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Kunnath AJ, Gifford RH, Wallace MT. Cholinergic modulation of sensory perception and plasticity. Neurosci Biobehav Rev 2023; 152:105323. [PMID: 37467908 PMCID: PMC10424559 DOI: 10.1016/j.neubiorev.2023.105323] [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: 04/03/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
Sensory systems are highly plastic, but the mechanisms of sensory plasticity remain unclear. People with vision or hearing loss demonstrate significant neural network reorganization that promotes adaptive changes in other sensory modalities as well as in their ability to combine information across the different senses (i.e., multisensory integration. Furthermore, sensory network remodeling is necessary for sensory restoration after a period of sensory deprivation. Acetylcholine is a powerful regulator of sensory plasticity, and studies suggest that cholinergic medications may improve visual and auditory abilities by facilitating sensory network plasticity. There are currently no approved therapeutics for sensory loss that target neuroplasticity. This review explores the systems-level effects of cholinergic signaling on human visual and auditory perception, with a focus on functional performance, sensory disorders, and neural activity. Understanding the role of acetylcholine in sensory plasticity will be essential for developing targeted treatments for sensory restoration.
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Affiliation(s)
- Ansley J Kunnath
- Neuroscience Graduate Program, Vanderbilt University, Nashville, TN, USA; Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - René H Gifford
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Mark T Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Psychology, Vanderbilt University, Nashville, TN, USA; Department of Pharmacology, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, TN, USA.
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2
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Todd J, Salisbury D, Michie PT. Why mismatch negativity continues to hold potential in probing altered brain function in schizophrenia. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e144. [PMID: 38867817 PMCID: PMC11114358 DOI: 10.1002/pcn5.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 06/14/2024]
Abstract
The brain potential known as mismatch negativity (MMN) is one of the most studied indices of altered brain function in schizophrenia. This review looks at what has been learned about MMN in schizophrenia over the last three decades and why the level of interest and activity in this field of research remains strong. A diligent consideration of available evidence suggests that MMN can serve as a biomarker in schizophrenia, but perhaps not the kind of biomarker that early research supposed. This review concludes that MMN measurement is likely to be most useful as a monitoring and response biomarker enabling tracking of an underlying pathology and efficacy of interventions, respectively. The role of, and challenges presented by, pre-clinical models is discussed as well as the merits of different methodologies that can be brought to bear in pursuing a deeper understanding of pathophysiology that might explain smaller MMN in schizophrenia.
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Affiliation(s)
- Juanita Todd
- School of Psychological SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Dean Salisbury
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Patricia T. Michie
- School of Psychological SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
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3
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Dondé C, Kantrowitz JT, Medalia A, Saperstein AM, Balla A, Sehatpour P, Martinez A, O'Connell MN, Javitt DC. Early auditory processing dysfunction in schizophrenia: Mechanisms and implications. Neurosci Biobehav Rev 2023; 148:105098. [PMID: 36796472 PMCID: PMC10106448 DOI: 10.1016/j.neubiorev.2023.105098] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Schizophrenia is a major mental disorder that affects approximately 1% of the population worldwide. Cognitive deficits are a key feature of the disorder and a primary cause of long-term disability. Over the past decades, significant literature has accumulated demonstrating impairments in early auditory perceptual processes in schizophrenia. In this review, we first describe early auditory dysfunction in schizophrenia from both a behavioral and neurophysiological perspective and examine their interrelationship with both higher order cognitive constructs and social cognitive processes. Then, we provide insights into underlying pathological processes, especially in relationship to glutamatergic and N-methyl-D-aspartate receptor (NMDAR) dysfunction models. Finally, we discuss the utility of early auditory measures as both treatment targets for precision intervention and as translational biomarkers for etiological investigation. Altogether, this review points out the crucial role of early auditory deficits in the pathophysiology of schizophrenia, in addition to major implications for early intervention and auditory-targeted approaches.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, F-38000 Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, F-38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France.
| | - Joshua T Kantrowitz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States; Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Alice Medalia
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Alice M Saperstein
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Andrea Balla
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Pejman Sehatpour
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Antigona Martinez
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Monica N O'Connell
- Translational Neuroscience Division, Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Daniel C Javitt
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Labelle A, Knott V. An α7 nAChR approach for the baseline-dependent modulation of deviance detection in schizophrenia: A pilot study assessing the combined effect of CDP-choline and galantamine. J Psychopharmacol 2023; 37:381-395. [PMID: 36927273 PMCID: PMC10101183 DOI: 10.1177/02698811231158903] [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] [Indexed: 03/18/2023]
Abstract
BACKGROUND Cognitive operations including pre-attentive sensory processing are markedly impaired in patients with schizophrenia (SCZ) but evidence significant interindividual heterogeneity, which moderates treatment response with nicotinic acetylcholine receptor (nAChR) agonists. Previous studies in healthy volunteers have shown baseline-dependency effects of the α7 nAChR agonist cytidine 5'-diphosphocholine (CDP-choline) administered alone and in combination with a nicotinic allosteric modulator (galantamine) on auditory deviance detection measured with the mismatch negativity (MMN) event-related potential (ERP). AIM The objective of this pilot study was to assess the acute effect of this combined α7 nAChR-targeted treatment (CDP-choline/galantamine) on speech MMN in patients with SCZ (N = 24) stratified by baseline MMN responses into low, medium, and high baseline auditory deviance detection subgroups. METHODS Patients with a stable diagnosis of SCZ attended two randomized, double-blind, placebo-controlled and counter-balanced testing sessions where they received a placebo or a CDP-choline (500 mg) and galantamine (16 mg) treatment. MMN ERPs were recorded during the presentation of a fast multi-feature speech MMN paradigm including five speech deviants. Clinical measures were acquired before and after treatment administration. RESULTS While no main treatment effect was observed, CDP-choline/galantamine significantly increased MMN amplitudes to frequency, duration, and vowel speech deviants in low group individuals. Individuals with higher positive and negative symptom scale negative, general, and total scores expressed the greatest MMN amplitude improvement following CDP-choline/galantamine. CONCLUSIONS These baseline-dependent nicotinic effects on early auditory information processing warrant different dosage and repeated administration assessments in patients with low baseline deviance detection levels.
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Affiliation(s)
- Joëlle Choueiry
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Crystal M Blais
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | - Alain Labelle
- The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.,Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada.,School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada.,The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
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5
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Weber LA, Tomiello S, Schöbi D, Wellstein KV, Mueller D, Iglesias S, Stephan KE. Auditory mismatch responses are differentially sensitive to changes in muscarinic acetylcholine versus dopamine receptor function. eLife 2022; 11:74835. [PMID: 35502897 PMCID: PMC9098218 DOI: 10.7554/elife.74835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
The auditory mismatch negativity (MMN) has been proposed as a biomarker of NMDA receptor (NMDAR) dysfunction in schizophrenia. Such dysfunction may be caused by aberrant interactions of different neuromodulators with NMDARs, which could explain clinical heterogeneity among patients. In two studies (N = 81 each), we used a double-blind placebo-controlled between-subject design to systematically test whether auditory mismatch responses under varying levels of environmental stability are sensitive to diminishing and enhancing cholinergic vs. dopaminergic function. We found a significant drug × mismatch interaction: while the muscarinic acetylcholine receptor antagonist biperiden delayed and topographically shifted mismatch responses, particularly during high stability, this effect could not be detected for amisulpride, a dopamine D2/D3 receptor antagonist. Neither galantamine nor levodopa, which elevate acetylcholine and dopamine levels, respectively, exerted significant effects on MMN. This differential MMN sensitivity to muscarinic versus dopaminergic receptor function may prove useful for developing tests that predict individual treatment responses in schizophrenia.
