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Biswal SR, Kumar A, Muthuswamy S, Kumar S. Genetic components of microdeletion syndromes and their role in determining schizophrenia traits. Mol Biol Rep 2024; 51:804. [PMID: 39001960 DOI: 10.1007/s11033-024-09731-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 06/17/2024] [Indexed: 07/15/2024]
Abstract
Schizophrenia is a neuropsychiatric disorder characterized by various symptoms such as hallucinations, delusions, and disordered thinking. The etiology of this disease is unknown; however, it has been linked to many microdeletion syndromes that are likely to contribute to the pathology of schizophrenia. In this review we have comprehensively analyzed the role of various microdeletion syndromes, like 3q29, 15q13.3, and 22q11.2, which are known to be involved with schizophrenia. A variety of factors lead to schizophrenia phenotypes, but copy number variants that disrupt gene regulation and impair brain function and cognition are one of the causes that have been identified. Multiple case studies have shown that loss of one or more genes in the microdeletion regions lead to brain activity defects. In this article, we present a coherent paradigm that connects copy number variations (CNVs) to numerous neurological and behavioral abnormalities associated with schizophrenia. It would be helpful in understanding the different aspects of the microdeletions and how they contribute in the pathophysiology of schizophrenia.
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Affiliation(s)
- Smruti Rekha Biswal
- Department of Life Science, National Institute of Technology (NIT), Rourkela, Odisha, 769008, India
| | - Ajay Kumar
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Srinivasan Muthuswamy
- Department of Life Science, National Institute of Technology (NIT), Rourkela, Odisha, 769008, India.
| | - Santosh Kumar
- Department of Life Science, National Institute of Technology (NIT), Rourkela, Odisha, 769008, India.
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2
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Leonard S, Benfante R. Unanswered questions in the regulation and function of the duplicated α7 nicotinic receptor gene CHRFAM7A. Pharmacol Res 2023; 192:106783. [PMID: 37164281 DOI: 10.1016/j.phrs.2023.106783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/20/2023] [Accepted: 04/30/2023] [Indexed: 05/12/2023]
Abstract
The α7 nicotinic receptor (α7 nAChR) is an important entry point for Ca2+ into the cell, which has broad and important effects on gene expression and function. The gene (CHRNA7), mapping to chromosome (15q14), has been genetically linked to a large number of diseases, many of which involve defects in cognition. While numerous mutations in CHRNA7 are associated with mental illness and inflammation, an important control point may be the function of a recently discovered partial duplication CHRNA7, CHRFAM7A, that negatively regulates the function of the α7 receptor, through the formation of heteropentamers; other functions cannot be excluded. The deregulation of this human specific gene (CHRFAM7A) has been linked to neurodevelopmental, neurodegenerative, and inflammatory disorders and has important copy number variations. Much effort is being made to understand its function and regulation both in healthy and pathological conditions. However, many questions remain to be answered regarding its functional role, its regulation, and its role in the etiogenesis of neurological and inflammatory disorders. Missing knowledge on the pharmacology of the heteroreceptor has limited the discovery of new molecules capable of modulating its activity. Here we review the state of the art on the role of CHRFAM7A, highlighting unanswered questions to be addressed. A possible therapeutic approach based on genome editing protocols is also discussed.
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Affiliation(s)
- Sherry Leonard
- Department of Psychiatry - University of Colorado Anschutz, Aurora, Colorado, USA
| | - Roberta Benfante
- CNR - Institute of Neuroscience, Vedano al Lambro (MB), Italy; Dept. Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy; NeuroMI - Milan Center for Neuroscience, University of Milano Bicocca, Milan, Italy.
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3
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Terry AV, Jones K, Bertrand D. Nicotinic acetylcholine receptors in neurological and psychiatric diseases. Pharmacol Res 2023; 191:106764. [PMID: 37044234 DOI: 10.1016/j.phrs.2023.106764] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 04/14/2023]
Abstract
Neuronal nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels that are widely distributed both pre- and post-synaptically in the mammalian brain. By modulating cation flux across cell membranes, neuronal nAChRs regulate neuronal excitability and the release of a variety of neurotransmitters to influence multiple physiologic and behavioral processes including synaptic plasticity, motor function, attention, learning and memory. Abnormalities of neuronal nAChRs have been implicated in the pathophysiology of neurologic disorders including Alzheimer's disease, Parkinson's disease, epilepsy, and Tourette´s syndrome, as well as psychiatric disorders including schizophrenia, depression, and anxiety. The potential role of nAChRs in a particular illness may be indicated by alterations in the expression of nAChRs in relevant brain regions, genetic variability in the genes encoding for nAChR subunit proteins, and/or clinical or preclinical observations where specific ligands showed a therapeutic effect. Over the past 25 years, extensive preclinical and some early clinical evidence suggested that ligands at nAChRs might have therapeutic potential for neurologic and psychiatric disorders. However, to date the only approved indications for nAChR ligands are smoking cessation and the treatment of dry eye disease. It has been argued that progress in nAChR drug discovery has been limited by translational gaps between the preclinical models and the human disease as well as unresolved questions regarding the pharmacological goal (i.e., agonism, antagonism or receptor desensitization) depending on the disease.
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Affiliation(s)
- Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia at Augusta University, Augusta, Georgia, 30912.
| | - Keri Jones
- Educational Innovation Institute, Medical College of Georgia at Augusta University, Augusta, Georgia, 30912
| | - Daniel Bertrand
- HiQScreen Sàrl, 6, rte de Compois, 1222 Vésenaz, Geneva, Switzerland
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Fišar Z. Biological hypotheses, risk factors, and biomarkers of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110626. [PMID: 36055561 DOI: 10.1016/j.pnpbp.2022.110626] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 12/19/2022]
Abstract
Both the discovery of biomarkers of schizophrenia and the verification of biological hypotheses of schizophrenia are an essential part of the process of understanding the etiology of this mental disorder. Schizophrenia has long been considered a neurodevelopmental disease whose symptoms are caused by impaired synaptic signal transduction and brain neuroplasticity. Both the onset and chronic course of schizophrenia are associated with risk factors-induced disruption of brain function and the establishment of a new homeostatic setpoint characterized by biomarkers. Different risk factors and biomarkers can converge to the same symptoms of schizophrenia, suggesting that the primary cause of the disease can be highly individual. Schizophrenia-related biomarkers include measurable biochemical changes induced by stress (elevated allostatic load), mitochondrial dysfunction, neuroinflammation, oxidative and nitrosative stress, and circadian rhythm disturbances. Here is a summary of selected valid biological hypotheses of schizophrenia formulated based on risk factors and biomarkers, neurodevelopment, neuroplasticity, brain chemistry, and antipsychotic medication. The integrative neurodevelopmental-vulnerability-neurochemical model is based on current knowledge of the neurobiology of the onset and progression of the disease and the effects of antipsychotics and psychotomimetics and reflects the complex and multifactorial nature of schizophrenia.
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Affiliation(s)
- Zdeněk Fišar
- Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Psychiatry, Czech Republic.
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Kayir H, Ruffolo J, McCunn P, Khokhar JY. The Relationship Between Cannabis, Cognition, and Schizophrenia: It's Complicated. Curr Top Behav Neurosci 2023; 63:437-461. [PMID: 36318403 DOI: 10.1007/7854_2022_396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The consequences of cannabis use, especially in the context of schizophrenia, have gained increased importance with the legalization of cannabis in North America and across the globe. Cannabis use has multifaceted impacts on cognition in schizophrenia patients and healthy subjects. Healthy subjects, particularly those who initiated cannabis use at earlier ages and used high-potency cannabis for longer durations, exhibited poorer cognition mainly in working memory and attention. Cannabis use in schizophrenia has been associated with symptom exacerbation, longer and more frequent psychotic episodes, and poorer treatment outcomes. However, cannabis-using patients have better overall cognitive performance compared to patients who were not cannabis users. Interestingly, these effects were only apparent in lifetime cannabis users, but not in current (or within last 6 months) users. Moreover, higher frequency and earlier age of cannabis use initiation (i.e., before 17 years of age) were associated with better cognitive performance, although they had an earlier illness onset. Three possible hypotheses seem to come forward to explain this paradox. First, some components of cannabis may have antipsychotic or cognitive-enhancing properties. Secondly, chronic cannabis use may alter endocannabinoid signaling in the brain which could be a protective factor for developing psychosis or cognitive impairments. A third explanation could be their representation of a phenotypically distinct patient group with more intact cognitive functioning and less neurodevelopmental pathology. Multiple factors need to be considered to understand the complex relationship between cannabis, cognitive function, and schizophrenia. In short, age at initiation, duration and rate of cannabis use, abstinence duration, co-use of substances and alcohol, prescribed medications, relative cannabinoid composition and potency of cannabis, presence of genetic and environmental vulnerability factors are prominent contributors to the variability in outcomes. Animal studies support the disruptive effects of Δ9-tetrahydrocannabinol (THC) administration during adolescence on attention and memory performance. They provide insights about interaction of cannabinoid receptors with other neurotransmitter systems, such as GABA and glutamate, and other regulatory molecules, such as PSD95 and synaptophysin. Cannabidiol (CBD), on the other hand, can improve cognitive deficits seen in neurodevelopmental and chemically-induced animal models of schizophrenia. Future studies focusing on bridging the translational gaps between human and animal studies, through the use of translationally relevant methods of exposure (e.g., vaping), consistent behavioral assessments, and congruent circuit interrogations (e.g., imaging) will help to further clarify this complex picture.
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Affiliation(s)
- Hakan Kayir
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jessica Ruffolo
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Patrick McCunn
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
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Self-Reported Medical and Nonmedical Cannabis Use: Results from the 2018 Behavioral Risk Factor Surveillance System in 14 States. J Community Health 2022; 47:641-649. [PMID: 35460471 PMCID: PMC9884044 DOI: 10.1007/s10900-021-01049-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 01/31/2023]
Abstract
As policies legalizing adult cannabis use increase in the United States, understanding and characterizing the proportion of individuals consuming cannabis for medical and nonmedical purposes is important to inform targeted health education efforts. Data came from 7672 adults (> = 18 years) with past month cannabis use who responded to questions about reason for cannabis use on the 2018 Behavioral Risk Factor Surveillance System survey in 14 states. State and aggregated data were analyzed using weighted frequencies for descriptive analyses, and prevalence ratios were computed to identify demographic and substance use characteristics associated with medical only use or use for both medical and nonmedical reasons (vs. nonmedical use). Overall, 28.6% (95% CI: 26.7, 30.4) of adults who use cannabis reported using cannabis medically, 34.2% (95% CI: 32.3, 36.2) nonmedically, and 37.2% (95% CI: 35.2, 39.2) both medically and nonmedically. Characteristics associated with medical only use (compared with nonmedical only use) included being female; aged > 45 years; out of work, a homemaker, or unable to work; having daily or near daily cannabis use; having past month cigarette use; having no past month alcohol use; self-reporting poor health; and ever having been diagnosed with certain chronic diseases. Medical only use of cannabis is the least prevalent reason for use; use for both medical and nonmedical reasons is the most prevalent. Monitoring reasons for cannabis use can aid states in understanding differences between medical and nonmedical cannabis users, providing context to use patterns, and targeting health education messages to appropriate audiences.
