There is a close
association between schizophrenia and increased rates of tobacco smoking. The
relationship between them stems, in part, from an effort by patients to use
nicotine to self-medicate symptoms and cognitive impairment associated with the
disease, shows a new study.
Researchers at Yale
University's school of medicine found that the level of nicotine receptors in
the brain was lower in schizophrenia patients than in a matched healthy group.
Further, smoking, which is known to increase the levels of receptors for
nicotine in the brain, had this effect in both groups, although it was blunted
in schizophrenia.
However, in the
schizophrenia group, the smoking-related increase in the level of nicotine
receptors was associated with lower levels of social withdrawal, blunted
emotional and motivational responses, as well as better cognitive function,
found the study.
Nicotine mimics the
actions of a natural chemical messenger, acetylcholine, which stimulates the
receptors for nicotine in the brain.
"We found that
lower nicotinic-acetylcholine receptor availability in smokers with
schizophrenia is associated with worse negative symptoms and worse performance
on tests of executive function," explained Irina Esterlis, an assistant
professor at Yale University.
These findings may be
relevant to the high rates of smoking in schizophrenia.
"The data seem
to suggest that smoking might produce some clinical benefits for some patients
by increasing the availability of receptor targets for nicotine in the
brain," noted John Krystal, editor of the journal Biological Psychiatry
that published the study.
"These findings
suggest that nicotinic-acetylcholine receptors may be a target for developing
treatments for negative symptoms and cognitive deficits associated with
schizophrenia, for which no effective treatments exist," Krystal
concluded.
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