Left Hippocampus Of Patients Research Articles

A eficácia do canabidiol no tratamento de transtornos mentais: Uma revisão sistemática de ensaios clínicos randomizados duplo-cegos

INTRODUCTION: The therapeutic application of cannabidiol (CBD) is gaining interest due to the growing body of evidence supporting its use in the treatment of mental disorders. OBJECTIVES: To develop a systematic review to evaluate the scientific evidence supporting the use of CBD in the treatment of psychiatric disorders. METHODS: Only double-blind randomized clinical trials were used. The search for scientific evidence was carried out in the PubMed and VHL databases, with the descriptors "cannabidiol" and "mental disorders". Between 2020 and 2022, 219 articles were found in PubMed and 79 in the VHL. Review articles, observational studies, manuscripts, repeated articles, and articles that did not focus on the treatment of mental disorders by the use of cannabidiol were excluded. Thus, 10 relevant studies remained for the present systematic review. RESULTS: Of the 10 articles selected, 90% presented positive results for the use of CBD in the treatment of various mental disorders. Among them, there was a higher prevalence of drug use for the treatment of psychosis, anxiety and behavioral mechanisms; evidencing its usefulness and benefits. It was observed that in cases of psychosis, CBD significantly increased glutamate levels in the left hippocampus of patients, proving its effectiveness. In research involving behavioral mechanisms, it was possible to verify that the use of CBD linearly decreased the levels of cortisol linked to stress in the patient's body, evidencing its therapeutic capacity. CONCLUSION: The use of CBD was useful to relieve the symptoms of some mental disorders, such as psychosis, anxiety, schizophrenia, autism, behavioral problems and stress. In addition, research has still shown uncertain and sometimes even contradictory results, which reinforces the need for more research on the action of this drug in the treatment of mental disorders.

Neurochemical correlates of cognitive functions in euthymic patients with bipolar disorder: 1H-MRS study.

We assessed and correlated neurochemical levels and cognitive functions in left dorsolateral prefrontal cortex (DLPFC) and left hippocampus in euthymic patients with bipolar disorder and compared these with healthy controls METHODOLOGY: Twenty-five right-handed euthymic patients (HAM-D score<7, and YMRS score<7) with bipolar disorder and 20 age and gender matched controls were compared for neurometabolites (n-acetylaspartate - tNAA, choline - Cho, creatinine - Cr, myoinositol - Ins, and glutamine/glutamate - Glu/Gln) measured in left DLPFC and left hippocampus using single voxel magnetic resonance spectroscopy (MRS) and cognitive functions assessed using trail making test (TMT - A and B), wisconsin card sorting test (WCST), and wechsler memory scale (WMS-III Indian adaptation). The two groups were comparable on socio-demographic variables. tNAA levels in DLPFC and hippocampus, and glutamate levels in hippocampus were found to be significantly lower and Inositol and glutamine levels in hippocampus were found to be significantly higher in patients as compared to controls. Patients performed significantly poorly as compared to controls on TMT A & B, all subscales of WMS - III, 5 subscales of WCST, including perseverative responses and errors. The tNAA and glutamate levels in left DLPFC in patients correlated with scores on TMT A & B, and several subscales of WCST and WMS-III. tNAA concentration in left hippocampus in patients correlated with scores on subscales of WMS-III. Neurochemical dysfunction in select brain areas directly correlates with impairment in cognitive functions seen in patients with bipolar disorder in euthymic phase.

