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Integration of brain structural information into prognostic and treatment formulation is key for achieving an all-encompassing biopsychosocial approach in psychiatry. Uncovering biological markers of specific mental illnesses, specific illness stages and of remission, may help further our understanding of the aetiology and precipitators of certain types of psychopathologies, identify central neurobiological processes as distinct from epiphenomena, validate boundaries of clinical groups, and potentially aid in predicting response to treatment. This book chapter reviewed the current structural neuroimaging evidence in three prominent mental illness domains: schizophrenia-spectrum, bipolar and depressive disorders. The large degree of overlap in abnormal neuropathology across the broad mental illness groups, which is no doubt partially due to within-group heterogeneity, makes the discovery of sets or networks of localized diagnosis-specific neural biomarkers unlikely. However, this is not to say that subtle distinctions in neural abnormalities do not exist, but rather challenges the usefulness of traditional diagnostic categories in the context of brain imaging being applied within a clinical staging model. A focus on identifying and characterising microscale circuits that are dysfunctional and which map onto symptomatology in a transdiagnostic manner, may have the greatest implications for clinical translation in the near future.
While previous studies have identified relationships between hippocampal volumes and memory performance in schizophrenia, these relationships are not apparent in healthy individuals. Further, few studies have examined the role of hippocampal subfields in illness-related memory deficits, and no study has examined potential differences across varying illness stages. The current study aimed to investigate whether individuals with early and established psychosis exhibited differential relationships between visuospatial associative memory and hippocampal subfield volumes.
Measurements of visuospatial associative memory performance and grey matter volume were obtained from 52 individuals with a chronic schizophrenia-spectrum disorder, 28 youth with recent-onset psychosis, 52 older healthy controls, and 28 younger healthy controls.
Both chronic and recent-onset patients had impaired visuospatial associative memory performance, however, only chronic patients showed hippocampal subfield volume loss. Both chronic and recent-onset patients demonstrated relationships between visuospatial associative memory performance and hippocampal subfield volumes in the CA4/dentate gyrus and the stratum that were not observed in older healthy controls. There were no group by volume interactions when chronic and recent-onset patients were compared.
The current study extends the findings of previous studies by identifying particular hippocampal subfields, including the hippocampal stratum layers and the dentate gyrus, that appear to be related to visuospatial associative memory ability in individuals with both chronic and first-episode psychosis.
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