The nature of hippocampal changes in
schizophrenia before first treatment, and whether hippocampal subfields are affected by
antipsychotic treatment are important questions for
schizophrenia research. Forty-one first-episode
antipsychotic-naïve acutely ill
schizophrenia inpatients had MRI scans before and six weeks after
antipsychotic treatment. Thirty-nine matched healthy controls were also scanned, twenty-two of which were scanned a second time six weeks later. Volumes of hippocampal subfields were measured via FreeSurfer v6.0 using a longitudinal analysis pipeline. Before treatment,
schizophrenia patients had no significant changes in total hippocampal volume but exhibited significantly greater subfield volumes than controls in bilateral molecular layers of the hippocampus (ML), bilateral granular cell layers of the dentate gyrus (GC-DG), and bilateral cornu ammonis area 4 (CA4). After six weeks of
antipsychotic treatment, patients showed volume reductions compared with pretreatment scans in total hippocampus bilaterally, with subfield volume reduction noted in previously enlarged subfields (i.e., bilateral ML, GC-DG and CA4) and in bilateral hippocampal tails, left CA1, CA3, and fimbria. Subfields with volume increases before treatment were reduced to the level of healthy controls (bilateral ML and GC-DG) or near to it (bilateral CA4)
after treatment. These results indicate subfield-specific hippocampal
hypertrophy prior to treatment, and that these abnormalities were reduced after acute
antipsychotic therapy in a dose-related manner together with volume reductions in other areas that were not hypertrophic before treatment.