Psychosis effect on hippocampal reduction in schizophrenia

Prog Neuropsychopharmacol Biol Psychiatry. 2014 Jan 3:48:186-92. doi: 10.1016/j.pnpbp.2013.10.008. Epub 2013 Oct 16.

Abstract

Introduction: In schizophrenia, disruption of the neurodevelopmental processes may lead to brain changes and subsequent clinical manifestations of the illness. Reports of the progressive nature of these morphological brain changes raise questions about their causes. The possible toxic effects of repeated stressful psychotic episodes may contribute to the disease progression.

Objectives: To analyze the influence of illness duration and previous psychotic episodes on hippocampal gray matter volume (GMV) in schizophrenia.

Methods: We performed an analysis of hippocampal GMV correlations with illness duration, number of previous psychotic episodes, and age in 24 schizophrenia patients and 24 matched healthy controls.

Results: We found a cluster of GMV voxels in the left hippocampal tail that negatively correlated with the number of previous psychotic episodes, independent from the effect of age. On the other hand we found no effect of illness duration independent of age on the hippocampal GMV. Finally, we found a cluster of significant group-by-age interaction in the left hippocampal head.

Conclusions: We found an additive adverse effect of psychotic episodes on hippocampal morphology in schizophrenia. Our findings support toxicity of psychosis concept, together with etiological heterogeneity of brain changes in schizophrenia.

Keywords: AAL; AMPA; BDNF; CA; DG; FDR; FWE; GABA; GLM; GMV; HPA; Hippocampus; MARTA; MRI; Morphometry; N-methyl D-aspartate; NMDA; Psychosis; SD; SDA; SPM; Schizophrenia; Toxicity; VBM; VGLUT1; WFU; Wake-Forrest University; automatic anatomical labeling; brain-derived neurotrophic factor; cornu ammonis; dentate gyrus; false discovery rate; family-wise errors; gamma-amino butyric acid; general linear model; gray matter volume; hypothalamo-pituitary axis; magnetic resonance imaging; multi-acting receptor-targeted antipsychotics; serotonine-dopamine antagonists; standard deviation; statistical parametrical mapping; vesicular glutamate transporter 1; voxel-based morphometry; α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Case-Control Studies
  • Female
  • Functional Laterality
  • Hippocampus / pathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / etiology*
  • Psychotic Disorders / pathology*
  • Schizophrenia / complications*
  • Young Adult