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Di Lascio S, Fornasari D, Benfante R. The Human-Restricted Isoform of the α7 nAChR, CHRFAM7A: A Double-Edged Sword in Neurological and Inflammatory Disorders. Int J Mol Sci 2022; 23:ijms23073463. [PMID: 35408823 PMCID: PMC8998457 DOI: 10.3390/ijms23073463] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 12/13/2022] Open
Abstract
CHRFAM7A is a relatively recent and exclusively human gene arising from the partial duplication of exons 5 to 10 of the α7 neuronal nicotinic acetylcholine receptor subunit (α7 nAChR) encoding gene, CHRNA7. CHRNA7 is related to several disorders that involve cognitive deficits, including neuropsychiatric, neurodegenerative, and inflammatory disorders. In extra-neuronal tissues, α7nAChR plays an important role in proliferation, differentiation, migration, adhesion, cell contact, apoptosis, angiogenesis, and tumor progression, as well as in the modulation of the inflammatory response through the “cholinergic anti-inflammatory pathway”. CHRFAM7A translates the dupα7 protein in a multitude of cell lines and heterologous systems, while maintaining processing and trafficking that are very similar to the full-length form. It does not form functional ion channel receptors alone. In the presence of CHRNA7 gene products, dupα7 can assemble and form heteromeric receptors that, in order to be functional, should include at least two α7 subunits to form the agonist binding site. When incorporated into the receptor, in vitro and in vivo data showed that dupα7 negatively modulated α7 activity, probably due to a reduction in the number of ACh binding sites. Very recent data in the literature report that the presence of the duplicated gene may be responsible for the translational gap in several human diseases. Here, we will review the studies that have been conducted on CHRFAM7A in different pathologies, with the intent of providing evidence regarding when and how the expression of this duplicated gene may be beneficial or detrimental in the pathogenesis, and eventually in the therapeutic response, to CHRNA7-related neurological and non-neurological diseases.
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Affiliation(s)
- Simona Di Lascio
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), Università degli Studi di Milano, 20129 Milan, Italy; (S.D.L.); (D.F.)
| | - Diego Fornasari
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), Università degli Studi di Milano, 20129 Milan, Italy; (S.D.L.); (D.F.)
- CNR Institute of Neuroscience, 20845 Vedano al Lambro, Italy
| | - Roberta Benfante
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), Università degli Studi di Milano, 20129 Milan, Italy; (S.D.L.); (D.F.)
- CNR Institute of Neuroscience, 20845 Vedano al Lambro, Italy
- NeuroMi, Milan Center for Neuroscience, University of Milano Bicocca, 20126 Milan, Italy
- Correspondence:
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Schick B, Barth E, Mayer B, Weber CL, Hagemeyer T, Schönfeldt C. Prospective, observational, single-centre cohort study with an independent control group matched for age and sex aimed at investigating the significance of cholinergic activity in patients with schizophrenia: study protocol of the CLASH-study. BMJ Open 2021; 11:e050501. [PMID: 34930729 PMCID: PMC8689167 DOI: 10.1136/bmjopen-2021-050501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Alterations in the cholinergic metabolism may cause various clinical symptoms of schizophrenia. In addition to the 'monoamine hypothesis,' neuroinflammation is also discussed as a cause of schizophrenia. To date, there has been no evidence of alterations in the central cholinergic transmitter balance in patients with schizophrenia under clinical conditions. By contrast, studies in critically ill patients have established the measurement of acetylcholinesterase activity as a suitable surrogate parameter of central cholinergic transmitter balance/possible pathophysiological changes. Butyrylcholinesterase activity has been established as a parameter indicating possible (neuro)inflammatory processes. Both parameters can now be measured using a point-of-care approach. Therefore, the primary objective of this study is to investigate whether acetylcholinesterase and butyrylcholinesterase activity differs in patients with various forms of schizophrenia. Secondary objectives address the possible association between acetylcholinesterase and butyrylcholinesterase activity and (1) schizophrenic symptoms using the Positive and Negative Syndrome Scale, (2) the quantity of antipsychotics taken and (3) the duration of illness. METHODS AND ANALYSIS The study is designed as a prospective, observational cohort study with one independent control group. It is being carried out at the Department of Psychiatry and Psychotherapy III, Ulm University Hospital, Germany. Patient enrolment started in October 2020, and the anticipated end of the study is in January 2022. The enrolment period was set from October 2020 to December 2021 (extension required due to SARS-CoV-2 pandemic). The sample size is calculated at 50 patients in each group. Esterase activity is measured on hospital admission (acute symptomatology) and after referral to a postacute ward over a period of three consecutive days. The matched control group will be created after reaching 50 patients with schizophrenia. This will be followed by a comprehensive statistical analysis of the data set. ETHICS AND DISSEMINATION The study was registered prospectively in the German Clinical Trials Register (DRKS-ID: DRKS00023143,URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023143) after approval by the ethics committee of the University of Ulm, Germany Trial Code No. 280/20. TRIAL REGISTRATION NUMBER DRKS00023143; Pre-results.
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Affiliation(s)
- Benedikt Schick
- Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany
| | - Eberhard Barth
- Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany
| | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Claire-Louise Weber
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Ulm, Germany
| | - Theresa Hagemeyer
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Ulm, Germany
| | - Carlos Schönfeldt
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, Ulm, Germany
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Fornaro M, Carvalho AF, De Prisco M, Mondin AM, Billeci M, Selby P, Iasevoli F, Berk M, Castle DJ, de Bartolomeis A. The prevalence, odds, predictors, and management of tobacco use disorder or nicotine dependence among people with severe mental illness: Systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 132:289-303. [PMID: 34838527 DOI: 10.1016/j.neubiorev.2021.11.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
The prevalence, correlates, and management of tobacco use disorder (TUD) or nicotine dependence (ND) among people with severe mental illness (SMI), namely schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD), remain unclear. Therefore, a systematic review and meta-analysis was conducted. Electronic databases were systematically searched from inception to July 12, 2020, for observational studies documenting the prevalence, odds, and correlates of TUD/ND among people with SMI; randomized controlled trials (RCTs) informing the management of TUD/ND in people with SMI were also included. Random-effects meta-analyses were conducted. Sources of heterogeneity were explored. Nineteen observational studies, including 7527 participants with SMI met inclusion criteria. TUD/ND co-occurred in 33.4-65% of people with SMI. Rates were higher among males. While bupropion and varenicline represent promising treatment opportunities for schizophrenia with TUD/ND, non-pharmacological interventions require further research, mainly for people with primary mood disorders. TUD/ND represent prevalent co-occurring conditions among people with SMI. Further well-designed RCTs are warranted to inform their management.
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Affiliation(s)
- Michele Fornaro
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Andre F Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Vic., Australia.
| | - Michele De Prisco
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Anna Maria Mondin
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Martina Billeci
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Peter Selby
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Felice Iasevoli
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
| | - David Jonathan Castle
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada.
| | - Andrea de Bartolomeis
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy; Chair Staff for Health Education and Sustainable Development, UNESCO, Naples, Italy.
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An Open Trial of Metacognitive Remediation Therapy and Pharmacotherapy to Promote Smoking Cessation among Individuals with Psychotic-Spectrum Disorders. J Smok Cessat 2021; 2021:6617716. [PMID: 34429783 PMCID: PMC8337155 DOI: 10.1155/2021/6617716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/22/2021] [Accepted: 07/07/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Individuals with psychotic-spectrum disorders may smoke due to the ameliorating effect of nicotine on the cognitive deficits that accompany these illnesses. Metacognitive remediation therapy (MCR) has been shown to produce improvements in cognitive functioning among individuals with psychotic-spectrum disorders and provides a foundation for a novel smoking cessation intervention for this population. Aims To complete an open investigation of pharmacotherapy and a modified version of MCR [MCR to Quit (MCR-Q)] in promoting smoking cessation among individuals with psychotic-spectrum disorders. Methods Forty-nine individuals with a psychotic-spectrum disorder and who currently smoke cigarettes participated in MCR-Q while also receiving evidence-based smoking cessation pharmacotherapy. Tobacco use was assessed as follows: (i) prior to MCR-Q, (ii) immediately after completing MCR-Q, and (iii) six weeks after completion of MCR-Q. Results /Findings. During participation in MCR-Q, nearly 80% of participants made a 24-hour quit attempt. Following the completion of MCR-Q, participants experienced reductions in level of nicotine dependency and exhaled carbon monoxide, with reductions in nicotine dependency sustained six weeks after completion of MCR-Q. Over the course of their participation in MCR-Q, participants reported strong therapeutic alliance with their MCR-Q therapist and high levels of intrinsic motivation with regard to completing MCR-Q exercises. Conclusions The results from the current study suggest cautious optimism with regard to the use of MCR-Q in combination with medication for individuals with psychotic-spectrum disorders who want to quit smoking.
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Harvey PD, Bigdeli TB, Fanous AH, Li Y, Rajeevan N, Sayward F, Radhakrishnan K, Huang G, Aslan M. Cooperative Studies Program (CSP) #572: A Study of Serious Mental Illness in Veterans as a Pathway to personalized medicine in Schizophrenia and Bipolar Illness. PERSONALIZED MEDICINE IN PSYCHIATRY 2021; 27-28:10.1016/j.pmip.2021.100078. [PMID: 34222732 PMCID: PMC8247126 DOI: 10.1016/j.pmip.2021.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Personalization of psychiatric treatment includes treatment of symptoms, cognition and functional deficits, suicide, and medical co-morbidities. VA Collaborative Study 572 examined a large sample of male and female veterans with schizophrenia (n=3,942) and with bipolar disorder (n=5,414) with phenotyping and genomic analyses. We present the results to date and future directions. METHODS All veterans received a structured diagnostic interview and assessments of suicidal ideation and behavior, PTSD, and health. Veterans with schizophrenia were assessed for negative symptoms and lifetime depression. All were assessed with a cognitive and functional capacity assessment. Data for genome wide association studies were collected. Controls came from the VA Million Veteran Program. RESULTS Suicidal ideation or behavior was present in 66%. Cognitive and functional deficits were consistent with previous studies. 40% of the veterans with schizophrenia had a lifetime major depressive episode and PTSD was present in over 30%. Polygenic risk score (PRS) analyses indicated that cognitive and functional deficits overlapped with PRS for cognition, education, and intelligence in the general population and PRS for suicidal ideation and behavior correlated with previous PRS for depression and suicidal ideation and behavior, as did the PRS for PTSD. DISCUSSION Results to date provide directions for personalization of treatment in SMI, veterans with SMI, and veterans in general. The results of the genomic analyses suggest that cognitive deficits in SMI may be associated with general population features. Upcoming genomic analyses will reexamine the issues above, as well as genomic factors associated with smoking, substance abuse, negative symptoms, and treatment response.
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Affiliation(s)
- Philip D. Harvey
- Bruce W. Carter Miami Veterans Affairs (VA) Medical Center, Miami, FL
- University of Miami School of Medicine, Miami, FL
| | - Tim B. Bigdeli
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Ayman H. Fanous
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Yuli Li
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Nallakkandi Rajeevan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Frederick Sayward
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Krishnan Radhakrishnan
- Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
- University of Kentucky School of Medicine, Lexington, KY
| | - Grant Huang
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Mihaela Aslan
- VA New York Harbor Healthcare System, Brooklyn, NY
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
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Phillips MB, Nigam A, Johnson JW. Interplay between Gating and Block of Ligand-Gated Ion Channels. Brain Sci 2020; 10:brainsci10120928. [PMID: 33271923 PMCID: PMC7760600 DOI: 10.3390/brainsci10120928] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/21/2020] [Accepted: 11/26/2020] [Indexed: 02/03/2023] Open
Abstract
Drugs that inhibit ion channel function by binding in the channel and preventing current flow, known as channel blockers, can be used as powerful tools for analysis of channel properties. Channel blockers are used to probe both the sophisticated structure and basic biophysical properties of ion channels. Gating, the mechanism that controls the opening and closing of ion channels, can be profoundly influenced by channel blocking drugs. Channel block and gating are reciprocally connected; gating controls access of channel blockers to their binding sites, and channel-blocking drugs can have profound and diverse effects on the rates of gating transitions and on the stability of channel open and closed states. This review synthesizes knowledge of the inherent intertwining of block and gating of excitatory ligand-gated ion channels, with a focus on the utility of channel blockers as analytic probes of ionotropic glutamate receptor channel function.
