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Interrelated neuropsychological and anatomical evidence of hippocampal pathology in the at-risk mental state

Published online by Cambridge University Press:  04 April 2008

R. Hurlemann ,
F. Jessen ,
M. Wagner ,
I. Frommann ,
S. Ruhrmann ,
A. Brockhaus ,
H. Picker ,
L. Scheef ,
W. Block  and
H. H. Schild
...Show all authors
R. Hurlemann*
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany
F. Jessen
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany
M. Wagner
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany
I. Frommann
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany
S. Ruhrmann
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
A. Brockhaus
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
H. Picker
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
L. Scheef
Affiliation:
Department of Radiology, University of Bonn, Bonn, Germany
W. Block
Affiliation:
Department of Radiology, University of Bonn, Bonn, Germany
H. H. Schild
Affiliation:
Department of Radiology, University of Bonn, Bonn, Germany
W. Moller-Hartmann
Affiliation:
Department of Radiology, University of Cologne, Cologne, Germany
B. Krug
Affiliation:
Department of Radiology, University of Cologne, Cologne, Germany
P. Falkai
Affiliation:
Department of Psychiatry, University of Goettingen, Goettingen, Germany
J. Klosterkotter
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
W. Maier
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany
*
*Address for correspondence: R. Hurlemann, M.Sc., M.D., Ph.D., Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. (Email: renehurlemann@gmx.de)
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Abstract

Background

Verbal learning and memory deficits are frequent among patients with schizophrenia and correlate with reduced magnetic resonance imaging (MRI) volumes of the hippocampus in these patients. A crucial question is the extent to which interrelated structural-functional deficits of the hippocampus reflect a vulnerability to schizophrenia, as opposed to the disorder per se.

Method

We combined brain structural measures and the Rey Auditory Verbal Learning Test (RAVLT) to assess hippocampal structure and function in 36 never-medicated individuals suspected to be in early (EPS) or late prodromal states (LPS) of schizophrenia relative to 30 healthy controls.

Results

Group comparisons revealed bilaterally reduced MRI hippocampal volumes in both EPS and LPS subjects. In LPS subjects but not in EPS subjects, these reductions were correlated with poorer performance in RAVLT delayed recall.

Conclusions

Our findings suggest progressive and interrelated structural-functional pathology of the hippocampus, as prodromal symptoms and behaviours accumulate, and the level of risk for psychosis increases. Given the inverse correlation of learning and memory deficits with social and vocational functioning in established schizophrenia, our findings substantiate the rationale for developing preventive treatment strategies that maintain cognitive capacities in the at-risk mental state.

Keywords

At-risk mental statehippocampuslearningmemoryprodromeschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 6 , June 2008 , pp. 843 - 851
Copyright
Copyright © Cambridge University Press 2008

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