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Volume alteration of hippocampal subfields in first-episode antipsychotic-naive schizophrenia patients before and after acute antipsychotic treatment.

ABSTRACT: The nature of hippocampal changes in schizophrenia before first treatment, and whether hippocampal subfields are affected by antipsychotic treatment are important questions for schizophrenia research. Forty-one first-episode antipsychotic-naïve acutely ill schizophrenia inpatients had MRI scans before and six weeks after antipsychotic treatment. Thirty-nine matched healthy controls were also scanned, twenty-two of which were scanned a second time six weeks later. Volumes of hippocampal subfields were measured via FreeSurfer v6.0 using a longitudinal analysis pipeline. Before treatment, schizophrenia patients had no significant changes in total hippocampal volume but exhibited significantly greater subfield volumes than controls in bilateral molecular layers of the hippocampus (ML), bilateral granular cell layers of the dentate gyrus (GC-DG), and bilateral cornu ammonis area 4 (CA4). After six weeks of antipsychotic treatment, patients showed volume reductions compared with pretreatment scans in total hippocampus bilaterally, with subfield volume reduction noted in previously enlarged subfields (i.e., bilateral ML, GC-DG and CA4) and in bilateral hippocampal tails, left CA1, CA3, and fimbria. Subfields with volume increases before treatment were reduced to the level of healthy controls (bilateral ML and GC-DG) or near to it (bilateral CA4) after treatment. These results indicate subfield-specific hippocampal hypertrophy prior to treatment, and that these abnormalities were reduced after acute antipsychotic therapy in a dose-related manner together with volume reductions in other areas that were not hypertrophic before treatment.

SUBMITTER: Li W

PROVIDER: S-EPMC6072650 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Volume alteration of hippocampal subfields in first-episode antipsychotic-naïve schizophrenia patients before and after acute antipsychotic treatment.

Li Wenbin W Li Kaiming K Guan Pujun P Chen Ying Y Xiao Yuan Y Lui Su S Sweeney John A JA Gong Qiyong Q

NeuroImage. Clinical 20180710

The nature of hippocampal changes in schizophrenia before first treatment, and whether hippocampal subfields are affected by antipsychotic treatment are important questions for schizophrenia research. Forty-one first-episode antipsychotic-naïve acutely ill schizophrenia inpatients had MRI scans before and six weeks after antipsychotic treatment. Thirty-nine matched healthy controls were also scanned, twenty-two of which were scanned a second time six weeks later. Volumes of hippocampal subfields ...[more]

PMID: 30094166

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Project description:BackgroundEnlarged ventricles and reduced hippocampal volume are consistently found in patients with first-episode schizophrenia. Studies investigating brain structure in antipsychotic-naive patients have generally focused on the striatum. In this study, we examined whether ventricular enlargement and hippocampal and caudate volume reductions are morphological traits of antipsychotic-naive first-episode schizophrenia.MethodsWe obtained high-resolution 3-dimensional T1-weighted magnetic resonance imaging scans for 38 antipsychotic-naive first-episode schizophrenia patients and 43 matched healthy controls by use of a 3-T scanner. We warped the brain images to each other by use of a high-dimensional intersubject registration algorithm. We performed voxel-wise group comparisons with permutation tests. We performed small volume correction for the hippocampus, caudate and ventricles by use of a false discovery rate correction (p < 0.05) to control for multiple comparisons. We derived and analyzed estimates of brain structure volumes. We grouped patients as those with (n = 9) or without (n = 29) any lifetime substance abuse to examine the possible effects of substance abuse.ResultsWe found that hippocampal and caudate volumes were decreased in patients with first-episode schizophrenia. We found no ventricular enlargement, differences in global volume or significant associations between tissue volume and duration of untreated illness or psychopathology. The hippocampal volume reductions appeared to be influenced by a history of substance abuse. Exploratory analyses indicated reduced volume of the nucleus accumbens in patients with first-episode schizophrenia.LimitationsThis study was not a priori designed to test for differences between schizophrenia patients with or without lifetime substance abuse, and this subgroup was small.ConclusionReductions in hippocampal and caudate volume may constitute morphological traits in antipsychotic-naive first-episode schizophrenia patients. However, the clinical implications of these findings are unclear. Moreover, past substance abuse may accentuate hippocampal volume reduction. Magnetic resonance imaging studies addressing the potential effects of substance abuse in antipsychotic-naive first-episode schizophrenia patients are warranted.

Dataset Information

Volume alteration of hippocampal subfields in first-episode antipsychotic-naive schizophrenia patients before and after acute antipsychotic treatment.

Publications

Volume alteration of hippocampal subfields in first-episode antipsychotic-naïve schizophrenia patients before and after acute antipsychotic treatment.

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