Cognitive impairment is known to be a core deficit in schizophrenia. Existing treatments for schizophrenia have limited efficacy
against cognitive impairment. The ubiquitous use of nicotine in this population is thought to reflect an attempt by patients to selfmedicate
certain symptoms associated with the illness. Concurrently there is evidence that nicotinic receptors that have lower affinity for
nicotine are more important in cognition. Therefore, a number of medications that target nicotinic acetylcholine receptors (nAChRs) have
been tested or are in development. In this article we summarize the clinical evidence of nAChRs dysfunction in schizophrenia and review
clinical studies testing either nicotine or nicotinic medications for the treatment of cognitive impairment in schizophrenia. Some evidence
suggests beneficial effects of nAChRs based treatments for the attentional deficits associated with schizophrenia. Standardized cognitive
test batteries have failed to capture consistent improvements from drugs acting at nAChRs. However, more proximal measures of brain
function, such as ERPs relevant to information processing impairments in schizophrenia, have shown some benefit. Further work is necessary
to conclude that nAChRs based treatments are of clinical utility in the treatment of cognitive deficits of schizophrenia.
Keywords: nAChR, nicotine, schizophrenia, cognition.
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