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Hippocampal volume change relates to clinical outcome in childhood-onset schizophrenia

Published online by Cambridge University Press:  04 May 2015

A. A. Anvari ,
L. A. Friedman ,
D. Greenstein ,
P. Gochman ,
N. Gogtay  and
J. L. Rapoport
A. A. Anvari*
Affiliation:
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
L. A. Friedman
Affiliation:
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
D. Greenstein
Affiliation:
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
P. Gochman
Affiliation:
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
N. Gogtay
Affiliation:
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
J. L. Rapoport
Affiliation:
Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
*
*Address for correspondence: A. A. Anvari, B.S., Child Psychiatry Branch, National Institute of Mental Health, Building 10, Room 3N202, 10 Center Drive, Bethesda, MD 20892-1600, USA. (Email: [email protected])
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Abstract

Background

Fixed hippocampal volume reductions and shape abnormalities are established findings in schizophrenia, but the relationship between hippocampal volume change and clinical outcome has been relatively unexplored in schizophrenia and other psychotic disorders. In light of recent findings correlating hippocampal volume change and clinical outcome in first-episode psychotic adults, we hypothesized that fewer decreases in hippocampal volume would be associated with better functional outcome and fewer psychotic symptoms in our rare and chronically ill population of childhood-onset schizophrenia (COS) patients.

Method

We prospectively obtained 114 structural brain magnetic resonance images (MRIs) from 27 COS subjects, each with three or more scans between the ages of 10 and 30 years. Change in hippocampal volume, measured by fit slope and percentage change, was regressed against clinical ratings (Children's Global Assessment Scale, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms) at last scan (controlling for sex, time between scans and total intracranial volume).

Results

Fewer negative symptoms were associated with less hippocampal volume decrease (fit slope: p = 0.0003, and percentage change: p = 0.005) while positive symptoms were not related to hippocampal change. There was also a relationship between improved clinical global functioning and maintained hippocampal volumes (fit slope: p = 0.025, and percentage change: p = 0.043).

Conclusions

These results suggest that abnormal hippocampal development in schizophrenia can be linked to global functioning and negative symptoms. The hippocampus can be considered a potential treatment target for future therapies.

Keywords

Childhood-onset schizophreniahippocampusmagnetic resonance imagingnegative symptomspsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 12 , September 2015 , pp. 2667 - 2674
Copyright
Copyright © Cambridge University Press 2015 

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