the regulation process by intercepting promising therapies to improve our personal condition before our disease has progressed too far to get a benefit. In short, we have to weigh the cost of acting too soon, on insufficient, possibly incorrect data, against the cost of acting too late, while knowing that the disease is relentlessly progressing. Either way, there is no risk-free option open to us.

What makes this case particularly interesting is that, here in the UK at least, nicotine patches are readily available: even in supermarkets.

On the evidence of the data that we have, should we try them?

I am not going to use them until there is more evidence. Why? Because, and this is the point of the thread, most of the data refers to possibly preventing PD, not curing it. What may be good for one may not be good for the other.

As a final point, I note that the epidemiological evidence is about smoking, while the trial is about nicotine. It is possible to think of other routes by which smoking could affect PD. See Conductor71's thread.

http://neurotalk.psychcentral.com/thread182519-2.html

John