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Volumetric and morphological characteristics of the hippocampus are associated with progression to schizophrenia in patients with first-episode psychosis

Published online by Cambridge University Press:  23 March 2020

R. Sauras ,
A. Keymer ,
A. Alonso-Solis ,
A. Díaz ,
C. Molins ,
F. Nuñez ,
M. Rabella ,
A. Roldán ,
E. Grasa  and
E. Alvarez
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R. Sauras
Affiliation:
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, 08025Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1a Planta, 08003Barcelona, Spain
A. Keymer
Affiliation:
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, 08025Barcelona, Spain
A. Alonso-Solis
Affiliation:
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, 08025Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1a Planta, 08003Barcelona, Spain
A. Díaz
Affiliation:
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, 08025Barcelona, Spain
C. Molins
Affiliation:
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, 08025Barcelona, Spain
F. Nuñez
Affiliation:
Neuroradiology Unit Hospital de Sant Pau, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Carrer Sant Antoni M. Claret, 167, 08025Barcelona, Spain
M. Rabella
Affiliation:
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, 08025Barcelona, Spain
A. Roldán
Affiliation:
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, 08025Barcelona, Spain
E. Grasa
Affiliation:
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1a Planta, 08003Barcelona, Spain
E. Alvarez
Affiliation:
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, 08025Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1a Planta, 08003Barcelona, Spain
M.J. Portella*
Affiliation:
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, 08025Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1a Planta, 08003Barcelona, Spain
I. Corripio
Affiliation:
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, 08025Barcelona, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carrer Dr. Aiguader, 88, 1a Planta, 08003Barcelona, Spain
*
*Corresponding author. Psychiatric Department, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Sant Antoni M. Claret, 167, 08025 Barcelona. Catalonia, Spain. Fax: +34 935 537 842. E-mail address:mportella@santpau.cat (M.J. Portella).
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Abstract

Background:

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.

Methods:

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).

Results:

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.

Conclusions:

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.

Keywords

First-episode of psychosisHippocampusShape analysisSchizophrenia
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 1 - 5
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

1

Present address. Centre Assistencial Emili Mira i Lopez, Parc de Salut Mar, Universitat Autònoma de Barcelona (UAB), Avinguda Prat de la Riba, 171 (Recinte Torribera), 08921 Santa Coloma de Gramanet, Spain.

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