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Affiliation(s)
- Lilian Aline Weber
- Translational Neuroimaging Unit (TNU), Institute for Biomedical EngineeringInstitute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Sara Tomiello
- Translational Neuroimaging Unit (TNU), Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Dario Schöbi
- Translational Neuroimaging Unit (TNU), Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Katharina V Wellstein
- Translational Neuroimaging Unit (TNU), Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Daniel Mueller
- Institute for Clinical Chemistry, University Hospital of Zurich, Zurich, Switzerland
| | - Sandra Iglesias
- Translational Neuroimaging Unit (TNU), Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Klaas Enno Stephan
- Translational Neuroimaging Unit (TNU), Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Illivitsky V, Knott V. CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study. Psychopharmacology (Berl) 2020; 237:3665-3687. [PMID: 32851421 DOI: 10.1007/s00213-020-05646-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE The combination of CDP-choline, an α7 nicotinic acetylcholine receptor (α7 nAChR) agonist, with galantamine, a positive allosteric modulator of nAChRs, is believed to counter the fast desensitization rate of the α7 nAChRs and may be of interest for schizophrenia (SCZ) patients. Beyond the positive and negative clinical symptoms, deficits in early auditory prediction-error processes are also observed in SCZ. Regularity violations activate these mechanisms that are indexed by electroencephalography-derived mismatch negativity (MMN) event-related potentials (ERPs) in response to auditory deviance. OBJECTIVES/METHODS This pilot study in thirty-three healthy humans assessed the effects of an optimized α7 nAChR strategy combining CDP-choline (500 mg) with galantamine (16 mg) on speech-elicited MMN amplitude and latency measures. The randomized, double-blinded, placebo-controlled, and counterbalanced design with a baseline stratification method allowed for assessment of individual response differences. RESULTS Increases in MMN generation mediated by the acute CDP-choline/galantamine treatment in individuals with low baseline MMN amplitude for frequency, intensity, duration, and vowel deviants were revealed. CONCLUSIONS These results, observed primarily at temporal recording sites overlying the auditory cortex, implicate α7 nAChRs in the enhancement of speech deviance detection and warrant further examination with respect to dysfunctional auditory deviance processing in individuals with SCZ.
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Affiliation(s)
- Joelle Choueiry
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada.
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Crystal M Blais
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | - Vadim Illivitsky
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
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7
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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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8
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Fisher DJ, Rudolph ED, Ells EML, Knott VJ, Labelle A, Tibbo PG. Mismatch negativity-indexed auditory change detection of speech sounds in early and chronic schizophrenia. Psychiatry Res Neuroimaging 2019; 287:1-9. [PMID: 30933744 DOI: 10.1016/j.pscychresns.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 03/11/2019] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Abstract
Auditory change detection, as indexed by the EEG-derived mismatch negativity, has been demonstrated to be dysfunctional in chronic schizophrenia using both pure-tone and speech (phoneme) sounds. It is unclear, however, whether reduced MMN amplitudes to speech sound deviants are observed within the first 5 years of the illness. The present study investigated MMNs elicited by across-vowel (phoneme) change in early schizophrenia (ESZ; Experiment 1) as well as chronic schizophrenia (CSZ; Experiment 2). In both experiments, clinical and control participants were presented the Finnish phoneme /e/ (standard; P = .90) and the Finnish phoneme /ö/ (deviant; P = .10) within an oddball paradigm. In experiment 2 we report significantly reduced MMN amplitudes in CSZ relative to HCs, but no differences were found when comparing ESZ and HC in experiment 1. Additionally, in our clinical samples, MMN amplitudes were correlated with symptom scores. These findings suggest that early detection of phonetic change may be impaired in chronic schizophrenia, but not early in the progression of the illness. As MMN reductions only emerged in patients with a longer course of illness, and appeared to change with symptom severity, this suggests a dynamic change in the early auditory processing of language over time in schizophrenia.
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Affiliation(s)
- Derek J Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychology, Saint Mary's University, Halifax, Nova Scotia, Canada.
| | - Erica D Rudolph
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; Department of Psychology, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - Emma M L Ells
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Verner J Knott
- The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Alain Labelle
- The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Early Psychosis Program, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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9
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Huang J, Zhuo C, Xu Y, Lin X. Auditory verbal hallucination and the auditory network: From molecules to connectivity. Neuroscience 2019; 410:59-67. [PMID: 31082536 DOI: 10.1016/j.neuroscience.2019.04.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 12/20/2022]
Abstract
Auditory verbal hallucinations (AVHs) frequently occur across multiple psychiatric diseases especially in schizophrenia (SCZ) patients. Functional imaging studies have revealed the hyperactivity of the auditory cortex and disrupted auditory-verbal network activity underlying AVH etiology. This review will firstly summarize major findings from both human AVH patients and animal models, with focuses on the auditory cortex and associated cortical/sub-cortical areas. Besides mesoscale connectivity or activity data, structure and functions at synaptic level will be discussed, in conjunction with molecular mechanisms. We have summarized major findings for the pathogenesis of AVH in SCZ patients, with focuses in the auditory cortex and prefrontal cortex (PFC). Those discoveries provide explanations for AVH from different perspectives including inter-regional connectivity, local activity in specific areas, structure and functions of synapse, and potentially molecular targets. Due to the uniqueness of AVH in humans, full replica using animals seems impossible. However, we can still extract useful information from animal SCZ models based on the disruption of auditory pathway during AVH episodes. Therefore, we will further interpolate the synaptic structures and molecular targets, whose dysregulation in SCZ models may be highly related with AVH episodes. As the last part, implications for future development of treatment strategies will be discussed.
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Affiliation(s)
- Jianjie Huang
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China; Department of Psychiatry, Institute of Mental Health, Jining University, Jining Shandong Province, 272191, China; Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, China, Tianjin, 300222, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China
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10
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Alkam T, Nabeshima T. Molecular mechanisms for nicotine intoxication. Neurochem Int 2019; 125:117-126. [PMID: 30779928 DOI: 10.1016/j.neuint.2019.02.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 01/25/2023]
Abstract
Nicotine, one of the more than 4700 ingredients in tobacco smoke, is a neurotoxin and once used as pesticides in agriculture. Although its use in agriculture is prohibited in many countries, nicotine intoxication is still a problem among the workers in tobacco farms, and young children as well as adults due to the accidental or suicidal ingestions of nicotine products. Understanding the mechanism of nicotine intoxication is important not only for the prevention and treatment but also for the appropriate regulatory approaches. Here, we review pharmacokinetics of nicotine and the molecular mechanisms for acute and chronic intoxication from nicotine that might be relevant to the central and the peripheral nervous system. We include green tobacco sickness, acute intoxication from popular nicotine products, circadian rhythm changes, chronic intoxication from nicotine through prenatal nicotine exposure, newborn behaviors, and sudden infant death syndrome.
