Medial temporal lobe structures and hippocampal subfields in psychotic disorders: Findings from the bipolar-schizophrenia network on intermediate phenotypes (B-SNIP) study

Ian Mathew, Tova M. Gardin, Neeraj Tandon, Shaun Eack, Alan N. Francis, Larry J. Seidman, Brett Clementz, Godfrey D. Pearlson, John A. Sweeney, Carol A. Tamminga, Matcheri S. Keshavan

Research output: Contribution to journalArticle

Abstract

IMPORTANCE Structural alterations in the hippocampus and other medial temporal lobe regions have been observed in schizophrenia. How these alterations and hippocampal subfields might differ across the psychosis spectrum remains unclear. OBJECTIVES To characterize medial temporal lobe structures, including hippocampal subfields, usingmagnetic resonance imaging and to examine their relation to psychosis and cognitive function across the psychosis spectrum. DESIGN, SETTING, AND PARTICIPANTS Case-control, cross-sectional neuroimaging study in a large series of probands with psychotic disorders and healthy volunteers as part of the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). Patients with psychotic disorders (schizophrenia, n = 219; schizoaffective disorder, n = 142; and psychotic bipolar disorder, n = 188) and healthy controls (n = 337) were recruited across ambulatory clinics at university health centers in the B-SNIP consortium. MAIN OUTCOMES AND MEASURES Medial temporal lobe and hippocampal subfieldswere quantified with an automated parcellation approach using FreeSurfer software. Memory and other cognitive parameters were assessed using standardized neuropsychological tests. RESULTS Hippocampal volume reductions were seen in all 3 diagnostic groups when compared with healthy controls; alterations in the entorhinal cortex and parahippocampal regions were limited to schizophrenia and schizoaffective disorders (P <.001). Smaller volumes across the hippocampal subfields were seen in all 3 psychotic disorders, with the most prominent differences being in cornu ammonis 2/3 (P <.001). Hippocampal volumes were positively correlated with psychosis severity, declarative memory, and overall cognitive performance (P <.05). CONCLUSIONS AND RELEVANCE Alterations in the hippocampuswere evident across psychotic disorders. Hippocampal subfields that participate in memory-related processes supporting pattern separation and pattern completion might be abnormal and may underlie the pathophysiology of psychosis.

Original languageEnglish (US)
Pages (from-to)769-777
Number of pages9
JournalJAMA Psychiatry
Volume71
Issue number7
DOIs
StatePublished - 2014
Externally publishedYes

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Temporal Lobe
Psychotic Disorders
Schizophrenia
Phenotype
Hippocampus
Entorhinal Cortex
Neuropsychological Tests
Bipolar Disorder
Neuroimaging
Cognition
Healthy Volunteers
Software
Cross-Sectional Studies

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)

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Medial temporal lobe structures and hippocampal subfields in psychotic disorders : Findings from the bipolar-schizophrenia network on intermediate phenotypes (B-SNIP) study. / Mathew, Ian; Gardin, Tova M.; Tandon, Neeraj; Eack, Shaun; Francis, Alan N.; Seidman, Larry J.; Clementz, Brett; Pearlson, Godfrey D.; Sweeney, John A.; Tamminga, Carol A.; Keshavan, Matcheri S.

In: JAMA Psychiatry, Vol. 71, No. 7, 2014, p. 769-777.

Research output: Contribution to journalArticle

Mathew, I, Gardin, TM, Tandon, N, Eack, S, Francis, AN, Seidman, LJ, Clementz, B, Pearlson, GD, Sweeney, JA, Tamminga, CA & Keshavan, MS 2014, 'Medial temporal lobe structures and hippocampal subfields in psychotic disorders: Findings from the bipolar-schizophrenia network on intermediate phenotypes (B-SNIP) study', JAMA Psychiatry, vol. 71, no. 7, pp. 769-777. https://doi.org/10.1001/jamapsychiatry.2014.453
Mathew, Ian ; Gardin, Tova M. ; Tandon, Neeraj ; Eack, Shaun ; Francis, Alan N. ; Seidman, Larry J. ; Clementz, Brett ; Pearlson, Godfrey D. ; Sweeney, John A. ; Tamminga, Carol A. ; Keshavan, Matcheri S. / Medial temporal lobe structures and hippocampal subfields in psychotic disorders : Findings from the bipolar-schizophrenia network on intermediate phenotypes (B-SNIP) study. In: JAMA Psychiatry. 2014 ; Vol. 71, No. 7. pp. 769-777.
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abstract = "IMPORTANCE Structural alterations in the hippocampus and other medial temporal lobe regions have been observed in schizophrenia. How these alterations and hippocampal subfields might differ across the psychosis spectrum remains unclear. OBJECTIVES To characterize medial temporal lobe structures, including hippocampal subfields, usingmagnetic resonance imaging and to examine their relation to psychosis and cognitive function across the psychosis spectrum. DESIGN, SETTING, AND PARTICIPANTS Case-control, cross-sectional neuroimaging study in a large series of probands with psychotic disorders and healthy volunteers as part of the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). Patients with psychotic disorders (schizophrenia, n = 219; schizoaffective disorder, n = 142; and psychotic bipolar disorder, n = 188) and healthy controls (n = 337) were recruited across ambulatory clinics at university health centers in the B-SNIP consortium. MAIN OUTCOMES AND MEASURES Medial temporal lobe and hippocampal subfieldswere quantified with an automated parcellation approach using FreeSurfer software. Memory and other cognitive parameters were assessed using standardized neuropsychological tests. RESULTS Hippocampal volume reductions were seen in all 3 diagnostic groups when compared with healthy controls; alterations in the entorhinal cortex and parahippocampal regions were limited to schizophrenia and schizoaffective disorders (P <.001). Smaller volumes across the hippocampal subfields were seen in all 3 psychotic disorders, with the most prominent differences being in cornu ammonis 2/3 (P <.001). Hippocampal volumes were positively correlated with psychosis severity, declarative memory, and overall cognitive performance (P <.05). CONCLUSIONS AND RELEVANCE Alterations in the hippocampuswere evident across psychotic disorders. Hippocampal subfields that participate in memory-related processes supporting pattern separation and pattern completion might be abnormal and may underlie the pathophysiology of psychosis.",
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T1 - Medial temporal lobe structures and hippocampal subfields in psychotic disorders

