Hippocampal CA1 deformity is related to symptom severity and antipsychotic dosage in schizophrenia.
Hippocampal CA1 deformity is related to symptom severity and antipsychotic dosage in schizophrenia.
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DOI：
10.1093/brain/aws335
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发表时间：
2013-03
期刊：
影响因子：
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通讯作者：
K. Zierhut;R. Grassmann;J. Kaufmann;J. Steiner;B. Bogerts;K. Schiltz
中科院分区：
文献类型：
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作者：
K. Zierhut;R. Grassmann;J. Kaufmann;J. Steiner;B. Bogerts;K. Schiltz
海马区的异常与精神分裂症的病理生理学密切相关。海马体体积缩小在发病时出现，主要见于海马体的前部和后部。然而，尚未观察到影响病理生理学关键区域的特定区域的海马体形状变形与症状学和所需维持药物之间的联系。这项研究的目的是描述CA1特异性海马体表面变形与症状严重程度之间的关系。此外，我们的目的是探索这种特殊的海马区形态异常是否在统计学上预测抗精神病药物的维持剂量。通过高分辨率、全脑、三维结构磁共振成像扫描的手动分割确定海马区的形状和体积。对32例精神分裂症患者的海马体体积、CA1区特殊形状畸形与阳性症状和阴性症状之间的关系进行了研究，并与34例健康对照组进行了比较。精神分裂症患者除了左侧海马区体积缩小外，还在左侧CA1区的前后区出现特殊的形状畸形。总体而言，阳性症状的严重程度与这些形态畸形密切相关，特别是妄想症和幻觉。此外，CA1畸形与所需的抗精神病药物剂量有关。研究结果在第二个独立样本中重复。可能反映萎缩的海马区CA1畸形，可能是由于特定的过度活动引起的，导致局限性体积减少。由于其生理功能，CA1的缺陷可能直接参与了精神分裂症的核心症状幻觉和妄想的发病机制。
Abnormalities of the hippocampus are intricately involved in the pathophysiology of schizophrenia. Hippocampal volume decrease is present at disease onset and has mainly been observed in the anterior and posterior part of the hippocampus. Nevertheless, an association between regionally specific hippocampal shape deformities putatively affecting a pathophysiologically crucial region, i.e. cornu ammonis field 1 (CA1), and symptomatology as well as required maintenance medication has not been observed. The aim of this study was to characterize the relationship between CA1-specific hippocampal surface deformations and symptom severity. Furthermore, we aimed to explore whether such specific morphological hippocampus abnormalities statistically predict the maintenance dosage of antipsychotic medication. Hippocampal shape and volume were determined by manual segmentation of high resolution, whole brain, three-dimensional structural magnetic resonance imaging scans. Associations between hippocampal volume, specific shape deformities in CA1, and positive and negative symptoms were assessed in 32 patients with schizophrenia and compared with 34 healthy control subjects. In addition to volume reductions of the left hippocampus, patients with schizophrenia displayed specific shape deformities in the left anterior and posterior CA1 subfield. Overall, the severity of positive symptoms was closely associated to these morphological deformities, specifically delusions and hallucinations. In addition, CA1 deformity was linked to the required antipsychotic dosage. Findings were replicated in a second, independent sample. Hippocampal CA1 deformity, possibly reflecting shrinkage, might result from a specific hyperactivity, leading to a circumscribed volume loss. Owing to its physiological function, deficits in CA1 may be directly involved in the pathogenesis of hallucinations and delusions, core symptoms in schizophrenia.