Trial Outcomes & Findings for The Effects of Nicotine on Cognition in Schizophrenia (NCT NCT00383747)

NCT ID: NCT00383747

Last Updated: 2017-04-28

Results Overview

The primary outcome measure was attention as measured by the Continuous Performance Test Identical Pairs (CPT-IP) Version 4.0 (Biobehavioral Technologies, New York, USA), developed for use in patients with schizophrenia and normal controls. In this task, participants were asked to respond when two identical pairs of numbers were presented in sequence by pressing a mouse key as quickly as possible using the dominant hand.The stimuli were presented with increasing cognitive load in successive blocks: two-,three- and four-digit target in the first, second and third block, respectively. Hit reaction time, a standard outcome variables on the CPTIP, is presented here. It was measured 3 hrs after application of the patch

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

60 participants

Primary outcome timeframe

Visit 1 and visit 2 (separated by an interval of 7-10 days)

Results posted on

2017-04-28

Participant Flow

Non-smoking adults with a DSM IV diagnosis of schizophrenia or schizoaffective disorder, depressed type, were recruited from an urban community mental health clinic. Non-smoking adults without psychiatric illness were recruited using advertising in local press and internet sites. All study procedures took place between January 2005 and July 2006.

Once enrolled, participants attended a baseline visit followed by 2 study days. At the first visit, subjects underwent a training session in the Cognitive Drug Research battery and subjects with schizophrenia completed baseline clinical scales including the Scale for Assessment of Negative Symptoms (SANS) and Positive and Negative Syndrome Scale

Participant milestones

Participant milestones
Measure
Non-smokers w/Schizophr: Nicotine Patch (V1) Then Placebo (V2)
Nonsmokers with schizophrenia on a stable dose of antipsychotic medication received first transdermal nicotine patch: 14mg transdermal nicotine application then placebo patch
Nonsmokers w/Schizophr: Placebo (V1) Then Nicotine Patch (V2)
Non smokers with schizophrenia received Placebo patch application then Nicotine patch: 14mg transdermal nicotine
Controls: Nicotine Patch (V1) Then Placebo (V2)
Non-smoking adults without psychiatric illness received transdermal nicotine patch: 14mg transdermal nicotine application then placebo patch
Controls: Placebo (V1) Then Nicotine Patch (V2)
Non-smoking adults without psychiatric illness received placebo patch then nicotine patch 14mg transdermal nicotine application
Visit 1
STARTED
14
14
16
16
Visit 1
COMPLETED
14
14
16
16
Visit 1
NOT COMPLETED
0
0
0
0
Visit 2
STARTED
14
14
16
16
Visit 2
COMPLETED
14
14
16
16
Visit 2
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The Effects of Nicotine on Cognition in Schizophrenia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Non Smokers With Schizophrenia
n=28 Participants
Controls
n=32 Participants
Total
n=60 Participants
Total of all reporting groups
Age, Continuous
47 years
STANDARD_DEVIATION 8 • n=5 Participants
40 years
STANDARD_DEVIATION 11 • n=7 Participants
43 years
STANDARD_DEVIATION 9 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
15 Participants
n=7 Participants
27 Participants
n=5 Participants
Sex: Female, Male
Male
16 Participants
n=5 Participants
17 Participants
n=7 Participants
33 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Visit 1 and visit 2 (separated by an interval of 7-10 days)

The primary outcome measure was attention as measured by the Continuous Performance Test Identical Pairs (CPT-IP) Version 4.0 (Biobehavioral Technologies, New York, USA), developed for use in patients with schizophrenia and normal controls. In this task, participants were asked to respond when two identical pairs of numbers were presented in sequence by pressing a mouse key as quickly as possible using the dominant hand.The stimuli were presented with increasing cognitive load in successive blocks: two-,three- and four-digit target in the first, second and third block, respectively. Hit reaction time, a standard outcome variables on the CPTIP, is presented here. It was measured 3 hrs after application of the patch

