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Hippocampal and amygdala volume reductions in first-episode schizophrenia

Published online by Cambridge University Press:  02 January 2018

A. Vita  and
L. de Peri
A. Vita
Affiliation:
Psychiatric Unit, University of Brescia, Brescia, Italy
L. de Peri
Affiliation:
University of Milan, Via Francesco Sforza n. 35, Milan 20122, Italy Email: luca_de_peri@libero.it
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Abstract

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The British Journal of Psychiatry , Volume 190 , Issue 3 , March 2007 , pp. 271
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Copyright © Royal College of Psychiatrists, 2007 

Steen et al (Reference Steen, Mull and McClure2006) 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 (Reference Vita, De Peri and SilenziVita 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 (Reference Velakoulis, Wood and WongVelakoulis 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 (Reference Velakoulis, Wood and Wong2006), 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 (Reference Steen, Mull and McClure2006), 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

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.Google Scholar
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.Google Scholar
Vita, A., De Peri, L., Silenzi, C., et al (2006) Brain morphology in first-episode schizophrenia. A metaanalysis of quantitative magnetic resonance imaging studies. Schizophrenia Research, 82, 75–88.Google Scholar
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