Journal article
Bilateral volume reduction in posterior hippocampus in psychosis of epilepsy
Journal of neurology, neurosurgery and psychiatry, Vol.90(6), pp.688-694
06/01/2019
DOI: 10.1136/jnnp-2018-319396
PMID: 30796132
Abstract
ObjectivePsychosis of epilepsy (POE) occurs more frequently in temporal lobe epilepsy, raising the question as to whether abnormalities of the hippocampus are aetiologically important. Despite decades of investigation, it is unclear whether hippocampal volume is reduced in POE, perhaps due to small sample sizes and methodological limitations of past research.MethodsIn this study, we examined the volume of the total hippocampus, and the hippocampal head, body and tail, in a large cohort of patients with POE and patients with epilepsy without psychosis (EC). One hundred adults participated: 50 with POE and 50 EC. Total and subregional hippocampal volumes were manually traced and compared between (1) POE and EC; (2) POE with temporal lobe epilepsy, extratemporal lobe epilepsy and generalised epilepsy; and (3) patients with POE with postictal psychosis (PIP) and interictal psychosis (IP).ResultsCompared with EC the POE group had smaller total left hippocampus volume (13.5% decrease, p<0.001), and smaller left hippocampal body (13.3% decrease, p=0.002), and left (41.5% decrease, p<0.001) and right (36.4% decrease, p<0.001) hippocampal tail volumes. Hippocampal head volumes did not differ between groups.ConclusionPosterior hippocampal volumes are bilaterally reduced in POE. Volume loss was observed on a posteroanterior gradient, with severe decreases in the tail and moderate volume decreases in the body, with no difference in the hippocampal head. Posterior hippocampal atrophy is evident to a similar degree in PIP and IP. Our findings converge with those reported for the paradigmatic psychotic disorder, schizophrenia, and suggest that posterior hippocampal atrophy may serve as a biomarker of the risk for psychosis, including in patients with epilepsy.
Details
- Title: Subtitle
- Bilateral volume reduction in posterior hippocampus in psychosis of epilepsy
- Creators
- James Allebone - The University of MelbourneRichard Kanaan - Austin HealthJerome Maller - Monash Alfred Psychiatry Research centreTerry O'Brien - Monash UniversitySaul Alator Mullen - Florey Institute of Neuroscience and Mental HealthMark Cook - The University of MelbourneSophia J Adams - The Royal Melbourne HospitalSimon Vogrin - St Vincent's Hospital MelbourneDavid N Vaughan - Austin HealthAlan Connelly - Austin HealthPatrick Kwan - Monash UniversityS F Berkovic - Austin HealthWendyl J D'Souza - The University of MelbourneGraeme Jackson - Austin HealthDennis Velakoulis - The Royal Melbourne HospitalSarah J Wilson - Austin Health
- Resource Type
- Journal article
- Publication Details
- Journal of neurology, neurosurgery and psychiatry, Vol.90(6), pp.688-694
- DOI
- 10.1136/jnnp-2018-319396
- PMID
- 30796132
- NLM abbreviation
- J Neurol Neurosurg Psychiatry
- ISSN
- 0022-3050
- eISSN
- 1468-330X
- Language
- English
- Date published
- 06/01/2019
- Academic Unit
- Radiology
- Record Identifier
- 9984848421802771
Metrics
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