Hippocampal size linked to illness severity, functioning in schizophrenia

By Mark Cowen, Senior medwireNews Reporter

Results from an Italian study show that greater hippocampal deflation is associated with increased illness severity and poorer social functioning in patients with schizophrenia.

Specifically, Paolo Brambilla (University of Udine) and colleagues found that greater bilateral hippocampal shape deflation was associated with increased length of illness and severity of positive and negative symptoms, and reduced educational level, quality of life, and general health status in patients with the disorder.

The findings may "assist in determining patients who would benefit from adequate therapeutic management such as psychosocial stimulation, cognitive rehabilitation or physical exercise," say the researchers.

"Such therapeutic strategies might potentially preserve or normalise hippocampal size, which could also be monitored to study the effects of clinical interventions, ultimately leading to better clinical and social outcomes," they add.

The team used magnetic resonance imaging to produce 3D brain maps of 67 patients with schizophrenia and 72 mentally healthy individuals (controls).

In the schizophrenia patients, clinical symptoms were assessed using the 24-item Brief Psychiatric Rating Scale (BPRS) and psychosocial functioning with the 36-item Short Form Health Questionnaire (SF-36) and the Manchester Short Assessment of Quality of Life (MANSA).

Analysis revealed no significant difference between schizophrenia patients and controls in either hippocampal radial distance or intracranial volume, after accounting for age and gender.

However, in the schizophrenia group, greater bilateral hippocampal shape deflation was significantly associated with increased length of illness, lower levels of education, and higher BPRS scores for positive and negative symptom severity, after adjustment for intracranial volume, gender, and handedness.

Greater bilateral hippocampal shape deflation in the schizophrenia group was also associated with poorer scores for physical health and mental health on the SF-36, and lower MANSA scores.

Brambilla et al conclude in the British Journal of Psychiatry: "Hippocampal deflation may be a structural sign of poor clinical outcome and social functioning in schizophrenia, helping to identify a subgroup of patients who might need specific treatment."

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