SchizophreniaNCT01046526
fMRI Study of Nicotinic Effect on Neurophysiology of Schizophrenia
An observational study of Schizophrenia and Psychopathology, run by National Institute on Drug Abuse (NIDA) at 1 site in United States.
Trial summary
Background: Individuals who have schizophrenia are significantly more likely to smoke than the general population, which leads to increased smoking-related illnesses and high rates of nicotine dependence. Read more about this study
- Who is it for?
- Ages 18 to 50 years
- Conditions the study is for
- Schizophrenia, Psychopathology, Nicotine Dependence
- How many people
- 100 participants
- Where
- 1 siteUnited States
- Study dates
- 8 Feb 2005to 3 May 2012
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Subjects (schizophrenia patients and healthy control smokers) must be between the ages of 18-50 and in good health based on history and physical exams. Age restrictions are based on age-related declines (usually occurring after age 55-58) in eye tracking performance. Schizophrenia patients are persons with a DSM-IV Axis-I diagnosis for schizophrenia, based on a best-estimate diagnosis by the Structured Clinical Interview for DSM-IV (SCID) supplemented by family informants and medical records, done at the MPRC. Those in nicotine protocols must demonstrate that they are experienced users based upon exhaled CO and must smoke a minimum of 10 cigarettes/day with duration of use of at least 1 year. Subjects may be users of alcohol and/or marijuana but may not meet criteria for dependence on either and may not have used either for at least 24 hours prior to scanning.
Who cannot join
- Subjects will be excluded if they are unable to undergo MRI scanning due to pregnancy, implanted metallic devices (cardiac pacemaker or neurostimulator, some artificial joints, metal pins, surgical clips or other implanted metal parts) or claustrophobia. Subjects will also be excluded if they have 1) any major medical illnesses to include, but not limited to, uncontrolled high blood pressure or high blood sugar, cardiovascular disease, asthma, peripheral vascular diseases, coagulopathies, history of superficial or deep vein thrombosis, HIV, or other infectious diseases (e.g. Hepatitis B), 2) mood or anxiety disorders, or substance-induced psychiatric disorders, 3) neurological illnesses to include, but not limited to, seizure disorders, multiple sclerosis, movement disorders, or history of head trauma, CVA, CNS tumor, and other conditions that cause neurocognitive sequelae, 4) significant alcohol or other drug use, other than nicotine dependence, 5) if their T1 weighted images reveal gross structural abnormalities and/or, 6)have a history of syncope. Urine pregnancy tests will be performed on all female volunteers of child-bearing age before each experimental session. Subjects who are positive for any drug other than nicotine or marijuana will be excluded. Subjects in nicotine protocols may not be actively seeking or engaged in smoking cessation treatment. If a subject requires change of antipsychotic medications because of exacerbation of psychotic symptoms, the subject will be considered clinically unstable and his/her participation will be discontinued. Patients with Axis-I mood disorders or substance-induced psychiatric disorders are excluded. We also exclude patients with significant alcohol or other illicit drug use, other than nicotine dependence. This is operationally defined as no SCID/DSM-IV Axis-I substance dependence in the past 6 months, and no current substance abuse. Exceptions are occasional use of marijuana.
Trial locations and contacts
1 site in 1 country.
United States1 site
Maryland Psychiatric Research Center (MPRC) 55 Wade Avenue
Catonsville, Maryland, 21228
About this study
Background:
- Individuals who have schizophrenia are significantly more likely to smoke than the general population, which leads to increased smoking-related illnesses and high rates of nicotine dependence. Research suggests that high rates of smoking and nicotine addiction in people with schizophrenia are related to the fact that nicotine temporally improves performance in several cognitive tasks, including sensory gating, long-term memory, and visual tracking-all of which are affected by schizophrenia.
- Smoking among schizophrenia patients may be a form of self-medication, since nicotine may temporarily treat and improve cognitive deficits caused by schizophrenia. Researchers are interested in studying the effects of nicotine on the brain activity of individuals with schizophrenia to better understand how nicotine affects the brain regions connected to memory, visual tracking, and attention.