Hippocampal intracerebral evoked potentials as a marker of its functionality in drug-resistant epilepsy

ObjectivesTo assess hippocampal function during stereoelectroencephalography (SEEG) investigations through the study of the medial temporal lobe event-related potential (ERP) MTL-P300. MethodsWe recorded the MTL-P300 during a visual oddball task, using hippocampal electrodes implanted for SEEG in 71 patients, in a preoperative epilepsy investigation. The presence of an MTL-P300 and its amplitude were correlated with hippocampal involvement during seizures and memory function. ResultsAnalysis using ROC curves revealed that an MTL-P300 amplitude below -46 µV, has a specificity of 93.3% in detecting the epileptogenic zone, and absence of the MTL-P300 in the left hippocampus of patients with typical language organization was associated with marked alteration of verbal memory scores. There was a significant correlation between performance in non-verbal memory tests and the amplitude of the MTL-P300 in the right hippocampus of patients with left hemispheric seizures (immediate visual recall: r = 0.67, p = 0.005; delayed visual recall: r = 0.56, p = 0.025). Using a linear regression, we confirmed that the absence of the MTL-P300 in the left hippocampus, the involvement of the left hippocampus during seizures, and the duration of epilepsy were predictors of verbal memory deficits. ConclusionAnalysis of the MTL-P300 during SEEG recording provides relevant information for the analysis of hippocampal functionality and can help to localize the epileptogenic zone.

Alterations of limbic structure volumes and limbic covariance network in patients with cluster headache

The aim of this study was to compare the limbic structures and covariance network in patients with cluster headache to those of healthy controls. We enrolled 23 patients with newly diagnosed cluster headache and 31 healthy controls. They underwent three-dimensional T1-weighted imaging utilizing a 3.0 Tesla MRI scanner. Volumetric analysis of the subcortical limbic structures, including the hippocampus, amygdala, thalamus, mammillary body, hypothalamus, basal forebrain, septal nuclei, fornix, and nucleus accumbens, was performed. We examined the limbic covariance network using a graph theory. The volumes of the limbic structures between patients with cluster headache and healthy controls were significantly different. The volume of the left hippocampus in patients with cluster headache was significantly lower than that in healthy controls (0.256 vs 0.291 %, p = 0.002). Patients with cluster headache showed significant alterations of the limbic covariance network. The average strength, global efficiency, local efficiency, mean clustering coefficient, and transitivity were lower (5.238 vs 10.322, p = 0.030; 0.355 vs 0.608, p = 0.020; 0.547 vs 1.553, p = 0.020; 0.424 vs 0.895, p = 0.016; respectively), whereas the characteristic path length was higher (3.314 vs 1.752, p = 0.040) in patients with cluster headache than in healthy controls. We detected alterations of limbic structure volumes in patients with cluster headache compared to healthy controls, especially in the hippocampus. We also found significant alterations in the limbic covariance network in patients with cluster headache who showed decreased segregation and integration. These abnormalities could be related to the pathophysiology of cluster headache.

Altered Gray Matter Volume, Functional Connectivity, and Degree Centrality in Early-Onset Type 2 Diabetes Mellitus.

Background: Structural and functional brain alterations that underlie cognitive decline have been observed in elderly adults with type 2 diabetes mellitus (T2DM); however, whether these alterations can be observed in patients with early-onset T2DM remains unclear. Therefore, we aimed to describe the abnormalities in brain volume and functional patterns in patients with early-onset T2DM in the present study.Methods: We enrolled 20 patients with early-onset T2DM and 20 healthy controls (HCs). Changes in brain volume were assessed using voxel-based morphology (VBM), while changes in brain function were assessed using degree centrality (DC) and functional connectivity (FC).Results: Compared to HCs, patients with early-onset T2DM exhibited gray matter reductions in the left orbital superior, middle, and inferior frontal gyri as well as the right superior frontal gyrus. The gray matter reductions in the right superior frontal gyrus were negatively associated with the urine albumin to creatinine ratio. Furthermore, increased DC values were observed in the left superior temporal gyrus, left Heschl gyrus, and left hippocampus in patients with early-onset T2DM. An FC analysis of these regions revealed elevated connectivity in the right precuneus, left inferior parietal gyrus, left Heschl gyrus, bilateral post-central gyrus, bilateral insula, bilateral superior temporal gyrus, and bilateral medial and paracingulate gyrus. Furthermore, the FC of the hubs to the superior temporal gyrus, insula, and Heschl gyrus was increased and positively correlated with trail making test-B.Conclusion: Decreased local gray matter volume and increased DC and FC may represent the neurobiological mechanism underlying cognitive dysfunction in patients with early-onset T2DM.