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Affiliation(s)
- Tursun Alkam
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan; Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA.
| | - Toshitaka Nabeshima
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan; Advanced Diagnostic System Research Laboratory, Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan.
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11
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Haaf M, Leicht G, Curic S, Mulert C. Glutamatergic Deficits in Schizophrenia - Biomarkers and Pharmacological Interventions within the Ketamine Model. Curr Pharm Biotechnol 2018; 19:293-307. [PMID: 29929462 PMCID: PMC6142413 DOI: 10.2174/1389201019666180620112528] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/12/2018] [Accepted: 05/26/2018] [Indexed: 11/30/2022]
Abstract
Background: The observation that N-methyl-D-aspartate glutamate receptor (NMDAR) antagonists such as ketamine transiently induce schizophrenia-like positive, negative and cognitive symptoms has led to a paradigm shift from dopaminergic to glutamatergic dysfunction in pharmacological models of schizophrenia. NMDAR hypofunction can explain many schizophrenia symptoms directly due to excitatory-to-inhibitory (E/I) imbalance, but also dopaminergic dysfunction itself. However, so far no new drug targeting the NMDAR has been successfully approved. In the search for possible biomarkers it is interesting that ketamine-induced psychopathological changes in healthy participants were accompanied by altered electro-(EEG), magnetoencephalographic (MEG) and functional magnetic resonance imaging (fMRI) signals. Methods: We systematically searched PubMed/Medline and Web of Knowledge databases (January 2006 to July 2017) to identify EEG/MEG and fMRI studies of the ketamine model of schizophrenia with human subjects. The search strategy identified 209 citations of which 46 articles met specified eligibility criteria. Results: In EEG/MEG studies, ketamine induced changes of event-related potentials, such as the P300 potential and the mismatch negativity, similar to alterations observed in schizophrenia patients. In fMRI studies, alterations of activation were observed in different brain regions, most prominently within the anterior cingulate cortex and limbic structures as well as task-relevant brain regions. These alterations were accompanied by changes in functional connectivity, indicating a balance shift of the underlying brain networks. Pharmacological treatments did alter ketamine-induced changes in EEG/MEG and fMRI studies to different extents. Conclusion: This review highlights the potential applicability of the ketamine model for schizophrenia drug development by offering the possibility to assess the effect of pharmacological agents on schizophrenia-like symptoms and to find relevant neurophysiological and neuroimaging biomarkers.
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Affiliation(s)
- Moritz Haaf
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stjepan Curic
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch (PNB), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry and Psychotherapy, UKGM, Justus-Liebig University Giessen, Giessen, Germany
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12
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Ramlakhan JU, Zomorrodi R, Downar J, Blumberger DM, Daskalakis ZJ, George TP, Kiang M, Barr MS. Using Mismatch Negativity to Investigate the Pathophysiology of Substance Use Disorders and Comorbid Psychosis. Clin EEG Neurosci 2018; 49:226-237. [PMID: 29502434 DOI: 10.1177/1550059418760077] [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] [Indexed: 01/25/2023]
Abstract
Substance use disorders (SUDs) have a devastating impact on society and place a heavy burden on health care systems. Given that alcohol, tobacco, and cannabis use have the highest prevalence, further understanding of the underlying pathophysiology of these SUDs is crucial. Electroencephalography is an inexpensive, temporally superior, and translatable technique which enables investigation of the pathobiology of SUDs through the evaluation of various event-related potential components, including mismatch negativity (MMN). The goals of this review were to investigate the effects of acute and chronic alcohol, tobacco, and cannabis use on MMN among nonpsychiatric populations and patients with comorbid psychosis. A literature search was performed using the database PubMed, and 36 articles met our inclusion and exclusion criteria. We found a pattern of attenuation of MMN amplitude among patients with alcoholism across acute and chronic alcohol use, and this dysregulation was not heritable. Reports were limited, and results were mixed on the effects of acute and chronic tobacco and cannabis use on MMN. Reports on comorbid SUDs and psychosis were even fewer, and also presented mixed findings. These preliminary results suggest that MMN deficits may be associated with SUDs, specifically alcohol use disorder, and serve as a possible biomarker for treating these common disorders.
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Affiliation(s)
- Jessica U Ramlakhan
- 1 Temerty Centre for Therapeutic Brain Intervention, Division of Mood and Anxiety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,2 Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL), Additions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Reza Zomorrodi
- 1 Temerty Centre for Therapeutic Brain Intervention, Division of Mood and Anxiety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jonathan Downar
- 3 Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,4 Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,5 Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Daniel M Blumberger
- 1 Temerty Centre for Therapeutic Brain Intervention, Division of Mood and Anxiety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,4 Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,5 Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Zafiris J Daskalakis
- 1 Temerty Centre for Therapeutic Brain Intervention, Division of Mood and Anxiety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,4 Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,5 Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Tony P George
- 2 Biobehavioural Addictions and Concurrent Disorders Research Laboratory (BACDRL), Additions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,4 Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,5 Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Michael Kiang
- 1 Temerty Centre for Therapeutic Brain Intervention, Division of Mood and Anxiety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,4 Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,5 Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mera S Barr
- 1 Temerty Centre for Therapeutic Brain Intervention, Division of Mood and Anxiety, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,4 Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,5 Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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13
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Fisher DJ, Campbell DJ, Abriel SC, Ells EML, Rudolph ED, Tibbo PG. Auditory Mismatch Negativity and P300a Elicited by the "Optimal" Multi-feature Paradigm in Early Schizophrenia. Clin EEG Neurosci 2018; 49:238-247. [PMID: 29502452 DOI: 10.1177/1550059418761459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The mismatch negativity (MMN) is an EEG-derived event-related potential (ERP) elicited by any violation of a predicted auditory "rule," regardless of whether one is attending to the stimuli and is thought to reflect updating of the stimulus context. Redirection of attention toward a rare, distracting stimulus event, however, can be measured by the subsequent P3a component of the P300. Chronic schizophrenia patients exhibit robust MMN deficits, as well as reductions in P3a amplitude. While, the substantial literature on the MMN in first-episode and early phase schizophrenia in this population reports reduced amplitudes, there also exist several contradictory studies. Conversely, P3a reduction in this population is relatively consistent, although the literature investigating this is small. The primary goal of this study was to contribute to our understanding of whether auditory change detection mechanisms are altered in early phase schizophrenia and, if so, under what conditions. Event-related potentials elicited by duration, frequency, gap, intensity, and location deviants (as elicited by the "optimal" multi-feature paradigm) were recorded in 14 early phase schizophrenia (EP) patients and 17 healthy controls (HCs). Electrical activity was recorded from 15 scalp electrodes. MMN/P3a amplitudes and latencies for each deviant were compared between groups and were correlated with clinical measures in EPs. There were no significant group differences for MMN amplitudes or latencies, though EPs did exhibit reduced P3a amplitudes to gap and duration deviants. Furthermore, PANSS (Positive and Negative Syndrome Scale) positive symptom scores were correlated with intensity MMN latencies and duration P3a amplitudes in EPs. These findings suggest that MMNs may not be as robustly reduced in early phase schizophrenia (relative to chronic illness), but that alterations may be more likely in patients with increased positive symptomatology. Furthermore, these findings offer further support to previous work suggesting that the understudied P3a may have good complementary utility as a marker of early cortical dysfunction in psychosis.
