Scents and nonsense: olfactory dysfunction in schizophrenia.
Scents and nonsense: olfactory dysfunction in schizophrenia.
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DOI：
10.1093/schbul/sbp111
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发表时间：
2009-11
影响因子：
6.6
通讯作者：
B. Turetsky;C. Hahn;Karin E. Borgmann-Winter;P. Moberg
中科院分区：
文献类型：
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作者：
B. Turetsky;C. Hahn;Karin E. Borgmann-Winter;P. Moberg
在感觉形态中，嗅觉与额叶和颞叶脑区关系最为密切，而额叶和颞叶脑区与精神分裂症有关，并且与这些脑区所服务的情感和记忆功能关系最为密切。因此，嗅觉探针可能是理想的工具，通过它来评估疾病相关的认知和情绪障碍的神经基质的结构和功能的完整性。也许更重要的是，精神分裂症患者的早期感觉传入也会受到干扰，嗅觉系统由于其重要的解剖位置可能特别容易受到这种干扰。因此，嗅觉功能障碍可能是精神分裂症病理学的一个敏感指标，甚至可以作为疾病脆弱性或发病的“早期预警”信号。在这篇文章中，我们审查的证据支持原发性嗅觉障碍的精神分裂症。收敛的数据表明，结构和功能异常从皮层延伸到嗅觉系统的最外围元素。这些部分反映了遗传介导的神经发育病因学。总体结构和功能异常反映为细胞和分子异常，表明神经支配减少或错误和/或细胞内信号调节异常。一个统一的机制假说可能是基因表达的表观遗传调控。通过鼻上皮活检从活体患者中获得嗅觉神经组织的机会，外周嗅觉系统提供了一个独特的可访问窗口，通过该窗口可以观察精神分裂症的病理生理学前因和后遗症。这可能有助于阐明潜在的大脑机制，并有助于识别临床相关的生物标志物。
Among the sensory modalities, olfaction is most closely associated with the frontal and temporal brain regions that are implicated in schizophrenia and most intimately related to the affective and mnemonic functions that these regions subserve. Olfactory probes may therefore be ideal tools through which to assess the structural and functional integrity of the neural substrates that underlie disease-related cognitive and emotional disturbances. Perhaps more importantly, to the extent that early sensory afferents are also disrupted in schizophrenia, the olfactory system-owing to its strategic anatomic location-may be especially vulnerable to such disruption. Olfactory dysfunction may therefore be a sensitive indicator of schizophrenia pathology and may even serve as an "early warning" sign of disease vulnerability or onset. In this article, we review the evidence supporting a primary olfactory sensory disturbance in schizophrenia. Convergent data indicate that structural and functional abnormalities extend from the cortex to the most peripheral elements of the olfactory system. These reflect, in part, a genetically mediated neurodevelopmental etiology. Gross structural and functional anomalies are mirrored by cellular and molecular abnormalities that suggest decreased or faulty innervation and/or dysregulation of intracellular signaling. A unifying mechanistic hypothesis may be the epigenetic regulation of gene expression. With the opportunity to obtain olfactory neural tissue from live patients through nasal epithelial biopsy, the peripheral olfactory system offers a uniquely accessible window through which the pathophysiological antecedents and sequelae of schizophrenia may be observed. This could help to clarify underlying brain mechanisms and facilitate identification of clinically relevant biomarkers.