Kaladjian A, Fakra E, Adida M, Belzeaux R, Cermolacce M, Azorin J-M
Pôle de psychiatrie des adultes, CHU Robert Debré, av. du Général Koenig, 51092 Reims cedex, France.
Encephale. 2011 Dec;37 Suppl 2:S123-6. doi: 10.1016/S0013-7006(11)70038-0.
Schizophrenia is a complex illness whose mechanisms are still largely unknown. Functional brain imaging, by making the link between psyche and brain, has recently become an indispensable tool to study in vivo the neural bases underlying cognitive dysfunction in this disease. But despite the proliferation of data coming from this approach, the exact impact of functional imaging on our understanding of the disease remains blurry. In general, studies of the brain functioning of patients with schizophrenia found activation abnormalities which vary in nature and localization depending of the cognitive paradigm used. However, it appears that neurofunctional abnormalities observed in patients cannot be reduced to a simple well-localized deficit. It would be rather an alteration of the dynamics of the interactions between different brain regions that underlie the cognitive disturbances encountered in the disease. Functional brain imaging now offers new perspectives to clarify the dynamics of the brain networks, and particularly those involved in high-level cognitive functions, such as cognitive control or social cognition which seem to play a crucial role in the disease. The characterization of these features is an important issue not only to develop new hypotheses on the pathophysiology of the disorder, but also more pragmatically to identify potential therapeutic targets.
精神分裂症是一种复杂的疾病,其发病机制在很大程度上仍然未知。通过在心理与大脑之间建立联系,功能性脑成像最近已成为在活体研究该疾病认知功能障碍潜在神经基础的不可或缺的工具。但是,尽管通过这种方法获得的数据大量增加,但功能性成像对我们理解该疾病的确切影响仍然模糊不清。一般来说,对精神分裂症患者大脑功能的研究发现,激活异常在性质和定位上会因所使用的认知范式而异。然而,患者中观察到的神经功能异常似乎不能简化为一个简单的、定位明确的缺陷。相反,它更像是不同脑区之间相互作用动态的改变,而这种改变是该疾病中所遇到的认知障碍的基础。功能性脑成像现在为阐明脑网络的动态,特别是那些涉及高级认知功能(如认知控制或社会认知,这些似乎在该疾病中起着关键作用)的脑网络动态提供了新的视角。这些特征的表征不仅对于就该疾病的病理生理学提出新假设很重要,而且更实际地说,对于确定潜在的治疗靶点也很重要。