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Affiliation(s)
- Derek J Fisher
- 1 Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.,2 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,3 Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Debra J Campbell
- 1 Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Shelagh C Abriel
- 1 Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Emma M L Ells
- 1 Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Erica D Rudolph
- 1 Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Philip G Tibbo
- 2 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,3 Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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14
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Alterations of complex mismatch negativity (cMMN) elicited by a two-tone pattern paradigm in early-phase psychosis. Biol Psychol 2018; 135:128-135. [DOI: 10.1016/j.biopsycho.2018.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/19/2018] [Accepted: 03/25/2018] [Indexed: 11/17/2022]
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15
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Identification of TAAR5 Agonist Activity of Alpha-NETA and Its Effect on Mismatch Negativity Amplitude in Awake Rats. Neurotox Res 2018; 34:442-451. [DOI: 10.1007/s12640-018-9902-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 12/20/2022]
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16
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McCleery A, Wynn JK, Mathalon DH, Roach BJ, Green MF. Hallucinations, neuroplasticity, and prediction errors in schizophrenia. Scand J Psychol 2018; 59:41-48. [PMID: 29356009 PMCID: PMC5969574 DOI: 10.1111/sjop.12413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
Abstract
Auditory hallucinations, a hallmark symptom of psychosis, are experienced by most people with a diagnosis of schizophrenia at some point in their illness. Auditory hallucinations can be understood as a failure in predictive coding, whereby abnormalities in sensory/perceptual processing combine with biased cognitive processes to result in a dampening of normal prediction error signaling. In this paper, we used a roving mismatch negativity (MMN) paradigm to optimize evaluation of prediction error signaling and short-term neuroplasticity in 30 people with schizophrenia (n = 16 with and n = 14 without recent auditory hallucinations) and 20 healthy comparison participants. The recent hallucinations group exhibited an abnormal roving MMN profile [F(2,27) = 3.98, p = 0.03], significantly reduced prediction error signaling [t(28) = -2.25, p = 0.03], and a trend for diminished short-term neuroplasticity [t(28) = 1.80, p = 0.08]. There were no statistically significant differences between the healthy comparison group and the combined schizophrenia group on any of the roving MMN indices. These findings are consistent with a predictive coding account of hallucinations in schizophrenia, which posits reduced prediction error signaling in those who are prone to hallucinations. These results also suggest that plasticity-mediated formation and online updating of predictive coding models may also be disrupted in individuals with recent hallucinations.
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Affiliation(s)
- Amanda McCleery
- University of California, Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
- Veterans Affairs Greater Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
| | - Jonathan K. Wynn
- University of California, Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
- Veterans Affairs Greater Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
| | - Daniel H. Mathalon
- Veterans Affairs San Francisco Healthcare System, University of California, San Francisco
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco
| | - Brian J. Roach
- Veterans Affairs San Francisco Healthcare System, University of California, San Francisco
| | - Michael F. Green
- University of California, Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
- Veterans Affairs Greater Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
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17
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Tavakoli P, Varma S, Campbell K. Highly relevant stimuli may passively elicit processes associated with consciousness during the sleep onset period. Conscious Cogn 2018; 58:60-74. [DOI: 10.1016/j.concog.2017.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/11/2017] [Accepted: 10/18/2017] [Indexed: 01/24/2023]
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18
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Hamilton HK, D’Souza DC, Ford JM, Roach BJ, Kort NS, Ahn KH, Bhakta S, Ranganathan M, Mathalon DH. Interactive effects of an N-methyl-d-aspartate receptor antagonist and a nicotinic acetylcholine receptor agonist on mismatch negativity: Implications for schizophrenia. Schizophr Res 2018; 191:87-94. [PMID: 28711472 PMCID: PMC5745273 DOI: 10.1016/j.schres.2017.06.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/18/2017] [Accepted: 06/21/2017] [Indexed: 11/29/2022]
Abstract
N-methyl-d-aspartate glutamate receptor (NMDAR) hypofunction has been implicated in the pathophysiology of schizophrenia, including auditory processing abnormalities reflected by the mismatch negativity (MMN) event-related potential component. Evidence suggesting cognitive benefits from nicotine administration, together with the high rate of cigarette use in patients with schizophrenia, has stimulated interest in whether nicotine modulates NMDAR hypofunction. We examined the interactive effects of ketamine, an NMDAR antagonist that produces transient schizophrenia-like neurophysiological effects, and nicotine, a nicotinic acetylcholine receptor (nAChR) agonist, in 30 healthy volunteers to determine whether nicotine prevents or attenuates MMN abnormalities. Secondary analyses compared the profile of ketamine and schizophrenia effects on MMN using previously reported data from 24 schizophrenia patients (Hay et al. 2015). Healthy volunteers completed four test days, during which they received ketamine/placebo and nicotine/placebo in a double-blind, counterbalanced design. MMN to intensity, frequency, duration, and frequency+duration double deviant sounds was assessed each day. Ketamine decreased intensity, frequency, and double deviant MMN amplitudes, whereas nicotine increased intensity and double deviant MMN amplitudes. A ketamine×nicotine interaction indicated, however, that nicotine failed to attenuate the decrease in MMN associated with ketamine. Although the present dose of ketamine produced smaller decrements in MMN than those associated with schizophrenia, the profile of effects across deviant types did not differ between ketamine and schizophrenia. Results suggest that while ketamine and schizophrenia produce similar profiles of MMN effects across deviant types, nicotinic agonists may have limited potential to improve these putative NMDAR hypofunction-mediated impairments in schizophrenia.
