A longitudinal study of hippocampal volume in first episode psychosis and chronic schizophrenia

Brain abnormalities have been identified in patients with schizophrenia, bu t what is unclear is whether these changes are progressive over the course of the disorder. In this longitudinal study, hippocampal and temporal lobe volumes were measured at two time points in 30 patients with first episode psychosis (mean follow-up interval = 1.9 years, range 0.54-4.18 years) and 12 with chronic schizophrenia (mean follow-up interval = 2.3 years, range 1 .03-4.12 years) and compared to 26 comparison subjects (mean follow-up inte rval 2.2 years, range 0.86-4.18 years). Hippocampal, temporal lobe, whole-b rain and intracranial volumes (ICV) were estimated from high-resolution mag netic resonance images. Only whole-brain volume showed significant loss ove r the follow-up interval in both patient groups. The rate of this volume lo ss was not different in the first episode group compared to the chronic gro up. There were no changes in either hippocampal or temporal lobe volumes. T he negative findings for the hippocampus and temporal lobes may mean that t he abnormalities in these regions are stable features of schizophrenia. Alt ernatively, the period before the onset of frank psychotic symptoms may be the point of greatest risk for progressive change. (C) 2001 Elsevier Scienc e B.V. All rights reserved.