RESUMEN
OBJECTIVE: There is a strong association between cigarette smoking and schizophrenia. Nicotine's actions in the brain are mediated through nicotinic acetylcholine receptors. Those containing α(4) and ß(2) subunits are the most abundant ones in the brain, have the highest affinity for nicotine, and are critical in mediating nicotine's reinforcing properties. Healthy tobacco smokers have significantly higher levels of ß(2)*-nicotinic acetylcholine receptors than do nonsmokers. However, in postmortem studies, smokers with schizophrenia do not show these higher levels. The purpose of this study was to measure ß(2)*-nicotinic acetylcholine receptors in vivo and to relate levels to concurrent behavioral measures of smoking and schizophrenia. METHOD: By using single-photon emission computed tomography with the ß(2)*-nicotinic acetylcholine receptor agonist radiotracer [(123)I]5-IA-85380, the availability of receptors was measured in smokers with schizophrenia (11 men) and matched comparison smokers after 1 week of confirmed smoking abstinence. RESULTS: Smokers with schizophrenia showed significantly lower (21%-26%) ß(2)*-nicotinic acetylcholine receptor availability relative to comparison smokers in the frontal cortex, parietal cortex, and thalamus (in descending order). There was a specific and robust negative correlation between regional ß(2)*-nicotinic acetylcholine receptor availability and negative symptoms. CONCLUSIONS: These are the first in vivo findings of lower ß(2)*-nicotinic acetylcholine receptor availability in smokers with schizophrenia. The relationship between ß(2)*-nicotinic acetylcholine receptor availability and negative symptoms may explain the high rates of smoking in schizophrenia and the relationship between smoking and negative symptoms. Findings support the development of medications targeting the ß(2)*-nicotinic acetylcholine receptor system for the treatment of negative symptoms.
Asunto(s)
Química Encefálica , Receptores Nicotínicos/análisis , Esquizofrenia/fisiopatología , Fumar/fisiopatología , Adulto , Química Encefálica/fisiología , Femenino , Lóbulo Frontal/química , Lóbulo Frontal/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Lóbulo Parietal/química , Lóbulo Parietal/fisiopatología , Receptores Nicotínicos/fisiología , Esquizofrenia/complicaciones , Fumar/psicología , Cese del Hábito de Fumar , Tálamo/química , Tálamo/fisiopatología , Tomografía Computarizada de Emisión de Fotón Único , Adulto JovenRESUMEN
Human postmortem studies have reported decreases with age in high-affinity nicotine binding in brain. We have been investigating in vivo the availability of the beta(2)-containing nicotinic acetylcholine receptor (beta(2)-nAChR) in healthy nonsmokers (18-85 years of age) using [(123)I]5-IA-85380 SPECT imaging. Age and regional beta(2)-nAChR availability (V(T)(,)) have been observed to be inversely correlated in all brain regions analyzed, with decline ranging from 21% (cerebellum) to 36% (thalamus), or by up to 5% per decade of life. Preliminary results have confirmed postmortem reports of age-related decline in high-affinity nicotine binding with age and may elucidate the role of beta(2)-nAChRs in the cognitive decline associated with aging.