Short-term effects of nicotine gum on facial detection in healthy nonsmokers: a pilot randomized controlled trial

Nicotine's effect on cognition, a friend or foe?

Tobacco smoking is a preventable cause of morbidity and mortality throughout the world. Smoking comes in form of absorption of many compounds, among which nicotine is the main psychoactive component of tobacco and its positive and negative reinforcement effects are proposed to be the key mechanism for the initiation and maintenance of smoking. Growing evidence suggests that the cognitive enhancement effects of nicotine may also contribute to the difficulty of quitting smoking, especially in individuals with psychiatric disorders. In this review, we first introduce the beneficial effect of nicotine on cognition including attention, short-term memory and long-term memory. We next summarize the beneficial effect of nicotine on cognition under pathological conditions, including Alzheimer's disease, Parkinson's disease, Schizophrenia, Stress-induced Anxiety, Depression, and drug-induced memory impairment. The possible mechanism underlying nicotine's effect is also explored. Finally, nicotine's detrimental effect on cognition is discussed, including in the prenatal and adolescent periods, and high-dose nicotine- and withdrawal-induced memory impairment is emphasized. Therefore, nicotine serves as both a friend and foe. Nicotine-derived compounds could be a promising strategy to alleviate neurological disease-associated cognitive deficit, however, due to nicotine's detrimental effect, continued educational programs and public awareness campaigns are needed to reduce tobacco use among pregnant women and smoking should be quitted even if it is e-cigarette, especially for the adolescents.

Correlates of clinical variables on early-stage visual processing in schizophrenia and bipolar disorder

The use of noninvasive tools can help understand mental states and changes that are caused by medications, symptom severity, and other clinical variables. We investigated low-level visual processing using the contrast sensitivity function (CSF), a reliable, robust, and widely used approach. Our main purpose was (1) to evaluate visual impairments in schizophrenia (SCZ) and bipolar disorder (BPD) patients and (2) to investigate associations between clinical variables and visual function in both diseases. Fifty-six healthy controls (HCs; mean age = 31.04 years), 42 BPD patients (mean age = 32.84 years) who took only lithium, and 39 SCZ patients who took only olanzapine (mean age = 32.80 years) were recruited for this study. CSF differed between groups. Both groups of patients exhibited lower discrimination at low, mid-, and high spatial frequencies compared with HCs. No differences were observed between patients, with the exception of high spatial frequency. These impairments were also related to clinical variables, revealed by a strong effect in the mediation analyses. These findings may aid investigations of other clinical variables and the role of state- and trait-like effects on visual and cognitive processing in these patient populations. This study underscores the need for visual remediation interventions.

Serum levels of olanzapine are associated with acute cognitive effects in bipolar disorder

Bipolar (BPD) patients have deficits in cognition, but there are still controversies about the effects of some medications on their cognitive performance. Here, we investigated the relationship between cognition in terms of executive functions, memory, and attention in both first-episode medication-naive BPD patients and BPD patients taking olanzapine. Forty-one healthy controls, 40 unmedicated drug-naive BPD patients, and 34 BPD patients who took only olanzapine were recruited for the study. Cognitive performance was assessed using the Flanker test, Stroop test, and Corsi-block test. Bayesian multivariate regression analysis was run considering maximum robustness to avoid bias and to predict the outcomes. Our results revealed that unmedicated medication-naive BPD patients performed worse than healthy controls and the olanzapine group in some tasks. Additionally, BPD patients who took olanzapine had better cognitive performance than healthy controls and unmedicated BPD patients. The acute cognitive effects were predicted by olanzapine dosage and serum levels (i.e., large effects). The potential pro-cognitive effects of olanzapine in BPD patients should be carefully interpreted by considering various other clinical variables. We expect that our findings will contribute to further research in this area, with the goal of helping other researchers, patients, and the population.