Outcome measures

Outcome measures
Measure
Non Smokers With Schizophrenia + Nicotine Patch
n=28 Participants
Nonsmokers with schizophrenia on a stable dose of antipsychotic medication + transdermal nicotine patch: 14mg transdermal nicotine application
Non Smokers With Schizophrenia + Placebo Nicotine Patch
n=28 Participants
Non smokers with schizophrenia + Placebo transdermal nicotine patch: 14mg transdermal nicotine application
Control + Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + transdermal nicotine patch: 14mg transdermal nicotine application
Controls + Placebo Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + placebo transdermal nicotine patch: 14mg transdermal nicotine application
Effects of Nicotine Patch Compared With Placebo in Non- Smokers With Schizophrenia and Control Groups on Attention Measured by the Continuous Performance Test Identical Pairs Version
2.2 milliseconds
Standard Deviation 0.8
2.1 milliseconds
Standard Deviation 0.8
3.4 milliseconds
Standard Deviation 0.6
3.2 milliseconds
Standard Deviation 0.6

SECONDARY outcome

Timeframe: Visit 1 and visit 2 (separated by an interval of 7-10 days)

This standard test of visual attention, processing speed and cognitive interference was performed, in which three cards (Stoelting Co., Wood Dale, IL, USA) were presented in order: the first card with color names, the second with colored patches of ink and the third with color namesprinted in incongruously colored ink. Participants were asked to read or name as many colors as possible in 45 s for each condition. The raw interference score was calculated by subtracting the predicted color-word score (calculated using raw word and color scores) from the observed raw color-word score. This value was converted to an interference T score by referring to a standardized table. A higher interference T score indicates better task performance with less interference. It was measured 3 hrs after application of the patch, after CPT

Outcome measures

Outcome measures
Measure
Non Smokers With Schizophrenia + Nicotine Patch
n=28 Participants
Nonsmokers with schizophrenia on a stable dose of antipsychotic medication + transdermal nicotine patch: 14mg transdermal nicotine application
Non Smokers With Schizophrenia + Placebo Nicotine Patch
n=28 Participants
Non smokers with schizophrenia + Placebo transdermal nicotine patch: 14mg transdermal nicotine application
Control + Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + transdermal nicotine patch: 14mg transdermal nicotine application
Controls + Placebo Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + placebo transdermal nicotine patch: 14mg transdermal nicotine application
Effects of Nicotine Patch Compared With Placebo in Non- Smokers With Schizophrenia and Control Groups on Visual Attention and Cognitive Interference as Measured by Three Card Stroop
50.4 score
Standard Deviation 5.8
49.0 score
Standard Deviation 4.6
56.8 score
Standard Deviation 10.3
58.8 score
Standard Deviation 10.0

SECONDARY outcome

Timeframe: Visit 1 and visit 2 (separated by an interval of 7-10 days)

This measure of working memory and auditory attention was performed under two conditions. In the first condition, participants were read progressively longer lists of letters and numbers and instructed to repeat these exactly as given, without reordering. In the second condition, participants were read progressively longer lists of numbers and letters and instructed to re-order the list and give the numbers first in ascending order and then the letters in alphabetical order (WMS-III). The sum of the trial scores provided the item score and the sum of the item scores provided the total score.It was measured 3 hrs after application of the patch, after CPT and Stroop. The total score ranges from 0 to 21.Higher scores of Letter number sequencing means better working memory and auditory attention

Outcome measures

Outcome measures
Measure
Non Smokers With Schizophrenia + Nicotine Patch
n=28 Participants
Nonsmokers with schizophrenia on a stable dose of antipsychotic medication + transdermal nicotine patch: 14mg transdermal nicotine application
Non Smokers With Schizophrenia + Placebo Nicotine Patch
n=28 Participants
Non smokers with schizophrenia + Placebo transdermal nicotine patch: 14mg transdermal nicotine application
Control + Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + transdermal nicotine patch: 14mg transdermal nicotine application
Controls + Placebo Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + placebo transdermal nicotine patch: 14mg transdermal nicotine application
Effects of Nicotine Patch Compared With Placebo in Non- Smokers With Schizophrenia and Control Groups on Letter Number Sequencing
without reorder
12.6 units on a scale
Standard Deviation 3.3
12.5 units on a scale
Standard Deviation 3.4
15.5 units on a scale
Standard Deviation 3.3
15.9 units on a scale
Standard Deviation 3.4
Effects of Nicotine Patch Compared With Placebo in Non- Smokers With Schizophrenia and Control Groups on Letter Number Sequencing
with reorder
8.8 units on a scale
Standard Deviation 3.1
9.0 units on a scale
Standard Deviation 2.6
12.2 units on a scale
Standard Deviation 3.4
12.6 units on a scale
Standard Deviation 3.1

