Abstract
BackgroundCognitive dysfunctions have long been observed in patients with schizophrenia, while cognitive symptoms are receiving a lot of attention due to the fact they can be considered core symptoms of schizophrenia. Cerebral blood flow has been by some researchers associated with cognitive functioning, or at least some aspects of cognitive functions. Because of its distinctive psychopharmacologic properties, aripiprazole is deemed a substantially different antipsychotic compared to the majority of the available compounds. It has been hypothesised that due to this fact it could have beneficial effects especially on cognition in schizophrenia. In line with that thought, the objective of this study was to investigate whether use of an atypical antipsychotic aripiprazole has beneficial effects on cerebral blood flow and cognitive functioning in patients with a first episode of schizophrenia during a three month treatment.MethodsForty patients were included in the ongoing study. At baseline and at three month follow up schizophrenia symptomatology was assessed by PANSS, cognitive functions by 5-KOG screening instrument for cognition in psychiatry, while cerebral blood flow was assessed by 99mTc-D,L-hexamethylene-propyleneamine oxime (99mTc-HMPAO) using a SPECT technique.ResultsAfter three months of treatment, we observed a significant improvement of schizophrenia symptoms and cognitive functions, measured by PANSS and 5-KOG, with all of the five subscales of the latter and its total score being significantly higher than at baseline (p<0.05). Similarly, cerebral blood-flow measured by SPECT improved at three months follow up compared to baseline.DiscussionUse of aripiprazole in first episode patients with schizophrenia is associated with increased fronto-temporal cerebral blood flow and improvement of schizophrenia symptomatology, including cognition indices. Although we cannot confirm it directly, it is possible that improved fronto-temporal cerebral blood flow led to the improvement in cognition indices.
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