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Tracking Information | |||||
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First Received Date † | May 30, 2008 | ||||
Last Updated Date | May 30, 2008 | ||||
Start Date † | December 2002 | ||||
Current Primary Outcome Measures † |
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Original Primary Outcome Measures † | Same as current | ||||
Change History | No Changes Posted | ||||
Current Secondary Outcome Measures † |
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Original Secondary Outcome Measures † | Same as current | ||||
Descriptive Information | |||||
Brief Title † | Nicotinic Modulation of Schizophrenia-Like Information Processing Deficits in Healthy Subjects | ||||
Official Title † | Nicotinic Modulation of (NMDA) Receptor Antagonist Schizophrenia-Like Information Processing Deficits in Humans | ||||
Brief Summary | Converging lines of evidence suggest that deficits in the NMDA glutamate receptors may contribute to the behavioral symptoms and cognitive deficits associated with schizophrenia. Schizophrenia patients have several informational processing abnormalities including deficits in P50 gating (ability to filter out irrelevant auditory stimuli and focus on salient stimuli), MMN (pre-attentive brainwave response to stimuli that deviate in physical nature from preceding stimuli), and P300 (the apportionment of attention to novel stimuli). NMDA antagonists impair information processing. Ketamine elicits impairments in MMN and P300 in healthy humans and Phencyclidine, which is much more potent than ketamine, was shown to disrupt P50 gating in rats. Studies at our center demonstrate that at doses similar to the dose proposed in this study, ketamine disrupts P50 gating in humans. Nicotine has been reported to improve performance on tasks of attention, learning and working memory in humans and animals. Other reports suggest that nicotine impairs or does not affect spatial working memory in healthy humans. Finally, the effects on P300 are equivocal in healthy humans. Schizophrenic patients may be self-medicating informational processing deficits: Smoking or nicotine improved deficits in P50 gating transiently, prepulse inhibition, smooth pursuit eye movement, and Continuous Performance Task in schizophrenic patients. This may explain the inordinately high rates and amounts of nicotine use in schizophrenia. However, the mechanism/s underlying nicotine effects on information processing abnormalities are poorly understood. The aim of this study is to determine whether nicotine improves the deficits in attention and information processing induced by a drug that blocks NMDA receptors in humans. Hypotheses:
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Detailed Description | This study examines the interactive effects of ketamine and nicotine. Ketamine is an Food and Drug Administration approved anesthetic. Sub anesthetic doses of ketamine temporarily interferes with the brain's ability to process information and may temporarily produce schizophrenia-like symptoms. Some of these symptoms include electrophysiological indices of altered information processing. Nicotine is hypothesized to reduce these schizophrenia-like information processing deficits. A screening day determines eligibility based on a thorough medical evaluation including nonsmokers and smokers aged 18-50 years old. Healthy subjects are recruited from the community and complete 1 training day which involves familiarizing with the cognitive test battery and 4 test days. Each test day is separated by at least 3 days, during which they will receive ketamine or placebo and nicotine or placebo in a double-blind counterbalanced design. There are 4 treatment conditions in a random order:
Ketamine and nicotine are infused over about 95 minutes. Throughout the day subjects will be asked questions about their thinking and mood, and asked to perform computer tasks. Memory, attention concentration and planning are tested. In addition, heart rate, blood pressure and temperature will be checked by a research nurse. Blood samples will be collected several times throughout the day. These evaluations will continue periodically throughout the test day. There will also be follow up questionnaires at one week, three months and six months. |
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Study Phase | Phase I | ||||
Study Type † | Interventional | ||||
Study Design † | Basic Science, Randomized, Double Blind (Subject, Caregiver, Investigator), Crossover Assignment, Efficacy Study | ||||
Condition † | Healthy Subjects | ||||
Intervention † |
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Study Arms / Comparison Groups |
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Publications * | |||||
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline. |
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Recruitment Information | |||||
Recruitment Status † | Recruiting | ||||
Estimated Enrollment † | 30 | ||||
Estimated Completion Date | January 2009 | ||||
Estimated Primary Completion Date | October 2008 (final data collection date for primary outcome measure) | ||||
Eligibility Criteria † | Inclusion Criteria:
Exclusion Criteria:
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Gender | Both | ||||
Ages | 18 Years to 50 Years | ||||
Accepts Healthy Volunteers | Yes | ||||
Contacts †† |
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Location Countries † | United States | ||||
Expanded Access Status | |||||
Administrative Information | |||||
NCT ID † | NCT00690170 | ||||
Responsible Party | Deepak Cyril D'Souza, M.D., Yale University, Department of Psychiatry | ||||
Secondary IDs †† | |||||
Study Sponsor † | Yale University | ||||
Collaborators †† | |||||
Investigators † |
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Information Provided By | Yale University | ||||
Verification Date | May 2008 | ||||
† Required WHO trial registration data element. †† WHO trial registration data element that is required only if it exists. |