The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls
The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls
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DOI：
10.1038/sj.npp.1301423
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发表时间：
2008-02-01
影响因子：
7.6
通讯作者：
Evins, A. Eden
中科院分区：
文献类型：
--
作者：
Barr, Ruth S.;Culhane, Melissa A.;Evins, A. Eden
大量的证据表明，神经元烟碱乙酰胆碱受体（nAChR）系统是不可或缺的注意力过程的调节和失调的精神分裂症。尼古丁激动剂可能具有治疗这种疾病中认知障碍的潜力。本研究调查了尼古丁经皮给药对精神分裂症患者（n = 28）和健康对照者（n = 32）注意力的影响。所有受试者均为非吸烟者，以消除吸烟者研究中可能发生的尼古丁戒断和复吸的混杂影响。受试者在随机、安慰剂对照、交叉设计中接受14 mg经皮尼古丁和相同的安慰剂。在每次贴剂贴敷前和贴敷后3小时进行认知成套测试。主要结局指标是连续性能测试相同配对（CPT-IP）版本的性能。尼古丁显著改善了两组在CPT-IP上的表现，如命中反应时间、命中反应时间标准差和随机误差所测量的。此外，尼古丁减少了CPT-IP的佣金错误，并在精神分裂症患者与对照组相比，在更大程度上改善了卡片Stroop任务的表现。总之，尼古丁改善了两组的注意力表现，并与精神分裂症受试者的冲动反应抑制的更大改善相关。这些结果证实了先前的研究结果，即单剂量尼古丁可改善注意力，并表明尼古丁可能特别改善非吸烟者精神分裂症患者的反应抑制。
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.