Schizophrenia Clinical Trial
Official title:
Clonazepam Effects on Brain Oscillations and Cognition in Schizophrenia
Cognitive deficits are some of the most prominent and disabling symptoms of schizophrenia. Evidence suggests that schizophrenia involves alterations to the functioning of a neural system under the control of a brain chemical called GABA. The present project will compare the effects of low-dose clonazepam (at a sub-sedating dose) to placebo, for effects on GABA- modulated brain activity measured by EEG, and associated cognitive processes in people who have schizophrenia.
Schizophrenia is a common, disabling mental illness with a considerable public health impact.
Cognitive dysfunction (e.g in attention, memory, etc.) is an enduring feature of the illness,
a strong predictor of functional outcome, and presently has no established treatment.
Therefore, advances in treatment of cognition in schizophrenia are likely to alleviate a
significant health burden. Deficits in executive control functions, such as those measurable
on task-switching paradigms, are among the most important cognitive deficits in
schizophrenia, and arise from disturbances in distributed neural networks operated by the
prefrontal cortex. An important phenomenon that underpins cortical information processing are
oscillations in brain activity that can be measured both with intracranial electrical
recordings and at the scalp with EEG. These networks and their cortical oscillatory
signatures are also strongly modulated by cortical interneurons that use gamma-amino butyric
acid (GABA) as a neurotransmitter. Post-mortem evidence suggests that GABAergic neurons are
altered in schizophrenia. Furthermore, studies in animals, using optogenetic manipulations
that are restricted to a subset of cortical GABA neurons, also suggest that GABA neurons can
be selectively modulated to improve PFC-dependent cognition in animal models of
schizophrenia. This includes experiments that involve administration of sub-sedating doses of
clonazepam, a representative FDA-approved medication from the benzodiazepine class.
Therefore, this neurochemical system represents a novel set of candidate treatment targets
that are both implicated in the pathophysiology of schizophrenia and the potential
remediation of associated cognitive dysfunction.
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