Read more
Objectives:
- To identify specific brain regions involved in the anticipatory learning deficits found in schizophrenia patients who smoke.
- To determine whether and how nicotine enhances performance in these regions.
Eligibility:
- Smokers (at least 10 cigarettes per day) between 18 and 50 years of age who either are healthy volunteers or have been diagnosed with schizophrenia/schizoaffective disorder.
Design:
- Participants will be asked to avoid consuming alcohol and restrict consuming caffeinated beverages for 24 hours before the study days. Participants will provide urine and breath samples at the start of the study to be tested for chemicals that may interfere with the study.
- The study will require two to four visits, with two fMRI sessions and other visits for a clinical interview or training.
Participants will have a training session with a possible mock MRI scan to learn how to do tasks that track eye movement and measure ability to pay attention.
- During the fMRI scanning sessions, participants will receive either a nicotine patch or a placebo patch without nicotine. After the patch is in place, participants will perform tasks while receiving MRI scans. The scans will take up to 2 hours.
- Participants will provide blood samples after finishing the MRI sessions.
Read the detailed description
The prevalence rate of smoking among schizophrenia patients is as high as 88 percent. This is associated with a 2-fold increase in deaths due to smoking related diseases-compounded by high rates of nicotine dependence and low abstinence rates following cessation programs. Converging lines of evidence suggest that high rates of smoking and nicotine addiction among schizophrenic patients is influenced by the presence of disease-related abnormalities in brain function. Genetic and post mortem studies show that patients exhibit abnormalities in neuronal nicotinic receptors, which are involved in a number of cognitive functions. Pharmacological studies show that nicotine temporally improves performance in several cognitive tasks including sensory gating, long-term memory, and visual tracking. These data support a growing consensus that smoking among schizophrenic patients is a form of self-medication, and suggest that the success of targeted smoking cessation programs will depend, in part, on finding alternative means of treating the underlying cognitive deficits. One of the most reproducible neurocognitive and biological changes in schizophrenia is abnormal visual tracking, or smooth pursuit eye movements. Preliminary data show that previously reported deficits in visual tracking are related to anticipatory learning deficits and that nicotine enhances performance in patients by temporarily treating this learning deficit. A better understanding of these processes may lead to better behavioral and/or pharmacological therapeutic interventions for excessive nicotine abuse and recidivism in this clinically vulnerable population. In order to identify brain regions underlying this learning deficit we propose to compare brain activations in 30 healthy controls and 30 patients with schizophrenia during anticipation of target motion using functional magnetic resonance imaging (fMRI). In order to identify the brain regions involved in nicotine-induced enhancement of anticipatory learning we will compare activation in patients under conditions of unexpected and anticipated target motion following administration of nicotine and placebo.
- Conditions
- Schizophrenia, Psychopathology, Nicotine Dependence
- Keywords
- Psychopathology, Nicotine Patch, Eye Tracking, Attention, Schizophrenic Participants
- Medical subject headings
- Schizophrenia, Tobacco Use Disorder
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jan 2010 (estimated)
- Study start8 Feb 2005
- Study completion3 May 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for SchizophreniaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Time perspective
- Other
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Institute on Drug Abuse (NIDA)
- Sponsor type
- US National Institutes of Health
- Collaborators
- National Institute of Mental Health (NIMH)
- Investigators
- George R Uhl, M.D., Principal investigator, National Institute on Drug Abuse (NIDA)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01046526
- Sponsor's protocol ID
- 999905398
- Other IDs
- 05-DA-N398
- Status last verified
- 3 May 2012
- First submitted
- 9 Jan 2010
- Last updated
- 2 Jul 2017
- Results posted
- No
Publications
Adam JJ, Backes W, Rijcken J, Hofman P, Kuipers H, Jolles J. Rapid visuomotor preparation in the human brain: a functional MRI study. Brain Res Cogn Brain Res. 2003 Mar;16(1):1-10. doi: 10.1016/s0926-6410(02)00204-5.
PubMed 12589883Adler LE, Hoffer LD, Wiser A, Freedman R. Normalization of auditory physiology by cigarette smoking in schizophrenic patients. Am J Psychiatry. 1993 Dec;150(12):1856-61. doi: 10.1176/ajp.150.12.1856.
