The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls.
Abundant evidence indicates that the neuronal nicotinic acetylcholine receptor (nAChR) system is integral to regulation of attentional processes and is dysregulated in schizophrenia. Nicotinic agonists may have potential for the treatment of cognitive impairment in this disease. This study investigated the effects of transdermal nicotine on attention in individuals with schizophrenia (n=28) and healthy controls (n=32). All participants were nonsmokers in order to eliminate confounding effects of nicotine withdrawal and reinstatement that may occur in the study of smokers. Subjects received 14 mg transdermal nicotine and identical placebo in a randomized, placebo-controlled, crossover design. A cognitive battery was conducted before and 3 h after each patch application. The primary outcome measure was performance on the Continuous Performance Test Identical Pairs (CPT-IP) Version. Nicotine significantly improved the performance on the CPT-IP as measured by hit reaction time, hit reaction time standard deviation and random errors in both groups. In addition, nicotine reduced commission errors on the CPT-IP and improved the performance on a Card Stroop task to a greater extent in those with schizophrenia vs controls. In summary, nicotine improved attentional performance in both groups and was associated with greater improvements in inhibition of impulsive responses in subjects with schizophrenia. These results confirm previous findings that a single dose of nicotine improves attention and suggest that nicotine may specifically improve response inhibition in nonsmokers with schizophrenia.
Barr
Ruth S
RS
The Schizophrenia Program of the Massachusetts General Hospital, Boston, MA 02114, USA.
Culhane
Melissa A
MA
Jubelt
Lindsay E
LE
Mufti
Rana S
RS
Dyer
Michael A
MA
Weiss
Anthony P
AP
Deckersbach
Thilo
T
Kelly
John F
JF
Freudenreich
Oliver
O
Goff
Donald C
DC
Evins
A Eden
AE
D000279:Administration, Cutaneous; D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001288:Attention / Q000187:drug effects; D003071:Cognition / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009538:Nicotine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000187:drug effects; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; D018722:Nicotinic Agonists; D009538:Nicotine