Ertuğrul Aygün, Rezaki Murat
Hacettepe U Tip Fak., Psikiyatri AD., Ankara.
Turk Psikiyatri Derg. 2005 Winter;16(4):268-75.
Although hallucinations are among the cardinal features of schizophrenia, the mechanisms underlying these symptoms have not been fully understood yet. In this review our objective is to summarize the studies about the neurobiology of auditory hallucinations in schizophrenia and discuss their significance for understanding schizophrenia.
This is a retrospective literature review and the relevant studies within the last 10 years are included. For this purpose Pubmed search engine and 'hallucination, schizophrenia, neurobiology' key words are used.
Hallucinations cause sensory modality specific activation in cerebral areas involved in normal sensation. A disturbance in perception of speech seems to have a central role in occurrence of auditory hallucinations. Anatomically, auditory hallucinations appear to involve primary and association cortices, Broca's and Wernicke's areas, subcortical, paralimbic, limbic regions, ventral striatum and thalamus. Furthermore they are suggested to be associated with the dysmodulation of the information flow from ventral striatum to thalamus and cortex caused by increased dopaminergic activity in mesolimbic pathway.
The validity of the models which are proposed to explain neurobiology of hallucinations in schizophrenia should be tested by new studies. The difficulties regarding the assessment and measurement of subjective mental phenomena are important impacts in studying and understanding the neural correlates of hallucinations. Functional neuroimaging, cognitive and molecular biological studies will hopefully enhance our knowledge about this disease.
尽管幻觉是精神分裂症的主要特征之一,但这些症状背后的机制尚未完全明了。在本综述中,我们的目的是总结关于精神分裂症听觉幻觉神经生物学的研究,并讨论它们对于理解精神分裂症的意义。
这是一项回顾性文献综述,纳入了过去10年的相关研究。为此,使用了PubMed搜索引擎和“幻觉、精神分裂症、神经生物学”等关键词。
幻觉会导致参与正常感觉的脑区出现特定感觉模态的激活。言语感知障碍似乎在听觉幻觉的发生中起核心作用。从解剖学上看,听觉幻觉似乎涉及初级和联合皮质、布洛卡区和韦尼克区、皮质下、边缘旁、边缘区域、腹侧纹状体和丘脑。此外,它们被认为与中脑边缘通路中多巴胺能活性增加导致的从腹侧纹状体到丘脑和皮质的信息流失调有关。
用于解释精神分裂症幻觉神经生物学的模型的有效性应由新的研究来检验。评估和测量主观心理现象方面的困难是研究和理解幻觉神经关联的重要影响因素。功能神经影像学、认知和分子生物学研究有望增进我们对这种疾病的认识。