PubMed 8238642Avila MT, Hong E, Thaker GK. Current progress in schizophrenia research. Eye movement abnormalities in schizophrenia: what is the nature of the deficit? J Nerv Ment Dis. 2002 Jul;190(7):479-80. doi: 10.1097/01.NMD.0000022450.48639.D3. No abstract available.
PubMed 12142851
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- fMRI Study of Nicotinic Effect on Neurophysiology of Schizophrenia
- ClinicalTrials.gov ID
- NCT01046526
- Acronym / sponsor ID
- 999905398
- Conditions
- Schizophrenia, Psychopathology, Nicotine Dependence
- Keywords
- Psychopathology, Nicotine Patch, Eye Tracking, Attention, Schizophrenic Participants
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- National Institute on Drug Abuse (NIDA)US National Institutes of Health
- Collaborators
- National Institute of Mental Health (NIMH)
- Study start
- 8 Feb 2005
- Study completion
- 3 May 2012
- First posted
- 12 Jan 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background:
- Individuals who have schizophrenia are significantly more likely to smoke than the general population, which leads to increased smoking-related illnesses and high rates of nicotine dependence. Research suggests that high rates of smoking and nicotine addiction in people with schizophrenia are related to the fact that nicotine temporally improves performance in several cognitive tasks, including sensory gating, long-term memory, and visual tracking-all of which are affected by schizophrenia.
- Smoking among schizophrenia patients may be a form of self-medication, since nicotine may temporarily treat and improve cognitive deficits caused by schizophrenia. Researchers are interested in studying the effects of nicotine on the brain activity of individuals with schizophrenia to better understand how nicotine affects the brain regions connected to memory, visual tracking, and attention.
Objectives:
- To identify specific brain regions involved in the anticipatory learning deficits found in schizophrenia patients who smoke.
- To determine whether and how nicotine enhances performance in these regions.
Eligibility:
- Smokers (at least 10 cigarettes per day) between 18 and 50 years of age who either are healthy volunteers or have been diagnosed with schizophrenia/schizoaffective disorder.
Design:
- Participants will be asked to avoid consuming alcohol and restrict consuming caffeinated beverages for 24 hours before the study days. Participants will provide urine and breath samples at the start of the study to be tested for chemicals that may interfere with the study.
- The study will require two to four visits, with two fMRI sessions and other visits for a clinical interview or training.
Participants will have a training session with a possible mock MRI scan to learn how to do tasks that track eye movement and measure ability to pay attention.
- During the fMRI scanning sessions, participants will receive either a nicotine patch or a placebo patch without nicotine. After the patch is in place, participants will perform tasks while receiving MRI scans. The scans will take up to 2 hours.
- Participants will provide blood samples after finishing the MRI sessions.
Detailed description
The prevalence rate of smoking among schizophrenia patients is as high as 88 percent. This is associated with a 2-fold increase in deaths due to smoking related diseases-compounded by high rates of nicotine dependence and low abstinence rates following cessation programs. Converging lines of evidence suggest that high rates of smoking and nicotine addiction among schizophrenic patients is influenced by the presence of disease-related abnormalities in brain function. Genetic and post mortem studies show that patients exhibit abnormalities in neuronal nicotinic receptors, which are involved in a number of cognitive functions. Pharmacological studies show that nicotine temporally improves performance in several cognitive tasks including sensory gating, long-term memory, and visual tracking. These data support a growing consensus that smoking among schizophrenic patients is a form of self-medication, and suggest that the success of targeted smoking cessation programs will depend, in part, on finding alternative means of treating the underlying cognitive deficits. One of the most reproducible neurocognitive and biological changes in schizophrenia is abnormal visual tracking, or smooth pursuit eye movements. Preliminary data show that previously reported deficits in visual tracking are related to anticipatory learning deficits and that nicotine enhances performance in patients by temporarily treating this learning deficit. A better understanding of these processes may lead to better behavioral and/or pharmacological therapeutic interventions for excessive nicotine abuse and recidivism in this clinically vulnerable population. In order to identify brain regions underlying this learning deficit we propose to compare brain activations in 30 healthy controls and 30 patients with schizophrenia during anticipation of target motion using functional magnetic resonance imaging (fMRI). In order to identify the brain regions involved in nicotine-induced enhancement of anticipatory learning we will compare activation in patients under conditions of unexpected and anticipated target motion following administration of nicotine and placebo.
