Butler Pamela D, Javitt Daniel C
Nathan Kline Institute for Psychiatric Research, Orangeburg, New York 10962, USA.
Curr Opin Psychiatry. 2005 Mar;18(2):151-7. doi: 10.1097/00001504-200503000-00008.
While cognitive dysfunction including memory and attentional deficits are well known in schizophrenia, recent work has also shown basic sensory processing deficits. Deficits are particularly prominent in the visual system and may be related to cognitive deficits and outcome. This article reviews studies of early-stage visual processing in schizophrenia published during the past year. These studies reflect the growing interest and importance of sensory processing deficits in schizophrenia.
The visual system is divided into magnocellular and parvocellular pathways which project to dorsal and ventral visual areas. Recent electrophysiological and behavioral investigations have found preferential magnocellular/dorsal stream dysfunction, with some deficits in parvocellular function as well. These early-stage deficits appear to be related to higher level cognitive, social, and community function. Structural studies of occipital cortex and particularly optic radiations provide anatomical support for early visual processing dysfunction.
These findings highlight the importance of sensory processing deficits, in addition to higher cognitive dysfunction, for understanding the pathophysiology of schizophrenia. Understanding the nature of sensory processing deficits may provide insight into mechanisms of pathology in schizophrenia, such as N-methyl-D-aspartate dysfunction or impaired signal amplification, and could lead to treatment strategies including sensory processing rehabilitation that may improve outcome.
虽然精神分裂症患者存在包括记忆和注意力缺陷在内的认知功能障碍已为人熟知,但近期研究也表明患者存在基本的感觉加工缺陷。这些缺陷在视觉系统中尤为突出,可能与认知缺陷及预后相关。本文回顾了过去一年中发表的关于精神分裂症早期视觉加工的研究。这些研究反映出感觉加工缺陷在精神分裂症中日益受到关注且具有重要意义。
视觉系统分为投射至背侧和腹侧视觉区域的大细胞和小细胞通路。近期的电生理和行为学研究发现大细胞/背侧通路存在优先功能障碍,小细胞功能也有一些缺陷。这些早期缺陷似乎与更高层次的认知、社交及社区功能有关。枕叶皮质尤其是视辐射的结构研究为早期视觉加工功能障碍提供了解剖学支持。
这些发现凸显了感觉加工缺陷在理解精神分裂症病理生理学方面的重要性,除了更高层次的认知功能障碍之外。了解感觉加工缺陷的本质可能有助于深入了解精神分裂症的病理机制,如N-甲基-D-天冬氨酸功能障碍或信号放大受损,并可能催生包括感觉加工康复在内的治疗策略,从而改善预后。