Phase II double blinded randomized placebo-controlled trial of minocycline to ameliorate chemotherapy-induced cognitive changes in breast cancer (BC) patients.

e12528 Background: Chemotherapy promotes oxidative stress and neuroinflammation through microglial activation. In preclinical models, minocycline is a potent mitigator of microglial activation. We evaluated the efficacy of co-administration of minocycline with chemotherapy and its effect on inflammatory markers, PET/CT imaging, and cognitive changes in patients with BC. Methods: Women initiating first line adjuvant or neoadjuvant chemotherapy for BC were randomized to receive 100mg twice daily minocycline or placebo during chemotherapy treatment. Depression, anxiety, and cognitive function symptoms were measured with CES-D, STAI, BRIEF-A, and MFMQ testing. Inflammatory changes were evaluated by cytokine panels and PET/CT brain imaging. PET/CT imaging was performed on a Philips Vereos with a single bed dynamic acquisition over the brain acquired continuously for 75 minutes after injection of 3mCi 18F-fluorodeoxyglucose (FDG). Linear mixed effects models were used for statistical analysis. Results: 60 BC patients were randomized (stage distribution: 18.3% IA, 30% IIA, 10% IDC, 8.3% IB, 18.3% IIB, 13.3% IIIA). Median age was 52 years (range 26 - 71). 27 patients (45%) received an anthracycline (AC)-containing regimen, while 33 (55%) received a non-AC-containing regimen. Minocycline group had 42.9% ER+/PR+, HER2- and 32.1% HER2+ disease, while placebo had 51.9% ER+/PR+, HER2- and 22.2% HER2+. Inflammatory cytokine levels increased over time with chemotherapy regardless of group (Log10 of IL-8, TNF-alpha, and TNF-RII +0.5, +0.21, +1.7 with p &lt; 0.001). There were no statistically significant differences between minocycline and placebo groups in changes in anxiety (STAI, -7.9 vs -7.6, p = 0.93), depression (CES-D, -0.3 vs -2.1, p = 0.39), cognitive function (BRIEF-A: +5.8 vs -0.4, p = 0.20; MFMQ: -1.8 vs -5.1, p = 0.49), or cytokine levels. 20 patients underwent PET/CT at treatment onset, 15 repeated imaging at cycle 4, and 13 at 6 months post-treatment. Although not significantly related to treatment group, distinct changes in brain metabolic characteristics in key regions such as the hippocampus were identifiable and quantifiable on an individual basis, and a significantly higher rate of FDG uptake was found over 75 minutes in the left hippocampus in patients who received AC-based chemotherapy compared to non-AC chemotherapy (p = 0.0271). Conclusions: Inflammation increased during chemotherapy. Minocycline co-administration did not mitigate changes in anxiety, depression, cognitive function, cytokine levels, or FDG-uptake in PET/CT imaging. The hippocampal differences in patients receiving AC verses non-AC chemotherapy suggest that AC therapy was more pro-inflammatory. This highlights the potential of PET/CT to monitor microglial activation, providing an objective assessment of neurocognitive function in future studies. Clinical trial information: NCT02203552.

Subcortical gray matter structural alterations in prediabetes and type 2 diabetes.

Type 2 diabetes (T2D) is a risk factor for cognitive impairment and potentially Alzheimer's disease. However, the precise mechanism underlying the effects of glucose on brain abnormalities is not fully understood. The differential effects of glucose alteration on brain changes in patients with T2D and those with prediabetes are also unclear. MRI data were collected from 21 patients with T2D (male/female, 7/14); 21 patients with prediabetes (male/female, 8/13); and 21 age-matched, sex-matched, and education-matched normal controls (male/female, 7/14). MRI data were analyzed using the Freesurfer software to obtain subcortical gray matter (GM) structural volumes. Spearman correlation analysis was performed between GM structural volume and clinical data. Reduced subcortical GM volumes were found in patients with prediabetes and those with T2D in the bilateral lateral hippocampus, left amygdala, and right putamen compared with healthy controls. In addition, postprandial blood sugar remained significantly associated with GM volume in the left hippocampus of patients with T2D. Our results indicate that prediabetes is not the harmless condition that it was previously thought to be, that impaired glycemia negatively affects the structures of the brain, and that long-lasting hyperglycemia accelerates brain atrophy in patients with T2D.

