Genetic and non-genetic vulnerability factors in schizophrenia: the basis of the "Two hit hypothesis"
Genetic and non-genetic vulnerability factors in schizophrenia: the basis of the "Two hit hypothesis"
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DOI：
10.1016/s0022-3956(99)00039-4
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发表时间：
1999-11-01
影响因子：
4.8
通讯作者：
Maier, W
中科院分区：
文献类型：
--
作者：
Bayer, TA;Falkai, P;Maier, W
精神分裂症是一种精神障碍，占总人口的0.5±1%。临床特征是思维过程紊乱、妄想、幻觉和/或社交技能下降(Andreasen，1995)。这种严重的精神障碍在人类成年初期就会发作，导致大多数患者终身残疾，因此是全球十大最昂贵的疾病之一。它的直接和间接成本每年高达330亿美元，同时包括所有种族背景、性别、社会经济阶层和国籍。病程的特点是出现急性精神病症状，然后是缓解期，动力和情感减退以及认知功能障碍等症状占主导地位。精神分裂症患者的神经病理和神经解剖学发现被认为是由于早期脑发育过程中结构重组的功能障碍(Waddington，1993；Weinberger，1995)，或出生后突触消除的成熟改变(Feinberg，1982)。形态计量学和活体神经成像研究描述了脑室扩大、颞叶和前额叶结构的脑萎缩以及脑回旋指数的增加(Arnold和Trojanowski，1996)。最一致的结果之一是精神分裂症患者大脑中缺乏星形胶质细胞，这将是严重和慢性神经退行性变的必要条件。
Schizophrenia is a psychiatric disorder that a icts 0.5±1% of the general population. It is clinically characterized by disturbed thought processes, delusions, hallucinations and/or reduced social skills (Andreasen, 1995). This severe mental disorder strikes human beings in their early adulthood, causes lifelong disability for most of the sufferers and is therefore one of the ten most expensive disorders worldwide. Its direct and indirect costs mount up to 33 billion dollars per year, while a icting all ethic backgrounds, genders, socioeconomic classes and nationalities. The course of the illness is characterized by episodes of acute psychotic symptoms followed by phases of remission where symptoms like reduced drive and affect as well as disturbed cognitive functions prevail. Despite the severeness of the disorder its origins are unclear until now.The neuropathological and neuroanatomical findings in patients with schizophrenia have been proposed to arise from dysfunction of structural reorganization during early brain development (Waddington, 1993; Weinberger, 1995), or postnatally from altered maturation of synaptic elimination (Feinberg, 1982). Morphometric and in vivo neuroimaging studies described enlarged ventricles, cerebral atrophy of temporal lobe and prefrontal structures, and increase in the gyrification index (Arnold and Trojanowski, 1996). One of the most consistent results is the lack of astrogliosis in schizophrenic brains, which would be a requirement for severe and chronic neurodegenerative