Study design
- Time perspective
- Other
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Subjects (schizophrenia patients and healthy control smokers) must be between the ages of 18-50 and in good health based on history and physical exams. Age restrictions are based on age-related declines (usually occurring after age 55-58) in eye tracking performance. Schizophrenia patients are persons with a DSM-IV Axis-I diagnosis for schizophrenia, based on a best-estimate diagnosis by the Structured Clinical Interview for DSM-IV (SCID) supplemented by family informants and medical records, done at the MPRC. Those in nicotine protocols must demonstrate that they are experienced users based upon exhaled CO and must smoke a minimum of 10 cigarettes/day with duration of use of at least 1 year. Subjects may be users of alcohol and/or marijuana but may not meet criteria for dependence on either and may not have used either for at least 24 hours prior to scanning.
Key exclusion criteria (1 listed)
- Subjects will be excluded if they are unable to undergo MRI scanning due to pregnancy, implanted metallic devices (cardiac pacemaker or neurostimulator, some artificial joints, metal pins, surgical clips or other implanted metal parts) or claustrophobia. Subjects will also be excluded if they have 1) any major medical illnesses to include, but not limited to, uncontrolled high blood pressure or high blood sugar, cardiovascular disease, asthma, peripheral vascular diseases, coagulopathies, history of superficial or deep vein thrombosis, HIV, or other infectious diseases (e.g. Hepatitis B), 2) mood or anxiety disorders, or substance-induced psychiatric disorders, 3) neurological illnesses to include, but not limited to, seizure disorders, multiple sclerosis, movement disorders, or history of head trauma, CVA, CNS tumor, and other conditions that cause neurocognitive sequelae, 4) significant alcohol or other drug use, other than nicotine dependence, 5) if their T1 weighted images reveal gross structural abnormalities and/or, 6)have a history of syncope. Urine pregnancy tests will be performed on all female volunteers of child-bearing age before each experimental session. Subjects who are positive for any drug other than nicotine or marijuana will be excluded. Subjects in nicotine protocols may not be actively seeking or engaged in smoking cessation treatment. If a subject requires change of antipsychotic medications because of exacerbation of psychotic symptoms, the subject will be considered clinically unstable and his/her participation will be discontinued. Patients with Axis-I mood disorders or substance-induced psychiatric disorders are excluded. We also exclude patients with significant alcohol or other illicit drug use, other than nicotine dependence. This is operationally defined as no SCID/DSM-IV Axis-I substance dependence in the past 6 months, and no current substance abuse. Exceptions are occasional use of marijuana.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2017.
- Background: PubMed 12589883Adam JJ, Backes W, Rijcken J, Hofman P, Kuipers H, Jolles J. Rapid visuomotor preparation in the human brain: a functional MRI study. Brain Res Cogn Brain Res. 2003 Mar;16(1):1-10. doi: 10.1016/s0926-6410(02)00204-5.
- Background: PubMed 8238642Adler LE, Hoffer LD, Wiser A, Freedman R. Normalization of auditory physiology by cigarette smoking in schizophrenic patients. Am J Psychiatry. 1993 Dec;150(12):1856-61. doi: 10.1176/ajp.150.12.1856.
- Background: PubMed 12142851Avila MT, Hong E, Thaker GK. Current progress in schizophrenia research. Eye movement abnormalities in schizophrenia: what is the nature of the deficit? J Nerv Ment Dis. 2002 Jul;190(7):479-80. doi: 10.1097/01.NMD.0000022450.48639.D3. No abstract available.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
George R Uhl, M.D. principal investigator
National Institute on Drug Abuse (NIDA)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Schizophrenia and Psychopathology, run by National Institute on Drug Abuse (NIDA) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01046526, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2017.