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Do cognitive and neuropsychological functioning deficits coincide with hippocampal alteration during first-psychotic episode?

Published online by Cambridge University Press:  03 December 2018

Bashkim Kadriu Open the ORCID record for Bashkim Kadriu [Opens in a new window] ,
Wen Gu ,
Panagiota Korenis  and
Jeffrey M Levine
Bashkim Kadriu*
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Wen Gu
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Panagiota Korenis
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Jeffrey M Levine
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
*
*Address for correspondence: Bashkim Kadriu, MD, National Institute of Mental Health, National Institutes of Health, 10 Center Dr, Room 7-5545, Bethesda, MD 20892, USA. (Email: [email protected])
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Abstract

Background

Numerous studies shown that structural hippocampal alterations are present in subjects at high risk of developing psychosis or schizophrenia. These findings indicate that in a subset of patients undergoing first-psychosis episode (FPE), hippocampal volume alterations are accompanied by associated cognitive and neuropsychological deficits. The combination of psychological deficits and neuroanatomical alterations, in turn, appears to increase treatment complexity and worsen clinical outcomes.

Objective

We aim to determine whether cognitive and neuropsychological functioning deficits precede or follow hippocampal alterations during early onset psychosis.

Methods

This cross-sectional study describes 3 case-studies of adolescent subjects, ages 16–17, admitted at the child and adolescent inpatient psychiatric unit in lieu of first psychotic episode. We conducted detailed structured clinical psychiatric interviews, anatomical-structural magnetic resonance imaging (MRI), sleep-deprived electroencephalogram (EEG) recordings, laboratory testing, and a comprehensive battery of psychological testing to better understand their clinical pictures.

Results

Psychological testing in each patient demonstrated the presence of low to borderline intellectual functioning coupled with neuropsychological deficits in different psychiatric domains. Interestingly, these changes coincided with structural MRI alterations in the hippocampal area.

Conclusions

Our case report adds to the armamentarium of literature signifying that radiologically detectable alterations of the hippocampus may occur either concomitantly or closely following the development of early cognitive deficits in patients with FPE.

Keywords

Electroencephalogram (EEG)first-psychosis episodehippocampalmorphometric alterationsneuropsychological testing
Type
Case based Review
Information
CNS Spectrums , Volume 24 , Issue 5 , October 2019 , pp. 472 - 478
Copyright
© Cambridge University Press 2018 

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