Neurotrophic factors and hippocampal activity in PTSD.

Although numerous studies have investigated the neurotrophic factors and hippocampal activity in posttraumatic stress disorder (PTSD) separately each other, it is unclear whether an association between neurotrophic factors and hippocampal activity is present. The aim of this study was to evaluate the functional changes in hippocampus before and after treatment with escitalopram and to associate these changes with peptides related to neuronal growth in patients with chronic PTSD and trauma survivors without PTSD. Fifteen earthquake survivors with chronic PTSD and thirteen drug naïve trauma exposed individuals without PTSD underwent fMRI scans in a block design. Serum levels of Nerve Growth Factor (NGF) and Brain Derived Neurotrophic Factor (BDNF) were measured before and after 12 weeks treatment with escitalopram. Baseline median serum level of NGF was significantly lower in patients with chronic PTSD than trauma survivors; however, 12 weeks of treatment with escitalopram significantly increased it. Higher activation was found both in left and right hippocampus for chronic PTSD group than trauma survivors. Treatment with escitalopram was significantly associated with suppression of the hyperactivation in left hippocampus in patients with chronic PTSD. Bilateral hyperactivation in hippocampus and lowered NGF may associate with neurobiological disarrangements in chronic PTSD. Treatment with escitalopram was significantly associated with both improvement in the severity of PTSD symptoms and biological alterations. Patients diagnosed with PTSD may have further and complicated deteriorations in hippocampal networks and neurotransmitter systems than individuals who had not been diagnosed with PTSD following the same traumatic experience.

18F-FDG uptake and clearance in the amygdala and hippocampus in patients with first-episode depression

Objective To observe the dynamic changes of 18F-FDG uptake and clearance in the amygdala and hippocampus in patients with first-episode depression(FED), and explore the neurobiology mechanism of FED. Methods 18F-FDG PET/CT imaging was performed on 35 patients with FED and 35 healthy volunteers from January 2014 to January 2016. SUVmax in the amygdala and hippocampus at different time points were collected. The clearance rates were calculated and the difference between patients and healthy volunteers were compared by two-sample t test. Results The FDG uptake in the left amygdala of patients reached the peak earlier compared with that in the healthy group, with the SUVmax of 12.94±2.03 at 25 min and 10.50±1.79 at 40 min, respectively. FDG uptake in the left amygdala at 10, 25, 40, 55, 70, 85 min between the 2 groups were significantly different (t values: 12.92, 8.65, 6.99, 12.34, 28.87, 13.87; all P<0.05). The clearance rate in the left amygdala of patients at different time interval was increased compared with that of the healthy group(40-55 min: t=32.53; 56-70 min: t=32.73; 71-85 min: t=11.10; all P<0.05). Compared with the healthy group, FDG uptake in the left hippocampus of patients was decreased significantly at 10, 25, 40, 55, 85 min (t values: 2.70, 7.75, 7.78, 8.81, 7.00; all P<0.05) for FDG uptake, and the clearance rate was also decreased significantly at different time interval(40-55 min: t=6.02; 56-70 min: t=62.15; 71-85 min: t=37.39; all P<0.05). Differences of metabolic changes in the right amygdala and the right hippocampus were not significant. Conclusions 18F-FDG metabolism in the amygdala and hippocampus of patients with FED may be abnormal, which is characterized by earlier peak uptake and quicker clearance in the left amygdala while lower uptake and slower clearance in the left hippocampus. Key words: Depressive disorder; Amygdala; Hippocampus; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose

Glycine transporter inhibitor sarcosine changes neuronal and glial parameters in the left dorsolateral prefrontal cortex and glutamatergic parameters in the left hippocampus in stable schizophrenia

IntroductionSarcosine - glycine transporter inhibitor - increases glycine concentration around NMDA (N-methyl-D-aspartate) receptors. Function of the glutamatergic system in the prefrontal cortex and hippocampus is impaired in schizophrenia, which may lead to negative and cognitive symptomatology.AimsWe evaluated the influence of sarcosine therapy on the concentration of metabolites (NAA, N-acetylaspartate; Glx, complex of glutamate, glutamine and γ-aminobutyric acid (GABA); mI, myo-inositol; Cr, creatine; Cho, choline) in the left dorso-lateral prefrontal cortex (DLPFC) and left hippocampus in patients with stable schizophrenia.MethodsFifty patients with schizophrenia, treated with constant antipsychotics doses, in stable clinical condition were randomly assigned (25 patients in each group) to administration of sarcosine (2 g) or placebo for six months. 1H-NMR spectroscopy (1.5 T) in both localisations and clinical evaluation (PANSS) was performed before and after sarcosine addition.ResultsInitially we noted no differences in metabolite concentrations between groups. In the left DLPFC, NAA/Cho, mI/Cr and mI/Cho ratios were significantly higher in the sarcosine than the placebo group after six months. In the sarcosine group, NAA/Cr, NAA/Cho, mI/Cr, mI/Cho ratios also increased compared to baseline values. In the placebo group, only the NAA/Cr ratio increased. In the left hippocampus Glx/Cr and Glx/Cho decreased in sarcosine group at the end of our study.ConclusionsThe addition of sarcosine to antipsychotic therapy for six months caused increase of neurons viability (NAA) and neurogilal activity (mI) markers in the left DLPFC and decrease of hyperglutamatergic overstimulation parameters in the left hippocampus with simultaneous improvement of clinical parameters including negative symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Supplementation of antipsychotic treatment with sarcosine – GlyT1 inhibitor – causes changes of glutamatergic 1NMR spectroscopy parameters in the left hippocampus in patients with stable schizophrenia

Glutamatergic system, the main stimulating system of the brain, plays an important role in the pathogenesis of schizophrenia. Hippocampus, a structure crucial for memory and cognitive functions and rich in glutamatergic neurons, is a natural object of interest in studies on psychoses. Sarcosine, a glycine transporter (GlyT-1) inhibitor influences the function of NMDA receptor and glutamate-dependent transmission.The aim of the study was to assess the effects of sarcosine on metabolism parameters in the left hippocampus in patients with schizophrenia. Assessments were performed using proton nuclear magnetic resonance (1H NMR) spectroscopy (1.5T).Fifty patients diagnosed with schizophrenia (DSM-IV-TR), with dominant negative symptoms, in stable clinical condition and stable antipsychotics doses were treated either with sarcosine (n=25) or placebo (n=25). Spectroscopic parameters were evaluated within groups and between two groups before and after 6-month intervention. All patients were also assessed with the Positive and Negative Syndrome Scale (PANSS).In the sarcosine group, after 6-month treatment, we found significant decrease in hippocampal Glx/Cr (Glx-complex of glutamate, glutamine and GABA, Cr-creatine) and Glx/Cho (Cho-choline), while N-acetylaspartate (NAA), myo-inositol (mI), Cr and Cho parameters remained stable along the study and also did not differ significantly between both groups.This is the first study showing that a pharmacological intervention in schizophrenia, particularly augmentation of the antypsychotic treatment with sarcosine, may reverse the pathological increase in glutamatergic transmission in the hippocampus. The results confirm involvement of glutamatergic system in the pathogenesis of schizophrenia and demonstrate beneficial effects of GlyT-1 inhibitor on the metabolism in the hippocampus and symptoms of schizophrenia.