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Affiliation(s)
- Matthew B. Phillips
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA; (M.B.P.); (A.N.)
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Aparna Nigam
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA; (M.B.P.); (A.N.)
| | - Jon W. Johnson
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA; (M.B.P.); (A.N.)
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Correspondence: ; Tel.: +1-(412)-624-4295
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13
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Ohi K, Nishizawa D, Muto Y, Sugiyama S, Hasegawa J, Soda M, Kitaichi K, Hashimoto R, Shioiri T, Ikeda K. Polygenic risk scores for late smoking initiation associated with the risk of schizophrenia. NPJ SCHIZOPHRENIA 2020; 6:36. [PMID: 33230172 PMCID: PMC7684279 DOI: 10.1038/s41537-020-00126-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023]
Abstract
Patients with schizophrenia display characteristic smoking-related behaviors and genetic correlations between smoking behaviors and schizophrenia have been identified in European individuals. However, the genetic etiology of the association remains to be clarified. The present study investigated transethnic genetic overlaps between European-based smoking behaviors and the risk of Japanese schizophrenia by conducting polygenic risk score (PRS) analyses. Large-scale European genome-wide association study (GWAS) datasets (n = 24,114-74,035) related to four smoking-related intermediate phenotypes [(i) smoking initiation, (ii) age at smoking initiation, (iii) smoking quantity, and (iv) smoking cessation] were utilized as discovery samples. PRSs derived from these discovery GWASs were calculated for 332 Japanese subjects [schizophrenia patients, their unaffected first-degree relatives (FRs), and healthy controls (HCs)] as a target sample. Based on GWASs of European smoking phenotypes, we investigated the effects of PRSs on smoking phenotypes and the risk of schizophrenia in the Japanese population. Of the four smoking-related behaviors, the PRSs for age at smoking initiation in Europeans significantly predicted the age at smoking initiation (R2 = 0.049, p = 0.026) and the PRSs for smoking cessation significantly predicted the smoking cessation (R2 = 0.092, p = 0.027) in Japanese ever-smokers. Furthermore, the PRSs related to age at smoking initiation in Europeans were higher in Japanese schizophrenia patients than in the HCs and those of the FRs were intermediate between those of patients with schizophrenia and those of the HCs (R2 = 0.015, p = 0.015). In our target subjects, patients with schizophrenia had a higher mean age at smoking initiation (p = 0.018) and rate of daily smoking initiation after age 20 years (p = 0.023) compared with the HCs. A total of 60.6% of the patients started to smoke before the onset of schizophrenia. These findings suggest that genetic factors affecting late smoking initiation are associated with the risk of schizophrenia.
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Affiliation(s)
- Kazutaka Ohi
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan. .,Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Yukimasa Muto
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shunsuke Sugiyama
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Midori Soda
- Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
| | - Kiyoyuki Kitaichi
- Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Toshiki Shioiri
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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14
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Wei S, Wang D, Wei G, Wang J, Zhou H, Xu H, Xia L, Tian Y, Dai Q, Zhu R, Wang W, Chen D, Xiu M, Wang L, Zhang XY. Association of cigarette smoking with cognitive impairment in male patients with chronic schizophrenia. Psychopharmacology (Berl) 2020; 237:3409-3416. [PMID: 32757027 DOI: 10.1007/s00213-020-05621-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Previous studies have shown that patients with schizophrenia have higher smoking rates and worse cognitive function than healthy controls. However, there is no consistent conclusion about the relationship between smoking and cognitive impairment. OBJECTIVES The main purpose of this study was to explore the effects of smoking on cognitive function by using MATRICS Cognitive Consensus Battery (MCCB) in Chinese male patients with schizophrenia. METHODS There were 164 patients with chronic schizophrenia and 82 healthy controls. All subjects were interviewed about smoking status. The cognitive function was assessed by MCCB and Stroop tests. The Positive and Negative Syndrome Scale (PANSS) was used to assess the clinical symptoms of the patients. RESULTS Compared with healthy controls, patients had lower MCCB scores in all of its domain scores (all p < 0.05). In the patients, the scores of spatial span test (42.3 ± 11.6), digital sequence test (42.9 ± 10.6), and Hopkins Verbal Learning Test (42.2 ± 10.1) were lower in smokers than those in nonsmokers (all p < 0.05, effect size: 0.28-0.45). Logistic regression analysis showed that the smoking status of the patients was correlated with digital sequence score (p < 0.05, OR = 1.072, 95%CI: 1.013-1.134). Multivariate regression analysis showed that the spatial span total score (β = - 0.26, t = - 2.74, p < 0.001) was associated with the duration of smoking in patients with schizophrenia. CONCLUSIONS Our findings show that smoking patients with chronic schizophrenia exhibit more severe cognitive impairment than nonsmoking patients, especially in working memory and executive function.
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Affiliation(s)
- Shuochi Wei
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Dongmei Wang
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Gaoxia Wei
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Jiesi Wang
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Huixia Zhou
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Hang Xu
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Luyao Xia
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Yang Tian
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Qilong Dai
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Rongrong Zhu
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Wenjia Wang
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Beijing, China
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Beijing, China
| | - Li Wang
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
| | - Xiang Yang Zhang
- Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
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15
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Dondé C, Brunelin J, Mondino M, Cellard C, Rolland B, Haesebaert F. The effects of acute nicotine administration on cognitive and early sensory processes in schizophrenia: a systematic review. Neurosci Biobehav Rev 2020; 118:121-133. [PMID: 32739422 DOI: 10.1016/j.neubiorev.2020.07.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/18/2020] [Accepted: 07/25/2020] [Indexed: 12/01/2022]
Abstract
Nicotine use, which is mostly done through smoking tobacco, is among the most burdensome comorbidities of schizophrenia. However, the ways in which nicotine affects the cognitive and early sensory alterations found in this illness are still debated. After conducting a systematic literature search, 29 studies were selected. These studies involve individuals with schizophrenia who underwent cognitive and/or early sensory function assessments after acute nicotine administration and include 560 schizophrenia subjects and 346 non-schizophrenia controls. The findings highlight that a single dose of nicotine can improve a range of cognitive functions in schizophrenia subjects, such as attention, working memory, and executive functions, with attention being the most responsive domain. In addition, nicotine can modulate early detection of changes in the sensory environment at both the auditory and visual levels. Nevertheless, effects vary strongly depending on the type of neuropsychological assessment and nicotine intake conditions used in each study. The current findings suggest the need to consider a potential decrease of cognitive and early sensory performance when patients with schizophrenia quit smoking.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, F-38000 Grenoble, France.
| | - Jérôme Brunelin
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Marine Mondino
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | | | - Benjamin Rolland
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
| | - Frédéric Haesebaert
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team, Lyon, F-69000, France; University Lyon 1, Villeurbanne, F-69000, France; Centre Hospitalier Le Vinatier, Bron, France.
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16
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Do Nicotinic Receptors Modulate High-Order Cognitive Processing? Trends Neurosci 2020; 43:550-564. [DOI: 10.1016/j.tins.2020.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/19/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
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17
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Björk J, Nilsson A, Bonander C, Strömberg U. A novel framework for classification of selection processes in epidemiological research. BMC Med Res Methodol 2020; 20:155. [PMID: 32536343 PMCID: PMC7294651 DOI: 10.1186/s12874-020-01015-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/13/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Selection and selection bias are terms that lack consistent definitions and have varying meaning and usage across disciplines. There is also confusion in current definitions between underlying mechanisms that lead to selection and their consequences. Consequences of selection on study validity must be judged on a case-by-case basis depending on research question, study design and analytical decisions. The overall aim of the study was to develop a simple but general framework for classifying various types of selection processes of relevance for epidemiological research. METHODS Several original articles from the epidemiological literature and from related areas of observational research were reviewed in search of examples of selection processes, used terminology and description of the underlying mechanisms. RESULTS We classified the identified selection processes in three dimensions: i) selection level (selection at the population level vs. study-specific selection), ii) type of mechanism (selection in exposure vs. selection in population composition), iii) timing of the selection (at exposure entry, during exposure/follow-up or post-outcome). CONCLUSIONS Increased understanding of when, how, and why selection occur is an important step towards improved validity of epidemiological research.
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Affiliation(s)
- Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden.
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.
| | - Anton Nilsson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
- Centre for Economic Demography, Lund University, Lund, Sweden
| | - Carl Bonander
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Ulf Strömberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
- Department of Research and Development, Region Halland, Halmstad, Sweden
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18
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Terry AV, Callahan PM. α7 nicotinic acetylcholine receptors as therapeutic targets in schizophrenia: Update on animal and clinical studies and strategies for the future. Neuropharmacology 2020; 170:108053. [PMID: 32188568 DOI: 10.1016/j.neuropharm.2020.108053] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
Schizophrenia is a devastating mental illness and its effective treatment is among the most challenging issues in psychiatry. The symptoms of schizophrenia are heterogeneous ranging from positive symptoms (e.g., delusions, hallucinations) to negative symptoms (e.g., anhedonia, social withdrawal) to cognitive dysfunction. Antipsychotics are effective at ameliorating positive symptoms in some patients; however, they are not reliably effective at improving the negative symptoms or cognitive impairments. The inability to address the cognitive impairments is a particular concern since they have the greatest long-term impact on functional outcomes. While decades of research have been devoted to the development of pro-cognitive agents for schizophrenia, to date, no drug has been approved for clinical use. Converging behavioral, neurobiological, and genetic evidence led to the identification of the α7-nicotinic acetylcholine receptor (α7-nAChR) as a therapeutic target several years ago and there is now extensive preclinical evidence that α7-nAChR ligands have pro-cognitive effects and other properties that should be beneficial to schizophrenia patients. However, like the other pro-cognitive strategies, no α7-nAChR ligand has been approved for clinical use in schizophrenia thus far. In this review, several topics are discussed that may impact the success of α7-nAChR ligands as pro-cognitive agents for schizophrenia including the translational value of the animal models used, clinical trial design limitations, confounding effects of polypharmacy, dose-effect relationships, and chronic versus intermittent dosing considerations. Determining the most optimal pharmacologic strategy at α7-nAChRs: agonist, positive allosteric modulator, or potentially even receptor antagonist is also discussed. article is part of the special issue on 'Contemporary Advances in Nicotine Neuropharmacology'.
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Affiliation(s)
- Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia; Small Animal Behavior Core, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia.
| | - Patrick M Callahan
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia; Small Animal Behavior Core, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia
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19
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Abstract
Human behavior can be controlled by physical or psychological dependencies associated with addiction. One of the most insidious addictions in our society is the use of tobacco products which contain nicotine. This addiction can be associated with specific receptors in the brain that respond to the natural neurotransmitter acetylcholine. These nicotinic acetylcholine receptors (nAChR) are ligand-gated ion channels formed by the assembly of one or multiple types of nAChR receptor subunits. In this paper, we review the structure and diversity of nAChR subunits and our understanding for how different nAChR subtypes play specific roles in the phenomenon of nicotine addiction. We focus on receptors containing β2 and/or α6 subunits and the special significance of α5-containing receptors. These subtypes all have roles in regulating dopamine-mediated neurotransmission in the mesolimbic reward pathways of the brain. We also discuss the unique roles of homomeric α7 nAChR in behavioral responses to nicotine and how our knowledge of nAChR functional diversity may help guide pharmacotherapeutic approaches for treating nicotine addiction. While nicotine addiction is a truly global problem, the use of areca nut (betel) products is also a serious addiction associated with public health issues across most of South Asia, impacting as many as 600 million people. We discuss how cholinergic receptors of the brain are also involved with areca addiction and the unique challenges for dealing with addiction to this substance.