Improvement in visual performance after nicotine gum administration in tobacco use disorder: a case report

Chronic tobacco consumption, identified as Tobacco Use Disorder (TUD), is a public health problem. We present a case report of a 37-year-old Brazilian male diagnosed with TUD at age 26, with no comorbidities, that presented visual improvements (i.e., lower thresholds and better discrimination) after nicotine gum administration. Here, we assessed contrast sensitivity and chromatic discrimination using the Metropsis and the Cambridge Colour Test, respectively. Results showed lower thresholds for both visual tasks after the use of nicotine gum. Even considering this is a single case report, our intent is to open new avenues for research involving smoking, addiction and the use of nicotine gum as a replacement tool or adjuvant tool for improvement of visual and/or cognitive processing. It is well known that nicotine gum has protective effects for some diseases, and improves some cognitive functions. However, unclear were its effects on visual processing of people with TUD.

Eye movement impairments in children with malnutrition

Malnutrition is characterised by deficient nutrient ingestion and absorption and is still one of the most important causes of morbidity and mortality in children worldwide. Our main rationale was that protein-energy malnutrition (PEM) may affect eye movement in children with malnutrition. Twenty children without PEM (mean age = 10.8; SD = 1.0 years) and 18 children with PEM (mean age = 10.9; SD = 1.2 years) were included in the present study. We applied three types of tests: one that consisted of a maze and two versions of the Spot the Seven Errors test using boats and elephants. Our results indicated that children with PEM exhibited performance deficits in the maze test (p < .001) and Spot the Seven Errors test for both boats (p < .001) and elephants (p < .001). These data suggest that nutritional impairments during the first year of life (i.e., a critical period) can directly impact eye movement. Eye tracking is a reliable technique to investigate higher-order processes, but our results should be interpreted with caution. Our findings highlight the relevance of cognitive development in malnourished children, which can negatively affect their development. Screening, assessment and rehabilitation strategies are essential in this at-risk population.

Relation between smoking and visual processing in bipolar disorder

BACKGROUND

Although some studies have shown impairments in patients with bipolar disorder (BPD) and in smokers, it is unclear how these two factors work together. Our premise was that chronic smoking affects color discrimination and this is more pronounced in BPD. Objective: Our main purpose was to investigate the influence of smoking and BPD on color discrimination. Methods: Twenty-three smokers and 23 BPD smokers patients, aged 25-45 years old, participated in this study. Color vision testing was performed using the Trivector subtest of the Cambridge Colour Test. Participants' task was to indicate the pseudoisochromatic stimulus in four directions (up, down, right, and left). Results: It was shown that the smokers had better color vision than BPD smokers for the Protan (p < .001), Deutan (p < .001), and Tritan (p < .001) (red, green, and blue, respectively) axes. Thus, the BPD smokers' group had greater difficulty distinguishing the chromaticity variations (i.e., presented diffuse color vision impairments and not specific to any axis). Conclusions: The present study highlights a possible relationship between smoking and BPD in color discrimination. This highlights the importance of understanding the diffuse effects of this relationship.

Nicotine gum enhances visual processing in healthy nonsmokers

OBJECTIVE

The main purpose of this study was to investigate the isolated effects of nicotine on visual processing, namely contrast processing.

METHODS

Thirteen participants, aged 18-40 years, were enrolled in this double blind, randomized and pilot controlled trial involving nicotine gum administration (placebo, 2-mg and 4-mg doses). The participants' instruction was to detect the location of vertical gratings (0.2; 1.0; 3.3; 5.7; 8.8; 13.2 and 15.9 cycles per degree) when it was presented either left or right on the monitor screen. A repeated multivariate analysis of variance was conducted to analyse the results for the visual processing tasks. Bayesian analyses were also carried out considering maximum robustness to avoid bias.

RESULTS

The findings that nicotine gum administration resulted in better contrast discrimination when compared to placebo gum (p < .001). More specifically, the 4-mg resulted in better visual sensitivity when compared to the 2-mg (p < .01) and the placebo (p < .001) gum. Demographic data were not related to the outcomes.

CONCLUSIONS

These data bring the need for support the findings. If proved, it is possible that nicotine, in small doses, can have a potential therapeutic use for those populations with low vision.

TRIAL REGISTRATION NUMBER

RBR-46tjy3.