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Biol Psychiatry. 2014 Sep 15;76(6):495-502. doi: 10.1016/j.biopsych.2013.11.001. Epub 2013 Nov 13.

In vivo evidence for β2 nicotinic acetylcholine receptor subunit upregulation in smokers as compared with nonsmokers with schizophrenia.

Author information

  • 1Department of Psychiatry, School of Medicine, Yale University; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut. Electronic address: irina.esterlis@yale.edu.
  • 2Department of Psychiatry, School of Medicine, Yale University; Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
  • 3Department of Psychiatry, School of Medicine, Yale University.

Abstract

BACKGROUND:

Schizophrenia is associated with very high rates of tobacco smoking. The latter may be related to an attempt to self-medicate symptoms and/or to alterations in function of high-affinity β2-subunit-containing nicotinic acetylcholine receptors (β2*-nAChRs).

METHODS:

Smoking and nonsmoking subjects with schizophrenia (n=31) and age-, smoking-, and sex-matched comparison subjects (n=31) participated in one [123I]5-IA-85380 single photon emission computed tomography scan to quantify β2*-nAChR availability. Psychiatric, cognitive, nicotine craving, and mood assessments were obtained during active smoking, as well as smoking abstinence.

RESULTS:

There were no differences in smoking characteristics between smokers with and without schizophrenia. Subjects with schizophrenia had lower β2*-nAChR availability relative to comparison group, and nonsmokers had lower β2*-nAChR availability relative to smokers. However, there was no smoking by diagnosis interaction. Relative to nonsmokers with schizophrenia, smokers with schizophrenia had higher β2*-nAChR availability in limited brain regions. In smokers with schizophrenia, higher β2*-nAChR availability was associated with lower negative symptoms of schizophrenia and better performance on tests of executive control. Chronic exposure to antipsychotic drugs was not associated with changes in β2*-nAChR availability in schizophrenia.

CONCLUSIONS:

Although subjects with schizophrenia have lower β2*-nAChR availability relative to comparison group, smokers with schizophrenia appear to upregulate in the cortical regions. Lower receptor availability in smokers with schizophrenia in the cortical regions is associated with a greater number of negative symptoms and worse performance on tests of executive function, suggesting smoking subjects with schizophrenia who upregulate to a lesser degree may be at risk for poorer outcomes.

© 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

KEYWORDS:

Executive control; SPECT; negative symptoms; nicotinic acetylcholine receptors; psychosis; tobacco smoking

PMID:
24360979
[PubMed - in process]
PMCID:
PMC4019710
[Available on 2015-09-15]
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