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20
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Tregellas JR, Wylie KP. Alpha7 Nicotinic Receptors as Therapeutic Targets in Schizophrenia. Nicotine Tob Res 2019; 21:349-356. [PMID: 30137618 DOI: 10.1093/ntr/nty034] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/09/2018] [Indexed: 12/12/2022]
Abstract
While current treatments for schizophrenia often provide much relief for positive symptoms such as hallucinations, other symptoms, particularly cognitive deficits, persist and contribute to substantial suffering and reduced quality of life for patients. In searching for novel therapeutic avenues to treat cognitive deficits in schizophrenia, recent work is exploring nicotinic receptor neurobiology. Supported by a large body of evidence, with contributions from studies of smoking behaviors, genetics, receptor distribution and function, animal models and nicotinic effects on illness symptoms, the alpha7 nicotinic receptor has emerged as a potential therapeutic target. Despite promise in early clinical trials, however, no drug targeting nicotinic systems has succeeded in larger phase 3 trials. Following a brief review of nicotinic receptor biology and the evidence that has led to pursuit of alpha7 nicotinic agonism as a therapeutic strategy, this review will provide an update on the status of recent trials, discuss potential issues that may have contributed to negative outcomes, and point to new directions and promising advances in developing alpha7 nicotinic receptor-based treatment for cognitive symptoms in schizophrenia. IMPLICATIONS By examining alpha7 nicotinic receptor biology and recent efforts to target the receptor in clinical trials, it is hoped that investigators will be motivated to explore novel, promising directions focusing on the receptor as a strategy to treat cognitive symptoms in schizophrenia.
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Affiliation(s)
- Jason R Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO.,Research Service, Denver VA Medical Center, Denver, CO
| | - Korey P Wylie
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO.,Research Service, Denver VA Medical Center, Denver, CO
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21
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Kunchulia M, Kotaria N, Pilz K, Kotorashvili A, Herzog MH. Associations between genetic variations and global motion perception. Exp Brain Res 2019; 237:2729-2734. [DOI: 10.1007/s00221-019-05627-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 08/13/2019] [Indexed: 02/04/2023]
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22
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Ohi K, Kuwata A, Shimada T, Kataoka Y, Yasuyama T, Uehara T, Kawasaki Y. Genome-Wide Variants Shared Between Smoking Quantity and Schizophrenia on 15q25 Are Associated With CHRNA5 Expression in the Brain. Schizophr Bull 2019; 45:813-823. [PMID: 30202994 PMCID: PMC6581148 DOI: 10.1093/schbul/sby093] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cigarette smokers with schizophrenia consume more cigarettes than smokers in the general population. Schizophrenia and smoking quantity may have shared genetic liability. Genome-wide association studies (GWASs) of schizophrenia and smoking quantity have highlighted a biological pleiotropy in which a robust 15q25 locus affects both traits. To identify the genetic variants shared between these traits on 15q25, we used summary statistics from large-scale GWAS meta-analyses of schizophrenia in the Psychiatric Genomics Consortium 2 and smoking quantity assessed by cigarettes smoked per day in the Tobacco and Genetics Consortium. To evaluate the regulatory potential of the shared genetic variants, expression quantitative trait loci analysis in 10 postmortem brain regions was performed using the BRAINEAC dataset in 134 neuropathologically normal individuals. Twenty-two genetic variants on 15q25 were associated with both smoking quantity and schizophrenia at the genome-wide significance level (P < 5.00 × 10-8). Major alleles of all variants were associated with higher smoking quantity and risk of schizophrenia. These genetic variants were associated with PSMA4, CHRNA3, and CHRNB4 expression in specific brain regions (lowest P = 4.81 × 10-4) and with CHRNA5 expression in multiple brain regions (lowest P = 8.70 × 10-6). Risk-associated major alleles of these variants were commonly associated with higher expression in several brain regions, excluding the medulla, at the transcript level. In addition, the risk-associated major allele at rs637137 was associated with higher CHRNA5 expression at the specific exon level in multiple brain regions (lowest P = 2.37 × 10-5). Our findings suggest that genome-wide variants shared between smoking quantity and schizophrenia contribute to a common pathophysiology underlying these traits involving altered CHRNA5 expression in the brain.
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Affiliation(s)
- Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan,Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan; tel: +81-76-286-2211, fax: +81-76-286-3341, e-mail:
| | - Aki Kuwata
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Takamitsu Shimada
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Yuzuru Kataoka
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Toshiki Yasuyama
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Takashi Uehara
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Yasuhiro Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
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23
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Dyrvig M, Mikkelsen JD, Lichota J. DNA methylation regulates CHRNA7 transcription and can be modulated by valproate. Neurosci Lett 2019; 704:145-152. [PMID: 30974230 DOI: 10.1016/j.neulet.2019.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 01/29/2023]
Abstract
The CHRNA7 gene encoding the α7 nicotinic acetylcholine receptor (nAChR) has repeatedly been linked with schizophrenia and the P50 sensory gating deficit. The α7 nAChR is considered a promising drug target for treatment of cognitive dysfunction in schizophrenia and improves memory and executive functions in patients and healthy individuals. However, clinical trials with pro-cognitive drugs are challenged by large inter-individual response variations and these have been linked to genotypic variations reducing CHRNA7 expression and α7 nAChR function. Genetic variants as well as environmental conditions may cause epigenetic dysregulation and it has previously been found that DNA methylation of a region surrounding the transcription start site of CHRNA7 is important for tissue specific regulation and gene silencing. In the present study we identify two additional regions involved in epigenetic regulation of the CHRNA7 promoter. In human temporal cortex we find large variations in expression of CHRNA7 and establish evidence for a significant correlation with DNA methylation levels of one region. We then establish evidence that genotypic variations can influence methylation levels of the CHRNA7 promoter. Epigenetic dysregulation can be reversed by pharmacological intervention and in HeLa cells. Valproate, a commonly used mood stabiliser, caused demethylation and increased CHRNA7 expression in HeLA cells. Similar demethylation effect and increased CHRNA7 expression was obtained in SH-SY5Y cells stimulated concomitantly with valproate and nicotine. In summary, both genetic and epigenetic information could be useful to predict treatment outcomes in patients and epigenetic modulation may serve as a mechanism for potentiating the effects of α7 nAChR agonists.
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Affiliation(s)
- Mads Dyrvig
- Laboratory of Neurobiology, Department of Health Science and Technology, Aalborg University, Denmark
| | - Jens D Mikkelsen
- Neurobiology Research Unit, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Jacek Lichota
- Laboratory of Metabolism Modifying Medicine, Department of Health Science and Technology, Aalborg University, Denmark.
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24
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Nicotine in action: cigarette smoking modulated homotopic functional connectivity in schizophrenia. Brain Imaging Behav 2018; 13:1612-1623. [DOI: 10.1007/s11682-018-0001-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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25
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Duncan LE, Shen H, Ballon JS, Hardy KV, Noordsy DL, Levinson DF. Genetic Correlation Profile of Schizophrenia Mirrors Epidemiological Results and Suggests Link Between Polygenic and Rare Variant (22q11.2) Cases of Schizophrenia. Schizophr Bull 2018; 44:1350-1361. [PMID: 29294133 PMCID: PMC6192473 DOI: 10.1093/schbul/sbx174] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
New methods in genetics research, such as linkage disequilibrium score regression (LDSR), quantify overlap in the common genetic variants that influence diverse phenotypes. It is becoming clear that genetic effects often cut across traditional diagnostic boundaries. Here, we introduce genetic correlation analysis (using LDSR) to a nongeneticist audience and report transdisciplinary discoveries about schizophrenia. This analytical study design used publically available genome wide association study (GWAS) data from approximately 1.5 million individuals. Genetic correlations between schizophrenia and 172 medical, psychiatric, personality, and metabolomic phenotypes were calculated using LDSR, as implemented in LDHub in order to identify known and new genetic correlations. Consistent with previous research, the strongest genetic correlation was with bipolar disorder. Positive genetic correlations were also found between schizophrenia and all other psychiatric phenotypes tested, the personality traits of neuroticism and openness to experience, and cigarette smoking. Novel results were found with medical phenotypes: schizophrenia was negatively genetically correlated with serum citrate, positively correlated with inflammatory bowel disease, and negatively correlated with BMI, hip, and waist circumference. The serum citrate finding provides a potential link between rare cases of schizophrenia (strongly influenced by 22q11.2 deletions) and more typical cases of schizophrenia (with polygenic influences). Overall, these genetic correlation findings match epidemiological findings, suggesting that common variant genetic effects are part of the scaffolding underlying phenotypic comorbidity. The "genetic correlation profile" is a succinct report of shared genetic effects, is easily updated with new information (eg, from future GWAS), and should become part of basic disease knowledge about schizophrenia.
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Affiliation(s)
- Laramie E Duncan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA,To whom correspondence should be addressed; tel: 650-723-3258, fax: 650-723-4655, e-mail:
| | - Hanyang Shen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Jacob S Ballon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Kate V Hardy
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Douglas L Noordsy
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
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26
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Kostrzewa RM, Wydra K, Filip M, Crawford CA, McDougall SA, Brown RW, Borroto-Escuela DO, Fuxe K, Gainetdinov RR. Dopamine D 2 Receptor Supersensitivity as a Spectrum of Neurotoxicity and Status in Psychiatric Disorders. J Pharmacol Exp Ther 2018; 366:519-526. [PMID: 29921706 DOI: 10.1124/jpet.118.247981] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/23/2018] [Indexed: 12/13/2022] Open
Abstract
Abnormality of dopamine D2 receptor (D2R) function, often observed as D2R supersensitivity (D2RSS), is a commonality of schizophrenia and related psychiatric disorders in humans. Moreover, virtually all psychotherapeutic agents for schizophrenia target D2R in brain. Permanent D2RSS as a feature of a new animal model of schizophrenia was first reported in 1991, and then behaviorally and biochemically characterized over the next 15-20 years. In this model of schizophrenia characterized by production of D2RSS in ontogeny, there are demonstrated alterations of signaling processes, as well as functional links between the biologic template of the animal model and ability of pharmacotherapeutics to modulate or reverse biologic and behavioral modalities toward normality. Another such animal model, featuring knockout of trace amine-associated receptor 1 (TAAR1), demonstrates D2RSS with an increase in the proportion of D2R in the high-affinity state. Currently, TAAR1 agonists are being explored as a therapeutic option for schizophrenia. There is likewise an overlay of D2RSS with substance use disorder. The aspect of adenosine A2A-D2 heteroreceptor complexes in substance use disorder is highlighted, and the association of adenosine A2A receptor antagonists in discriminative and rewarding effects of psychostimulants is outlined. In summary, these new animal models of schizophrenia have face, construct, and predictive validity, and distinct advantages over earlier models. While the review summarizes elements of D2RSS in schizophrenia per se, and its interplay with substance use disorder, a major focus is on presumed new molecular targets attending D2RSS in schizophrenia and related clinical entities.
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Affiliation(s)
- Richard M Kostrzewa
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Karolina Wydra
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Malgorzata Filip
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Cynthia A Crawford
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Sanders A McDougall
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Russell W Brown
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Dasiel O Borroto-Escuela
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Kjell Fuxe
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
| | - Raul R Gainetdinov
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee (R.M.K., R.W.B.); Institute of Pharmacology, Polish Academy of Sciences, Department of Drug Addiction Pharmacology, Krakow, Poland (K.W., M.F.); Department of Psychology, California State University, San Bernardino, California (C.A.C., S.A.M.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (D.O.B.-E., K.F.); Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia (R.R.G.); and Skolkovo Institute of Science and Technology, Skolkovo, Moscow, Russia (R.R.G.)