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Affiliation(s)
- Holly K. Hamilton
- San Francisco VA Health Care System, 4150 Clement St 116D, San Francisco, CA 94121 USA,University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
| | - Deepak C. D’Souza
- Veterans Affairs Connecticut Health Care System, 950 Campbell Ave, 116A, West Haven, CT 06516 USA,Yale University, 300 George St, Suite 901, New Haven, CT 06511 USA
| | - Judith M. Ford
- San Francisco VA Health Care System, 4150 Clement St 116D, San Francisco, CA 94121 USA,University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
| | - Brian J. Roach
- Northern California Institute for Research and Education, 4150 Clement St, San Francisco, CA 94121 USA
| | - Naomi S. Kort
- University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
| | - Kyung-Heup Ahn
- Veterans Affairs Connecticut Health Care System, 950 Campbell Ave, 116A, West Haven, CT 06516 USA,Yale University, 300 George St, Suite 901, New Haven, CT 06511 USA
| | - Savita Bhakta
- Yale University, 300 George St, Suite 901, New Haven, CT 06511 USA
| | | | - Daniel H. Mathalon
- San Francisco VA Health Care System, 4150 Clement St 116D, San Francisco, CA 94121 USA,University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143 USA
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19
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Javitt DC, Lee M, Kantrowitz JT, Martinez A. Mismatch negativity as a biomarker of theta band oscillatory dysfunction in schizophrenia. Schizophr Res 2018; 191:51-60. [PMID: 28666633 DOI: 10.1016/j.schres.2017.06.023] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/11/2017] [Accepted: 06/14/2017] [Indexed: 11/19/2022]
Abstract
Mismatch negativity (MMN) is among the best established biomarkers of cortical dysfunction in schizophrenia. MMN generators are localized primarily to primary and secondary auditory regions, and are known to reflect activity mediated by cortical N-methyl-d-aspartate-type glutamate receptors (NMDAR). Nevertheless, mechanisms underlying MMN generation at the local circuit level remain incompletely understood. This review synthesizes recent advances in circuit-level conceptualization of MMN based upon neuro-oscillatory findings. In the neuro-oscillatory (aka event-related spectral perturbation, ERSP) approach, responses to sensory stimuli are decomposed into underlying frequency bands prior to analysis. MMN reflects activity primarily in theta (4-7Hz) frequency band, which is thought to depend primarily upon interplay between cortical pyramidal neurons and somatostatin (SST)-type local circuit GABAergic interneurons. Schizophrenia-related deficits in theta generation are also observed not only in MMN, but also in other auditory and visual contexts. At the local circuit level, SST interneurons are known to maintain tonic inhibition over cortical pyramidal interneurons. SST interneurons, in turn, are inhibited by a class of interneurons expressing vasoactive intestinal polypeptide (VIP). In rodents, SST interneurons have been shown to respond differentially to deviant vs. standard stimuli, and inhibition of SST interneurons has been found to selectively inhibit deviance-related activity in rodent visual cortex. Here we propose that deficits in theta frequency generation, as exemplified by MMN, may contribute significantly to cortical dysfunction in schizophrenia, and may be tied to impaired interplay between cortical pyramidal neurons and local circuit SST-type GABAergic interneurons.
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Affiliation(s)
- Daniel C Javitt
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, NY 10032, United States; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States.
| | - Migyung Lee
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, NY 10032, United States; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Joshua T Kantrowitz
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, NY 10032, United States; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Antigona Martinez
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, New York, NY 10032, United States; Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
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20
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Smucny J, Tregellas JR. Targeting neuronal dysfunction in schizophrenia with nicotine: Evidence from neurophysiology to neuroimaging. J Psychopharmacol 2017; 31:801-811. [PMID: 28441884 PMCID: PMC5963521 DOI: 10.1177/0269881117705071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Patients with schizophrenia self-administer nicotine at rates higher than is self-administered for any other psychiatric illness. Although the reasons are unclear, one hypothesis suggests that nicotine is a form of 'self-medication' in order to restore normal levels of nicotinic signaling and target abnormalities in neuronal function associated with cognitive processes. This brief review discusses evidence from neurophysiological and neuroimaging studies in schizophrenia patients that nicotinic agonists may effectively target dysfunctional neuronal circuits in the illness. Evidence suggests that nicotine significantly modulates a number of these circuits, although relatively few studies have used modern neuroimaging techniques (e.g. functional magnetic resonance imaging (fMRI)) to examine the effects of nicotinic drugs on disease-related neurobiology. The neuronal effects of nicotine and other nicotinic agonists in schizophrenia remain a priority for psychiatry research.
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,Research Service, Denver VA Medical Center, Denver, CO, USA
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21
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Tavakoli P, Campbell K. Can an auditory multi-feature optimal paradigm be used for the study of processes associated with attention capture in passive listeners? Brain Res 2016; 1648:394-408. [PMID: 27495985 DOI: 10.1016/j.brainres.2016.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 06/12/2016] [Accepted: 08/02/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE A rarely occurring and highly relevant auditory stimulus occurring outside of the current focus of attention can cause a switching of attention. Such attention capture is often studied in oddball paradigms consisting of a frequently occurring "standard" stimulus which is changed at odd times to form a "deviant". The deviant may result in the capturing of attention. An auditory ERP, the P3a, is often associated with this process. To collect a sufficient amount of data is however very time-consuming. A more multi-feature "optimal" paradigm has been proposed but it is not known if it is appropriate for the study of attention capture. METHODS An optimal paradigm was run in which 6 different rare deviants (p=.08) were separated by a standard stimulus (p=.50) and compared to results when 4 oddball paradigms were also run. RESULTS A large P3a was elicited by some of the deviants in the optimal paradigm but not by others. However, very similar results were observed when separate oddball paradigms were run. CONCLUSIONS & SIGNIFICANCE The present study indicates that the optimal paradigm provides a very time-saving method to study attention capture and the P3a.
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Affiliation(s)
- Paniz Tavakoli
- School of Psychology, University of Ottawa, Ottawa, Canada K1N 6N5
| | - Kenneth Campbell
- School of Psychology, University of Ottawa, Ottawa, Canada K1N 6N5.
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22
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Ayala YA, Pérez-González D, Malmierca MS. Stimulus-specific adaptation in the inferior colliculus: The role of excitatory, inhibitory and modulatory inputs. Biol Psychol 2016; 116:10-22. [DOI: 10.1016/j.biopsycho.2015.06.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/27/2015] [Accepted: 06/30/2015] [Indexed: 01/01/2023]
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23
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Featherstone RE, Siegel SJ. The Role of Nicotine in Schizophrenia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 124:23-78. [PMID: 26472525 DOI: 10.1016/bs.irn.2015.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Schizophrenia is associated with by severe disruptions in thought, cognition, emotion, and behavior. Patients show a marked increase in rates of smoking and nicotine dependence relative to nonaffected individuals, a finding commonly ascribed to the potential ameliorative effects of nicotine on symptom severity and cognitive impairment. Indeed, many studies have demonstrated improvement in patients following the administration of nicotine. Such findings have led to an increased emphasis on the development of therapeutic agents to target the nicotinic system as well as increasing the impetus to understand the genetic basis for nicotinic dysfunction in schizophrenia. The goal of this review article is to provide a critical summary of evidence for the role of the nicotinic system in schizophrenia. The first part will review the role of nicotine in normalization of primary dysfunctions and endophenotypical changes found in schizophrenia. The second part will provide a summary of genetic evidence linking polymorphisms in nicotinic receptor genes to smoking and schizophrenia. The third part will summarize attempts to treat schizophrenia using agents specifically targeting nicotinic and nicotinic receptor subtypes. Although currently available antipsychotic treatments are generally able to manage some aspects of schizophrenia (e.g., positive symptoms) they fail to address several other critically effected aspects of the disease. As such, the search for novel mechanisms to treat this disease is necessary.
