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Titolo:
The neuropathology of schizophrenia - A critical review of the data and their interpretation
Autore:
Harrison, PJ;
Indirizzi:
Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford OX3 7JX, England Univ Oxford Oxford England OX3 7JX ept Psychiat, Oxford OX3 7JX, England
Titolo Testata:
BRAIN
, volume: 122, anno: 1999,
parte:, 4
pagine: 593 - 624
SICI:
0006-8950(199904)122:<593:TNOS-A>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEDIAL TEMPORAL-LOBE; MAGNETIC-RESONANCE SPECTROSCOPY; FIRST-EPISODE SCHIZOPHRENIA; STRUCTURAL BRAIN ABNORMALITIES; CHILDHOOD-ONSET SCHIZOPHRENIA; MEDIODORSAL THALAMIC NUCLEUS; FIBRILLARY ACIDIC PROTEIN; HUMAN ENTORHINAL CORTEX; CEREBRAL VENTRICULAR ENLARGEMENT; CHRONIC HALOPERIDOL TREATMENT;
Keywords:
Alzheimer's disease; cytoarchitecture; morphometry; synapse; psychosis;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
428
Recensione:
Indirizzi per estratti:
Indirizzo: Harrison, PJ UnivEngland, Warneford Hosp, Dept Psychiat, Neurosci Bldg, Oxford OX3 7JX, Univ Oxford Neurosci Bldg Oxford England OX3 7JX rd OX3 7JX,
Citazione:
P.J. Harrison, "The neuropathology of schizophrenia - A critical review of the data and their interpretation", BRAIN, 122, 1999, pp. 593-624

Abstract

Despite a hundred years' research, the neuropathology of schizophrenia remains obscure. However, neither can the null hypothesis be sustained-that itis a 'functional' psychosis, a disorder with no structural basis. A numberof abnormalities have been identified and confirmed by meta-analysis, including ventricular enlargement and decreased cerebral (cortical and hippocampal) volume. These are characteristic of schizophrenia as a whole, rather than being restricted to a subtype, and are present in first-episode, unmedicated patients. There is considerable evidence for preferential involvementof the temporal lobe and moderate evidence for an alteration in normal cerebral asymmetries. There are several candidates for the histological and molecular correlates of the macroscopic features. The probable proximal explanation for decreased cortical volume is reduced neuropil and neuronal size,rather than a loss of neurons. These morphometric changes are in turn suggestive of alterations in synaptic, dendritic and axonal organization, a view supported by immunocytochemical and ultrastructural findings. Pathology in subcortical structures is not well established, apart from dorsal thalamic nuclei, which are smaller and contain fewer neurons. Other cytoarchitectural features of schizophrenia which are often discussed, notably entorhinalcortex heterotopias and hippocampal neuronal disarray, remain to be confirmed. The phenotype of the affected neuronal and synaptic populations is uncertain. A case can be made for impairment of hippocampal and corticocortical excitatory pathways, but in general the relationship between neurochemical findings (which centre upon dopamine, 5-hydroxytryptamine, glutamate and GABA systems) and the neuropathology of schizophrenia is unclear. Gliosis is not an intrinsic feature; its absence supports, but does not prove, the prevailing hypothesis that schizophrenia is a disorder of prenatal neurodevelopment. The cognitive impairment which frequently accompanies schizophrenia is not due to Alzheimer's disease or any other recognized neurodegenerative disorder. Its basis is unknown. Functional imaging data indicate that the pathophysiology of schizophrenia reflects aberrant activity in, and integration of, the components of distributed circuits involving the prefrontal cortex, hippocampus and certain subcortical structures. It is hypothesized that the neuropathological features represent the anatomical substrate of these functional abnormalities in neural connectivity. Investigation of thisproposal is a goal of current neuropathological studies, which must also seek (i) to establish which of the recent histological findings are robust and cardinal, and (ii) to define the relationship of the pathological phenotype with the clinical syndrome, its neurochemistry and its pathogenesis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 00:19:17