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Zhao S, Xia H, Mu J, Wang L, Zhu L, Wang A, Zhou X. 10-year CVD risk in Han Chinese mainland patients with schizophrenia. Psychiatry Res 2018; 264:322-326. [PMID: 29665562 DOI: 10.1016/j.psychres.2018.04.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 04/02/2018] [Accepted: 04/06/2018] [Indexed: 12/14/2022]
Abstract
People with schizophrenia have a shortened life expectancy, with cardiovascular disease (CVD) being the primary contributor to this excessive mortality. A total of 466 inpatients with schizophrenia and 507 healthy community controls in the Chinese mainland were recruited in this study. Sociodemographic information, medical history, and smoking history were recorded. In addition, total cholesterol (TC), fasting blood glucose (FBG), triglycerides (TG), and high-destiny lipoprotein cholesterol (HDL-C) were analyzed. The 10-year CVD risk was significantly higher in patients with schizophrenia compared with healthy controls. Male schizophrenia patients had significantly higher Framingham risk scores (FRS) than the females. Patients with schizophrenia carried significantly greater risk factors of CVD; body-mass index (BMI), TG and smoking prevalence were significantly higher than in the health community controls, while FBG and HDL-C were on the contrary. Smoking was significantly associated with FRS among schizophrenia inpatients. Collectively, these results suggest that Han Chinese mainland patients with schizophrenia harbor a high 10-year CVD risk when compared with healthy controls, especially in males. CVD in schizophrenia patients requires greater attention by clinicians and researchers.
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Affiliation(s)
- Shuai Zhao
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, PR China; Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Chaohu, Anhui, PR China
| | - HaiLong Xia
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Chaohu, Anhui, PR China
| | - JingJing Mu
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui, PR China
| | - Long Wang
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui, PR China
| | - Li Zhu
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui, PR China
| | - AnZhen Wang
- Department of Psychiatry, Anhui Mental Health Center, Hefei, Anhui, PR China
| | - XiaoQin Zhou
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, PR China; Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Chaohu, Anhui, PR China.
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28
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Al Risi K, Al Maqbali M, Asiri WA, Al Sinawi H. Rate of Tobacco Smoking Among Psychiatric Outpatients Attending a Tertiary Care Hospital in Oman:
A Cross-sectional Study. Oman Med J 2018; 33:224-228. [PMID: 29896330 DOI: 10.5001/omj.2018.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives Tobacco smoking is the single most avoidable cause of morbidity and mortality around the world. Patients with psychiatric disorders tend to smoke tobacco at a higher rate than the general population, with significant adverse health consequences. This study aimed to determine the rate of tobacco smoking among psychiatric outpatients attending Sultan Qaboos University Hospital, a tertiary care hospital in Muscat, Oman. Methods We conducted a cross-sectional study among psychiatric outpatients attending a psychiatric clinic from 1 January to 1 August 2017. The patients' demographic information, history of smoking, previous hospitalizations, and the number of and specific psychotropics used during treatment was documented. The degree of dependence on tobacco smoking was measured using the Fagerstrom test for nicotine dependence. Results A total of 272 patients were included in this study. The overall rate of smoking among psychiatric patients was 13.6%. Patients with schizophrenia had the highest rate of smoking (22.2%), followed by those with bipolar (13.1%), and anxiety disorders (11.1%). Patients who smoked tobacco were more likely to be admitted to the psychiatric ward than non-smokers (p < 0.050). Conclusions Tobacco smoking is common among psychiatric patients, a finding consistent with similar studies conducted in different parts of the world. Assessment of smoking status and its associated adverse health associations among patients with mental disorders is of paramount importance.
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Affiliation(s)
- Khalid Al Risi
- Psychiatry Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | | | - Hamed Al Sinawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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29
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Abstract
The high prevalence of nicotine dependence contributes to excess mortality in schizophrenia. Cue reactivity, or the encounter of drug-related cues or contexts, triggers craving, drug-seeking, and relapse. Prior functional magnetic resonance imaging (fMRI) research indicates that individuals with schizophrenia have blunted neural responses to rewarding stimuli in association with more severe negative symptoms. The objectives of this study are to determine if smokers with schizophrenia have altered neural reactivity to smoking cues compared with non-psychiatrically ill smokers and to evaluate the influence of negative symptoms on cue reactivity. Twenty smokers with schizophrenia and 19 control smokers underwent fMRI while viewing smoking-related and neutral cues. The primary analysis was group comparison of Smoking-Neutral contrast using whole-brain analysis (Pcorrected < .05). Smokers with schizophrenia had significantly greater baseline carbon monoxide levels and longer duration of smoking, suggesting more nicotine use. While both groups had greater brain reactivity to smoking vs neutral cues, smokers with schizophrenia had significantly decreased cue reactivity (Smoking-Neutral) compared to controls in bilateral frontal midline regions. There were significant negative correlations between negative symptoms and frontal midline reactivity. Despite greater nicotine use, smokers with schizophrenia exhibited decreased smoking cue-induced neural reactivity in frontal midline regions, suggesting that increased smoking and low cessation rates in schizophrenia are not primarily driven by responses to smoking-related cues. The finding of negative correlations between cue reactivity and negative symptoms is consistent with previous research demonstrating decreased neural responses to rewarding cues, particularly in patients with negative symptoms.
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Affiliation(s)
- Lauren V Moran
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA,To whom correspondence should be addressed; McLean Hospital, 115 Mill Street, AB3S, Belmont, MA 02478, US; tel: 617-855-3395; fax: 617-855-2895; e-mail:
| | - Jennifer M Betts
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA
| | - Dost Ongur
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA
| | - Amy C Janes
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA
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30
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Boggs DL, Surti TS, Esterlis I, Pittman B, Cosgrove K, Sewell RA, Ranganathan M, D’Souza DC. Minimal effects of prolonged smoking abstinence or resumption on cognitive performance challenge the "self-medication" hypothesis in schizophrenia. Schizophr Res 2018; 194:62-69. [PMID: 28392208 PMCID: PMC5630481 DOI: 10.1016/j.schres.2017.03.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 01/22/2023]
Abstract
One prominent, long-standing view is that individuals with schizophrenia smoke cigarettes more than the general population to "self-medicate" cognitive deficits and other symptoms. This study tested the self-medication hypothesis by examining the effects of smoking abstinence and resumption on cognition in patients with schizophrenia. Nicotine-dependent smokers with schizophrenia (n=26) were trained on a cognitive battery and then hospitalized to achieve and maintain confirmed abstinence from smoking for ~1 week. Cognition was tested while smoking as usual (baseline), one day after smoking cessation (early abstinence), ~1 week later (extended abstinence), and within ~3 weeks of resuming smoking (resumption). The test battery included measures of processing speed, attention, conflict resolution, verbal memory, working memory, verbal fluency, and executive function to evaluate multiple cognitive domains affected by schizophrenia. Positive and negative symptoms of schizophrenia, depressive symptoms, and dyskinesia were also measured at baseline and after prolonged abstinence. There were no significant changes in global cognitive test performance with smoking cessation, abstinence, or resumption. There were small decreases in a measure of processing speed and delayed verbal recall with abstinence, but these findings failed to survive adjustments for multiple comparisons. Surprisingly, in this within subject "On-Off-Off-On" design, there were no significant effects of early or prolonged abstinence from smoking on cognitive and behavioral measures in smokers with schizophrenia. The results of this study challenge the widely held "self-medication" hypothesis of smoking and schizophrenia, question the extent of pro-cognitive effects of smoking and nicotine in schizophrenia, and support encouraging smoking cessation in schizophrenia.
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Affiliation(s)
- Douglas L Boggs
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Toral S. Surti
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519 USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519 USA
| | - Kelly Cosgrove
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519 USA
| | - R. Andrew Sewell
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519 USA
| | - Mohini Ranganathan
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519 USA
| | - Deepak Cyril D’Souza
- Psychiatry Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516 USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, 06519 USA
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31
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Moran LV, Stoeckel LE, Wang K, Caine CE, Villafuerte R, Calderon V, Baker JT, Ongur D, Janes AC, Evins AE, Pizzagalli DA. Nicotine-induced activation of caudate and anterior cingulate cortex in response to errors in schizophrenia. Psychopharmacology (Berl) 2018; 235:789-802. [PMID: 29181816 PMCID: PMC5823729 DOI: 10.1007/s00213-017-4794-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 11/20/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Nicotine improves attention and processing speed in individuals with schizophrenia. Few studies have investigated the effects of nicotine on cognitive control. Prior functional magnetic resonance imaging (fMRI) research demonstrates blunted activation of dorsal anterior cingulate cortex (dACC) and rostral anterior cingulate cortex (rACC) in response to error and decreased post-error slowing in schizophrenia. METHODS Participants with schizophrenia (n = 13) and healthy controls (n = 12) participated in a randomized, placebo-controlled, crossover study of the effects of transdermal nicotine on cognitive control. For each drug condition, participants underwent fMRI while performing the stop signal task where participants attempt to inhibit prepotent responses to "go (motor activation)" signals when an occasional "stop (motor inhibition)" signal appears. Error processing was evaluated by comparing "stop error" trials (failed response inhibition) to "go" trials. Resting-state fMRI data were collected prior to the task. RESULTS Participants with schizophrenia had increased nicotine-induced activation of right caudate in response to errors compared to controls (DRUG × GROUP effect: p corrected < 0.05). Both groups had significant nicotine-induced activation of dACC and rACC in response to errors. Using right caudate activation to errors as a seed for resting-state functional connectivity analysis, relative to controls, participants with schizophrenia had significantly decreased connectivity between the right caudate and dACC/bilateral dorsolateral prefrontal cortices. CONCLUSIONS In sum, we replicated prior findings of decreased post-error slowing in schizophrenia and found that nicotine was associated with more adaptive (i.e., increased) post-error reaction time (RT). This proof-of-concept pilot study suggests a role for nicotinic agents in targeting cognitive control deficits in schizophrenia.
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Affiliation(s)
- Lauren V. Moran
- McLean Hospital, Belmont, MA 02478,Harvard Medical School, Department of Psychiatry, Belmont, MA 02478,Correspondence to: Lauren Moran, MD McLean Hospital, 115 Mill Street, AB3S Belmont MA, 02478
| | - Luke E. Stoeckel
- Harvard Medical School, Department of Psychiatry, Belmont, MA 02478,Massachusetts General Hospital, Department of Psychiatry, Boston, MA 02114
| | | | | | | | - Vanessa Calderon
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA 02114
| | - Justin T. Baker
- McLean Hospital, Belmont, MA 02478,Harvard Medical School, Department of Psychiatry, Belmont, MA 02478
| | - Dost Ongur
- McLean Hospital, Belmont, MA 02478,Harvard Medical School, Department of Psychiatry, Belmont, MA 02478
| | - Amy C. Janes
- McLean Hospital, Belmont, MA 02478,Harvard Medical School, Department of Psychiatry, Belmont, MA 02478
| | - A. Eden Evins
- Harvard Medical School, Department of Psychiatry, Belmont, MA 02478,Massachusetts General Hospital, Department of Psychiatry, Boston, MA 02114
| | - Diego A. Pizzagalli
- McLean Hospital, Belmont, MA 02478,Harvard Medical School, Department of Psychiatry, Belmont, MA 02478
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Wylie KP, Smucny J, Legget KT, Tregellas JR. Targeting Functional Biomarkers in Schizophrenia with Neuroimaging. Curr Pharm Des 2017; 22:2117-23. [PMID: 26818860 DOI: 10.2174/1381612822666160127113912] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/26/2016] [Indexed: 01/09/2023]
Abstract
Many of the most debilitating symptoms for psychiatric disorders such as schizophrenia remain poorly treated. As such, the development of novel treatments is urgently needed. Unfortunately, the costs associated with high failure rates for investigational compounds as they enter clinical trials has led to pharmaceutical companies downsizing or eliminating research programs needed to develop these drugs. One way of increasing the probability of success for investigational compounds is to incorporate alternative methods of identifying biological targets in order to more effectively screen new drugs. A promising method of accomplishing this goal for psychiatric drugs is to use functional magnetic resonance imaging (fMRI). fMRI investigates neural circuits, shedding light on the biology that generates symptoms such as hallucinations. Once identified, relevant neural circuits can be targeted with pharmacologic interventions and the response to these drugs measured with fMRI. This review describes the early use of fMRI in this context, and discusses the alpha7 nicotinic receptor agonist 3-(2,4-dimethoxybenzylidene) anabaseine (DMXB-A), as an example of the potential value of fMRI for psychiatric drug development.
