Grant: Operating Grant

Cognitive impairment is a core feature of schizophrenia which persists and leads to poor social functioning and quality of life regardless of changes in the patient's symptom state with conventional treatments. Hence, cognition has become a prime target for the development of new interventions for schizophrenia. This clinical study will evaluate the capacity of CDP-choline, a derivative of one of the brain's own chemicals, to stimulate an essential neural receptor and thereby improve cognitive function in schizophrenia. The work will be a proof-of-concept for a larger scale clinical trial of the effects of chronic administration of CDP-choline on cognitive impairment in schizophrenia, an illness afflicting over 400,000 Canadians and costing upwards of 7 billion annually. In healthy people, there is a brain process called 'auditory sensory gating' which allows them to filter out irrelevant stimuli and focus their attention on relevant inputs. This is diminished in people with schizophrenia, possibly contributing to their attentional and cognitive disturbances. Research indicates that this diminishment is associated with a decrease in the number of alpha 7 brain cell receptors, which are activated by nicotine. The heavy smoking seen in schizophrenia may be self-medication since this activation temporarily reverses their gating and cognitive deficits (i.e. improves attention, memory, and thinking/reasoning processes). Since nicotine has obvious drawbacks and CDP-choline stimulates alpha 7 receptors, we will be specifically testing CDP-choline's efficacy as an add-on treatment for cognitive and gating deficits in relatively young people, both smokers and nonsmokers, experiencing a first episode of schizophrenia. Our findings will help to make "Go/No-Go" decisions to pursue large scale, chronic CDP-choline treatment studies in early phase patients aimed at improving cognitive and functional outcomes.