Psychiatric Department Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Carrer Sant Antoni M. Claret, 167, 08025 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1(a) Planta, 08003 Barcelona, Spain.
Psychiatric Department Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Carrer Sant Antoni M. Claret, 167, 08025 Barcelona, Spain.
Eur Psychiatry. 2017 Sep;45:1-5. doi: 10.1016/j.eurpsy.2017.06.006. Epub 2017 Jul 5.
Abnormalities in the hippocampus have been implicated in the pathophysiology of psychosis. However, it is still unclear whether certain abnormalities are a pre-existing vulnerability factor, a sign of disease progression or a consequence of environmental factors. We hypothesized that first-episode psychosis patients who progress to schizophrenia after one year of follow up will display greater volumetric and morphological changes from the very beginning of the disorder.
We studied the hippocampus of 41 patients with a first-episode psychosis and 41 matched healthy controls. MRI was performed at the time of the inclusion in the study. After one year, the whole sample was reevaluated and divided in two groups depending on the diagnoses (schizophrenia vs. non-schizophrenia).
Patients who progressed to schizophrenia showed a significantly smaller left hippocampus volume than control group and no-schizophrenia group (F=3.54; df=2, 77; P=0.03). We also found significant differences in the morphology of the anterior hippocampus (CA1) of patients with first-episode psychosis who developed schizophrenia compared with patients who did not.
These results are consistent with the assumption of hyperfunctioning dopaminergic cortico-subcortical circuits in schizophrenia, which might be related with an alteration of subcortical structures, such as the hippocampus, along the course of the disease. According with these results, hippocampus abnormalities may serve as a prognostic marker of clinical outcome in patients with a first-episode psychosis.
海马体的异常与精神分裂症的病理生理学有关。然而，目前尚不清楚某些异常是预先存在的脆弱因素、疾病进展的迹象还是环境因素的结果。我们假设，在随访一年后发展为精神分裂症的首发精神病患者，从疾病开始就会显示出更大的体积和形态变化。
我们研究了 41 名首发精神病患者和 41 名匹配的健康对照者的海马体。在研究纳入时进行了 MRI 检查。一年后，对整个样本进行了重新评估，并根据诊断（精神分裂症与非精神分裂症）分为两组。
进展为精神分裂症的患者的左侧海马体体积明显小于对照组和非精神分裂症组（F=3.54；df=2,77；P=0.03）。我们还发现，与未发展为精神分裂症的患者相比，首发精神病患者中发展为精神分裂症的患者的前海马体（CA1）形态存在显著差异。
这些结果与精神分裂症中多巴胺能皮质下皮层回路功能亢进的假设一致，这可能与海马体等皮质下结构的改变有关。根据这些结果，海马体异常可能是首发精神病患者临床结局的预后标志物。
