Unit of Psychiatry, Department of Medicine, University of Udine, Udine, Italy.
UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
Schizophr Bull. 2018 Apr 6;44(3):552-559. doi: 10.1093/schbul/sbx108.
Hippocampal abnormalities have been largely reported in patients with schizophrenia and bipolar disorder, and are considered to be involved in the pathophysiology of the psychosis. The hippocampus consists of several subfields but it remains unclear their involvement in the early stages of psychosis.
The aim of this study was to investigate volumetric alterations in hippocampal subfields in patients at the first-episode psychosis (FEP).
Magnetic resonance imaging (MRI) data were collected in 134 subjects (58 FEP patients; 76 healthy controls [HC]). A novel automated hippocampal segmentation algorithm was used to segment the hippocampal subfields, based on an atlas constructed from ultra-high resolution imaging on ex vivo hippocampal tissue. The general linear model was used to investigate volume differences between FEP patients and HC, with age, gender and total intracranial volume as covariates.
We found significantly lower volumes of bilateral CA1, CA4, and granule cell layer (GCL), and of left CA3, and left molecular layer (ML) in FEP patients compared to HC. Only the volumes of the left hippocampus and its subfields were significantly lower in FEP than HC at the False Discovery Rate (FDR) of 0.1. No correlation was found between hippocampal subfield volume and duration of illness, age of onset, duration of medication, and Positive and Negative Syndrome Scale (PANSS).
We report abnormally low volumes of left hippocampal subfields in patients with FEP, sustaining its role as a putative neural marker of psychosis onset.
精神分裂症和双相情感障碍患者的海马体异常已被广泛报道，被认为与精神病的病理生理学有关。海马体由几个亚区组成，但它们在精神病的早期阶段的参与程度仍不清楚。
本研究旨在探讨首发精神病（FEP）患者海马亚区的体积改变。
对 134 名受试者（58 名 FEP 患者；76 名健康对照[HC]）进行了磁共振成像（MRI）数据采集。采用一种新的基于超高分辩率离体海马组织图谱的自动海马亚区分割算法，对海马亚区进行分割。采用一般线性模型，以年龄、性别和总颅内体积为协变量，探讨 FEP 患者与 HC 之间的体积差异。
与 HC 相比，FEP 患者双侧 CA1、CA4 和颗粒细胞层（GCL）以及左侧 CA3 和左侧分子层（ML）的体积明显较小。仅在 FDR 为 0.1 时，FEP 患者的左侧海马及其亚区的体积明显小于 HC。未发现海马亚区体积与病程、发病年龄、药物治疗时间、阳性和阴性症状量表（PANSS）之间存在相关性。
我们报告了 FEP 患者左侧海马亚区体积异常降低，支持其作为精神病发病的潜在神经标志物的作用。
