The following is a summary of “Longitudinal study on hippocampal subfields and glucose metabolism in early psychosis,” published in the July 2024 issue of Psychiatry by Armio et al.
Altered hippocampal morphology and glucose metabolism are observed in psychotic disorders, including patients with first-episode psychosis (FEP) and patients with clinical high-risk (CHR).
Researchers conducted a retrospective study determining whether deficits in hippocampal subfield volumes correlate with deviations in glucose metabolism in early psychosis and if the parameters change over a 1-year follow-up.
They involved 78 patients with FEP, 48 with CHR, and 83 HCs. Hippocampal subfield volumes were assessed using Freesurfer from 3T MRI scans, and glucose metabolism was measured in fasting plasma samples. Subfield volumes and glucose parameters were evaluated at baseline and 1 year later.
The result showed that hippocampal subfield volumes were significantly lower in patients with FEP compared to controls, with the most pronounced reductions in the CA1, molecular layer, and hippocampal tail, especially in non-affective psychoses. Patients with CHR also showed reduced hippocampal tail volumes, and the volume deficits remained stable over 1 year. Both patients with non-diabetic, CHR, and FEP exhibited poorer glucose parameters at baseline, with insulin levels and insulin resistance increasing significantly during follow-up in patients with CHR, particularly patients who converted to psychosis. The worsening in insulin resistance was linked to deterioration in function and symptoms. In patients with FEP, smaller hippocampal tail volumes were associated with higher plasma insulin and insulin resistance at the 1-year mark.
Investigators concluded that stable hippocampal subfield volume deficits, particularly in non-affective psychoses, were linked to worsening glucose metabolism, highlighting the importance of early metabolic health monitoring in patients with CHR progressing to psychosis.
Source: nature.com/articles/s41537-024-00475-z