P3‐130: Effects of white matter hyperintensities on the volumes of right and left hippocampus in patients with Alzheimer's disease

P3‐130: Effects of white matter hyperintensities on the volumes of right and left hippocampus in patients with Alzheimer's disease

A 1H magnetic spectroscopy study in the first-episode patients with positive symptoms of schizophrenia

Objective To identify the possible alterations of brain function in prefrontal lobes and hippocampus in the first-episode patients with positive symptoms of schizophrenia using magnetic resonance spectroscopy. Methods 20 patients were selected to perform MRI and HMRS examination. Proton multi-voxel spectroscopy imaging(1 H-MRSI)was obtained from two sides of the hippocampus and frontal lobes regions. The metabolites included N-acetylaspartate (NAA), and choline-containing compounds (Cho), creatine and phosphocreatine (Cr).The ratios of NAA/Cr, Cho/Cr and NAA/Cho were determined. Results (1)The Cho/Cr ratio was significantly reduced in left frontal white matter of patients compared to right(1. 178 ± 0.210 vs 1.437 ± 0. 337). (2) There was no statistically significant difference in metabolite levels in between left anterior cingulate gray matter and right (N AA. Cr: 1. 339 ± 0.452 vs 1. 748 ± 0. 147;Cho/Cr: 1. 406 ± 0. 394 vs 1. 761 ± 0.362) (P ＜ 0.05). (3) The NAA/Cr, Cho/Cr were significantly reduced in left hippocampus of patients compared to right. Conclusion The results implicate that the metabolic abnormalities might exist in the left hippocampus and frontal lobe of schizophrenic patients with positive symptoms. Key words: Schizophrenia; Frontal lobes; Hippocampus; Magnetic resonance spectroscopy

An isotropic study of cerebral white matter fiber tracts in first-onset schizophrenia

ObjectiveTo measure white matter fiber tracts in some brain regions of using the diffusion tensor imaging (DTI) in patients with first-onset schizophrenia.MethodsDTI was performed in 12 patients with first-onset schizophrenia and 12 gender ,age,and education matched controls. Fractional anisotropy (FA) were measured in regions of interest (ROI) of different anatomic sites,such as genu and splenium of corpus callosum,anterior and posterior limb of internal capsule,head of hippocampus,amygdaloid body,frontal white matter,and anterior cingulate fasciculus. Results(1) No differences of FA values in ROIs between left and right sides were found in both patients (frontal lobe,0.516±0.088,0.545±0.064)and controls (frontal lobe,0.525±0.055,0.528±0.054) (P>0.05). (2) FA values of DTI showed significantly lower in the head of left hippocampus in first-onset schizophrenia(0.174±0.030) than that in controls(0.203±0.020)(P<0.05). ConclusionIntegrity of white matter fiber was disrupted in the head of left hippocampus in patients with first-onset schizophrenia. Key words: Schizophrenia; Hippocampus; Diffusion tensor imaging

Neurochemical pathology in hippocampus in euthymic patients with bipolar I disorder

Subcortical regions such as hippocampus, thalamus and ventral putamen are assumed to be involved in the pathophysiology of mood regulation. Disturbed hippocampal neuronal function indicated by reduced N-acetyl-aspartate (NAA) levels in bipolar patients was shown by several studies. Results in thalamus and putamen are inconsistent. N-acetyl-aspartate, choline (Cho), creatine (Cr) and myo-inositol (Ins) were measured in left hippocampus, left thalamus and left putamen using proton magnetic resonance spectroscopy in 13 euthymic patients with bipolar I disorder and 13 pairwise matched healthy control subjects. Metabolic ratios NAA/Cr, NAA/Cho, Cho/Cr and Ins/Cr were calculated. Patients with bipolar I disorder demonstrated significantly reduced NAA/Cr in the left hippocampus compared with healthy control subjects. No alterations were found in thalamus or putamen. We hypothesize that this NAA/Cr reduction might reflect neuronal dysfunction in the left hippocampus in patients with bipolar disorder.

