Hippocampal Reductions and Childhood Trauma in First-Episode Schizophrenia

Exposure to childhood trauma exerts disease-specific effects on hippocampal structures in patients who are women  experiencing their first-episode of schizophrenia, which is consistent with increased stress sensitivity in this patient population, according to research results published in Schizophrenia Research.

Recognizing that few studies have assessed the impact of childhood trauma exposure on hippocampal morphometry in minimally treated patients with first-episode schizophrenia, the investigators sought to explore the associations of childhood trauma with hippocampal subfield volumes in a cross-sectional, case-control, single-site study conducted in South Africa. The study was performed in a cohort of antipsychotic-naïve or minimally treated patients with first-episode schizophrenia spectrum disorder and matched controls.

Overall, a total of 161 patients were enrolled in the study: 79 patients with first-episode schizophrenia spectrum disorder and 82 matched controls. All patients completed a Childhood Trauma Questionnaire (CTQ) and underwent magnetic resonance imaging evaluation.

The researchers reconstructed hippocampal subfields. Furthermore, they examined intercorrelations between the various subfields by entering them as dependent variables into a multivariate analysis of covariance (MANCOVA), modeling for interactions between diagnosis, childhood trauma total score, and gender while at the same time controlling for substance utilization, scanner sequence, and age.

Per MANCOVA, a significant interaction was reported between sex, childhood trauma total scores, and diagnosis across the hippocampal subregions (P =.012). Bonferroni-corrected post hoc analysis demonstrated a significant sex diagnosis CTQ score interaction for the hippocampal fissure only (P =.003). In order to explore a potential hemispheric difference, the analysis was repeated for both hemispheres, with a slightly more significant result shown for the right hippocampal fissure (P =.004) compared with the left hippocampal fissure (P =.010).

The investigators concluded that the findings from this study imply a unique association between early life trauma and biological changes in stress-sensitive brain regions. In particular, a relationship was shown between CTQ total scores and larger hippocampal fissures in first-episode patients who were women with schizophrenia spectrum disorder, but not in patients who were men or controls who were women.

Disclosure: Robin Emsley, MBChB, has participated in speakers/advisory boards and received honoraria from Janssen, Lundbeck, Servier and Otsuka.

Reference

du PlessisS, Scheffler F, Luckhoff H, et al. Childhood trauma and hippocampal subfield volumes in first-episode schizophrenia and healthy controls [published online October 22, 2019]. Schizophr Res. doi:10.1016/j.schres.2019.10.009