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Affiliation(s)
- Korey P Wylie
- Department of Psychiatry, Anschutz Medical Campus, Bldg. 500, Mail Stop F546, 13001 East 17th Place, Aurora, CO, 80045, USA.
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The current agonists and positive allosteric modulators of α7 nAChR for CNS indications in clinical trials. Acta Pharm Sin B 2017; 7:611-622. [PMID: 29159020 PMCID: PMC5687317 DOI: 10.1016/j.apsb.2017.09.001] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/02/2017] [Accepted: 08/25/2017] [Indexed: 01/06/2023] Open
Abstract
The alpha-7 nicotinic acetylcholine receptor (α7 nAChR), consisting of homomeric α7 subunits, is a ligand-gated Ca2+-permeable ion channel implicated in cognition and neuropsychiatric disorders. Enhancement of α7 nAChR function is considered to be a potential therapeutic strategy aiming at ameliorating cognitive deficits of neuropsychiatric disorders such as Alzheimer's disease (AD) and schizophrenia. Currently, a number of α7 nAChR modulators have been reported and several of them have advanced into clinical trials. In this brief review, we outline recent progress made in understanding the role of the α7 nAChR in multiple neuropsychiatric disorders and the pharmacological effects of α7 nAChR modulators used in clinical trials.
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Key Words
- 5-CSRTT, five-choice serial reaction time task
- 5-HT, serotonin
- ACh, acetylcholine
- AD, Alzheimer's disease
- ADHD, attention deficit hyperactivity disorder
- Acetylcholine
- Alpha7
- Alzheimer's disease
- Aβ, amyloid-β peptide
- CNS, central nervous system
- DMTS, delayed matching-to-sample
- ECD, extracellular domain
- GABA, γ-aminobutyric acid
- Ion channel
- MLA, methyllycaconitine
- NOR, novel object recognition
- PAMs, positive allosteric modulators
- PCP, neonatal phencyclidine
- PD, Parkinson's disease
- PPI, prepulse inhibition
- Positive allosteric modulators
- SAR, structure–activity relationship
- Schizophrenia
- TMD, transmembrane domains
- nAChR
- nAChR, nicotinic acetylcholine receptor
- α-Btx, α-bungarotoxin
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Chuhma N, Mingote S, Kalmbach A, Yetnikoff L, Rayport S. Heterogeneity in Dopamine Neuron Synaptic Actions Across the Striatum and Its Relevance for Schizophrenia. Biol Psychiatry 2017; 81:43-51. [PMID: 27692238 PMCID: PMC5121049 DOI: 10.1016/j.biopsych.2016.07.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 07/03/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023]
Abstract
Brain imaging has revealed alterations in dopamine uptake, release, and receptor levels in patients with schizophrenia that have been resolved on the scale of striatal subregions. However, the underlying synaptic mechanisms are on a finer scale. Dopamine neuron synaptic actions vary across the striatum, involving variations not only in dopamine release but also in dopamine neuron connectivity, cotransmission, modulation, and activity. Optogenetic studies have revealed that dopamine neurons release dopamine in a synaptic signal mode, and that the neurons also release glutamate and gamma-aminobutyric acid as cotransmitters, with striking regional variation. Fast glutamate and gamma-aminobutyric acid cotransmission convey discrete patterns of dopamine neuron activity to striatal neurons. Glutamate may function not only in a signaling role at a subset of dopamine neuron synapses, but also in mediating vesicular synergy, contributing to regional differences in loading of dopamine into synaptic vesicles. Regional differences in dopamine neuron signaling are likely to be differentially involved in the schizophrenia disease process and likely determine the subregional specificity of the action of psychostimulants that exacerbate the disorder, and antipsychotics that ameliorate the disorder. Elucidating dopamine neuron synaptic signaling offers the potential for achieving greater pharmacological specificity through intersectional pharmacological actions targeting subsets of dopamine neuron synapses.
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Affiliation(s)
- Nao Chuhma
- Department of Psychiatry, Columbia University, New York, New York; Department of Molecular Therapeutics, NYS Psychiatric Institute, New York, New York
| | - Susana Mingote
- Department of Psychiatry, Columbia University, New York, New York; Department of Molecular Therapeutics, NYS Psychiatric Institute, New York, New York
| | - Abigail Kalmbach
- Department of Psychiatry, Columbia University, New York, New York; Department of Molecular Therapeutics, NYS Psychiatric Institute, New York, New York
| | - Leora Yetnikoff
- Department of Psychiatry, Columbia University, New York, New York; Department of Molecular Therapeutics, NYS Psychiatric Institute, New York, New York
| | - Stephen Rayport
- Department of Psychiatry, Columbia University, New York, New York; Department of Molecular Therapeutics, NYS Psychiatric Institute, New York, New York.
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Reed AC, Harris JG, Olincy A. Schizophrenia, smoking status, and performance on the matrics Cognitive Consensus Battery. Psychiatry Res 2016; 246:1-8. [PMID: 27639816 DOI: 10.1016/j.psychres.2016.08.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 08/21/2016] [Accepted: 08/27/2016] [Indexed: 10/21/2022]
Abstract
Cognitive deficits and high rates of nicotine dependence are consistently documented in the schizophrenia literature. However, there is currently no consensus about how regular smoking influences cognition in schizophrenia or which cognitive domains are most affected by chronic smoking. Previous studies have also failed to disambiguate the effects of chronic nicotine from those of acute exposure. The current study uses a novel approach to testing nicotine addicted patients at a time-point between acute enhancement and withdrawal and implements the MATRICS Cognitive Consensus Battery (MCCB) to compare the overall cognitive performance of regular smokers (n=40) and nonsmokers (n=36) with schizophrenia. Controlling for age, gender, and education, smokers with schizophrenia were significantly more impaired on a visual learning task, the Brief Visuospatial Memory Test-Revised (BVMT-R), than their nonsmoking peers. Among smokers, smoking behavior (i.e., exhaled carbon monoxide levels of smokers) predicted BVMT-R T score; greater smoking was associated with more impaired visual learning. Negative symptom severity was not predictive of greater visual learning deficits in smokers or nonsmokers. Future longitudinal research will be required to determine if there is a dose-response relationship between chronic nicotine and visual learning impairment in patients at various stages of psychotic illness.
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Affiliation(s)
- Alexandra C Reed
- Center for Schizophrenia Research, Department of Psychiatry, University of Colorado, 13001 East 17th Place, Aurora CO 80045, USA.
| | - Josette G Harris
- Center for Schizophrenia Research, Department of Psychiatry, University of Colorado, 13001 East 17th Place, Aurora CO 80045, USA.
| | - Ann Olincy
- Center for Schizophrenia Research, Department of Psychiatry, University of Colorado, 13001 East 17th Place, Aurora CO 80045, USA; Health Sciences Center, Veterans Affairs Medical Research Service, Denver, CO, USA.
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Jeon DW, Shim JC, Kong BG, Moon JJ, Seo YS, Kim SJ, Oh MK, Jung DU. Adjunctive varenicline treatment for smoking reduction in patients with schizophrenia: A randomized double-blind placebo-controlled trial. Schizophr Res 2016; 176:206-211. [PMID: 27543252 DOI: 10.1016/j.schres.2016.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 07/27/2016] [Accepted: 08/15/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Smoking is more common among patients with schizophrenia than it is in the general population. Varenicline, a partial and full agonist at the α4β2 and α7 nicotine acetylcholine receptors, respectively, has been shown to be an effective anti-smoking treatment. This study examined the effects of varenicline treatment on smoking reduction in patients with schizophrenia. METHODS Sixty smokers with schizophrenia were recruited and randomized to receive either varenicline or placebo. Smoking behavior was assessed with the Minnesota Nicotine Withdrawal Scale (mNWS), Brief Questionnaire of Smoking Urge (QSU-brief), and Modified Cigarette Evaluation Questionnaire (mCEQ). Exhaled carbon monoxide was also measured to assess smoking dependency and status. Data were analyzed with the two-tailed Student's t-test, χ(2) test, and repeated measures ANOVA. RESULTS During the 8-week study, there was a significant time×group interaction, which showed that smoking decreased over time in the varenicline group. Expired CO levels also decreased in the varenicline group, showing a significant time effect, group effect, and time×group interaction. Total mCEQ scores decreased in the varenicline group, demonstrating a significant time×group interaction. Among the five domains of the mCEQ, the smoking satisfaction, psychological reward, and enjoyment of respiratory tract sensation domains showed significant time×group interactions in the varenicline group. The QSU-brief and mNWS demonstrated a significant time effect, but not significant time×group interactions. Adjunctive varenicline treatment with antipsychotics was generally well-tolerated and safe. CONCLUSIONS Varenicline showed significant efficacy in reducing smoking in people with schizophrenia.
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Affiliation(s)
- Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| | - Joo-Cheol Shim
- Shim Joo Cheol Psychiatry Clinic, Busan, Republic of Korea.
| | - Bo-Geum Kong
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| | - Young-Soo Seo
- Department of Psychiatry, Sharing and Happiness Hospital, Busan, Republic of Korea.
| | - Sung-Jin Kim
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| | - Min-Kyung Oh
- Department of Clinical Pharmacology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
| | - Do-Un Jung
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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Parikh V, Kutlu MG, Gould TJ. nAChR dysfunction as a common substrate for schizophrenia and comorbid nicotine addiction: Current trends and perspectives. Schizophr Res 2016; 171:1-15. [PMID: 26803692 PMCID: PMC4762752 DOI: 10.1016/j.schres.2016.01.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/07/2016] [Accepted: 01/10/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The prevalence of tobacco use in the population with schizophrenia is enormously high. Moreover, nicotine dependence is found to be associated with symptom severity and poor outcome in patients with schizophrenia. The neurobiological mechanisms that explain schizophrenia-nicotine dependence comorbidity are not known. This study systematically reviews the evidence highlighting the contribution of nicotinic acetylcholine receptors (nAChRs) to nicotine abuse in schizophrenia. METHODS Electronic data bases (Medline, Google Scholar, and Web of Science) were searched using the selected key words that match the aims set forth for this review. A total of 276 articles were used for the qualitative synthesis of this review. RESULTS Substantial evidence from preclinical and clinical studies indicated that dysregulation of α7 and β2-subunit containing nAChRs account for the cognitive and affective symptoms of schizophrenia and nicotine use may represent a strategy to remediate these symptoms. Additionally, recent meta-analyses proposed that early tobacco use may itself increase the risk of developing schizophrenia. Genetic studies demonstrating that nAChR dysfunction that may act as a shared vulnerability factor for comorbid tobacco dependence and schizophrenia were found to support this view. The development of nAChR modulators was considered an effective therapeutic strategy to ameliorate psychiatric symptoms and to promote smoking cessation in schizophrenia patients. CONCLUSIONS The relationship between schizophrenia and smoking is complex. While the debate for the self-medication versus addiction vulnerability hypothesis continues, it is widely accepted that a dysfunction in the central nAChRs represent a common substrate for various symptoms of schizophrenia and comorbid nicotine dependence.
