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Hippocampal subfields and psychotic symptoms: Functional connectivity insights from pediatric bipolar disorder

Zhe Shen¹, Dong Cui², Qing Jiao²

¹Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No. 3333 Binsheng Road, Zhejiang, Hangzhou, China.

Psychiatry Research. Neuroimaging

|November 19, 2025

Abstract

Objective:

This study aims to investigate the structural and functional abnormalities in the hippocampus of pediatric bipolar disorder (PBD) patients, distinguishing between non-psychotic (NP-PBD) and psychotic (P-PBD) subtypes, compared to healthy controls (HCs).

Method:

The research involved 72 participants, including PBD patients and healthy controls, recruited from The Second Xiangya Hospital of Central South University. Structural and resting-state functional MRI data were collected. The study focused on measuring the volumes of hippocampal subfields and examining changes in resting-state functional connectivity (RSFC).

Results:

No significant differences in hippocampal subfield volumes were observed among the three groups. However, significant alterations in hippocampal subfield-related functional connectivity were found, particularly between the right hippocampus and various brain regions. These alterations were more pronounced in the P-PBD group, suggesting a distinct pattern of neural connectivity in patients with psychotic symptoms.

Conclusion:

While structural abnormalities in hippocampal subfields were not evident, functional connectivity disruptions were significant, highlighting the potential of RSFC as a biomarker for PBD. These findings emphasize the critical role of functional neuroimaging in understanding the pathophysiology of PBD and suggest that disruptions in hippocampal connectivity may underpin the disorder, particularly in the psychotic subtype.

Keywords:

Functional connectivity Hippocampal subfields Pediatric bipolar disorder Psychotic symptoms

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