HIPPOCAMPAL VOLUME REDUCTION IN SCHIZOPHRENIA AS ASSESSED BY MAGNETIC-RESONANCE-IMAGING - A METAANALYTIC STUDY

Background: Although many quantitative magnetic resonance imaging stud ies have found significant volume reductions in the hippocampi of pati ents with schizophrenia compared with those of normal control subjects , others have not. Therefore, the issue of hippocampal volume differen ces associated with schizophrenia remains in question. Methods: Two me ta-analyses were conducted to reduce the potential effects of sampling error and methodological differences in data acquisition and analysis . Eighteen studies with a total patient number of 522 and a to tal con trol number of 426 met the initial selection criteria. Results: Meta-a nalysis 1 yielded mean effect sizes of 0.37 (P<.001) for the left hipp ocampus and 0.39 (P<.001) for the right, corresponding to a bilateral reduction of 4%. Meta-analysis 2 indicated that the inclusion of the a mygdala in the region of interest significantly increased effect sizes across studies (effect size for the left hippocampus and amygdala, 0. 67; for the right, 0.72), whereas variables such as illness duration, total slice width, magnet strength, the use of the intracranial volume as a covariate, measurement reliability, and study quality did not. N o laterality differences were observed in these data. Conclusions: Sch izophrenia is associated with a bilateral volumetric reduction of the hippocampus and probably of the amygdala as well. These findings reinf orce the importance of the medial temporal region in schizophrenia and are consistent with frequently reported memory deficits in these pati ents. Future quantitative magnetic resonance imaging studies evaluatin g the hippocampal volume should measure the hippocampus and amygdala s eparately and compare the volumetric reduction in these structures to that observed in other gray matter areas.