The hippocampus in schizophrenia: a review of the neuropathological evidence and its pathophysiological implications
The hippocampus in schizophrenia: a review of the neuropathological evidence and its pathophysiological implications
复制标题
DOI：
10.1007/s00213-003-1761-y
复制
发表时间：
2004-06-01
影响因子：
3.4
通讯作者：
Harrison, PJ
中科院分区：
文献类型：
--
作者：
Harrison, PJ
这篇论文将海马体作为精神分裂症的神经病理学和病理生理学的中心。证据来自一系列方法，包括体内（神经心理学、结构和功能成像）和死后（组织学、形态计量学、基因表达和神经化学）。神经病理学上，主要阳性结果涉及神经元形态、组织、突触前和树突参数。这些结果共同表明，海马体内部的突触回路或“线路”及其外部连接发生了变化，尤其是与前额皮质的连接。这些变化似乎代表了精神分裂症背后的异常功能连接的解剖学成分。谷氨酸能通路受到显著影响，但不是唯一的影响。左侧海马体的变化似乎比右侧更大，与其他子区相比，CA1相对不受影响。精神分裂症患者的海马病理可能是由于遗传因素、神经发育异常和/或神经可塑性异常所致；它不是由于任何公认的神经退行性过程。海马体受累可能与精神分裂症的神经心理障碍有关，而不是与精神症状有关。
This paper puts the case for the hippocampus as being central to the neuropathology and pathophysiology of schizophrenia. The evidence comes from a range of approaches, both in vivo (neuropsychology, structural and functional imaging) and post mortem (histology, morphometry, gene expression, and neurochemistry). Neuropathologically, the main positive findings concern neuronal morphology, organisation, and presynaptic and dendritic parameters. The results are together suggestive of an altered synaptic circuitry or "wiring" within the hippocampus and its extrinsic connections, especially with the prefrontal cortex. These changes plausibly represent the anatomical component of the aberrant functional connectivity that underlies schizophrenia. Glutamatergic pathways are prominently but not exclusively affected. Changes appear somewhat greater in the left hippocampus than the right, and CA1 is relatively uninvolved compared to other subfields. Hippocampal pathology in schizophrenia may be due to genetic factors, aberrant neurodevelopment, and/or abnormal neural plasticity; it is not due to any recognised neurodegenerative process. Hippocampal involvement is likely to be associated with the neuropsychological impairments of schizophrenia rather than with its psychotic symptoms.