Another in the endless mass shootings in USA - this time Denver

[Peter Lemkin]

Grants and Contracts:
Reward Processing in Schizophrenia: the Effects of Aripiprazole and Risperidone, 2008-present

Dr.Lynne Fenton anti-psychotic drug pusher.I sure would like to see what drugs were in the dudes system.......

Don't hold your breath Keith!

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From another study on the exact same topic...all of Fenton's have apparently been taken off the internet!:

Background- This is a study of the way people with schizophrenia may feel when they get rewards. Certain parts of the brain play a part in people feeling happy when they win some sort of reward or have a good thing happen to them. Some people with schizophrenia may have trouble feeling pleasure because part of their brains, the frontal cortex, may not work properly. We are doing this study to understand how the frontal cortex works in people with and without schizophrenia when they are trying to win a reward. We will use a special kind of brain scan called Functional Magnetic Resonance Imaging (fMRI) to show the brain working in action. fMRI scanning uses a big magnet to take special pictures of the brain.

A new medicine called aripiprazole has been approved by the Food and Drug Administration for treating symptoms of schizophrenia. This medicine has a new mechanism of action that helps neural functioning in the part of the brain that is involved with planning and goal setting. We think this new medication may help with brain processing of rewards. We are therefore studying the brain with fMRI scans before and during treatment with this aripiprazole.

Objective- The objective of this study is to determine whether subjects with negative symptoms of schizophrenia have abnormal functioning of brain circuits relevant to reward processing, and to determine whether any such abnormalities are normalized by treatment with aripiprazole.

Research Plan-Aim 1. Define impairments in the neural correlates of reward processing in primary deficit syndrome schizophrenics compared to normal controls.

Ten stable outpatients with primary deficit syndrome schizophrenia will be compared to ten normal controls in a BOLD contrast fMRI experiment constructed to assess in a parametric design the recruitment of reward circuitry in response to increasing monetary reward. We predict that frontal cortical areas important in reward processing such as the OFC and ACC will have reduced activation in the schizophrenic subjects.

Aim 2. Assess the ability of aripiprazole to normalize reward circuit functioning in deficit syndrome schizophrenia, and correlate fMRI changes with clinical changes in negative symptoms.

The ten schizophrenic subjects in Aim 1 will be switched from standard antipsychotic treatment to twelve weeks of open label aripiprazole and retested with the fMRI monetary reward task. We predict that twelve weeks of aripiprazole treatment will normalize the activation of OFC and ACC in response to monetary reward stimuli. We further predict that the degree of normalization in fMRI activation will correlate with negative symptom improvement on aripiprazole.

Methods- Up to 25 volunteers with schizophrenia and 25 volunteers without a psychiatric disorder will participate in this study at the Atlanta VA Medical Center. Subjects will first be interviewed about their medical and psychiatric history, and any current symptoms they are having. They will receive an fMRI scan during which they will play a computer game that rewards correct responses with money. This fMRI session will allow for the assessment of which parts of the brain are functioning during rewarding conditions. The results will be compared for subjects with and without schizophrenia.

The subjects with schizophrenia will have their antipsychotic medication tapered and switched to aripiprazole during a twelve week treatment phase. They will be seen at the end of Week 1, Week 2, Week 4, Week 6, Week 8, Week 10, and Week 12. At the last visit the fMRI scan will be repeated during the same reward task.

Clinical Relevance- The inability to experience pleasure and the inability to pursue goals is an important symptom of schizophrenia. These symptoms probably play a huge role in preventing many people with schizophrenia from leading full and fulfilling lives. A central defect in reward processing pathways in the brain may account for these symptoms. If aripiprazole can be demonstrated to improve functioning in these brain pathways, this would greatly advance our understanding of schizophrenia and could bring greater functioning to patients with schizophrenia.