Objective: To investigate hippocampal development deviation and its association with cognition in patients with major psychiatric disorders (MPDs), including schizophrenia, bipolar disorder and major depressive disorder.
Methods: The T1-weighted MRI data of 174 first-episode drug-naïve schizophrenia (FES) atients, 169 bipolar disorder (BD) patients, 184 major depressive disorder (MDD) patients, and 321 healthy controls were collected and their hippocampal volume was extracted after preprocessing with Freesurfer 5.3. A normative neurodevelopment model was applied to calculate the hippocampal deviation scores. Data on cognitive functions, including visual memory, attention, spatial working memory, were collected. Comparison by different sexes was made to identify difference between the hippocampal development deviation scores of the control group and those of the disease groups. We also investigated the moderating effect of age on the deviation score and explored the association between the deviation score and cognitive function.
Results: The hippocampal development deviation scores of patients with MPDs were significantly lower than those of the healthy controls (false discovery rate [FDR]-P<0.05). Analysis of the moderating effect of age revealed lower deviation scores in young patients (<[25.83-28.56] yr.) and higher deviation scores in old patients (>[35.87-54.35] yr.) in comparison with those of the healthy controls. The right hippocampal deviation scores in male FES patients were positively correlated with the number of errors for tasks concerning spatial working memory ( r=0.32, FDR-P=0.04).
Conclusion: Our findings suggest abnormal hippocampal development in MPDs patients and its different distribution in MPDs patients of different age groups. The hippocampal development deviation score may provide a new perspective for further understanding of etiology in MPDs.
目的: 研究重性精神疾病（精神分裂症、双相障碍和重性抑郁障碍）海马发育偏倚及其与认知功能的关系。
方法: 采集174例首发未用药精神分裂症患者，169例双相障碍患者，184例未用药重性抑郁障碍患者和321例健康受试的结构磁共振成像数据，经Freesurfer预处理后得到海马体积。使用大脑发育常模计算海马发育偏倚分数。采集视觉记忆、注意力、空间工作记忆等认知功能数据。性别分层比较海马发育偏倚分数在对照组和疾病组之间的差异，探索年龄对海马发育偏倚分数的调节效应，计算海马发育偏倚分数与认知功能的相关性。
结果: 重性精神疾病患者海马发育偏倚分数均低于健康对照（FDR-P<0.05）。调节效应分析显示低年龄组〔<（25.83～28.56）岁〕患者海马发育偏倚分数低于正常对照，高年龄组〔>（35.87～54.35）岁〕患者海马发育偏倚分数高于正常对照。男性精神分裂症患者的右侧海马发育偏倚分数与空间工作记忆错误数量成正相关（r=0.32，FDR-P=0.04）。
结论: 本研究结果提示重性精神疾病患者中海马发育存在异常，且不同年龄海马发育异常存在差异。基于大脑发育常模的海马发育偏倚分数可以为进一步了解重性精神疾病提供新的视角。
Keywords: Cognition; Deviation score; Hippocampus; Major psychiatric disorders; Normative neurodevelopment model.
Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).