Abstract
Aripiprazole has been reported to exert variable effects on cognitive function in patients with schizophrenia. Therefore, in the present study, we evaluated biological markers, clinical data, and psychiatric symptoms in order to identify factors that influence cognitive function in patients with schizophrenia undergoing aripiprazole treatment. We evaluated cognitive function in 51 patients with schizophrenia using Brief Assessment of Cognition in Schizophrenia (BACS), as well as background information, psychiatric symptoms, plasma catecholamine metabolites—homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG)—, and serum brain-derived neurotrophic factor (BDNF). Multivariate analyses were performed in order to identify factors independently associated with cognitive function. Brain-derived neurotrophic factor levels, number of hospitalizations, and MHPG levels were associated with verbal memory and learning. Total hospitalization period and MHPG levels were associated with working memory. Age at first hospitalization and education were associated with motor speed. The number of hospital admissions, Positive and Negative Syndrome Scale negative subscale scores (PANSS-N), MHPG levels, BDNF levels, and Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) scores were associated with verbal fluency. Homovanillic acid and MHPG levels, duration of illness, and PANSS-N scores were associated with attention and processing speed. Brain-derived neurotrophic factor and MHPG levels were associated with executive function. These results suggest that treatment of psychiatric symptoms and cognitive dysfunction may be improved in patients treated with aripiprazole by controlling for these contributing factors.
Highlights
Aripiprazole has a unique pharmacology with partial agonist activity at dopamine D2/D3 receptors, associated with a low risk of hyperprolactinemia [1,2], and partial agonist activity at serotonin (5-HT) 5-HT1A receptors and antagonist activity at 5-HT2A receptors
The present study investigated the factors associated with preserved cognitive functioning in psychiatrically stable patients with schizophrenia treated with aripiprazole monotherapy
The plasma Brain-derived neurotrophic factor (BDNF) level was associated with verbal memory and learning ability, verbal fluency, and executive function, which may be partly explained by dysfunction of the hippocampal complex
Summary
Aripiprazole has a unique pharmacology with partial agonist activity at dopamine D2/D3 receptors, associated with a low risk of hyperprolactinemia [1,2], and partial agonist activity at serotonin (5-HT) 5-HT1A receptors and antagonist activity at 5-HT2A receptors. It has a low risk of metabolic side effects, weight gain, increase in total cholesterol and blood pressure, hyperprolactinemia and sedation [3,4]. The role of BDNF in cognition has been shown for some animal and human schizophrenia [23,24,25,26]
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