The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls.

Abstract

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.

• Authors: Ruth S Barr, Melissa A Culhane, Lindsay E Jubelt, Rana S Mufti, Michael A Dyer, Anthony P Weiss, Thilo Deckersbach, John F Kelly, Oliver Freudenreich, Donald C Goff, A Eden Evins
• Journal: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology (Neuropsychopharmacology) Vol. 33 Issue 3 Pg. 480-90 (Feb 2008) ISSN: 0893-133X [Print] England
• PMID: 17443126 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• Nicotinic Agonists
• Nicotine

Topics

• Administration, Cutaneous
• Adult
• Analysis of Variance
• Antipsychotic Agents (therapeutic use)
• Attention (drug effects)
• Cognition (drug effects)
• Cross-Over Studies
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Neuropsychological Tests
• Nicotine (administration & dosage, adverse effects, pharmacology)
• Nicotinic Agonists (administration & dosage, adverse effects, pharmacology)
• Psychiatric Status Rating Scales
• Psychomotor Performance (drug effects)
• Schizophrenic Psychology