Context
Hippocampal shrinkage is commonly reported in schizophrenia, but its role in the illness is still poorly understood. In particular, it is unclear how clinical and psychosocial variables relate to hippocampal volumes.
Objectives
To address this, new methods for three-dimensional (3-D) computational image analysis may offer more detailed investigation of neuroanatomic differences than standard volumetric measures.
Design
We used high-resolution magnetic resonance imaging and surface-based modeling to map the 3D profile of hippocampal differences. 3D parametric mesh models of the hippocampus were created from manual tracings. Regression models were used to relate diagnostic measures to maps of radial distance. Color-coded maps were generated to show the profile of associations.
Participants
67 adults with schizophrenia (mean age= 39.40±12.08 years; 44 males/23 females) and 72 healthy controls (mean age= 39.28±11.03 years; 38 males/34 females).
Results
There were no detectable differences in hippocampal radial distance between schizophrenia patients and controls. In patients, however, bilateral shrinkage was associated with greater illness severity (i.e. length of illness, positive and negative symptoms), and with poorer social functioning (i.e. educational level, quality of life and health status), which survived Bonferroni correction.
Conclusions
Illness severity and poor social functioning may be associated with hippocampal shrinkage in schizophrenia. As a structural sign of poor outcome, imaging measures may help to identify a subgroup of patients who may need specific treatment to resist hippocampal decreased volumes, such as cognitive rehabilitation, or physical exercise.