The British Journal of Psychiatry (2007) 190: 271. doi: 10.1192/bjp.190.3.271
© 2007 The Royal College of Psychiatrists
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Correspondence

Hippocampal and amygdala volume reductions in first-episode schizophrenia

A. Vita

Psychiatric Unit, University of Brescia, Brescia, Italy

L. de Peri

University of Milan, Via Francesco Sforza n. 35, Milan 20122, Italy. Email: luca_de_peri{at}libero.it

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

Steen et al (2006) performed a systematic review and meta-analysis of cross-sectional and longitudinal magnetic resonance imaging (MRI) studies of brain volumes in patients with first-episode psychosis and healthy controls. Despite some methodological differences, the findings were in line with a recent meta-analysis performed by our group (Vita et al, 2006).

A significant decrease in hippocampal but not amygdala volumes was found in patients at illness onset in both reviews. Another relevant paper reporting amygdala and hippocampal volumes in a large sample of patients with first-episode schizophrenia was published after these two meta-analyses (Velakoulis et al, 2006). Thus we considered it worthwhile to conduct a new set of meta-analyses including these MRI data.

The results of the new meta-analyses for hippocampus (7 studies, 290 patients, 355 controls) and amygdala (5 studies, 218 patients, 175 controls) confirmed our previous findings. Even with the inclusion of the study of Velakoulis et al (2006), the composite effect sizes for the hippocampus remained significant (d=0.357, 95% CI 0.208–0.541 for the right hippocampus and 0.574, 95% CI 0.405–0.742 for the left hippocampus) whereas those for the amygdala were not (d=-0.046, 95% CI -0.247 to 0.154 for the right amygdala and 0.025, 95% CI -0.175 to 0.226 for the left amygdala).

These results, in line with those of Steen et al (2006), support the hypothesis of different patterns of involvement of temporolimbic structures over the course of schizophrenia, with the hippocampus affected earlier than the amygdala. In our opinion, these findings have important implications for future neurobiological studies of schizophrenia and emphasise the importance of longitudinal studies to address the issue of different times of occurrence and progression of brain abnormalities in people with first-episode schizophrenia.

REFERENCES

  1. Steen, R. G., Mull, C., McClure, R. M., et al (2006) Brain volume in first-episode schizophrenia. Systematic review and meta-analysis of magnetic resonance imaging studies. British Journal of Psychiatry, 188, 510 -518.[Abstract/Free Full Text]
  2. Velakoulis, D., Wood, S. J., Wong, M. T., et al (2006) Hippocampal and amygdala volumes according to psychosis stage and diagnosis: a magnetic resonance imaging study of chronic schizophrenia, first-episode psychosis, and ultra-high-risk individuals. Archives of General Psychiatry, 63, 139 -149.[Abstract/Free Full Text]
  3. Vita, A., De Peri, L., Silenzi, C., et al (2006) Brain morphology in first-episode schizophrenia. A meta-analysis of quantitative magnetic resonance imaging studies. Schizophrenia Research, 82, 75-88.[CrossRef][Medline]



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