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Title: | Bilateral volume reduction in posterior hippocampus in psychosis of epilepsy. | Austin Authors: | Allebone, James;Kanaan, Richard A A ;Maller, Jerome;O'Brien, Terry;Mullen, Saul A ;Cook, Mark;Adams, Sophia J;Vogrin, Simon;Vaughan, David N;Connelly, Alan;Kwan, Patrick;Berkovic, Samuel F ;D'Souza, Wendyl J;Jackson, Graeme D ;Velakoulis, Dennis;Wilson, Sarah J | Affiliation: | Department of Psychiatry, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia Department of Neuroscience, Alfred Hospital, Monash University, Melbourne, Australia St Vincent's Hospital, Melbourne, Victoria, Australia Graeme Clark Institute, University of Melbourne, Melbourne, Australia ANU College of Health and Medicine, Australian National University, Canberra, Victoria, Australia Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Melbourne, Australia Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia Comprehensive Epilepsy Program Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia Department of Medicine, St Vincent's Hospital, The University of Melbourne, Australia Royal Melbourne Hospital, Melbourne, Victoria, Australia |
Issue Date: | Jun-2019 | Date: | 2019-02-22 | Publication information: | Journal of neurology, neurosurgery, and psychiatry 2019; 90(6): 688-694 | Abstract: | Psychosis of epilepsy (POE) occurs more frequently in temporal lobe epilepsy, raising the question as to whether abnormalities of the hippocampus are aetiologically important. Despite decades of investigation, it is unclear whether hippocampal volume is reduced in POE, perhaps due to small sample sizes and methodological limitations of past research. In this study, we examined the volume of the total hippocampus, and the hippocampal head, body and tail, in a large cohort of patients with POE and patients with epilepsy without psychosis (EC). One hundred adults participated: 50 with POE and 50 EC. Total and subregional hippocampal volumes were manually traced and compared between (1) POE and EC; (2) POE with temporal lobe epilepsy, extratemporal lobe epilepsy and generalised epilepsy; and (3) patients with POE with postictal psychosis (PIP) and interictal psychosis (IP). Compared with EC the POE group had smaller total left hippocampus volume (13.5% decrease, p<0.001), and smaller left hippocampal body (13.3% decrease, p=0.002), and left (41.5% decrease, p<0.001) and right (36.4% decrease, p<0.001) hippocampal tail volumes. Hippocampal head volumes did not differ between groups. Posterior hippocampal volumes are bilaterally reduced in POE. Volume loss was observed on a posteroanterior gradient, with severe decreases in the tail and moderate volume decreases in the body, with no difference in the hippocampal head. Posterior hippocampal atrophy is evident to a similar degree in PIP and IP. Our findings converge with those reported for the paradigmatic psychotic disorder, schizophrenia, and suggest that posterior hippocampal atrophy may serve as a biomarker of the risk for psychosis, including in patients with epilepsy. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/20285 | DOI: | 10.1136/jnnp-2018-319396 | ORCID: | 0000-0003-0992-1917 0000-0002-2872-1112 0000-0002-1750-5131 0000-0002-6225-7739 0000-0003-4580-841X |
Journal: | Journal of neurology, neurosurgery, and psychiatry | PubMed URL: | 30796132 | Type: | Journal Article | Subjects: | epilepsy hippocampus interictal psychosis postictal psychosis psychosis |
Appears in Collections: | Journal articles |
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