Llewellyn Sue
Faculty of Humanities, The University of Manchester, Booth Street West, Manchester M15 6PB, UK.
Med Hypotheses. 2009 Oct;73(4):572-9. doi: 10.1016/j.mehy.2009.05.033. Epub 2009 Jul 19.
This paper proposes that schizophrenia is a state of mind/brain 'trapped' in-between waking and dreaming. Furthermore, it suggests that both waking and dreaming are functional. An in-between state would be disordered; neither waking nor dreaming would function properly, as the mind/brain would be attempting two, ultimately incompatible, sets of tasks simultaneously. In support of this hypothesis, evidence is synthesised across four different domains: the chemistry of the dreaming state; work on dreaming as functional for memory; the membrane theory of schizophrenia; and chaos theory. The brain produces itself; self-organizing through its modulatory systems. Differentiation between dreaming and waking is achieved through aminergic/cholinergic/dopaminergic reciprocity. Chaos theory indicates that self-organizing systems function most creatively on the 'edge of chaos'; a state which lies between order and disorder. In the mind/brain 'order' represents rigid differentiation between waking and dreaming, whereas 'disorder' results from their interpenetration. How could the latter occur? In sum, the causal sequence would be as follows. Genetic susceptibility to schizophrenia is expressed through fatty acid deficiencies which precipitate neuronal cell membrane abnormalities. In consequence, all neurotransmitter systems become disrupted. Ultimately, the reciprocal interaction between aminergic/cholinergic neuromodulation breaks down. Disrupted cholinergic input interferes with the reciprocal relationship between mesolimbic and mesocortical dopaminergic systems. Loss of reciprocity between aminergic, cholinergic and dopaminergic neuromodulation results in chronic interpenetration; a 'trapped' state, in-between waking and dreaming results. This would be 'schizophrenia'. Currently, imaging techniques do not capture dynamic neuromodulation, so this hypothesis cannot yet be tested inductively. However, the paper suggests that further evidence would be gained through a closer attention to the phenomenology of schizophrenia in the waking and dreaming states.
本文提出,精神分裂症是一种介于清醒和梦境之间的思维/大脑“被困”状态。此外,它表明清醒和梦境都是有功能的。介于两者之间的状态会是紊乱的;清醒和梦境都无法正常运作,因为思维/大脑会同时尝试两组最终不相容的任务。为支持这一假说,我们综合了四个不同领域的证据:梦境状态的化学机制;关于梦境对记忆具有功能性的研究;精神分裂症的膜理论;以及混沌理论。大脑自我生成;通过其调节系统进行自我组织。梦境与清醒之间的区分是通过胺能/胆碱能/多巴胺能的相互作用实现的。混沌理论表明,自我组织系统在“混沌边缘”发挥最具创造性的功能;这是一种介于有序和无序之间的状态。在思维/大脑中,“有序”代表清醒和梦境之间的严格区分,而“无序”则源于它们的相互渗透。后者是如何发生的呢?总之,因果序列如下。精神分裂症的遗传易感性通过脂肪酸缺乏表现出来,脂肪酸缺乏会导致神经元细胞膜异常。结果,所有神经递质系统都会受到干扰。最终,胺能/胆碱能神经调节之间的相互作用会瓦解。胆碱能输入的中断会干扰中脑边缘和中脑皮质多巴胺能系统之间的相互关系。胺能、胆碱能和多巴胺能神经调节之间相互作用的丧失会导致慢性相互渗透;一种介于清醒和梦境结果之间的“被困”状态。这就是“精神分裂症”。目前,成像技术无法捕捉动态神经调节,因此这一假说尚无法通过归纳法进行检验。然而,本文表明,通过更密切关注清醒和梦境状态下精神分裂症的现象学,将能获得更多证据。