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Affiliation(s)
- Robert E Featherstone
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Steven J Siegel
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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24
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Rudolph ED, Ells EM, Campbell DJ, Abriel SC, Tibbo PG, Salisbury DF, Fisher DJ. Finding the missing-stimulus mismatch negativity (MMN) in early psychosis: altered MMN to violations of an auditory gestalt. Schizophr Res 2015; 166:158-63. [PMID: 26072323 PMCID: PMC4791035 DOI: 10.1016/j.schres.2015.05.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 05/13/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Abstract
The mismatch negativity (MMN) is an EEG-derived event-related potential (ERP) elicited by any violation of a predicted auditory 'rule', regardless of whether one is attending to the stimuli, and is thought to reflect updating of the stimulus context. Chronic schizophrenia patients exhibit robust MMN deficits, while MMN reduction in first-episode and early phase psychosis is significantly less consistent. Traditional two-tone "oddball" MMN measures of sensory information processing may be considered too simple for use in early phase psychosis in which pathology has not progressed fully, and a paradigm that probes higher order processes may be more appropriate for elucidating auditory change detection deficits. This study investigated whether MMN deficits could be detected in early phase psychosis (EP) patients using an abstract 'missing stimulus' pattern paradigm (Salisbury, 2012). The stimuli were 400 groups of six tones (1000Hz, 50ms duration, 330ms stimulus onset asynchrony), which was presented with an inter-trial interval of 750ms. Occasionally a group contained a deviant, meaning that it was missing either the 4th or 6th tone (50 trials each). EEG recordings of 13 EP patients (≤5year duration of illness) and 15 healthy controls (HC) were collected. Patients and controls did not significantly differ on age or years of education. Analyses of MMN amplitudes elicited by missing stimuli revealed amplitude reductions in EP patients, suggesting that these deficits are present very early in the progression of the illness. While there were no correlations between MMN measures and measures such as duration of illness, medication dosage or age, MMN amplitude reductions were correlated with positive symptomatology (i.e. auditory hallucinations). These findings suggest that MMNs elicited by the 'missing stimulus' paradigm are impaired in psychosis patients early in the progression of illness and that previously reported MMN-indexed deficits related to auditory hallucinations in chronic patients may also be present in EP patients. As such, this paradigm may have promise in identifying early processing deficits in this population.
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Affiliation(s)
- Erica D. Rudolph
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Emma M.L. Ells
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Debra J. Campbell
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Shelagh C. Abriel
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Philip G. Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada, Capital District Health Authority, Halifax, Nova Scotia, Canada
| | - Dean F. Salisbury
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Derek J. Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada, Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada, Capital District Health Authority, Halifax, Nova Scotia, Canada, Corresponding author at: Department of Psychology, Mount Saint Vincent University, 166 Bedford Hwy., Halifax, NS B3M 2J6, Canada. Tel.: +1 902 457 5503. (D.J. Fisher)
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25
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Impey D, El-Marj N, Parks A, Choueiry J, Fisher D, Knott VJ. Mismatch negativity in tobacco-naïve cannabis users and its alteration with acute nicotine administration. Pharmacol Biochem Behav 2015; 136:73-81. [PMID: 26188167 DOI: 10.1016/j.pbb.2015.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 11/29/2022]
Abstract
Chronic cannabis use may interact with factors, such as age of onset of cannabis use, family history, and genetic factors, to elicit schizophrenia (SZ)-like symptoms, including sensory and cognitive deficits. However, evidence of a relationship between cannabis use and cognitive impairment is confounded by concomitant use of tobacco. The objective of this study was to compare tobacco-naïve cannabis users with individuals without a history of tobacco/cannabis use on the auditory mismatch negativity (MMN) event-related potential (ERP), a neural measure of auditory deviance detection which is diminished in SZ. An exploratory arm of the study, conducted within a randomized, double-blind, placebo controlled design, examined the acute effects of nicotine gum (6mg) on MMN in cannabis users. MMN was recorded in response to 5 deviant stimuli within an optimal MMN paradigm in 44 healthy, non-tobacco smoking volunteers aged 18-26. Cannabis users (n=21) started smoking cannabis prior to age 17, at least 1 joint per month. To examine the effects of chronicity, users were grouped into relatively heavy long-term (HLT; n=11) users and light short-term (LST; n=10) users. Impaired deviance detection was shown in cannabis users vs. nonusers as reflected by a smaller MMN to duration deviants. Chronicity of use was also associated with MMN alterations, as HLTs displayed a reduced duration and gap MMN vs. LSTs. Compared with placebo, nicotine treatment enhanced select MMN deviants in cannabis user subgroups. As deficits associated with early and persistent cannabis use are similar to those seen in SZ, these dose-dependant disturbances in early sensory processing with cannabis use may be one cognitive pathway which mediates an increased risk for SZ in vulnerable youth, and be influenced by concurrent cigarette smoking behavior.
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Affiliation(s)
- Danielle Impey
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | - Nicole El-Marj
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Andrea Parks
- Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, Neuroscience Program, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Verner J Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, Neuroscience Program, University of Ottawa, Ottawa, ON, Canada
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Knott V, Impey D, Choueiry J, Smith D, de la Salle S, Saghir S, Smith M, Beaudry E, Ilivitsky V, Labelle A. An acute dose, randomized trial of the effects of CDP-Choline on Mismatch Negativity (MMN) in healthy volunteers stratified by deviance detection level. ACTA ACUST UNITED AC 2015. [DOI: 10.1186/s40810-014-0002-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Gaebler AJ, Mathiak K, Koten JW, König AA, Koush Y, Weyer D, Depner C, Matentzoglu S, Edgar JC, Willmes K, Zvyagintsev M. Auditory mismatch impairments are characterized by core neural dysfunctions in schizophrenia. Brain 2015; 138:1410-23. [PMID: 25743635 DOI: 10.1093/brain/awv049] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 01/12/2015] [Indexed: 01/18/2023] Open
Abstract
Major theories on the neural basis of schizophrenic core symptoms highlight aberrant salience network activity (insula and anterior cingulate cortex), prefrontal hypoactivation, sensory processing deficits as well as an impaired connectivity between temporal and prefrontal cortices. The mismatch negativity is a potential biomarker of schizophrenia and its reduction might be a consequence of each of these mechanisms. In contrast to the previous electroencephalographic studies, functional magnetic resonance imaging may disentangle the involved brain networks at high spatial resolution and determine contributions from localized brain responses and functional connectivity to the schizophrenic impairments. Twenty-four patients and 24 matched control subjects underwent functional magnetic resonance imaging during an optimized auditory mismatch task. Haemodynamic responses and functional connectivity were compared between groups. These data sets further entered a diagnostic classification analysis to assess impairments on the individual patient level. In the control group, mismatch responses were detected in the auditory cortex, prefrontal cortex and the salience network (insula and anterior cingulate cortex). Furthermore, mismatch processing was associated with a deactivation of the visual system and the dorsal attention network indicating a shift of resources from the visual to the auditory domain. The patients exhibited reduced activation in all of the respective systems (right auditory cortex, prefrontal cortex, and the salience network) as well as reduced deactivation of the visual system and the dorsal attention network. Group differences were most prominent in the anterior cingulate cortex and adjacent prefrontal areas. The latter regions also exhibited a reduced functional connectivity with the auditory cortex in the patients. In the classification analysis, haemodynamic responses yielded a maximal accuracy of 83% based on four features; functional connectivity data performed similarly or worse for up to about 10 features. However, connectivity data yielded a better performance when including more than 10 features yielding up to 90% accuracy. Among others, the most discriminating features represented functional connections between the auditory cortex and the anterior cingulate cortex as well as adjacent prefrontal areas. Auditory mismatch impairments incorporate major neural dysfunctions in schizophrenia. Our data suggest synergistic effects of sensory processing deficits, aberrant salience attribution, prefrontal hypoactivation as well as a disrupted connectivity between temporal and prefrontal cortices. These deficits are associated with subsequent disturbances in modality-specific resource allocation. Capturing different schizophrenic core dysfunctions, functional magnetic resonance imaging during this optimized mismatch paradigm reveals processing impairments on the individual patient level, rendering it a potential biomarker of schizophrenia.
