Tamminga C A, Medoff D R
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Md, USA.
Dialogues Clin Neurosci. 2000 Dec;2(4):339-48. doi: 10.31887/DCNS.2000.2.4/ctamminga.
Schizophrenia is an illness where the clinical signs and symptoms, course, and cognitive characteristics are well described. Successful pharmacological treatments do exist, even though they are likely palliative. However, this broad knowledge base has not yet led to the identification of its pathophysiology or etiology The risk factors for schizophrenia are most prominently genetic and scientists anticipate that contributions from the new genetic information in the human genome will help progress towards discovering a disease mechanism. Brain-imaging techniques have opened up the schizophrenic brain for direct inquiries, in terms of structure, neurochemisiry, and function. New proposals for diagnosis include grouping schizophrenia together with schizophrenia-related personality disorders into the same disease entity, and calling this schizophrenia spectrum disorder. New hypotheses of pathophysiology do not overlook dopamine as playing a major role, but do emphasize the participation of integrative neural systems in the expression of the illness and of the limbic system in generating symptoms. Critical observations for future discovery are likely to arise from molecular genetics, combined with hypothesis-generating experiments using brain imaging and human postmortem tissue.
精神分裂症是一种临床体征、症状、病程及认知特征都有详尽描述的疾病。尽管现有的成功药物治疗可能只是缓解性的,但确实存在。然而,基于广泛的知识储备,尚未明确其病理生理学或病因。精神分裂症的风险因素最主要是遗传方面的,科学家预计人类基因组中的新遗传信息将有助于推动疾病机制的发现。脑成像技术已使对精神分裂症患者大脑的结构、神经化学和功能进行直接研究成为可能。新的诊断建议包括将精神分裂症与精神分裂症相关人格障碍归为同一疾病实体,并称之为精神分裂症谱系障碍。新的病理生理学假说虽不忽视多巴胺起主要作用,但强调整合神经系统在疾病表现中的参与以及边缘系统在产生症状中的作用。未来发现的关键观察结果可能来自分子遗传学,以及结合使用脑成像和人类尸检组织进行的产生假说的实验。