Abigail Gee

Context:

Psychosis is a mental health condition that affects around 3 in 100 people in their lifetime. Most treatments for psychosis target a brain chemical called dopamine, but they don’t work for everyone and don’t address many of the symptoms.

People who have experienced psychosis and people at risk of developing psychosis show differences in a part of the brain called the hippocampus, including increased activity and blood flow. This increased activity has been associated with difficulties in thinking and memory (also known as cognition).

The basis of this hippocampal hyperactivity is thought to be a change in the balance between excitation and inhibition of brain cells. Excitation causes brain cells to send signals more frequently, and inhibition causes cells to send signals less frequently. A balance between these signals is important for the whole brain, including the hippocampus, to function properly.

Levetiracetam is a medication that is widely used to treat epilepsy and helps to balance excitation and inhibition in the brain. It has shown promise in reducing increased activity in the hippocampus and improving performance on memory tasks.

Aims & Findings:

The aim of the study is to use brain imaging, specifically Magnetic Resonance Imaging (MRI), to test if levetiracetam can help reduce increased activity in the hippocampus, alter connectivity to other brain regions and change levels of brain chemicals in people who are at identified as being at risk of developing psychosis.

Participants aged 18-40 years are identified as at risk for psychosis through clinical teams in South and East London: Outreach and Support in South London (OASIS) and Hackney Early Detection (Heads UP) teams. We are also recruiting a group of people who do not have a diagnosis of any mental health conditions to act as a comparison group. All participants attend an initial appointment that involves answering questions about their experiences and feelings, and an assessment of thinking and memory. Participants who are at risk for psychosis then attend two scanning appointments, during which they take capsules of levetiracetam or a placebo (in a random order) before having a 45-minute MRI scan. The control group has one MRI scan, without any medication, to act as a comparison for our imaging measures.

Our study will provide important evidence about how levetiracetam affects brain function, and how this relates to cognition. This knowledge may lead to innovative approaches for understanding and treating psychosis early.

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