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Affiliation(s)
- Arnim Johannes Gaebler
- 1 Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany 2 JARA-Translational Brain Medicine, Aachen, Germany
| | - Klaus Mathiak
- 1 Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany 2 JARA-Translational Brain Medicine, Aachen, Germany
| | - Jan Willem Koten
- 3 Neuropsychology Section, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany 4 Neuropsychology Section, Department of Psychology, Karl Franzens University, Graz, Austria
| | - Andrea Anna König
- 1 Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany 2 JARA-Translational Brain Medicine, Aachen, Germany
| | - Yury Koush
- 5 Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland 6 Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - David Weyer
- 7 Brain Imaging Facility, IZKF Aachen, RWTH Aachen University, Aachen, Germany
| | - Conny Depner
- 8 Katharina Kasper Via Nobis GmbH, Hospital for Psychiatry and Psychotherapy, Gangelt, Germany
| | - Simeon Matentzoglu
- 8 Katharina Kasper Via Nobis GmbH, Hospital for Psychiatry and Psychotherapy, Gangelt, Germany
| | - James Christopher Edgar
- 9 Department of Radiology, Lurie Family Foundation MEG Imaging Centre, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Klaus Willmes
- 3 Neuropsychology Section, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany
| | - Mikhail Zvyagintsev
- 1 Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany 2 JARA-Translational Brain Medicine, Aachen, Germany 7 Brain Imaging Facility, IZKF Aachen, RWTH Aachen University, Aachen, Germany
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Mismatch negativity (MMN) deficiency: a break-through biomarker in predicting psychosis onset. Int J Psychophysiol 2015; 95:338-44. [PMID: 25562834 DOI: 10.1016/j.ijpsycho.2014.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/14/2014] [Accepted: 12/26/2014] [Indexed: 11/24/2022]
Abstract
Currently, the mismatch negativity (MMN) deficit is one of the most robust and replicable findings in schizophrenia, reflecting cognitive and functional decline, psychosocial and socio-occupational impairment, and executive dysfunction in these patients. An important break-through has very recently taken place here in the prediction of conversion to psychosis when the MMN in particular to change in tone duration was recorded in clinically at risk-mental state (ARMS) individuals. Attenuations in the MMN in these patients may be very useful in helping clinicians determine who are most likely to develop a psychotic disorder, as we will review in the present article.
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Knott V, Impey D, Philippe T, Smith D, Choueiry J, de la Salle S, Dort H. Modulation of auditory deviance detection by acute nicotine is baseline and deviant dependent in healthy nonsmokers: a mismatch negativity study. Hum Psychopharmacol 2014; 29:446-58. [PMID: 25196041 DOI: 10.1002/hup.2418] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 03/19/2014] [Accepted: 05/19/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Cognitive enhancement resulting from nicotinic acetylcholine receptor stimulation may be evidenced by increased efficiency of the auditory-frontal cortex network of auditory discrimination, which is impaired in schizophrenia, a cognitive disorder associated with excessive tobacco use. Investigating automatic (preattentive) detection of acoustic change with the mismatch negativity (MMN) brain event-related potential in response to nicotine in individuals with varying baseline levels of auditory discrimination may provide useful insight into the cholinergic regulation of this neural network and its potential amelioration with novel nicotinic agents. METHODS Sixty healthy, non-smoking male volunteers were presented with an 'optimal' multi-feature MMN paradigm in a randomized, placebo controlled double-blind design with 6 mg of nicotine gum. RESULTS Participants with low, medium, and high baseline amplitudes responded differently to nicotine (vs. placebo), and nicotine response was feature specific. Whereas MMN in individuals with high amplitudes was diminished by nicotine, MMN increased in those with low amplitudes. Nicotine effects were not shown in medium amplitude participants. CONCLUSIONS These findings provide preliminary support for the role of nicotinic neurotransmission in sensory memory processing of auditory change and suggest that nicotinic receptor modulation can both enhance and diminish change detection, depending on baseline MMN and its eliciting stimulus feature.
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Affiliation(s)
- Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Neuroscience Program, Department of Cellular and Molecular Medicine, University of Ottawa, Ontario, Canada
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Abstract
OBJECTIVE Individuals with mental health concerns are disproportionately affected by and suffer the negative consequences of tobacco use disorder, perhaps because smoking has historically been part of psychiatry's culture. In the early 1990s, psychiatric inpatient facilities were exempted from U.S. hospital smoking bans, in response to public outcry with national media attention. Almost 2 decades later, the current study characterizes online conversation about psychiatric hospital smoking bans. Previous commenting studies have demonstrated commenting's negativity, documenting the "nasty effect" wherein negative comments color perceptions of neutral articles. Thus, we focused particular attention on cited barriers to implementing health-positive smoke-free policies. METHODS We collected online comments (N = 261) responding to popular media articles on smoking bans in inpatient psychiatry between 2013 and 2014 and conducted an inductive and exploratory qualitative content analysis. RESULTS Verifying previous studies documenting the prevalence of negative commenting, of the comments explicitly supporting or refuting psychiatry smoking bans, there were over twice as many con comments (n = 44) than pro (n = 18). Many commenters argued for access to outdoor smoking areas and warned of patient agitation and risk posed to care workers. Identified content themes included psychiatric medication and negative side effects, broken mental health systems and institutions, denigration of the health risks of tobacco in the context of mental illness, typical pro-smoking arguments about "smokers' rights" and alternatives (including e-cigarettes), addiction, and stigma. CONCLUSIONS The current findings provide a platform to begin to understand how people talk about mental health issues and smoking. Our analysis also raised complex issues concerning forces that impact U.S. patients with serious mental illness but over which they have little control, including medication, the U.S. health system, stigma, perceptions that life with chronic serious mental illness is not worth living, and psychological and physical pain of coping with mental illness. In consideration of identified barriers raised in opposition to smoking bans in inpatient psychiatry, efforts should emphasize patient stakeholder involvement; patient, visitor, and staff protection from smoke exposure; the effectiveness of nicotine replacement for managing withdrawal; and the lack of evidence that cigarettes are therapeutic.