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Affiliation(s)
- Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19112, United States.
| | - Munir Gunes Kutlu
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19112, United States
| | - Thomas J Gould
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19112, United States
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Smith DM, Fisher D, Blier P, Ilivitsky V, Knott V. The separate and combined effects of monoamine oxidase A inhibition and nicotine on the mismatch negativity event related potential. Pharmacol Biochem Behav 2015; 137:44-52. [PMID: 26226350 DOI: 10.1016/j.pbb.2015.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/29/2015] [Accepted: 07/13/2015] [Indexed: 12/20/2022]
Abstract
The mismatch negativity (MMN) auditory event-related potential (ERP) has been extensively studied as a potential biomarker for abnormal auditory processing in schizophrenia (SZ), a population which exhibits abnormally high smoking rates. The relationship between nicotinic activation and cognition in SZ may be related to underlying nicotinic and NMDA receptor dysfunction within the disease. However, transient cognitive improvements via smoking in patients may also result from monoamine oxidase (MAO) inhibition, achieved through tobacco smoke. In 24 healthy non-smoking males, we investigated the separate and combined effects of nicotine and MAO-A inhibition via moclobemide (75mg) on the optimal-5 variation of the MMN paradigm. No significant drug effects were observed in our total sample, however, stratification of individuals into low (N=12) and high (N=12) baseline MMN amplitude groups revealed increases in duration MMN amplitude relative to placebo by nicotine, as well as moclobemide, but not after the combination of the two. Because previous research has shown there was no effect of monoamine modulation on MMN, this study shows an unexpected effect of moclobemide on duration MMN.
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Affiliation(s)
- Dylan M Smith
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada; Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | | | - Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada; Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
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Fergusson DM, Hall W, Boden JM, Horwood LJ. Rethinking cigarette smoking, cannabis use, and psychosis. Lancet Psychiatry 2015; 2:581-2. [PMID: 26303540 DOI: 10.1016/s2215-0366(15)00208-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Affiliation(s)
- David M Fergusson
- Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand.
| | - Wayne Hall
- The University of Queensland Centre for Youth Substance Abuse Research, Herston, Australia; The National Addiction Centre, Kings College London
| | - Joseph M Boden
- Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
| | - L John Horwood
- Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
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Shaqiri A, Willemin J, Sierro G, Roinishvili M, Iannantuoni L, Rürup L, Chkonia E, Herzog MH, Mohr C. Does chronic nicotine consumption influence visual backward masking in schizophrenia and schizotypy? SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:93-99. [PMID: 29114459 PMCID: PMC5609643 DOI: 10.1016/j.scog.2015.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 01/25/2023]
Abstract
Nicotine consumption is higher for people within the schizophrenia spectrum compared to controls. This observation supports the self-medication hypothesis, that nicotine relieves symptoms in, for example, schizophrenia patients. We tested whether performance in an endophenotype of schizophrenia (visual backward masking, VBM) is modulated by nicotine consumption in i) smoking and non-smoking schizophrenia patients, their first-degree relatives, and age-matched controls, ii) non-smoking and smoking university students, and iii) non-smoking, early and late onset nicotine smokers. Overall, our results confirmed that VBM deficits are an endophenotype of schizophrenia, i.e., deficits were highest in patients, followed by their relatives, students scoring high in Cognitive Disorganisation, and controls. Moreover, we found i) beneficial effects of chronic nicotine consumption on VBM performance, in particular with increasing age, and ii) little impact of clinical status alone or in interaction with nicotine consumption on VBM performance. Given the younger age of undergraduate students (up to 30 years) versus controls and patients (up to 66 years), we propose that age-dependent VBM deficits emerge when schizotypy effects are targeted in populations of a larger age range, but that nicotine consumption might counteract these deficits (supporting the self-medication hypothesis).
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Affiliation(s)
- Albulena Shaqiri
- Laboratory of Psychophysics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
- Corresponding author at: Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Station 19, CH-1015, Lausanne, Switzerland. Tel: + 41 21 693 2772; fax: + 41 21 69 31749.
| | - Julie Willemin
- Institute of Psychology, Faculty of Social and Political Sciences, Bâtiment Geopolis, Quartier Mouline, 1015 Lausanne, Switzerland
| | - Guillaume Sierro
- Institute of Psychology, Faculty of Social and Political Sciences, Bâtiment Geopolis, Quartier Mouline, 1015 Lausanne, Switzerland
| | - Maya Roinishvili
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
| | - Luisa Iannantuoni
- Institute of Psychology, Faculty of Social and Political Sciences, Bâtiment Geopolis, Quartier Mouline, 1015 Lausanne, Switzerland
| | - Linda Rürup
- Institute for Psychology and Cognition Research, University Bremen, Bremen, Germany
| | - Eka Chkonia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Michael H. Herzog
- Laboratory of Psychophysics, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Christine Mohr
- Institute of Psychology, Faculty of Social and Political Sciences, Bâtiment Geopolis, Quartier Mouline, 1015 Lausanne, Switzerland
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Berg SA, Sentir AM, Bell RL, Engleman EA, Chambers RA. Nicotine effects in adolescence and adulthood on cognition and α₄β₂-nicotinic receptors in the neonatal ventral hippocampal lesion rat model of schizophrenia. Psychopharmacology (Berl) 2015; 232:1681-92. [PMID: 25388292 PMCID: PMC4412763 DOI: 10.1007/s00213-014-3800-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 10/31/2014] [Indexed: 11/26/2022]
Abstract
RATIONAL Nicotine use in schizophrenia has traditionally been explained as "self-medication" of cognitive and/or nicotinic acetylcholinergic receptor (nAChR) abnormalities. OBJECTIVES We test this hypothesis in a neurodevelopmental rat model of schizophrenia that shows increased addiction behaviors including enhanced nicotine reinforcement and drug-seeking. METHODS Nicotine transdermal patch (5 mg/kg/day vs. placebo × 10 days in adolescence or adulthood) effects on subsequent radial-arm maze learning (15 sessions) and frontal-cortical-striatal nAChR densities (α4β2; [3H]-epibatidine binding) were examined in neonatal ventral hippocampal lesion (NVHL) and SHAM-operated rats. RESULTS NVHL cognitive deficits were not differentially affected by nicotine history compared to SHAMs. Nicotine history produced minimal cognitive effects while increasing food-reward consumption on the maze, compounding with NVHL-induced overconsumption. Acute nicotine (0.5 mg/kg) delivered before the final maze sessions produced modest improvements in maze performance in rats with nicotine patch histories only, but not differentially so in NVHLs. Consistent with in vivo neuroimaging of β2 nAChR binding in schizophrenia smokers vs. non-smokers and healthy controls, adult NVHLs showed 12% reductions in nAChR binding in MPFC (p < 0.05) but not ventral striatum (<5% changes, p > .40), whereas nicotine history elevated nAChRs across both regions (>30%, p < 0.001) without interacting with NVHLs. Adolescent vs. adult nicotine exposure did not alter nAChRs differentially. CONCLUSIONS Although replicating nicotine-induced upregulation of nAChRs in human smokers and demonstrating NVHL validity in terms of schizophrenia-associated nAChR density patterns, these findings do not support hypotheses explaining increased nicotine use in schizophrenia as reflecting illness-specific effects of nicotine to therapeutically alter cognition or nAChR densities.
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Affiliation(s)
- Sarah A Berg
- Laboratory for Translational Neuroscience of Dual Diagnosis & Development, Suite 314D, 320 West 16th Street, Indianapolis, IN, 46202, USA,
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Zhang XY, Chen DC, Tan YL, Tan SP, Luo X, Zuo L, Rao W, Yu Q, Kou C, Allen M, Correll CU, Wu J, Soares JC. A functional polymorphism in the interleukin-1beta and severity of nicotine dependence in male schizophrenia: a case-control study. J Psychiatr Res 2015; 64:51-8. [PMID: 25858413 DOI: 10.1016/j.jpsychires.2015.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 02/01/2023]
Abstract
Previous studies have shown that the functional 511C/T polymorphism in the IL-1beta-gene may be implicated in the susceptibility for schizophrenia. Moreover, recent studies suggested that IL-1 participates in the progression of lung disease in smokers, which are overrepresented in schizophrenia. We aimed to investigate the possible relationship between the IL-1beta-511C/T polymorphism and smoking behavior in schizophrenia versus healthy controls in a Chinese population. The IL-1beta-511C/T polymorphism was genotyped in 638 male patients with chronic schizophrenia (smoker/never-smoker = 486/152) and 469 male controls (smoker/never-smoker = 243/226). The cigarettes smoked per day, the Heaviness of Smoking Index (HSI) and the Fagerstrom Test for nicotine dependence (FTND) were assessed. Patients were also rated on the Positive and Negative Syndrome Scale (PANSS). The results showed no significant differences in genotype and allele distribution between patients and controls, and between smokers and never-smokers in either the patient or control group. However, in patients, smokers with the C/C genotype had significantly higher HSI (p < 0.005) and FTND (p < 0.05) scores than smokers with the T/T genotype, without significant differences in controls. Furthermore, there was a linear positive correlation between the number of C alleles and the HSI (p < 0.005) in patients. Our findings suggest that the IL-1beta-511C/T polymorphism may not be related to schizophrenia or smoking status in Chinese individuals, but may affect the severity of nicotine dependence among male smokers with schizophrenia.
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Affiliation(s)
- Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Da-Chun Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun-Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu-ping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lingjun Zuo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Wenwang Rao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Qiong Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Melissa Allen
- Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Jingqin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Wang X, Peng Z, Ziedonis DM, Wang C, Yu B, Li T. Evaluation of tobacco use on Chinese population through ATTOC model: a cross-sectional survey on hospitalized psychiatric patients. Int J Clin Exp Med 2015; 8:6008-6015. [PMID: 26131197 PMCID: PMC4483824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 03/31/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the feasibility of Addressing Tobaccos through Organizational Change (ATTOC) intervention to Chinese psychiatric patients, and to better address tobacco use through the ATTOC intervention model in the context of China. METHODS The study was conducted in Mental Health Center of West China Hospital in 2010. A total of 100 hospitalized psychiatric patients were recruited to carry out ATTOC intervention. Subjects suffers from mental illness were diagnosed by professional psychiatrists according to the International Statistical Classification of Diseases (ICD-10) criteria. RESULTS The prevalence of tobacco use in hospitalized psychiatric patients were closely correlated with the type of mental illness, family smoking history, sex, age, marital status, education status, etc. However, most psychiatric patients knew little about these, and tended to ignore the importance of smoking cessation. CONCLUSIONS The ATTOC intervention program of the U.S. may be suitable for hospitalized Chinese psychiatric patients, and it could be applied for the tobacco smoking treatment in China. However, the health effects of tobacco use still did not draw amount attentions from both the clinicians and general public. It is urgently needed to raise people's awareness and carry out ATTOC intervention to control tobacco use, and ultimately terminate tobacco use.
