Valentina Baglivo1, Bo Cao2, Benson Mwangi2, Marcella Bellani3,4, Cinzia Perlini4,5, Antonio Lasalvia3, Nicola Dusi3,4, Chiara Bonetto6, Doriana Cristofalo6, Franco Alessandrini7, Giada Zoccatelli7, Elisa Ciceri7, Lamonaca Dario8, Ceccato Enrico9, Pileggi Francesca10, Fausto Mazzi11, Santonastaso Paolo12, Matteo Balestrieri1, Jair C Soares2, Mirella Ruggeri3,6, Paolo Brambilla2,13. 1. Unit of Psychiatry, Department of Medicine, University of Udine, Udine, Italy. 2. UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX. 3. UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Verona, Italy. 4. InterUniversity Centre for Behavioural Neurosciences (ICBN), University of Verona, Verona, Italy. 5. Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Verona, Italy. 6. Section of Psychiatry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy. 7. Neuroradiology Department, Azienda Ospedaliera Universitaria, Verona, Italy. 8. Department of Psychiatry, CSM AULSS 21 Legnago, Verona, Italy. 9. Department of Mental Health, Hospital of Montecchio Maggiore, Vicenza, Italy. 10. Department of Mental Health, Azienda ULSS Bologna, Bologna, Italy. 11. Department of Mental Health, Modena, Italy. 12. Department of Neuroscience, University of Padova, Padova, Italy. 13. Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Abstract
Background: Hippocampal abnormalities have been largely reported in patients with schizophrenia and bipolar disorder, and are considered to be involved in the pathophysiology of the psychosis. The hippocampus consists of several subfields but it remains unclear their involvement in the early stages of psychosis. Aim: The aim of this study was to investigate volumetric alterations in hippocampal subfields in patients at the first-episode psychosis (FEP). Methods: Magnetic resonance imaging (MRI) data were collected in 134 subjects (58 FEP patients; 76 healthy controls [HC]). A novel automated hippocampal segmentation algorithm was used to segment the hippocampal subfields, based on an atlas constructed from ultra-high resolution imaging on ex vivo hippocampal tissue. The general linear model was used to investigate volume differences between FEP patients and HC, with age, gender and total intracranial volume as covariates. Results: We found significantly lower volumes of bilateral CA1, CA4, and granule cell layer (GCL), and of left CA3, and left molecular layer (ML) in FEP patients compared to HC. Only the volumes of the left hippocampus and its subfields were significantly lower in FEP than HC at the False Discovery Rate (FDR) of 0.1. No correlation was found between hippocampal subfield volume and duration of illness, age of onset, duration of medication, and Positive and Negative Syndrome Scale (PANSS). Conclusion: We report abnormally low volumes of left hippocampal subfields in patients with FEP, sustaining its role as a putative neural marker of psychosis onset.
Background: Hippocampal abnormalities have been largely reported in patients with schizophrenia and bipolar disorder, and are considered to be involved in the pathophysiology of the psychosis. The hippocampus consists of several subfields but it remains unclear their involvement in the early stages of psychosis. Aim: The aim of this study was to investigate volumetric alterations in hippocampal subfields in patients at the first-episode psychosis (FEP). Methods: Magnetic resonance imaging (MRI) data were collected in 134 subjects (58 FEP patients; 76 healthy controls [HC]). A novel automated hippocampal segmentation algorithm was used to segment the hippocampal subfields, based on an atlas constructed from ultra-high resolution imaging on ex vivo hippocampal tissue. The general linear model was used to investigate volume differences between FEP patients and HC, with age, gender and total intracranial volume as covariates. Results: We found significantly lower volumes of bilateral CA1, CA4, and granule cell layer (GCL), and of left CA3, and left molecular layer (ML) in FEP patients compared to HC. Only the volumes of the left hippocampus and its subfields were significantly lower in FEP than HC at the False Discovery Rate (FDR) of 0.1. No correlation was found between hippocampal subfield volume and duration of illness, age of onset, duration of medication, and Positive and Negative Syndrome Scale (PANSS). Conclusion: We report abnormally low volumes of left hippocampal subfields in patients with FEP, sustaining its role as a putative neural marker of psychosis onset.
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