Hippocampal volume and persistent distressing psychotic-like experiences across early adolescence: the moderating...

Persistent distressing psychotic-like experiences (PLEs) in youth are associated with cognitive, functional, and psychiatric impairments. Reduced hippocampal volume (HV) is a nonspecific neurodevelopmental risk marker across psychiatric disorders. While physical activity is associated with better mental health, the characteristics of physical activity most relevant to these outcomes remain unclear. This study examined whether HV is associated with persistent distressing PLEs in early adolescence and whether physical activity, particularly team sports, moderates this relationship.

Using data from 9476 Adolescent Brain Cognitive Development Study youth, this longitudinal study examined associations between HV (age 10) and persistent distressing PLEs (ages 10-13), and whether physical activity (age 10) moderated these associations. HV was derived from structural MRI. Physical activity type and frequency were parent-reported. PLEs were assessed using the Prodromal Questionnaire-Brief Child Version. Multilevel logistic regression models adjusted for intracranial volume, demographics, study site, and family.

Reduced right HV was associated with greater odds of persistent distressing PLEs (adjusted odds ratio [aOR] per 1-SD increase = 0.91, 95% CI: 0.85 to 0.98). Team sports participation moderated this association (interaction aOR = 1.07, 95% CI: 1.01 to 1.14), such that it was no longer statistically significant at higher participation levels (+1 SD; β = 0.001, 95% CI: -0.01 to 0.01).

Reduced right HV was associated with persistent distressing PLEs, with a weaker association observed among youth with greater team sports participation, suggesting a potential role of physical activity and social context. Findings warrant further investigation of features of team-based activities as potential modifiable factors in future prevention research.