The Research Of Schizophrenia Comorbid Nicotine Dependence

Objective 1.To compare the differences between smoking and non-smoking schizophrenia patients in cognitive function,and to explore the potential mechanism of schizophrenia patients' high smoking rate;2.To investigate the differences and similarities in related brain pathways of schizophrenia and smoking;3.To assess the safety and efficiency of bupropion combined with naltrexone for schizophrenia patients in smoking and weight control.Method 1.83 patients with schizophrenia(smoking group 43,non-smoking group 40)completed the CO monitoring,questionnaire,Fagerstrom Test for Nicotine Dependence(FTND),repeatable battery for the assessment of neuropsychological status(RBANS)to assess cognitive function,and positive and negative symptom scale(PANSS)to assess mental symptoms.2.A cross-sectional study was carried out on resting state functional magnetic resonance imaging(fMRI)scans of 19 schizophrenic smokers and 20 healthy volunteers(11 smokers and 9 nonsmokers).Regional Homogeneity(ReHo)method was selected to compare and analyze the brain function in resting state.3.A randomized double-blind,and placebo-controlled study,which included 22 cases of schizophrenia patients with comorbid smoking and obesity were divided into experimental group and placebo group by 1:1 ratio.Experimental group were treated for 24 weeks of naltrexone combined with bupropion,biochemical metabolism and clinical evaluation were observed to evaluate the effectiveness of the dual drugs combination in weight loose and tobacco cessation.Result 1.Patients with schizophrenia showed poorer cognitive function,and may be more prone to smoking behavior.2.Single factor variance analysis observes differences in three brain regions: left inferior temporal gyrus,right fusiform gyrus,right superior temporal gyrus,middle occipital gyrus,left caudate nucleus,right insula,right hippocampus,left operculum inferior frontal gyrus,right parahippocampal gyrus,right precentral gyrus,right postcentral gyrus,right middle frontal gyrus and right dorsolateral frontal gyrus and cerebellum.In the followed analysis suggests left caudate nucleus and left insula ReHo increased in schizophrenic smokers in comparison with healthy non-smokers;left insula and left inferior frontal operculum ReHo increased in schizophrenic smokers in comparison with healthy smokers.The right side of the central frontal gyrus,right postcentral gyrus,and right dorsolateral frontal gyrus schizophrenia smokers decreased in ReHo in comparison with two healthy control groups.3 At the end of 24,there were two patients in each group with CO concentration below 10 ppm..The change of smoking volume was small,only 1 patient in the experimental group,the number of cigarettes smoked per day decreased by only 3 days in the experimental group at the end of the twenty-fourth week.The BMI in the experimental group was significantly lower than the baseline at the end of the second week and the end of the fourth week.The twelfth groups of patients in the experimental group at the end of the weekend and the end of the week on the end of the week,the triglyceride level was lower than that of the baseline,and the low density lipoprotein(LDL)was lower than the baseline at the end of the twelfth week of treatment.Conclusion 1.More severe cognition damage in smoking schizophrenia patients in comparison to non-smoking patients.The conclusion of this study stand against the "self-medication" hypothesis,smoking does not improve nor benefit schizophrenia patients' cognitive function.2.Provides neurobiological evidences of schizophrenia patients with frontal and insular smoking local consistency change may be based in schizophrenia comorbidity tobacco dependence.The approach may assist the specific understanding of schizophrenia in the brain functional activity of smokers.3.Naltrexone combined bupropion may have a certain impact in weight control of smoking schizophrenia patients,need to expand the sample size for further verification.