SECONDARY outcome

Timeframe: Visit 1 and visit 2 (separated by an interval of 7-10 days)

The Grooved Pegboard (model 32025 Lafayette Instrument Company, Lafayette, IN, USA). In this test of lateralized psychomotor speed, participants had 45 s to place as many pegs as possible into grooves on a board using their dominant hand. The number of correctly placed pegs were recorded for each of the two trials.It was measured 3 hrs after application of the patch after CPT, Stroop and Letter number sequencing

Outcome measures

Outcome measures
Measure
Non Smokers With Schizophrenia + Nicotine Patch
n=28 Participants
Nonsmokers with schizophrenia on a stable dose of antipsychotic medication + transdermal nicotine patch: 14mg transdermal nicotine application
Non Smokers With Schizophrenia + Placebo Nicotine Patch
n=28 Participants
Non smokers with schizophrenia + Placebo transdermal nicotine patch: 14mg transdermal nicotine application
Control + Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + transdermal nicotine patch: 14mg transdermal nicotine application
Controls + Placebo Nicotine Patch
n=32 Participants
Non-smoking adults without psychiatric illness + placebo transdermal nicotine patch: 14mg transdermal nicotine application
Effects of Nicotine Patch Compared With Placebo in Non- Smokers With Schizophrenia and Control Groups on Lateralized Psychomotor Speed Measured by the Grooved Pegboard
14.4 number of pegs into grooves
Standard Deviation 3.6
14.5 number of pegs into grooves
Standard Deviation 3.2
19.1 number of pegs into grooves
Standard Deviation 3.2
18.6 number of pegs into grooves
Standard Deviation 2.7

Adverse Events

Non Smokers With Schizophrenia

Serious events: 2 serious events
Other events: 3 other events
Deaths: 0 deaths

Controls

Serious events: 0 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Non Smokers With Schizophrenia
n=28 participants at risk
Controls
n=32 participants at risk
Immune system disorders
allergic reaction to peanuts
3.6%
1/28 • Number of events 1 • Adverse event data was collected at every visit
0.00%
0/32 • Adverse event data was collected at every visit
Psychiatric disorders
deterioration in mental state
3.6%
1/28 • Number of events 1 • Adverse event data was collected at every visit
0.00%
0/32 • Adverse event data was collected at every visit

Other adverse events

Other adverse events
Measure
Non Smokers With Schizophrenia
n=28 participants at risk
Controls
n=32 participants at risk
Gastrointestinal disorders
Vomiting
3.6%
1/28 • Number of events 1 • Adverse event data was collected at every visit
6.2%
2/32 • Number of events 2 • Adverse event data was collected at every visit
Gastrointestinal disorders
Nausea
7.1%
2/28 • Number of events 2 • Adverse event data was collected at every visit
12.5%
4/32 • Number of events 4 • Adverse event data was collected at every visit
Skin and subcutaneous tissue disorders
skin irritations
0/0 • Adverse event data was collected at every visit
0/0 • Adverse event data was collected at every visit
Nervous system disorders
Dizziness
0/0 • Adverse event data was collected at every visit
0/0 • Adverse event data was collected at every visit
General disorders
Headache
0/0 • Adverse event data was collected at every visit
0/0 • Adverse event data was collected at every visit
General disorders
Palpitations
0/0 • Adverse event data was collected at every visit
0/0 • Adverse event data was collected at every visit

Additional Information

A. Eden Evins, MD, MPH. Director of the MGH-Harvard Center for Addiction Medicine

Massachusetts General Hospital - Harvard Medical School

Phone: 6176434679

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place