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Am J Psychiatry 159:217-226, February 2002
© 2002 American Psychiatric Association


Article

Neuropsychological Correlates of Hippocampal Volumes in Patients Experiencing a First Episode of Schizophrenia

Philip R. Szeszko, Ph.D., Rael D. Strous, M.D., Robert S. Goldman, Ph.D., Manzar Ashtari, Ph.D., Kevin H. Knuth, Ph.D., Jeffrey A. Lieberman, M.D., and Robert M. Bilder, Ph.D.

OBJECTIVE: Despite evidence for hippocampal structural abnormalities in patients with schizophrenia, their functional correlates remain largely unknown. This study investigated the neuropsychological correlates of hippocampal volume in 43 men and 32 women experiencing a first episode of schizophrenia. METHOD: Posterior and anterior hippocampal volumes were computed from contiguous 3.1-mm magnetic resonance images and examined in relationship to six domains of neuropsychological functioning. Significant structure-function associations were investigated by examining the correlations between functioning and individual hippocampal slice volumes across the long axis of the hippocampus after interpolation to 10 equally spaced slice positions. RESULTS: Among men, worse executive and motor functioning correlated significantly with smaller anterior, but not posterior, hippocampal volume. The relationship between executive and motor functioning and hippocampal volume was not linear, however, when examined across the long axis of the hippocampus. Anterior hippocampal volume was more strongly correlated with both executive and motor functioning than with either memory or language functioning in men. None of the correlations between either posterior or anterior hippocampal volumes and the neuropsychological domains was significant among women. Anterior hippocampal volume was more strongly correlated with motor functioning in men than in women. CONCLUSIONS: Anterior hippocampal abnormalities associated with deficits on tests considered sensitive to frontal lobe functions implicate a defect in the integrated system linking frontal and mesiotemporal lobe regions. These findings further suggest that there are sex differences in structure-function relations in schizophrenia such that men may have more pronounced frontolimbic system abnormalities.




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