An in vivo MR spectroscopy imaging on hippocampus in patients with posttraumatic stress disorder

目的 探讨创伤后应激障碍(PTSD)患者双侧海马活体MR波谱(MRS)的特点,为创伤后应激障碍的诊断和病因学机制提供线索.方法应用多体素活体MRS成像技术,对12例PTSD患者和12例正常对照者进行波谱分析,检测双侧海马的N-乙酰天门冬氨酸(NAA),肌酸(Cr)和含胆碱化合物(Cho)峰值,并进行统计学比较.结果PTSD患者左侧海马的NAA/Cr比值明显低于正常对照组(F=9.99,P=0.006),Cho/Cr比值差异无统计学意义(F=0.36,P=0.55);右侧海马的NAA/Cr比值、Cho/Cr比值差异均无统计学意义(F=1.44,P=0.25).性别之间的波谱差异比较无统计学意义(F=0.56,P=0.82);年龄、受教育时间、PTSD症状严重程度与左侧海马NAA/Cr比值的相关系数分别为0.47、0.35和0.18,差异无统计学意义(P＞0.05).结论PTSD患者左侧海马存在病理性变化,NAA/Cr比值低于正常人。

Reduced hippocampal volume in drug-free depressed patients

A number of studies have used magnetic resonance imaging to examine the volumetric differences in temporal lobe structures especially the hippocampus in patients suffering from major depressive disorder (MDD). Although some studies reported lower hippocampal volume, others did not. It is proposed that the inconsistency among studies may be due to the heterogeneity of patients and antidepressant treatment during scanning. In this study, we aimed to evaluate the hippocampus in drug-free patients. Twenty-four patients (6 males and 18 females) diagnosed as having MDD according to the DSM-IV criteria and 24 healthy controls (6 males and 18 females) were included in the study. Eleven of the patients had their first mood episode and were drug-naïve. Other patients were drug-free for at least 4 weeks. The Hamilton depression rating scale (HAM-D) assessed the severity of depression. Magnetic resonance imaging was performed on a 1.5-T MR unit. The Cavalieri method of modern design stereology in conjunction with point counting was used to estimate hippocampal volume. The data were evaluated by a repeated measure of ANOVA and the intracranial volume was taken as a covariate. A significant hippocampal volume difference was observed between the patients and healthy controls (F=4.43, df=1.45, P<0.05); however, laterality had no effect on the volumes (F=0.03, df=1.45, P>0.05). The left hippocampus of patients was significantly lower than those of controls (t=1.98, df=46, P<0.05). Correlation analysis showed a correlation between HAM-D scores and the right hippocampal volume. The results of this study indicate that hippocampus volume is reduced in depressed patients especially in the left side. This finding in the drug-free depressed outpatients without a history of alcohol dependence supports previous studies that have reported lower hippocampal volume.

In vivo hippocampal 31P NMR metabolites in Alzheimer's disease and ageing

Memory loss is the most common early symptom of Alzheimer's disease (AD). For this study, we chose the hippocampi as regions of interest. The hippocampus, which is closely associated with memory processing, is known to be vulnerable to damage in the early stage of AD. We considered both inter-group (patients vs controls) and intra-group (right vs left hippocampus) comparisons. We examined seven patients meeting the DSM-III-R criteria of senile dementia and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS - ADRDA) criteria of probable AD, and II aged controls. This study focused on the measurement of phosphorus 31 ((31)P) Nuclear Magnetic Resonance (NMR) spectroscopy metabolites in each hippocampus. We found significant differences in phosphorus metabolites for both intra-group comparison (pH shifted towards relative alkalosis in the left hippocampus of patients) and inter-group consideration (reduced phosphodiesters [Pde]and elevated gamma adenosine triphosphate (ATP) in the right hippocampus, higher inorganic phosphate (pHi) in the left hippocampus for patients as compared to controls). We suggest energy failure and membrane functional breakdown in patients compared to aged controls.