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Psych Congress  

A Brain Imaging and Neurocognitive study of Schizophrenic Subjects Treated with Aripiprazole

Steven Potkin, MD
James Fallon, PhD
David Keator, MS
Theo van Erp, PhD
Adrian Preda, MD
Dana Nguyen, PhD
Aaron Kemp, MBA
University of California, Irvine

Aripiprazole was the first dopamine D2 partial agonist with demonstrated antipsychotic efficacy. FDG PET scans, a neurocognitive battery, and clinical symptom assessment scales were administered to 21 subjects meeting DSM-IV criteria for schizophrenia. Neurocognitive tests, using a computerized interactive battery (CMINDS), and clinical symptoms were rated at baseline, 6 and 12 weeks following 20-30 mg of open-label, aripiprazole treatment. FDG PET scans were obtained at baseline and 6 weeks post-treatment. Fifteen subjects completed baseline and 6 week assessments. Subjects demonstrated an improvement in the PANSS total, positive and negative subscales, as well as the clinical global assessment (CGI) (p<0.05). No change was noted on the Calgary depression scale or the movement rating scales. Improvement at 6 weeks was noted in auditory memory, visual recognition, fine motor control and the Stroop color-word interference (p’s<0.05). Improvement in memory and visual recognition were also seen at 3 months (p’s<0.05). There was a decrease in false alarms indicating improved inhibition, and less interference on the Stroop test, indicating improved prefrontal functioning. There were greater changes in FDG metabolism in the non-dominant hemisphere ; FDG increases were observed in the intermediate stream (including language and mirror neuron-related cortices), frontal and prefrontal cortices, and striatum. Aripiprazole’s metabolic effect is consistent with an atypical antipsychotic pattern, and in accord with aripiprazole’s pharmacological profile, including D2, D3, 5HT-1a and 5HT-2a receptor affinities. Aripiprazole improved both positive and negative symptoms, memory, and executive function on clinical and cognitive assessments and demonstrated a metabolic pattern consistent with improved cortical function.

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