George TP, Termine A, Sacco KA, Allen TM, Reutenauer E, Vessicchio JC et al. A preliminary study of the effects of cigarette smoking on prepulse inhibition in schizophrenia: involvement of nicotinic receptor mechanisms. Schizophr Res 87: 307-315

Department of Psychiatry, Yale University, New Haven, Connecticut, United States
Schizophrenia Research (Impact Factor: 3.92). 11/2006; 87(1-3):307-15. DOI: 10.1016/j.schres.2006.05.022
Source: PubMed


Schizophrenics exhibit deficits in prepulse inhibition (PPI) of the startle response, and have high rates of cigarette smoking. We evaluated the effects of cigarette smoking on PPI deficits in schizophrenia, and the role of nicotinic acetylcholine receptors (nAChRs) in mediating cigarette smoking-related PPI enhancement.
PPI was assessed at baseline, after overnight abstinence, and after smoking reinstatement during three separate test weeks in nicotine-dependent schizophrenia (n=15) and control (n=14) smokers pre-treated with the nAChR antagonist mecamylamine (MEC; 0.0, 5.0 or 10.0 mg/day).
PPI was comparable between schizophrenia and control smokers after ad lib cigarette smoking. Overnight smoking abstinence significantly reduced PPI, while smoking reinstatement reversed abstinence-induced worsening of PPI deficits in schizophrenia. However, acute abstinence and reinstatement did not alter PPI in controls. PPI enhancement by smoking reinstatement in schizophrenia was dose-dependently blocked by MEC, whereas MEC had no effect on PPI in control smokers.
These results suggest that: 1) Non-deprived smokers with schizophrenia have comparable levels of PPI to non-deprived smoking controls; 2) In schizophrenia, PPI is impaired by smoking abstinence and improved by acute smoking reinstatement, and; 3) enhancement of PPI by cigarette smoking in schizophrenia is mediated by stimulation of central nAChRs. Our findings may contribute to understanding the increased vulnerability to nicotine dependence in schizophrenia, with implications for treatment of PPI deficits in this disorder.

