title: Hippocampal subregion volume changes associated with antipsychotic treatment in first-episode psychosis.
abstract: BACKGROUND
  Hippocampal dysfunction is considered central to many neurobiological models of schizophrenia, yet there are few longitudinal in vivo neuroimaging studies that have investigated the relationship between antipsychotic treatment and morphologic changes within specific hippocampal subregions among patients with psychosis.
  
  
  METHODS
  A total of 29 patients experiencing a first episode of psychosis with little or no prior antipsychotic exposure received structural neuroimaging examinations at illness onset and then following 12 weeks of treatment with either risperidone or aripiprazole in a double-blind randomized clinical trial. In addition, 29 healthy volunteers received structural neuroimaging examinations at baseline and 12-week time points. We manually delineated six hippocampal subregions [i.e. anterior cornu ammonis (CA) 1-3, posterior CA1-3, subiculum, dentate gyrus/CA4, entorhinal cortex, and fimbria] from 3T magnetic resonance images using an established method with high inter- and intra-rater reliability.
  
  
  RESULTS
  Following antipsychotic treatment patients demonstrated significant reductions in dentate gyrus/CA4 volume and increases in subiculum volume. Healthy volunteers demonstrated non-significant volumetric changes in these subregions across the two time points. We observed a significant quadratic (i.e. inverted U) association between changes in dentate gyrus/CA4 volume and cumulative antipsychotic dosage between the scans.
  
  
  CONCLUSIONS
  This study provides the first evidence to our knowledge regarding longitudinal in vivo volumetric changes within specific hippocampal subregions in patients with psychosis following antipsychotic treatment. The finding of a non-linear relationship between changes in dentate gyrus/CA4 subregion volume and antipsychotic exposure may provide new avenues into understanding dosing strategies for therapeutic interventions relevant to neurobiological models of hippocampal dysfunction in psychosis.
authors.affiliation: Department of Psychiatry,New York University School of Medicine,New York, NY,USA.
authors.forename: K
authors.initials: K
authors.lastname: Rhindress
authors.affiliation: Department of Psychiatry,Hofstra Northwell School of Medicine,Hempstead, NY,USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Robinson
authors.affiliation: Department of Psychiatry,Weill Cornell Medical College,White Plains, NY,USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Gallego
authors.affiliation: Department of Psychology,St John's University,Queens, NY,USA.
authors.forename: R
authors.initials: R
authors.lastname: Wellington
authors.affiliation: Department of Psychiatry,Hofstra Northwell School of Medicine,Hempstead, NY,USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Malhotra
authors.affiliation: James J. Peters VA Medical Center,Bronx, NY,USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Szeszko
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D000068180:Aripiprazole / Q000008:administration & dosage / Q000494:pharmacology*; D018891:Dentate Gyrus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy*; D018967:Risperidone / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D000068180:Aripiprazole; D018967:Risperidone
keywords: Antipsychotic treatment; dendate gyrus; hippocampus; psychosis; subiculum