Hippocampal structural alterations in early-stage psychosis: specificity and relationship to clinical outcomes

Brunner, G., Gajwani, R. , Gross, J. , Gumley, A. I. , Krishnadas, R. , Lawrie, S. M., Schwannauer, M., Schultze-Lutter, F., Fracasso, A. and Uhlhaas, P. J. (2022) Hippocampal structural alterations in early-stage psychosis: specificity and relationship to clinical outcomes. NeuroImage: Clinical, 35, 103087. (doi: 10.1016/j.nicl.2022.103087) (PMID:35780662) (PMCID:PMC9421451)

Abstract

Hippocampal dysfunctions are a core feature of schizophrenia, but conflicting evidence exists whether volumetric and morphological changes are present in early-stage psychosis and to what extent these deficits are related to clinical trajectories. In this study, we recruited individuals at clinical high risk for psychosis (CHR-P) (n = 108), patients with a first episode of psychosis (FEP) (n = 37), healthy controls (HC) (n = 70) as well as a psychiatric control group with substance abuse and affective disorders (CHR-N: n = 38). MRI-data at baseline were obtained and volumetric as well as vertex analyses of the hippocampus were carried out. Moreover, volumetric changes were examined in the amygdala, caudate, nucleus accumbens, pallidum, putamen and thalamus. In addition, we obtained follow-up functional and symptomatic assessments in CHR-P individuals to examine the question whether anatomical deficits at baseline predicted clinical trajectories. Our results show that the hippocampus is the only structure showing significant volumetric decrease in early-stage psychosis, with FEPs showing significantly smaller hippocampal volumes bilaterally alongside widespread shape changes in the vertex analysis. For the CHR-P group, volumetric decreases were confined to the left hippocampus. However, hippocampal alterations in the CHR-P group were not robustly associated with clinical outcomes, including the persistence of attenuated psychotic symptoms and functional trajectories. Accordingly, our findings highlight that dysfunctions in hippocampal anatomy are an important feature of early-stage psychosis which may, however, not be related to clinical outcomes in CHR-P participants.

• Item Type: Articles
• Additional Information: G.B. is supported by the University of Glasgow Lord Kelvin-Adan Smith PhD scholarship. A.F. is supported by a grant from the Biotechnology and Biology research council (BBSRC, grant number: BB/S006605/1) and the Bial Foundation, Bial Foundation Grants Programme Grant id: A-29315, number: 203/2020, grant edition: G-15516.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Uhlhaas, Professor Peter and Gross, Professor Joachim and Gumley, Professor Andrew and Gajwani, Dr Ruchika and Krishnadas, Dr Rajeev
• Authors: Brunner, G., Gajwani, R., Gross, J., Gumley, A. I., Krishnadas, R., Lawrie, S. M., Schwannauer, M., Schultze-Lutter, F., Fracasso, A., and Uhlhaas, P. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: NeuroImage: Clinical
• Publisher: Elsevier
• ISSN: 2213-1582
• ISSN (Online): 2213-1582
• Published Online: 16 June 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in NeuroImage: Clinical 35:103087
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
303685		Stable perception of external stimuli over time: oculo-motor and visual processing mechanisms	Alessio Fracasso	Biotechnology and Biological Sciences Research Council (BBSRC)	BB/S006605/1	Centre for Cognitive Neuroimaging