Incomplete hippocampal inversion in schizophrenia: prevalence, severity, and impact on hippocampal structure

Maxwell J. Roeske, Maureen McHugo, Simon Vandekar, Jennifer Urbano Blackford, Neil D. Woodward, Stephan Heckers

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Incomplete hippocampal inversion (IHI) is an anatomical variant of the human brain resulting from an arrest in brain development, especially prevalent in the left hemisphere. We hypothesized that IHI is more common in schizophrenia and contributes to the well-known hippocampal structural differences. We studied 199 schizophrenia patients and 161 healthy control participants with 3 T MRI to establish IHI prevalence and the relationship of IHI with hippocampal volume and asymmetry. IHI was more prevalent (left hemisphere: 15% of healthy control participants, 27% of schizophrenia patients; right hemisphere: 4% of healthy control participants, 10% of schizophrenia patients) and more severe in schizophrenia patients compared to healthy control participants. Severe IHI cases were associated with a higher rate of automated segmentation failure. IHI contributed to smaller hippocampal volume and increased R > L volume asymmetry in schizophrenia. The increased prevalence and severity of IHI supports the neurodevelopmental model of schizophrenia. The impact of this developmental variant deserves further exploration in studies of the hippocampus in schizophrenia.

Original languageEnglish (US)
Pages (from-to)5407-5416
Number of pages10
JournalMolecular Psychiatry
Issue number9
StatePublished - Sep 2021
Externally publishedYes

ASJC Scopus subject areas

  • Molecular Biology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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