T2 - Findings from the bipolar-schizophrenia network on intermediate phenotypes (B-SNIP) study

AU - Mathew, Ian

AU - Gardin, Tova M.

AU - Tandon, Neeraj

AU - Eack, Shaun

AU - Francis, Alan N.

AU - Seidman, Larry J.

AU - Clementz, Brett

AU - Pearlson, Godfrey D.

AU - Sweeney, John A.

AU - Tamminga, Carol A.

AU - Keshavan, Matcheri S.

PY - 2014

Y1 - 2014

N2 - IMPORTANCE Structural alterations in the hippocampus and other medial temporal lobe regions have been observed in schizophrenia. How these alterations and hippocampal subfields might differ across the psychosis spectrum remains unclear. OBJECTIVES To characterize medial temporal lobe structures, including hippocampal subfields, usingmagnetic resonance imaging and to examine their relation to psychosis and cognitive function across the psychosis spectrum. DESIGN, SETTING, AND PARTICIPANTS Case-control, cross-sectional neuroimaging study in a large series of probands with psychotic disorders and healthy volunteers as part of the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). Patients with psychotic disorders (schizophrenia, n = 219; schizoaffective disorder, n = 142; and psychotic bipolar disorder, n = 188) and healthy controls (n = 337) were recruited across ambulatory clinics at university health centers in the B-SNIP consortium. MAIN OUTCOMES AND MEASURES Medial temporal lobe and hippocampal subfieldswere quantified with an automated parcellation approach using FreeSurfer software. Memory and other cognitive parameters were assessed using standardized neuropsychological tests. RESULTS Hippocampal volume reductions were seen in all 3 diagnostic groups when compared with healthy controls; alterations in the entorhinal cortex and parahippocampal regions were limited to schizophrenia and schizoaffective disorders (P <.001). Smaller volumes across the hippocampal subfields were seen in all 3 psychotic disorders, with the most prominent differences being in cornu ammonis 2/3 (P <.001). Hippocampal volumes were positively correlated with psychosis severity, declarative memory, and overall cognitive performance (P <.05). CONCLUSIONS AND RELEVANCE Alterations in the hippocampuswere evident across psychotic disorders. Hippocampal subfields that participate in memory-related processes supporting pattern separation and pattern completion might be abnormal and may underlie the pathophysiology of psychosis.

AB - IMPORTANCE Structural alterations in the hippocampus and other medial temporal lobe regions have been observed in schizophrenia. How these alterations and hippocampal subfields might differ across the psychosis spectrum remains unclear. OBJECTIVES To characterize medial temporal lobe structures, including hippocampal subfields, usingmagnetic resonance imaging and to examine their relation to psychosis and cognitive function across the psychosis spectrum. DESIGN, SETTING, AND PARTICIPANTS Case-control, cross-sectional neuroimaging study in a large series of probands with psychotic disorders and healthy volunteers as part of the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). Patients with psychotic disorders (schizophrenia, n = 219; schizoaffective disorder, n = 142; and psychotic bipolar disorder, n = 188) and healthy controls (n = 337) were recruited across ambulatory clinics at university health centers in the B-SNIP consortium. MAIN OUTCOMES AND MEASURES Medial temporal lobe and hippocampal subfieldswere quantified with an automated parcellation approach using FreeSurfer software. Memory and other cognitive parameters were assessed using standardized neuropsychological tests. RESULTS Hippocampal volume reductions were seen in all 3 diagnostic groups when compared with healthy controls; alterations in the entorhinal cortex and parahippocampal regions were limited to schizophrenia and schizoaffective disorders (P <.001). Smaller volumes across the hippocampal subfields were seen in all 3 psychotic disorders, with the most prominent differences being in cornu ammonis 2/3 (P <.001). Hippocampal volumes were positively correlated with psychosis severity, declarative memory, and overall cognitive performance (P <.05). CONCLUSIONS AND RELEVANCE Alterations in the hippocampuswere evident across psychotic disorders. Hippocampal subfields that participate in memory-related processes supporting pattern separation and pattern completion might be abnormal and may underlie the pathophysiology of psychosis.

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