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Am J Psychiatry. 2019 Oct 18:appiajp201919020151. doi: 10.1176/appi.ajp.2019.19020151. [Epub ahead of print]

Hyperactivity and Reduced Activation of Anterior Hippocampus in Early Psychosis.

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Department of Psychiatry and Behavioral Sciences (McHugo, Armstrong, Blackford, Woodward, Heckers) and Department of Biostatistics (Vandekar), Vanderbilt University Medical Center, Nashville, Tenn.; and Department of Neurosurgery, Massachusetts General Hospital, Boston (Talati).



In schizophrenia, the anterior hippocampus is hyperactive and shows reduced task-related recruitment, but the relationship between these two findings is unclear. The authors tested the hypothesis that hyperactivity impairs recruitment of the anterior hippocampus during scene processing.


Functional MRI data from 45 early-psychosis patients and 35 demographically matched healthy control subjects were analyzed using a block-design 1-back scene-processing task. Hippocampal activation in response to scenes and faces compared with scrambled images was measured. In a subset of 20 early-psychosis patients and 31 healthy control subjects, baseline hippocampal activity using cerebral blood volume (CBV) mapping was measured. Correlation analyses were used to examine the association between baseline hippocampal activity and task-related hippocampal activation.


Activation of the anterior hippocampus was significantly reduced and CBV in the anterior hippocampus was significantly increased in the early stages of psychosis. Increased CBV in early-psychosis patients was inversely correlated with task-related activation during scene processing in the anterior hippocampus.


Anterior hippocampal hyperactivity in early-psychosis patients appears to limit effective recruitment of this region during task performance. These findings provide novel support for the anterior hippocampus as a therapeutic target in the treatment of cognitive deficits in psychosis.


Brain Imaging; Hippocampus; Psychosis; Schizophrenia

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