The effect of second-generation antipsychotics on hippocampal volume in first episode of psychosis: longitudinal study

Michael Bodnar, Ashok K Malla, Carolina Makowski, M Mallar Chakravarty, Ridha Joober, Martin Lepage, Michael Bodnar, Ashok K Malla, Carolina Makowski, M Mallar Chakravarty, Ridha Joober, Martin Lepage

Abstract

Background: Current neuroscience literature has related treatment with aripiprazole to improved memory performance and subcellular changes in the hippocampus.

Aims: To explore the volumetric changes in hippocampal grey matter in people with a first episode of psychosis (FEP) treated with second-generation antipsychotics.

Method: Baseline and 1-year follow-up magnetic resonance images were obtained. Hippocampal volumes were estimated by using FreeSurfer and MAGeT-Brain. Subgroups included: aripiprazole (n=13), olanzapine (n=12), risperidone/paliperidone (n=24), refused-antipsychotics (n=13) and controls (n=44).

Results: Aripiprazole subgroup displayed significant increases in bilateral hippocampal volume compared with all other subgroups (FreeSurfer: all P's<0.012; MAGeT-Brain: all P's<0.040).

Conclusions: Aripiprazole is a first-line, second-generation treatment option that may provide an added benefit of pro-hippocampal growth. The biological underpinnings of these changes should be the focus of future investigations and may be key towards achieving a better clinical outcome for more individuals.

Declaration of interest: M.L. received financial assistance/compensation for research and educational events from Janssen-Ortho, Eli Lilly, Roche and Otsuka/Lundbeck Alliance. A.K.M. received financial assistance/compensation for research and educational activities from Pfizer, Janssen-Ortho, AstraZeneca and Bristol-Myers Squibb. R.J. received consultancy honorariums from Pfizer and Janssen-Ortho.

Copyright and usage: © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Figures

Fig. 1. Positive and negative symptom totals…
Fig. 1. Positive and negative symptom totals among first-episode psychosis (FEP) subgroups.
The error bars represent standard error. All people with FEP showed a significant improvement in both measures over the first 6 months of treatment. The risperidone/paliperidone (Risp/Palp) subgroup had higher negative symptoms overall compared with the other three subgroups. SAPS, Scale for the Assessment of Positive Symptoms; SANS, Scale for the Assessment of Negative Symptoms; Olanz, olanzapine; Aripip, aripiprazole; APs, antipsychotics.
Fig. 2. Change in grey matter volume…
Fig. 2. Change in grey matter volume in the hippocampus for first-episode psychosis (FEP) subgroups and controls.
The error bars represent standard error. The aripiprazole (Aripip) subgroup displayed a significantly larger change in bilateral hippocampal volume compared with all FEP subgroups and controls for volumes derived from both FreeSurfer and MAGeT-Brain. Risp/Palip, risperidone/paliperidone; Olanz, olanzapine; APs, antipsychotics.

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