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Affiliation(s)
- Xue Wang
- Mental Health Center, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan Province, China
| | - Zugui Peng
- Mental Health Center, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan Province, China
| | - Douglas M Ziedonis
- Department of Psychiatry, University of Massachusetts Medical SchoolWorcester, Massachusetts, USA
| | - Chaomin Wang
- Mental Health Center, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan Province, China
| | - Bo Yu
- Mental Health Center, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan Province, China
| | - Tao Li
- Mental Health Center, West China Hospital of Sichuan UniversityChengdu 610041, Sichuan Province, China
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Ameller A, Gorwood P. Poids de la comorbidité addictive dans le risque d’observance partielle au traitement médicamenteux et de rechute dans la schizophrénie. Encephale 2015; 41:174-83. [DOI: 10.1016/j.encep.2015.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/03/2015] [Indexed: 11/26/2022]
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Neurocognitive effects of acute choline supplementation in low, medium and high performer healthy volunteers. Pharmacol Biochem Behav 2015; 131:119-29. [PMID: 25681529 DOI: 10.1016/j.pbb.2015.02.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/20/2015] [Accepted: 02/04/2015] [Indexed: 12/28/2022]
Abstract
Novel pharmacological treatments targeting alpha 7 nicotinic acetylcholine receptor (α7 nAChR) hypofunction in schizophrenia have shown mixed success in ameliorating cognitive impairments associated with this disorder. Choline, a selective agonist at α7 receptors is increased with oral administration of cytidine 5'-diphosphocholine (CDP-choline), the cognitive effects of which were assessed in healthy volunteers. Using the CogState test battery, behavioral performance in schizophrenia-relevant cognitive domains was assessed in 24 male participants following a single low (500mg) and moderate (1000mg) dose of CDP-choline. Relative to placebo, CDP-choline improved processing speed, working memory, verbal learning, verbal memory, and executive function in low baseline performers, while exerting no effects in medium baseline performers, and diminishing cognition in high baseline performers. Dose effects varied with cognitive domain but were evident with both the 500mg and 1000mg doses. These preliminary findings of cognitive enhancement in relatively impaired performers are consistent with the α7 receptor mechanism and support further trials with CDP-choline as a potential pro-cognitive strategy for cognitive impairment in schizophrenia.
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Dineley KT, Pandya AA, Yakel JL. Nicotinic ACh receptors as therapeutic targets in CNS disorders. Trends Pharmacol Sci 2015; 36:96-108. [PMID: 25639674 PMCID: PMC4324614 DOI: 10.1016/j.tips.2014.12.002] [Citation(s) in RCA: 334] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 01/30/2023]
Abstract
The neurotransmitter acetylcholine (ACh) can regulate neuronal excitability by acting on the cys-loop cation-conducting ligand-gated nicotinic ACh receptor (nAChR) channels. These receptors are widely distributed throughout the central nervous system (CNS), being expressed on neurons and non-neuronal cells, where they participate in a variety of physiological responses such as anxiety, the central processing of pain, food intake, nicotine seeking behavior, and cognitive functions. In the mammalian brain, nine different subunits have been found thus far, which assemble into pentameric complexes with much subunit diversity; however, the α7 and α4β2 subtypes predominate in the CNS. Neuronal nAChR dysfunction is involved in the pathophysiology of many neurological disorders. Here we will briefly discuss the functional makeup and expression of the nAChRs in mammalian brain, and their role as targets in neurodegenerative diseases (in particular Alzheimer's disease, AD), neurodevelopmental disorders (in particular autism and schizophrenia), and neuropathic pain.
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Affiliation(s)
- Kelly T Dineley
- Department of Neurology, Mitchell Center for Neurodegenerative Diseases, University of Texas Medical Branch at Galveston (UTMB), Galveston, TX, USA
| | - Anshul A Pandya
- Chukchi Campus, Department of Bioscience, College of Rural and Community Development, University of Alaska Fairbanks, P.O. Box 297, Kotzebue, AK 99752-0297, USA
| | - Jerrel L Yakel
- Laboratory of Neurobiology, National Institute of Environmental Health Sciences, National Institutes of Health (NIEHS/NIH), Department of Health and Human Services (DHHS), F2-08, P.O. Box 12233, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
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Ahring PK, Olsen JA, Nielsen EØ, Peters D, Pedersen MHF, Rohde LA, Kastrup JS, Shahsavar A, Indurthi DC, Chebib M, Gajhede M, Balle T. Engineered α4β2 nicotinic acetylcholine receptors as models for measuring agonist binding and effect at the orthosteric low-affinity α4-α4 interface. Neuropharmacology 2015; 92:135-45. [PMID: 25595102 DOI: 10.1016/j.neuropharm.2014.12.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/19/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
The nicotinic acetylcholine receptor α4β2 is important for normal mammalian brain function and is known to express in two different stoichiometries, (α4)2(β2)3 and (α4)3(β2)2. While these are similar in many aspects, the (α4)3(β2)2 stoichiometry differs by harboring a third orthosteric acetylcholine binding site located at the α4-α4 interface. Interestingly, the third binding site has, so far, only been documented using electrophysiological assays, actual binding affinities of nicotinic receptor ligands to this site are not known. The present study was therefore aimed at determining binding affinities of nicotinic ligands to the α4-α4 interface. Given that epibatidine shows large functional potency differences at α4-β2 vs. α4-α4 interfaces, biphasic binding properties would be expected at (α4)3(β2)2 receptors. However, standard saturation binding experiments with [(3)H]epibatidine did not reveal biphasic binding under the conditions utilized. Therefore, an engineered β2 construct (β2(HQT)), which converts the β(-) face to resemble that of an α4(-) face, was utilized to create (α4)3(β2(HQT))2 receptors harboring three α4-α4 interfaces. With this receptor, low affinity binding of epibatidine with a Kd of ∼5 nM was observed in sharp contrast to a Kd value of ∼10 pM observed for wild-type receptors. A strong correlation between binding affinities at the (α4)3(β2(HQT))2 receptor and functional potencies at the wild-type receptor of a range of nicotinic ligands highlighted the validity of using the mutational approach. Finally, large differences in activities at α4-β2 vs. α4-α4 interfaces were observed for structurally related agonists underscoring the need for establishing all binding parameters of compounds at α4β2 receptors.
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Affiliation(s)
- Philip K Ahring
- Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia; Saniona AB, 2750 Ballerup, Denmark
| | - Jeppe A Olsen
- Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia; NeuroSearch A/S, 2750 Ballerup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | | | | | - Martin H F Pedersen
- Hevesy Laboratory, Technical University of Denmark, DTU Nutech, 4000 Roskilde, Denmark
| | - Line A Rohde
- NeuroSearch A/S, 2750 Ballerup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Jette S Kastrup
- Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Azadeh Shahsavar
- Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | | | - Mary Chebib
- Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia
| | - Michael Gajhede
- Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Thomas Balle
- Faculty of Pharmacy, The University of Sydney, NSW 2006, Australia.
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Hashimoto K. Targeting of α7 Nicotinic Acetylcholine Receptors in the Treatment of Schizophrenia and the Use of Auditory Sensory Gating as a Translational Biomarker. Curr Pharm Des 2015; 21:3797-806. [PMID: 26044974 PMCID: PMC5024727 DOI: 10.2174/1381612821666150605111345] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 06/04/2015] [Indexed: 11/22/2022]
Abstract
Accumulating evidence suggests that the α7 subtype of nicotinic acetylcholine receptors (nAChRs) plays a key role in inflammatory processes, thought to be involved in the pathophysiology of neuropsychiatric diseases, such as schizophrenia and Alzheimer's disease. Preclinical and clinical studies showed that the diminished suppression of P50 auditory evoked potentials in patients with schizophrenia may be associated with a decreased density of α7 nAChRs in the brain. This points to a role for auditory sensory gating (P50) as a translational biomarker. A number of agonists and positive allosteric modulators (PAMs) for α7 nAChR promoted beneficial effects in animal models with sensory gating and cognitive deficits. Additionally, several clinical studies showed that α7 nAChR agonists could improve suppression in auditory P50 evoked potentials, as well as cognitive deficits, and negative symptoms in patients with schizophrenia. Taken together, α7 nAChR presents as an extremely attractive therapeutic target for schizophrenia. In this article, the author discusses recent findings on α7 nAChR agonists such as DMXB-A, RG3487, TC-5619, tropisetron, EVP-6124 (encenicline), ABT-126, AQW051 and α7 nAChR PAMs such as JNJ-39393406, PNU- 120596 and AVL-3288 (also known as UCI-4083), and their potential as therapeutic drugs for neuropsychiatric diseases, such as schizophrenia.
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Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic, Mental Health, 1-8-1 Inohana, Chiba 260-8670, Japan.
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The effects of varenicline on sensory gating and exploratory behavior with pretreatment with nicotinic or 5-HT3A receptor antagonists. Behav Pharmacol 2014; 26:217-26. [PMID: 25485645 DOI: 10.1097/fbp.0000000000000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Individuals with schizophrenia smoke at high frequency relative to the general population. Despite the harmful effects of cigarette smoking, smoking among schizophrenic patients improves cognitive impairments not addressed or worsened by common neuroleptics. Varenicline, a nonselective neuronal nicotinic receptor (NNR) agonist and full agonist of 5-HT3A receptors, helps reduce smoking among schizophrenic patients. To determine whether varenicline also improves a cognitive symptom of schizophrenia, namely, impaired sensory gating, a transgenic mouse with schizophrenia, th-fgfr1(tk-), was used. Varenicline dose-dependently increased prepulse inhibition (PPI) of the startle response, a measure of sensory gating, in th-fgfr1(tk-) mice and normalized PPI deficits relative to nontransgenic controls. With the highest dose (10 mg/kg), however, there was a robust elevation of PPI and startle response, as well as reduced exploratory behavior in the open field and elevated plus maze. Pretreatment with the nonspecific NNR antagonist mecamylamine attenuated the exaggerated PPI response and, similar to the 5-HT3A receptor antagonist ondansetron, it prevented the reduction in exploratory behavior. Collectively, these results indicate that varenicline at low-to-moderate doses may be beneficial against impaired sensory gating in schizophrenia; however, higher doses may induce anxiogenic effects, which can be prevented with antagonists of NNRs or 5-HT3A receptors.
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50
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Kunchulia M, Pilz KS, Herzog MH. Small effects of smoking on visual spatiotemporal processing. Sci Rep 2014; 4:7316. [PMID: 25471068 PMCID: PMC4255184 DOI: 10.1038/srep07316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 11/17/2014] [Indexed: 11/25/2022] Open
Abstract
Nicotine is an important stimulant that is involved in modulating many neuronal processes, including those related to vision. Nicotine is also thought to play a key role in schizophrenia: A genetic variation of the cholinergic nicotine receptor gene, alpha-7 subunit (CHRNA7) has been shown to be associated with stronger backward masking deficits in schizophrenic patients. In this study, we tested visual backward masking in healthy smokers and non-smokers to further understand the effects of nicotine on spatiotemporal vision. In the first study, we tested 48 participants, a group of non-smokers (n = 12) and three groups of regular smokers that were either nicotine deprived (n = 12), non-deprived (n = 12) or deprived but were allowed to smoke a cigarette directly before the start of the experiment (n = 12). Performance was similar across groups, except for some small negative effects in nicotine-deprived participants. In the second study, we compared backward masking performance between regular smokers and non-smokers for older (n = 37, 13 smokers) and younger (n = 67, 21 smokers) adults. Older adults performed generally worse than younger adults but there were no significant differences in performance between smokers and non-smokers. Taken together, these findings indicate that nicotine has no long-term negative effects on visual spatiotemporal processing as determined by visual backward masking.
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Affiliation(s)
- Marina Kunchulia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
| | - Karin S. Pilz
- School of Psychology, University of Aberdeen, Scotland, UK
| | - Michael H. Herzog
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, Ecole Polytechnique Federale de Lausanne (EPFL), Switzerland
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