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    • "In a naturalistic experiment, individuals with schizophrenia who smoked right before having their PPI measured had greater PPI than nonsmoking individuals with schizophrenia, or individuals with schizophrenia who smoked but were abstinent immediately before the PPI measurement (Kumari et al. 2001). In a more controlled study, smoking abstinence reduced PPI, and smoking reinstated PPI, to a much greater extent in smokers with schizophrenia than in controls (George et al. 2006). Smokers with schizophrenia had PPI comparable to nonschizophrenic smokers, whereas among nonsmokers, individuals with schizophrenia exhibited a PPI deficit compared to nonschizophrenics (Woznica et al. 2009). "
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    ABSTRACT: Cigarette smokers smoke in part because nicotine helps regulate attention. Prepulse inhibition (PPI) of the startle reflex is a measure of early attentional gating that is reduced in abstinent smokers and in groups with attention regulation difficulties. Attention difficulties are found in people with posttraumatic stress disorder (PTSD). The aim of this study is to assess whether smoking and abstinence differentially affect the startle response and PPI in smokers with and without PTSD. Startle response and PPI (prepulses at 60, 120, or 240 ms) were measured in smokers with (N = 39) and without (N = 61) PTSD, while smoking and again while abstinent. Participants with PTSD produced both larger magnitude and faster latency startle responses than controls. Across groups, PPI was greater when smoking than when abstinent. The PTSD and control group exhibited different patterns of PPI across prepulse intervals when smoking and when abstinent. Older age was associated with reduced PPI, but only when abstinent from smoking. The effects of PTSD on startle magnitude and of smoking on PPI replicate earlier studies. The different pattern of PPI exhibited in PTSD and control groups across prepulse intervals, while smoking and abstinent suggests that previous research on smoking and PPI has been limited by not including longer prepulse intervals, and that nicotine may affect the time course as well as increasing the level of PPI. The reduced PPI among older participants during abstinence suggests that nicotine may play a role in maintaining attention in older smokers, which may motivate continued smoking in older individuals.
    Psychopharmacology 07/2013; 230(3). DOI:10.1007/s00213-013-3181-y · 3.88 Impact Factor
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    • "Smoking rates amongst persons with schizophrenia are markedly elevated relative to the general population (Lohr & Flynn, 1992) and nicotine has been shown ameliorate some of the cognitive deficits associated with schizophrenia (Dalack, 1998). As with antipsychotic medications, nicotine also increases PPI amongst smokers with schizophrenia (George et al., 2006) and interestingly, there is evidence that atypical antipsychotic medications may decrease smoking amongst these patients (Matthews et al., 2011). It is conceivable that PPI measures are particularly sensitive to the effects of nicotine on cognitive processes related to the reinforcement of smoking in certain individuals. "
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    ABSTRACT: RATIONALE: The reinforcing properties of nicotine may be, in part, derived from its ability to enhance certain forms of cognitive processing. Several animal and human studies have shown that nicotine increases prepulse inhibition (PPI) of the startle reflex. However, it remains unclear whether these effects are related to smoking susceptibility. OBJECTIVES: The current study examined the effects of intravenously delivered nicotine on PPI in smokers and non-smokers, as well as its association with a quantitative index of familial smoking. METHODS: The sample consisted of 30 non-smokers and 16 smokers, who completed an initial assessment, followed on a separate day by a laboratory assessment of PPI prior to and following each of two intravenous nicotine infusions. Separate doses were used in smoker and non-smoker samples. RESULTS: Analyses indicated that both nicotine infusions acutely enhanced PPI among non-smokers, and this enhancement was positively related to the degree of smoking among first and second-degree relatives. Smokers also displayed PPI enhancement after receiving the first infusion, but this effect was unrelated to familial smoking. CONCLUSIONS: These data suggest that the PPI paradigm may have utility as an endophenotype for cognitive processes which contribute to smoking risk.
    Psychopharmacology 04/2013; 229(2). DOI:10.1007/s00213-013-3107-8 · 3.88 Impact Factor
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    • "Smoking and nicotine administration also improves reduced PPI in schizophrenic patients (Kumari et al., 2001; Postma et al., 2006; Woznica et al., 2009), an effect mediated by central neuronal nicotinic receptors (NNRs) (George et al., 2006). It was shown that nicotine's Fig. 3. Impaired sensory-gating and social behavior in th-fgfr1(tk-) mice and their normalization by drugs.(A) "
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    ABSTRACT: Schizophrenia is a neurodevelopmental disorder featuring complex aberrations in the structure, wiring, and chemistry of multiple neuronal systems. The abnormal developmental trajectory of the brain appears to be established during gestation, long before clinical symptoms of the disease appear in early adult life. Many genes are associated with schizophrenia, however, altered expression of no one gene has been shown to be present in a majority of schizophrenia patients. How does altered expression of such a variety of genes lead to the complex set of abnormalities observed in the schizophrenic brain? We hypothesize that the protein products of these genes converge on common neurodevelopmental pathways that affect the development of multiple neural circuits and neurotransmitter systems. One such neurodevelopmental pathway is Integrative Nuclear FGFR1 Signaling (INFS). INFS integrates diverse neurogenic signals that direct the postmitotic development of embryonic stem cells, neural progenitors and immature neurons, by direct gene reprogramming. Additionally, FGFR1 and its partner proteins link multiple upstream pathways in which schizophrenia-linked genes are known to function and interact directly with those genes. A th-fgfr1(tk-) transgenic mouse with impaired FGF receptor signaling establishes a number of important characteristics that mimic human schizophrenia - a neurodevelopmental origin, anatomical abnormalities at birth, a delayed onset of behavioral symptoms, deficits across multiple domains of the disorder and symptom improvement with typical and atypical antipsychotics, 5-HT antagonists, and nicotinic receptor agonists. Our research suggests that altered FGF receptor signaling plays a central role in the developmental abnormalities underlying schizophrenia and that nicotinic agonists are an effective class of compounds for the treatment of schizophrenia.
    Schizophrenia Research 12/2012; 143(2-3). DOI:10.1016/j.schres.2012.11.004 · 3.92 Impact Factor
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