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Mathalon DH, Ahn KH, Perry EB, Cho HS, Roach BJ, Blais RK, Bhakta S, Ranganathan M, Ford JM, D'Souza DC. Effects of nicotine on the neurophysiological and behavioral effects of ketamine in humans. Front Psychiatry 2014; 5:3. [PMID: 24478731 PMCID: PMC3900858 DOI: 10.3389/fpsyt.2014.00003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 01/07/2014] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND N-methyl-d-aspartate (NMDA) receptor hypofunction has been implicated in the pathophysiology of schizophrenia and its associated neurocognitive impairments. The high rate of cigarette smoking in schizophrenia raises questions about how nicotine modulates putative NMDA receptor hypofunction in the illness. Accordingly, we examined the modulatory effects of brain nicotinic acetylcholine receptor (nAChR) stimulation on NMDA receptor hypofunction by examining the interactive effects of nicotine, a nAChR agonist, and ketamine, a non-competitive NMDA receptor antagonist, on behavioral and neurophysiological measures in healthy human volunteers. METHODS From an initial sample of 17 subjects (age range 18-55 years), 8 subjects successfully completed 4 test sessions, each separated by at least 3 days, during which they received ketamine or placebo and two injections of nicotine or placebo in a double-blind, counterbalanced manner. Schizophrenia-like effects Positive and Negative Syndrome Scale, perceptual alterations Clinician Administered Dissociative Symptoms Scale, subjective effects Visual Analog Scale and auditory event-related brain potentials (mismatch negativity, MMN; P300) were assessed during each test session. RESULTS Consistent with existing studies, ketamine induced transient schizophrenia-like behavioral effects. P300 was reduced and delayed by ketamine regardless of whether it was elicited by a target (P3b) or novel (P3a) stimulus, while nicotine only reduced the amplitude of P3a. Nicotine did not rescue P300 from the effects of ketamine; the interactions of ketamine and nicotine were not significant. While nicotine significantly reduced MMN amplitude, ketamine did not. CONCLUSION Nicotine failed to modulate ketamine-induced neurophysiological and behavioral effects in this preliminary study. Interestingly, ketamine reduced P3b amplitude and nicotine reduced P3a amplitude, suggesting independent roles of NMDA receptor and nAChR in the generation of P3b and P3a, respectively.
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Affiliation(s)
- Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco , San Francisco, CA , USA ; Mental Health Service (116D), San Francisco VA Medical Center , San Francisco, CA , USA
| | - Kyung-Heup Ahn
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Schizophrenia Biological Research Center (116A), VA Connecticut Healthcare System , West Haven, CT , USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center , New Haven, CT , USA
| | - Edward B Perry
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Schizophrenia Biological Research Center (116A), VA Connecticut Healthcare System , West Haven, CT , USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center , New Haven, CT , USA
| | - Hyun-Sang Cho
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Department of Psychiatry, Yonsei University College of Medicine , Seoul , South Korea
| | - Brian J Roach
- Mental Health Service (116D), San Francisco VA Medical Center , San Francisco, CA , USA
| | - Rebecca K Blais
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Savita Bhakta
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Mohini Ranganathan
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Judith M Ford
- Department of Psychiatry, University of California San Francisco , San Francisco, CA , USA ; Mental Health Service (116D), San Francisco VA Medical Center , San Francisco, CA , USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Schizophrenia Biological Research Center (116A), VA Connecticut Healthcare System , West Haven, CT , USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center , New Haven, CT , USA
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Kim SS, Chung S, Park JI, Jung AJ, Kalman D, Ziedonis DM. Smoking among individuals with schizophrenia in Korea: gender differences. Arch Psychiatr Nurs 2013; 27:241-5. [PMID: 24070993 PMCID: PMC3785671 DOI: 10.1016/j.apnu.2013.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 06/11/2013] [Accepted: 06/12/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study examined gender differences in smoking and quitting among individuals diagnosed with schizophrenia in Korea. In addition, the study investigated differences in caffeine use by gender and smoking status. METHOD An anonymous self-report survey was conducted with psychiatric inpatients. RESULTS Compared to males, females were less likely to be current smokers (P<.001) and more likely to be former smokers (P<.01). Females were also less likely to be daily caffeine users (P<.001). Having more years of education (P<.05) and higher nicotine dependence scores (P<.05) were associated with decreased odds of intending to quit smoking, whereas having more previous quit attempts (P<.01) was associated with increased odds. These findings were significant even after adjusting for gender. Smokers were more likely to be daily caffeine users (P<.001) than their non-smoking counterparts. CONCLUSION Nurses in Korea should play an active role in tobacco control for patients with schizophrenia by providing cessation counseling and educating the effect of caffeine use on cigarette consumption, while tailoring the service to gender differences found in this study.
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Affiliation(s)
- Sun S Kim
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA.
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Paavilainen P. The mismatch-negativity (MMN) component of the auditory event-related potential to violations of abstract regularities: A review. Int J Psychophysiol 2013; 88:109-23. [PMID: 23542165 DOI: 10.1016/j.ijpsycho.2013.03.015] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 03/19/2013] [Accepted: 03/21/2013] [Indexed: 11/26/2022]
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Effects of acute nicotine on somatosensory change-related cortical responses. Neuroscience 2013; 229:20-6. [DOI: 10.1016/j.neuroscience.2012.10.060] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 10/29/2012] [Accepted: 10/30/2012] [Indexed: 12/11/2022]
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Effects of acute nicotine on auditory change-related cortical responses. Psychopharmacology (Berl) 2012; 224:327-35. [PMID: 22707251 DOI: 10.1007/s00213-012-2757-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/23/2012] [Indexed: 10/28/2022]
Abstract
RATIONALE AND OBJECTIVE Nicotine is known to have enhancing effects on some aspects of attention and cognition. The purpose of the present study was to elucidate the effects of nicotine on pre-attentive change-related cortical activity. METHODS Change-related cortical activity in response to an abrupt increase (3 dB) and decrease (6 dB) in sound pressure in a continuous sound was recorded by using magnetoencephalography. Nicotine was administered with a nicotine gum (4 mg of nicotine). Eleven healthy nonsmokers were tested with a double-blind and placebo-controlled design. Effects of nicotine on the main component of the onset response peaking at around 50 ms (P50m) and the main component of the change-related response at around 120 ms (Change-N1m) were investigated. RESULTS Nicotine failed to affect P50m, while it significantly increased the amplitude of Change-N1m evoked by both auditory changes. The magnitude of the amplitude increase was similar among subjects regardless of the magnitude of the baseline response, which resulted in the percent increase of Change-N1m being greater for subjects with Change-N1m of smaller amplitude. CONCLUSIONS Since Change-N1m represents a pre-attentive automatic process to encode new auditory events, the present results suggest that nicotine can exert beneficial cognitive effects without a direct impact on attention.
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Reiser EM, Schulter G, Weiss EM, Fink A, Rominger C, Papousek I. Decrease of prefrontal–posterior EEG coherence: Loose control during social–emotional stimulation. Brain Cogn 2012; 80:144-54. [DOI: 10.1016/j.bandc.2012.06.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 05/28/2012] [Accepted: 06/03/2012] [Indexed: 11/27/2022]
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