Schizophrenia: a disease of interhemispheric processes at forebrain and brainstem levels?
Schizophrenia: a disease of interhemispheric processes at forebrain and brainstem levels?
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精神分裂症：一种前脑和脑干水平的半球间过程疾病？
DOI：
10.1016/s0166-4328(89)80087-7
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发表时间：
1989
影响因子：
2.7
通讯作者：
Doty,RW
中科院分区：
文献类型：
--
作者：
Doty,RW
证据令人信服地表明，人类的每个大脑半球都能够进行人类的精神活动。既然如此，人类的每一个正常的思想和行动都要求两个半球达成共识，或者一个半球对另一个半球的统治，无论如何都要整合成一个意识心理的统一体。这是如何实现的仍然是完全神秘的，但解剖学和行为学数据表明，两个半球，以及它们各自的双边，解剖功能组件，通过神经竞争保持动态平衡。虽然前脑连合必须大大有助于这一竞争过程中，它是强调在这篇评论中，脑桥和中脑的多巴胺能中缝核也参与了半球间的事件。中缝的每一侧都向前脑的两侧突出，并且每一侧都接受来自前脑和缰脚间系统的双侧输入。因此，在两个半球之间存在着一个由前脑连合通路和脑干通路组成的复杂回路。有许多理由相信，由各种致病因子或过程（可能包括易感个体的严重精神应激）引起的这一环的扰动，是精神分裂症异常多样的病理学的基础。异常的特征反映了两个半球之间可能预期的是两个半球无法整合他们潜在的独立思想。此外，更多的证据表明，这种疾病存在于或主要通过网状神经元能系统发生，该系统在意识、做梦、对拟精神病药物的反应、运动甚至新皮层的营养状态中发挥着重要作用。该系统也很好地控制腹侧被盖区的多巴胺能神经元，因此与精神分裂症中多巴胺能特征的突出有关;脂褐质负载以及与血管和室管膜的密切关系可能使中缝的神经元特别容易受到有害物质的影响。
The evidence is convincing that each human cerebral hemisphere is capable of human mental activity. This being so, every normal human thought and action demands either a consensus between the two hemispheres, or a dominance of one over the other, in any event integrated into a unity of conscious mentation. How this is achieved remains wholly mysterious, but anatomical and behavioral data suggest that the two hemispheres, and their respective bilateral, anatomical-functional components, maintain a dynamic equilibrium through neural competition. While the forebrain commissures must contribute substantially to this competitive process, it is emphasized in this review that the serotonergic raphé nuclei of pons and mesencephalon are also participants in interhemispheric events. Each side of the raphé projects heavily to both sides of the forebrain, and each is in receipt of bilateral input from the forebrain and the habenulo-interpeduncular system. A multifarious loop thus exists between the two hemispheres, comprised of both forebrain commissural and brainstem paths. There are many reasons for believing that perturbation of this loop, by a variety of pathogenic agents or processes, probably including severe mental stress in susceptible individuals, underlies the extraordinarily diverse symptomatology of schizophrenia. Abnormality of features reflecting interhemispheric of what might be expected were the two hemispheres unable to integrate their potentially independent thoughts. Furthermore, additional evidence suggests that the disorder lies within, or is focussed primarily through, the raphé serotonergic system, that plays such a fundamental role in consciousness, in dreaming, in response to psychotomimetic drugs, and probably in movement, and even the trophic state of the neocortex. This system is also well situated to control the dopaminergic neurons of the ventral tegmental area, thus relating to the prominence of dopaminergic features in schizophrenia; and the lipofuscin loading and intimate relation with blood vessels and ependyma may make neurons of the raphé uniquely vulnerable to deleterious agents.