Hippocampal subregion volume alterations at baseline and following antidepressant treatment in youth at high risk for bipolar disorder.

What was studied

This randomized trial studied young people at high risk of bipolar disorder. It looked at the brain. They had a close relative with the disorder. They also had moderate to severe depression or anxiety. In all, 105 high-risk youth and 51 healthy controls took part. All had brain MRI at baseline. High-risk youth then got psychotherapy plus escitalopram or placebo. MRI was repeated after 4 weeks. Symptom checks went on to week 16. The team measured the volume of hippocampal subregions.

What they found

At baseline, high-risk youth had larger volumes in several hippocampal parts than controls. These included the CA3 and CA4 areas and parts of the dentate gyrus. They had smaller volumes in the fimbria and the left parasubiculum. With escitalopram, the left hippocampal tail shrank over 4 weeks. That shrinkage went with better disinhibition and impulsivity symptoms. The link held through week 16.

What it means for patients

The team says the larger areas may be adaptive changes. They say the smaller fimbria and parasubiculum point to weak spots in at-risk youth. They say shrinkage of the left hippocampal tail with escitalopram may reflect neural plasticity. They tie it to better emotional symptoms.

Why it is not certain yet

The team words the meanings as may reflect. The abstract does not give effect sizes. Imaging after treatment began was done only at 4 weeks. The abstract does not say how many youth were in each treatment group.

Source

Hippocampal subregion volume alterations at baseline and following antidepressant treatment in youth at high risk for bipolar disorder.

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