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ORIGINAL ARTICLE
Year : 2014  |  Volume : 35  |  Issue : 1  |  Page : 22-38

Cognitive and clinical correlates of hippocampus volume, an MRI 2-year follow-up study


1 Department of Psychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
2 Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
3 Department of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
4 Department of MRI, Hadi Hospital, State of Kuwait, Kuwait

Correspondence Address:
Mamdoh El Gamal
Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1105.127273

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Background Enlarged ventricles and reduced hippocampal volume are consistently found in patients with first-episode psychosis. Many studies examining brain structure changes in antipsychotic-naive patients have generally focused on the striatum. In this study, we examined whether reduction in hippocampal volume is a morphological trait in such a group of patients in an attempt to find its clinical and cognitive correlates for patients with different diagnoses of first-episode psychosis both at their first contact and at short-term follow-up. Patients and methods We obtained high-resolution three-dimensional T-weighed MRI scans of the hippocampus for 90 patients with first-episode psychosis (49 patients with schizophrenia, 21 patients with bipolar psychoses, and 20 patients with depressive psychosis) as well as 23 healthy controls both at the baseline and after 2 years of assessment. Assessment of the clinical picture was carried out using the structured SCID interviews, HDRS, YMRS, and PANSS. Cognitive function and intellectual abilities were examined using WMS-III, the Trail Making Test, and WAIS. Results A greater reduction in hippocampal volume was evident in the schizophrenia group than the bipolar and depressive psychosis groups compared with the healthy controls both at baseline and after 2 years, indicative of being a morphological trait for such patients. Negative symptoms were related to hippocampal volume reduction in the schizophrenia group. The initial assessment of untreated patients revealed reduction in their hippocampus volume which correlated with the longer duration of untreatment. After 2 years of follow-up, recurrent hospitalization was found to be related to further volume reduction. Impaired working memory, verbal memory, and baseline intellectual abilities were related positively to structural hippocampal changes. Cognitive and clinical correlation with a reduction in hippocampal size was less evident in the bipolar psychosis group, which may highlight different structural changes in other areas in the striatum. Conclusion and recommendation Hippocampal volume reduction may be considered as morphological traits for some patients with first-episode psychosis, and linked to some clinical and cognitive impairment. Study of the shape, localized regions of the hippocampus as well as other brain areas may help to clarify the circuits shared in the pathophysiology of psychoses of different types. Early detection of structural changes with the study of high-risk patients may aid effective treatment and improve outcomes.


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